A New Deep State-Space Analysis Framework for Patient Latent State Estimation and Classification from EHR Time Series Data

Many diseases, including cancer and chronic conditions, require extended treatment periods and long-term strategies. Machine learning and AI research focusing on electronic health records (EHRs) have emerged to address this need. Effective treatment strategies involve more than capturing sequential changes in patient test values. It requires an explainable and clinically interpretable model by capturing the patient's internal state over time. In this study, we propose the "deep state-space analysis framework," using time-series unsupervised learning of EHRs with a deep state-space model. This framework enables learning, visualizing, and clustering of temporal changes in patient latent states related to disease progression. We evaluated our framework using time-series laboratory data from 12,695 cancer patients. By estimating latent states, we successfully discover latent states related to prognosis. By visualization and cluster analysis, the temporal transition of patient status and test items during state transitions characteristic of each anticancer drug were identified. Our framework surpasses existing methods in capturing interpretable latent space. It can be expected to enhance our comprehension of disease progression from EHRs, aiding treatment adjustments and prognostic determinations.Comment: 21 pages, 6 figure

The exploration of psychological mechanism underlying ibasyo feeling in female undergraduates : the relations with over-adaptation, depression, and self-esteem.

The present study explored the relationships among "ibashyo" feeling , over-adaptation, and psychological health in female undergraduates. "Ibasyo" Feeling Scale (Kishi & Moroi, 2011), Over-Adaptation Scale (Ishizu & Ambo, 2008), the Self-rating Depression Scale (Zung, 1965), and Self-Esteem Scale (Rosenberg, 1979) were administered to female undergraduates (N=424). By the factor analysis (likelihood method with promax rotations), five factors for "Ibasyo" Feeling Scale and four factors for Over-Adaptation Scale were extracted. According to the covariance structure analysis, over-adaptation deteriorated positive feeling for "ibasyo" and psychological health, and positive feeling for "ibasyo" heightened the psychological health. The significance of research in psychological mechanism underlying "ibasyo" feeling was discussed.論

Systems Analysis of ATF3 in Stress Response and Cancer Reveals Opposing Effects on Pro-Apoptotic Genes in p53 Pathway

Stress-inducible transcription factors play a pivotal role in cellular adaptation to environment to maintain homeostasis and integrity of the genome. Activating transcription factor 3 (ATF3) is induced by a variety of stress and inflammatory conditions and is over-expressed in many kinds of cancer cells. However, molecular mechanisms underlying pleiotropic functions of ATF3 have remained elusive. Here we employed systems analysis to identify genome-wide targets of ATF3 that is either induced by an alkylating agent methyl methanesulfonate (MMS) or over-expressed in a prostate tumour cell line LNCaP. We show that stress-induced and cancer-associated ATF3 is recruited to 5,984 and 1,423 targets, respectively, in the human genome, 89% of which are common. Notably, ATF3 targets are highly enriched for not only ATF/CRE motifs but also binding sites of several other stress-inducible transcription factors indicating an extensive network of stress response factors in transcriptional regulation of target genes. Further analysis of effects of ATF3 knockdown on these targets revealed that stress-induced ATF3 regulates genes in metabolic pathways, cell cycle, apoptosis, cell adhesion, and signalling including insulin, p53, Wnt, and VEGF pathways. Cancer-associated ATF3 is involved in regulation of distinct sets of genes in processes such as calcium signalling, Wnt, p53 and diabetes pathways. Notably, stress-induced ATF3 binds to 40% of p53 targets and activates pro-apoptotic genes such as TNFRSF10B/DR5 and BBC3/PUMA. Cancer-associated ATF3, by contrast, represses these pro-apoptotic genes in addition to CDKN1A/p21. Taken together, our data reveal an extensive network of stress-inducible transcription factors and demonstrate that ATF3 has opposing, cell context-dependent effects on p53 target genes in DNA damage response and cancer development

