A 60-year-old man developed acute myocardial infarction from the total occlusion of the right coronary artery via metastatic squamous lung cancer and was treated with percutaneous coronary ...intervention (PCI). Computed tomography and transthoracic echocardiography (TTE) revealed a metastatic tumor, and three-dimensional TTE was useful for determining the size and location of the tumor in relation to the coronary artery. Six months after PCI, the patient died, and an autopsy confirmed extensive metastasis to the heart and nearby vessels as detected by three-dimensional TTE. Although rare, lung cancer metastasis to the heart may directly occlude the coronary artery.
Background:Nocturnal blood pressure (BP) is an independent risk factor of cardiovascular events. The NOCTURNE study, a multicenter, randomized controlled trial (RCT) using our recently developed ...information and communication technology (ICT) nocturnal home BP monitoring (HBPM) device, was performed to compare the nocturnal HBP-lowering effects of differential ARB-based combination therapies in 411 Japanese patients with nocturnal hypertension (HT).Methods and Results:Patients with nocturnal BP ≥120/70 mmHg at baseline even under ARB therapy (100 mg irbesartan daily) were enrolled. The ARB/CCB combination therapy (irbesartan 100 mg+amlodipine 5 mg) achieved a significantly greater reduction in nocturnal home systolic BP (primary endpoint) than the ARB/diuretic combination (daily irbesartan 100 mg+trichlormethiazide 1 mg) (−14.4 vs. −10.5 mmHg, P<0.0001), independently of urinary sodium excretion and/or nocturnal BP dipping status. However, the change in nocturnal home systolic BP was comparable among the post-hoc subgroups with higher salt sensitivity (diabetes, chronic kidney disease, and elderly patients).Conclusions:This is the first RCT demonstrating the feasibility of clinical assessment of nocturnal BP by ICT-nocturnal HBPM. The ARB/CCB combination was shown to be superior to ARB/diuretic in patients with uncontrolled nocturnal HT independently of sodium intake, despite the similar impact of the 2 combinations in patients with higher salt sensitivity.
•Severe rotavirus gastroenteritis (RVGE) in children leads to hospitalization.•Local-subsidized vaccination reduced RVGE hospitalization in children <5 years.•This reduction was sustained over the ...3 years of vaccination implementation.•RVGE-related outpatient visits also decreased by 83% in children <1 year.•Herd protection was observed in the non-vaccinated birth cohort.
In Nagoya city, Japan, rotavirus (RV) vaccination has been available since 2011 with estimated coverage reaching 92% by 2015 after the introduction of a public subsidy in 2012. This study assessed the impact of vaccination on the RV gastroenteritis (RVGE) burden in children aged <5 years old (y) by comparing RVGE hospitalizations and outpatient visits during pre-vaccination (2007–2011), transition (2011–2012) and subsidization (2012–2016) periods.
All hospitalizations and outpatient visits in children aged <5 y from 2 administrative districts of Nagoya city were identified from the hospital-based electronic databases of 4 hospitals. RVGE cases were identified by diagnostic code and/or positive results of diagnostic kits.
Compared to the pre-vaccination period, there was a decrease in RVGE hospitalizations for children <5 y from 5.59 per 1000 person-year (kPY) to 3.65/kPY in the subsidization period (i.e. 34.69%). In children <1 y, the incidence of RVGE hospitalizations decreased continuously from 6.62/kPY in the pre-vaccination period to 1.84/kPY in the subsidization period (i.e. 72.19%). The highest decrease was observed in the subsidization season i.e. when high coverage was reached: 69% and 75.57% in the 2013/2014 season for 2–3 y and 3–4 y, and 74.03% in the 2014/2015 season for 4–5 y, respectively. Proportion of RVGE outpatient visits decreased by 87.44% for children <1 y and 57.05% for <5 y from the pre-vaccination to the subsidization period. This decrease started the first year of subsidization for children <1 y, 1–2 y and 2–3 y (78.89%, 18.86% and 5.80%) and the second year (2013/2014 season) for children 3–4 y and 4–5 y (87.73% and 51.78%).
Although yearly fluctuations have been observed, the introduction of vaccination significantly decreased pediatric RVGE hospitalizations and outpatient visits, especially in the age group eligible for vaccination. During the second and third year of subsidization, we observed a herd protection effect on other age groups <5 y who were not eligible for vaccination.
Clinicaltrial.gov.registered#:NCT01733862.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
This study compares the factors that are inferred to directly and indirectly influence the process of determining employees' turnover intention in Japan. This study focuses on the differences made by ...firm type, that is, Japanese firms vs. foreign-owned or foreign-affiliated firms. Multiple-group structural equation modeling was attempted by applying factors such as perceived organizational support, the positiveness of a worker, firm-specific skills, organizational commitment, perception of career opportunities within the current firm and in other firms, and turnover intention. It was found that the inferred determinants of turnover intention differed by firm type; specifically, career prospects, either internal or external, do not directly affect turnover intention in Japanese firms. For workers in foreign firms, positivity is significantly higher than that of Japanese firms. Positivity plays a crucial role in both firms; moreover, our study provides supporting evidence of the existence of sub-markets in Japan and shows that the transition of workers from foreign-owned to Japanese firms might be rare.
Backgrounds
Intramuscular injection of the SARS-CoV-2 vaccine has raised concerns about its use in patients with neuromuscular disorders (NMDs). We evaluated the response of patients with NMDs to the ...BNT162b2 vaccine.
Methods
Healthy subjects, patients with spinal muscular atrophy (SMA), and patients with Duchenne muscular dystrophy (DMD) were included. All participants received two BNT162b2 doses. SARS-CoV-2 antibody titers at baseline and 2 weeks after each vaccination were compared between groups. Residual muscle volume was evaluated in NMDs group. A questionnaire documented adverse reactions.
Results
Eleven patients with NMDs (9 with SMA, 2 with DMD; 7 males; aged 32.7 ± 19.3 years) and 346 healthy subjects (60 males, aged 40.0 ± 12.4 years) were included. Antibody titers (U/mL) were similar between groups (baseline: <0.40 vs. <0.40, first vaccination, 145 ± 258 vs. 103 ± 1192, and second vaccination, 1528 ± 1265 vs. 1429 ± 944; p = 1.000, 0.909, and 0.736, respectively). A negative correlation was found between antibody titers and residual muscle volume but was not significant (Mercuri scale, r = −0.429, p = 0.249; fat infiltration rate, r = −0.194, p = 0.618). The adverse reactions were comparable between groups.
Conclusion
The BNT162b2 vaccine is safe and effective in patients with NMDs.
In this study, we report on a basic study using oil film forming lubricant additives. With the aim of developing drivetrain lubricants having high efficiency for electric vehicles, we confirmed the ...effects of our newly developed additive and validated the working mechanism. The additive showed the effect of reducing friction in the mixed lubrication and improved efficiency of the reduction gear box and durability of parts. Furthermore, we confirmed that the friction reduction in the mixed lubrication is due to the prevention of metal contact between parts accompanying the improvement of the oil film thickness.
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