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This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s11418-023-01686-x., Food allergy is recognized as a global medical problem with increasing prevalence in recent years. Currently, the treatment of food allergy mainly involves avoidance of allergens and allergen-specific immunotherapy. Barring the spontaneous resolution of food allergy during the growth process, this disease is difficult to treat fundamentally. In recent years, the use of functional food ingredients derived from natural products has been attracting attention for their prophylactic use in food allergy. Theaflavins, i.e., black tea polyphenols, are potent antioxidants that have inhibitory effects on a variety of diseases. However, little is known about the preventive effect of theaflavins on food allergy. In this study, we designed a mouse model of food allergy and examined the effect of theaflavins using the severity of diarrhea, a symptom of food allergy, as an indicator. The administration of a black tea extract rich in theaflavins or theaflavin 1 (subgroup of theaflavins) to mice reduced the severity of diarrhea when compared with a normal diet. A reduction in malondialdehyde levels, a key marker of lipid peroxidation, was also observed. Overall, these data suggest that theaflavins may potentially inhibit food allergy by alleviating oxidative stress in the colon and can be a potential food material for prevention of food allergy.

It is well known that black and green tea extracts, particularly polyphenols, have antimicrobial activity against various pathogenic microbes including viruses. However, there is limited data on the antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which emerged rapidly in China in late 2019 and which has been responsible for coronavirus disease 2019 (COVID‐19) pandemic globally. In this study, 20 compounds and three extracts were obtained from black and green tea and found that three tea extracts showed significant antiviral activity against SARS‐CoV‐2, whereby the viral titre decreased about 5 logs TCID50 per ml by 1·375 mg ml−1 black tea extract and two‐fold diluted tea bag infusion obtained from black tea when incubated at 25°C for 10 s. However, when concentrations of black and green tea extracts were equally adjusted to 344 µg ml−1, green tea extracts showed more antiviral activity against SARS‐CoV‐2. This simple and highly respected beverage may be a cheap and widely acceptable means to reduce SARS‐CoV‐2 viral burden in the mouth and upper gastrointestinal and respiratory tracts in developed as well as developing countries., Significance and Impact of the Study: Here, we show that black tea extract and tea bag infusion could reduce the viral titre of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in vitro by 5 logs TCID50 per ml within 10 s. Black and green teas are widely available and are relatively cheap to purchase in both developed and developing countries. In translational terms, drinking tea might contribute to the in vivo reduction in numbers of SARS‐CoV‐2 virus in saliva of infected persons, as well as lowering the viral burden in the mouth and upper gastrointestinal and respiratory tracts. A clinical trial is urgently needed to establish if drinking tea results in the prevention of transmission of SARS‐CoV‐2 virus between infected and non‐infected persons.

Background: The relationship between transesophageal echocardiography findings and cognitive function. Objective: This study aimed to establish an association between transesophageal echocardiography findings and cognitive function in stroke survivors. Methods: A single-center study was conducted between April 1, 2017 and March 31, 2022. All subjects that were included had a past history of ischemic stroke and were admitted after >21 days from onset. The participants underwent cognitive function tests including a Mini-Mental State Examination, Revised Hasegawa Dementia Scale, Frontal Assessment Battery, and transesophageal echocardiography. Results: The results of 126 participants were analyzed. The cognitive function of participants with a spontaneous echo contrast (+) in the left atrium including appendage or of those with an aorta-arch plaque with a maximum thickness ≥4 mm significantly worse while neither the patent foramen ovale nor the branch extending plaque influenced cognitive function (The median cognitive scores of the spontaneous echo contrast (–) versus (+) were 26 versus 22, p

Background: Many issues persist in the today’s Alzheimer’s disease (AD) screening and the breakthrough method is desired. Objective: We aim to validate the association between venous reflux and AD, and to develop a new method for AD screening. Methods: We examined spontaneous echo contrast, area, diameter, retrograde velocity, and anterograde velocity of the bilateral cervical internal jugular vein (IJV) using carotid ultrasonography. Results: A total of 112 patients participated in this study, with 26 diagnosed as AD. The proportion of both or either IJV spontaneous echo contrast (+) occupied 25 of total 26 AD patients, which showed 96.2%of sensitivity and 98.5%negative predictive value. The IJV velocities also showed significant correlation with AD diagnosis, although the IJV area or diameter did not. Conclusion: Our results indicate that the validation of the spontaneous echo contrast or velocities of the IJV are convenient AD diagnosis screening methods and that the venous reflux disturbance correlates with AD development.

