Effects of tiotropium on lung function in current smokers and never smokers with bronchial asthma.

The effects of tiotropium, an inhaled long-acting muscarinic antagonist, on lung function were investigated in current smokers and nonsmokers with asthma treated with inhaled corticosteroids (ICSs) and other asthma controllers: inhaled long-acting ß2 agonists, leukotriene receptor antagonists, and/or theophylline. We conducted a double-blind, placebo-controlled study of an inhaled single dose of tiotropium in 9 asthmatics currently smoking and 9 asthmatics who have never smoked in a crossover manner. Lung function was measured before and 1, 3, and 24 h after inhalation of 18 µg of tiotropium or a placebo. The primary outcome was a change in forced expiratory volume in 1 s (FEV1) from the baseline, and the secondary outcomes were changes in peak expiratory flow rate (PEFR), V˙50, and V˙25. At baseline, asthmatics with and without a smoking history had a mean FEV1 of 2590 ml and 2220 ml and were taking a mean dose of ICSs of 1208 and 1000 µg/day, respectively. The increase from the baseline FEV1 was 169 ml and 105 ml higher at 3 h after tiotropium than after the placebo in current smokers and nonsmokers, respectively. PEFR, V˙50, and V˙25 were also significantly increased after tiotropium as compared with the placebo in both study groups. Changes in FEV1 and PEFR tended to be greater in asthmatics currently smoking than in subjects who have never smoked, although there were no statistical differences at any time points. Tiotropium resulted in improved lung function and symptoms both in current smoker and nonsmoker asthmatics. These findings suggest that tiotropium will provide a new strategy for the treatment of bronchial asthma.

[Expression of negative emotional responses to the 2011 Great East Japan Earthquake: Analysis of big data from social media].

In this article, we investigated the expression of emotional responses to the 2011 Great East Japan Earthquake by analyzing the frequency of negative emotional terms in tweets posted on Twitter, one of the most popular social media platforms. We focused on differences in time-series variations and diurnal changes between two kinds of disasters: natural disasters (earthquakes and tsunamis) and nuclear accidents. The number of tweets containing negative emotional responses increased sharply shortly after the first huge earthquake and decreased over time, whereas tweets about nuclear accidents showed no correlation with elapsed time. Expressions of anxiety about natural disasters had a circadian rhythm, with a peak at midnight, whereas expressions of anger about the nuclear accident were highly sensitive to critical events related to the accident. These findings were discussed in terms of similarities and differences compared to earlier studies on emotional responses in social media.

The impact of television on-air time on hand hygiene compliance behaviors during COVID-19 outbreak.

BACKGROUND: There is limited data to support the impact of the COVID-19 pandemic on hand hygiene compliance among hospital visitors. METHODS: We monitored hand hygiene compliance among university hospital visitors in Osaka, Japan by direct observation, from December 2019 to March 2022. During this time, we measured the amount of coverage time dedicated to COVID-19 related news on the local public television channel and the number of confirmed cases and deaths. RESULTS: Over 148 days, 111,071 visitors hand hygiene compliance was monitored. The baseline compliance was 5.3% (213 of 4,026) in December 2019. From late January 2020, compliance rose significantly to almost 70% in August 2020. It remained at a level of 70%-75% until October 2021, after which, the compliance slowly declined to the mid-60% range. The number of newly confirmed cases and deaths were not related to the change in compliance, but the association between the on-air time of COVID-19-related news and compliance was statistically significant. CONCLUSIONS: Hand hygiene compliance dramatically increased following the COVID-19 pandemic. The role of television in increasing hand hygiene compliance was significant.

Survival and acute exacerbation for patients with idiopathic pulmonary fibrosis (IPF) or non-IPF idiopathic interstitial pneumonias: 5-year follow-up analysis of a prospective multi-institutional patient registry.

