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Kanako Azuma,1 Takashi Kawaguchi,2 Takuhiro Yamaguchi,3 Sayuri Motegi,1 Kimito Yamada,4 Kenji Onda,5 Satoru Iwase,6 Sakae Unezaki,2 Hironori Takeuchi1 1Department of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan; 2Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 3Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan; 4Department of Breast Surgery, Tokyo Medical University Hospital, Tokyo, Japan; 5Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan; 6Department of Emergency & Palliative Medicine, Faculty of Medicine, Saitama Medical University, Saitama, JapanCorrespondence: Takashi Kawaguchi Email tkawa@toyaku.ac.jpPurpose: The importance of shared decision-making (SDM) between physicians and patients is increasingly recognized. In Japan, patients have shown more willingness to participate in treatment if medical professionals provide sufficient information; however, relationships between physicians and patients have traditionally been asymmetric, with patients accepting information from physicians without discussion. To explore the benefits of SDM in cancer treatment, including confidence in treatment decisions, satisfaction with treatment, and trust in healthcare providers, this study developed Japanese versions of the Control Preference Scale (CPS) and Information Needs Questionnaire (INQ).Patients and Methods: Reliability and validity of the CPS and INQ were tested with 49 breast cancer patients.Results: The CPS showed good test–retest reliability (kappa coefficient: 0.61, weighted kappa coefficient: 0.61, Kendall’s tau coefficient: 0.61) and acceptable criterion validity. The INQ showed adequate consistency; the mean number of circular triads and coefficient of consistency were 3 (range 0– 19) and 0.9 (range 0.37– 1), respectively. Using the CPS and INQ to identify patients’ roles in decision-making and information needs, results further suggested that breast cancer patients in Japan want to participate in SDM. Medical issues, including disease spread and cure, were found to be of high interest, while social and psychological issues, including sexual attractiveness, genetic risk, and family impact, tended to be low.Conclusion: The Japanese CPS and INQ can be used to assess patients’ needs to improve care. Further, as patients’ information needs change along the care trajectory, these tools should be used throughout treatment.Keywords: shared decision-making, breast cancer, treatment option, control preference scale, information needs questionnaire

In this study, we considered AI service systems that use artificial intelligence technologies for business functions. Presently, AI technologies are being introduced to support human activities in various business domains. Consequently, it is believed that some business tasks performed by humans will be replaced by AI technologies. In this study, we focused on such tasks and proposed an assessment method for identifying them accordingly. In this method, we defined a model that represents the business tasks executed by practitioners. We also identified the features required for each element in the task so that they can be incorporated when applying AI technologies to the business task. In addition, we introduced a model that divides the business tasks, which will be performed by practitioners for a while, into several groups. Accordingly, we can identify the types of human capabilities that will still be required in a business task in the near future. By analyzing two sample businesses, we confirmed the efficacy of the proposed method.

In this study, we consider the construction of a model for representing an artificial intelligence (AI) service system project. When developing a system using AI technologies to support a business task in a company, all project members from both business and IT divisions must have common understandings on the project before starting it. For this purpose, a business–IT alignment model for AI service systems is proposed as a business–AI alignment model. However, we need to substantiate this business–AI alignment model for each project, because it is a generic model. To address this problem, we propose a method for constructing the business– AI alignment model and apply it to a real project for developing an AI service system in a case study, and confirm that we can construct the project-specific business–AI alignment model–without support of data scientists.

Recently, steroid reduction/withdrawal regimens have been attempted to minimize the side effects of steroids in renal transplantation. However, some recipients have experienced an increase/resumption of steroid administrations and acute graft rejection (AR). Therefore, we investigated the relationship between the individual lymphocyte sensitivity to steroids and the clinical outcome after steroid reduction/withdrawal. We cultured peripheral blood mononuclear cells (PBMCs) isolated from 24 recipients with concanavalin A (Con A) in the presence of methylprednisolone (MPSL) or cortisol (COR) for four days, and the 50% of PBMC proliferation (IC50) values and the PBMC sensitivity to steroids were calculated. Regarding the experience of steroid increase/resumption and incidence of AR within one year of steroid reduction/withdrawal, the IC50 values of these drugs before transplantation in the clinical event group were significantly higher than those in the event-free group. The cumulative incidence of steroid increase/resumption and AR in the PBMC high-sensitivity groups to these drugs before transplantation were significantly lower than those in the low-sensitivity groups. These observations suggested that an individual’s lymphocyte sensitivity to steroids could be a reliable biomarker to predict the clinical outcome after steroid reduction/withdrawal and to select the patients whose dose of steroids can be decreased and/or withdrawn after transplantation.