Background and purpose Multiple embolic sources are sometimes observed simultaneously in patients with embolic stroke. The present study investigated the effects of coexisting aortic arch atheroma ≥ 4 mm thick and atrial fibrillation (AF) on short-term stroke recurrence and functional outcome. Methods Transesophageal echocardiography (TEE) was performed in consecutive embolic stroke patients, and 395 patients were classified into 4 groups according to the presence of aortic arch atheroma ≥ 4 mm thick and AF: AF - /ARCH - group, AF + /ARCH - group, AF - /ARCH + group, and AF + /ARCH + group. In accordance with these 4 groups, we evaluated stroke recurrence and all-cause death for 3 months after stroke onset, and also evaluated the 3-month functional outcome using the modified Rankin scale (mRS). Results Among the 128 AF patients, 39.1% also had aortic arch atheroma ≥ 4 mm thick. Of the 395 enrolled cases, the AF + /ARCH + group showed the highest frequencies of stroke recurrence and all-cause death during 3 months after onset. On multivariate analysis, stroke recurrence or all-cause death during 3 months after onset was relatively more frequent in the AF + /ARCH + group than in the AF + /ARCH - group (OR, 2.34; 95% CI, 0.82-6.69; p = 0.11), but that was not statistically significant, and poor functional outcome (mRS score 3-6) at 3 months was significantly more frequent in the AF + /ARCH + group than in the AF + /ARCH - group (OR, 2.59; 95% CI, 1.08-6.24; p = 0.0339). Conclusions Aortic arch atheroma concomitant with AF is not rare and appears associated with increased risks of stroke recurrence and poor functional outcome.

A series of Ru and Ni supported catalysts were prepared and their catalytic performance was evaluated in the steam reforming of xylenes. The effects of active metals, active metal loading sequence, and the calcination temperature of the support on the catalyst activity and stability were investigated. The bimetallic 2Ru → 15Ni catalyst shows much higher activity and stability than the monometallic 2Ru and 15Ni catalyst owing to the synergic effect of Ni and Ru. The 2Ru → 15Ni catalyst has the least coke deposition owing to its high conversion performance and much less coke precursor being formed on the catalyst surface. After decoking, most of the small-sized pores cannot be recovered because of the pore collapse under severe hydrothermal conditions. o-Xylene has the lowest reactivity due to electronic and steric effects. Besides the steam reforming reaction, demethylation and C–C cracking are also observed, forming benzene and toluene. The catalyst with a loading sequence of 15Ni → 2Ru shows high activity at low temperatures (550–600 °C), but undergoes an activity drop at high temperatures (625–650 °C) because the Ni sintering at high temperatures greatly affects the state of Ru on the catalyst. The catalyst with a loading sequence of 2Ru → 15Ni has an advantage at high temperatures owing to its better sintering resistance. The simultaneously loaded 2Ru ↔ 15Ni catalyst shows the lowest activity. The high calcination temperature of the support enhances the catalyst stability by eliminating the small-sized pores before reaction; on the other hand, the elimination of pores decreases the dispersion of the active metals. The 2Ru → 15Ni catalyst calcined at 1000 °C balances the active metal dispersion and resistance to sintering under severe hydrothermal conditions, showing the best activity and stability. The catalyst calcined at 1000 °C has the best coke resistance with only 0.166 g gcat−1 of coke formation after the 24 h durability test. The DTG results indicate that the carbon formed on the catalysts is mainly graphitic carbon.

It is important to gauge mortality in real time following an ischemic stroke. However, there is limited in-hospital and post-discharge clinical data that focuses on the real-time prognosis of acute ischemic strokes.To comprehensively analyze ischemic stroke mortality during a hospital stay and 1 year after the onset of a stroke.Initially, 1514 consecutive acute ischemic stroke patients were admitted to our facility within 7 days after the onset of a stroke. Of these, 1116 patients who were successfully surveyed 1 year after onset were finally analyzed. Baseline, physical, laboratory, and stroke clinical data were recorded and analyzed.The proportion of deaths within 1 year was 14.5%, 4.9% without discharge was and 9.6% after discharge within 1 year. Cardioembolic ischemic strokes were responsible for nearly 50% of the deaths within 1 year while the remaining deaths were due to non-cardioembolic ischemic strokes. After 1 year, survival rate in the hospital decreased significantly, depending on whether the stroke was recurrent or if there was bleeding without a stroke.Our study reveals the real-time survival data 1 year after the onset of a stroke, in-hospital and post-discharge mortality rates, and several issues associated with the treatment of acute ischemic strokes.

