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Abstract Diagnosing Alzheimer’s disease (AD) through pathological markers is typically costly and invasive. This study aims to find a noninvasive, cost-effective method using portable electroencephalography (EEG) to detect changes in AD-related biomarkers in cerebrospinal fluid (CSF). A total of 102 patients, both with and without AD-related biomarker changes (amyloid beta and phosphorylated tau), were recorded using a 2-minute resting-state portable EEG. A machine-learning algorithm then analyzed the EEG data to identify these biomarker changes. The results showed that the machine learning model could distinguish patients with AD-related biomarker changes, achieving 68.1% accuracy (AUROC 0.75) for amyloid beta and 71.2% accuracy (AUROC 0.77) for phosphorylated tau, with gamma activities being key features. When excluding cases with idiopathic normal pressure hydrocephalus, accuracy improved to 74.1% (AUROC 0.80) for amyloid beta and 73.1% (AUROC 0.80) for phosphorylated tau. This study suggests that portable EEG combined with machine learning is a promising noninvasive and cost-effective tool for early AD-related pathological marker screening, which could enhance neurophysiological understanding and diagnostic accessibility.

AbstractThis study evaluated the performance of ChatGPT with GPT-4 Omni (GPT-4o) on the 118th Japanese Medical Licensing Examination. The study focused on both text-only and image-based questions. The model demonstrated a high level of accuracy overall, with no significant difference in performance between text-only and image-based questions. Common errors included clinical judgment mistakes and prioritization issues, underscoring the need for further improvement in the integration of artificial intelligence into medical education and practice.

Abstract Background Electroconvulsive therapy (ECT) is widely recognized as one of the most effective treatments for various psychiatric disorders and is generally considered safe. However, a few reports have mentioned that multiple ECT sessions could induce electroencephalography (EEG) abnormalities and epileptic seizures, a serious side effect of ECT. We experienced a case with EEG abnormalities after multiple ECT sessions and aimed to share our insights on conducting ECT safely. Case Presentation We present the case of a 73‐year‐old female diagnosed with major depressive disorder. She underwent regular ECT sessions to alleviate her psychiatric symptoms. However, after more than 80 sessions, previously undetected EEG abnormalities were observed. Since the patient did not have clinical seizures, we were able to continue ECT at longer intervals without the use of antiepileptic drugs. Conclusion Our case suggests the importance of routine EEG testing in patients undergoing prolonged ECT. While careful monitoring is necessary, continuing ECT without antiepileptic medication in patients with EEG abnormalities could be permissible.

Abstract Associations between delirium and postoperative adverse events in cardiovascular surgery have been reported and the preoperative identification of high-risk patients of delirium is needed to implement focused interventions. We aimed to develop and validate machine learning models to predict post-cardiovascular surgery delirium. Patients aged ≥ 40 years who underwent cardiovascular surgery at a single hospital were prospectively enrolled. Preoperative and intraoperative factors were assessed. Each patient was evaluated for postoperative delirium 7 days after surgery. We developed machine learning models using the Bernoulli naive Bayes, Support vector machine, Random forest, Extra-trees, and XGBoost algorithms. Stratified fivefold cross-validation was performed for each developed model. Of the 87 patients, 24 (27.6%) developed postoperative delirium. Age, use of psychotropic drugs, cognitive function (Mini-Cog

BackgroundThe current biomarker-supported diagnosis of Alzheimer’s disease (AD) is hindered by invasiveness and cost issues. This study aimed to address these challenges by utilizing portable electroencephalography (EEG). We propose a novel, non-invasive, and cost-effective method for identifying AD, using a sample of patients with biomarker-verified AD, to facilitate early and accessible disease screening.MethodsThis study included 35 patients with biomarker-verified AD, confirmed via cerebrospinal fluid sampling, and 35 age- and sex-balanced healthy volunteers (HVs). All participants underwent portable EEG recordings, focusing on 2-minute resting-state EEG epochs with closed eyes state. EEG recordings were transformed into scalogram images, which were analyzed using “vision Transformer(ViT),” a cutting-edge deep learning model, to differentiate patients from HVs.ResultsThe application of ViT to the scalogram images derived from portable EEG data demonstrated a significant capability to distinguish between patients with biomarker-verified AD and HVs. The method achieved an accuracy of 73%, with an area under the receiver operating characteristic curve of 0.80, indicating robust performance in identifying AD pathology using neurophysiological measures.ConclusionsOur findings highlight the potential of portable EEG combined with advanced deep learning techniques as a transformative tool for screening of biomarker-verified AD. This study not only contributes to the neurophysiological understanding of AD but also opens new avenues for the development of accessible and non-invasive diagnostic methods. The proposed approach paves the way for future clinical applications, offering a promising solution to the limitations of advanced diagnostic practices for dementia.