OBJECTIVE: Few prospective cohort studies with relatively large numbers of patients with non-idiopathic pulmonary fibrosis (non-IPF) of idiopathic interstitial pneumonia (IIP) have been described. We aimed to assess disease progression and cause of death for patients with non-IPF IIPs or IPF under real-life conditions. METHODS: Data were analysed for a prospective multi-institutional cohort of 528 IIP patients enrolled in Japan between September 2013 and April 2016. Diagnosis of IPF versus non-IPF IIPs was based on central multidisciplinary discussion, and follow-up surveillance was performed for up to 5 years after patient registration. Survival and acute exacerbation (AE) were assessed. RESULTS: IPF was the most common diagnosis (58.0%), followed by unclassifiable IIPs (35.8%) and others (6.2%). The 5-year survival rate for non-IPF IIP and IPF groups was 72.8% and 53.7%, respectively, with chronic respiratory failure being the primary cause of death in both groups. AE was the second most common cause of death for both non-IPF IIP (24.1%) and IPF (23.5%) patients. The cumulative incidence of AE did not differ significantly between the two groups (p=0.36), with a 1-year incidence rate of 7.4% and 9.0% in non-IPF IIP and IPF patients, respectively. We found that 30.2% and 39.4% of non-IPF IIP and IPF patients, respectively, who experienced AE died within 3 months after an AE event, whereas 55.8% and 66.7% of such patients, respectively, died within 5 years after registration. CONCLUSION: Closer monitoring of disease progression and palliative care interventions after AE are important for non-IPF IIP patients as well as for IPF patients.

Creation and Validation of the Japanese Cute Infant Face (JCIF) Dataset.

Research interest in cuteness perception and its effects on subsequent behavior and physiological responses has recently been increasing. The purpose of the present study was to produce a dataset of Japanese infant faces that are free of portrait rights and can be used for cuteness research. A total of 80 original facial images of 6-month-old infants were collected from their parents. The cuteness level of each picture was rated on a 7-point scale by 200 Japanese people (100 men and 100 women in their 20s-60s). Prototypical high- and low-cuteness faces were created by averaging the top 10 and bottom 10 faces according to the mean cuteness ratings. Then, 50 composite faces were made by mixing two faces randomly chosen from the 60 unused middle-cuteness faces. The normative cuteness ratings of these composite faces were obtained from 229 Japanese men and women in their 20s-60s. The shape of each composite face was transformed to be cuter (+50%) or less cute (-50%) along a continuum between the high- and low-cuteness prototypical faces. A two-alternative forced-choice task (N = 587) confirmed that cuteness discrimination was better than the chance level for all 50 face pairs. Moreover, the results showed that young men had poorer sensitivity to cuteness differences in infant faces than older men and women of any age. This Japanese Cute Infant Face (JCIF, "jay-sif") dataset, including composite face images and normative rating scores, is publicly available online.

Examination of morphological traits of children's faces related to perceptions of cuteness using Gaussian process ordinal regression.

Konrad Lorenz, an ethologist, proposed that certain physical elements are perceived as cute and induce caretaking behavior in other individuals, with the evolutionary function of enhancing offspring survival. He called these features Kindchenschema, baby schema. According to his introspection, these include a large forehead, chubby round features, and chubby cheeks. Previous studies are limited to examining the effects of these facial features on perceived cuteness. However, other morphological factors may be related to perceived cuteness. This study uses Bayesian optimization, one of the global sequential optimization methods for estimating unknown functions, to search for facial morphological features that enhance the perceptions of facial cuteness. We applied Bayesian optimization incorporating Gaussian process ordinal regression (GPOR), which allows an estimation of the latent cuteness function based on evaluations using the Likert scale. A total of 96 preschool children provided the facial images used in this study. We summarized the facial shape variations using methodologies of geometric morphometrics and principal component analysis (PCA) up to the third principal component (PC), which we refer to as the face space. A total of 40 participants evaluated the images created by warping the average facial texture of the children's faces with randomly generated parameters in the face space. Facial traits related to perceived cuteness were estimated based on the averaged cuteness function. Perceived cuteness was linked to the relative lower position of facial components and narrower jawline but not to the forehead height.

A case of autoimmune pulmonary alveolar proteinosis with severe respiratory failure treated with segmental lung lavage and oral statin therapy.

Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease characterized by the accumulation of alveolar surfactants due to dysfunction of granulocyte-macrophage colony-stimulating factor-dependent cholesterol clearance. Whole-lung lavage is the current standard of care for PAP, but it can lead to the exacerbation of hypoxia. A medication targeting cholesterol homeostasis is a promising therapy for refractory PAP. We present a case of autoimmune PAP with severe hypoxia that was successfully treated with segmental lung lavage (SLL). Following SLL for disease relapse, statin treatment for dyslipidemia was started. After initiating statin treatment, the patient did not require bronchoalveolar lavage for 10 months.

