認知障害のある高齢者における相貌認知と行動の関係

取得学位 : 博士（保健学）, 学位授与番号 : 医博甲第1705号, 学位授与年月日 : 平成17年3月22日, 学位授与大学 : 金沢大学, 主査 :生田 宗博, 副査 :染矢 富士子, 二木 淑

Comparison of Value Set Based on DCE and/or TTO Data: Scoring for EQ-5D-5L Health States in Japan

AbstractBackgroundThe valuation study of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L) involved composite time trade-off (cTTO) and a discrete choice experiment (DCE). The DCE scores must be anchored to the quality-of-life scale from 0 (death) to 1 (full health). Nevertheless, the characteristics of the statistical methods used for converting the EQ-5D-5L DCE results by using TTO information are not yet clearly known.ObjectivesTo present the Japanese DCE value set of the EQ-5D-5L and compare three methods for converting latent DCE values.MethodsThe survey sampled the general population at five locations in Japan. 1098 respondents were stratified by age and sex. To obtain and compare the value sets of the EQ-5D-5L, the cTTO and DCE data were analyzed by a linear mixed model and conditional logit, respectively. The DCE scores were converted to the quality-of-life scale by anchoring to the worst state using cTTO, mapping DCE onto cTTO, and a hybrid model.ResultsThe data from 1026 respondents were analyzed. All the coefficients in the cTTO and DCE value sets were consistent throughout all the analyses. Compared with the cTTO algorithm, the mapping and hybrid methods yielded very similar scoring coefficients. The hybrid model results, however, produced a lower root mean square error and fewer health states with errors exceeding 0.05 than did the other models. The DCE anchored to the worst state overestimated the cTTO scores of almost all the health states.ConclusionsJapanese value sets based on DCE were demonstrated. On comparing the observed cTTO scores, we found that the hybrid model was slightly superior to the simpler methods, including the TTO model

Comparison of the Motion Accuracy of a Six Degrees of Freedom Radiotherapy Couch with and without Weights

In this study, we compared the motion accuracy of a six degrees of freedom (6D) couch for precision radiotherapy with or without weights attached to the couch. Two digital cameras were focused on the iso-center of a linear accelerator. Images of a needle which had been fixed to the 6D couch were obtained using the cameras when the couch moved in translation and rotation around each axis. The three-dimensional (3D) coordinates of the needle were calculated from coordinate values in the images. A coordinate error of the needle position relative to the theoretical position was calculated. The errors were obtained with or without a 60 kg weight attached to the 6D couch, and these errors were compared with each other. The mean distance of the 3D error vectors for the weighted test was 0.21 ± 0.11 mm, and >0.16 ± 0.09 mm for the non-weighted test (p < 0.05). However, the difference of two values was 0.06 mm which is smaller than the minimum distance the 6D couch system can correctly move. The variance of 0.16 mm for the Y coordinate errors for the weighted test only was larger than that for the non-weighted test, which was 0.06 mm (p < 0.05). We found that a total weight of 60 kg did not affect the accuracy of the 6D couch clinically. However, the variance of the Y coordinate errors was increased. This might suggest that the addition of this weight increased the uncertainty of the motion of the 6D couch

A metric for evaluation of deformable image registration

We propose a new metric, local uncertainty (LU), for the evaluation of deformable image registration (DIR) for dose accumulation in radiotherapy. LU measures the uncertainty of placement of each voxel in an image set after a DIR. The underlying concept of LU is that the distance between a focused voxel and a surrounding voxel on an image feature such as an edge is unchanged locally when the organ that includes these voxels is deformed. A candidate for the focused voxel after DIR can be calculated from three surrounding voxels and their distances. The positions of the candidates of the focused voxel calculated from several groups of any three surrounding voxels would vary. The variation of candidate positions indicates uncertainty of the focused voxel position. Thus, the standard deviation of candidate positions is treated as an LU value. The LU can be calculated in uniform signal regions. Assessment of DIR results in such regions is important for dose accumulation. The LU calculation was applied to a pair of computed tomography (CT) head and neck examinations after DIR. These CT examinations were for the initial radiotherapy planning and re-planning for a treatment course where the tumor underwent shrinkage during treatment. We generated an LU image showing high LU values in the shrinking tumor region and low LU values in undeformable bone. We have proposed the LU as a new metric for DIR

Long-term stability of the Hounsfield unit to electron density calibration curve in cone-beam computed tomography images for adaptive radiotherapy treatment planning

