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Hashimoto N, Hanada H, Miyoshi H, Nagaishi M, Sato K, Hontani H, Ohshima K, Takeuchi I. Multimodal Gated Mixture of Experts Using Whole Slide Image and Flow Cytometry for Multiple Instance Learning Classification of Lymphoma. J Pathol Inform 2024; 15:100359. [PMID: 38322152 PMCID: PMC10844119 DOI: 10.1016/j.jpi.2023.100359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/07/2023] [Accepted: 12/23/2023] [Indexed: 02/08/2024] Open
Abstract
In this study, we present a deep-learning-based multimodal classification method for lymphoma diagnosis in digital pathology, which utilizes a whole slide image (WSI) as the primary image data and flow cytometry (FCM) data as auxiliary information. In pathological diagnosis of malignant lymphoma, FCM serves as valuable auxiliary information during the diagnosis process, offering useful insights into predicting the major class (superclass) of subtypes. By incorporating both images and FCM data into the classification process, we can develop a method that mimics the diagnostic process of pathologists, enhancing the explainability. In order to incorporate the hierarchical structure between superclasses and their subclasses, the proposed method utilizes a network structure that effectively combines the mixture of experts (MoE) and multiple instance learning (MIL) techniques, where MIL is widely recognized for its effectiveness in handling WSIs in digital pathology. The MoE network in the proposed method consists of a gating network for superclass classification and multiple expert networks for (sub)class classification, specialized for each superclass. To evaluate the effectiveness of our method, we conducted experiments involving a six-class classification task using 600 lymphoma cases. The proposed method achieved a classification accuracy of 72.3%, surpassing the 69.5% obtained through the straightforward combination of FCM and images, as well as the 70.2% achieved by the method using only images. Moreover, the combination of multiple weights in the MoE and MIL allows for the visualization of specific cellular and tumor regions, resulting in a highly explanatory model that cannot be attained with conventional methods. It is anticipated that by targeting a larger number of classes and increasing the number of expert networks, the proposed method could be effectively applied to the real problem of lymphoma diagnosis.
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Affiliation(s)
- Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
| | - Hiroyuki Hanada
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Miharu Nagaishi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, 4668555, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 8300011, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
- Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 4648603, Japan
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Takeuchi I, Funayama R, Shoji H, Nambu R, Jimbo K, Hara T, Shimizu H, Nomura I, Iwama I, Kudo T, Shimizu T, Arai K. Evaluation of deficient nutrients in infants and toddlers mainly taking amino acid-based elemental formulas: An exploratory study. Ann Nutr Metab 2024:000539146. [PMID: 38754393 DOI: 10.1159/000539146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION This study evaluated nutrient deficiencies in infants and toddlers with inflammatory bowel disease (IBD) and eosinophilic gastrointestinal disorders (EGID), whose primary nutritional source is elemental formulas (EFs). METHODS The nutrient status of children with IBD and EGID aged 6 months to 6 years was evaluated. RESULTS Twenty-one children fed with EFs (EF group) and 25 controls (CL group) were enrolled. The selenium level in the EF group was lower than that in the CL group (2.2 µg/dL vs. 9.3 µg/dL; p<0.01). Although fat-soluble vitamins were deficient in some EF group participants, no significant differences were observed in their concentration and insufficiency proportion. However, ascorbic acid deficiency was more frequent in the EF group, with significantly lower levels (8.6 µg/mL vs. 12.0 µg/mL; p<0.01). The triene:tetraene ratio was significantly higher in the EF group (0.046 vs. 0.010; p<0.01). Asparagine and taurine levels were significantly lower in the EF group (asparagine: p<0.01; taurine: p<0.01) and tyrosine and phenylalanine levels were higher in the EF group, resulting in a lower Fisher's ratio (p<0.01). CONCLUSION Long-term feeding with EFs can cause deficiencies in essential fatty acids, selenium, and ascorbic acid and also carries a risk of amino acid imbalance in infants and toddlers.
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Fujimori K, Ikenobe N, Gocho Y, Uchiyama T, Deguchi T, Sakaguchi H, Tomizawa D, Takeuchi I, Shimizu H, Arai K, Ishiguro A, Matsumoto K, Iguchi A. Hematopoietic stem cell transplantation in two sisters with bone marrow failure associated with POLE gene variants. Pediatr Blood Cancer 2024; 71:e30919. [PMID: 38407463 DOI: 10.1002/pbc.30919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/04/2024] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Kentaro Fujimori
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Norihito Ikenobe
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshihiro Gocho
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Toru Uchiyama
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takao Deguchi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotoshi Sakaguchi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Takeuchi
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Ishiguro
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Iguchi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Kawasaki T, Nakamura T, Ohtake M, Akimoto T, Manaka H, Hamada K, Sakata K, Iwashita M, Takeuchi I, Yamamoto T. Clinical characteristics of aneurysmal subarachnoid haemorrhage complicated by Takotsubo cardiomyopathy resulting in good neurological outcome. Br J Neurosurg 2024:1-8. [PMID: 38571386 DOI: 10.1080/02688697.2024.2334432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Takotsubo cardiomyopathy (TC) is a well-known complication of subarachnoid haemorrhage (SAH), often accompanied by neurogenic myocardial dysfunction. Although TC has been reported to be associated with higher morbidity and mortality among patients with aneurysmal SAH (aSAH), some patients have been reported to recover, the profiles and follow-up outcomes of these survivors remain unclear. MATERIALS AND METHODS To characterize the profiles of patients with aSAH complicated by TC who experienced favourable outcomes using long-term follow-up data, a consecutive series of patients with aSAH were enrolled and TC diagnosis was based on the revised version of the Mayo Clinic criteria. Clinical outcomes were assessed at 6 months according to modified Rankin Scale scores. RESULTS Among 165 consecutive patients with aSAH, 15 cases were complicated by TC, corresponding to an occurrence rate of 9.0%. Five patients with aSAH complicated by TC (33.3%) experienced a favourable outcome, and the mean value of systolic blood pressure on arrival was significantly lower than in those who experienced an unfavourable outcome (p = 0.032). CONCLUSION According to analysis, it is possible cardiac dysfunction with decreased cerebral perfusion pressure and catecholamine toxicity transiently worsens conscious disturbance in aSAH complicated by TC. Therefore, it is important to carefully screen patients with aSAH to identify those complicated by TC, and for close collaboration of the multidisciplinary team to design appropriate treatment strategies.
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Affiliation(s)
- Takafumi Kawasaki
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Taishi Nakamura
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Ohtake
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Taisuke Akimoto
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroshi Manaka
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Koichi Hamada
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsumi Sakata
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Masayuki Iwashita
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Ishibashi H, Nishimura S, Tanaka K, Haruta S, Takayama K, Yamashiro H, Takeuchi I. Transcriptome analysis reveals limited toxic effects of the UV-filter benzophenone-3 (BP-3) on the hermatypic coral Acropora tenuis and its symbiotic dinoflagellates. Mar Pollut Bull 2024; 201:116260. [PMID: 38522341 DOI: 10.1016/j.marpolbul.2024.116260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/22/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024]
Abstract
This study aimed to investigate the toxic and transcriptomic effects of the ultraviolet filter benzophenone-3 (BP-3) on Acropora tenuis and its symbiotic dinoflagellates while using acetone as a solvent. Seven-day exposure to 50 and 500 μg/L, which is higher than most BP-3 records from coastal waters, did not affect coral colour or dinoflagellate photosynthesis. Differentially expressed genes (DEGs) between seawater and solvent controls were <20 in both corals and dinoflagellates. Eleven coral DEGs were detected after treatment with 50 μg/L BP-3. Fourteen coral DEGs, including several fluorescent protein genes, were detected after treatment with 500 μg/L BP-3. In contrast, no dinoflagellate DEGs were detected in the BP-3 treatment group. These results suggest that the effects of 50-500 μg/L BP-3 on adult A. tenuis and its dinoflagellates are limited. Our experimental methods with lower acetone toxicity provide a basis for establishing standard ecotoxicity tests for corals.
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Affiliation(s)
- Hiroshi Ishibashi
- Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan; Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Saori Nishimura
- Faculty of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Kokoro Tanaka
- Faculty of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Shinsuke Haruta
- Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan; Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Kotaro Takayama
- Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan; Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan
| | - Hideyuki Yamashiro
- Sesoko Station, Tropical Biosphere Research Center, University of the Ryukyus, 3422 Sesoko, Motobu, Okinawa, Japan
| | - Ichiro Takeuchi
- Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan; Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, 3-5-7 Tarumi, Matsuyama, Ehime 790-8566, Japan.
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Honzawa H, Taniguchi H, Abe T, Takeuchi I, Inoue A, Hifumi T, Sakamoto T, Kuroda Y. Prophylactic distal perfusion catheter and survival in patients with out-of-hospital cardiac arrest: Secondary analysis of the SAVE-J II study. Am J Emerg Med 2024; 78:69-75. [PMID: 38237215 DOI: 10.1016/j.ajem.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 12/14/2023] [Accepted: 01/08/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE The effect of a prophylactic distal perfusion catheter (DPC) after extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) remains unclear. Therefore, we aimed to clarify the association between prophylactic DPC and prognosis in patients with OHCA undergoing ECPR. MATERIALS AND METHODS A secondary analysis of the Study of Advanced Life Support for Ventricular Fibrillation with Extracorporeal Circulation in Japan (SAVE-J II) database was performed to compare groups of patients with and without prophylactic DPCs. A multivariate analysis of survival at discharge was performed using factors that were significant in the two-arm comparison. RESULTS A total of 2044 patients were included in the analysis after excluding those who met the exclusion criteria. Survival at discharge was observed in 548 (26.9%) patients. In total, 100 (4.9%) patients developed limb ischemia, among whom 14 (0.7%) required therapeutic intervention. Multivariate analysis showed that prophylactic DPC did not result in a significant difference in survival at discharge (odds ratio: 0.898 [0.652-1.236], p = 0.509). CONCLUSIONS The implementation of prophylactic DPC after ECPR for patients with OHCA may not contribute to survival at discharge.
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Affiliation(s)
- Hiroshi Honzawa
- Emergency Care Department, Yokohama City University Hospital, Yokohama, Japan.
| | - Hayato Taniguchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeru Abe
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Emergency Care Department, Yokohama City University Hospital, Yokohama, Japan; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Akihiko Inoue
- Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Japan
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Tetsuya Sakamoto
- Department of Emergency Medicine, Teikyo University school of Medicine, Tokyo, Japan
| | - Yasuhiro Kuroda
- Department of Emergency, Disaster and Critical Care Medicine, Kagawa University Hospital, Kagawa, Japan
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Yamaguchi K, Abe T, Matsumoto S, Nakajima K, Shimizu M, Takeuchi I. Laparoscopy for emergency abdominal surgery is associated with reduced physical functional decline in older patients: a cohort study. BMC Geriatr 2024; 24:250. [PMID: 38475701 DOI: 10.1186/s12877-024-04872-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND An increasing number of older patients require emergency abdominal surgery for acute abdomen. They are susceptible to surgical stress and lose their independence in performing daily activities. Laparoscopic surgery is associated with faster recovery, less postoperative pain, and shorter hospital stay. However, few studies have examined the relationship between laparoscopic surgery and physical functional decline. Thus, we aimed to examine the relationship between changes in physical function and the surgical procedure. METHODS In this was a single-center, retrospective cohort study, we enrolled patients who were aged ≥ 65 years and underwent emergency abdominal surgery for acute abdomen between January 1, 2019, and December 31, 2021. We assessed their activities of daily living using the Barthel Index. Functional decline was defined as a decrease of ≥ 20 points in Barthel Index at 28 days postoperatively, compared with the preoperative value. We evaluated an association between functional decline and surgical procedures among older patients, using multiple logistic regression analysis. RESULTS During the study period, 852 patients underwent emergency abdominal surgery. Among these, 280 patients were eligible for the analysis. Among them, 94 underwent laparoscopic surgery, while 186 underwent open surgery. Patients who underwent laparoscopic surgery showed a less functional decline at 28 days postoperatively (6 vs. 49, p < 0.001). After adjustments for other covariates, laparoscopic surgery was an independent preventive factor for postoperative functional decline (OR, 0.22; 95% CI, 0.05-0.83; p < 0.05). CONCLUSIONS In emergency abdominal surgery, laparoscopic surgery reduces postoperative physical functional decline in older patients. Widespread use of laparoscopic surgery can potentially preserve patient quality of life and may be important for the better development of emergency abdominal surgery.
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Affiliation(s)
- Keishi Yamaguchi
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minamiku, Yokohama, 232-0024, Japan.
- Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.
| | - Takeru Abe
- Center for Integrated Science and Humanities, Fukushima Medical University, Fukushima, Japan
| | - Shokei Matsumoto
- Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Kento Nakajima
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minamiku, Yokohama, 232-0024, Japan
| | - Masayuki Shimizu
- Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minamiku, Yokohama, 232-0024, Japan
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Nagaishi M, Miyoshi H, Kugler M, Sato K, Kohno K, Takeuchi M, Yamada K, Furuta T, Hashimoto N, Takeuchi I, Hontani H, Ohshima K. The Detection of Neoplastic Cells Using Objective Cytomorphologic Parameters in Malignant Lymphoma. J Transl Med 2024; 104:100302. [PMID: 38092181 DOI: 10.1016/j.labinv.2023.100302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 01/13/2024] Open
Abstract
Pathologic evaluation is the most crucial method for diagnosing malignant lymphomas. However, there are no established diagnostic criteria for evaluating pathologic morphology. We manually circled cell nuclei in the lesions of 10 patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and reactive lymphadenitis. Seventeen parameters related to nuclear shape, color, and other characteristics were measured. We attempted to compare the statistical differences between these subtypes and extract distinctive disease-specific populations on the basis of these parameters. Statistically significant differences were observed between the different types of lymphoma for many of the 17 parameters. Through t-distributed stochastic neighbor embedding analysis, we extracted a cluster of cells that showed distinctive features of DLBCL and were not found in follicular lymphoma or reactive lymphadenitis. We created a decision tree to identify the characteristics of the cells within that cluster. Based on a 5-fold cross-validation study, the average sensitivity, specificity, and accuracy obtained were 84.1%, 98.4%, and 97.3%, respectively. A similar result was achieved using a validation experiment. Important parameters that indicate the features of DLBCL include Area, ConcaveCount, MaxGray, and ModeGray. By quantifying pathologic morphology, it was possible to objectively represent the cell morphology specific to each lymphoma subtype using quantitative indicators. The quantified morphologic information has the potential to serve as a reproducible and flexible diagnostic tool.
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Affiliation(s)
- Miharu Nagaishi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan.
| | - Mauricio Kugler
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
| | | | - Ichiro Takeuchi
- Center for Advanced Intelligence Project, RIKEN, Tokyo, Japan; Department of Mechanical Systems Engineering, Nagoya University, Nagoya, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University, School of Medicine, Kurume, Japan
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Takeuchi I, Tanase-Nakao K, Ogawa A, Sugawara T, Migita O, Kashima M, Yamazaki T, Iguchi A, Naiki Y, Uchiyama T, Tamaoki J, Maeda H, Shimizu H, Kawai T, Taniguchi K, Hirata H, Kobayashi M, Matsumoto K, Naruse K, Hata K, Akutsu H, Kato T, Narumi S, Arai K, Ishiguro A. Congenital anaemia associated with loss-of-function variants in DNA polymerase epsilon 1. J Med Genet 2024; 61:239-243. [PMID: 37833059 DOI: 10.1136/jmg-2023-109444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
DNA polymerase epsilon (Pol ε), a component of the core replisome, is involved in DNA replication. Although genetic defects of Pol ε have been reported to cause immunodeficiency syndromes, its role in haematopoiesis remains unknown. Here, we identified compound heterozygous variants (p.[Asp1131fs];[Thr1891del]) in POLE, encoding Pol ε catalytic subunit A (POLE1), in siblings with a syndromic form of severe congenital transfusion-dependent anaemia. In contrast to Diamond-Blackfan anaemia, marked reticulocytopenia or marked erythroid hypoplasia was not found. Their bone marrow aspirates during infancy revealed erythroid dysplasia with strongly positive TP53 in immunostaining. Repetitive examinations demonstrated trilineage myelodysplasia within 2 years from birth. They had short stature and facial dysmorphism. HEK293 cell-based expression experiments and analyses of patient-derived induced pluripotent stem cells (iPSCs) disclosed a reduced mRNA level of Asp1131fs-POLE1 and defective nuclear translocation of Thr1891del-POLE1. Analysis of iPSCs showed compensatory mRNA upregulation of the other replisome components and increase of the TP53 protein, both suggesting dysfunction of the replisome. We created Pole-knockout medaka fish and found that heterozygous fishes were viable, but with decreased RBCs. Our observations expand the phenotypic spectrum of the Pol ε defect in humans, additionally providing unique evidence linking Pol ε to haematopoiesis.
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Affiliation(s)
- Ichiro Takeuchi
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Kanako Tanase-Nakao
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Ayame Ogawa
- Department of Biology, Faculty of Education and Integrated Arts and Sciences, Waseda University, Tokyo, Japan
- Integrative Bioscience and Biomedical Engineering, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Tohru Sugawara
- Center for Regenerative Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Osuke Migita
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Laboratory Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Makoto Kashima
- Department of Chemistry and Biological Science, Aoyama Gakuin University, Sagamihara, Kanagawa, Japan
| | - Touko Yamazaki
- Laboratory of Bioresources, National Institute for Basic Biology, Okazaki, Aichi, Japan
| | - Akihiro Iguchi
- Children Cancer's Center, Division of Hematology, National Center for Child Health and Development, Tokyo, Japan
| | - Yasuhiro Naiki
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Toru Uchiyama
- Department of Genome Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Junya Tamaoki
- Department of Molecular and Developmental Biology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroki Maeda
- Department of Molecular and Developmental Biology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hirotaka Shimizu
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Toshinao Kawai
- Division of Immunology, National Center for Child Health and Development, Tokyo, Japan
| | - Kosuke Taniguchi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiromi Hirata
- Department of Chemistry and Biological Science, Aoyama Gakuin University, Sagamihara, Kanagawa, Japan
| | - Makoto Kobayashi
- Department of Molecular and Developmental Biology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kimikazu Matsumoto
- Children Cancer's Center, Division of Hematology, National Center for Child Health and Development, Tokyo, Japan
| | - Kiyoshi Naruse
- Laboratory of Bioresources, National Institute for Basic Biology, Okazaki, Aichi, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hidenori Akutsu
- Center for Regenerative Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takashi Kato
- Department of Biology, Faculty of Education and Integrated Arts and Sciences, Waseda University, Tokyo, Japan
- Integrative Bioscience and Biomedical Engineering, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Satoshi Narumi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Ishiguro
- Children Cancer's Center, Division of Hematology, National Center for Child Health and Development, Tokyo, Japan
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
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Sharma M, Suratannon N, Leung D, Baris S, Takeuchi I, Samra S, Yanagi K, Rosa Duque JS, Benamar M, Del Bel KL, Momenilandi M, Béziat V, Casanova JL, van Hagen PM, Arai K, Nomura I, Kaname T, Chatchatee P, Morita H, Chatila TA, Lau YL, Turvey SE. Human germline gain-of-function in STAT6: from severe allergic disease to lymphoma and beyond. Trends Immunol 2024; 45:138-153. [PMID: 38238227 DOI: 10.1016/j.it.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024]
Abstract
Signal transducer and activator of transcription (STAT)-6 is a transcription factor central to pro-allergic immune responses, although the function of human STAT6 at the whole-organism level has long remained unknown. Germline heterozygous gain-of-function (GOF) rare variants in STAT6 have been recently recognized to cause a broad and severe clinical phenotype of early-onset, multi-system allergic disease. Here, we provide an overview of the clinical presentation of STAT6-GOF disease, discussing how dysregulation of the STAT6 pathway causes severe allergic disease, and identifying possible targeted treatment approaches. Finally, we explore the mechanistic overlap between STAT6-GOF disease and other monogenic atopic disorders, and how this group of inborn errors of immunity (IEIs) powerfully inform our fundamental understanding of common human allergic disease.
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11
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Wu X, Khan AI, Lee H, Hsu CF, Zhang H, Yu H, Roy N, Davydov AV, Takeuchi I, Bao X, Wong HSP, Pop E. Novel nanocomposite-superlattices for low energy and high stability nanoscale phase-change memory. Nat Commun 2024; 15:13. [PMID: 38253559 PMCID: PMC10803317 DOI: 10.1038/s41467-023-42792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/20/2023] [Indexed: 01/24/2024] Open
Abstract
Data-centric applications are pushing the limits of energy-efficiency in today's computing systems, including those based on phase-change memory (PCM). This technology must achieve low-power and stable operation at nanoscale dimensions to succeed in high-density memory arrays. Here we use a novel combination of phase-change material superlattices and nanocomposites (based on Ge4Sb6Te7), to achieve record-low power density ≈ 5 MW/cm2 and ≈ 0.7 V switching voltage (compatible with modern logic processors) in PCM devices with the smallest dimensions to date (≈ 40 nm) for a superlattice technology on a CMOS-compatible substrate. These devices also simultaneously exhibit low resistance drift with 8 resistance states, good endurance (≈ 2 × 108 cycles), and fast switching (≈ 40 ns). The efficient switching is enabled by strong heat confinement within the superlattice materials and the nanoscale device dimensions. The microstructural properties of the Ge4Sb6Te7 nanocomposite and its high crystallization temperature ensure the fast-switching speed and stability in our superlattice PCM devices. These results re-establish PCM technology as one of the frontrunners for energy-efficient data storage and computing.
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Affiliation(s)
- Xiangjin Wu
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Asir Intisar Khan
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Hengyuan Lee
- Corporate Research, Taiwan Semiconductor Manufacturing Company (TSMC), Hsinchu, Taiwan
| | - Chen-Feng Hsu
- Corporate Research, Taiwan Semiconductor Manufacturing Company (TSMC), Hsinchu, Taiwan
| | - Huairuo Zhang
- Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
- Theiss Research, Inc., La Jolla, CA, USA
| | - Heshan Yu
- Department of Materials Science and Engineering, University of Maryland, College Park, MD, USA
- School of Microelectronics, Tianjin University, Tianjin, China
| | - Neel Roy
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Albert V Davydov
- Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Ichiro Takeuchi
- Department of Materials Science and Engineering, University of Maryland, College Park, MD, USA
| | - Xinyu Bao
- Corporate Research, Taiwan Semiconductor Manufacturing Company (TSMC), San Jose, CA, USA
| | - H-S Philip Wong
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Eric Pop
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
- Department of Materials Science & Engineering, Stanford University, Stanford, CA, USA.
- Precourt Institute for Energy, Stanford University, Stanford, CA, USA.
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12
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Wu C, Deng H, Huang YS, Yu H, Takeuchi I, Ríos Ocampo CA, Li M. Freeform direct-write and rewritable photonic integrated circuits in phase-change thin films. Sci Adv 2024; 10:eadk1361. [PMID: 38181081 PMCID: PMC10775994 DOI: 10.1126/sciadv.adk1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024]
Abstract
Photonic integrated circuits (PICs) with rapid prototyping and reprogramming capabilities promise revolutionary impacts on a plethora of photonic technologies. We report direct-write and rewritable photonic circuits on a low-loss phase-change material (PCM) thin film. Complete end-to-end PICs are directly laser-written in one step without additional fabrication processes, and any part of the circuit can be erased and rewritten, facilitating rapid design modification. We demonstrate the versatility of this technique for diverse applications, including an optical interconnect fabric for reconfigurable networking, a photonic crossbar array for optical computing, and a tunable optical filter for optical signal processing. By combining the programmability of the direct laser writing technique with PCM, our technique unlocks opportunities for programmable photonic networking, computing, and signal processing. Moreover, the rewritable photonic circuits enable rapid prototyping and testing in a convenient and cost-efficient manner, eliminate the need for nanofabrication facilities, and thus promote the proliferation of photonics research and education to a broader community.
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Affiliation(s)
- Changming Wu
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
| | - Haoqin Deng
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
| | - Yi-Siou Huang
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
- Institute for Research in Electronics and Applied Physics, University of Maryland, College Park, MD 20742, USA
| | - Heshan Yu
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
- School of Microelectronics, Tianjin University, Tianjin 300072, China
| | - Ichiro Takeuchi
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
| | - Carlos A. Ríos Ocampo
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
- Institute for Research in Electronics and Applied Physics, University of Maryland, College Park, MD 20742, USA
| | - Mo Li
- Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195, USA
- Department of Physics, University of Washington, Seattle, WA 98195, USA
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Shizawa K, Ohtake M, Akimoto T, Kawasaki T, Seki S, Imanishi Y, Yasuda M, Kawasaki T, Sakata K, Takeuchi I, Yamamoto T. The Examination of Prognostic Factors and Treatment Strategies for Traumatic Cerebrospinal Fluid Leakage. Cureus 2024; 16:e52874. [PMID: 38406021 PMCID: PMC10890926 DOI: 10.7759/cureus.52874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction This study aimed to determine the optimal timing for surgical intervention and the prognostic factors of cerebrospinal fluid (CSF) leakage. Methods We identified 25 patients with probable CSF leaks from 472 consecutive patients with head trauma. In addition to baseline characteristics and findings on admission, injury severity score (ISS), abbreviated injury score (AIS), and other factors related to CSF leakage were considered. We analyzed the prognostic factors after setting the primary endpoint as the modified Rankin Scale (mRS) at the time of discharge to determine the appropriate timing for surgical intervention. Results Univariate analysis revealed significantly poorer prognoses for elderly patients (p<0.001) and cases with low Glasgow Coma Scale (GCS) levels (p=0.039) and high D-dimer levels (p=0.028), which was consistent with findings from the analyses of all patients with head trauma. We found that multiple traumas (AIS≥3 at two or more sites, p=0.047) and high lactate levels (p=0.043) were poor prognostic factors specific to CSF leakage cases, while a longer time to CSF leakage cessation was also associated with a poorer prognosis (median, six days versus 13 days, p=0.014). An evaluation of the time to closure found that spontaneous cessation occurred within 14 days in most cases. Conclusions Conservative medical treatment is the first choice for most cases of traumatic CSF leakage. Surgical intervention should be considered if leakage does not cease after 14 days post injury. Furthermore, severe multiple injuries and high lactate levels were poor prognostic factors specific to patients with CSF leakage.
