Search

Abstract Nematic liquid crystals (NLCs), that is, fluids with optical anisotropy as well as electric‐ and magnetic‐field responsiveness, have been widely used in commercial liquid crystal displays. Recent advancements have extended the scope of NLC molecules to large calamitic π‐conjugated systems, which heralds prospects for novel applications that exploit their superior electronic or optical functionalities in, for example, electric field controlled fluorescence switch devices. However, NLC phases of such extended π‐systems usually flow only at high temperatures, which hampers device applications that operate around room temperature. Here, we show near‐room‐temperature NLCs of a π‐conjugated fluorophore by introducing a flexible cyclic structure into the mesogenic core. 3,8‐Bis(4‐propylphenyl)‐6,7‐dihydro‐5H‐benzo[7]annulene (DPB[7]‐C3) has a nematic phase in a significantly lower temperature range (52.6–160.4°C) than the DPB[7]‐C3 analog without flexible alkylene bridges, (E)‐4‐propyl‐4′‐(4‐propylstyryl)‐1,1′‐biphenyl (248–262°C). We attribute this large decrease in the phase transition temperature to large intramolecular conformational entropies that arise from the geometric change of the cyclic structure, which involves rotational motion of single biaryl‐bonds and bending motions along the long molecular axis in the thermal equilibrium state. The practical utility of these NLC molecules is demonstrated by preparing an electric‐field‐responsive large‐area fluorescent switch device with a sub‐millisecond response time from a mixture of 3,8‐bis(4‐alkylphenyl)‐6,7‐dihydro‐5H‐benzo[7]annulenes (DPB[7]‐Cns).

Abstract Background The COVID-19 pandemic has affected every aspect of our lives, including the decision to become pregnant. Existing literature suggests that infertility and the decision to delay childbearing at a younger age are associated with a lower level of well-being and regrets when women start to desire a baby. Thus, the decision to delay childbearing due to the pandemic could negatively affect the well-being of women. This study focuses on how pregnancy decisions affect the well-being of women during the COVID-19 pandemic. Methods From the Japan COVID-19 and Society Internet Survey, a nationally representative web-based survey, 768 observations of married women aged 18 to 50 years who had the intention of getting pregnant during the pre-pandemic period (conducted in 2020 and 2021) were used. Loneliness, severe psychological distress, and suicidal ideation were used as well-being indicators. For pooled data, a generalised estimated equation (GEE) model was used to estimate how pregnancy decision related to well-being indicators. For a sub-analysis, the sample was divided by the survey year and a Poisson regression model was used. Results The GEE analysis showed an association between delaying childbearing and severe psychological distress, with the prevalence ratio (PR) being 2.06 [95% CI (1.40–3.03)]. Furthermore, loneliness and suicidal ideation that occurred after the beginning of the pandemic were significantly related to the decision to delay childbearing—1.55 [95% CI (1.03,2.34)] and 2.55 [95% CI (1.45–4.51)], respectively. Moreover, these PRs were larger for 2021 compared to 2020. Conclusion During the COVID-19 pandemic, approximately one-fifth of married women who had childbearing intentions before the pandemic decided to postpone pregnancy. They exhibited a deteriorated mental health state. Furthermore, the negative associations were larger in 2021 compared to 2020. Loneliness has negative consequences for both mental and physical health, as well as elevated severe psychological distress and suicidal ideation among those who decided to postpone pregnancy. Therefore, the current results should not be overlooked by society.

Abstract Background Although many conventional healthcare services to prevent postpartum depression are provided face-to-face, physical and psychosocial barriers remain. These barriers may be overcome by using mobile health services (mHealth). To examine the effectiveness of mHealth professional consultation services in preventing postpartum depressive symptoms in real-world settings, we conducted this randomized controlled trial in Japan, where universal free face-to-face perinatal care is available. Methods This study included 734 pregnant women living in Yokohama city who could communicate in Japanese, recruited at public offices and childcare support facilities. The participants were randomized to the mHealth group (intervention, n = 365), where they could use a free app-based mHealth consultation service with gynecologists/obstetricians, pediatricians, and midwives whenever and as many times as they wanted between 6 p.m. and 10 p.m. on weekdays throughout their pregnancy and postpartum periods (funded by the City of Yokohama government) or the usual care group (control, n = 369). The primary outcome was the risk of elevated postpartum depressive symptoms, defined as Edinburgh Postnatal Depression Scale score ≥ 9. Secondary outcomes were self-efficacy, loneliness, perceived barriers to healthcare access, number of clinic visits, and ambulance usage. All outcomes were collected three months post-delivery. We also conducted subgroup analyses assessing the differences in the treatment effect by sociodemographic status. Results Most women completed all questionnaires (n = 639 of 734, response rate: 87%). The mean baseline age was 32.9 ± 4.2 years, and 62% were primipara. Three months post-delivery, women in the mHealth group had a lower risk of elevated postpartum depressive symptoms (47/310 [15.2%]) compared to the usual care group (75/329 [22.8%], risk ratio: 0.67 [95% confidence interval: 0.48–0.93]). Compared with the usual care group, women in the mHealth group had higher self-efficacy, less loneliness, and fewer perceived barriers to healthcare access. No differences were observed in the frequency of clinic visits or ambulance usage. Furthermore, in the subgroup analyses, we did not find differences in the treatment effect by sociodemographic status. Conclusions Local government-funded mHealth consultation services have a preventive effect on postpartum depressive symptoms, removing physical and psychological barriers to healthcare access in real-world settings. Trial registration UMIN-CTR identifier: UMIN000041611. Registered 31 August 2021.