In this work, we propose a model of a project to develop an artificial intelligence (AI) service system used in an office environment. Our model is based on enterprise architecture (EA) approach and consists of business layer elements, application layer elements, and motivation extensions, so that project participants from both business and IT divisions can have the same understanding of the project. By applying the proposed model to the project analysis results, we show that we can derive actionable insights for project risk management.

When customers are interested in a service or intend to buy it, they sometimes have questions on that service. In this study, we considered an inquiry system in which customers ask questions on a specific service and obtain correct information on the service. For such an inquiry system, a question-answering (Q&A) technology is needed. Many programming modules for such a technology have been developed and can be easily used for system development. In many Q&A technologies, machine-learning techniques are involved, and we need to prepare training data consisting of pairs of an answer and assumed questions. For training-data preparation, an answer set for a service should be defined as the first step and the answer set should cover all the information on the service that customers may ask about. By using a customer-behavior model and introducing a service-function model, we propose a method of effectively collecting knowledge information for an answer set on a service. Through a case study, we show that we can collect exhaustive knowledge information for an answer set with our method compared to the case in which domain experts collect knowledge information in their own way. For an actual project, we also considered an actual inquiry-system-development project, with training data obtained with the proposed method, and showed that the system covers almost all the information on the service that customers may ask after a user test.

An SN2 mechanism was proposed for highly stereoselective glycosylation of benzoic acid with unprotected α-D-glucose under Mitsunobu conditions in dioxane, while an SN1 mechanism seems to be responsible for non-stereoselective glycosylation in DMF. The SN2-type glycosylation can be applicable to various unprotected pyranoses as glycosyl donors and a wide range of carboxylic acids, phenols, and imides as glycosyl acceptors, retaining its high stereoselectivity (34 examples). Glycosylation of a carboxylic acid with unprotected α-D-mannose proceeded also in an SN2 manner to directly afford a usually less accessible 1,2-cis-mannoside. An extremely short-step total synthesis of a middle molecule (1874 Da) natural glycoside with antitumor activity, coriariin A, was achieved via a double SN2 glycosylation strategy with two molecules of unprotected α-D-glucose.

A short-step total synthesis of the natural glycosides pterocarinin C and tellimagrandin II (eugeniin) has been performed by sequential and site-selective functionalization of free hydroxy groups of unprotected D-glucose. The key reactions are β-selective glycosidation of a gallic acid derivative using unprotected D-glucose as a glycosyl donor and catalyst-controlled site-selective introduction of a galloyl group into the inherently less reactive hydroxy group of the glucoside.

BACKGROUND Everolimus (EVL) plus tacrolimus (TAC) therapy is effective and safe in renal transplantation. However, the pharmacokinetic and pharmacodynamic information for EVL combined with TAC is limited. We investigated the pharmacodynamic drug-drug interaction between EVL and TAC at their therapeutic concentration range. MATERIAL AND METHODS Isolated peripheral blood mononuclear cells (PBMCs) from 22 healthy participants aged 22 to 24 years were cultured with concanavalin A (Con A) in the presence of EVL and/or TAC for 4 days, and the proliferation rate of the PBMCs was calculated. RESULTS TAC promoted the inhibitory efficacy of EVL against the mitogen-activated proliferation of PBMCs at the EVL therapeutic concentration range. When 0.175 ng/mL or more of TAC was combined with 30 ng/mL or more of EVL, the antagonistic effect of TAC on the inhibitory efficacy of EVL against the mitogen-activated proliferation of PBMCs was observed. Conversely, when 0.4 ng/mL TAC and 10 ng/mL or more of EVL were combined, the antagonistic effect of EVL on the inhibitory efficacy of TAC against the mitogen-activated proliferation of PBMCs was observed. CONCLUSIONS The pharmacodynamic synergistic efficacy of EVL and TAC in combination on mitogen-activated PBMCs was evident at the therapeutic concentration range, which is used in renal transplantation. However, these drugs antagonize each other to suppress the proliferation of activated PBMCs at concentrations higher than those clinically used.

