Characteristics and Transition of Sleep-Wake Rhythm in Nursery School Children: The Importance of Nocturnal Sleep.

In this study, we investigated the sleep-wake rhythm of nursery school children with the aim of supporting their health and mental/physical development. We analyzed 4881 children from infancy to 6 years of age, using 2 week sleep tables recorded by their guardians. The tables contained night bedtimes, wake times, nighttime/daytime sleep duration, and the differences in these between weekdays and weekends.

Detrimental Effect of Acute Hyperglycemia on the Outcomes of Large Ischemic Region Stroke.

Background: Although endovascular therapy (EVT) is effective for large ischemic region strokes, the impact of hyperglycemia remains unclear.

Methods And Results: We analyzed data from the RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism-Japan Large Ischemic Core) trial, which randomized stroke patients with Alberta Stroke Program Early Computed Tomography Score of 3 to 5 to EVT versus medical management. Outcomes were compared among patients with normoglycemia (<140 mg/dL), moderate hyperglycemia (≥140, <180 mg/dL), and severe hyperglycemia (≥180 mg/dL) on admission.

Single Amino Acid Substitution Within the Helicase of Varicella Zoster Virus Makes It Resistant to Amenamevir.

A helicase-primase inhibitor, amenamevir (ASP2151), is the active pharmaceutical ingredient of a drug for the herpes zoster that is caused by reactivation of varicella-zoster virus (VZV). Here we report a new amenamevir-resistant VZV isolated under the selection pressure of amenamevir. The resistant virus has a nonsynonymous mutation K350N in the helicase gene ORF55.

Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer.

Effective antiretroviral therapy (ART) is now nearly ubiquitous. However, the survival benefits conferred with ART contribute to an aging human immunodeficiency virus (HIV) population and increased risk of chronic diseases, like atherosclerotic cardiovascular disease (ASCVD). Furthermore, HIV is a known risk enhancer of ASCVD and acknowledged as such in the current 2018 AHA/ACC Blood Cholesterol guidelines [1].

Real-world outcomes of avelumab plus axitinib in patients with advanced renal cell carcinoma in Japan: long-term follow-up from the J-DART2 retrospective study.

Background: Avelumab + axitinib was approved for advanced renal cell carcinoma (aRCC) in Japan in December 2019. We report long-term real-world outcomes with first-line avelumab + axitinib from the J-DART2 study in Japan.

Methods: J-DART2 was a multicenter, noninterventional, retrospective study examining clinical data from patients with curatively unresectable locally advanced or metastatic RCC who started treatment with first-line avelumab + axitinib in Japan between December 2019 and October 2022.

Advancing clinical MRI exams with artificial intelligence: Japan's contributions and future prospects.

In this narrative review, we review the applications of artificial intelligence (AI) into clinical magnetic resonance imaging (MRI) exams, with a particular focus on Japan's contributions to this field. In the first part of the review, we introduce the various applications of AI in optimizing different aspects of the MRI process, including scan protocols, patient preparation, image acquisition, image reconstruction, and postprocessing techniques. Additionally, we examine AI's growing influence in clinical decision-making, particularly in areas such as segmentation, radiation therapy planning, and reporting assistance.

Protein phosphatase 2A inhibitors: a possible pharmacotherapy for benzodiazepine dependence.

Objectives: Benzodiazepines (BZDs) activate the γ-aminobutyric acid (GABA) subtype A (GABAA) receptors, and thus are widely used medicines for the treatment of anxiety and insomnia. For chronic use, tolerance to BZDs is a major problem. Patients with chronic insomnia that develop tolerance to BZDs lose therapeutic effects but also potentially suffer from BZD dependence resulting in BZD withdrawal.

Clinical characteristics of monoclonal immunoglobulin-associated renal disease: a retrospective cohort study.

Introduction: Clinical epidemiological data on monoclonal gammopathy of renal significance (MGRS) are lacking. In this retrospective observational study, MGRS was compared with B-cell or plasma cell malignancies (BCM/PCM) with renal involvement to clarify differences in their clinical features.

Methods: Among the 1408 renal biopsies performed at our hospital, 25 MGRS and 18 BCM/PCM patients were identified.

Practical cut-off value for radon concentration in indoor air using an activated-charcoal radon collector.

