Alcohol Consumption or Excessive Use of Psychotropic Medication Prior to Suicidal Self-injury in Patients with Adjustment Disorder, Depression, and Schizophrenia: A Cross-sectional Study

The use of alcohol or drug(s) prior to self-injury is a possible inducing factor for suicidal self-injuries among patients with adjustment disorder. We analyzed the cases of 175 individuals who were admitted to the intensive care unit (ICU) of Tokyo Medical and Dental University Medical Hospital for suicidal self-injury to determine whether alcohol consumption or an excessive use of prescribed psychotropic medications prior to self-injury is more common in patients with adjustment disorder. During a 7-year period (July 2006 to June 2013) following their deliberate self-injuries, 971 patients were admitted to the ICU. Our study sample (n=175) was restricted to patients with adjustment disorder (n=48), major depressive disorder (n=90), or schizophrenia (n=37). The outcome variable was alcohol consumption or excessive use of medications prior to suicidal self-injury. A logistic regression analysis revealed that the patients with adjustment disorder more commonly showed alcohol consumption or excessive medication use prior to their suicidal self-injury compared to those with schizophrenia (odds ratio: 8.10; 95%CI: 2.97-24.60). To inhibit suicidal self-injury among patients with adjustment disorder, it is important to continue efforts to provide psychoeducation about alcohol use and to instruct the patients to take their prescribed medication(s) only as directed by their physician

A method for Selecting Scenes and Emotion-based Descriptions for a Robot's Diary

In this study, we examined scene selection methods and emotion-based descriptions for a robot's daily diary. We proposed a scene selection method and an emotion description method that take into account semantic and affective information, and created several types of diaries. Experiments were conducted to examine the change in sentiment values and preference of each diary, and it was found that the robot's feelings and impressions changed more from date to date when scenes were selected using the affective captions. Furthermore, we found that the robot's emotion generally improves the preference of the robot's diary regardless of the scene it describes. However, presenting negative or mixed emotions at once may decrease the preference of the diary or reduce the robot's robot-likeness, and thus the method of presenting emotions still needs further investigation.Comment: 6 pages, 5 figures, ROMAN 202

Automatic Diary Generation System including Information on Joint Experiences between Humans and Robots

In this study, we propose an automatic diary generation system that uses information from past joint experiences with the aim of increasing the favorability for robots through shared experiences between humans and robots. For the verbalization of the robot's memory, the system applies a large-scale language model, which is a rapidly developing field. Since this model does not have memories of experiences, it generates a diary by receiving information from joint experiences. As an experiment, a robot and a human went for a walk and generated a diary with interaction and dialogue history. The proposed diary achieved high scores in comfort and performance in the evaluation of the robot's impression. In the survey of diaries giving more favorable impressions, diaries with information on joint experiences were selected higher than diaries without such information, because diaries with information on joint experiences showed more cooperation between the robot and the human and more intimacy from the robot.Comment: 12 pages, 5 figures, IAS-1

How should tracers be injected to detect for sentinel nodes in gastric cancer – submucosally from inside or subserosally from outside of the stomach?

<p>Abstract</p> <p>Background</p> <p>In sentinel node (SN) detection for cases of early gastric cancer, the submucosal dye injection method appears to be more reasonable than the subserosal injection. To compare the two injection methods, we have focused on the rate of concordance between hot nodes (HNs) obtained from the radioisotope (RI) method and green nodes (GNs) obtained from the dye-guided method in addition to the number and distribution of GNs detected, and the sensitivity of metastatic detection.</p> <p>Methods</p> <p>The subjects of this study were 63 consecutive patients with gastric cancer (sT1–T2, sN0, tumor diameter ≦ 4 cm) in whom we attempted SN detection using a combination of RI and dye methods. ^99mTc-tin colloid was injected a day before the surgery, and indocyanine green was injected either submucosally (n = 43) with endoscopes or subserosally (n = 20) by direct vision.</p> <p>Results</p> <p>An average of hot and green nodes (H&G: 4 ± 3 vs. 4 ± 3), hot and non-green nodes (H&NG: 2 ± 3 vs. 1 ± 2), cold and green nodes (C&G: 2 ± 2 vs. 3 ± 4), and the rate of concordance (H&G/H&G + H&NG + C&G: 45 + 27% vs. 48 ± 30%) were not significantly different between the submucosal and subserosal injection methods. The spread of GNs to tier 2 stations (24% vs. 30%) and metastatic detection sensitivity (86% vs. 100%) were also not different between the submucosal and subserosal injection methods.</p> <p>Conclusion</p> <p>The tracer injection sites do not have to be limited to the submucosa.</p

What Is the Problem in Clinical Application of Sentinel Node Concept to Gastric Cancer Surgery?