Extracting multiple layers of social networks through a 7-month survey using a wearable device: a case study from a farming community in Japan.

As individuals are susceptible to social influences from those to whom they are connected, structures of social networks have been an important research subject in social sciences. However, quantifying these structures in real life has been comparatively more difficult. One reason is data collection methods-how to assess elusive social contacts (e.g., unintended brief contacts in a coffee room); however, recent studies have overcome this difficulty using wearable devices. Another reason relates to the multi-layered nature of social relations-individuals are often embedded in multiple networks that are overlapping and complicatedly interwoven. A novel method to disentangle such complexity is needed. Here, we propose a new method to detect multiple latent subnetworks behind interpersonal contacts. We collected data of proximities among residents in a Japanese farming community for 7 months using wearable devices which detect other devices nearby via Bluetooth communication. We performed non-negative matrix factorization (NMF) on the proximity log sequences and extracted five latent subnetworks. One of the subnetworks represented social relations regarding farming activities, and another subnetwork captured the patterns of social contacts taking place in a community hall, which played the role of a "hub" of diverse residents within the community. We also found that the eigenvector centrality score in the farming-related network was positively associated with self-reported pro-community attitude, while the centrality score regarding the community hall was associated with increased self-reported health. Supplementary Information: The online version contains supplementary material available at 10.1007/s42001-022-00162-y.

Benralizumab use in chronic eosinophilic pneumonia with eosinophilic bronchiolitis and chronic airway infection.

Chronic eosinophilic pneumonia (CEP) is a rare disorder characterized by marked accumulation of eosinophils in lung tissues and/or bronchoalveolar lavage fluid (BALF). Patients with CEP usually respond well to corticosteroids. However, more than half of these patients relapse while tapering and/or after discontinuing corticosteroids. Long-term adverse effects of corticosteroids can be serious. We report a case of comorbid CEP, severe bronchial asthma, eosinophilic bronchiolitis, and chronic airway infection. Corticosteroid treatment induced remission of the CEP, but recurrent exacerbation of the chronic airway infection occurred. Thus, she was treated with benralizumab, a monoclonal antibody against the alpha-chain of interleukin-5 receptor. After the initiation of benralizumab, the steroid was stopped successfully and her CEP, asthma, and airway infection remained well controlled. Micronodular nodules on high-resolution computed tomography (HRCT) reflecting bronchiolitis were also improved with benralizumab treatment. Benralizumab may be a treatment option for patients not tolerating steroids.

[Two cases of intravascular lymphomatosis diagnosed by transbronchial lung biopsy].

Patient 1 was a 54-year-old woman who was admitted with high-grade fever. Abnormal laboratory findings included hypoxemia, and elevated levels of LDH and soluble interleukin-2 receptor (sIL-2R). Chest computed tomography scans (CT) revealed diffuse ground-glass shadows in both lungs. Transbronchial lung biopsy (TBLB) confirmed the diagnosis of intravascular lymphomatosis (IVL). Patient 2 was a 46-year-old man who was also admitted with high-grade fever. Abnormal laboratory findings included slight hypoxemia, and elevated levels of LDH and sIL-2R. Chest CT images revealed diffuse, fine nodular densities in both lungs and several small nodules in the bilateral lower lobes. Perfusion scintigraphy revealed multiple defects in both lungs. TBLB specimens yielded a diagnosis of IVL. Although antemortem diagnosis of IVL is frequently difficult, it is necessary to perform TBLB in those patients who show fever not responding to antibiotics, elevated levels of LDH and sIL-2R, and hypoxemia.

[A case of right paratracheal air cyst].

An 87-year-old female was being examined by her primary care doctor during a follow-up of 4 to 5 years after a diagnosis of non-tuberculous mycobacterial infection. An exacerbation of a shadow was suspected on a chest X-ray film, and therefore the patient was referred to our hospital. Her chief clinical symptom was mild occasional coughing, but no clearly abnormal findings were observed on the clinical examination. On chest CT, a cystic lesion was detected in the right posterodorsal side of the trachea at the level of the thoracic aperture, resulting in the diagnosis of a right paratracheal air cyst. Right paratracheal air cyst is a relatively rare disease, but it is believed that such a diagnosis can be made easily based on its localization and the CT findings, and it is a disease to which attention should be paid, which is why we are reporting it.