The World Health Organization (WHO) recommends that countries adopt the reference level of 100 Bq m-3 for indoor radon gas. Adopting the reference level requires a preliminary assessment of the indoor radon concentration. In the preliminary investigation, a cut-off value is useful, which is a value for selecting samples that can be reliably determined to be below the reference level (in this paper, the WHO reference level) using a straightforward method.

Effect of house dust mite sublingual immunotherapy in patients with adult atopic dermatitis with rhinitis.

Whether house dust mite (HDM) sublingual immunotherapy (SLIT) is effective for the skin symptoms of adult atopic dermatitis (AD) is unclear. HDM SLIT was added to conventional AD treatment for 10 HDM-sensitized AD patients with rhinitis for 2 years. Seven out of ten enrolled patients completed the study.

Clinical practice pattern of Pneumocystis pneumonia prophylaxis in systemic lupus erythematosus: a cross-sectional study from lupus registry of nationwide institutions (LUNA).

Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection in patients undergoing immunosuppressive therapy, such as glucocorticoid (GC) medication, for systemic autoimmune diseases like systemic lupus erythematosus (SLE). Despite the confirmed effectiveness of PCP prophylaxis, its clinical administration, especially in conjunction with GC dosage, remains unclear. We aimed to describe the clinical practice of PCP prophylaxis in association with SLE in Japan, evaluate the relationship between GC dosage and PCP prophylaxis, and explore the practice patterns associated with PCP prophylaxis.

Association of lower serum sclerostin levels with elevated risk for increased arterial stiffness: The JPOS Cohort Study.

Objectives: Studies on the relationship between serum sclerostin, a Wnt/β-catenin pathway inhibitor, and atherosclerosis have yielded inconsistent results. We aim to longitudinally investigate the relationship between serum sclerostin levels and the risk of increased arterial stiffness in Japanese community-dwelling women.

Methods: Of 1044 women aged ≥50 years whose brachial-ankle pulse wave velocity (baPWV) value was available in a baseline survey in 2011-2012, we excluded 374 whose baPWVs were ≥1800 cm/s, set as the cutoff for increased arterial stiffness, and eight with missing data.

Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version).

Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non-insulin-dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase.

Bioprosthetic Valve Positions in Patients With Atrial Fibrillation - Insights From the BPV-AF Registry.

Background: Data on the impact of valve position on clinical outcomes in patients with atrial fibrillation (AF) and bioprosthetic valves (BPVs) are limited.

Methods And Results: The BPV-AF Registry was a multicenter, prospective, observational study involving 894 patients with BPVs and AF. In this post-hoc substudy, patients were classified according to BPV position: aortic (n=588; 65.

Efficient Loading into and Controlled Release of Lipophilic Compound from Liposomes by Using Cyclodextrin as Novel Trapping Agent.

Lipid bilayer vesicles, liposomes are representative drug delivery carriers. High encapsulation efficiency and release control of drugs are essential for clinical application of liposomes. For efficient drug loading into liposomes, remote loading method using driving force like transmembrane gradients of pH and ions are utilized.

Helpfulness of effective atomic number image in forensic dental identification: Photon-counting computed tomography is suitable.

The identities of unidentified persons are often confirmed by matching dental treatment information. Although treatment restorations consisting of artificial materials can be confirmed visually and/or by X-ray photography, they should be quantitatively analyzed. This study demonstrates that effective atomic number (Z) images can be created using photon-counting computed tomography (PC-CT) and used to identify artificial materials employed in dentistry.

Enhancing anti-EGFRvIII CAR T cell therapy against glioblastoma with a paracrine SIRPγ-derived CD47 blocker.

A significant challenge for chimeric antigen receptor (CAR) T cell therapy against glioblastoma (GBM) is its immunosuppressive microenvironment, which is densely populated by protumoral glioma-associated microglia and macrophages (GAMs). Myeloid immune checkpoint therapy targeting the CD47-signal regulatory protein alpha (SIRPα) axis induces GAM phagocytic function, but CD47 blockade monotherapy is associated with toxicity and low bioavailability in solid tumors. In this work, we engineer a CAR T cell against epidermal growth factor receptor variant III (EGFRvIII), constitutively secreting a signal regulatory protein gamma-related protein (SGRP) with high affinity to CD47.