The treatment of ischemic stroke has recently witnessed dramatic developments. However, there are limited data on ischemic stroke characteristics in aged patients. As part of the South Tochigi Acute Ischemic Stroke Registry, we prospectively enrolled 636 consecutive acute ischemic stroke patients (within 7 days after the onset) who were ≥ 60 years of age and who were admitted to two independent institutes from April 1, 2016 to February 28, 2019. We analyzed three groups divided by age: early-aged (60–69 years), middle-aged (70–79 years), and oldest-aged (≥ 80 years). From the 636 subjects, 194 were early-aged, 215 were middle-aged, and 227 were oldest-aged. There were significant differences in the ischemic stroke subtypes in each aging group (p

Naringenin (NRG) is a plant-derived flavonoid. Due to its antioxidant, anti-inflammatory, and analgesic activities it is beneficial to human health and is often used as a functional food ingredient; however, it has poor water solubility and low in vivo bioavailability. Therefore, the efficacy of NRG can be improved by enhancing its water solubility to increase gastrointestinal absorption. Conventional methods for the formulation of NRG are very complex and use toxic organic solvents, making them impractical for the production of functional foods. The objective of this study was to develop a safe and effective NRG-based functional food material. Previously, we established a technology to prepare amorphous solid dispersions (SDs) from functional food ingredients with poor water solubility and used hot-melt extrusion technology that is comparatively simple and does not involve the use of organic solvents. In this study, we prepared NRG SD and evaluated them both physicochemically and biochemically. NRG SD had superior water solubility and gastrointestinal absorption relative to native NRG and showed higher analgesic efficacy in rats than crystalline NRG. NRG SD was administered to mice in a mixed diet for 28 days, and organ weights and hematological/clinical biochemical parameters were assessed. NRG SD did not demonstrate severe adverse effects. The results suggest that NRG SD is a safe and highly efficacious formulation that can be used as a functional food material in the future.

We report on the real-time spectral dynamics on an initial stage of build-up femtosecond pulse in a homemade passively mode-locked Yb fiber laser with a semiconductor saturable absorber mirror using time stretch spectroscopy.

We have demonstrated a simple method for achieving broadband amplification and short-pulse generation in a polarizing maintained (PM) Yb fiber amplifier with the implementation of a narrow bandpass filter (NBF). By using an NBF with a spectral bandwidth of 3.3 nm at a wavelength of 1036 nm before the PM Yb amplifier, the spectral bandwidth was extended by self-phase modulation (SPM) in the PM YDF amplifier. The recompressed pulse duration of 125 fs obtained with the NBF was nearly three times shorter than that (350 fs) achieved without the NBF, and therefore the peak intensity of 0.35 MW with the NBF was over two times greater in comparison with that (0.16 MW) obtained without the NBF. We believe that this simple method is useful for developing an all-fiber laser system for high-power short pulse generation.

Although the relationship between amyotrophic lateral sclerosis (ALS) and cervical spondylotic myelopathy (CSM) is important, data relating to CSM complications in ALS remain lacking. We aimed to investigate and validate the spinal cord conditions of ALS patients. We recruited all patients diagnosed with ALS, Parkinson’s disease (PD), or chronic inflammatory demyelinating polyneuropathy (CIDP) who were admitted to our department from April 1, 2017, to March 31, 2020. We analyzed the cervical or thoracolumbar magnetic resonance imaging (MRI) scans of these 128 patients. Data relating to spondylosis, cord compression, spinal canal diameter, spinal cord diameter, and the closest distance between the cervical spinal canal and cord were validated using MRI. Of the 128 patients, 52 had ALS, 48 had PD, and 28 had CIDP. The proportions of both cervical spondylosis and cervical cord compression were highest in the ALS group compared with the other patient groups (p

We demonstrate the observation of shot-to-shot spectral instability in a mode-locked fiber laser with the successive single-shot spectrum measurement. Using time stretch to capture 8000 consecutive single-shot spectra during 100 μs in real-time, instability of individual pulse spectrum structure, noise-like pulse (NLP), could be detected. With an excessive intra-cavity power, NLP is formed by a nonlinear polarization rotation. The behavior of spectral instability opens for new opportunities to understand the complex ultrafast phenomena.