Abstract Background Second malignant neoplasms (SMNs) are one of the most severe late complications after pediatric cancer treatment. However, the effect of genetic variation on SMNs remains unclear. In this study, we revealed germline genetic factors that contribute to the development of SMNs after treatment of pediatric solid tumors. Methods We performed whole‐exome sequencing in 14 pediatric patients with SMNs, including three brain tumors. Results Our analysis revealed that five of 14 (35.7%) patients had pathogenic germline variants in cancer‐predisposing genes (CPGs), which was significantly higher than in the control cohort (p

Abstract Background Previous studies have identified noninvasive methods for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). We assessed the association between AF recurrence and atrial late potentials (ALPs), which were measured using P‐wave signal‐averaged electrocardiography (P‐SAECG). Methods Consecutive patients with paroxysmal AF who underwent their first CA at our institution between August 2015 and August 2019 were enrolled. P‐SAECG was performed before CA. Two ALP parameters were evaluated: the root‐mean‐square voltage during the terminal 20 ms (RMS20) and the P‐wave duration (PWD). Positive ALPs were defined as an RMS20 115 ms. Patients were allocated to either the recurrence or nonrecurrence group based on the presence of AF recurrence at the 1‐year follow‐up post‐CA. Results Of the 190 patients (age: 65 ± 11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. The positive ALP rate was significantly higher in the recurrence group than in the nonrecurrence group (86% vs. 64%, p = .04), despite the absence of differences in other baseline characteristics between the two groups. In the multivariate analysis, positive ALP was an independent predictor of AF recurrence (odds ratio: 3.83, 95% confidence interval: 1.05–14.1, p = .04). Conclusions Positive ALP on pre‐CA P‐SAECG is associated with AF recurrence after CA.

Pediatric T-cell acute lymphoblastic leukemia (T-ALL) in the anterior mediastinum has an acute onset and requires early treatment. The diagnostic strategy for anterior mediastinal masses in pediatric patients usually involves imaging evaluation, surgical biopsy, or resection for diagnosis and treatment. Thereafter, appropriate chemotherapy regimen selection is based on the pathological diagnosis. In some cases, general anesthesia is avoided to prevent complications such as airway compression and circulatory collapse. We present 3 cases with T-ALL where ultrasound was used for the first evaluation of the anterior mediastinal mass. A 5-year-old girl had lymph node swelling at the supraclavicular fossa. Ultrasound examination showed a huge anterior mediastinal mass with an abnormal thymus, surrounding the proximal main trachea in the mediastinum. These sonographic findings indicated a possibility for tracheal compression during general anesthesia. A 12-year-old boy had dyspnea. Ultrasound examination showed a massive pericardial effusion and stenosis of the right pulmonary artery. These sonographic findings indicated a risk of circulation collapse. An 8-year-old boy had cervical swelling and dyspnea. Ultrasound examination showed a huge mass on the anterior mediastinum and a huge thrombus in the left atrium. This sonographic finding indicated a risk of thromboembolism. Ultrasonography is useful in pediatric patients with anterior mediastinal masses due to T-ALL. By focusing on the thymus, a diagnosis of T-ALL might be recommended. To avoid catastrophic circulation collapse, tracheal and vascular compression should be evaluated. Direct invasion may also be detectable.