Late-onset epilepsy, particularly focal impaired awareness seizures, often present without convulsions and can cause memory impairment. This can lead patients to initially seek consultation at memory clinics, potentially delaying referral to epilepsy specialists. We report on three patients, aged 40s to 70s, admitted for cognitive evaluation who were finally diagnosed with epileptic seizures as the underlying cause of their symptoms. Notably, all initially presented to local clinics with symptoms suggesting cognitive impairment. Despite initial diagnostic uncertainty, all patients exhibited epileptic activity on electroencephalography (EEG) and responded positively to antiepileptic drugs, suggesting epileptic mechanisms were involved in their symptoms. Both traditional clinical EEG systems and newly developed, one-minute portable EEG devices were used in their evaluations. The portable device, medically approved in Japan, successfully captured sharp-waves like activities with the same durations, amplitudes, and shapes as traditional devices. This highlights its potential to improve epilepsy diagnosis and future screening due to its portability and ease of use. Implementing portable EEG devices could promote timely and appropriate treatment, preventing misdiagnosis of neurological conditions.

IntroductionPostoperative delirium (POD) is common and life-threatening, however, with intensive interventions, a potentially preventable clinical syndrome. Although electroencephalography (EEG) is a promising biomarker of delirium, standard 20-leads EEG holds difficulties for screening usage in clinical practice.ObjectiveWe aimed to develop an accurate algorithm to predict POD using EEG data obtained from portable device.MethodsWe recruited 128 patients who underwent scheduled cardiovascular surgery. Cognitive function assessments were conducted, and portable EEG recordings were obtained prior to surgery.ResultsAmong the patients, 47 (36.7%) patients with POD were identified and they did not significantly differ from patients without POD in sex ratio, age, cognitive function, or treatment duration of intensive care unit. However, significant differences were observed in the preoperative EEG power spectrum densities at various frequencies, especially gamma activity, between patients with and without POD. POD was successfully predicted using preoperative EEG data with a machine learning algorithm, yielding accuracy of 86% and area under the receiver operating characteristic curve of 0.93.DiscussionThis study provides new insights into the objective and biological vulnerability to delirium. The developed algorithm can be applied in general hospitals without advanced equipment and expertise, thereby enabling the reduction of POD occurrences with intensive interventions for high-risk patients.

Recent studies provide mixed results regarding whether the perception of facial attractiveness is increased or decreased by partial occlusion with a sanitary mask. One set of studies demonstrated that occluding the bottom half of a face increased facial attractiveness. This effect is thought to occur because the occluded area is interpolated by an average facial representation that is perceived as attractive. However, several groups of studies showed that partial occlusion can increase or decrease perceived attractiveness depending on the attractiveness of the original (unoccluded) face, due to regression to the mean. To reconcile this inconsistency, we propose that the occluded area is interpolated not by an average facial representation, but by a template of moderate attractiveness, shaped by the distribution of each viewer’s experience. This hypothesis predicts an interaction between occlusion and the attractiveness of the original face so that occluded attractive faces are rated as less attractive, while occluded unattractive faces are rated as more attractive. To examine this hypothesis, the present study used attractiveness-rating tasks with mask-free versus masked faces in own-race and other-races categories. Viewers were familiar with own-race faces and unfamiliar with other-races faces. If moderate-attractiveness interpolation were the explanatory factor, the interaction between the occlusion and the attractiveness of the original face should be found only in the rating of own-race faces. Consistent with this hypothesis, the interaction between the occlusion and the attractiveness of the original faces was significant only for the own-race faces. Specifically, wearing a sanitary mask decreased the facial attractiveness of attractive faces in the own-race, while it increased the attractiveness regardless of the level of facial attractiveness in other-races. These findings suggest that the occluded area of own-race faces is interpolated by a facial template of moderate attractiveness. The other-races template could be developed using familiar exemplars such as celebrities. Thus, interpolation by such a template should result in elevated attractiveness relative to that by an own-race template. Accordingly, the apparent inconsistency in the literature regarding the effect of partial occlusion on physical attractiveness can be explained in terms of differences in the template involving interpolation of the occluded area.

