Effects of artificial intelligence assistance on endoscopist performance: Comparison of diagnostic performance in superficial esophageal squamous cell carcinoma detection using video-based models

Objectives: Superficial esophageal squamous cell carcinoma (ESCC) detection is crucial. Although narrow-band imaging improves detection, its effectiveness is diminished by inexperienced endoscopists. The effects of artificial intelligence (AI) assistance on ESCC detection by endoscopists remain unclear. Therefore, this study aimed to develop and validate an AI model for ESCC detection using endoscopic video analysis and evaluate diagnostic improvements. Methods: Endoscopic videos with and without ESCC lesions were collected from May 2020 to January 2022. The AI model trained on annotated videos and 18 endoscopists (eight experts, 10 non-experts) evaluated their diagnostic performance. After 4 weeks, the endoscopists re-evaluated the test data with AI assistance. Sensitivity, specificity, and accuracy were compared between endoscopists with and without AI assistance. Results: Training data comprised 280 cases (140 with and 140 without lesions), and test data, 115 cases (52 with and 63 without lesions). In the test data, the median lesion size was 14.5 mm (range: 1–100 mm), with pathological depths ranging from high-grade intraepithelial to submucosal neoplasia. The model's sensitivity, specificity, and accuracy were 76.0%, 79.4%, and 77.2%, respectively. With AI assistance, endoscopist sensitivity (57.4% vs. 66.5%) and accuracy (68.6% vs. 75.9%) improved significantly, while specificity increased slightly (87.0% vs. 91.6%). Experts demonstrated substantial improvements in sensitivity (59.1% vs. 70.0%) and accuracy (72.1% vs. 79.3%). Non-expert accuracy increased significantly (65.8% vs. 73.3%), with slight improvements in sensitivity (56.1% vs. 63.7%) and specificity (81.9% vs. 89.2%). Conclusions: AI assistance enhances ESCC detection and improves endoscopists' diagnostic performance, regardless of experience

Colorectal anastomotic leakage after conversion surgery for advanced endometrial cancer treated with lenvatinib plus pembrolizumab: a case report

The combination therapy of lenvatinib plus pembrolizumab (LP) is increasingly recognized as an important second-line regimen for advanced or recurrent endometrial cancer (EC). However, the safety and efficacy of conversion surgery with low anterior rectal resection for unresectable EC following LP therapy is unknown. A 37-year-old woman was referred with unresectable EC with pleural fluid, peritoneal dissemination, and ascites. After the failure of first-line platinum-based chemotherapy, she was administered LP as second-line treatment. After 10 treatment cycles, uterine and peritoneal tumors significantly reduced in size, except the left ovarian metastatic tumor which became slightly larger. Cytoreductive surgery, including low anterior resection of the rectum and colorectal anastomosis, achieved complete resection. However, on postoperative day 11, the patient experienced an anastomotic leakage around the colorectal anastomosis site, necessitating a double-barreled colostomy and percutaneous drainage. She was discharged 15 days after the second surgery and resumed LP therapy after 44 days following the second surgery. We report a case in which conversion surgery after LP therapy was conducted for unresectable advanced endometrial cancer. Our findings indicate that if bowel resection is required, a longer preoperative withdrawal period may be necessary to prevent postoperative anastomotic leakage

BMP-9 mediates fibroproliferation in fibrodysplasia ossificans progressiva through TGF-β signaling

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder presenting with progressive heterotopic ossification (HO) in soft tissues. Early-stage FOP is characterized by recurrent episodes of painful tissue swelling (flare-ups), with numerous proliferation-activated mesenchymal stromal cells (MSCs) subsequently causing HO. However, the mechanisms underlying flare-up progression remain unclear. In this study, we evaluated the proliferation of MSCs obtained from FOP patient-derived induced pluripotent stem cells (FOP-iPSCs) to elucidate the mechanisms underlying flare-ups and found that bone morphogenetic protein (BMP)-9 mediated enhanced proliferation by abnormal activation of transforming growth factor (TGF)-β signaling pathway in MSCs from FOP-iPSCs. In FOP model mice, elevated BMP-9 levels correlated with elevated phosphorylation of SMAD2/3 and increased cellular proliferation in the affected tissues, while systemic BMP-9 neutralization and knockout mitigated flare-ups and HO. Thus, BMP-9 aberrantly transduces TGF-β signaling and induces fibroproliferation, initiating flare-ups. This study provides novel insights into the development of future FOP therapies

Phase II Trial of Adjuvant S-1 Following Neoadjuvant Chemotherapy and Surgery in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma: The PIECE Trial

