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Abstract Background We report a case of anaphylaxis induced by natto (fermented soybeans) allergy that occurred following dermal sensitization from a jellyfish sting. Case presentation A 49-year-old male presented to the emergency room complaining of an acute onset of erythema with pruritis that appeared while he was surfing. Given that his heart rate dropped to ~ 40 bpm without a decline in blood pressure or oxygen saturation, we suspected anaphylaxis and administered 0.5 mg of adrenaline intramuscularly. Immediately after the muscular adrenaline injection, his heart rate recovered to ~ 60–70 bpm. Conclusions The major allergen that induces natto allergy is poly(γ-glutamic acid) (PGA), which is present in its mucilage. Given that PGA is also produced by jellyfish tentacles, it can be inferred that the PGA sensitization occurred via dermal exposure to jellyfish PGA. This is an example of a food allergy induced by animal stings. As PGA is a high-molecular-weight polymer, natto allergy, despite being IgE-mediated, often presents with late-onset anaphylaxis, which typically develops half a day after digestion. PGA has a wide range of applications in pharmaceuticals, cosmetics, and foods. Patients may develop allergic symptoms and experience repeated anaphylaxis with no known cause. Therefore, it is important to obtain a detailed medical history and individually instruct patients suspected of being allergic to PGA to avoid PGA-containing products.

Abstract Background Activation of melanocortin 1 receptor (MC1R) is known to exert broad anti-inflammatory and anti-fibrotic effects. The purpose of this study is to investigate the potential of dersimelagon, a novel oral MC1R agonist, as a therapeutic agent for systemic sclerosis (SSc). Methods The effects of dersimelagon phosphoric acid (MT-7117) on skin fibrosis and lung inflammation were evaluated in bleomycin (BLM)-induced SSc murine models that were optimized for prophylactic and therapeutic evaluation. Microarray-based gene expression analysis and serum protein profiling were performed in the BLM-induced SSc models. The effect of MT-7117 on transforming growth factor-β (TGF-β)-induced activation of human dermal fibroblasts was evaluated in vitro. Immunohistochemical analyses of MC1R expression in the skin of SSc patients were performed. Results Prophylactic treatment with MT-7117 (≥ 0.3 mg/kg/day p.o.) significantly inhibited skin fibrosis and lung inflammation, and therapeutic treatment with MT-7117 (≥ 3 mg/kg/day p.o.) significantly suppressed the development of skin fibrosis in the BLM-induced SSc models. Gene array analysis demonstrated that MT-7117 exerts an anti-inflammatory effect via suppression of the activation of inflammatory cells and inflammation-related signals; additionally, vascular dysfunction was extracted as the pathology targeted by MT-7117. Serum protein profiling revealed that multiple SSc-related biomarkers including P-selectin, osteoprotegerin, cystatin C, growth and differentiation factor-15, and S100A9 were suppressed by MT-7117. MT-7117 inhibited the activation of human dermal fibroblasts by suppressing TGF-β-induced ACTA2 (encoding α-smooth muscle actin) mRNA elevation. MC1R was expressed by monocytes/macrophages, neutrophils, blood vessels (endothelial cells), fibroblasts, and epidermis (keratinocytes) in the skin of SSc patients, suggesting that these MC1R-positive cells could be targets for MT-7117. Conclusions MT-7117 demonstrates disease-modifying effects in preclinical models of SSc. Investigations of its mechanism of action and target expression analyses indicate that MT-7117 exerts its positive effect by affecting inflammation, vascular dysfunction, and fibrosis, which are all key pathologies of SSc. The results of the present study suggest that MT-7117 is a potential therapeutic agent for SSc. A phase 2 clinical trial investigating the efficacy and tolerability of MT-7117 in patients with early, progressive diffuse cutaneous SSc is currently in progress.

Since atopic dermatitis (AD) is a heterogeneous condition, the subtyping of AD is a crucial issue. The classical subtypes of AD are represented by extrinsic and intrinsic subtypes, European–American and Asian subtypes, and adult and pediatric subtypes. While the subtyping of AD was historically conducted based on the phenotype, recent findings on the mechanisms of AD have revealed the importance of the endotype, which can characterize individual patients more accurately. Considering the current development of AD therapies, AD endotyping is a prerequisite for a personalized therapeutic choice. Endotypes of AD can be stratified from different viewpoints, including cytokine expression patterns, allergen properties, epidermal barrier conditions, ceramide variation, the involvement of innate immunity, and serum biomarkers. Among them, the cytokine-based endotype seems to be the most useful one and is categorized into type 2 cytokine (IL-4, IL-13 and IL-31)-high, type 1 cytokine (IFN-γ)-high, and/or type 3 cytokine (IL-22 and IL-17)-high, or mixed subtypes. Recently proposed biomarker endotyping aims at individualized treatment options, although the daily clinical use of endotypes is a future issue. To better understand the endotypes for clinicians, attempts to adjust each of the classical subtypes to endotypes are required. This review will discuss the correspondence of the classical subtypes to the various endotypes that have recently been proposed.