助産診断技術論演習におけるシミュレーション教育方法の実践報告

　分娩期における助産診断・技術の習得を目指したシミュレーション教育の方法として，模擬患者，シミュレーター，オリジナル教材，映像の活用を組み合わせた助産診断技術論演習の実際について報告する．本演習授業である30コマのうち，分娩期の助産診断・技術に関する演習を12コマ実施した．4コマで1事例の演習を行い，3事例の設定をした．単元の流れは，①事例を提示，②初期診断を行い，ベッドサイドでの情報収集項目を整理，③模擬産婦から情報収集，④アセスメントにより，分娩進行の助産診断および助産ケアの計画立案，ならびにベッドサイドで得る情報項目の確認，⑤模擬産婦へ助産ケアの実施，ならびに情報収集を行う．これら，一連の助産過程を実施し，その場面を撮影して学習教材の一部とした．また，シミュレーターを組み合わせて活用し，作成したオリジナル教材を用いた．その結果，教員からみた学生は，分娩進行やその過程についてイメージを描くことができ，正常経過の分娩進行に対する知識が得られ，助産ケアが実施できたと思われた．また，本演習のシミュレーション教育により，コミュニケーション能力と事例に関する知識，技術の向上が示唆された

Diabetes mellitus itself increases cardio- cerebrovascular risk and renal complications in primary aldosteronism

This is a pre-copyedited, author-produced version of an article accepted for publication in The Journal of Clinical Endocrinology & Metabolism following peer review. The version of record Aya Saiki, Michio Otsuki, Daisuke Tamada, Tetsuhiro Kitamura, Iichiro Shimomura, Isao Kurihara, Takamasa Ichijo, Yoshiyu Takeda, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Toshihiko Yanase, Yoshihiro Ogawa, Junji Kawashima, Masakatsu Sone, Nobuya Inagaki, Takanobu Yoshimoto, Ryuji Okamoto, Katsutoshi Takahashi, Hiroki Kobayashi, Kouichi Tamura, Kohei Kamemura, Koichi Yamamoto, Shoichiro Izawa, Miki Kakutani, Masanobu Yamada, Akiyo Tanabe, Mitsuhide Naruse, Diabetes Mellitus Itself Increases Cardio-Cerebrovascular Risk and Renal Complications in Primary Aldosteronism, The Journal of Clinical Endocrinology & Metabolism, Volume 105, Issue 7, July 2020, Pages e2531–e2537 is available online at: https://doi.org/10.1210/clinem/dgaa177

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

デンワ カイワ ニ オケル ダンワ カンリ : ニホンゴ ボゴ ワシャ ト ニホンゴ ヒ ボゴ ワシャ ノ ソウゴ コウイ ノ ヒカク ブンセキ

本稿では、日本語母語話者同士および非母語話者と母語話者の電話会話を取り上げ、開始部と終結部を分析した。日本語母語話者の談話管理の特徴として、開始部においては「あ」が受け手がかけ手を認定するメタメッセージを伝える談話標識として機能していること、終結部においては「じゃ」が終結への意向を暗示し、移行場所で段階的に終結へと導く談話標識として機能していることを明らかにした。また、単独で用いられる「はい」は、開始部において相手の認定を示す場合や終結部の移行場所において終結への意向を受け入れる場合には、相手のメタメッセージを受け入れたことにはならず、単なるあいづちとなる。 非母語話者の場合、こうした「あ」「はい」「じゃ」の機能を十分に理解していなかったり、適切な運用ができなかったりする。すなわち、隣接ペアの完成という局所的な処理という観点からはスムーズに進んでいるようにみえても、全体機構におけるメタメッセージの理解や運用においては問題が残リ、局所的機構と全体機構の二重の関係をふまえた談話管理能力が不足していると考えられる。In this study we analyze the opening and closing sections of telephone conversations in Japanese between pairs of native speakers, and between native and non-native speakers. Among the characteristics of conversation management in native speakers, we identify the use of a, which serves in the opening as a discourse marker conveying the meta-message that the answerer has recognized the caller, and of ja, which indicates the speaker\u27s intention to end the conversation, serving as a discourse marker that leads orderly into the closing section of the conversation. Further, in the opening, where a sign of recognition is called for, and at the transition to the closing, where a sign of acceptance of the intention to end the conversation is expected, the word hai by itself may function merely as a back channel, without implying acceptance of the other party\u27s meta-message. In the telephone conversations involving non-native speakers of Japanese, instances may be seen in which they have not fully comprehended the functions of a, hai, and ja, or have not been able to use them appropriately. When examined at the local level for completion of adjacency pairs, the conversation may seem to be progressing smoothly, yet there may still be problems with the understanding and employment of meta-messages at the global level. We may see this as an inability to adjust rules for conversation management in local level exchanges to the position of these exchanges in the overall structure