A practical method was developed for the preparation of a diastereomeric library of C2-symmetric chiral 4-pyrrolidinopyridine catalysts with dual amide side chains. Use of a racemic precursor is the key to the concise production of catalysts with diverse stereochemisty.

Short total syntheses of natural glycosides (ellagitannins) were performed through sequential and regioselective functionalization of the hydroxy groups of unprotected glucose. The key reactions are β-selective glycosidation of a gallic acid derivative by using unprotected glucose as a glycosyl donor and catalyst-controlled regioselective introduction of a galloyl group into the inherently less reactive hydroxy group of the glucoside., Article first published online: 9 APR 2015

A short-step total synthesis of the natural glycosides pterocarinin C and tellimagrandin II (eugeniin) has been performed by sequential and site-selective functionalization of free hydroxy groups of unprotected D-glucose. The key reactions are β-selective glycosidation of a gallic acid derivative using unprotected D-glucose as a glycosyl donor and catalyst-controlled site-selective introduction of a galloyl group into the inherently less reactive hydroxy group of the glucoside.

A practical method was developed for the preparation of a diastereomeric library of C2-symmetric chiral 4-pyrrolidinopyridine catalysts with dual amide side chains. Use of a racemic precursor is the key to the concise production of catalysts with diverse stereochemisty.

Though steroid withdrawal is done in many renal transplant recipients, some patients must restart steroids. Little report has investigated steroid withdrawal under pharmacodynamic monitoring. We assessed lymphocyte sensitivity to endogenous cortisol as a biomarker for determining the safety of steroid withdrawal in renal transplant patients, as we hypothesized that patients hyposensitive to cortisol could not be sufficiently immunosuppressed by their intrinsic cortisol as a substitute for the reduced or withdrawn steroid. Lymphocyte sensitivity to cortisol was examined in 30 long stable renal transplant recipients. Lymphocyte sensitivity to cortisol and its relationship with the clinical outcome after steroid reduction and withdrawal was investigated. The lymphocyte sensitivities to cortisol were estimated as IC(50) of lymphocyte blastogenesis. The lymphocyte proliferation rate for concentration of serum cortisol compared between incident and non-incident groups. Serum creatinine levels (S-Cr) increased in a significantly higher number of patients hyposensitive to cortisol (IC(50)≧10000 ng/ml) than in normally sensitive patients (IC(50)10000 ng/ml). The incidences of steroid withdrawal syndrome and necessity for increasing steroid dose or restarting steroid administration were also higher in the patients hyposensitive to cortisol. The patients in whom the lymphocyte proliferation rate was less than 60% did not show increase in S-Cr, experience steroid withdrawal symptoms, or require an increase in the steroid dose or restart of steroid administration. The patients who have the normal IC(50) values of cortisol, can withdraw steroid more safely. The lymphocyte sensitivity to cortisol may be a useful biomarker for selecting patients who can sustain steroid withdrawal.

Business-oriented conversations between customers and agents need to be analyzed to obtain valuable insights that can be used to improve product and service quality, operational efficiency, and revenue. For such an analysis, it is critical to identify appropriate textual segments and expressions to focus on, especially when the textual data consists of complete transcripts, which are often lengthy and redundant. In this paper, we propose a method to identify important segments from the conversations by looking for changes in the accuracy of a categorizer designed to separate different business outcomes. We then use text mining to extract important associations between key entities (insights). We show the effectiveness of the method for making chance discoveries by using real life data from a car rental service center.

It is important for R&D managers, consultants, and other people seeking broad knowledge in technology fields to survey technical literature such as research papers, white papers, and technology news articles. One of the important kinds of information for those people regards the effectiveness of new technologies in their own businesses. General search engines are good at selecting documents revealing the details of a specific technology or a technology field, but it is hard to obtain useful information about how a technology will apply to individual business cases from such search results. There is a need for a technology survey assistance tool that helps users find technologies with suitable capabilities. In this paper, two technical tasks were tackled to develop the prototype of this assistance tool: Extraction of advantage phrases and scoring for the advantage phrases to find novel applications in the target technology field. We describe a new method to identify advantage phrases in technical documents and our scoring function that gives higher scores to novel applications of the technology. The results of evaluations showed our phrase identification method with only a few phrasal patterns performs almost as well as human annotators, and the proposed scoring conforms better to the decisions made by professionals than random sort.