Abstract Background Despite the effectiveness of implantable cardioverter defibrillators (ICDs) in the prevention of sudden cardiac death, shock therapy causes patients to experience pain and psychological distress, which contradicts the purpose of palliative care. It is difficult to predict the time course for heart failure (HF) patients, unlike that for cancer patients. The aim of this study was to evaluate the deactivation status of ICD therapy in Japanese patients with end‐stage HF. Methods We retrospectively studied 51 ICD patients who died due to worsening HF at Tokyo Women's Medical University Hospital from 2010 to 2019. The frequency of ICD therapy delivered before death and information about the discussion of deactivation and do not attempt resuscitation (DNAR) decisions were reviewed using medical charts. Results Of 51 patients, 12 (24%) patients deactivated ICD therapy and seven patients underwent deactivation within 24 hours of a DNAR order. The median time from deactivation to death was 3 days (range, 0‐56). Of 39 patients with DNAR orders, 27 (69%) did not undergo deactivation. A relatively high proportion of patients (n = 14, 27%) experienced ICD shocks within 1 month of death. The frequency of electrical storms within 1 month of death was also high (n = 12, 24%). Conclusions Our study showed that only one‐fourth of Japanese patients with end‐stage HF underwent deactivation of ICD therapy. A relatively high frequency of shock therapy was observed in the last month before death.

Context: Left ventricular ejection fraction (LVEF) recovery is an important treatment goal for patients with heart failure (HF) and reduced EF (HFrEF); however, the applicability of the left atrial volume index (LAVI) in predicting long-term LVEF recovery in HFrEF remains unknown. Aim: We aimed to assess the predictive value of the LAVI in predicting long-term LVEF recovery in patients hospitalized with HFrEF. Settings and Design: This was a retrospective cohort study. Materials and Methods: We analyzed 70 decompensated patients with HF, hospitalized between 2013 and 2014, with an LVEF 3 years postdischarge. Predictive LAVI values used to predict long-term LVEF improvement were determined. Statistical Analysis: The survival rate was determined using Kaplan–Meier analysis. In receiver operating characteristic curve (ROC) analysis, the area under the curve (AUC) and optimal cutoff values were obtained from several echocardiographic parameters. Univariate and multivariate logistic regression analyses identified predictors of LVEF improvement. Results: Twenty-seven (39%) patients had recovered LVEFs. During a median follow-up period of 76 (60–80) months, the survival rate was significantly higher in the recovered group (log-rank test, P = 0.001). ROC analysis showed that LAVI's predictive performance in long-term LVEF improvement (AUC 0.78, 95% confidence interval [CI] 0.66–0.87) was optimal at a cutoff of 35 g/m2. LAVI

Goto et al present a bolometer based around the heat generation in magnetic tunnel junctions under auto-oscillation conditions. Unlike superconducting bolometers, the presented device operates at room temperature and sub-GHz frequencies, opening possibilities for use in microwave devices.

Abstract Background Medroxyprogesterone and megestrol acetate are synthetic progesterone derivatives. Progestagen is an approved drug for cancer cachexia in the USA and in some European countries. These agents have been described to increase appetite and to lead to weight gain. However, the effects on survival are still unknown. The aim of this study was to evaluate the effects of progesterone on survival, cardiac function, and appetite and body weight in the Yoshida hepatoma AH‐130 rat cancer cachexia model. Methods and Results In this study, the effects of progesterone were tested in cachectic tumour‐bearing rats. Rats were treated with 0.5, 5 or 50 mg/kg/day, respectively, or placebo daily, starting 1 day after tumour inoculation for a period of 16 days. Cardiac function was analysed by echocardiography at baseline and at day 11. Food intake was assessed before tumour inoculation and at day 11. Body weight and body composition were evaluated at the beginning and the end of study or the day of euthanasia. Survival was significantly improved by 5 mg/kg/day (hazard ratio: 0.48, 95% confidence interval: 0.24–0.95, P = 0.0356). However, there was no significant difference between the progesterone treatment groups compared with placebo in body weight change and body composition, as well as food intake on day 11. Cardiac function also showed no significant difference compared with placebo. Conclusions Progesterone improves survival but has no beneficial effects on cardiac function, body weight, and food intake in this aggressive hepatoma cancer cachexia rat model. Further studies are needed to elucidate the mechanism of the survival benefit.

