Clinically Feasible and Accurate View Classification of Echocardiographic Images Using Deep Learning

A proper echocardiographic study requires several video clips recorded from different acquisition angles for observation of the complex cardiac anatomy. However, these video clips are not necessarily labeled in a database. Identification of the acquired view becomes the first step of analyzing an echocardiogram. Currently, there is no consensus whether the mislabeled samples can be used to create a feasible clinical prediction model of ejection fraction (EF). The aim of this study was to test two types of input methods for the classification of images, and to test the accuracy of the prediction model for EF in a learning database containing mislabeled images that were not checked by observers. We enrolled 340 patients with five standard views (long axis, short axis, 3-chamber view, 4-chamber view and 2-chamber view) and 10 images in a cycle, used for training a convolutional neural network to classify views (total 17,000 labeled images). All DICOM images were rigidly registered and rescaled into a reference image to fit the size of echocardiographic images. We employed 5-fold cross validation to examine model performance. We tested models trained by two types of data, averaged images and 10 selected images. Our best model (from 10 selected images) classified video views with 98.1% overall test accuracy in the independent cohort. In our view classification model, 1.9% of the images were mislabeled. To determine if this 98.1% accuracy was acceptable for creating the clinical prediction model using echocardiographic data, we tested the prediction model for EF using learning data with a 1.9% error rate. The accuracy of the prediction model for EF was warranted, even with training data containing 1.9% mislabeled images. The CNN algorithm can classify images into five standard views in a clinical setting. Our results suggest that this approach may provide a clinically feasible accuracy level of view classification for the analysis of echocardiographic data

Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD

Literature review of research trends on unnatural deaths in older adult in Japan from 2000 to 2020: A text mining analysis

The purpose of this study was to determine the current state of research on unnatural deaths　in older adults in Japan. We searched original articles published in Japan from 2000 to 2020 by using the key terms“ older adult” and“ unnatural death” and identified 32 articles. We analyzed the articles by quantitative text mining with KH Coder （ver.3.0） software. The most frequently extracted words were“ death,”“ many,”“ discovery,”“ suicide,”“ cause of death,” and“ autopsy.” In the co-occurrence network analysis of words,“ death,”“ many,”“ suicide,” and“ man” had high mediation centrality. We used subgraph detection to classify the top 50 words into 5 groups: “Time delay before discovery of single older adult men after death,”“ Trend for unnatural deaths of missing older adults,”“ Relationship between mental illness and solitary death,”“ Investigation of cause of death by forensic autopsy,” and “Measures for preventing solitary death of older adults isolated from society.” Currently, studies are limited regarding possible measures to prevent solitary deaths among older adults isolated from society. In Japan, there is an urgent need to support older adults at risk of social isolation, such as single men and people with mental illnesses, to help maintain or improve their social integration

Eosinophilic myocarditis without hypereosinophilia accompanied by giant cell infiltration

AbstractA 53-year-old woman with a history of allergic disease was admitted to our hospital because of syncope induced by sustained ventricular tachycardia. The clinical course and the laboratory data did not correspond to those of acute myocarditis. Although eosinophils in the peripheral blood count were not increased, the diagnosis of eosinophilic myocarditis was made following a right ventricular endomyocardial biopsy that showed a remarkable infiltration of eosinophils. While giant cells were another histopathological feature of this case, they were considered to be an expression of the disease severity. This is a rare case of eosinophilic myocarditis, without peripheral eosinophilia.<Learning objective: Eosinophils in the peripheral blood usually increase in eosinophilic myocarditis. We describe a case of eosinophilic myocarditis without hypereosinophilia. Even in the absence of hypereosinophilia, endomyocardial biopsy should be performed during the investigation of unexplained myocardial disease.

ISAI: Investigating Solar Axion by Iron-57

The existence of the axion is a unique solution for the strong CP problem, and the axion is one of the most promising candidates of the dark matter. Investigating Solar Axion by Iron-57 (ISAI) is being prepared as a complemented table-top experiment to confirm the solar axion scenario. Probing an X-ray emission from the nuclear transitions associated with the axion-nucleon coupling is a leading approach. ISAI searches for the monochromatic 14.4 keV X-ray from the first excited state of 57Fe using a state-of-the-art pixelized silicon detector, dubbed XRPIX, under an extremely low-background environment. We highlight scientific objectives, experimental design and the latest status of ISAI

Seaweed intake and risk of cardiovascular disease: the Japan Public Health Center–based Prospective (JPHC) Study