[A case of Streptomyces pneumonia].

A 85-year-old man who had a past history of gastrectomy but no subsequent chemotherapy was suffering fever and fatigue. The infiltrative shadow with cavitation on his chest X-ray film did not improve despite treatment with several antibiotics after admission. Transcutaneous needle aspiration performed for diagnosis of the cavitated lung lesion yielded Streptomyces. A definitive diagnosis of streptomyces lung infection was established. We believed that this is the first case of streptomyces infection of the lung reported in Japan. The current case was also rare because he did not have any immunosuppressive status, while almost all cases previously reported.

Pulmonary varix mimicking arteriovenous malformation.

We report here a case of a 44-year-old female with a pulmonary varix. The patient was asymptomatic; a routine chest X-ray incidentally revealed a serpiginous mass in the left hilar region. Computed tomography revealed a serpiginous, dilated vascular structure in the left upper lobe that continued into the lower lobe and was suggestive of an arteriovenous malformation. Pulmonary angiography revealed no arterial abnormality; however, the filling of an abnormally dilated pulmonary vein was observed. Angiography is considered to be the most useful method for the confirmatory diagnosis of pulmonary varices.

Smiling emphasizes perceived distinctiveness of faces.

In this study, 114 Japanese observers (56 men and 58 women) rated the distinctiveness of 48 neutral faces and 48 smiling faces. Analysis showed smiling faces were rated as significantly more distinctive than neutral ones. Greater perceived distinctiveness provides an explanation for previous results that smiling faces are better remembered than faces with neutral expressions.

[Treatment outcome of patients with pulmonary tuberculosis before and after the induction of directly observed therapy (DOT)].

PURPOSE: To evaluate the treatment outcome of patients with pulmonary tuberculosis before and after the induction of DOT. METHODS: A retrospective study of the outcome of 239 tuberculosis patients treated during January 1996 to June 2003. We reviewed clinical charts collected on all patients with positive cultures for Mycobacterium tuberculosis. The patients of non-DOT group had received a traditional unsupervised drug regimen, before we have undertaken DOT. The patients of DOT group received therapy under direct observation by nurses. We compared sputum smear conversion period, sputum culture conversion period, duration of admission and treatment, recurrence rate, treatment success (cure and completion of treatment) rate and incidence of adverse effects between DOT and non-DOT group. RESULTS: Sputum conversion period and incidence of adverse effects were not significantly different between both groups. The duration of admission and treatment of DOT group was significantly shorter than those of non-DOT group. Rate of relapse and treatment success was not different between two groups. Over-80-year-old patients treated by DOT revealed a higher culture conversion rate after 2-month treatment than those who were not treated with DOT. CONCLUSION: We could not prove the usefulness of DOT during hospitalization for tuberculosis patients from the points of treatment success rate and relapse rate.

[Pulmonary alveolar proteinosis noted in a patient with thymoma].

A 74-year-old woman had general fatigue and mild fever in August 2004. Her chest X-ray showed slight ground glass opacities in the upper and middle lung fields of both lungs. Though she was prescribed antibacterial drugs, the abnormal shadows on chest X-ray did not improve. The chest CT showed ground glass opacities and reticular shadows with thickened alveolar septa (crazy-paving appearance) in both lungs, and a clearly defined mass in the anterior mediastinum. She underwent thymo-thymectomy with wedge resection of the upper lobe of the left lung. Anterior mediastinum tumor was pathologically diagnosed as thymoma. Lung biopsy demonstrated alveoli filled with SP-A positive granular materials, and we diagnosed pulmonary alveolar proteinosis. About 1 month after operation, the shadows on chest CT showed improvement. We think there might be some relationship between thymoma and pulmonary alveolar proteinosis.

Intraday Activity Levels May Better Reflect the Differences Between Major Depressive Disorder and Bipolar Disorder Than Average Daily Activity Levels.

