Utilization of the Inkling™ for the Rey - Osterrieth Complex Figure test

　The Rey - Osterrieth Complex Figure (ROCF) test assess visual-construction abilility, visual memory and executive function. Three different methods are traditionally used to track and to record the strokes during the production of the complex figure: single pen, switching felt pens and flowcharts. The Inkling™ is an instrument which attributes are to track, to record and to save the information of every stroke depicted in a standard piece of paper. The purpose of the study is to examine the advantages and disadvantages of using the Inkling™ in the ROCF test. 66 ROCF performances were analyzed from subjects aged 6 to 86 years old. Each subject performed the ROCF test twice; first with pen switching method without flowcharts and later with the Inkling™ or viceversa. The comparison of the performances evidenced 5 characteristics: Four subjects distracted by the color of the felt pens, three subjects interfered by the switching of the felt pens, three subjects which performance was facilitated by the colors of the felt pens, nine subjects with unclear score for Fragmentation and fourteen subjects with unclear score for Planning. The advantages that the Inkling™ showed were compensation for the process of flowcharts, avoid interference, and reduce the burden of unclear scoring for Fragmentation and Planning

Elastic Response in the Dilute non-Kramers System Y1−x_{1-x}Prx_xIr2_2Zn20_{20}

Ultrasonic investigations of the single-site quadrupolar Kondo effect in diluted Pr system Y$_{0.966}$Pr$_{0.034}$Ir$_2$Zn$_{20}$ are reported. The elastic constant $(C_{11}-C_{12})/2$ is measured down to ~40 mK using ultrasound for the dilute system Y$_{0.966}$Pr$_{0.034}$Ir$_2$Zn$_{20}$ and the pure compound YIr$_2$Zn$_{20}$. We found that the elastic constant $(C_{11}-C_{12})/2$ of the Pr-dilute system exhibits a logarithmic temperature dependence below $T_0$ ~0.3 K, where non-Fermi-liquid (NFL) behavior in the specific heat and electrical resistivity is observed. This logarithmic temperature variation manifested in the $\Gamma_3$-symmetry quadrupolar susceptibility is consistent with the theoretical prediction of the quadrupolar Kondo effect by D. L. Cox. On the other hand, the pure compound YIr$_2$Zn$_{20}$ without $4f$-electron contributions shows nearly no change in its elastic constants evidencing negligible phonon contributions. In addition, clear acoustic de Haas-van Alphen (dHvA) oscillations in the elastic constant were detected for both compounds on applying magnetic field. This is mainly interpreted as contribution from the Fermi surface of YIr$_2$Zn$_{20}$.Comment: 9 pages, 4 figures, Proceedings of J-Physics 2019 International Conferenc

CAUSES OF FUNCTIONAL DECLINE IN ELDERLY HOSPITALIZED PATIENTS RECEIVING EITHER INDIVIDUAL OR EXCLUSIVE REHABILITATION THERAPY: A COHORT STUDY

Background: Recently, exclusive rehabilitation therapy was introduced to prevent functional decline due to hospital-associated deconditioning by managing older inpatients’ activities of daily living in Japan. However, this type of therapy does not provide one-on-one exercises similar to individual rehabilitation therapy. This study aimed to report the present ward conditions and the causes of the functional decline in elderly patients receiving individual or exclusive rehabilitation therapy. Methods: A total of 1,636 inpatients, aged 65 years or older, were included in the study. Barthel Index at admission and discharge was assessed prospectively to analyze functional decline. We further analyzed the causes of functional decline by investigating the inpatient’s medical records. Results: Forty-three inpatients (2.6%) had functional decline during hospitalization. There were no significant differences in age, Barthel Index at the time of admission, and the type of clinical department between inpatients with and without functional decline. The functional decline rate in individual rehabilitation therapy was 8.2%, which was significantly higher compared to exclusive rehabilitation therapy (0.8%). The most common causes of functional decline were a pain, low postoperative physical fitness, malignant neoplasm, and new-onset cerebral stroke. Conclusion: We report the present ward conditions in elderly patients receiving either individual or exclusive rehabilitation therapies. Functional decline was correlated to the inpatients’ disease and conditions. The causes of the functional decline can be classified based on whether rehabilitation was effective or ineffective. If the functional decline was caused by hospital-associated deconditioning, we should address the functional decline by providing appropriate rehabilitation methods

eSPRESSO: topological clustering of single-cell transcriptomics data to reveal informative genes for spatio–temporal architectures of cells