BackgroundThe minerals, vitamins, soluble dietary fibers, and flavonoids of seaweed are protective for preventing cardiovascular diseases. However, the association between seaweed intake and risk of cardiovascular disease has not been established.ObjectivesWe examined the dietary intake of seaweed and its impact upon stroke and ischemic heart disease risk among a Japanese study population.MethodsWe surveyed 40,707 men and 45,406 women from 2 large cohorts (age range: 40–69 y). Seaweed intake was determined by FFQ at baseline (1990–1994). Incidences of stroke and ischemic heart disease were ascertained until the end of 2009 (Cohort I) or 2012 (Cohort II). Sex-specific cardiovascular disease HRs (95% CIs) were estimated using Cox proportional hazard models after stratification by area and adjustment for cardiovascular disease risk and dietary factors.ResultsDuring 1,493,232 person-years of follow-up, 4777 strokes (2863 ischemic stroke, 1361 intraparenchymal hemorrhages, and 531 subarachnoid hemorrhages) and 1204 ischemic heart disease cases were identified. Among men, significant multivariable HRs (95% CIs) for almost daily consumption compared with almost no consumption of seaweed were seen in ischemic heart disease [0.76 (0.58, 0.99); P-trend = 0.04] and total cardiovascular diseases [0.88 (0.78, 1.00); P-trend = 0.08]. Among women, such inverse associations were 0.56 (0.36, 0.85; P-trend = 0.006) for ischemic heart disease and 0.89 (0.76, 1.05; P-trend = 0.10) for total cardiovascular diseases. No significant associations were observed between seaweed intake and risk of total stroke or stroke types among either men or women.ConclusionsSeaweed intake was inversely associated with risk of ischemic heart disease

Factors that contribute to long-term survival in patients with leukemia not in remission at allogeneic hematopoietic cell transplantation

<p>Abstract</p> <p>Background</p> <p>There has been insufficient examination of the factors affecting long-term survival of more than 5 years in patients with leukemia that is not in remission at transplantation.</p> <p>Method</p> <p>We retrospectively analyzed leukemia not in remission at allogeneic hematopoietic cell transplantation (allo-HCT) performed at our institution between January 1999 and July 2009. Forty-two patients with a median age of 39 years received intensified conditioning (n = 9), standard (n = 12) or reduced-intensity conditioning (n = 21) for allo-HCT. Fourteen patients received individual chemotherapy for cytoreduction during the three weeks prior to reduced-intensity conditioning. Diagnoses comprised acute leukemia (n = 29), chronic myeloid leukemia-accelerated phase (n = 2), myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) (n = 10) and plasma cell leukemia (n = 1). In those with acute leukemia, cytogenetic abnormalities were intermediate (44%) or poor (56%). The median number of blast cells in bone marrow (BM) was 26.0% (range; 0.2-100) before the start of chemotherapy for allo-HCT. Six patients had leukemic involvement of the central nervous system. Stem cell sources were related BM (7%), related peripheral blood (31%), unrelated BM (48%) and unrelated cord blood (CB) (14%).</p> <p>Results</p> <p>Engraftment was achieved in 33 (79%) of 42 patients. Median time to engraftment was 17 days (range: 9-32). At five years, the cumulative probabilities of acute graft-versus-host disease (GVHD) and chronic GVHD were 63% and 37%, respectively. With a median follow-up of 85 months for surviving patients, the five-year Kaplan-Meier estimates of leukemia-free survival rate and overall survival (OS) were 17% and 19%, respectively. At five years, the cumulative probability of non-relapse mortality was 38%. In the univariable analyses of the influence of pre-transplant variables on OS, poor-risk cytogenetics, number of BM blasts (>26%), MDS overt AML and CB as stem cell source were significantly associated with worse prognosis (p = .03, p = .01, p = .02 and p < .001, respectively). In addition, based on a landmark analysis at 6 months post-transplant, the five-year Kaplan-Meier estimates of OS in patients with and without prior history of chronic GVHD were 64% and 17% (p = .022), respectively.</p> <p>Conclusion</p> <p>Graft-versus-leukemia effects possibly mediated by chronic GVHD may have played a crucial role in long-term survival in, or cure of active leukemia.</p

eDNA metabarcoding analysis reveals the consequence of creating ecosystem‐scale refugia from deer grazing for the soil microbial communities

シカの森林被害は土壌微生物にも波及する --大規模生態系操作実験と環境DNA分析の融合--. 京都大学プレスリリース. 2023-12-22.Ungulate overbrowsing is a growing problem in forests worldwide due to its prolonged and pervasive impact on plant biodiversity and ecosystem functioning. It has been shown that overbrowsing not only reduces plant species diversity and biomass (i.e., direct effects) but also causes a loss of associated trophic levels that could potentially feedback to influence plant community structure (i.e., indirect effects). One of the primary pathways of such indirect effects that have not been fully examined is the impact of overbrowsing on soil microorganisms. Recent studies have shown that soil microorganisms maintain vegetation diversity and drive succession, so it is of critical importance to understand how soil microbial communities might be affected by or protected from the deer impact. To assess the consequence of creating artificial grazing refugia on the structure and composition of soil microbial communities, we compared the distribution and abundance of soil microbial taxa (bacteria, archaea, fungi) at the fenced versus unfenced control sites in the context of a catchment-scale field experiment in Japan. The eDNA metabarcoding analysis of soil microbial communities showed that the numbers of archaea and basidiomycetes fungal species were greater in the fenced site than in the control, while no such pattern was found for bacteria and ascomycetes fungi. Despite the lack of significant influence of the fence treatment on taxonomic composition in the soil fungal communities, their functional guild composition was influenced by the fenced treatment, with significant changes in the abundance of animal pathogens. Thus, although the effect of fencing on soil microbial communities is characterized by complex responses that vary from taxon to taxon, our work suggests that creating ecosystem-scale refugia from deer overgrazing might help sustain certain, if not all, taxa of soil microbial communities