More than ten years have passed since the sentinel node (SN) concept for gastric cancer surgery was first discussed. Less invasive modified surgical approaches based on the SN concept have already been put into practice for malignant melanoma and breast cancer, however the SN concept is not yet placed in a standard position in gastric cancer surgery even after two multi-institutional prospective clinical trials, the Japan Clinical Oncology Group trial (JCOG0302) and the Japanese Society for Sentinel Node Navigation Surgery (SNNS) trial. What is the problem in the clinical application of the SN concept to gastric cancer surgery? There is no doubt that we need reliable indicator(s) to determine with certainty the absence of metastasis in the lymph nodes in order to avoid unnecessary lymphadenectomy. There are several matters of debate in performing the actual procedure, such as the type of tracer, the site of injection, how to detect and harvest, how to detect metastases of SNs, and learning period. These issues have to be addressed further to establish the most suitable procedure. Novel technologies such as indocyanine green (ICG) fluorescence imaging and one-step nucleic acid amplification (OSNA) may overcome the current difficulties. Once we know what the problems are and how to tackle them, we can pursue the goal

The Tumor-Log Odds of Positive Lymph Nodes-Metastasis Staging System, a Promising New Staging System for Gastric Cancer after D2 Resection in China

BACKGROUND: In this study, we established a hypothetical tumor-lodds-metastasis (TLM) and tumor-ratio-metastasis (TRM) staging system. Moreover, we compared them with the 7(th) edition of American Joint Committee on Cancer tumor-nodes-metastasis (AJCC TNM) staging system in gastric cancer patients after D2 resection. METHODS: A total of 1000 gastric carcinoma patients receiving treatment in our center were selected for the analysis. Finally, 730 patients who received D2 resection were retrospectively studied. Patients were staged using the TLM, TRM and the 7(th) edition AJCC TNM system. Survival analysis was performed with a Cox regression model. We used two parameters to compare the TNM, TRM and TLM staging system, the -2log likelihood and the hazard ratio. RESULTS: The cut points of lymph node ratio (LNR) were set as 0, 0-0.3, 0.3-0.6, 0.6-1.0. And for the log odds of positive lymph nodes (LODDS), the cut points were established as≤-0.5, -0.5-0, 0-0.5, >0.5. There were significant differences in survival among patients in different LODDS classifications for each pN or LNR groups. When stratified by the LODDS classifications, the prognosis was highly homologous between those in the according pN or LNR classifications. Multivariate analysis showed that TLM staging system was better than the TRM or TNM system for the prognostic evaluation. CONCLUSIONS: The TLM system was superior to the TRM or TNM system for prognostic assessment of gastric adenocarcinoma patients after D2 resection

Evaluation of the 7th AJCC TNM Staging System in Point of Lymph Node Classification

Purpose: The 7th AJCC tumor node metastasis (TNM) staging system modified the classification of the lymph node metastasis widely compared to the 6th edition. To evaluate the prognostic predictability of the new TNM staging system, we analyzed the survival rate of the gastric cancer patients assessed by the 7th staging system. Materials and Methods: Among 2,083 patients who underwent resection for gastric cancer at the department of surgery, Hanyang Medical Center from July 1992 to December 2009, This study retrospectively reviewed 5-year survival rate (5YSR) of 624 patients (TanyN3M0: 464 patients, TanyNanyM1: 160 patients) focusing on the number of metastatic lymph node and distant metastasis. We evaluated the applicability of the new staging system. Results: There were no significant differences in 5YSR between stage IIIC with more than 29 metastatic lymph nodes and stage IV (P=0.053). No significant differences were observed between stage IIIB with more than 28 metastatic lymph nodes and stage IV (P=0.093). Distinct survival differences were present between patients who were categorized as TanyN3M0 with 7 to 32 metastatic lymph nodes and stage IV. But patients with more than 33 metastatic lymph nodes did not show any significant differences compared to stage IV (P=0.055). Among patients with TanyN3M0, statistical significances were seen between patients with 7 to 30 metastatic lymph nodes and those with more than 31 metastatic lymph nodes. Conclusions: In the new staging system, modifications of N classification is mandatory to improve prognostic prediction. Further study involving a greater number of cases is required to demonstrate the most appropriate cutoffs for N classification. ??? 2011 by The Korean Gastric Cancer Association