BackgroundAlthough remote communication technologies have been widely used to maintain connections with others against interpersonal contact restrictions and exacerbated loneliness during the COVID-19 pandemic, it is unclear whether and what types of remote communication technologies are effective in mitigating loneliness. ObjectiveThis study aimed to investigate the association between remote communication and loneliness when face-to-face meetings with others were strongly prohibited and whether this association varied across types of communication tools, age, and gender. MethodsWe used cross-sectional data from the Japan COVID-19 and Society Internet Survey conducted from August to September 2020. From registered panelists of the research agency, 28,000 randomly sampled participants completed the survey on the website. We created 2 study cohorts who stopped meeting with family members living apart and friends during the pandemic. We categorized whether participants had technology-based remote communication (voice calling, text messaging, and video calling) with family and friends. Loneliness was assessed using the 3-item University of California, Los Angeles Loneliness Scale. We used a modified Poisson regression model to investigate the association between loneliness and remote communication with family members living apart or friends. We also conducted subgroup analyses based on age and gender. ResultsA total of 4483 participants stopped meeting with family members living apart, and 6783 participants stopped meeting with friends during the COVID-19 pandemic. Remote communication with family members living apart did not show an association with loneliness, whereas remote communication with friends was associated with a low prevalence of loneliness (family: adjusted prevalence ratio [aPR]=0.89, 95% CI 0.74-1.08; P=.24 and friends: aPR=0.82, 95% CI 0.73-0.91; P

The molecular heterogeneity of KMT2A-rearranged infant acute lymphoblastic leukemia (ALL) remains poorly characterised. Here, the authors perform multi-omics analysis for 84 ALL patients and suggest 5 distinct subgroups for risk stratification and personalised treatment.’

Worry about crime has been linked to several detrimental outcomes including worse mental health. However, there has been little research on the association between worry about crime and loneliness, even though loneliness is increasingly being recognised as a serious public health issue. To address this deficit, this study examined the association between worry about crime and loneliness in nine countries of the former Soviet Union (FSU - Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine), using data from 18,000 respondents aged 18 and above that were collected during the Health in Times of Transition (HITT) survey in 2010/11. Results from a pooled logistic regression analysis showed that compared to those who reported no worry about crime, individuals with a high level of worry had significantly higher odds of loneliness (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.17–1.75). Sex- and age-stratified analyses further showed that the association was observed in women with a mid (OR: 1.37, 95%CI: 1.10–1.71) and a high level (OR: 1.70, 95%CI: 1.33–2.17) of worry about crime but not in men, and that a high level of worry about crime was linked to loneliness in adults aged 35–59 (OR: 1.39, 95%CI: 1.02–1.91) and 60 and above (OR: 1.64, 95%CI: 1.12–2.40) but not in those aged 18–34. High levels of worry about crime are associated with loneliness in the FSU countries. Reducing crime and its associated worries may have important public health benefits in these countries.

Abstract Aim More than 15,000 elite athletes participated in the Tokyo 2020 Olympic and Paralympic Games. Providing adequate medical services to these elite athletes was a priority. Hence, a polyclinic was established in the Athletes' Village. Visitors were triaged at the emergency department of the polyclinic to enable early treatment of critical illnesses or injuries in the emergency room (ER) and to identify patients suspected of having coronavirus disease as early as possible. No reports of emergency department activities at large sporting events in the pandemic era are available. Here, we aim to summarize the activities at the emergency department of the polyclinic. Methods Data were collected using an electronic medical record system, nursing records, and questionnaires administered during triage from July 13 to September 8, 2021. Polyclinic data involving accredited athletes and team members were summarized. Results During the Olympic Games, 12,318 triage cases were reported, of which 75 were treated in the ER. During the Paralympic Games, 8398 triage cases were reported, of which 94 were treated in the ER. During the Olympic Games, musculoskeletal issues (26 patients) were the most common. During the Paralympic Games, ear, nose, and throat issues were the most common (21 patients). Two patients experienced cardiopulmonary arrest in the Athletes' Village and were transported to the hospital postresuscitation. Conclusion During the study period, many critically ill patients were triaged and treated at the emergency department. Our data can be used to improve medical care and infection prevention at future international sporting events.