The clinical efficacy of calcineurin inhibitors administered to renal transplant patients is considered to be a strong function of the area under the concentration time curve (AUC). Interestingly, monitoring timings of blood concentrations for two similar calcineurin inhibitors, cyclosporine (CYA; Neoral®) and tacrolimus (TAC; Prograf®) are different. Namely, CYA blood concentration is usually monitored at 2 h after administration (C2) substituted for peak concentration (Cp) and TAC at trough concentration (Ct). In the literature, data describing such characteristics of CYA and TAC have been presented in the past. However, each of these patient groups had different backgrounds. We have attempted to examine the behavior of blood concentration curves simultaneously for both CYA and TAC by establishing controlled groups of renal transplant patients with similar clinical backgrounds. Furthermore, we have analyzed the correlation with Cp and Ct versus AUC implementing area under the trough level (AUTL), or area above the trough level (AATL) as new pharmacokinetic parameters, such that C2 for CYA and Ct for TAC have been verified using controlled clinical data. We have also found distinct differences in the pharmacokinetics between CYA and TAC with the relationships between AUC, Cp, and Ct.

Background: We have often observed that the blood trough concentration (Ct) of the once-daily, prolonged-release formulation of tacrolimus (Graceptor®; GRC) becomes unstable, and it is difficult to adjust it in the early period after transplantation. Consequently, we compared the relationships between pharmacokinetic parameters and influencing factors in a group of GRC-treated patients compared with those in a group of Prograf® (PRG)-treated patients. Methods: The study included 8 patients who were newly treated with GRC and 44 patients who were newly treated with PRG. We performed 24-hour therapeutic drug monitoring to compare the relationships between pharmacokinetic parameters, including the area under the curve (AUC), the ratio of the area under the trough level (AUTL)/AUC to indicate the relationships among AUCs, peak concentration (Cp), and Ct. The Cp/Ct values, and dose/body weight (UC/ [D/BW]) values reflected bioavailability and the influencing factors; number of days after transplantation and Dose/BW in the GRC-treated and PRG-treated patients. Results: The Cp/Ct values were higher and the AUTL/AUC and AUC corrected by dose/body weight (AUC/[D/BW]) values were lower with a low number of days after transplantation (particularly within 20 days) and a large dose than a high number of days after transplantation and a small dose in the GRC-treated patients. No such associations were observed in the PRG-treated patients. Conclusion: Care is required when using GRC as there is a tendency for Cp to increase owing to rapid absorption within 20 days after transplantation. Blood levels may be unstable and side effects may be more prevalent in some patients. Moreover, the utilization rate is low and the dose is high in such patients; therefore, unstable gastrointestinal function caused by a variety of factors may play a role in the early period after transplantation.

The authors present an approach for fabricating stable white light emission from polymer light-emitting electrochemical cells (PLECs) having an active layer which consists of blue-fluorescent poly(9,9-di-n-dodecylfluorenyl-2,7-diyl) (PFD) and π-conjugated triphenylamine molecules. This white light emission originates from exciplexes formed between PFD and amines in electronically excited states. A device containing PFD, 4,4',4''-tris[2-naphthyl(phenyl)amino]triphenylamine (2-TNATA), Poly(ethylene oxide) and K2CF3SO3 showed white light emission with Commission internationale de l'éclairage (CIE) coordinates of (0.33, 0.43) and a Color Rendering Index (CRI) of Ra = 73 at an applied voltage of 3.5 V. Constant voltage measurements showed that the CIE coordinates of (0.27, 0.37), Ra of 67, and the emission color observed immediately after application of a voltage of 5 V were nearly unchanged and stable after 300 sec.