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Affiliation(s)
- Kaoru Shizawa
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
| | - Makoto Ohtake
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN
| | - Taisuke Akimoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
| | - Takafumi Kawasaki
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
| | - Shunsuke Seki
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, JPN
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN
| | - Yuya Imanishi
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
| | - Masaki Yasuda
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
| | - Takashi Kawasaki
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, JPN
| | - Katsumi Sakata
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, JPN
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, JPN
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14
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Utada S, Taniguchi H, Honzawa H, Takeda T, Abe T, Takeuchi I. Usefulness of the Yokohama Advanced Cardiopulmonary Help Team in patients with acute respiratory distress syndrome. Acute Med Surg 2024; 11:e953. [PMID: 38655504 PMCID: PMC11036131 DOI: 10.1002/ams2.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
Aim To evaluate whether establishing an extracorporeal membrane oxygenation (ECMO) specialist team, termed the Yokohama Advanced Cardiopulmonary Help Team (YACHT), affected the outcomes and centralization of patients requiring ECMO in Yokohama-Yokosuka regions. Methods This retrospective observational study included patients aged ≥18 years and treated with venovenous-ECMO for severe acute respiratory distress syndrome (ARDS) from 2014 to 2023. The primary outcome was intensive care unit (ICU) mortality. The secondary outcomes included ICU-, mechanical ventilator-, and ECMO-free days and complications during the first 28 days. Results This study included 46 (12 without- and 34 with-YACHT) patients. Among with-YACHT patients, 24 were transferred to our hospital from other hospitals, 14 were assessed by dispatched ECMO physicians, and 9 were transferred after ECMO introduction. No without-YACHT patients were transferred from other hospitals. With-YACHT patients experienced coronavirus disease 2019-associated respiratory failure more frequently (0 vs. 27, p < 0.001) and had higher Acute Physiology and Chronic Health Evaluation II scores (19 vs. 24, p = 0.037) and lower Respiratory Extracorporeal Membrane Oxygenation Survival Prediction scores (4 vs. 2, p = 0.021). ICU mortality was not significantly different between the groups (2 vs. 4, p = 0.67). ICU- (14 vs. 9, p = 0.10), ventilator- (11 vs. 5, p = 0.01), and ECMO-free days (20 vs. 14, p = 0.038) were higher before YACHT establishment. The incidences of complications were not significantly different between the groups. Conclusions Mortality was not significantly different pre- and post-YACHT establishment; however, it helped promote regionalization and centralization in Yokohama-Yokosuka areas. We will collect more cases to demonstrate YACHT's usefulness.
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Affiliation(s)
- Shusuke Utada
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Hayato Taniguchi
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Hiroshi Honzawa
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Tomoaki Takeda
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Takeru Abe
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
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15
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Michishita T, Suzuki N, Abe T, Nakajima K, Gakumazawa M, Doi T, Takeuchi I. Appropriate Endotracheal Tube Position for Percutaneous Dilatational Tracheostomy: A Single-Center Observational Study. Cureus 2024; 16:e51895. [PMID: 38333485 PMCID: PMC10851040 DOI: 10.7759/cureus.51895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Aim This study aimed to investigate the appropriate endotracheal tube (ETT) position during percutaneous dilatational tracheostomy (PDT). Methods This single-center observational study included hospitalized patients who underwent surgical tracheostomy (ST) between August 2021 and October 2022. During ST, the trachea was opened, and the ETT was pulled out visually. It stopped when the ETT was no longer visible, and the tracheostomy tube was placed in the trachea. The ETT position was measured by considering the ETT position during ST to be the appropriate position during PDT. The correlation between the measured ETT position and patient characteristics was evaluated. A prediction equation for the ETT position was derived from the derivation group, and validation of the prediction equation was evaluated by the validation group. Results Forty-six and 15 patients were in the derivation and validation groups, respectively. Weight, duration of intubation, and in-hospital mortality were significantly different between the two groups. The measured ETT position correlated with body height (r=0.60, p<0.001) and sex (r=0.45, p=0.002), while the ETT position before ST showed a weak correlation (r=0.34, p=0.020). The predicted and measured values in the validation group correlated with each other (r=0.58, p=0.024). Conclusion The appropriate ETT position for PDT correlates with body height, and the equation "body height×0.112-0.323 cm" was derived. This predictive equation may be useful as a guide for ETT positioning during PDT puncture.
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Affiliation(s)
| | - Naoya Suzuki
- Department of Emergency Medicine, Yokosuka Kyosai Hospital, Yokosuka, JPN
| | - Takeru Abe
- Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, JPN
| | - Kento Nakajima
- Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, JPN
| | | | - Tomoki Doi
- Department of Emergency Medicine, Yokosuka Kyosai Hospital, Yokosuka, JPN
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, JPN
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16
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Watanabe K, Mori K, Sato K, Abe T, Imaki S, Takeuchi I. Out-of-hospital cardiac arrest patients during the coronavirus disease 2019 pandemic. Sci Rep 2023; 13:23005. [PMID: 38155197 PMCID: PMC10754886 DOI: 10.1038/s41598-023-50150-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/15/2023] [Indexed: 12/30/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic had severe impact on the outcome of out-of-hospital cardiac arrest (OHCA) patients and the possibility of bystander cardiopulmonary resuscitation (CPR). Previous studies focused only on the short periods of the pandemic and reported a significant increase in the number of infections. In a retrospective cohort study we aimed to compare the outcomes of OHCA patients 1 year before and 1 year after the onset of COVID-19. Data of 519 OHCA patients during the pre-pandemic (January-December 2019; 262 patients) and intra-pandemic (April 2020-March 2021; 257 patients) periods in Yokohama Municipal Hospital, Japan were collected and analysed retrospectively. The study outcomes were the return of spontaneous circulation (ROSC), admission to hospital, survival to discharge, and cerebral performance category at discharge. The intra-pandemic period was associated with decreased bystander CPR (P = 0.004), prolonged transport time (P < 0.001), delayed first adrenaline administration (P < 0.001), and decrease in ROSC (P = 0.023). Logistic regression analysis revealed that the following factors were significantly associated with ROSC: "pandemic", "shockable initial waveform", and "witness presence".
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Affiliation(s)
- Kenta Watanabe
- Department of Emergency Medicine, Yokohama Municipal Citizen's Hospital, Yokohama City, Kanagawa, Japan.
- Department of Emergency Medicine, Yokohama City University, Yokohama City, Kanagawa, Japan.
| | - Kosuke Mori
- Department of Emergency Medicine, Yokohama Municipal Citizen's Hospital, Yokohama City, Kanagawa, Japan
- Department of Emergency Medicine, Yokohama City University, Yokohama City, Kanagawa, Japan
| | - Kosuke Sato
- Department of Emergency Medicine, Yokohama Municipal Citizen's Hospital, Yokohama City, Kanagawa, Japan
- Department of Emergency Medicine, Yokohama City University, Yokohama City, Kanagawa, Japan
| | - Takeru Abe
- Medical Center Advanced Critical Care and Emergency Center, Yokohama City University, Yokohama City, Kanagawa, Japan
| | - Shouhei Imaki
- Department of Emergency Medicine, Yokohama Municipal Citizen's Hospital, Yokohama City, Kanagawa, Japan
- Department of Emergency Medicine, Yokohama City University, Yokohama City, Kanagawa, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University, Yokohama City, Kanagawa, Japan
- Medical Center Advanced Critical Care and Emergency Center, Yokohama City University, Yokohama City, Kanagawa, Japan
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17
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Sakai K, Okoda K, Nishii M, Saji R, Ogawa F, Abe T, Takeuchi I. Combining blood glucose and SpO 2/FiO 2 ratio facilitates prediction of imminent ventilatory needs in emergency room COVID-19 patients. Sci Rep 2023; 13:22718. [PMID: 38123659 PMCID: PMC10733355 DOI: 10.1038/s41598-023-50075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
The increasing requirement of mechanical ventilation (MV) due to the novel coronavirus disease (COVID-19) is still a global threat. The aim of this study is to identify markers that can easily stratify the impending use of MV in the emergency room (ER). A total of 106 patients with COVID-19 requiring oxygen support were enrolled. Fifty-nine patients were provided MV 0.5 h (interquartile range: 0.3 to 1.4) post-admission. Clinical and laboratory data before intubation were collected. Using a multivariate logistic regression model, we identified four markers associated with the impending use of MV, including the ratio of peripheral blood oxygen saturation to fraction of inspired oxygen (SpO2/FiO2 ratio), alanine aminotransferase, blood glucose (BG), and lymphocyte counts. Among these markers, SpO2/FiO2 ratio and BG, which can be measured easily and immediately, showed higher accuracy (AUC: 0.88) than SpO2/FiO2 ratio alone (AUC: 0.84), despite no significant difference (DeLong test: P = 0.591). Moreover, even in patients without severe respiratory failure (SpO2/FiO2 ratio > 300), BG (> 138 mg/dL) was predictive of MV use. Measuring BG and SpO2/FiO2 ratio may be a simple and versatile new strategy to accurately identify ER patients with COVID-19 at high risk for the imminent need of MV.
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Affiliation(s)
- Kazuya Sakai
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kai Okoda
- Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Mototsugu Nishii
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Ryo Saji
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Fumihiro Ogawa
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
- Yokohama City University, School of Medicine, Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Yoshida T, Hanada H, Nakagawa K, Taji K, Tsuda K, Takeuchi I. Efficient model selection for predictive pattern mining model by safe pattern pruning. Patterns (N Y) 2023; 4:100890. [PMID: 38106611 PMCID: PMC10724371 DOI: 10.1016/j.patter.2023.100890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/02/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023]
Abstract
Predictive pattern mining is an approach used to construct prediction models when the input is represented by structured data, such as sets, graphs, and sequences. The main idea behind predictive pattern mining is to build a prediction model by considering unified inconsistent notation sub-structures, such as subsets, subgraphs, and subsequences (referred to as patterns), present in the structured data as features of the model. The primary challenge in predictive pattern mining lies in the exponential growth of the number of patterns with the complexity of the structured data. In this study, we propose the safe pattern pruning method to address the explosion of pattern numbers in predictive pattern mining. We also discuss how it can be effectively employed throughout the entire model building process in practical data analysis. To demonstrate the effectiveness of the proposed method, we conduct numerical experiments on regression and classification problems involving sets, graphs, and sequences.
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Affiliation(s)
- Takumi Yoshida
- Department of Engineering, Nagoya Institute of Technology, Nagoya, Aichi 466-8555, Japan
| | - Hiroyuki Hanada
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
| | - Kazuya Nakagawa
- Department of Engineering, Nagoya Institute of Technology, Nagoya, Aichi 466-8555, Japan
| | - Kouichi Taji
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - Koji Tsuda
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
- Department of Bioinformatics and Systems Biology, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ichiro Takeuchi
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
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Ito N, Kudo T, Eguchi H, Jimbo K, Furuhata A, Okuno T, Takeuchi I, Arai K, Ishige T, Okazaki Y, Shimizu T. Attenuated Expression of SLCO2A1 Caused by DNA Methylation in Pediatric Inflammatory Bowel Disease. Inflamm Bowel Dis 2023; 29:1920-1928. [PMID: 37327083 DOI: 10.1093/ibd/izad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND SLCO2A1 encodes a prostaglandin (PG) transporter, and autosomal recessive pathogenic variants of this gene cause chronic enteropathy associated with SLCO2A1. It is unclear whether a heterozygous pathogenic variant of SLCO2A1 has a role in the pathogenesis of other types of inflammatory bowel disease (IBD). In this study, we investigated the possible involvement of a local epigenetic alteration in SLCO2A1 in patients with a heterozygous pathogenic variant. METHODS We conducted whole-exome sequencing of samples from 2 sisters with suspected monogenic IBD. In addition, we performed bisulfite sequencing using DNA extracted from their small and large intestine samples to explore epigenetic alterations. RESULTS A heterozygous splicing site variant, SLCO2A1:c.940 + 1G > A, was detected in both patients. To explore the possible involvement of epigenetic alterations, we analyzed protein and messenger RNA expression of SLCO2A1, and observed attenuated SLCO2A1 expression in the inflamed lesions of these patients compared with that in the control individuals. Furthermore, bisulfite sequencing indicated dense methylation in the promoter region of SLCO2A1 only in the inflamed lesions of both patients. The urinary PG metabolite levels in these patients were comparable to those in patients with chronic enteropathy associated with SLCO2A1 and higher than those in the control individuals. We found considerably higher levels of the metabolites in patient 1, who showed more severe symptoms than patient 2. CONCLUSIONS Local DNA methylation attenuated SLCO2A1 expression, which may evoke local inflammation of the mucosa by the unincorporated PG. These findings may improve our understanding of the epigenetic mechanisms underlying IBD development.
