Enumerated sparse extraction of important surgical planning features for mandibular reconstruction

[2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC 2020); Montreal, Quebec, Canada, 20-24 July 2020]Because implicit medical knowledge and experience are used to perform medical treatment, such decisions must be clarified when systematizing surgical procedures. We propose an algorithm that extracts low-dimensional features that are important for determining the number of fibular segments in mandibular reconstruction using the enumeration of Lasso solutions (eLasso). To perform the multi-class classification, we extend the eLasso using an importance evaluation criterion that quantifies the contribution of the extracted features. Experiment results show that the extracted 7-dimensional feature set has the same estimation performance as the set using all 49-dimensional features

resection of oligometastases from CRC

A 74-year-old woman underwent right hemicolectomy and partial ileal resection for ascending colon cancer with synchronous peritoneal metastasis. Histopathological examination showed moderately differentiated adenocarcinoma with mucinous component, pT4b N3 M1, and Stage IV. Postoperative chemotherapy comprising 36 courses of mFOLFOX6 with bevacizumab was administered. Twenty-two months after the surgery, computed tomography (CT) revealed a 20 mm nodular lesion adjacent to the gastric wall, and laparoscopic resection of the nodule was performed. Thirty-nine months after the second surgery, CT showed a 24 mm nodular lesion involving the liver parenchyma, and partial hepatectomy involving the nodule was performed. Histopathological examination of the nodules resected by the second and third surgeries showed the same features as the primary ascending colon cancer. The nodules were diagnosed as metachronous peritoneal metastases. The patient followed up without chemotherapy after the second and third surgery, showed no recurrence for 26 months after the third surgery. Fortunately, more than 7 years have passed since the primary tumor resection. Hence, surgical resection for synchronous and repeated metachronous peritoneal oligometastases from colon cancer can offer long-term survival

Diabetes indicators and oral health behavior

Objective : The aim of this study was to evaluate the association between diabetes-related indicators and oral health behavior among patients with type 2 diabetes. Methods : Seventy-four outpatients were included. We administered a questionnaire and divided the patients into two groups according to oral health behavior and eating habits. We then compared diabetes-related clinical records between the groups and performed logistic regression analysis. Results : Participants who brushed their teeth before bedtime every night had lower BMIs than those who did not. Participants who reported eating slowly and chewing well every day had significantly lower HbA1c than their counterparts. Participants who reported gum bleeding had significantly higher LDL-cholesterol than their counterparts. Binominal logistic regression analysis revealed that BMI < 25 was associated with not brushing teeth before bedtime every night, HbA1c < 7.5 with not eating slowly or chewing well every day, and LDL-cholesterol < 120 with gum bleeding (odds ratio : 0.140, 95% confidence interval : 0.036–0.540 ; OR : 0.085, 95% CI : 0.010.0–736, OR : 0.275, 95% CI : 0.077.0–979, respectively). Conclusions : Our findings suggest that toothbrushing before bedtime every night is associated with reduced risk of obesity and that eating slowly and chewing well are advantageous for glycemic control in patients with type 2 diabetes

Specifics of Space Cooperation Potential Between Japan and India (IAC-16-E3.1.9)