This paper presents a technique for adding sentence boundaries to text obtained by Automatic Speech Recognition (ASR) of conversational speech audio. We show that starting with imprecise boundary information, added using only silence information from an ASR system, we can improve boundary detection using Head and Tail phrases. We develop our technique and show its effectiveness on two manually transcribed and one automatically transcribed corpus. The main purpose of adding sentence boundaries to ASR transcripts is to improve linguistic analysis, namely information extraction, for text mining systems that handle huge volumes of textual data and analyze trends and features of the concepts. Hence, we also show how the addition of boundaries improves two basic natural language processing tasks--PoS label assignment and adjective-noun extraction.

Substituted piperidines are emerging as important medicinally-active structural motifs. Here, we report highly stereoselective carbolithiation reactions of α-aryl piperidine enecarbamates that offer direct access to vicinally-substituted piperidine compounds. We have also demonstrated that the carbanion intermediates can be trapped with a carbon electrophile.

This paper describes the application of IBM TAKMI® for Biomedical Documents to facilitate knowledge discovery from the very large text databases characteristic of life science and healthcare applications. This set of tools, designated MedTAKMI, is an extension of the TAKMI (Text Analysis and Knowledge MIning) system originally developed for text mining in customer-relationship-management applications. MedTAKMI dynamically and interactively mines a collection of documents to obtain characteristic features within them. By using multifaceted mining of these documents together with biomedically motivated categories for term extraction and a series of drill-down queries, users can obtain knowledge about a specific topic after seeing only a few key documents. In addition, the use of natural language techniques makes it possible to extract deeper relationships among biomedical concepts. The MedTAKMI system is capable of mining the entire MEDLINE® database of 11 million biomedical journal abstracts. It is currently running at a customer site.

The steroid receptor (SR) complex contains FKBP51 and FKBP52, which bind to tacrolimus (TAC) and cyclophilin 40, which, in turn, bind to cyclosporine (CYA); these influence the intranuclear mobility of steroid–SR complexes. Pharmacodynamic interactions are thought to exist between steroids and calcineurin inhibitors (CNIs) on the SR complex. We examined the effect of CNIs on steroid sensitivity. Methylprednisolone (MPSL) sensitivity was estimated as the concentration inhibiting mitosis in 50% (IC50) of peripheral blood mononuclear cells and as the area under the MPSL concentration–proliferation suppressive rate curves (CPS-AUC) in 30 healthy subjects. MPSL sensitivity was compared between the additive group (AG) as the MPSL sensitivity that was a result of addition of the proliferation suppressive rate of CNIs to that of MPSL and the mixed culture group (MCG) as MPSL sensitivity of mixed culture with both MPSL and CNIs in identical patients. IC50 values of MPSL and cortisol sensitivity were examined before and 2 months after CNI administration in 23 renal transplant recipients. IC50 and CPS-AUC values of MPSL were lower in the MCG than in the AG with administration of TAC and CYA. The CPS-AUC ratio of MCG and AG was lower in the TAC group. IC50 values of MPSL and cortisol tended to be lower after administration of TAC and CYA, and a significant difference was observed in the IC50 of cortisol after TAC administration. Steroid sensitivity increased with both TAC and CYA. Furthermore, TAC had a greater effect on increasing sensitivity. Thus, concomitant administration of CNIs and steroids can increase steroid sensitivity.

Introduction: Aromatase inhibitor use for postmenopausal hormone-sensitive breast cancer patients often results in drug-induced osteoarthropathy, while its accurate mechanism has not been clarified. We investigated the implication of female hormones and several cytokines in osteoarthropathy complicated with aromatase inhibitor treatment, and the efficacy of vitamin E on the severity of osteoarthropathy, in breast cancer patients. Methods: Sixty two breast cancer patients treated with aromatase inhibitor for average of 1.77 years were included. These patients were orally administered vitamin E (150mg/day) for 29.8 days to alleviate aromatase inhibitor-related osteoarthropathy. Severity of osteoarthropathy was scored, and the patients were grouped based on the severity or vitamin E efficacy. Serum estradiol, progesterone, vitamin E, interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), IL-2, IL-4, IL-6, IL-10, and IL-17A concentrations were measured by ELISA or beads array procedures followed by flow cytometry. Results: There was no significant difference in serum concentrations of the biomarkers between the severe and the mild osteoarthropathy groups before vitamin E administration. The osteoarthropathy scores significantly decreased after vitamin E administration (p=0.0243), while serum-estradiol concentrations did not change. The serum-estradiol concentrations before vitamin E administration in the group sensitive to the vitamin E efficacy were significantly lower, as compared with those in the insensitive group (p=0.0005). The rate of the highly sensitive patients to the vitamin E efficacy in those exhibiting low serum-estradiol concentrations was significantly higher than that in the high serum-estradiol group (p=0.0004). In the sensitive group, serum-estradiol concentrations after taking vitamin E were significantly higher than those before taking vitamin E (p=0.0124). Conclusions: Vitamin E administration seemed to be a potential way for relieving osteoarthropathy complicated with aromatase inhibitor use. Using serum-estradiol concentration, it would be possible to select out the breast cancer patients who will respond well to the vitamin E therapy for osteoarthropathy complicated with aromatase inhibitor.

