救急隊員が実施する蘇生処置に対する受益者の支払意思額 : 仮想市場調査法を用いた調査

Background: Japanese emergency medical services (EMS) can be used by anyone for free. Recently, EMS usage has increased; the increased costs and the prolonged time for ambulance transport have become recent social problems. Objective: We surveyed the willingness to pay (WTP) for resuscitation provided by EMS. Methods: In November 2011, men and women (3160) aged 20 - 59 years were asked to assume that they were experiencing a cardiopulmonary arrest (CPA), and their WTP for EMS services was assessed in the following three situations: Case A, ambulance transport alone; Case B, chest compression in addition to ambulance transport; and Case C, artificial ventilation through chest compression and intratracheal intubation, in addition to ambulance transport. We calculated the mean WTP for each case. Results: The WTP for Case A, B, and C were ¥6,696 ($65.0), ¥16,081 ($156.1), and ¥27,505 ($267.0), respectively. The WTP for Case B was significantly higher in respondents aged 40 - 59 years compared to those aged 20 - 39 years. The WTP for case B and C were significantly higher in males compared to females. WTP was significantly lower in students than it was in private employees. Although women’s intention to pay was higher than that of men, their WTP was lower than that of men. Public employees’ and students’ intention to pay was significantly lower than that of private employees. Conclusions: Our study provides information about the optimal fee for EMS, which will be useful for discussions on the feasibility of introducing a fee for EMS in Japan.博士（医学）・甲第678号・平成30年3月15日Copyright © 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0

Japanese Encephalitis Virus in Meningitis Patients, Japan

Cerebrospinal fluid specimens from 57 patients diagnosed with meningitis were tested for Japanese encephalitis virus. Total RNA was extracted from the specimens and amplified. Two products had highest homology with Nakayama strain and 2 with Ishikawa strain. Results suggest that Japanese encephalitis virus causes some aseptic meningitis in Japan

The Rapeseed Project for Restoring Tsunami-Salt-Damaged Farmland after the GEJE

Oral Presentatio

Internal structures of a subaerial dacite cryptodome at Usu volcano, Hokkaido, Japan

A partly eroded, subaerial, dacite cryptodome at Showa-Shinzan, Usu volcano, Hokkaido, Japan, displays its internal structures, and provides an excellent opportunity to study contact relationship between cryptodome and overlying sediment. The margin of the cryptodome comprises two facies: inner coherent dacite and outer dacite breccia. The coherent dacite facies is ~5 m in the exposed section, and consists of homogeneous or weakly flow-banded, feldspar-phyric dacite. The dacite breccia facies envelope the coherent dacite facies, and is 4-5 m thick. The breccia is monomictic, non-stratified and consists of angular dacite clasts up to 15 cm across in a cogenetic matrix. The overlying sediment directly covers the dacite breccia facies, and comprises reddish-brown, fluvial deposit. The dacite breccia formed by　fracturing of coherent dacite in response to cooling contraction, and shearing of the fractured dacite due to movement of the growing cryptodome.特集 : 「2003年度実施の地域との共同研究の報告

Artificial Intelligence Analysis of the Gene Expression of Follicular Lymphoma Predicted the Overall Survival and Correlated with the Immune Microenvironment Response Signatures

