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Miko Iwata,* Masakazu Hatano,* Kana Ito, Haruna Matsuzaki, Shigeki Yamada Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan*These authors contributed equally to this workCorrespondence: Masakazu Hatano, Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan, Tel +81 562932157, Fax +81 562934537, Email hatanomasakazu@yahoo.co.jpPurpose: Several nationwide population-based studies have reported that patients with psychiatric disorders are at higher risk of developing chronic kidney disease, chronic liver disease, and metabolic syndrome than the general population; however, there are insufficient studies in the Japanese population. Thus, we aimed to clarify the influence of psychiatric disorders on clinical laboratory data in the Japanese population.Patients and Methods: This cross-sectional study was based on medical records from the Department of Psychiatry at Fujita Health University Hospital and the 6th National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data Japan (specific health checkups in 2018) in the Ministry of Health, Labor and Welfare. The primary endpoint was the incidence of clinical laboratory abnormalities in patients with psychiatric disorders and the general Japanese population.Results: Compared to the general Japanese population, patients with psychiatric disorders had significantly higher rates of the following clinical laboratory abnormalities: estimated glomerular filtration rate, alanine transaminase, aspartate aminotransferase (AST), body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hemoglobin A1c (HbA1c). In the age-specific analysis, AST, BMI, HDL-C, and HbA1c levels were more frequently abnormal in patients with psychiatric disorders only in the 40– 49 and 50– 59 age groups.Conclusion: Our results showed that patients with psychiatric disorders have higher rates of various clinical laboratory abnormalities than the general Japanese population, with stronger influences in the middle-aged group. These data suggest the importance of monitoring and preventing chronic diseases in patients with psychiatric disorders in Japan.Keywords: big data, chronic kidney disease, diabetes mellitus, liver diseases, metabolic syndrome, mental disorders

Haruna Matsuzaki,1,* Masakazu Hatano,1,* Miko Iwata,1 Takeo Saito,2 Shigeki Yamada1 1Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan; 2Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan*These authors contributed equally to this workCorrespondence: Masakazu Hatano, Department of Clinical Pharmacy, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, Japan, Tel +81 562932157, Fax +81 562934537, Email hatanomasakazu@yahoo.co.jpPurpose: Clozapine is more effective than other antipsychotics and is the only antipsychotic approved for treatment-resistant schizophrenia. The objective of this study is to reveal the effect of clozapine on employment using a bidirectional mirror-image model.Patients and Methods: This design was a retrospective observational study that investigated the employment status of patients with treatment-resistant schizophrenia based on medical records. The bidirectional mirror-image model consisted of 1) switching from other antipsychotics to clozapine and 2) switching from clozapine to other antipsychotics. The observation period was 1 year for each pre- and post-clozapine initiation and discontinuation.Results: We included 36 patients in the bidirectional mirror-image model. The regular employment plus employment support rate was significantly higher in the clozapine phase than in the other antipsychotic phase in the bidirectional mirror-image model (30.6% vs 11.1%, P = 0.039). The days of regular employment plus employment support were also significantly longer in the clozapine phase (61.3 ± 106.2 vs 24.7 ± 82.7 days, P = 0.032). As per the unidirectional mirror-image model, switching to clozapine resulted in significantly higher regular employment plus employment support rates in the clozapine phase than those in the other antipsychotic phase (33.3% vs 10.0%, P = 0.039). Switching from clozapine to other antipsychotics did not exhibit significant differences in any outcomes.Conclusion: The results suggest that clozapine is superior to other antipsychotics with respect to achieving employment in patients with treatment-resistant schizophrenia. However, biases specific to the mirror-image model need to be considered.Keywords: clozapine, antipsychotic agents, treatment-resistant schizophrenia, observational study, mental health recovery