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Affiliation(s)
- Natsuki Ito
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Diagnostics and Therapeutics of Intractable Diseases and Intractable Disease Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takahiro Kudo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hidetaka Eguchi
- Diagnostics and Therapeutics of Intractable Diseases and Intractable Disease Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keisuke Jimbo
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Furuhata
- Biomedical Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiaki Okuno
- Department of Biochemistry, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ichiro Takeuchi
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Ishige
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases and Intractable Disease Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Umeda S, Abe T, Obata S, Aoki S, Takeuchi I. Effectiveness of call system implementation for postpartum hemorrhage in a tertiary emergency medical center: a retrospective cohort study. BMC Pregnancy Childbirth 2023; 23:787. [PMID: 37951860 PMCID: PMC10638699 DOI: 10.1186/s12884-023-06095-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Postpartum hemorrhage is the leading cause of maternal death and severe maternal morbidity worldwide. Previous studies have reported the importance of multidisciplinary treatment approaches for postpartum hemorrhage; however, only a few studies have shown a clear improvement in maternal outcomes. Therefore, this study aimed to investigate the efficacy of a call system for postpartum hemorrhage in a tertiary emergency facility for rapid multidisciplinary treatment and its effect on maternal outcomes. METHODS This single-center retrospective cohort study included patients transferred to our hospital due to postpartum hemorrhage between April 1, 2013, and March 31, 2019. The primary outcome was mortality, and the secondary outcomes were morbidity (duration of hospital stay, duration of intensive care unit stay, admission to the intensive care unit, respirator use, duration of ventilator support, acute kidney injury, transfusion-associated circulatory overload/transfusion-related acute lung injury, hysterectomy, composite adverse events, blood transfusion initiation time, blood transfusion volume, and treatment for postpartum hemorrhage). An in-hospital call system implementation commenced on April 1, 2016. The study outcomes were compared 3 years before and after implementing the call system. RESULTS The blood transfusion initiation time and duration of hospital stay were significantly shortened after implementing the call system for postpartum hemorrhage. No maternal deaths were observed after implementing the system. CONCLUSIONS Implementing call systems specialized for postpartum hemorrhage in tertiary emergency facilities may improve maternal outcomes.
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Affiliation(s)
- Sayo Umeda
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.
| | - Takeru Abe
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Soichiro Obata
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
- Department of Emergency Medicine, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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21
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Hanada H, Hashimoto N, Taji K, Takeuchi I. Generalized Low-Rank Update: Model Parameter Bounds for Low-Rank Training Data Modifications. Neural Comput 2023; 35:1970-2005. [PMID: 37844324 DOI: 10.1162/neco_a_01619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/27/2023] [Indexed: 10/18/2023]
Abstract
In this study, we have developed an incremental machine learning (ML) method that efficiently obtains the optimal model when a small number of instances or features are added or removed. This problem holds practical importance in model selection, such as cross-validation (CV) and feature selection. Among the class of ML methods known as linear estimators, there exists an efficient model update framework, the low-rank update, that can effectively handle changes in a small number of rows and columns within the data matrix. However, for ML methods beyond linear estimators, there is currently no comprehensive framework available to obtain knowledge about the updated solution within a specific computational complexity. In light of this, our study introduces a the generalized low-rank update (GLRU) method, which extends the low-rank update framework of linear estimators to ML methods formulated as a certain class of regularized empirical risk minimization, including commonly used methods such as support vector machines and logistic regression. The proposed GLRU method not only expands the range of its applicability but also provides information about the updated solutions with a computational complexity proportional to the number of data set changes. To demonstrate the effectiveness of the GLRU method, we conduct experiments showcasing its efficiency in performing cross-validation and feature selection compared to other baseline methods.
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Affiliation(s)
- Hiroyuki Hanada
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
| | - Noriaki Hashimoto
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
| | - Kouichi Taji
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - Ichiro Takeuchi
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
- Center for Advanced Intelligence Project, RIKEN, Tokyo 103-0027, Japan
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22
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Kirigaya J, Iwahashi N, Abe T, Gohbara M, Hanajima Y, Horii M, Okada K, Matsuzawa Y, Yasuda S, Kosuge M, Ebina T, Takeuchi I, Uchida K, Tamura K, Hibi K. Clinical Usefulness of Echocardiographic Measurement of Proximal Aortic Diameter in Early Differentiation Between Type A Acute Aortic Dissection and ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc 2023; 12:e029506. [PMID: 37850479 PMCID: PMC10727378 DOI: 10.1161/jaha.123.029506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023]
Abstract
Background Contradictions between management modalities of type A acute aortic dissection (TAAAD) and ST-elevation-myocardial infarction (STEMI) may result in clinical catastrophe. Therefore, we aimed to explore which 2-dimensional echocardiography (2DE) findings are optimal for differentiating TAAAD from STEMI. Methods and Results This study included 340 patients with STEMI and 340 patients with TAAAD who underwent 2DE in the emergency department between 2012 and 2021. The proximal ascending aorta (PAA) diameter and other echocardiographic parameters were analyzed. PAA diameters were measured at 4 levels in the parasternal view: Valsalva, the sinotubular junction (STJ), the PAA at 1 cm above the STJ, and the PAA at 2 cm above the STJ. Receiver-operating characteristic curve analysis showed that Valsalva, STJ, PAA at 1 cm above the STJ, and PAA at 2 cm above the STJ were significant predictors of TAAAD (areas under the curve: 0.777, 0.924, 0.965, and 0.975, respectively; P<0.001) with the respective cutoff values of 39.4, 38.5, 39.8, and 41.2 mm. Multivariable analysis suggested that all 2DE parameters were significant predictors of TAAAD. Among the 2DE parameters examined, the incorporation of PAA at 2 cm above the STJ to clinical indicators exhibited the most significant diagnostic capability (C-statistics, 0.97; net reclassification improvement, 1.81; integrated discrimination improvement, 0.61). When only TAAAD with coronary malperfusion and STEMI were analyzed, the diagnostic utility of PAA at 1 cm above the STJ was evident (C-statistics, 0.99; net reclassification improvement, 1.79; integrated discrimination improvement, 0.67), with PAA at 2 cm above the STJ ranking second in diagnostic significance (C-statistics, 0.99; net reclassification improvement, 1.12; integrated discrimination improvement, 0.66). Conclusions PAA measurements were the most beneficial for diagnosing TAAAD in all 2DE findings and TAAAD from STEMI.
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Affiliation(s)
- Jin Kirigaya
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Noriaki Iwahashi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Takeru Abe
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Masaomi Gohbara
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Yohei Hanajima
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Mutsuo Horii
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Kozo Okada
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Yasushi Matsuzawa
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Shota Yasuda
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Masami Kosuge
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Toshiaki Ebina
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Keiji Uchida
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kiyoshi Hibi
- Division of CardiologyYokohama City University Medical CenterYokohamaJapan
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Fuse Y, Takeuchi K, Hashimoto N, Nagata Y, Takagi Y, Nagatani T, Takeuchi I, Saito R. Deep learning based identification of pituitary adenoma on surgical endoscopic images: a pilot study. Neurosurg Rev 2023; 46:291. [PMID: 37910280 DOI: 10.1007/s10143-023-02196-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
Accurate tumor identification during surgical excision is necessary for neurosurgeons to determine the extent of resection without damaging the surrounding tissues. No conventional technologies have achieved reliable performance for pituitary adenomas. This study proposes a deep learning approach using intraoperative endoscopic images to discriminate pituitary adenomas from non-tumorous tissue inside the sella turcica. Static images were extracted from 50 intraoperative videos of patients with pituitary adenomas. All patients underwent endoscopic transsphenoidal surgery with a 4 K ultrahigh-definition endoscope. The tumor and non-tumorous tissue within the sella turcica were delineated on static images. Using intraoperative images, we developed and validated deep learning models to identify tumorous tissue. Model performance was evaluated using a fivefold per-patient methodology. As a proof-of-concept, the model's predictions were pathologically cross-referenced with a medical professional's diagnosis using the intraoperative images of a prospectively enrolled patient. In total, 605 static images were obtained. Among the cropped 117,223 patches, 58,088 were labeled as tumors, while the remaining 59,135 were labeled as non-tumorous tissues. The evaluation of the image dataset revealed that the wide-ResNet model had the highest accuracy of 0.768, with an F1 score of 0.766. A preliminary evaluation on one patient indicated alignment between the ground truth set by neurosurgeons, the model's predictions, and histopathological findings. Our deep learning algorithm has a positive tumor discrimination performance in intraoperative 4-K endoscopic images in patients with pituitary adenomas.
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Affiliation(s)
- Yutaro Fuse
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
- Academia-Industry Collaboration Platform for Cultivating Medical AI Leaders (AI-MAILs), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhito Takeuchi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | | | - Yuichi Nagata
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yusuke Takagi
- Department of Computer Science, Nagoya Institute of Technology, Nagoya, Japan
| | - Tetsuya Nagatani
- Department of Neurosurgery, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- Department of Mechanical Systems Engineering, Graduate School of Engineering, Nagoya University, Nagoya, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Yamaguchi Y, Atsumi T, Kanamori K, Tanibata N, Takeda H, Nakayama M, Karasuyama M, Takeuchi I. Drawing a materials map with an autoencoder for lithium ionic conductors. Sci Rep 2023; 13:16799. [PMID: 37798325 PMCID: PMC10556005 DOI: 10.1038/s41598-023-43921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023] Open
Abstract
Efforts to optimize known materials and enhance their performance are ongoing, driven by the advancements resulting from the discovery of novel functional materials. Traditionally, the search for and optimization of functional materials has relied on the experience and intuition of specialized researchers. However, materials informatics (MI), which integrates materials data and machine learning, has frequently been used to realize systematic and efficient materials exploration without depending on manual tasks. Nonetheless, the discovery of new materials using MI remains challenging. In this study, we propose a method for the discovery of materials outside the scope of existing databases by combining MI with the experience and intuition of researchers. Specifically, we designed a two-dimensional map that plots known materials data based on their composition and structure, facilitating researchers' intuitive search for new materials. The materials map was implemented using an autoencoder-based neural network. We focused on the conductivity of 708 lithium oxide materials and considered the correlation with migration energy (ME), an index of lithium-ion conductivity. The distribution of existing data reflected in the materials map can contribute to the development of new lithium-ion conductive materials by enhancing the experience and intuition of material researchers.
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Affiliation(s)
- Yudai Yamaguchi
- Department of Advanced Ceramics, Nagoya Institute of Technology, Gokiso, Showa, Nagoya, Aichi, 466-8555, Japan
| | - Taruto Atsumi
- Department of Advanced Ceramics, Nagoya Institute of Technology, Gokiso, Showa, Nagoya, Aichi, 466-8555, Japan
| | - Kenta Kanamori
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
| | - Naoto Tanibata
- Department of Advanced Ceramics, Nagoya Institute of Technology, Gokiso, Showa, Nagoya, Aichi, 466-8555, Japan
| | - Hayami Takeda
- Department of Advanced Ceramics, Nagoya Institute of Technology, Gokiso, Showa, Nagoya, Aichi, 466-8555, Japan
| | - Masanobu Nakayama
- Department of Advanced Ceramics, Nagoya Institute of Technology, Gokiso, Showa, Nagoya, Aichi, 466-8555, Japan.
| | - Masayuki Karasuyama
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
| | - Ichiro Takeuchi
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan
- Faculty of Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Aichi, 464-8601, Japan
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25
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Abe T, Yamada S, Kikuchi H, Sazawa A, Katano H, Suzuki H, Takeuchi I, Minami K, Morita K, Tsuchiya K, Takada N, Maru S, Sato S, Yamashita T, Mochizuki T, Akino T, Sasaki Y, Shinno Y, Murahashi N, Kawazu T, Furumido J, Miyata H, Matsumoto R, Osawa T, Murai S, Shinohara N. Impact of postoperative complications on long-term survival in bladder cancer patients. Jpn J Clin Oncol 2023; 53:966-976. [PMID: 37461191 PMCID: PMC10550200 DOI: 10.1093/jjco/hyad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/29/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE To determine the impact of postoperative complications on long-term survival outcomes in patients with bladder cancer undergoing radical cystectomy. METHODS This retrospective multi-institutional study included 766 bladder cancer patients who underwent radical cystectomy between 2011 and 2017. Patient characteristics, perioperative outcomes, all complications within 90 days after surgery and survival outcomes were collected. Each complication was graded based on the Clavien-Dindo system, and grouped using a standardized grouping method. The Comprehensive Complication Index, which incorporates all complications into a single formula weighted by their severity, was utilized. Overall survival and recurrence-free survival (local, distant or urothelial recurrences) were stratified by Comprehensive Complication Index (high: ≥26.2; low: <26.2). A multivariate model was utilized to identify independent prognostic factors. RESULTS The incidence of any and major complications (≥Clavien-Dindo grade III) was 70 and 24%, respectively. In terms of Comprehensive Complication Index, 34% (261/766) of the patients had ≥26.2. Patients with Comprehensive Complication Index ≥ 26.2 had shorter overall survival (4-year, 59.5 vs. 69.8%, respectively, log-rank test, P = 0.0037) and recurrence free survival (51.9 vs. 60.1%, respectively, P = 0.0234), than those with Comprehensive Complication Index < 26.2. The Cox multivariate model identified the age, performance status, pT-stage, pN-stage and higher CCI (overall survival: HR = 1.35, P = 0.0174, recurrence-free survival: HR = 1.26, P = 0.0443) as independent predictors of both overall survivial and recurrence-free survival. CONCLUSIONS Postoperative complications assessed by Comprehensive Complication Index had adverse effects on long-term survival outcomes. Physicians should be aware that major postoperative complications can adversely affect long-term disease control.