Follicular lymphoma (FL) is the second most common lymphoma in Western countries. FL is characterized by being incurable, usually having an indolent clinical course with frequent relapses, and an eventual patient’s death or transformation to Diffuse Large B-cell Lymphoma. The immune response and the tumoral immune microenvironment, including FOXP3+Tregs, PD-1+TFH cells, TNFRSF14 (HVEM), and BTLA play a role in the pathogenesis. We aimed to analyze the gene expression of FL by Artificial Intelligence (machine learning, deep learning), to identify genes associated with the prognosis of the patients and with the microenvironment in terms of overall survival (OS). A series of 184 cases of the GSE16131 dataset was analyzed by multilayer perceptron (MLP) and radial basis function (RBF) neural networks. In the analysis, MLP and RBF had a synergistic effect. From an initial set of 22,215 genes probes, a final set of 43 genes was highlighted. These 43 genes predicted the OS and correlated with the immune microenvironment: in a multivariate Cox analysis, 18 genes were associated with a poor prognosis (namely, MED8, KRT19, CDC40, SLC24A2, PRB1, KIAA0100, EVA1B, KLK10, TMEM70, BTN2A3P, TRPM4, MED6, FRYL, CBFA2T2, RANBP9, BNIP2, PTP4A2 and ALDH1L1) and 25 genes were associated with a good prognosis of the patients. Gene set enrichment analysis (GSEA) confirmed these findings and showed a typical sinusoidal-like shape. Some of the most relevant genes for poor OS were EVA1B, KRT19, BTN2A3P, KLK10, TRPM4, TMEM70, and SLC24A2 (hazard risk = from 1.7 to 4.3, p < 0.005) and for good OS, these were TDRD12 and ZNF230 (HR = 0.34 and 0.28, p < 0.001). EVA1B, KRT19, BTN2AP3, KLK10, and TRPM4 also associated with M2-like macrophage markers including CD163, MRC1 (CD206), and IL10 in the core enrichment for dead OS outcome by GSEA and to poor OS by Kaplan–Meier with Log rank test. The scientific literature showed that some of these genes also play a role in other types of cancer. In conclusion, by Artificial Intelligence, we have identified new biomarkers with prognostic relevance in FL

The Use of the Random Number Generator and Artificial Intelligence Analysis for Dimensionality Reduction of Follicular Lymphoma Transcriptomic Data

Follicular lymphoma (FL) is one of the most frequent subtypes of non-Hodgkin lymphomas. This research predicted the prognosis of 184 untreated follicular lymphoma patients (LLMPP GSE16131 series), using gene expression data and artificial intelligence (AI) neural networks. A new strategy based on the random number generation was used to create 120 different and independent multilayer perceptron (MLP) solutions, and 22,215 gene probes were ranked according to their averaged normalized importance for predicting the overall survival. After dimensionality reduction, the final neural network architecture included (1) newly identified predictor genes related to cell adhesion and migration, cell signaling, and metabolism (EPB41L4B, MOCOS, SPIN2A, BTD, SRGAP3, CTNS, PRB1, L1CAM, and CEP57); (2) the international prognostic index (IPI); and (3) other relevant immuno-oncology, immune microenvironment, and checkpoint markers (CD163, CSF1R, FOXP3, PDCD1, TNFRSF14 (HVEM), and IL10). The performance of this neural network was good, with an area under the curve (AUC) of 0.89. A comparison with other machine learning techniques (C5 tree, logistic regression, Bayesian network, discriminant analysis, KNN algorithms, LSVM, random trees, SVM, tree-AS, XGBoost linear, XGBoost tree, CHAID, Quest, C&R tree, random forest, and neural network) was also made. In conclusion, the overall survival of follicular lymphoma was predicted with a neural network with high accuracy

A Combination of Multilayer Perceptron, Radial Basis Function Artificial Neural Networks and Machine Learning Image Segmentation for the Dimension Reduction and the Prognosis Assessment of Diffuse Large B-Cell Lymphoma

The prognosis of diffuse large B-cell lymphoma (DLBCL) is heterogeneous. Therefore, we aimed to highlight predictive biomarkers. First, artificial intelligence was applied into a discovery series of gene expression of 414 patients (GSE10846). A dimension reduction algorithm aimed to correlate with the overall survival and other clinicopathological variables; and included a combination of Multilayer Perceptron (MLP) and Radial Basis Function (RBF) artificial neural networks, gene-set enrichment analysis (GSEA), Cox regression and other machine learning and predictive analytics modeling [C5.0 algorithm, logistic regression, Bayesian Network, discriminant analysis, random trees, tree-AS, Chi-squared Automatic Interaction Detection CHAID tree, Quest, classification and regression (C&R) tree and neural net)]. From an initial 54,613 gene-probes, a set of 488 genes and a final set of 16 genes were defined. Secondly, two identified markers of the immune checkpoint, PD-L1 (CD274) and IKAROS (IKZF4), were validated in an independent series from Tokai University, and the immunohistochemical expression was quantified, using a machine-learning-based Weka segmentation. High PD-L1 associated with poor overall and progression-free survival, non-GCB phenotype, Epstein–Barr virus infection (EBER+), high RGS1 expression and several clinicopathological variables, such as high IPI and absence of clinical response. Conversely, high expression of IKAROS was associated with a good overall and progression-free survival, GCB phenotype and a positive clinical response to treatment. Finally, the set of 16 genes (PAF1, USP28, SORT1, MAP7D3, FITM2, CENPO, PRCC, ALDH6A1, CSNK2A1, TOR1AIP1, NUP98, UBE2H, UBXN7, SLC44A2, NR2C2AP and LETM1), in combination with PD-L1, IKAROS, BCL2, MYC, CD163 and TNFAIP8, predicted the survival outcome of DLBCL with an overall accuracy of 82.1%. In conclusion, building predictive models of DLBCL is a feasible analytical strategy

