Lifestyle and fertility-specific quality of life affect reproductive outcomes in couples undergoing in vitro fertilization.

Objective: A Mediterranean dietary pattern, sleeping habits, physical activity, and lifestyle appear to affect reproductive health. There are few reports about whether fertility-specific quality of life (QOL) is linked to infertility treatment outcomes. The aim of this study is to investigate when lifestyle factors and fertility-specific QOL are comprehensively considered, which factors influence assisted reproductive technology (ART) outcomes. Methods: This prospective cohort includes 291 women undergoing a first ART treatment at multiple centers in Japan and was designed to evaluate the influence of diet, physical activity, sleeping pattern, computer use duration, and fertility-specific quality of life tool (FertiQoL) score on ART treatment outcomes using a questionnaire. The primary endpoint was the good-quality blastocyst rate per oocyte retrieval and the secondary endpoints were a positive pregnancy test and gestational sac (GS) detection. Results: The good-quality blastocyst rate per oocyte retrieval tended to be negatively associated with frequent fish consumption. After all embryo transfer (ET) cycles, a positive pregnancy test tended to be positively associated with longer sleep and longer computer use (OR = 1.6, 95% CI = 0.9-2.7 and OR = 1.7, CI = 1.0-2.8, respectively) and negatively associated with a smoking partner (OR = 0.6, CI = 0.3-1.0). GS detection was positively and significantly associated with frequent olive oil intake and longer computer use (OR = 1.7, CI = 1.0-3.0 and OR = 1.7, CI = 1.0-3.0, respectively). After ET cycles with a single blastocyst, a positive pregnancy test was positively and significantly associated with longer computer use (OR = 2.0, CI = 1.1-3.7), while GS detection was significantly more likely in women with longer computer use (OR = 2.1, CI = 1.1-3.8) and tended to be more likely in women with a higher FertiQoL Total scaled treatment score (OR = 1.8, CI = 1.0-3.3). p < 0.05 was considered statistically significant and 0.05 ≤ p <0.01 as tendency. Conclusions: Olive oil may be an important factor in dietary habits. Fertility-specific QOL and smoking cessation guidance for partners are important for infertile couples.

Fulminant necrotizing eosinophilic myocarditis after COVID-19 vaccination survived with mechanical circulatory support.

A 69-year-old man was hospitalized for heart failure 7 days after coronavirus disease 2019 (COVID-19) mRNA vaccination. Electrocardiography showed ST-segment elevation and echocardiography demonstrated severe left ventricular dysfunction. Venoarterial extracorporeal membrane oxygenation and Impella 5.0 were instituted because of cardiogenic shock and ventricular fibrillation. Endomyocardial biopsy demonstrated necrotizing eosinophilic myocarditis (NEM). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) PCR test was negative. He had no infection or history of new drug exposure. NEM was likely related to COVID-19 vaccination. He was administered 10 mg/kg of prednisolone following methylprednisolone pulse treatment (1000 mg/day for 3 days). Left ventricular function recovered and he was weaned from mechanical circulatory support (MCS). Follow-up endomyocardial biopsy showed no inflammatory cell infiltration. This is the first report of biopsy-proven NEM after COVID-19 vaccination survived with MCS and immunosuppression therapy. It is a rare condition but early, accurate diagnosis and early aggressive intervention can rescue patients.

Home-based cardiac rehabilitation using information and communication technology for heart failure patients with frailty.