In this manuscript, we propose to use optical pulse compression in a dispersion managed fiber (DMF) with highly nonlinear fiber to enhance the output power in photonic-based 100-GHz RF generation. Even though the average dispersion is zero, RF gain of more than 5.0 dB can be obtained with moderate optical power to the DMF. Using four-sectioned DMF with zero average dispersion, we found the possibility of near octave-band operation in RF frequency.

A mode-locked laser that can produce a broadband spectrum and ultrashort pulse has been applied for many applications in an extensive range of scientific fields. To obtain stable mode-locking during a long time alignment-free, a semiconductor saturable absorber is one of the most suitable devices. Dynamics from noise to a stable mode-locking state in the spectral-domain are known as complex and a non-repetitive phenomenon with the time scale from nanoseconds to milliseconds. Thus, a conventional spectrometer, which is composed of a grating and line sensor, cannot capture the spectral behavior from noise to stable mode-locking. As a powerful spectral measurement technique, a time-stretch dispersive Fourier transformation (TS-DFT) has been recently used to enable a successive single-shot spectral measurement over a couple of milliseconds time span. Here, we experimentally demonstrate real-time spectral evolution of femtosecond pulse build-up in a homemade passive mode-locked Yb fiber laser with a semiconductor saturable absorber mirror using TS-DFT. Capturing 700 consecutive spectra (~ 17 µs time window) in real-time using the time-stretch technique, we are able to resolve the transient dynamics that lead to stable mode-locking. Before setting stable mode-locking, an oscillating or shifting fringe pattern in the consecutive spectra was detected. This signature proves the existence of multiple pulses (including a soliton molecule) which is temporally separated with a different relative phase. The dynamics on multiple pulses is originated from a fast relaxation time of the saturable absorption effect. This study provides novel insights into understanding the pulse behavior during the birth of an ultrafast mode-locked laser pulse and the stable single-pulse operation which is highly stabilized.

We present our work on training speaker embeddings, especially effective for speaker diarization. For various speaker recognition tasks, extracting speaker embeddings using Deep Neural Networks (DNNs) has become major methods. These embeddings are generally trained to be discriminate speakers and be robust with respect to different acoustic conditions. In speaker diarization, however, the acoustic conditions can be used as consistent information for discriminating speakers. Such information can include the distances to a microphone in a meeting, or the channels for each speaker in telephone conversation recorded in monaural. Hence, the proposed speaker-embedding network leverages differences in acoustic conditions to train effective speaker embeddings for speaker diarization. The information on acoustic conditions can be anything that contributes to distinguishing between recording environments; for example, we explore using i-vectors. Experiments conducted on a practical diarization system demonstrated that the proposed embeddings significantly improve performance over embeddings without information on acoustic conditions.

When building a language model (LM) for spontaneous speech, the ideal situation is to have a large amount of spoken, in-domain training data. Having such abundant data, however, is not realistic. We address this problem by generating texts in spoken language from those in written language by using a neural machine translation (NMT) model. We collected faithful transcripts of fully spontaneous speech and corresponding written versions and used them as a parallel corpus to train the NMT model. We used top-k random sampling, which generates a large variety of texts of higher quality as compared to other generation methods for NMT. We indicate that the NMT model is capable of converting written texts in a certain domain to spoken texts, and that the converted texts are effective for training LMs. Our experimental results show significant improvement of speech recognition accuracy with the LMs.

Aim: Aortic arch atherosclerosis, particularly complex aortic arch plaques (CAPs), is an important source of cerebral emboli. CAPs and atrial fibrillation (AF) often co-exist; however, the prevalence and risk of CAPs in acute ischemic stroke patients with AF is unclear. Methods: In patients with acute ischemic stroke with non-valvular AF admitted to Jichi Medical University Hospital during April 2016 to September 2019, we retrospectively evaluated the presence of CAPs on transesophageal echocardiography (TEE). Results: CAPs were observed in 41 (38.7 %) of 106 patients with non-valvular AF. Older age, diabetes mellitus, chronic kidney disease, low high-density lipoprotein cholesterol (HDL-C) levels, higher levels of glycohemoglobin A1c (HbA1c), higher CHADS 2 and CHA 2 DS 2 -VASc scores, and intracranial or carotid artery stenosis were more frequently observed in CAPs-positive than in CAPs-negative patients. In multivariable analyses, older age (odds ratio [OR]: 1.2 per year increase; 95% confidence interval [CI]: 1.07–1.24; P ＜0.0001), diabetes mellitus (OR: 4.7; 95%CI: 1.27-17.35; P ＜0.05), and low HDL-C (OR: 0.95 per 1 mg/dl increase; 95%CI: 0.92-0.99; P ＜0.01) were independent risk factors for CAPs. The prevalence of CAPs was age-dependent, and there was a significantly higher risk in patients aged either 75–84 years or ＞84 years than in those aged ＜65 (OR: 7.6; 95%CI: 1.50-38.62, and OR: 32.1; 95%CI: 5.14-200.11, respectively). Conclusions: Even in patients with ischemic stroke with non-valvular AF, concomitant CAPs should be considered in older individuals and those who have diabetes or low HDL-C.