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Affiliation(s)
- Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shuhei Yamada
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroshi Kikuchi
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Department of Urology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Ataru Sazawa
- Department of Urology, Obihiro Kousei Hospital, Obihiro, Japan
| | - Hidenori Katano
- Department of Urology, Iwamizawa Municipal General Hospital, Iwamizawa, Japan
| | - Hidetaka Suzuki
- Department of Urology, Hakodate Central Hospital, Hakodate, Japan
| | - Ichiro Takeuchi
- Department of Urology, Tomakomai City Hospital, Tomakomai, Japan
| | - Keita Minami
- Department of Urology, Sapporo City General Hospital, Sapporo, Japan
| | - Ken Morita
- Department of Urology, Kushiro City General Hospital, Kushiro, Japan
| | | | - Norikata Takada
- Department of Urology, Hokkaido Cancer Center, Sapporo, Japan
| | - Shintaro Maru
- Department of Urology, Jinyukai Hospital, Sapporo, Japan
| | - Soshu Sato
- Department of Urology, Ebetsu City Hospital, Ebetsu, Japan
| | | | - Tango Mochizuki
- Department of Urology, Abashiri Kousei Hospital, Abashiri, Japan
| | | | | | | | - Norihiro Murahashi
- Department of Urology, Asahikawa Kousei Hospital, Asahikawa, Japan
- Department of Urology, JCHO Sapporo Hokushin Hospital, Sapporo, Japan
| | - Takafumi Kawazu
- Department of Urology, Hokkaido Urology Memorial Hospital, Sapporo, Japan
| | - Jun Furumido
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Department of Urology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Haruka Miyata
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryuji Matsumoto
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takahiro Osawa
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Sachiyo Murai
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuo Shinohara
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Toida C, Muguruma T, Gakumazawa M, Shinohara M, Abe T, Takeuchi I. Validation of the Conventional Trauma and Injury Severity Score and a Newly Developed Survival Predictive Model in Pediatric Patients with Blunt Trauma: A Nationwide Observation Study. Children (Basel) 2023; 10:1542. [PMID: 37761503 PMCID: PMC10529461 DOI: 10.3390/children10091542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
To date, there is no clinically useful prediction model that is suitable for Japanese pediatric trauma patients. Herein, this study aimed to developed a model for predicting the survival of Japanese pediatric patients with blunt trauma and compare its validity with that of the conventional TRISS model. Patients registered in the Japan Trauma Data Bank were grouped into a derivation cohort (2009-2013) and validation cohort (2014-2018). Logistic regression analysis was performed using the derivation dataset to establish prediction models using age, injury severity, and physiology. The validity of the modified model was evaluated by the area under the receiver operating characteristic curve (AUC). Among 11 predictor models, Model 1 and Model 11 had the best performance (AUC = 0.980). The AUC of all models was lower in patients with survival probability Ps < 0.5 than in patients with Ps ≥ 0.5. The AUC of all models was lower in neonates/infants than in other age categories. Model 11 also had the best performance (AUC = 0.762 and 0.909, respectively) in patients with Ps < 0.5 and neonates/infants. The predictive ability of the newly modified models was not superior to that of the current TRISS model. Our results may be useful to develop a highly accurate prediction model based on the new predictive variables and cutoff values associated with the survival mortality of injured Japanese pediatric patients who are younger and more severely injured by using a nationwide dataset with fewer missing data and added valuables, which can be used to evaluate the age-related physiological and anatomical severity of injured patients.
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Affiliation(s)
- Chiaki Toida
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
| | - Takashi Muguruma
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
| | - Masayasu Gakumazawa
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
| | - Mafumi Shinohara
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama 232-0024, Japan; (T.M.); (M.G.); (M.S.); (T.A.); (I.T.)
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Nomura S, Hirano Y, Takeuchi I, Shimizu H, Arai K. Anxiety, Depression, and Quality of Life in Parents of Adolescents with Inflammatory Bowel Disease: A Longitudinal Study. Pediatr Gastroenterol Hepatol Nutr 2023; 26:239-248. [PMID: 37736216 PMCID: PMC10509017 DOI: 10.5223/pghn.2023.26.5.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/21/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose The parents of adolescents with inflammatory bowel disease may experience impaired mental health and quality of life. This longitudinal study aimed to verify whether the mental health and quality of life of the parents of adolescents with inflammatory bowel disease declined when their children had active disease. Methods Sociodemographic data, parental anxiety, depression, and quality of life were analyzed using validated questionnaires for each variable. After the baseline survey, the second and follow-up surveys were conducted at 3 and 12 months, respectively. The active disease group comprised eight parents whose children had active disease during the baseline and second surveys. The remission group comprised 14 parents whose children remained in remission during both surveys. The improved group comprised nine parents whose children experienced active disease at baseline and remission during the second survey. Parental mental health and quality of life were compared among the groups. Results Significantly higher levels of anxiety were observed in the active disease group in all surveys (p<0.050). Although depression levels and quality of life did not differ significantly among the three groups, pairing the active disease group with other groups showed some large effect sizes. Conclusion Parents tended to experience decreased mental health and quality of life when their adolescents experienced active inflammatory bowel disease. Consequently, our hypothesis was partially verified. Therefore, parents need support when their children have active disease; this finding highlights the need for parental support systems.
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Affiliation(s)
- Satomi Nomura
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
- Department of Child Nursing, National College of Nursing, Tokyo, Japan
| | - Yuri Hirano
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Takeuchi
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Tokyo, Japan
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Ishibashi H, Minamide S, Takeuchi I. Expression analyses of stress-responsive genes in the hermatypic coral Acropora tenuis and its symbiotic dinoflagellates after exposure to the herbicide Diuron. Mar Life Sci Technol 2023; 5:289-299. [PMID: 37637253 PMCID: PMC10449730 DOI: 10.1007/s42995-023-00183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/31/2023] [Indexed: 08/29/2023]
Abstract
Diuron is one of the most frequently applied herbicides in sugarcane farming in southern Japan, and Australia. In addition, it is used as a booster substance in copper-based antifouling paints. Due to these various uses, Diuron is released into the marine environment; however, little information is available on gene expression in corals and their symbiotic algae exposed to Diuron. We investigated the effects of Diuron on stress-responsive gene expression in the hermatypic coral Acropora tenuis and its symbiotic dinoflagellates. After seven days of exposure to 1 µg/L and 10 µg/L Diuron, no significant changes in the body colour of corals were observed. However, quantitative reverse transcription-polymerase chain reaction analyses revealed that the expression levels of stress-responsive genes, such as heat shock protein 90 (HSP90), HSP70, and calreticulin (CALR), were significantly downregulated in corals exposed to 10 µg/L of Diuron for seven days. Moreover, aquaglyceroporin was significantly downregulated in corals exposed to environmentally relevant concentrations of 1 µg/L Diuron. In contrast, no such effects were observed on the expression levels of other stress-responsive genes, such as oxidative stress-responsive proteins, methionine adenosyltransferase, and green/red fluorescent proteins. Diuron exposure had no significant effect on the expression levels of HSP90, HSP70, or HSP40 in the symbiotic dinoflagellates. These results suggest that stress-responsive genes, such as HSPs, respond differently to Diuron in corals and their symbiotic dinoflagellates and that A. tenuis HSPs and CALRs may be useful molecular biomarkers for predicting stress responses induced by the herbicide Diuron. Supplementary Information The online version contains supplementary material available at 10.1007/s42995-023-00183-0.
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Affiliation(s)
- Hiroshi Ishibashi
- Graduate School of Agriculture, Ehime University, Matsuyama, Ehime 790-8566 Japan
- Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime 790-8566 Japan
| | - Seigo Minamide
- Graduate School of Agriculture, Ehime University, Matsuyama, Ehime 790-8566 Japan
| | - Ichiro Takeuchi
- Graduate School of Agriculture, Ehime University, Matsuyama, Ehime 790-8566 Japan
- Center of Advanced Technology for the Environment, Graduate School of Agriculture, Ehime University, Matsuyama, Ehime 790-8566 Japan
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Shinohara M, Abe T, Takeuchi I. Association between Blood Pressure Recording in Prehospital Setting and Patient Outcome in Pediatric Trauma Patients: A Propensity Score Matching Study. J Trauma Acute Care Surg 2023:01586154-990000000-00458. [PMID: 37478337 DOI: 10.1097/ta.0000000000004114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
Abstract
BACKGROUND Rapid identification of the severity of injuries in the field is important to ensure appropriate hospital care for better outcomes. Vital signs are used as a field triage tool for critically ill or injured patients in prehospital settings. Several studies have shown that recording vital signs, especially blood pressure, in pediatric patients is sometimes omitted in prehospital settings compared with that in adults. However, little is known about the association between the lack of measurement of prehospital vital signs and patient outcomes. In this study, we examined the association between the rate of vital sign measurements in the field and patient outcomes in injured children. METHODS This study analyzed secondary data from the Japan Trauma Data Bank. We included pediatric patients (0-17 years) with injuries who were transported by emergency medical services. Hospital survival was the primary outcome. We performed a propensity-matched analysis with nearest-neighbor matching without replacement by adjusting for demographic and clinical variables to evaluate the effect of recording vital signs. RESULTS During the study period, 13,413 pediatric patients were included. There were 9,187 and 1,798 patients with and without prehospital blood pressure records, respectively. After matching, there were no differences in the patient characteristics or disease severity. Hospital mortality was significantly higher in the non-recorded group than in the recorded group (4.3% vs. 1.1%; P < .001). The multiple logistic regression analysis results showed no prehospital record of blood pressure being associated with death (odds ratio [OR], 6.82; 95% confidence interval [CI], 2.40-19.33). Glasgow Coma Scale score and Injury Severity Score were also associated with death (OR, 0.71; 95% CI, 0.63- 0.81 and OR, 1.10; 95% CI, 1.06-11.14, respectively). CONCLUSIONS Pediatric patients without any blood pressure records in prehospital settings had higher mortality rates than those with prehospital blood pressure records. LEVEL OF EVIDENCE Therapeutic/Care Management IV.
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Affiliation(s)
| | - Takeru Abe
- Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center
| | - Ichiro Takeuchi
- Department of Critical Care and Emergency Medicine, National Hospital Organization Yokohama Medical Center
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30
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Salagre E, Segovia P, González-Barrio MÁ, Jugovac M, Moras P, Pis I, Bondino F, Pearson J, Wang RS, Takeuchi I, Fuller EJ, Talin AA, Mascaraque A, Michel EG. Physical Delithiation of Epitaxial LiCoO 2 Battery Cathodes as a Platform for Surface Electronic Structure Investigation. ACS Appl Mater Interfaces 2023. [PMID: 37466037 PMCID: PMC10401565 DOI: 10.1021/acsami.3c06147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
We report a novel delithiation process for epitaxial thin films of LiCoO2(001) cathodes using only physical methods, based on ion sputtering and annealing cycles. Preferential Li sputtering followed by annealing produces a surface layer with a Li molar fraction in the range 0.5 < x < 1, characterized by good crystalline quality. This delithiation procedure allows the unambiguous identification of the effects of Li extraction without chemical byproducts and experimental complications caused by electrolyte interaction with the LiCoO2 surface. An analysis by X-ray photoelectron spectroscopy (XPS) and X-ray absorption spectroscopy (XAS) provides a detailed description of the delithiation process and the role of O and Co atoms in charge compensation. We observe the simultaneous formation of Co4+ ions and of holes localized near O atoms upon Li removal, while the surface shows a (2 × 1) reconstruction. The delithiation method described here can be applied to other crystalline battery elements and provide information on their properties that is otherwise difficult to obtain.