AIMS: Cardiac rehabilitation (CR) is an evidence-based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This study investigated the efficacy and safety of a comprehensive home-based cardiac rehabilitation (HBCR) programme that combines patient education, exercise guidance, and nutritional guidance using information and communication technology (ICT). METHODS AND RESULTS: This study was a single-centre, open-label, randomized, controlled trial. Between April 2020 and November 2020, 30 outpatients with chronic HF (New York Heart Association II-III) and physical frailty were enrolled. The control group (n = 15) continued with standard care, while the HBCR group (n = 15) also received comprehensive, individualized CR, including ICT-based exercise and nutrition guidance using ICT via a Fitbit® device for 3 months. The CR team communicated with each patient in HBCR group once a week via the application messaging tool and planned the training frequency and intensity of training individually for the next week according to each patient's symptoms and recorded pulse data during exercise. Dietitians conducted a nutritional assessment and then provided individual nutritional advice using the picture-posting function of the application. The primary outcome was the change in the 6 min walking distance (6MWD). The participants' mean age was 63.7 ± 10.1 years, 53% were male, and 87% had non-ischaemic heart disease. The observed change in the 6MWD was significantly greater in the HBCR group (52.1 ± 43.9 m vs. -4.3 ± 38.8 m; P < 0.001) at a 73% of adherence rate. There was no significant change in adverse events in either group. CONCLUSIONS: Our comprehensive HBCR programme using ICT for HF patients with physical frailty improved exercise tolerance and improved lower extremity muscle strength in our sample, suggesting management with individualized ICT-based programmes as a safe and effective approach. Considering the increasing number of HF patients with frailty worldwide, our approach provides an efficient method to keep patients engaged in physical activity in their daily life.

Duration of fever and other symptoms after the inhalation of laninamivir octanoate hydrate in the 2016/17 Japanese influenza season; comparison with the 2011/12 to 2015/16 seasons.

The duration of fever and symptoms after laninamivir octanoate hydrate (laninamivir) inhalation were investigated in the Japanese 2016/17 influenza season and the results were compared with those of the 2011/12 to 2015/16 seasons. A total of 1278 patients were evaluated for the duration of fever and symptoms in the six studied seasons. In the 2016/17 season, the influenza types/subtypes of the patients were 6 A (H1N1)pdm09 (2.9%), 183 A (H3N2) (87.6%), and 20 B (9.6%). The respective median durations of fever for A (H1N1)pdm09, A (H3N2), and B were 38.0, 33.0, and 38.5 h, without significant difference (p = 0.9201), and the median durations of symptoms were 86.5, 73.0, and 99.0 h, with significant difference (p = 0.0342). The median durations of fever and symptoms after laninamivir inhalation were quite consistent for the six studied seasons for A (H1N1)pdm09, A (H3N2), and B, without any significant differences. The percentage of patients with unresolved fever patients displayed a similar pattern through the six studied seasons for all these virus types. There was no significant difference in the duration of fever or symptoms between the Victoria and Yamagata lineages in the 2016/17 season and those of the previous studied seasons. Over the seasons tested, ten adverse drug reactions (ADRs) were reported from 1341 patients. The most frequent ADR was diarrhea and all ADRs were self-resolving and not serious. These results indicate the continuing clinical effectiveness of laninamivir against influenza A (H1N1)pdm09, A (H3N2), and B, with no safety issues.

In vitro neuraminidase inhibitory concentration (IC50) of four neuraminidase inhibitors in the Japanese 2016-17 season: Comparison with the 2010-11 to 2015-16 seasons.

To assess the extent of susceptibility to the four most commonly used neuraminidase inhibitors (NAIs) in the viruses epidemic in the 2016-17 Japanese influenza season, we measured the 50% inhibitory concentration (IC50) of these NAIs for influenza virus isolates from patients and compared them with the results from the 2010-11 to 2015-16 seasons. Viral isolation was done with specimens obtained prior to treatment, and the type and subtype was determined by RT-PCR using type- and subtype-specific primers. The IC50 was determined by a neuraminidase inhibition assay using a fluorescent substrate. A total of 276 virus isolates, 6 A (H1N1)pdm09 (2.2%), 249 A (H3N2) (90.2%), and 21 B (7.6%), had the IC50 measured for the four NAIs. B isolates included 11 (52.4%), 9 (42.9%), and one (4.8%) of the Victoria, Yamagata, and undetermined strains, respectively. No A (H1N1)pdm09 with highly reduced sensitivity for oseltamivir was found in the 2016-17 season. No isolate with highly reduced sensitivity to the four NAIs have been found for A (H3N2) or B from the 2010-11 to 2016-17 seasons. No significant trend of increase or decrease was found in the geometric mean IC50s of the four NAIs during the seven studied seasons. These results indicate that the sensitivity to the four commonly used NAIs has been maintained and that any change in the effectiveness of these NAIs would be minute. Common usage of NAIs for patient treatment has not been a driving force in the selection of NAI resistant viruses.