Space activities in the Asia Pacific region have been increasingly developing and diversifying. Many nations have sought to acquire indigenous space capabilities for a wide variety of reasons. Active commercial and security space activities can also be seen in this region. Asian nations also dream to explore the unknown in outer space by promoting space science and exploration. International space cooperation has also been considered as a key element in developing space activities in this region. In this context, the University of Tokyo (UoT) and National Institute of Advanced Studies (NIAS) have conducted a joint research on regional space policy and programs, especially focusing on policy analysis on space policies in Japan and India as a first step. A recent study by UoT and NIAS has explored lot of commonalities and uniqueness in space policies of the two nations. These commonalities and uniqueness in space policies offer potential opportunities for future space collaboration between the two. As leading spacefaring nations, Japan and India have been playing a key role in developing space activities in the Asia Pacific region. By cooperating together, Japan and India will be able to identify and advance regional common interests in space activities in the region. In particular, recent space policies in Japan and India have placed emphasis on space applications for societal needs such as communication, remote sensing, positioning, and so on. Japan-Indian cooperation in this area will contribute to social development in the Asia Pacific region by complementing and supplementing regional space capabilities. On the other hand, Japan and India have also had substantial experiences in space science and exploration. In this regard, Japan-India joint space mission will also be a potential item for future cooperation and will be a great boost to space science and exploration activities at a regional and global level. A third pillar of collaboration is for industry-to-industry tie-ups and development of commons in space industry in the two nations. Space industrial capabilities in both nations can jointly be involved to develop and offer unique space services in applications of earth observation, satellite communications, disaster management, and security, and undertake joint manufacturing activities. Based on the analysis of the commonalities and uniqueness in space program of Japan and India, this paper examines and explores in detail potential ”mission" opportunities for space cooperation between the two nations. Hopefully, these identifications will help Japan-India space cooperation in the future

Policy Analysis: Space Programmes of Japan And India

Today, increasing number of counties in the Asia Pacific region is using outer space with various purposes. Many countries are also aspiring to acquire indigenous capability for space activities. Moreover, increasing private/commercial activities are seen in this region, which is creating competition in the market for technology, applications and services. Security needs are also major drivers of space activity in many countries. Under the umbrella of Space Policy and LawNetwork in Asia Pacific (SPLANAP), University of Tokyo (Japan) and National Institute of Advanced Studies (India) have taken up a joint study to research and prepare a report on space policies of the Asia Pacific region, especially including Japan, India and many other space faring nations in this region. As the first step of this joint project, the team has undertaken a comparative analysis of space policies in Japan and India. Japan and India are leading space faring countries in this region. In Japan, promoting advanced technology inn ovation and scientific research has been the major policy objective. In addition, space utilization, as well as industrialization of spaceare also primary drivers for the space policy objectives since the enactment of Basic Space Law in 2008. In this rega rd, Japan has faced policy challenges regarding how to promote space utilization and industrialization and how to coordinate policies and goals of various stakeholders. There is a compelling need for a new thinking for space strategy based on the recent changes in Japan’s space policy. On the other hand, India has long history in “space for national development” and has actively used space systems like communication satellite and remote sensing satellite to meet various social needs, which include disaster monitoring, natural resources management, tele-education, tele-medicine, national communication, navigation services and so on. India has also developed some mechanism for policy coordinating between space agency and user organization. In recent years, India has also actively pursued space exploration program, including ambition for human space flight. In a recent study by NIAS, a clear need for a comprehensive national space policy in India has been established. In this context, this paper presents the results of the comparison of space policies and governances in Japan and India and examine commonalities/differences, characteristic, relative strengths/challenges. This comparative analysis contributes to clearly identifying policy challenges faced by the both nations and getting clue to resolving those challenge

Essential anatomy for lateral lymph node dissection

In Western countries, the gold-standard therapeutic strategy for rectal cancer is preoperative chemoradiotherapy (CRT) following total mesorectal excision (TME), without lateral lymph node dissection (LLND). However, preoperative CRT has recently been reported to be insufficient to control lateral lymph node recurrence in cases of enlarged lateral lymph nodes before CRT, and LLND is considered necessary in such cases. We performed a literature review on aspects of pelvic anatomy associated with rectal surgery and LLND, and then combined this information with our experience and knowledge of pelvic anatomy. In this review, drawing upon research using a 3-dimensional anatomical model and actual operative views, we aimed to clarify the essential anatomy for LLND. The LLND procedure was developed in Asian countries and can now be safely performed in terms of functional preservation. Nonetheless, the longer operative time, hemorrhage, and higher complication rates with TME accompanied by LLND than with TME alone indicate that LLND is still a challenging procedure. Laparoscopic or robotic LLND has been shown to be useful and is widely performed; however, without a sufficient understanding of anatomical landmarks, misrecognition of vessels and nerves often occurs. To perform safe and accurate LLND, understanding the landmarks of LLND is essential