Although some private companies have implemented “time-based” workplace smoking bans covering all working hours including lunchtime, little is known about their impact on tobacco use. We examined associations between workplace smoking bans during working hours (including and excluding lunchtime) versus no ban and workers’ combustible cigarette and heated tobacco product (HTP) use.We used data from the Japan “Society and New Tobacco” Internet Survey 2020 and in total 4,222 workers aged 20–74 were included in the analyses. Using inverse probability weighting, prevalence ratios (PRs) and 95% confidence interval (CI) for tobacco use were calculated according to “time-based” smoke-free policies: workplace smoking bans for working hours including lunchtime (lunchtime ban), workplace smoking ban for working hours excluding lunchtime (lunchtime allowed), and no ban for working hours (no ban).The PRs of “lunchtime ban” for workers’ use of combustible cigarettes and HTPs were lower than “no ban”: 0.43 (CI: 0.29, 0.63) for combustible cigarette use and 0.61 (CI: 0.41, 0.90) for HTPs use. Meanwhile, the PRs for “lunchtime allowed” was not significant: 0.84 (CI: 0.70, 1.01) for combustible cigarettes use and 1.15 (CI: 0.94, 1.40) for HTPs use.Workplace bans on smoking during working hours which include lunchtime may successfully reduce workers’ combustible cigarette and HTP use, but allowing their use during lunchtime may reduce the effectiveness of the ban. Not only conventional “place-based” smoke-free policies, but also “time-based” smoke-free policies are useful for tobacco control in the workplace.

“Clothes with horizontal (or vertical) stripes are perceived as wider and shorter (slimmer and taller).” This belief is common yet inconsistent with the Helmholtz illusion. It has often attracted attention from researchers of perception. Despite the controversy among empirical studies, it is persistently supported by the general public. This article explores the early appearance of this common belief in Japan in historical records. Consequently, we discovered the descriptions of the common belief in a Japanese beauty handbook titled “ Miyako Fuzoku Kewai Den [Cosmetic manners and customs in Edo],” published in 1813. In Japan, this belief was not born in modern times. Instead, it was established over 200 years ago, when vertical striped patterns on clothes were popularized.

Wearing face masks in public has become the norm in many countries post-2020. Although mask-wearing is effective in controlling infection, it has the negative side effect of occluding the mask wearer’s facial expressions. The purpose of this study was to investigate the effects of wearing transparent masks on the perception of facial expressions. Participants were required to categorize the perceived facial emotion of female (Experiment 1) and male (Experiment 2) faces with different facial expressions and to rate the perceived emotion intensity of the faces. Based on the group, the participants were assigned to, the faces were presented with a surgical mask, a transparent mask, or without a mask. The results showed that wearing a surgical mask impaired the performance of reading facial expressions, both with respect to recognition and perceived intensity of facial emotions. Specifically, the impairments were robustly observed in fear and happy faces for emotion recognition, and in happy faces for perceived intensity of emotion in Experiments 1 and 2. However, the impairments were moderated by wearing a transparent mask instead of a surgical mask. During the coronavirus disease 2019 (COVID-19) pandemic, the transparent mask can be used in a range of situations where face-to-face communication is important.

This study tests the influence of wearing a protective face mask on the perceived attractiveness of the wearer. Participants who identified as White, and who varied in their ideological stance toward mask wearing, rated the attractiveness of facial photographs. The photos varied in baseline attractiveness (low, medium, and high), race (White and Asian), and whether or not the face was wearing a protective mask. Attitudes regarding protective masks were measured after the rating task using a survey to identify participants as either pro- or anti-mask. The results showed that masked individuals of the same race were generally rated as more attractive than unmasked individuals, but that masked individuals of another race were rated as less attractive than unmasked individuals. Moreover, pro-mask participants rated masked individuals as generally more attractive than unmasked individuals, whereas anti-maskers rated masked individuals as less attractive. A control experiment, replicating the procedure but replacing the protective masks with a partially occluding notebook, showed that these effects were mask-specific. These results demonstrate that perceived attractiveness is affected by characteristics of the viewer (attitudes toward protective masks), their relationship to the target (same or different race), and by circumstances external to both (pandemic).

Wearing a sanitary mask tended, in the main, to reduce the wearer’s sense of perceived facial attractiveness before the COVID-19 epidemic. This phenomenon, termed the sanitary-mask effect , was explained using a two-factor model involving the occlusion of cues used for the judgment of attractiveness and unhealthiness priming (e.g., presumed illness). However, these data were collected during the pre-COVID-19 period. Thus, in this study, we examined whether the COVID-19 epidemic changed the perceived attractiveness and healthiness when viewing faces with and without sanitary masks. We also used questionnaires to evaluate beliefs regarding mask wearers. We found that the perception of mask-worn faces differed before versus after the onset of the COVID-19 epidemic. Specifically, mask-wearing improved wearers’ sense of the attractiveness of faces, which were rated as less attractive when a mask was not worn after the onset of the COVID-19 epidemic. Furthermore, mask-worn faces were rated as healthier after the onset of the COVID-19. The proportion of respondents with negative associations regarding mask-wearing (e.g., unhealthiness) decreased relative to before the epidemic. We suggest that the weakening of this association altered the sanitary-mask effect with a relative emphasis on the occlusion component, reflecting the temporal impact of a global social incident (the COVID-19 epidemic) on the perception of facial attractiveness.