It is important to establish an objective index to differentiate mood disorders (i.e., bipolar disorder; BD and major depressive disorder; MDD). The present study focused on the pattern of changes of physical activity in the amount of activity intraday, and examined the relationship between activity patterns and mood disorders. One hundred and eighteen inpatients with MDD or BD in a depressive state provided the activity data by using wearable activity trackers for 3 weeks. In order to illuminate the characteristic patterns of intraday activities, Principal Component Analysis (PCA) was adopted to extract the main components of intraday activity changes. We found that some of the PCs reflected the differences between the types of mood disorder. BD participants showed high activity pattern in the morning and low activity pattern in evenings. However, MDD showed the opposite. Our results suggest that activity tracking focused on daytime activity patterns may provide objective auxiliary diagnostic information.

Disseminated Cryptococcosis with Marked Eosinophilia in a Postpartum Woman.

Disseminated cryptococcosis usually develops in immunosuppressed patients. A 33-year-old postpartum woman developed disseminated cryptococcosis with marked eosinophilia. She presented with a cough and a week-long fever. A computed tomography scan showed multiple pulmonary nodules randomly distributed. Eosinophils were observed to have increased in number in both her peripheral blood and bronchoalveolar lavage fluid. A transbronchial lung biopsy and cerebrospinal fluid specimens revealed findings consistent with cryptococcal infection. Disseminated cryptococcosis can present with marked eosinophilia of the peripheral blood and lung tissues. Additionally, the postpartum immune status may sometimes be involved in the development of opportunistic infections in previously healthy women.

Effects of salmeterol in patients with persistent asthma receiving inhaled corticosteroid plus theophylline.

BACKGROUND: Patients with severe asthma require multiple therapies to improve lung function and reduce symptoms. The use of long-acting inhaled beta(2)-agonists plus theophylline in addition to high doses of inhaled corticosteroids (ICSs) for the treatment of severe asthma has not been extensively studied. OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of salmeterol combined with high-dose ICSs plus theophylline in severe asthma. METHODS: We undertook a randomized, placebo-controlled, crossover study to compare the effect of a single dose of inhaled salmeterol (50 microg) or a placebo in patients with severe asthma whose conditions were not being adequately controlled by therapies with high-dose ICSs plus oral theophylline with or without leukotriene receptor antagonists. RESULTS: Twenty patients took part in the trial. Compared with the placebo, the inhalation of salmeterol significantly increased the FEV(1). Even in the 9 patients treated with high-dose ICSs plus theophylline plus a leukotriene receptor antagonist, the FEV(1) increased significantly more after salmeterol than after the placebo. CONCLUSION: Patients with severe asthma receiving high-dose ICSs plus theophylline may benefit from the addition of salmeterol.

Influence of royal jelly on mouse hepatic gene expression and safety assessment with a DNA microarray.

We used a DNA microarray to compare the gene expression profiles in liver among three groups of mice fed a diet containing 5% royal jelly (RJ), a diet containing 5% RJ stored at 40 degrees C for 7 d (40-7d RJ) or a control diet which provides the same total energy as RJ. Expression of 267 genes was increased or decreased by 1.8-fold or more in animals given the RJ diet for 14 d as compared with control diet, though serum total cholesterol, triglyceride, phospholipid, glucose, insulin and leptin levels were unaffected. Many genes involved in cell growth, signal transduction, energy metabolism and transcription regulation were responsive to the RJ diet. Among the 267 genes whose expression was altered by RJ, 60% showed no change or a reduced change in response to 40-7d RJ diet. The 40-7d RJ diet contained little 57-kDa protein, identified as a possible freshness marker of RJ. Furthermore, the RJ diet did not influence the gene expression of cytochrome P450 enzymes and detoxifying enzymes, whereas the 40-7d RJ diet increased the gene expression of glutathione S-transferase and glutathione peroxidase. Indeed, the RJ diet decreased the gene expression of cytochrome P450 4A14 (CYP4A14), which catalyzes peroxidation of endogenous lipids that is associated with nonalcoholic steatohepatitis and alcoholic liver disease, while the 40-7d RJ diet was not effective to decrease the gene expression of CYP4A14. The results indicate that the efficacy of RJ decreased and the toxicity of RJ increased during storage at high temperature. We suggest that application of DNA microarray technology to the biochemical evaluation of food safety may be effective for rapid and precise quality control.