Assessment of Space Programs and Policies for Regional Cooperation in the Asia Pacific Region

International space cooperation in the Asia Pacific region have entered a new stage. Today a lot of nations in this region have actively developed space capabilities, and have come to use them for a variety of purposes. In addition to the long-experienced spacefaring nations such as Japan, India, and China, many emerging nations like Malaysia, Philippine, Singapore, Indonesia, Vietnam, Thailand, South Korea, etc., have made active efforts to develop space technology and applications and to undertake their space programs. Such space applications as earth observation, satellite communication, and positioning emerged in this region have tremendous potentials as a driving force for peaceful development and prosperity of the Asia Pacific region in many facets: disaster management, climate change study, national and regional security, environment management, agriculture, urban planning, geospatial program, land management, as well as the advancement of science and technology. Against this backdrop, many nations also seek to establish national space policy with an aim to set out the vision and goals of nation’s space programs. The University of Tokyo and National Institute of Advanced Studies have created a research network, Space Policy and Law Network in Asia Pacific (SPLANAP), among researchers and experts in the Asia Pacific region and started a research project to examine space policy and program directions in the region. In particular, as the first step of this research project, a comparative analysis of space programs and policy perspectives in Japan and India has been taken up to examine commonalities and uniqueness in space policies of both nations and to identify potential opportunities for the future cooperation between the two nations. Based on the previous work in this research project, this study aims to move to the next phase of the research and to extend the scope of the analysis by including several other nations, such as Malaysia, Philippine, and Singapore. While updating information on the recent developments in space programs and policy in Japan and India, as well as adding new analyses from the perspectives of the above mentioned three nations, this study will examine common interests and potential opportunities for regional space cooperation from a wider point of view

Preoperative risk stratification of lymph node metastasis for non-functional pancreatic neuroendocrine neoplasm: An international dual-institutional study

BACKGROUND: /Objectives: Although the presence of lymph node metastasis (LNM) defines malignant potential, preoperative prediction of LNM has not been established for non-functional pancreatic neuroendocrine neoplasm (NF-PNEN). We sought to develop a prediction system using only preoperatively available factors that would stratify the risk of LNM for NF-PNEN. METHODS: We retrospectively reviewed patients who underwent R0/1 resection of NF-PNEN at Kyoto University (2007-2019) and the University of California, San Francisco (2010-2019). Risk stratification of LNM was developed using preoperative factors by the logistic regression analysis. Long-term outcomes were compared across the risk groups. RESULTS: A total of 131 patients were included in this study. Lymph nodes were pathologically examined in 116 patients, 23 (20%) of whom had LNM. Radiological tumor size [1.5-3.5 cm (odds ratio: 13.5, 95% confidence interval: 1.77-398) and >3.5 cm (72.4, 9.06-2257) against ≤1.5 cm], <50% cystic component (8.46 × 10^6, 1.68 × 10^106-), and dilatation of main pancreatic duct ≥5 mm (31.2, 3.94-702) were independently associated with LNM. When patients were classified as the low-risk (43 patients), intermediate-risk (44 patients), and high-risk groups (29 patients), proportions of LNM differed significantly across the groups (0%, 14%, and 59%, respectively). Recurrence-free survival (RFS) of the low- and intermediate-risk groups were significantly better than that of the high-risk group (5-year RFS rates of 92.2%, 85.4%, and 47.1%, respectively). CONCLUSIONS: The prediction system using preoperative radiological factors stratifies the risk of LNM for NF-PNEN. This stratification helps to predict malignant potential and determine the surgical procedure and necessity of regional lymphadenectomy