Background: Neoadjuvant chemotherapy followed by surgery (NAC-S) is the standard therapy for locally advanced esophageal squamous cell carcinoma (ESCC) in Japan. Objective: The aim of this phase II trial was to assess the efficacy and safety of the addition of adjuvant S-1 after R0 resection in ESCC patients who received NAC-S. Patients and methods: Key eligibility criteria included clinical stage IB–III (without T4 disease) ESCC, age 20–75 years, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients received adjuvant therapy with four cycles of S-1 (80 mg/m²/day) administered orally for 4 weeks of 6-week cycles. The primary endpoint was 3 year relapse-free survival (RFS). If the lower confidence limit for 3 year RFS was >50%, we judged that the primary endpoint of this study was met. Results: A total of 52 patients were enrolled between January 2016 and January 2019. Two patients were excluded from analysis; five patients were determined to have R1 or R2 resection, and seven patients did not receive adjuvant S-1. The 3-year RFS and overall survival rates in the intention-to-treat population were 72.3% (90% confidence interval [CI] 59.9–81.5) and 85.0% (90% CI 73.9–91.6), indicating that the primary endpoint was met. Grade ≥3 adverse events with an incidence ≥10% included neutropenia (13.2%), anorexia (13.2%), and diarrhea (10.5%). There were no treatment-related deaths. Conclusion: Adjuvant S-1 after NAC-S showed promising efficacy with a manageable safety profile for patients with resectable ESCC and warrants further evaluation in larger studies

EGAP Writing 2: Research Writing_2025 Edition

本文ファイル登録(2025-02-26)本文ファイル差し替え(2025-04-23) To Students and Teachers [1] Paragraph Structure Review [3] Academic Essay Structure & Topic Selection [7] Thesis Statement & Essay Outline [16] Body Paragraphs & Transitional Words [22] Paraphrasing, Summarizing, & Quoting [28] Introduction & Conclusion Paragraphs [34] Proofreading & Revision [42] Quality of Thought: Evaluating Topics [45] Quality of Thought: Evaluating Thesis Support [53] Quality of Content: Evaluating Evidence [61] Quality of Language: Integrating Evidence [67] Quality of Language: Academic Style [77] Quality of Feedback & Revision [85] Overall Quality [92] Key Vocabulary [118

<Articles>Hegels Konzepte der Kunst und Religion als „absoluter Geist" : Von der Differenzschrift zur Phänomenologie

本論文は、日本哲学会編『Tetsugaku』vol.5(2021)に掲載された論文 Shunsuke KUDOMI, Hegels Kunstbegriff in den Jenaer Jahren: Zur Differenzierung von Kunst und Religionに修正を施し、日本語に改稿したものです。Der vorliegende Aufsatz befasst sich mit Hegels Begriff der Kunst und Religion in den Jenaer Jahren. Es wird dabei darauf abgezielt, die systematische Bedeutung der Kunst durch eine Differenzierung von Kunst und Religion zu erklären. Hierzu möchte ich betrachten, wie Hegel seine Kunstlehre und den Begriff der „Kunstreligion" in der Phänomenologie des Geistes (1807) entwickelt. Um das Konzept der (Religion der) Kunst zu erklären, rekonstruiere ich die Chronologie des hegelschen Denkens in seiner Jenaer Zeit. Auf der Ebene der Funktion unterscheiden sich die Bestimmungen der Kunst und der Religion voneinander in der Weise, wie sie als die ästhetische Anschauung des Absoluten konzipiert werden. Hegel definiert dabei auf der einen Seite die Kunst als „Kunst als Kunstwerk" und auf der anderen Seite Religion als „Kunst ohne Kunstwerk". Diese beiden Anschauungsweisen des Absoluten versteht Hegel wiederum als Formen der Kunst, die mit und zur Spekulation eine Polaritätsstruktur bilden. Zusammenfassend kann man sagen, dass die Kunst in Hegels späteren Jenaer Jahren nicht mehr die angemessene Form ist, um das Absolute in der modernen Gemeinschaft aufzufassen. Damit betont Hegel ihre Beschränkungen und den Vergangenheitscharakter der Kunst. Hingegen entwickelt Hegel den Begriff der Religion vor allem durch eine Auseinandersetzung mit Schleiermacher. Kunst und Religion werden also zwar jeweils in verschiedenen Schriften thematisiert, doch erst in der Phänomenologie des Geistes von Hegel in einen logischen und systematischen Zusammenhang gebracht. Entscheidend für den Übergang zur Religion ist, dass die Kunstreligion als Moment der Religion aufbewahrt wird. Hegel stellt dies durch den Begriff der „Erinnerung" heraus und erläutert den Übergang parallel anhand des tragischen Dramas. Diese Er-Innerung steht in einem Verhältnis zum Kunstwerk in der modernen Zeit. Obwohl Hegel Kunst von der Phänomenologie bis hin zur Enzyklopädie von 1817 als „Religion der Kunst" konzipiert, zeigt er doch auch die Möglichkeit auf, Kunst als solche nicht abhängig von der Religion zu thematisieren. Um seine Konzeptionen der „Kunst" und der „Religion" besser zu verstehen, ist es nötig, sie nicht nur aus Sicht des Systems zu betrachten, sondern zusätzlich auch durch weitere Perspektiven in seinen Darstellungen zu ergänzen

Data for Intrinsic low-temperature magnetic properties on the ultra-clean UTe2 with Tc = 2.1 K revealed by 125Te NMR

このデータはUTe2のNMR等測定データであ

Society Transactions

2021年6月12日(土), 於名古屋市立大学病院3F大ホール (Zoom併用ハイブリッド形式

APPENDIX

MNGD Special issue 06: Making Networks for Glocal Developmen