Non-variceal upper gastrointestinal bleeding (NVUGIB) is still a common and life-threatening disease, thus it would have a big impact on medical care cost. However, little is known about risk factors for increased medical care cost in NVUGIB patients. The purpose of the study was to clarify predictor of requiring high medical care cost in NVUGIB patients. Patients who underwent endoscopic hemostasis due to NVUGIB between April 2012 and March 2015 were included in this retrospective study. We analyzed the association between patients’ background including activity of daily livings (ADL) and high medical care cost using logistic regression model. Medical care cost was calculated in reference to the “Diagnosis Procedure Combination” which is diagnosis-dominant case-mix system in Japan. The cutoff value of high medical care cost was defined as its first quartile. ADL was assessed according to Katz-6 score. We defined impaired ADL patient who revealed Katz-6 score more than 1. A total of 128 consecutive patients were included in this study. Median medical care cost was 5323 USD (IQR 3661–8172 USD). There were 13 patients (10%) in impaired ADL group. In univariate analysis, age and impaired ADL before admission revealed significant association with high cost. Of these, impaired ADL was an only independent risk factor [odds ratio 15.3 (95% CI 2.49–183)] in multivariate analysis. Impairment in ADL before admission was an independent predictor for high medical care cost with NVUGIB patients.

Desmoplastic malignant mesothelioma (DMM) is a relatively rare histologic subtype of malignant pleural mesothelioma (MPM). Among MPMs, the diagnosis of DMM is particularly difficult because the tumor is largely composed of dense hyalinized fibrous stroma and few malignant cells. We present two cases of DMM, one in a 47-year-old man and the other in a 64-year-old man. From detailed pathologic findings in these two cases, we conclude that cases of DMM that cannot otherwise be diagnosed with the use of conventional pleural biopsy, may be diagnosed successfully with the use of wedge lung resection.

In this paper we present a comprehensive study on building and adapting deep neural network based speech recognition systems for automatic closed captioning. We develop the proposed systems by first building base automatic speech recognition (ASR) systems that are not specific to any particular show or station. These models are trained on nearly 6000 hours of broadcast news data using conventional hybrid and more recent attention based end-to-end acoustic models. We then employ various adaptation and data augmentation strategies to further improve the trained base models. We use 535 hours of data from two independent BN sources to study how the base models can be customized. We observe up to 32% relative improvement using the proposed techniques on test sets related to, but independent of the adaptation data. At these low word error rates (WERs), we believe the customized BN ASR systems can be used effectively for automatic closed captioning.

Prolongation is a speech disfluency that lengthens some portions of speech utterances. It is frequently observed in children's spontaneous speech, while it is rare in read speech. To make acoustic models more robust to children's spontaneous speech, collecting a large amount of children's speech data containing prolongation is usually required, which is very impractical in many cases. To tackle this problem, we propose a novel data augmentation method that virtually generates additional data by simulating prolongation. The method inserts pseudo frames into specific positions of speech utterances to simulate prolongation. The acoustic features of the inserted frames are calculated from the original frames on both sides. This is based on our analysis that many of vowels are actually stretched in children's spontaneous speech. Our proposed procedure can generate partially stretched utterances with low computational costs, unlike a conventional speed or tempo perturbation method that extends and shrinks entire utterances at a uniform rate. The effectiveness of the proposed method were confirmed with the experiments of acoustic model adaptations, in which our proposed method focusing on vowel stretch showed consistent improvement compared with conventional speed and tempo perturbation approach.

A strain distribution introduced by tensile deformation in a ferrite + martensite multilayered steel was visualized using the digital image correlation method and its local deformation and fracture behavior were characterized. The strain was continuously distributed along 45 degrees from the tensile direction regardless of the layers and was predominately to concentrate in martensite layers. Voids or cracks were generated from highly strained martensite layers and their coalescence led to the fracture. Therefore, the deformability and ductility of hard layer play an important role in the deformation and fracture in a multilayered steel.