[Background] Bioinformatics capability to analyze spatio–temporal dynamics of gene expression is essential in understanding animal development. Animal cells are spatially organized as functional tissues where cellular gene expression data contain information that governs morphogenesis during the developmental process. Although several computational tissue reconstruction methods using transcriptomics data have been proposed, those methods have been ineffective in arranging cells in their correct positions in tissues or organs unless spatial information is explicitly provided. [Results] This study demonstrates stochastic self-organizing map clustering with Markov chain Monte Carlo calculations for optimizing informative genes effectively reconstruct any spatio–temporal topology of cells from their transcriptome profiles with only a coarse topological guideline. The method, eSPRESSO (enhanced SPatial REconstruction by Stochastic Self-Organizing Map), provides a powerful in silico spatio–temporal tissue reconstruction capability, as confirmed by using human embryonic heart and mouse embryo, brain, embryonic heart, and liver lobule with generally high reproducibility (average max. accuracy = 92.0%), while revealing topologically informative genes, or spatial discriminator genes. Furthermore, eSPRESSO was used for temporal analysis of human pancreatic organoids to infer rational developmental trajectories with several candidate ‘temporal’ discriminator genes responsible for various cell type differentiations. [Conclusions] eSPRESSO provides a novel strategy for analyzing mechanisms underlying the spatio–temporal formation of cellular organizations

Clinical application of the Rey-Osterrieth Complex Figure Test for children with developmental disorders

　本研究では，10 名の読みや書きなどの学習面に困難を抱える発達障害をともなう子ども にWechsler式知能検査およびRey-Osterrieth複雑図形検査（ROCF）を実施し，認知特性の 実態把握の過程におけるROCFの有用性を検討した。ROCFの記録には被検者の描画過程 をデータ化してパソコンに取り込むことのできるタッチペン （Inkling™） を用い，成績評価 には，描画の質的評価も含むBoston Qualitative Scoring System （BQSS） を用いた。 Wechsler式知能検査における知覚統合や知覚推理の下位検査の得点が良好であっても， ROCFにおいて構成力や描画過程に困難が少なからず認められ，これらは学習面における困 難の背景にある病態を反映したものと考えられた。また，本検査成績を検討する上で， BQSSの概要得点の1 つである組織構成，概要得点に含まれていないクラスター要素や細部 要素の配置の評価の重要性についても論じた

Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study

AbstractObjectiveDisease progression because of acquired resistance is common in advanced or metastatic epidermal growth factor receptor (EGFR)-mutation positive non-small cell lung cancer (NSCLC), despite initial response to EGFR-tyrosine kinase inhibitors (TKIs). In Japan, transbronchial tissue biopsy is the most common sampling method used for re-biopsy to identify patients eligible for treatment. We aimed to investigate the success rate of re-biopsy and re-biopsy status of patients with advanced or metastatic NSCLC completing first-line EGFR-TKI therapy.Patients and methodsThis was a retrospective, multi-center, Japanese study. The target patients in the study were EGFR mutation-positive NSCLC patients. The primary endpoint was the success rate (number of cases in which tumor cells were detected/total number of re-biopsies performed×100). Secondary endpoints included differences between the status of the first biopsy and that of the re-biopsy in the same patient population, and the details of cases in which re-biopsy could not be carried out. Re-biopsy-associated complications were also assessed.ResultsOverall, 395 patients were evaluated (median age 63 years), with adenocarcinoma being the most common tumor type. Re-biopsy was successful in 314 patients (79.5%). Compared with the sampling method at first biopsy, at re-biopsy, the surgical resection rate increased from 1.8% to 7.8%, and percutaneous tissue biopsy increased from 7.6% to 29.1%, suggesting the difficulty of performing re-biopsy. Approximately half of the patients had T790M mutations, which involved a Del19 mutation in 55.6% of patients and an L858R mutation in 43.0%. Twenty-three patients (5.8%) had re-biopsy- associated complications, most commonly pneumothorax.ConclusionsSuccess rate for re-biopsy in this study was approximately 80%. Our study sheds light on the re-biopsy status after disease progression in patients with advanced or metastatic NSCLC. This information is important to improve the selection of patients who may benefit from third-generation TKIs

Combination of Myogenic and Neurogenic Motor Evoked Potential Monitoring During Thoracoabdominal Aortic Surgery

A 64-year-old woman was evaluated for thoracoabdominal aortic aneurysms (TAAAs). Preoperative computed tomography showed a TAAA extending from the level of the diaphragm to the renal arteries. The Adamkiewicz artery (AKA) arose at the Th10 level, close to the aneurysm, and an abdominal aortic prosthesis and left iliac artery aneurysm were detected. Myogenic and neurogenic motor evoked potentials (MEPs) were monitored during the surgical repair of the TAAA, and there were differences between the two types of MEPs during surgery. Both MEPs fell below 50% of their baseline levels during surgery, which suggested critical ischemia, but the decrease in the myogenic MEP occurred at a different time from the decrease in the neurogenic MEP. A time-course analysis suggested that AKA reimplantation was unnecessary and all intercostal arteries were ligated. Both MEPs recovered completely by the end of surgery and there were no postoperative neurologic deficits. Our findings suggest that the combination of myogenic and neurogenic MEP monitoring is helpful in evaluating spinal cord injury during the surgical repair of TAAAs