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Affiliation(s)
- Elena Salagre
- Dto. Física Materia Condensada, Univ. Autónoma de Madrid, 28049 Madrid, Spain
| | - Pilar Segovia
- Dto. Física Materia Condensada, Univ. Autónoma de Madrid, 28049 Madrid, Spain
- IFIMAC (Condensed Matter Physics Center), Univ. Autónoma de Madrid, 28049 Madrid, Spain
| | | | - Matteo Jugovac
- Istituto di Struttura della Materia-CNR (ISM-CNR), Trieste 34149, Italy
| | - Paolo Moras
- Istituto di Struttura della Materia-CNR (ISM-CNR), Trieste 34149, Italy
| | - Igor Pis
- IOM CNR Laboratorio TASC, AREA Science Park, Trieste 34149, Italy
| | - Federica Bondino
- IOM CNR Laboratorio TASC, AREA Science Park, Trieste 34149, Italy
| | - Justin Pearson
- Materials Science and Engineering, Univ. of Maryland, College Park, Maryland 20742, United States
| | - Richmond Shiwei Wang
- Materials Science and Engineering, Univ. of Maryland, College Park, Maryland 20742, United States
| | - Ichiro Takeuchi
- Materials Science and Engineering, Univ. of Maryland, College Park, Maryland 20742, United States
| | - Elliot J Fuller
- Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Alec A Talin
- Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Arantzazu Mascaraque
- Dto. Física de Materiales, Fac. Ciencias Físicas, Univ. Complutense de Madrid, 28040 Madrid, Spain
| | - Enrique G Michel
- Dto. Física Materia Condensada, Univ. Autónoma de Madrid, 28049 Madrid, Spain
- IFIMAC (Condensed Matter Physics Center), Univ. Autónoma de Madrid, 28049 Madrid, Spain
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Kirigaya J, Iwahashi N, Terasaka K, Takeuchi I. Prevention and management of critical care complications in cardiogenic shock: a narrative review. J Intensive Care 2023; 11:31. [PMID: 37408036 PMCID: PMC10324237 DOI: 10.1186/s40560-023-00675-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Cardiogenic shock (CS) is a common cause of morbidity and mortality in cardiac intensive care units (CICUs), even in the contemporary era. MAIN TEXT Although mechanical circulatory supports have recently become widely available and used in transforming the management of CS, their routine use to improve outcomes has not been established. Transportation to a high-volume center, early reperfusion, tailored mechanical circulatory supports, regionalized systems of care with multidisciplinary CS teams, a dedicated CICU, and a systemic approach, including preventing noncardiogenic complications, are the key components of CS treatment strategies. CONCLUSIONS This narrative review aimed to discuss the challenges of preventing patients from developing CS-related complications and provide a comprehensive practical approach for its management.
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Affiliation(s)
- Jin Kirigaya
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, 232-0024, Japan
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kengo Terasaka
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, 232-0024, Japan
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, 232-0024, Japan.
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Oka I, Funayama R, Shimizu H, Takeuchi I, Nojiri S, Shimizu T, Arai K. Predictors of Small Bowel Transit Time for Capsule Endoscopy in Children with Inflammatory Bowel Disease. Pediatr Gastroenterol Hepatol Nutr 2023; 26:181-192. [PMID: 37485028 PMCID: PMC10356975 DOI: 10.5223/pghn.2023.26.4.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 04/03/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule's transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children's hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results Overall, 92 patients, aged 1-17 years, with inflammatory bowel disease (63 Crohn's disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: -58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.
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Affiliation(s)
- Itsuhiro Oka
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Rie Funayama
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Hirotaka Shimizu
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Takeuchi
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Katsuhiro Arai
- Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
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Yamaguchi K, Matsumoto S, Abe T, Nakajima K, Senoo S, Shimizu M, Takeuchi I. Predictive value of total psoas muscle index for postoperative physical functional decline in older patients undergoing emergency abdominal surgery. BMC Surg 2023; 23:171. [PMID: 37355574 DOI: 10.1186/s12893-023-02085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 06/19/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Older individuals increasingly require emergency abdominal surgeries. They are susceptible to surgical stress and loss of independence in performing daily activities. We hypothesized that the psoas muscle volume would be significantly associated with postoperative functional decline (FD) in older patients undergoing emergency abdominal surgery and aimed to evaluate the use of the psoas muscle volume on computed tomography (CT) scans. METHODS A retrospective, single-center study of patients aged ≥ 65 years who had undergone emergency abdominal surgery between January 2019 and June 2021 was performed. We assessed patients' activities of daily living using the Barthel Index. FD was defined as a ≥ 5-point decrease between preoperative and 28-day postoperative values. The psoas muscle volume was measured by CT, which was used for diagnosis, and normalized by height to calculate total psoas muscle index (TPI). We evaluated associations between FD and TPI using receiver operating characteristics (ROC) analysis and multiple logistic regression analysis. RESULTS Of 238 eligible patients, 71 (29.8%) had clinical postoperative FD. Compared to the non-FD group, the FD group was significantly older and had a higher proportion of females, higher Charlson Comorbidity Index, lower body mass index, higher American Society of Anesthesiology score, lower serum albumin level, and lower TPI. ROC analyses revealed that TPI had the highest area under the curve (0.802; 95% confidence interval [CI], 0.75-0.86). A multivariable logistic regression model revealed that low TPI was an independent predictor of postoperative FD (odds ratio, 0.14; 95% CI, 0.06-0.32). CONCLUSIONS TPI can predict postoperative FD due to emergency abdominal surgery. Identification of patients who are at high risk of FD before surgery may be useful for enhancing the regionalized system of care for emergency general surgery.
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Affiliation(s)
- Keishi Yamaguchi
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-Ku, Yokohama-Shi, Kanagawa, 232-0024, Japan
| | - Shokei Matsumoto
- Department of Trauma and Emergency Surgery, Saiseikai Yokohama-Shi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-Ku, Yokohama-Shi, Kanagawa, 230-0012, Japan.
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-Ku, Yokohama-Shi, Kanagawa, 232-0024, Japan
| | - Kento Nakajima
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-Ku, Yokohama-Shi, Kanagawa, 232-0024, Japan
| | - Satomi Senoo
- Department of Trauma and Emergency Surgery, Saiseikai Yokohama-Shi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-Ku, Yokohama-Shi, Kanagawa, 230-0012, Japan
| | - Masayuki Shimizu
- Department of Trauma and Emergency Surgery, Saiseikai Yokohama-Shi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-Ku, Yokohama-Shi, Kanagawa, 230-0012, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, 4-57 Urafunecho, Minami-Ku, Yokohama-Shi, Kanagawa, 232-0024, Japan
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Qian S, Catalini D, Muehlbauer J, Liu B, Mevada H, Hou H, Hwang Y, Radermacher R, Takeuchi I. High-performance multimode elastocaloric cooling system. Science 2023; 380:722-727. [PMID: 37200413 DOI: 10.1126/science.adg7043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/13/2023] [Indexed: 05/20/2023]
Abstract
Developing zero-global warming potential refrigerants has emerged as one area that helps address global climate change concerns. Various high-efficiency caloric cooling techniques meet this goal, but scaling them up to technologically meaningful performance remains challenging. We have developed an elastocaloric cooling system with a maximum cooling power of 260 watts and a maximum temperature span of 22.5 kelvin. These values are among the highest reported for any caloric cooling system. Its key feature is the compression of fatigue-resistant elastocaloric nitinol (NiTi) tubes configured in a versatile multimode heat exchange architecture, which allows the harnessing of both high delivered cooling power and large temperature spans. Our system shows that elastocaloric cooling, which only emerged 8 years ago, is a promising direction for commercializing caloric cooling.
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Affiliation(s)
- Suxin Qian
- Department of Refrigeration and Cryogenic Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, People's Republic of China
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - David Catalini
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - Jan Muehlbauer
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - Boyang Liu
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
| | - Het Mevada
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - Huilong Hou
- Key Laboratory of Aerospace Materials and Performance (Ministry of Education), School of Materials Science and Engineering, Beihang University, Beijing 100191, People's Republic of China
- Zhongfa Aviation Institute of Beihang University, Hangzhou, Zhejiang 310023, People's Republic of China
- Tianmushan Laboratory (Zhejiang Provincial Laboratory for Aviation), Hangzhou, Zhejiang 310023, People's Republic of China
| | - Yunho Hwang
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - Reinhard Radermacher
- Center for Environmental Energy Engineering, Department of Mechanical Engineering, University of Maryland, College Park, MD 20742, USA
| | - Ichiro Takeuchi
- Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742, USA
- Maryland Quantum Materials Center, Department of Physics, University of Maryland, College Park, MD 20742, USA
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Goto K, Tamehiro N, Yoshida T, Hanada H, Sakuma T, Adachi R, Kondo K, Takeuchi I. Novel Machine Learning Method AllerStat Identifies Statistically Significant Allergen-Specific Patterns in Protein Sequences. J Biol Chem 2023; 299:104733. [PMID: 37086787 DOI: 10.1016/j.jbc.2023.104733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/24/2023] Open
Abstract
Cutting-edge technologies such as genome editing and synthetic biology allow us to produce novel foods and functional proteins. However, their toxicity and allergenicity must be accurately evaluated. It is known that specific amino-acid sequences in proteins make some proteins allergic, but many of these sequences remain uncharacterized. In this study, we introduce a data-driven approach and a machine-learning (ML) method to find undiscovered allergen specific patterns (ASPs) among amino acid sequences. The proposed method enables an exhaustive search for amino-acid subsequences whose frequencies are statistically significantly higher in allergenic proteins. As a proof-of-concept, we created a database containing 21,154 proteins of which the presence or absence of allergic reactions are already known, and applied the proposed method to the database. The detected ASPs in this proof-of-concept study were consistent with known biological findings, and the allergenicity prediction performance using the detected ASPs was higher than extant approaches, indicating this method may be useful in evaluating the utility of synthetic foods and proteins.
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Affiliation(s)
- Kento Goto
- Department of Computer Science, Nagoya Institute of Technology. Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
| | - Norimasa Tamehiro
- Division of Biochemistry, National Institute of Health Sciences. 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki, Kanagawa, 210-9501, Japan
| | - Takumi Yoshida
- Department of Computer Science, Nagoya Institute of Technology. Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
| | - Hiroyuki Hanada
- Center for Advanced Intelligence Project, RIKEN. 1-4-1 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan
| | - Takuto Sakuma
- Department of Computer Science, Nagoya Institute of Technology. Gokiso-cho, Showa-ku, Nagoya, Aichi, 466-8555, Japan
| | - Reiko Adachi
- Division of Biochemistry, National Institute of Health Sciences. 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki, Kanagawa, 210-9501, Japan
| | - Kazunari Kondo
- Division of Biochemistry, National Institute of Health Sciences. 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki, Kanagawa, 210-9501, Japan.
| | - Ichiro Takeuchi
- Graduate School of Engineering, Nagoya University.Furo-cho, Chikusa-ku, Nagoya, 464-8603, Japan; Center for Advanced Intelligence Project, RIKEN. 1-4-1 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
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Kikuchi M, Tahara Y, Yamaguchi J, Nakashima T, Nomura O, Tanaka A, Kojima S, Hashiba K, Nakayama N, Hanada H, Mano T, Yamamoto T, Matsuo K, Takeuchi I, Matoba T, Nonogi H. Executive Summary - Acute Coronary Syndrome in the Japan Resuscitation Council Guidelines for Resuscitation 2020. Circ J 2023; 87:866-878. [PMID: 37081690 DOI: 10.1253/circj.cj-23-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Affiliation(s)
- Migaku Kikuchi
- Department of Cardiovascular Medicine, Emergency and Critical Care Center, Dokkyo Medical University School of Medicine
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Takahiro Nakashima
- Department of Emergency Medicine and Michigan Center for Integrative Research in Critical Care, University of Michigan
| | - Osamu Nomura
- Department of Emergency and Disaster Medicine, Hirosaki University
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Sunao Kojima
- Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
| | | | - Naoki Nakayama
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
| | - Hiroyuki Hanada
- Department of Emergency and Disaster Medicine, Hirosaki University
| | | | - Takeshi Yamamoto
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
| | - Kunihiro Matsuo
- Department of Acute Care Medicine, Fukuoka University Chikushi Hospital
| | - Ichiro Takeuchi
- Department of Emergency and Disaster Medicine, Yokohama City University
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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Miyazaki H, Hino K, Ito T, Abe T, Nomoto M, Furuno T, Takeuchi I, Hishimoto A. Relationship of emergency department visits for suicide attempts with meteorological and air pollution conditions. J Affect Disord 2023; 333:154-160. [PMID: 37080497 DOI: 10.1016/j.jad.2023.04.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Environmental factors such as meteorological and air pollution conditions have been identified as risk factors for suicide. This study aimed to clarify the relationship of the number of visits to the emergency department for suicide attempts with meteorological and air pollution conditions. METHODS This cross-sectional study included patients who attempted suicide and were transported to Yokohama City University Medical Center from April 2005 to March 2022. The meteorological conditions recorded at the time of transport included mean atmospheric pressure, mean temperature, maximum temperature, minimum temperature, mean humidity, wind speed, and sunshine hours, and the air pollution conditions included SO2 (ppm), NO (ppm), NO2 (ppm), NOX (ppm), OX (ppm), CH4 (ppmC), NMHC (ppmC), THC (ppmC), SPM (μg/m3), and PM2.5 (μg/m3). Poisson regression analysis was used to examine the association between the number of suicide attempts and the meteorological and air pollution conditions. Subgroup analyses were conducted by classifying the subjects according to the means of suicide attempt; comparisons were performed using t-tests. RESULTS The study included 1737 patients. Multivariate Poisson regression analyses revealed a significant positive relationship between the number of suicide attempts and SO2 levels and a significant negative relationship between the number of suicide attempts and NO levels. When subjects were divided by means of suicide attempt, different relationships with meteorological and air pollution conditions were observed. CONCLUSION Meteorological and air pollution conditions are environmental factors that can enable a more detailed understanding of suicide behavior according to the means of suicide attempts.