Background: The therapeutic goals of atrial fibrillation (AF) patients are to reduce symptoms and prevent severe complications associated with AF. This study compared the efficacy of flecainide versus pilsicainide in reducing the frequency of AF and improving quality of life (QOL) in symptomatic paroxysmal AF patients without structural heart disease. Methods: The Atrial Fibrillation and Quality Of Life (AF-QOL) study was a prospective, multicenter, randomized, open-label crossover study that compared flecainide and pilsicainide as antiarrhythmic drug therapy. Patients were randomized to receive 3 months of treatment with flecainide twice daily or pilsicainide 3 times daily. Each treatment consisted of a dose-finding phase (weeks 1–4) and an efficacy phase (weeks 5–12). Forty-three patients completed the trial. The main outcome was the number of days with documented AF episodes using a patient-operated electrocardiogram. QOL questionnaires (SF-36 and AF-specific QOL scores) were also completed. Results: The median (range) AF frequencies (days/8 weeks) were 2 (0–50) in the flecainide treatment group and 1 (0–54) in the pilsicainide treatment group (no significant between-group difference). No significant difference in the first recurrence of AF during the efficacy phase was noted between flecainide and pilsicainide treatments. The frequency and severity scores of AF-related symptoms improved from baseline to the end of the treatment periods. No significant differences in SF-36 or AF-related QOL scores were noted between the treatment groups. Conclusions: This study found no difference in AF frequency or QOL between symptomatic paroxysmal AF patients who received flecainide or pilsicainide.

Antecedentes/Objetivo. Muchos pacientes con desfibriladores cardioversores implantables experimentan síntomas depresivos. Además, la conducta de evitación es un problema común entre estos pacientes. El objetivo fue examinar la asociación entre las conductas de evitación y síntomas depresivos en pacientes con desfibriladores cardioversores implantables. Método: Se llevó a cabo un estudio transversal en un único centro entre mayo de 2010 y marzo de 2011. Mediante autoinformes se midieron conductas de evitación (evitación a lugares, evitación a objetos y evitación a situaciones) y síntomas depresivos (mediante el Inventario de Depresión de Beck, Versión II) en 119 participantes. El instrumento de evitación se desarrolló para este estudio, con adecuada fiabilidad de consistencia interna. Resultados: Noventa y dos pacientes (77,3%) tenían más de 50 años y 86 pacientes (72,3%) eran hombres. Cincuenta y un pacientes (42,9%) informaron de “evitación a lugares”, 34 pacientes (28,6%) informaron de “evitación a objetos” y 63 pacientes (52,9%) informaron “evitación a actividad”. La conducta de evitación se asoció con un aumento en la probabilidad de síntomas depresivos (OR 1,31; IC del 95%, 1,06- 1,62). Conclusiones: Este es el primer estudio para identificar la relación entre la conducta de evitación y síntomas depresivos en pacientes portadores de desfibriladores cardioversores implantables, aunque existen algunas limitaciones metodológicas. © 2017 Asociación Española de Psicología Conductual. Published by Elsevier España, S.L.U. This is an open access article under the CC BY−NC−ND license (http://creativecommons. org/licenses/by−nc−nd/4.0/).

In this research, we propose a numerical method to design surface texture with the desired friction characteristics, which are arbitrarily given according to the design purpose. The surface texture is parameterized, and the parameters are determined with the response surface method. The surface texture models are made based on the orthogonal array of Design of Experiments, and their friction characteristics between the surface texture model and the finger model are evaluated using the finite element sliding analysis. The three-dimensional multi-layered finger model with fingerprints is constructed based on the friction experiments and the sliding analyses in advance. The objective function and the constraint conditions are defined combining the desired friction characteristics, such as average friction coefficient, minimum friction coefficient, and average friction amplitude. The parameters of the surface texture is determined by the mathematical programming and the response surfaces. Numerical examples show that the proposed method is effective for the design of surface textures.

Overlapping characteristics of Brugada syndrome (BrS) and arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) have been reported in recent studies, but little is known about the overlapping disease state of BrS and ARVC/D. A 36-year-old man, hospitalized at our institution for syncope, presented with this overlapping disease state. The electrocardiogram showed spontaneous coved-type ST-segment elevation, and ventricular fibrillation was induced by right ventricular outflow tract stimulation in an electrophysiological study. BrS was subsequently diagnosed; additionally, the presence of epsilon-like waves and right ventricular structural abnormalities met with the 2010 revised task force criteria for ARVC/D. After careful investigation for both BrS and ARVC/D, an implantable cardioverter defibrillator was inserted in the patient. This case revealed 2 important clinical findings: (1) BrS and ARVC/D clinical features can coexist in a single patient, and EPS might be useful for determining the phenotype of overlapping disease (e.g., BrS-like or ARVC/D-like). (2) An overlapping disease state of BrS and ARVC/D can change phenotypically during its clinical course. Therefore, careful examination and attentive follow-up are required for patients with BrS or ARVC/D.