Prognostic significance of on-treatment home and clinic blood pressure for predicting cardiovascular events in hypertensive patients in the HONEST study.

OBJECTIVE: We investigated the prognostic significance of morning home SBP (MHSBP) and clinic SBP (CSBP) at baseline and during follow-up in on-treatment hypertensive patients. METHODS: In the Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure study, more than 20 000 Japanese hypertensive patients who started treatment with olmesartan were followed for cardiovascular events for 2 years. MHSBP and CSBP measured at baseline and during follow-up were compared in terms of the prognostic significance in predicting cardiovascular events. RESULTS: The analysis included 21 591 patients (50.6% female; average age 64.9 years; mean follow-up 2.02 years; and 280 cardiovascular events). The mean MHSBP and CSBP were 151.2 and 153.6 mmHg at baseline and 135.2 and 135.2 mmHg during follow-up. Hazard ratios per 1 mmHg increase were 1.011 (95% confidence interval 1.004-1.019) and 1.006 (1.000-1.012) at baseline, and 1.039 (1.029-1.049) and 1.026 (1.016-1.036) during follow-up. When MHSBP and CSBP at baseline and during follow-up were included in the same model, only MHSBP during follow-up was identified as a significant predictive factor. The concordance index of all blood pressure variables showed reasonable discrimination abilities, and that of mean during follow-up were higher than that of SBP at baseline. The results of net reclassification improvement analyses showed that follow-up MHSBP had better reclassification ability than follow-up CSBP. CONCLUSION: SBP during follow-up (as compared with SBP at baseline), particularly MHSBP (as compared with CSBP), had better prognostic significance in predicting cardiovascular events in Japanese hypertensive patients during a 2-year clinical study.

Differences between clinic blood pressure and morning home blood pressure, as shown by Bland-Altman plots, in a large observational study (HONEST study).

When interpreting home blood pressure (BP) measurements in hypertensive patients, differences between clinic and home BP should be noted. To investigate the differences between clinic and morning home BP in hypertensive patients, we analyzed clinic systolic BP (CSBP) and morning home systolic BP (MHSBP) data from the large-scale observational HONEST (Home BP measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study (n=21 340), using BP measurements obtained before starting olmesartan administration. We generated Bland-Altman plots, with the horizontal axis representing mean CSBP and MHSBP ([CSBP+MHSBP]/2) and the vertical axis representing the difference between CSBP and MHSBP (CSBP-MHSBP). We also did simulation experiments to explore factors affecting the results of the Bland-Altman plots. The difference between CSBP and MHSBP increased as the mean of the two values increased, and when the mean of CSBP and MHSBP was close to 140 mm Hg, the difference was theoretically 0 in average, although large interindividual BP variability existed in this BP range. Results were unaffected by factors such as previous antihypertensive treatment, age and concomitant diabetes or chronic kidney disease. Bland-Altman plots generated from simulated data of normal distribution showed that the slope of the regression line sloped upward, consistent with the results of the HONEST study, when the interindividual BP variability of MHSBP was less than that of CSBP. In conclusion, differences between mean CSBP and MHSBP may be caused by large interindividual variability in CSBP. Therefore, the differences between MHSBP and CSBP may vary between patient groups, which should be noted in the management of hypertension.

Teaching others rule-use improves executive function and prefrontal activations in young children.

Intervention of executive function during early childhood is an important research topic. This study examined the effect of a child-friendly intervention program, where children interacted with a doll or a puppet. Children were presented with cognitive shifting tasks before and after an intervention. In the intervention, children interacted with a doll or a puppet, and taught rules of the cognitive shifting tasks to the object. As the results, 3- to 5-year-old children significantly improved the performances and strengthened activations in the lateral prefrontal regions as measured by near-infrared spectroscopy. The results suggest that interaction with a doll or a puppet may have a significant impact on the development of executive function.

A revised method for determination of serum mercaptalbumin and non-mercaptalbumin by high-performance liquid chromatography coupled with postcolumn bromocresol green reaction.