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Affiliation(s)
- Hidehito Miyazaki
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Psychiatric Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan; Numazu-chuo Hospital, 24-1 Nakase-cho, Numazu, Shizuoka 410-8575, Japan.
| | - Kousuke Hino
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan; Numazu-chuo Hospital, 24-1 Nakase-cho, Numazu, Shizuoka 410-8575, Japan
| | - Tsubasa Ito
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Psychiatric Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan
| | - Takeru Abe
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan
| | - Munetaka Nomoto
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Psychiatric Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan
| | - Taku Furuno
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan; Psychiatric Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan
| | - Ichiro Takeuchi
- Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, 4-57 Urafunecho, Minamiku, Yokohama, Kanagawa 232-0024, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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Hashimoto N, Takagi Y, Masuda H, Miyoshi H, Kohno K, Nagaishi M, Sato K, Takeuchi M, Furuta T, Kawamoto K, Yamada K, Moritsubo M, Inoue K, Shimasaki Y, Ogura Y, Imamoto T, Mishina T, Tanaka K, Kawaguchi Y, Nakamura S, Ohshima K, Hontani H, Takeuchi I. Case-based similar image retrieval for weakly annotated large histopathological images of malignant lymphoma using deep metric learning. Med Image Anal 2023; 85:102752. [PMID: 36716701 DOI: 10.1016/j.media.2023.102752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
In the present study, we propose a novel case-based similar image retrieval (SIR) method for hematoxylin and eosin (H&E) stained histopathological images of malignant lymphoma. When a whole slide image (WSI) is used as an input query, it is desirable to be able to retrieve similar cases by focusing on image patches in pathologically important regions such as tumor cells. To address this problem, we employ attention-based multiple instance learning, which enables us to focus on tumor-specific regions when the similarity between cases is computed. Moreover, we employ contrastive distance metric learning to incorporate immunohistochemical (IHC) staining patterns as useful supervised information for defining appropriate similarity between heterogeneous malignant lymphoma cases. In the experiment with 249 malignant lymphoma patients, we confirmed that the proposed method exhibited higher evaluation measures than the baseline case-based SIR methods. Furthermore, the subjective evaluation by pathologists revealed that our similarity measure using IHC staining patterns is appropriate for representing the similarity of H&E stained tissue images for malignant lymphoma.
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Affiliation(s)
- Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan
| | - Yusuke Takagi
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Hiroki Masuda
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kei Kohno
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Miharu Nagaishi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kensaku Sato
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Keisuke Kawamoto
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kyohei Yamada
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Kanako Inoue
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yasumasa Shimasaki
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yusuke Ogura
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Teppei Imamoto
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Tatsuzo Mishina
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Ken Tanaka
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Yoshino Kawaguchi
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume 830-0011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 103-0027, Japan; Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan.
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Oi Y, Ogawa F, Yamashiro T, Matsushita S, Oguri A, Utada S, Misawa N, Honzawa H, Abe T, Takeuchi I. Prediction of prognosis in patients with severe COVID-19 pneumonia using CT score by emergency physicians: a single-center retrospective study. Sci Rep 2023; 13:4045. [PMID: 36899171 PMCID: PMC10004443 DOI: 10.1038/s41598-023-31312-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
We aimed to develop a method to determine the CT score that can be easily obtained from CT images and examine its prognostic value for severe COVID pneumonia. Patients with COVID pneumonia who required ventilatory management by intubation were included. CT score was based on anatomical information in axial CT images and were divided into three sections of height from the apex to the bottom. The extent of pneumonia in each section was rated from 0 to 5 and summed. The primary outcome was the prediction of patients who died or were managed on extracorporeal membrane oxygenation (ECMO) based on the CT score at admission. Of the 71 patients included, 12 (16.9%) died or required ECMO management, and the CT score predicted death or ECMO management with ROC of 0.718 (0.561-0.875). The death or ECMO versus survival group (median [quartiles]) had a CT score of 17.75 (14.75-20) versus 13 (11-16.5), p = 0.017. In conclusion, a higher score on our generated CT score could predict the likelihood of death or ECMO management. A CT score at the time of admission allows for early preparation and transfer to a hospital that can manage patients who may need ECMO.
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Affiliation(s)
- Yasufumi Oi
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. .,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
| | - Fumihiro Ogawa
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Tsuneo Yamashiro
- Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shoichiro Matsushita
- Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Ayako Oguri
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shusuke Utada
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Naho Misawa
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hiroshi Honzawa
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan.,Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Ichiro Takeuchi
- Emergency Care Department, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.,Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Japan.,Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
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Stensberg J, Han X, Lee S, McGill SA, Paglione J, Takeuchi I, Kane CL, Wu L. Observation of the Superconducting Proximity Effect from Surface States in SmB_{6}/YB_{6} Thin Film Heterostructures via Terahertz Spectroscopy. Phys Rev Lett 2023; 130:096901. [PMID: 36930917 DOI: 10.1103/physrevlett.130.096901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/12/2022] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The ac conduction of epitaxially grown SmB_{6} thin films and superconducting heterostructures of SmB_{6}/YB_{6} are investigated via time-domain terahertz spectroscopy. A two-channel model of thickness-dependent bulk states and thickness-independent surface states accurately describes the measured conductance of bare SmB_{6} thin films, demonstrating the presence of surface states in SmB_{6}. While the observed reductions in the simultaneously measured superconducting gap, transition temperature, and superfluid density of SmB_{6}/YB_{6} heterostructures relative to bare YB_{6} indicate the penetration of proximity-induced superconductivity into the SmB_{6} overlayer; the corresponding SmB_{6}-thickness independence between different heterostructures indicates that the induced superconductivity is predominantly confined to the interface surface state of the SmB_{6}. This study demonstrates the ability of terahertz spectroscopy to probe proximity-induced superconductivity at an interface buried within a heterostructure, and our results show that SmB_{6} behaves as a predominantly insulating bulk surrounded by conducting surface states in both the normal and induced-superconducting states in both terahertz and dc responses, which is consistent with the topological Kondo insulator picture.
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Affiliation(s)
- Jonathan Stensberg
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Xingyue Han
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Seunghun Lee
- Department of Materials Science and Engineering, University of Maryland, College Park, Maryland 20742, USA
- Department of Physics, Pukyong National University, Busan 48513, Republic of Korea
| | - Stephen A McGill
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida 32310, USA
| | - Johnpierre Paglione
- Maryland Quantum Materials Center, Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - Ichiro Takeuchi
- Department of Materials Science and Engineering, University of Maryland, College Park, Maryland 20742, USA
- Maryland Quantum Materials Center, Department of Physics, University of Maryland, College Park, Maryland 20742, USA
| | - Charles L Kane
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Liang Wu
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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Ohya A, Ohtake M, Kawamura Y, Akimoto T, Iwashita M, Yamamoto T, Takeuchi I. Diagnosis and treatment approaches for simultaneous onset of subarachnoid hemorrhage and thyroid storm: a case report. Int J Emerg Med 2023; 16:15. [PMID: 36858963 PMCID: PMC9976426 DOI: 10.1186/s12245-023-00490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Subarachnoid hemorrhage and thyroid storm are similar in their clinical symptomatology, and diagnosis of these conditions, when they occur simultaneously, is difficult. Here, we report a rare case of concurrent subarachnoid hemorrhage and thyroid storm we encountered at our hospital. CASE PRESENTATION The patient was a 52-year-old woman. While bathing at home, the patient experienced a sudden disturbance of consciousness and was brought to our hospital. The main physical findings upon admittance were Glasgow Coma Scale score of E1V2M4, elevated blood pressure (208/145 mmHg), and tachycardia with atrial fibrillation (180 bpm) along with body temperature of 36.1 °C. Brain computed tomography revealed subarachnoid hemorrhage associated with a ruptured aneurysm of the posterior communicating artery branching from the left internal carotid artery, and aneurysm clipping was performed. Blood tests upon admission revealed high levels of free T3 and free T4 and low levels of thyroid-stimulating hormone. Upon determining that the patient had hyperthyroidism, thiamazole was administered. However, due to continuous impaired consciousness, fever, and persistence of tachycardia, the patient was diagnosed with thyroid storm. Oral potassium iodide and hydrocortisone were added to the treatment. The treatment was successful as the patient's symptoms improved, and she became lucid. In this case, we believe that in the presence of untreated hyperthyroidism, the onset of subarachnoid hemorrhage induced thyroid storm. Tachycardia of 130 bpm or higher, which is the diagnostic criterion for thyroid storm, rarely occurs with subarachnoid hemorrhage. Therefore, we believe it is an important factor for recognizing the presence of the thyroid storm. In this case, clipping surgery was prioritized which resulted in a favorable outcome. However, it is possible that invasive surgery may have exacerbated thyroid storm, suggesting that treatment should be tailored as per patient's condition. CONCLUSION If a pulse rate of 130 bpm or higher is observed alongside subarachnoid hemorrhage, we recommend considering the possibility of concomitant thyroid storm and testing for thyroid hormone. If concomitant thyroid storm is present, we believe that a treatment plan tailored to the patient's condition is critical, and early diagnosis will lead to a favorable outcome for the patient.
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Affiliation(s)
- Aimi Ohya
- grid.413045.70000 0004 0467 212XDepartment of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Makoto Ohtake
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan. .,Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan.
| | - Yusuke Kawamura
- grid.413045.70000 0004 0467 212XDepartment of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Taisuke Akimoto
- grid.413045.70000 0004 0467 212XDepartment of Neurosurgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Masayuki Iwashita
- grid.413045.70000 0004 0467 212XDepartment of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
| | - Tetsuya Yamamoto
- grid.268441.d0000 0001 1033 6139Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ichiro Takeuchi
- grid.413045.70000 0004 0467 212XDepartment of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Japan
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Toida C, Muguruma T, Gakumazawa M, Shinohara M, Abe T, Takeuchi I. Evaluating the definition of severely injured patients: a Japanese nationwide 5-year retrospective study. BMJ Open 2023; 13:e062619. [PMID: 36822812 PMCID: PMC9950884 DOI: 10.1136/bmjopen-2022-062619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES The definition of severely injured patients lacks universal consensus based on quantitative measures. The most widely used definition of severe injury is based on the Injury Severity Score (ISS), which is calculated using the Abbreviated Injury Scale in Japan. This study aimed to compare the prevalence, in-hospital mortality and OR for mortality in patients with ISS ≥16, ISS ≥18 and ISS ≥26 by age groups. DESIGN Retrospective cohort study. SETTING Japan Trauma Data Bank, which is a nationwide trauma registry with data from 280 hospitals. PARTICIPANTS We used data of 117 199 injured patients from a national database. We included injured patients who were transferred from the scene of injury by ambulance and/or physician. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence, in-hospital mortality and OR for mortality with respect to age and injury level (ISS group). RESULTS In all age categories, the in-hospital mortality of patient groups with an ISS ≥16, ISS ≥18 and ISS ≥26 was 13.3%, 17.4% and 23.5%, respectively. The in-hospital mortality for patients aged >75 years was the highest (20% greater than that of the other age groups). Moreover, in-hospital mortality for age group 5-14 years was the lowest (4.0-10.9%). In all the age groups, the OR for mortality for patients with ISS ≥16, ISS ≥18 and ISS ≥26 was 12.8, 11.0 and 8.4, respectively. CONCLUSIONS Our results revealed the lack of an acceptable definition, with a high in-hospital mortality and high OR for mortality for all age groups.
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Affiliation(s)
- Chiaki Toida
- Department of Emergency Medicine, Teikyo University School of Medicine Graduate School of Medicine, Itabashi-ku, Tokyo, Japan
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takashi Muguruma
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Masayasu Gakumazawa
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Mafumi Shinohara
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Takeru Abe
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Ichiro Takeuchi
- Department of Emergency Medicine, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan
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43
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Kato H, Hanada H, Takeuchi I. Safe RuleFit: Learning Optimal Sparse Rule Model by Meta Safe Screening. IEEE Trans Pattern Anal Mach Intell 2023; 45:2330-2343. [PMID: 35471868 DOI: 10.1109/tpami.2022.3167993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We consider the problem of learning a sparse rule model, a prediction model in the form of a sparse linear combination of rules, where a rule is an indicator function defined over a hyper-rectangle in the input space. Since the number of all possible such rules is extremely large, it has been computationally intractable to select the optimal set of active rules. In this paper, to solve this difficulty for learning the optimal sparse rule model, we propose Safe RuleFit (SRF). Our basic idea is to develop meta safe screening (mSS), which is a non-trivial extension of well-known safe screening (SS) techniques. While SS is used for screening out one feature, mSS can be used for screening out multiple features by exploiting the inclusion-relations of hyper-rectangles in the input space. SRF provides a general framework for fitting sparse rule models for regression and classification, and it can be extended to handle more general sparse regularizations such as group regularization. We demonstrate the advantages of SRF through intensive numerical experiments.