HLA haplotype-homozygous (HLA-homo) induced pluripotent stem cells (iPSCs) are being prepared to be used for allogeneic transplantation of regenerated tissue into recipients carrying an identical haplotype in one of the alleles (HLA-hetero). However, it remains unaddressed whether natural killer (NK) cells respond to these regenerated cells. HLA-C allotypes, known to serve as major ligands for inhibitory receptors of NK cells, can be classified into group 1 (C1) and group 2 (C2), based on their binding specificities. We found that the T cells and vascular endothelial cells regenerated from HLA-homo-C1/C1 iPSCs were killed by specific NK cell subsets from a putative HLA-hetero-C1/C2 recipient. Such cytotoxicity was canceled when target cells were regenerated from iPSCs transduced with the C2 gene identical to the recipient. These results clarify that NK cells can kill regenerated cells by sensing the lack of HLA-C expression and further provide the basis for an approach to prevent such NK cell-mediated rejection responses.

BackgroundOptimizing the collagenase G (ColG):collagenase H (ColH) ratio is a key strategy for achieving tailored donor-tissue specific islet isolation. Collagen V (Col V) and collagen III (Col III) are crucial target matrices of ColG and ColH, respectively. We herein investigated the relevance between the expression of target matrices in pancreatic tissues and influence of ColG:ColH ratio on islet isolation outcome.MethodsIslet isolation was performed in Lewis and SD rats using different ColG:ColH ratios (5:1, 1:1 and 1:5; n = 7/group). The composition of Col III and Col V was examined using immunohistochemical staining, real-time polymerase chain reaction (PCR), Western blotting and mass spectrometry. Chain types in collagen I (Col I) were also assessed using mass spectrometry.ResultsNo beneficial effects were observed by increasing the ColG amount, irrespective of the rat strain. In contrast, the islet yield in Lewis rats was considerably increased by high amounts of ColH but decreased in SD rats, suggesting that Lewis pancreas contains more Col III than SD pancreas. Neither immunohistochemical nor real-time PCR showed correlation with isolation outcome. However, Western blotting revealed that Lewis contained considerably higher amount of Col III than SD (p = 0.10). Likewise, Col-I(α1)/Col-III(α1) and Col-I(α2)/Col-III(α1) were significantly lower in Lewis than in SD rats (p = 0.007, respectively). Furthermore, the isolation outcome was considerably correlated with the composition of homotrimeric Col I.ConclusionsThe Col III expression and the composition of homotrimeric Col I in pancreatic tissues determined using mass analyses appeared useful for optimizing the ColG:ColH ratio in islet isolation.

In addition to electronic cigarettes (e-cigarettes), tobacco companies have recently begun to sell heat-not-burn tobacco products, Ploom and iQOS in Japan. Previous research has reported an inverse association between combustible cigarette smoking and educational attainment, but little is known about the association for e-cigarettes, especially heat-not-burn tobacco products. Our objective was to analyze the relationship between educational attainment and e-cigarette and heat-not-burn tobacco use.An internet survey (randomly sampled research agency panelists) in Japan.A total of 7338 respondents aged 18-69 years in 2015 (3632 men and 3706women).Adjusted odds ratios (ORs) of educational attainment for current smoking (combustible cigarettes), e-cigarette ever-use, and heat-not-burn ever-use were calculated by multivariable logistic regression models using covariates including socio-demographic factors. Stratified analyses according to smoking status (combustible cigarettes) were additionally performed for e-cigarette ever-use and heat-not-burn tobacco product ever-use.Associations between educational attainment and e-cigarette ever-use or heat-not-burn tobacco ever-use are not straightforward, although these associations are not statistically significant except for one cell. For example, using "graduate school" education as a reference category, adjusted ORs for "high school" were 1.44 (95% confidence interval [CI]: 0.85-2.44) for e-cigarettes ever-use and 0.75 (95% CI:0.19-2.97) for heat-not-burn tobacco product ever-use. Among current smokers, compared with "graduate school" (reference), those with lower educational attainment showed 0.6 to 0.7 ORs for e-cigarette ever-use: e.g.,"4-year university"(OR = 0.54, 95% CI:0.24-1.24) and "high school" (OR = 0.69, 95% CI: 0.30-1.60). Among former smokers, lower education indicated higher ORs for both e-cigarettes and heat-not-burn tobacco ever-use.This study provides baseline information on educational gradients of e-cigarette and heat-not-burn tobacco products, ever-use. As heat-not-burn tobacco products are increasing their market share in Japan, continuous monitoring of these products will be necessary.