BACKGROUND: Previously, high-performance liquid chromatography (HPLC) equipped with ultraviolet or fluorescence detectors has been used for separation of human mercaptalbumin (HMA) and human non-mercaptalbumin (HNA). However, it is difficult to perform reliable chromatographic analysis due to peak interference of such serum compounds as uric acid and bilirubin. The aim of this study is to explore a selective and simple analytical method for the determination of HMA and HNA. METHOD: HMA and HNA in serum sample were separated by HPLC and reacted with bromocresol green using a postcolumn reaction scheme. RESULTS: A complete separation of HMA and HNA is achieved in less than 30 min by using weak anion exchange columns and isocratic elution. Within-run and between-day precisions at albumin concentration of 45 g/L were 4.2 and 1.7% for HMA and 4.5 and 4.6% for HNA, respectively. There was no interference in HMA and HNA peaks when bilirubin-, haemoglobin- or chyle-spiked pooled serum samples were analysed. CONCLUSION: Our method is reliable and not labour-intensive and, therefore, might be applicable for clinical and epidemiological studies.

Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study.

UNLABELLED: This study aimed to investigate the relationship between on-treatment morning home blood pressure (HBP) and incidence of cardiovascular events using data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure (HONEST) study, a prospective observational study of 21 591 outpatients with essential hypertension (mean age, 64.9 years; women, 50.6%) enrolled between 2009 and 2010 at clinics and hospitals in Japan. They received olmesartan-based treatment throughout. The primary end point was major cardiovascular events. After a mean follow-up period of 2.02 years, cardiovascular events occurred in 280 patients (incidence, 6.46/1000 patient-years). The risk for the primary end point was significantly higher in patients with on-treatment morning HBP ≥145 to <155 mm Hg (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.12-2.99) and ≥155 mm Hg (HR, 5.03; 95% CI, 3.05-8.31) than <125 mm Hg and with on-treatment clinic blood pressure ≥150 to <160 mm Hg (HR, 1.69; 95% CI, 1.10-2.60) and ≥160 mm Hg (HR, 4.38; 95% CI, 2.84-6.75) than <130 mm Hg. Morning HBP associated with minimum risk was 124 mm Hg by spline regression analysis. Cardiovascular risk was increased in patients with morning HBP ≥145 mm Hg and clinic blood pressure <130 mm Hg (HR, 2.47; 95% CI, 1.20-5.08) compared with morning HBP <125 mm Hg and clinic blood pressure <130 mm Hg. In conclusion, it is essential to control morning HBP to <145 mm Hg, even in patients with controlled clinic blood pressure. CLINICAL TRIAL REGISTRATION URL: http://www.umin.ac.jp/ctr/index.htm. UMIN Clinical Trials Registry, trial No. UMIN000002567.

Effects of olmesartan-based treatment on masked, white-coat, poorly controlled, and well-controlled hypertension: HONEST study.

The authors examined the effects of olmesartan-based treatment on clinic systolic blood pressure (CSBP) and morning home systolic blood pressure (HSBP) in 21,340 patients with masked hypertension (MH), white-coat hypertension (WCH), poorly controlled hypertension (PCH), and well-controlled hypertension (CH) using data from the Home Blood Pressure Measurement With Olmesartan Naive Patients to Establish Standard Target Blood Pressure (HONEST) study. MH, WCH, PCH, and CH were defined using CSBP 140 mm Hg and MHSBP 135 mm Hg as cutoff values at baseline. At 16 weeks, the MH, WCH, PCH, and CH groups had changes in CSBP by -1.0, -15.2, -23.1, and 1.8 mm Hg, and changes in morning HSBP by -12.5, 1.0, -20.3, and 2.0 mm Hg, respectively. In conclusion, in "real-world" clinical practice, olmesartan-based treatment decreased high morning HBP or CBP without excessive decreases in normal morning HBP or CBP according to patients' BP status.

Application of statistical analysis to mixed soil detergency.