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Khan AI, Yu H, Zhang H, Goggin JR, Kwon H, Wu X, Perez C, Neilson KM, Asheghi M, Goodson KE, Vora PM, Davydov A, Takeuchi I, Pop E. Energy Efficient Neuro-Inspired Phase-Change Memory Based on Ge 4 Sb 6 Te 7 as a Novel Epitaxial Nanocomposite. Adv Mater 2023:e2300107. [PMID: 36720651 DOI: 10.1002/adma.202300107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Phase-change memory (PCM) is a promising candidate for neuro-inspired, data-intensive artificial intelligence applications, which relies on the physical attributes of PCM materials including gradual change of resistance states and multilevel operation with low resistance drift. However, achieving these attributes simultaneously remains a fundamental challenge for PCM materials such as Ge2 Sb2 Te5 , the most commonly used material. Here bi-directional gradual resistance changes with ≈10× resistance window using low energy pulses are demonstrated in nanoscale PCM devices based on Ge4 Sb6 Te7 , a new phase-change nanocomposite material . These devices show 13 resistance levels with low resistance drift for the first 8 levels, a resistance on/off ratio of ≈1000, and low variability. These attributes are enabled by the unique microstructural and electro-thermal properties of Ge4 Sb6 Te7 , a nanocomposite consisting of epitaxial SbTe nanoclusters within the Ge-Sb-Te matrix, and a higher crystallization but lower melting temperature than Ge2 Sb2 Te5 . These results advance the pathway toward energy-efficient analog computing using PCM.
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Affiliation(s)
- Asir Intisar Khan
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Heshan Yu
- Department of Materials Science and Engineering, University of Maryland, College Park, MD, 20742, USA
| | - Huairuo Zhang
- Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA
- Theiss Research, Inc., La Jolla, CA, 92037, USA
| | - John R Goggin
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, 22030, USA
- Quantum Science and Engineering Center, George Mason University, Fairfax, VA, 22030, USA
| | - Heungdong Kwon
- Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Xiangjin Wu
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Christopher Perez
- Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Kathryn M Neilson
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Mehdi Asheghi
- Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Kenneth E Goodson
- Department of Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Patrick M Vora
- Department of Physics and Astronomy, George Mason University, Fairfax, VA, 22030, USA
- Quantum Science and Engineering Center, George Mason University, Fairfax, VA, 22030, USA
| | - Albert Davydov
- Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, MD, 20899, USA
- Quantum Science and Engineering Center, George Mason University, Fairfax, VA, 22030, USA
| | - Ichiro Takeuchi
- Department of Materials Science and Engineering, University of Maryland, College Park, MD, 20742, USA
| | - Eric Pop
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
- Department of Materials Science & Engineering, Stanford University, Stanford, CA, 94305, USA
- Precourt Institute for Energy, Stanford University, Stanford, CA, 94305, USA
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Akimoto T, Ohtake M, Kawasaki T, Fushimi S, Shimohigoshi W, Manaka H, Kawasaki T, Sakata K, Takeuchi I, Yamamoto T. Predictors of Outcomes Six Months after Endovascular Coil Embolization of Poor-Grade Aneurysmal Subarachnoid Hemorrhage. J Neuroendovasc Ther 2023; 17:47-55. [PMID: 37502127 PMCID: PMC10370525 DOI: 10.5797/jnet.oa.2022-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 11/09/2022] [Indexed: 07/29/2023]
Abstract
Objective To identify factors associated with the outcome and prognosis of coil embolization for poor-grade aneurysmal subarachnoid hemorrhage (aSAH). Methods We retrospectively reviewed 118 patients with World Federation of Neurosurgical Societies (WFNS) grade IV or V subarachnoid hemorrhage at our institute between January 2010 and December 2020. Outcomes were assessed using modified Rankin Scale (mRS) scores at discharge and at six months after aSAH onset. In addition, patient background, aneurysm characteristics, and treatment outcome were compared between patients showing favorable (mRS scores: 0-2) and unfavorable (mRS scores: 3-6) outcomes at six months. Factors for change of mRS during follow-up were explored, and cut off values were calculated for age using the receiver operating characteristic analysis. Results Endovascular treatment was performed in 51 of the 118 enrolled patients. Data were analyzed for 43 of these patients who underwent coil embolization of ruptured aneurysms and had complete datasets. The mean age was 61.7 years and 24 (55.8%) patients had WFNS grade V aSAH. Coil embolization-related complications were observed in three patients. There were no treatment-related deaths; however, eight patients (18.6%) died at three months. Multivariate analysis showed that the maximum diameter of the aneurysm (p=0.041) and the postoperative dual antiplatelet therapy (DAPT) (p=0.040) were associated with unfavorable and favorable outcomes, respectively. Older age (p=0.033) was independently associated with mRS score deterioration following discharge. Age 72 years and older was the cut off value for mRS deterioration. Conclusion Aneurysm size and postoperative DAPT might be associated with outcomes at 6 months. Moreover, we identified older age as an independent factor that influences mRS deterioration following discharge; thus, especially in cases of elderly patients over 72 years of age, it is highly likely that long-term care to prevent disuse and regular follow-up on imaging will be necessary.
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Affiliation(s)
- Taisuke Akimoto
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Makoto Ohtake
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Takafumi Kawasaki
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shuto Fushimi
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Wataru Shimohigoshi
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Hiroshi Manaka
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Takashi Kawasaki
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Katsumi Sakata
- Department of Neurosurgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Ichiro Takeuchi
- Department of Emergency and Critical Care, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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46
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Takagi Y, Hashimoto N, Masuda H, Miyoshi H, Ohshima K, Hontani H, Takeuchi I. Transformer-based personalized attention mechanism for medical images with clinical records. J Pathol Inform 2023; 14:100185. [PMID: 36691660 PMCID: PMC9860154 DOI: 10.1016/j.jpi.2022.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/10/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
In medical image diagnosis, identifying the attention region, i.e., the region of interest for which the diagnosis is made, is an important task. Various methods have been developed to automatically identify target regions from given medical images. However, in actual medical practice, the diagnosis is made based on both the images and various clinical records. Consequently, pathologists examine medical images with prior knowledge of the patients and the attention regions may change depending on the clinical records. In this study, we propose a method, called the Personalized Attention Mechanism (PersAM) method, by which the attention regions in medical images according to the clinical records. The primary idea underlying the PersAM method is the encoding of the relationships between medical images and clinical records using a variant of the Transformer architecture. To demonstrate the effectiveness of the PersAM method, we applied it to a large-scale digital pathology problem involving identifying the subtypes of 842 malignant lymphoma patients based on their gigapixel whole-slide images and clinical records.
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Affiliation(s)
- Yusuke Takagi
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Noriaki Hashimoto
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 1030027, Japan
| | - Hiroki Masuda
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 8300011, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 8300011, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 4668555, Japan
| | - Ichiro Takeuchi
- RIKEN Center for Advanced Intelligence Project, 1-4-1 Nihonbashi, Chuo-ku, Tokyo 1030027, Japan,Department of Mechanical Systems Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 4648603, Japan,Corresponding author.
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Honzawa H, Taniguchi H, Ogawa F, Oi Y, Abe T, Takeuchi I. Association of obesity paradox with prognosis of veno-venous-extracorporeal membrane oxygenation in patients with coronavirus disease 2019. Acute Med Surg 2023; 10:e871. [PMID: 37469378 PMCID: PMC10352545 DOI: 10.1002/ams2.871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/15/2023] [Accepted: 06/17/2023] [Indexed: 07/21/2023] Open
Abstract
Aim Although the obesity paradox is known for various diseases, including cancer and acute respiratory distress syndrome, little is known about veno-venous extracorporeal membrane oxygenation (VV-ECMO) in patients with coronavirus disease 2019 (COVID-19). In this study, we aimed to investigate the association between body mass index (BMI) and prognosis in critical patients with COVID-19 requiring VV-ECMO. Methods We conducted a retrospective observational single-center study at Yokohama City University Civic General Medical Center between March 2020 and October 2021. Participants were patients with COVID-19 who required VV-ECMO. They were classified into two groups: BMI ≤30 kg/m2 and >30 kg/m2. Results In total, 23 patients were included in the analysis, with a median BMI of 28.7 kg/m2. Overall, 22 patients were successfully weaned from the ECMO. When comparing the two groups, there was a trend toward fewer days from onset to ECMO induction in the BMI >30 kg/m2 group. Moreover, the two groups had a similar prognosis. There were no statistically significant differences in the number of days from onset to hospitalization or the duration of ECMO induction between the groups. Conclusion VV-ECMO induction for patients with COVID-19 may lead to earlier indications in patients with BMI >30 kg/m2 than in those with BMI ≤30 kg/m2.
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Affiliation(s)
- Hiroshi Honzawa
- Emergency Care DepartmentYokohama City University HospitalYokohamaJapan
| | - Hayato Taniguchi
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Fumihiro Ogawa
- Emergency Care DepartmentYokohama City University HospitalYokohamaJapan
| | - Yasufumi Oi
- Emergency Care DepartmentYokohama City University HospitalYokohamaJapan
| | - Takeru Abe
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
| | - Ichiro Takeuchi
- Emergency Care DepartmentYokohama City University HospitalYokohamaJapan
- Advanced Critical Care and Emergency CenterYokohama City University Medical CenterYokohamaJapan
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Komorizono R, Takeuchi I, Yoshioka T, Yano T, Kumagai H, Ishiguro A, Arai K. Intestinal polypoid arteriovenous malformation in a 5-year-old boy with recurrent anemia. Pediatr Int 2023; 65:e15564. [PMID: 37368523 DOI: 10.1111/ped.15564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/22/2023] [Accepted: 05/17/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Rina Komorizono
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
| | - Ichiro Takeuchi
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Tomonori Yano
- Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
| | - Hideki Kumagai
- Department of Pediatrics, Jichi Medical University, Tochigi, Japan
| | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
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Miyata E, Arai K, Takeuchi I, Shimizu H, Shimizu T. Refractory pediatric ulcerative colitis responding to high dose tofacitinib. Pediatr Int 2023; 65:e15551. [PMID: 37350552 DOI: 10.1111/ped.15551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/01/2023] [Accepted: 04/21/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Eri Miyata
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Setagaya-ku, Japan
- Department of Pediatrics, Juntendo University Faculty of Medicine, Bunkyo-ku, Japan
| | - Katsuhiro Arai
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Ichiro Takeuchi
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, Center for Pediatric Inflammatory Bowel Disease, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Bunkyo-ku, Japan
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Takeuchi I, Imaki S, Furuya R, Iwashita M, Takahashi K, Furuya A, Yoshida A, Abe T. Continuous positive airway pressure treatment from the prehospital field in a Japanese regional Doctor Car system. Acute Med Surg 2023; 10:e893. [PMID: 37736501 PMCID: PMC10509749 DOI: 10.1002/ams2.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/12/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023] Open
Abstract
Background Continuous positive airway pressure (CPAP) therapy is an effective treatment for patients with severe heart failure, and certain guidelines recommend its early initiation. However, the current Japanese law strictly prohibits paramedics from administering this treatment. To demonstrate the efficacy and safety of prehospital administration of CPAP therapy, this study was conducted by the Yokohama Medical Control Council (Yokohama MC). Methods The Yokohama MC established a protocol for CPAP treatment and dispatched Doctor Cars to attend to patients with severe respiratory failure. The Boussignac CPAP system was installed in all Yokohama Doctor Cars, including Workstation-type Doctor Cars and Hospital-type Doctor Cars. Data from this study were collected and recorded in the Yokohama City Doctor Car Registry system from October 2020 to January 2022. Results The Doctor Car was dispatched 661 times, and CPAP therapy was administered to 13 patients in the prehospital field. It is important to note that the number of CPAP cases was lower than anticipated due to the coronavirus disease 2019 (COVID-19) pandemic, given concerns about aerosol production. When assessing changes over time in oxygen saturation (SpO2), the median (interquartile range), excluding missing values, was 89% (83%-93%) without oxygen, 95% (94%-99.3%) with oxygen, and 100% (97%-100%) with CPAP. The differences between these groups were statistically significant with a p-value of <0.0001. Respiratory distress was primarily attributed to heart failure in 10 patients (91%) and pneumothorax in 1 patient (9%). Notably, none of the patients' conditions worsened after the use of CPAP. Conclusion We have detailed the administration of CPAP therapy in the prehospital field within a local city in Japan. To the best of our knowledge, this represents the inaugural report of a prospective observational study on the prehospital administration of CPAP therapy originating from Japan.
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Affiliation(s)
- Ichiro Takeuchi
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineYokohama City University Medical CenterYokohamaJapan
| | - Shohei Imaki
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of EmergencyYokohama Municipal Citizen's HospitalYokohamaJapan
| | - Ryosuke Furuya
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineNational Hospital Organization Yokohama Medical CenterYokohamaJapan
| | - Masayuki Iwashita
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineYokohama City University Medical CenterYokohamaJapan
| | - Kohei Takahashi
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineYokohama City University Medical CenterYokohamaJapan
| | - Akihiro Furuya
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Yokohama City Fire BureauYokohamaJapan
| | - Atsushi Yoshida
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineNational Hospital Organization Yokohama Medical CenterYokohamaJapan
| | - Takeru Abe
- Yokohama City Medical Control Council (Yokohama MC)YokohamaJapan
- Department of Emergency and Critical Care MedicineYokohama City University Medical CenterYokohamaJapan
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