Aim To use cone-beam computed tomography (CBCT) images for treatment planning, the Hounsfield unit (HU)-electron density (ED) calibration table for CBCT should be stable. The purpose of this study was to verify the stability of the HU values for the CBCT system over 1 year and to evaluate the effects of variation in HU-ED calibration curves on dose calculation. Materials and Methods A tissue characterisation phantom was scanned with the field of view (FOV) of size S (FOV-S) and FOV of size M (FOV-M) using the CBCT system once a month for 1 year. A single field treatment plan was constructed on digital phantom images to validate the dose distribution using mean HU-ED calibration curves and possible variations. Results HU values for each material rod over the observation period varied with trend. The HU value of the cortical bone rod decreased by about 100 HU for the FOV-S and by about 300 HU for the FOV-M. Possible variation in the HU-ED calibration curves produced a ≤17·9% dose difference in the dose maximum in the treatment plan. Conclusions The CBCT system should be calibrated periodically for consistent dose calculation. © Cambridge University Press 2015. Aim To use cone-beam computed tomography (CBCT) images for treatment planning, the Hounsfield unit (HU)-electron density (ED) calibration table for CBCT should be stable. The purpose of this study was to verify the stability of the HU values for the CBCT system over 1 year and to evaluate the effects of variation in HU-ED calibration curves on dose calculation. Materials and Methods A tissue characterisation phantom was scanned with the field of view (FOV) of size S (FOV-S) and FOV of size M (FOV-M) using the CBCT system once a month for 1 year. A single field treatment plan was constructed on digital phantom images to validate the dose distribution using mean HU-ED calibration curves and possible variations. Results HU values for each material rod over the observation period varied with trend. The HU value of the cortical bone rod decreased by about 100 HU for the FOV-S and by about 300 HU for the FOV-M. Possible variation in the HU-ED calibration curves produced a ≤17·9% dose difference in the dose maximum in the treatment plan. Conclusions The CBCT system should be calibrated periodically for consistent dose calculation. © Cambridge University Press 2015

Assessment of activities and the participation domain based on the ICF for the elderly requiring care

ICFの「活動と参加」の評価を通して,要介護高齢者における生活機能低下の全体像を把握することを目的に調査を実施した.要介護高齢者672名を対象に,ICFの「活動と参加」の第2レベル73項目について,「実行状況」と「能力」の両面から評価点を評価し,Item　Indexとしてそれぞれの困難度を求めた.「活動と参加」における領域ごとの比較では第5領域「セルフケア」のItem Indexが最も低くなり,「実行状況」で37.7,「能力」で34.4となった.逆に高くなったのは第6領域「家庭生活」であり,それぞれ89.6,77.7となった.本研究の結果は要介護高齢者の生活機能低下の現状と評価手段としてのICF活用の可能性を示すものである.The purpose of this study was to understand the degree of functioning and disability level in elderly requiring care through the evaluation of each domain of "activity and participation" in ICF. The study investigated 672 elderly requiring care. In the investigation, regarding the 2nd level of 73 "activity and participation" domains in the ICF, the elderly were evaluated from "performance" and "capacity", and then converted to the Item Index. Subsequently, each item was evaluated, and the degree of difficulty for both performance and capacity was determined. In the comparison of both performance and capacity, the Item Index of Chapter 5 "SELF-CARE" was the lowest, while "performance" was 37. 7, and "capacity" was 34. 4. Conversely, the Item Index of Chapter 6 "DOMESTIC LIFE" became higher: it was 89. 6 and 77. 7 respectively. The results indicate the degree of both dysfunction and disability of the elderly requiring care, and also demonstrate the possibility of the ICF as an assessment tool

Impact of pitch angle setup error and setup error correction on dose distribution in volumetric modulated arc therapy for prostate cancer

In volumetric modulated arc therapy (VMAT) for prostate cancer, a positional and rotational error correction is performed according to the position and angle of the prostate. The correction often involves body leaning, and there is concern regarding variation in the dose distribution. Our purpose in this study was to evaluate the impact of body pitch rotation on the dose distribution regarding VMAT. Treatment plans were obtained retrospectively from eight patients with prostate cancer. The body in the computed tomography images for the original VMAT plan was shifted to create VMAT plans with virtual pitch angle errors of ±1.5° and ±3°. Dose distributions for the tilted plans were recalculated with use of the same beam arrangement as that used for the original VMAT plan. The mean value of the maximum dose differences in the dose distributions between the original VMAT plan and the tilted plans was 2.98 ± 0.96 %. The value of the homogeneity index for the planning target volume (PTV) had an increasing trend according to the pitch angle error, and the values of the D95 for the PTV and D2ml, V50, V60, and V70 for the rectum had decreasing trends (p < 0.05). However, there was no correlation between differences in these indexes and the maximum dose difference. The pitch angle error caused by body leaning had little effect on the dose distribution; in contrast, the pitch angle correction reduced the effects of organ displacement and improved these indexes. Thus, the pitch angle setup error in VMAT for prostate cancer should be corrected. © 2016 Japanese Society of Radiological Technology and Japan Society of Medical PhysicsEmbargo Perios 12 month