Background/Aims: Although colonic diverticular bleeding (CDB) often ceases spontaneously, re-bleeding occurs in about 30%. Bleeding diverticulum can be treated directly by endoscopic hemostasis; however, it is difficult to perform colonoscopy in all cases with limited medical resource and certain risks. The aim of this study was to clarify who should undergo colonoscopy as well as appropriate methods of initial management in CDB patients. Methods: A total of 285 patients who were diagnosed as CDB and underwent colonoscopy from March 2004 to October 2015 were retrospectively analyzed. First, the association between re-bleeding and various factors including patients’ background and initial management were analyzed. Second, the examination conditions that influenced bleeding point identification were analyzed. Results: Of 285 patients, 187 were men and 98 were women. Median age was 75 years, and the median observation period was 17.5 months. Re-bleeding was observed in 79 patients (28%). A history of CDB (OR 2.1, p = 0.0090) and chronic kidney disease (CKD; OR 2.3, p = 0.035) were risk factors, and bleeding point identification (OR 0.20, p = 0.0037) was a preventive factor for re-bleeding. Bleeding point identification significantly reduced approximately 80% of re-bleeding. Furthermore, extravasation on CT (OR 3.7, p = 0.031) and urgent colonoscopy (OR 5.3, p < 0.001) were predictors for identification of bleeding point. Compared to bleeding point identification of 11% in all patients who underwent colonoscopy, identification rate in those who had extravasation on CT and underwent urgent colonoscopy was as high as 70%. Conclusions: Contrast-enhanced CT upon arrival is suggested, and patients with extravasation on CT would be good candidates for urgent colonoscopy, as well as patients who have a history of CDB and CKD.

Amyotrophic lateral sclerosis (ALS) affects persons of all races, and there continues to be a need for effective therapies to treat the disease.To compare the pharmacokinetics (PK) of edaravone between Japanese and Caucasian populations.Data from five PK studies among Japanese and Caucasian healthy volunteers were pooled and evaluated. In population PK (PPK) modelling, compartment models and other models with linear elimination were evaluated for appropriateness. Covariate effects by race, sex, weight, and age were investigated to explain variability in PK parameters. Simulations of the final PPK model were performed using a virtual population based on ALS clinical trials.The analysis included 86 subjects. A three-compartment model with Michaelis-Menten plus linear elimination was selected as the best fit model. Race was statistically detected as a covariate for the second peripheral volume of distribution (V2), indicating a 26% increase for Caucasian subjects compared to Japanese subjects. However, based on simulation of PPK model for a virtual ALS population, the small difference of V2 was associated with a difference of CThe PPK analyses demonstrated no clinically relevant difference in the PK profiles of edaravone by race, sex, weight, or age.

Background Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases. The phenotypes that have clinical features of both asthma and COPD are still incompletely understood. Objective To clarify the best discriminators of the asthma-COPD overlap phenotype from asthma and COPD subgroups using a clustering approach. Methods This study assessed pathophysiological parameters, including mRNA expression levels of T helper cell-related transcription factors, namely, TBX21 (Th1), GATA3 (Th2), RORC (Th17), and FOXP3 (Treg), in peripheral blood mononuclear cells in asthma patients (n = 152) and in COPD patients (n = 50). Clusters were determined using k-means clustering. Exacerbations of asthma and COPD were recorded during the 1-year follow-up period. Results The cluster analysis revealed four biological clusters: cluster 1, predominantly patients with COPD; cluster 2, patients with an asthma-COPD overlap phenotype; cluster 3, patients with non-atopic and late-onset asthma; and cluster 4, patients with early-onset atopic asthma. Hazard ratios for exacerbation were 2.5 (95% confidence interval [CI], 1.1–5.6) in cluster 1 and 2.3 (95% CI, 1.0–5.0) in cluster 2 compared with patients in other clusters. Cluster 2 was discriminated from other clusters by total serum IgE level ≥ 310 IU/mL, blood eosinophil counts ≥ 280 cells/μL, a higher ratio of TBX21/GATA3, FEV1/FVC ratio < 0.67, and smoking ≥ 10 pack-years with an area under the curve of 0.94 (95% CI, 0.90–0.98) in the receiver operating characteristic analysis. Conclusions & Clinical Relevance The asthma-COPD overlap phenotype was characterized by peripheral blood eosinophilia and higher levels of IgE despite the Th2-low endotype. This article is protected by copyright. All rights reserved.