Background: Trauma reactions, including post-traumatic stress disorder (PTSD), in patients with implantable cardioverter defibrillators (ICDs) have recently garnered increased attention. The aim of this preliminary study was to examine the incidence of and risk factors for PTSD and to assess its impact on psychosocial distress and health-related quality of life (QOL) in Japanese patients with ICD. Methods: Seventy-four outpatients with ICD (63 men, 11 women; age 59.3±13.6 years) completed a questionnaire comprising a modified PTSD Checklist Specified for a stressor that included arrhythmias and ICD shocks, the Zung Self-Rating Depression Scale (SDS), the State-Trait Anxiety Inventory (STAI)-State scale, and Medical Outcomes Study 36-item Short-Form (SF-36) for health-related QOL. We compared relevant sociodemographic and medical variables of patients with and without PTSD. The mean number of days since ICD implantation was 2471±703. Results: Of 74 patients, 28 (37.8%) had received ICDs for secondary prevention, 42 (56.8%) had experienced ICD shocks, 36 (48.6%) had experienced ≥1 appropriate ICD shock, and 12 (16.2%) had experienced electrical storms. We diagnosed 19 patients (25.8%) with PTSD. Compared with the non-PTSD group, the PTSD group had significantly higher SDS and STAI-S scores and significantly lower scores in all eight subscales of the SF-36. Multiple logistic regression analysis identified experiencing ≥1 appropriate ICD shock (odds ratio [OR]: 6.0, 95% confidence interval [CI]: 1.45–24.63, and p

Abstract Despite the effectiveness of an implantable cardioverter defibrillator (ICD), its implantation and concomitant therapies, including shocks, can induce psychological distress in patients. Depression has been observed in approximately 30% of ICD patients, and shocks may contribute to the persistence of depression. Anxiety is common, with reports of 24–87% of ICD patients experiencing symptoms of anxiety after implantation, and type D personality and ICD‐related concerns may play important roles in the level of anxiety in ICD patients. However, the association between ICD shocks and anxiety is controversial. The prevalence of posttraumatic stress disorder (PTSD) in ICD patients is approximately 20%, and type D personality, comorbidities, and frequent shocks may contribute to PTSD. It is also important to pay attention to the psychological distress in the partners of ICD patients.

This paper describes the underwater data collection utilizing stationary sensor node and movable sensor node. We consider applying the system to investigate the conditions of marine ecosystem around the coral reef at Okinawa, Japan. The framework and fundamental design of our proposed underwater information gathering system under development are introduced. It is also reported the development of the prototypes of the sensory node and movable sensor node. Basic examinations utilizing such prototype at underwater environment are also described. This paper also describes experimental results of image gathering from via wireless local area network communication. Our future trials based on the current developmental situation are also discussed.

We have been developing a wireless sensor network system to support coral ecological system survey activities. This paper studies the required functions of a wireless sensor node for gathering information on underwater environmental conditions. For this purpose, a prototype sensor node is developed to clarify necessary functions through a practical experiment. In this paper, the hardware configuration of a latest prototype of wireless sensor node is described. The design of this prototype was based on our previous experiments and the comments of coral reef researchers. We conducted practical field experiments to observe the coral reefs along the Okinawa coast in Japan by using the prototype. Moreover, a browsing system of gathered information by the sensor network is described. Finally, we discuss the experimental results and the required functions of the sensor node for the future research.

This paper describes an autonomous deployment and restoration of a Wireless Sensor Network (WSN) using mobile robots. The authors have been developing an information-gathering system using mobile robots and WSNs in underground spaces in post-disaster environments. In our system, mobile robots carry wireless sensor nodes (SN) and deploy them into the environment while measuring Received Signal Strength Indication (RSSI) values to ensure communication, thereby enabling the WSN to be deployed and restored autonomously. If the WSN is disrupted, mobile robots restore the communication route by deploying additional or alternate SNs to suitable positions. Utilizing the proposed method, a mobile robot can deploy a WSN and gather environmental information via the WSN. Experimental results using a verification system equipped with a SN deployment and retrieval mechanism are presented.