Impacts of rule revision in game of Women’s Japan Basketball League influence that rule revision exerts on game in basketball

日本女子バスケットボールリーグ（WJBL）では2015年のルール改正を2014−2015シーズンから適用した。本研究ではWJBLの2014−2015シーズン（以下新ルールゲーム）と2013−2014シーズン（以下旧ルールゲーム）のスタッツを比較することで、そのルール改正の影響を調べた。新旧ルールゲームの比較では、フリースロー成功数（p＝0.036）、フリースロー試投数（p＝0.013）、ファウル数（p＝0.012）がそれぞれ有意に減少し、ディフェンス ・ リバウンド数（以下DFR）（p＝0.032）が有意に増加した。また、新旧ルールゲームの各勝ちチーム群の比較では、フリースロー成功確率（以下FT%）（p＝0.033）、DFR（p＝0.014）、ターンオーバー数（以下TON）（p＝0.032）がいずれも有意に増加していた。DFR、TONが増加したのは、新ルールに各チームが対応しておらず、苦しいシュートの選択、またはミスプレイにつながった可能性が示唆された。今回のルール改正ではゲームのスピード・アップを図り、攻撃やショットの機会をより増やすことを目的としていたが、WJBLの014−2015シーズンにおいては意図する効果は認められなかった。The newest rule revision of basketball in Japan was done in 2015, this rule had been applied at 2014-2015 seasons in WJBL（Women’s Japan Basketball League）. Then in this study, we researched the result of past games of WJBL that the rule revision in 2015 what influence the game. As a result, a significant difference was found in Free Throws Made（p=0.036） , Free Throws Attempted（p=0.013）, Fouls（p=0.012）, and Defense Rebounds （p=0.032） in comparing between the old and new rule games. Moreover, a significant difference was found in Free Throws Percentage（p=0.033）, Defense Rebounds （p=0.014）, and Turnovers （p=0.032） in comparing between winning team groups of the old and new rule game. Each team did not respond to the new rule, and it was suggested that Defense Rebounds and Turnovers had increased because players choose difficult shot or make mistakes. The purpose in the rule revision was to aim at the speedup of the game and to increase the chance of the attack and the shot more, but the effect of intending was not admitted at 2014-2015 season in WJBL

Game Analysis in Men’s University Basketball Game : For Hokushinetsu University of Basketball League in Division 1

バスケットボールについての研究では、選手個人やチームの技能を向上させることを目的としてさまざまなゲーム分析が実践されてきた。しかし、これまで行われてきた分析対象はトップカテゴリーが多く、地方の大学を対象としたものはほとんどない。そこで、本研究では北信越大学バスケットボール連盟男子1部リーグを対象に、試合中のどの要素が勝敗に影響を及ぼすか検討することを目的にゲーム分析を実施した。分析対象は第48回笹本杯争奪北信越大学バスケット ボール春季リーグ戦男子1 部リーグ全10試合とし、各試 合の勝ったチームの結果を勝ちチーム群、負けたチーム の結果を負けチーム群に分けて2群の比較を行った。分 析項目は、総得点、3ポイントシュート、2ポイント シュート、フリースロー、リバウンド、ターンオーバー、 攻撃回数とした。分析結果は総得点、3ポイントシュート（試投数、成功数、成功率）、2ポイントシュート（成功数）、攻撃効率に有意な差がみられた。その他の項目には有意な差は見られず、北信越大学リーグの特徴として、3ポイントシュートが勝敗に大きな影響を及ぼし、アウトサイドで 攻撃を展開していることが示唆された。Objectives ： The purpose of this research is to analyze the basketball game for Hokushinetsu University of Basketball League, and to clarify the tendency of the games.Methods ： Ten games of Men’s Hokushinetsu University of Basketball League in Division 1 were registered for this study. The analysis item was assumed to be total points, two points shot, three points shot, free throw, rebound, turnover, and possession.Results : The group of winner team indicated a value that was higher than the defeat team by total points, three points shot, two points shot and total points/possession.Whereas, two points shot, free throw, rebound, turnover didn’t have the influence.Conclusion : This result may indicate that the exterior shot is effectively used as a tendency to the win team in Hokushinetsu University of Basketball League.This has important implications for working out the tactic, and must be need further study