In previous studies, statistical method using distribution of detergent power and that of resistance of soil against washing was applied to analyze detergency of oily soil and solid particle soil. In this paper, this method was applied to an analysis of detergency of mixed soil. Artificially soiled cloth prepared by aqueous dispersion method was used as a mixed soil sample. Four-time consecutive washing tests were conducted under the same washing condition in Terg-O-Tometer using two kinds of detergent solution and distilled water. Change of removal efficiencies due to repetitive washing was used to determine the two distributions. Result shows that detergent power can be expressed as cumulative distribution function. In washing simulation using the cumulative distribution functions, the predicted removal efficiencies corresponded with experimental values. Moreover, the effect of soil aging on distribution of soil resistance against washing was found to move the distribution curve toward high resistance. These results show that the method using two statistical distributions can be applied to the detergency of mixed soil.

Large decrease in acute aquatic toxicity of linear alkylbenzene sulfonate in hard water and seawater by adding adsorbent.

LAS (Linear Alkylbenzene Sulphonate) shows relatively high aquatic toxicity in hard freshwater or seawater. In this paper, we studied the effect of adsorbent on the aquatic toxicity of LAS in hard freshwater and seawater. Daphnia magna and Artemia salina were used for acute aquatic toxicity test in freshwater and seawater, respectively. Kaolin was used as a model adsorbent and toxic surface tension (gamma(tox)) was used as an indicator of toxic condition. Results showed that the values of gamma(tox) of LAS to D. magna and A. salina were about 45-55 mN/m and 35-40 mN/m, respectively. Surface tension of LAS solution decreased and its aquatic toxicity increased with increasing the water hardness or the salinity. By adding adsorbent into the solutions, the surface activity and the aquatic toxicity were decreased greatly, and the effect of water hardness or salinity on surface tension and aquatic toxicity were removed. That is to say, the surface tension curve of soft freshwater corresponds with that of hard freshwater containing adsorbent and the surface tension curve at low salinity corresponds with that obtained for high salinity solutions containing the adsorbent. Therefore, our experimental data leads to the conclusion that the relatively high aquatic toxicity of LAS in concentrated solution of inorganic salts disappears in the presence of adsorbents. This is an important viewpoint in conducting environmental risk assessment of surfactants.

Statistical analysis of washing efficiency for solid particle soil.

In a previous study, statistical method using two distributions was applied to analyze detergency of oily soil. The method uses statistical distributions of detergent power and adhesive force of soil. In this paper, this method was applied to an analysis of detergency of solid particles. Soiled cotton cloth was prepared with red iron oxide dispersion liquid in Terg-O-Tometer. Four-time consecutive washings tests were conducted with dodecyl sulfuric acid sodium salt (SDS) and alcohol ethoxylate (AE) aqueous solutions in Terg-O-Tometer. Change of removal efficiencies due to repetitive washing was utilized to seek the two distributions. Predicted removal efficiencies calculated from computer simulation corresponded to experimental values. Different adhered states of soil, prepared by varying soiling conditions, were expressed as Removal Resistance. As soiling mechanical power increased, Removal Resistance shifted toward higher adhesive force of soil and an amount of soil had also increased. Iron oxide concentration only had an affect on an amount of soil. The results showed that the method using two statistical distributions can be applied to the detergency of solid particle.

Effects of water hardness and existence of adsorbent on toxic surface tension of surfactants for aquatic species.

We have studied the effectiveness of surface tension on surfactants risk assessment. gamma(tox) was defined as surface tension at a point where acute aquatic toxicity of a surfactant emerges. Oryzias latipes, Daphnia magna, and Podocopida were used for acute aquatic toxicity test of 7 surfactants and 3 detergents. Gamma(tox)values were plotted on surface tension curves, and the effect of water hardness on toxicity and surface tension were examined. Results showed that gamma(tox) varies greatly by kind of surfactant or detergent. Therefore, aquatic toxicity cannot only be explained by surface tension. The change of aquatic toxicity with varying water hardness, however, could be explained by the change of surface tension. Aquatic toxicity of LAS (Linear Alkylbenzene Sulphonate) increased and aquatic toxicity of SOAP decreased with an increase of water hardness, but both gamma(tox), values were constant. Aquatic toxicity was decreased by an addition of mud soil as adsorbent into surfactant solution. The toxicity change can be explained by the surface tension since gamma(tox) value of solution with and without mud soil were equal. These results showed that the change of aquatic toxicity of a surfactant caused by water property, such as water hardness, could be explained by the change of surface tension.