Aim: Several studies have reported that corticosteroid administration for cardiac arrest patients may improve outcomes. However, these previous studies have not examined the effect of corticosteroid use in out-of-hospital cardiac arrest (OHCA) patients administered extracorporeal cardiopulmonary resuscitation (ECPR). Therefore, we aimed to examine the effectiveness of corticosteroids in OHCA patients administered ECPR. Methods: Using the Japanese Diagnosis Procedure Combination inpatient database, we included OHCA patients who were administered ECPR on the day of admission between July 2010 and March 2019. The patients were categorized into the corticosteroid and control groups according to whether they received corticosteroids on the day of admission or not. The primary outcome was in-hospital mortality and the secondary outcomes included percentages of neurologically favorable survival, major bleeding complications, and infection-related complications. We compared the outcomes using a propensity score matching analysis. Results: We identified 6,142 eligible patients (459 vs 5,683, the corticosteroid and control group, respectively). One-to-four propensity score matching analysis (457 vs 1,827) showed in-hospital mortality was significantly higher in the corticosteroid group compared with the control group (82.1% vs 76.6%; risk difference, 5.5%; 95% CI, 1.5 to 9.5%). Neurologically favorable outcomes did not differ between the two groups (13.6% vs 16.9%; risk difference, −3.3%; 95% CI, −6.9 to 0.3%). The percentage of major bleeding complications and infection-related complications did not significantly differ between the two groups. Conclusions: The results of this study demonstrated that administration of corticosteroids on the day of admission to OHCA patients administered ECPR was associated with increased in-hospital mortality.

The formation of the nematic to twist-bend nematic (NTB) phase has emerged as a fascinating phenomenon in the field of supramolecular chemistry, based on complex intermolecular interactions. Through a careful analysis of molecular structures and dynamics, we elucidate how these intermolecular interactions drive the complex twist-bend modulation observed in the NTB. The study employs broadband dielectric spectroscopy spanning frequencies from 10 to 2 × 109 Hz to investigate the molecular orientational dynamics within the glass-forming thioether-linked cyanobiphenyl liquid crystal dimers, namely, CBSC7SCB and CBSC7OCB. The experimental findings align with theoretical expectations, revealing the presence of two distinct relaxation processes contributing to the dielectric permittivity of these dimers. The low-frequency relaxation mode is attributed to an “end-over-end rotation” of the dipolar groups parallel to the director. The high-frequency relaxation mode is associated with precessional motions of the dipolar groups about the director. Various models are employed to describe the temperature-dependent behavior of the relaxation times for both modes. Particularly, the critical-like description via the dynamic scaling model seems to give not only quite good numerical fittings, but also provides a consistent physical picture of the orientational dynamics in accordance with findings from infrared (IR) spectroscopy. Here, as the longitudinal correlations of dipoles intensify, the m1 mode experiences a sudden upsurge in enthalpy, while the m2 mode undergoes continuous changes, displaying critical mode coupling behavior. Interestingly, both types of molecular motion exhibit a strong cooperative interplay within the lower temperature range of the NTB phase, evolving in tandem as the material’s temperature approaches the glass transition point. Consequently, both molecular motions converge to determine the glassy dynamics, characterized by a shared glass transition temperature, Tg.

Abstract Background Although the lesion size index (LSI) has been well established, it is sometimes difficult to achieve first‐pass pulmonary vein isolation (PVI) and to avoid acute pulmonary vein reconnections, even with LSI‐guided procedures. The purpose of this study was to assess the predictive accuracy of a novel parameter, the optimized lesion size index (o‐LSI), to perform PVI. Methods The voltage maps created by the Advisor™ high‐density (HD) grid catheter before PVI in 35 atrial fibrillation (AF) patients were examined for an association between the voltage amplitude and insufficient ablation sites (IAS), which were defined as either (i) spontaneous reconnection sites, (ii) dormant PV conduction sites unmasked with 20 mg of adenosine triphosphate disodium hydrate (ATP) injection, or (iii) PV‐LA gap sites after the initial PVI. Results IAS was observed in 25/1417 of the total ablation sites. IAS was significantly associated with higher bipolar voltage areas (4.20 ± 2.68 vs 2.43 ± 1.93 mV, P

Abstract Background Right ventricular (RV) pacing causes left ventricular (LV) dyssynchrony sometimes resulting in pacing‐induced cardiomyopathy. However, RV pacing for hypertrophic obstructive cardiomyopathy is one of the treatment options. LV flow energy loss (EL) using vector flow mapping (VFM) is a novel hemodynamic index for assessing cardiac function. Our study aimed to elucidate the impact of RV pacing on EL in normal LV function and hypertrophic cardiomyopathy (HCM) patients. Methods A total of 36 patients with dual‐chamber pacemakers for sick sinus syndrome or implantable cardioverter defibrillators for fatal ventricular tachyarrhythmias were enrolled. All patients were divided into two groups: 16 patients with HCM (HCM group) and others (non‐HCM group). The absolute changes in EL under AAI (without RV pacing) and DDD (with RV pacing) modes were assessed using VFM on color Doppler echocardiography. Results In the non‐HCM group, the mean systolic EL significantly increased from the AAI to DDD modes (14.0 ± 7.7 to 17.0 ± 8.6 mW/m, P = .003), whereas the mean diastolic EL did not change (19.0 ± 12.3 to 17.0 ± 14.8 mW/m, P = .231). In the HCM group, the mean systolic EL significantly decreased from the AAI to DDD modes (26.7 ± 14.2 to 21.6 ± 11.9 mW/m, P