Haruna Matsuzaki,1 Masakazu Hatano,1,2 Miko Iwata,1 Shigeki Yamada1 1Department of Clinical Pharmacy, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, JapanCorrespondence: Masakazu HatanoFujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, JapanTel +81 562932157Fax +81 562934537Email hatanomasakazu@yahoo.co.jpObjective: Asenapine is a second-generation antipsychotic agent that is classified as a multi-acting receptor-targeted antipsychotic and is similar to olanzapine. Our study aimed to compare the treatment continuation rate and reason for discontinuation of asenapine or olanzapine in schizophrenia using real-world data.Methods: This design was a retrospective study. The primary endpoint was Kaplan–Meier estimates of the continuation rate at six months, with the propensity score method applied to adjust for potential confounders.Results: A total of 95 patients were analyzed in this study (asenapine, n = 46; olanzapine, n = 49). Matched data were adjusted to consider six covariates (age, sex, chlorpromazine equivalent, diazepam equivalent, history of clozapine use, and history of modified electro convulsive therapy). The continuation rate at six months was 27.3% (95% CI, 15.6– 47.6) in the asenapine group and 50.8% (95% CI, 34.3– 75.3) in the olanzapine group (hazard ratio, 0.41; 95% CI, 0.21– 0.82; P = 0.0088 by the Log rank test) in matched data. Cases of discontinuation because of the lack of efficacy were almost as frequent for asenapine (13.0%) as for olanzapine (10.2%). Discontinuation due to bitter taste (6.5%) and burden of the dosing method (6.5%) were observed only with asenapine, whereas anticholinergic side effects such as dry mouth (4.1%) and constipation (2.0%) were observed only with olanzapine.Conclusion: The low continuation rate of asenapine in real-world data may be related to specific factors such as bitter taste and burden of the dosing method.Keywords: asenapine, olanzapine, antipsychotic agents, schizophrenia, retrospective studies, propensity score

Control of the charge state of the nitrogen-vacancy (NV) center is crucial because of its instability and its transitions between the negative (NV–) and neutral (NV0) NV charge states under laser irradiation In this study, we fabricated an n-i-n junction, with an i-layer sandwiched between two phosphorus-doped n-layers; then, we measured the charge state of NV centers under steady state and laser irradiation in a known band structure where the Fermi energy changes gradually. The steady-state charge state measured by a nondestructive single shot exhibited stable NV– and NV0 signals when the Fermi level was even slightly above and below the transition level, respectively. This result indicates that the charge state can be significantly stabilized through band engineering. Both charge-state populations were observed only when the Fermi level was close to the transition level. Under continuous green laser irradiation, the ratio of NV– measured by the photoluminescence spectra changed gradually with the Fermi level in the depletion layer because of the balance between excitation from the laser and the supply of charge from the band. This outcome agrees reasonably with the calculated bands. Furthermore, we measured the PL spectra of the ensemble NV centers and discovered that their charge state can be well-controlled, as in the single NV center. The charge state of the i-layer at the interface can be stabilized by depositing a thin n-layer on the surface. These results would contribute significantly to improve sensor performance. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Although breast milk is considered the optimal nutrition for infants, it is also the primary cause of postnatal cytomegalovirus (CMV) infection. Preterm infants with postnatal CMV infections are susceptible to a variety of life-threatening conditions. CASE SUMMARY: Twin male infants were delivered via emergency caesarian section at 27 weeks' gestation secondary to maternal complete uterine rupture. The Apgar scores at 1 and 5 min were 1 and 1 for the older twin (Twin A) and 0 and 3 for the younger twin (Twin B). Their birth weights were 1203 g (+ 0.65SD) and 495 g (– 3.79SD) respectively. On day 41, laboratory blood test results for Twin B showed a moderate elevation in C-reactive protein (CRP), thrombocytopenia. CMV quantitative polymerase chain reaction (qPCR) tests in Twin B's urine and blood as well as in the mother's breast milk were positive, but stored, dried umbilical cord CMV qPCR tests were negative. Twin B was diagnosed with a postnatal CMV infection secondary to infected breast milk and ganciclovir was commenced on day 52. Treatment was switched to valganciclovir at 74 days of age, but a negative CMV-DNA level in the blood was not achieved. Postnatal CMV infection in this infant led to an exacerbation of pre-existing bronchopulmonary dysplasia (BPD) and he demised at 182 days of age. CONCLUSION: Postnatal cytomegalovirus infections may lead to exacerbations of BPD. Early use of raw breast milk in preterm infants should be done with careful consideration of this potential complication. [ABSTRACT FROM AUTHOR]