Copy Number Alteration and Mutational Profile of High-Grade B-Cell Lymphoma with MYC and BCL2 and/or BCL6 Rearrangements, Diffuse Large B-Cell Lymphoma with MYC-Rearrangement, and Diffuse Large B-Cell Lymphoma with MYC-Cluster Amplification.

The authors thank the technicians and scientists of the Genomics Core Facility of the IDIBAPS for their assistance in performing the NGS analysis.Diffuse large B-cell lymphoma (DLBCL) with MYC alteration is classified as high-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements (double/triple-hit lymphoma; DHL/THL), DLBCL with MYC rearrangement (single-hit lymphoma; SHL) and DLBCL with MYC-cluster amplification (MCAD). To elucidate the genetic features of DHL/THL, SHL, and MCAD, 23 lymphoma cases from Tokai University Hospital were analyzed. The series included 10 cases of DHL/THL, 10 cases of SHL and 3 cases of MCAD. The analysis used whole-genome copy number microarray analysis (OncoScan) and a custom-made next-generation sequencing (NGS) panel of 115 genes associated with aggressive B-cell lymphomas. The copy number alteration (CNA) profiles were similar between DHL/THL and SHL. MCAD had fewer CNAs than those of DHL/THL and SHL, except for +8q24. The NGS profile characterized DHL/THL with a higher "mutation burden" than SHL (17 vs. 10, p = 0.010), and the most relevant genes for DHL/THL were BCL2 and SOCS1, and for SHL was DTX1. MCAD was characterized by mutations of DDX3X, TCF3, HLA-A, and TP53, whereas MYC was unmutated. In conclusion, DHL/THL, SHL, and MCAD have different profiles.S

High Expression of Caspase-8 Associated with Improved Survival in Diffuse Large B-Cell Lymphoma: Machine Learning and Artificial Neural Networks Analyses

High expression of the anti-apoptotic TNFAIP8 is associated with poor survival of the patients with diffuse large B-cell lymphoma (DLBCL), and one of the functions of TNFAIP8 is to inhibit the pro-apoptosis Caspase-8. We aimed to analyze the immunohistochemical expression of Caspase-8 (active subunit p18; CASP8) in a series of 97 cases of DLBCL from Tokai University Hospital, and to correlate with other Caspase-8 pathway-related markers, including cleaved Caspase-3, cleaved PARP, BCL2, TP53, MDM2, MYC, Ki67, E2F1, CDK6, MYB and LMO2. After digital image quantification, the correlation with several clinicopathological characteristics of the patients showed that high protein expression of Caspase-8 was associated with a favorable overall and progression-free survival (Hazard Risks = 0.3; p = 0.005 and 0.03, respectively). Caspase-8 also positively correlated with cCASP3, MDM2, E2F1, TNFAIP8, BCL2 and Ki67. Next, the Caspase-8 protein expression was modeled using predictive analytics, and a high overall predictive accuracy (>80%) was obtained with CHAID decision tree, Bayesian network, discriminant analysis, C5 tree, logistic regression, and Artificial Intelligence Neural Network methods (both Multilayer perceptron and Radial basis function); the most relevant markers were cCASP3, E2F1, TP53, cPARP, MDM2, BCL2 and TNFAIP8. Finally, the CASP8 gene expression was also successfully modeled in an independent DLBCL series of 414 cases from the Lymphoma/Leukemia Molecular Profiling Project (LLMPP). In conclusion, high protein expression of Caspase-8 is associated with a favorable prognosis of DLBCL. Predictive modeling is a feasible analytic strategy that results in a solution that can be understood (i.e., explainable artificial intelligence, “white-box” algorithms)