The twist–bend nematic (NTB) phase is a liquid crystal (LC) phase with a heliconical structure that typically forms below the temperature of the conventional nematic (N) phase. By contrast, the direct transition between the NTB and isotropic (Iso) phases without the intermediation of the N phase rarely occurs. Herein, we demonstrate the effects of linkage type (i.e., methylene, ether, and thioether) on the typical Iso–N–NTB and rare direct Iso–NTB phase-transition behaviors of cyanobiphenyl (CB) dimers CB3CB, CB2OCB, and CB2SCB bearing three-atom-based propane, ethoxy, and ethylthio spacers, respectively. In our previous study, CB2SCB exhibited the monotropic direct Iso–NTB phase transition. In this study, we report that CB3CB also shows the direct Iso–NTB phase transition, whereas CB2OCB exhibits the typical Iso–N–NTB phase sequence with decreasing temperature. The Iso–LC (Iso–NTB or Iso–N) phase-transition temperatures upon cooling show the order CB2OCB (108 °C) > CB3CB (49 °C) > CB2SCB (43 °C). The thioether-linked CB2SCB is vitrifiable, whereas CB3CB and CB2OCB exhibit strong crystallization tendencies. The phase-transition behaviors are also discussed in terms of the three bent homologous series with different oligomethylene spacers n: CBnCB, CBnOCB, and CBnSCB.

Background Recent clinical trials have demonstrated the possible pleiotropic effects of SGLT2 (sodium–glucose cotransporter 2) inhibitors in clinical cardiovascular diseases. Atrial electrical and structural remodeling is important as an atrial fibrillation (AF) substrate. Methods and Results The present study assessed the effect of canagliflozin (CAN), an SGLT2 inhibitor, on atrial remodeling in a canine AF model. The study included 12 beagle dogs, with 10 receiving continuous rapid atrial pacing and 2 acting as the nonpacing group. The 10 dogs that received continuous rapid atrial pacing for 3 weeks were subdivided as follows: pacing control group (n=5) and pacing+CAN (3 mg/kg per day) group (n=5). The atrial effective refractory period, conduction velocity, and AF inducibility were evaluated weekly through atrial epicardial wires. After the protocol, atrial tissues were sampled for histological examination. The degree of reactive oxygen species expression was evaluated by dihydroethidium staining. The atrial effective refractory period reduction was smaller (P=0.06) and the degree of conduction velocity decrease was smaller in the pacing+CAN group compared with the pacing control group (P=0.009). The AF inducibility gradually increased in the pacing control group, but such an increase was suppressed in the pacing+CAN group (P=0.011). The pacing control group exhibited interstitial fibrosis and enhanced oxidative stress, which were suppressed in the pacing+CAN group. Conclusions CAN and possibly other SGLT2 inhibitors might be useful for preventing AF and suppressing the promotion of atrial remodeling as an AF substrate.

Abstract A 57‐year‐old man was admitted to our hospital due to syncopal attack. He was diagnosed with Brugada syndrome due to which a subcutaneous implantable cardiac defibrillator (S‐ICD) was inserted using the standard technique. Two hours after the implantation, he experienced inappropriate shock while conscious. Device interrogation revealed a contentious baseline shift and frequent oversensing of low‐amplitude signals, which was followed by a shock. Lateral chest X‐ray revealed subcutaneous air surrounding the proximal electrode. Another inappropriate shock could be avoided by changing the sensing vector. The subcutaneous air was completely resolved 7 days after implantation.

The objective of the present research was to determine the appropriate amount of fluoride to use professional topical application and the residual amounts of fluoride in the oral cavity using a 2% neutral sodium fluoride (NaF) foam with a dedicated tray. Using dentition study models, a method for determining the appropriate amount of NaF foam was investigated. In eight adult subjects, the appropriate amount of NaF foam, the concentration of fluoride in the saliva following professional topical application, and the amount of residual fluoride in the oral cavity following professional topical application was examined. The results indicated that the appropriate amount of NaF foam was approximately 0.8 g, the amount of residual fluoride in the oral cavity was approximately 25% of the amount of foam used.