Water management is important for the development of polymer electrolyte fuel cells (PEFCs) having high performance and reliability. Experimental and numerical studies were carried out on PEFCs with serpentine channels. Two channel widths, 2 mm and 8 mm, were examined. It was found that the rib of each separator played the role of a cover that reduced the rate of water vapor removal from the gas diffusion layer.

In daily life, huge costs can arise from just one incorrect performance on a visual search task (e.g., a fatal accident due to a driver overlooking a pedestrian). One potential way to prevent such drastic accidents would be for people to modify their decision criterion (e.g., placing a greater priority on accuracy rather than speed) during a visual search. The aim of the present study was to manipulate the criterion by creating an awareness of being watched by another person. During a visual search task, study participants were watched (or not watched) via video cameras and monitors. The results showed that, when they believed they were being watched by another person, they searched more slowly and accurately, as measured by reaction times and hit/miss rates. These findings also were obtained when participants were videotaped and they believed their recorded behavior would be watched by another person in the future. The study primarily demonstrated the role of being watched by another on the modulation of the decision criterion for responding during visual searches.

Objective: Assess cost and complication outcomes after liver transplantation (LT) using normothermic machine perfusion (NMP). Background: End-ischemic NMP is often used to aid logistics, yet its impact on outcomes after LT remains unclear, as does its true impact on costs associated with transplantation. Methods: Deceased donor liver recipients at 2 centers (January 1, 2019, to June 30, 2023) were included. Retransplants, splits, and combined grafts were excluded. End-ischemic NMP (OrganOx-Metra) was implemented in October 2022 for extended-criteria donation after brain death (DBDs), all donations after circulatory deaths (DCDs), and logistics. NMP cases were matched 1:2 with static cold storage controls (SCS) using the Balance-of-Risk [donation after brain death (DBD)-grafts] and UK-DCD Score (DCDgrafts). Results: Overall, 803 transplantations were included, 174 (21.7%) receiving NMP. Matching was achieved between 118 NMP-DBDs with 236 SCS; and 37 NMP-DCD with 74 corresponding SCS. For both graft types, median inpatient comprehensive complications index values were comparable between groups. DCD-NMP grafts experienced reduced cumulative 90-day comprehensive complications index (27.6 vs 41.9, P=0.028). NMP also reduced the need for early relaparotomy and renal replacement therapy, with subsequently less frequent major complications (Clavien-Dindo =IVa). This effect was more pronounced in DCD transplants. NMP had no protective effect on early biliary complications. Organ acquisition/preservation costs were higher with NMP, yet NMP-treated grafts had lower 90-day pretransplant costs in the context of shorter waiting list times. Overall costs were comparable for both cohorts. Conclusions: This is the first risk-adjusted outcome and cost analysis comparing NMP and SCS. In addition to logistical benefits, NMP was associated with a reduction in relaparotomy and bleeding in DBD grafts, and overall complications and post-LT renal replacement for DCDs. While organ acquisition/preservation was more costly withNMP, overall 90-day health care costs-per-transplantation were comparable. [ABSTRACT FROM AUTHOR]

Wearing a face mask is effective in controlling the spread of infections. However, it has the negative side effect of obscuring the wearer's facial expressions. This paper introduces studies investigating the effects of wearing a surgical mask and a transparent mask on the perception of facial expressions among Japanese adults and children. The results showed that wearing a surgical mask impaired one's performance of reading facial expressions. However, this impairment was mitigated when a transparent mask was worn instead of a surgical mask. Transparent masks can be used in various situations that require the use of face masks. [ABSTRACT FROM AUTHOR]

The present article summarizes an oral presentation provided at the second forum of Japanese Psychonomic Science. We discuss the effects of partial occlusion of face masks on interpersonal communication in terms of perception of facial emotional expressions, person identification, perception of physical attractiveness. We discuss the two-factor model of attractiveness perception of masked faces and the moderate interpolation hypothesis of perception of attractiveness for masked faces. [ABSTRACT FROM AUTHOR]