Lymphocyte sensitivity to endogenous glucocorticoid cortisol could be a biological marker for safe reduction and withdrawal of steroids in renal transplant recipients. We compared peripheral lymphocyte sensitivity with cortisol between transplant recipients treated with tacrolimus (Tac) and those treated with cyclosporine. The suppressive efficacies of cortisol against T-cell mitogen-stimulated proliferation of peripheral lymphocytes were investigated in 44 renal transplant patients, who either had reduced or been withdrawn from steroid treatment. Twenty of the 44 patients were treated with Tac, and the other 24 patients were treated with cyclosporine A (CyA). The lymphocyte sensitivity to cortisol was compared between these two patient groups. The cortisol IC50 values in the Tac and CyA groups were 0.09 ± 0.12 and 14.2 ± 12.7 ng/ml, respectively. Lymphocyte sensitivity to cortisol in the Tac-treated group was significantly higher than that in the CyA-treated group (p = 0.0283). On the other hand, incidences of steroid withdrawal syndrome and increases in serum creatinine concentration were not significantly different between the Tac and CyA groups. Lymphocyte sensitivity to cortisol was higher in the Tac-treated patients than that in the CyA-treated ones. Since the cortisol sensitivity of peripheral lymphocytes is suggested to be a predictive marker for safe steroid withdrawal, Tac administration shows promise in aiding successful withdrawal of steroid treatment in long-term renal transplant recipients.

Calcineurin inhibitors (CNIs) are maintenance immunosuppressive drugs that have been used as the main therapy for organ transplantation for many years. Of the CNIs, cyclosporine (CYA) and tacrolimus (TAC) are used in clinical practice. The CYA binding protein is cyclophilin and that of TAC is FK-binding protein (FKBP), but both drugs have same mechanism of action: the inhibition of interleukin 2 (IL-2) production by binding the binding protein complex to calcineurin (CN). It is thought that the area under the concentration time curve (AUC) for both drugs may be the pharmacokinetic (PK) parameter that is the most associated with clinical effect. However, oral CYA administration gave a blood concentration–time curve with a high CYA peak concentration (Cp), and oral TAC showed a gradual blood concentration–time curve, keeping at the minimum of the therapeutic range; both drugs vary significantly in their pharmacokinetics1). The Cp of CYA has increased since the Neoral® preparation of CYA was used, compared with Sandimmune®, whereas the Cp of TAC decreased since using a sustained release preparation; thus the differences between CYA and TAC are considerable2). Although the optimal pharmacokinetics of both drugs may be similar to those of other drugs with the same mechanism of action, no conclusions have been reached on whether the peak blood concentration, or a specific maintained blood concentration, is required for CNI pharmacokinetics, even if both drugs show identical AUCs. In addition, although CYA and TAC are similar CNI drugs, there are differences in the recommended monitoring points of CYA and TAC; these points are the C2 level (the blood concentration 2 h after oral administration), which mainly reflects Cp, and the trough concentration (Ct)3-8), respectively911). To solve these problems, it is necessary to consider comprehensively not only AUC, but also Cp, Ct, and time above the minimum effective concentration (%T > MEC). We discuss the optimal pharmacokinetics of CNIs by comparing various aspects of CYA and TAC.

Although pharmacist counseling assumes an important role in the clinical setting, oncology pharmacy practitioners worldwide currently lack adequate guidance. This study aimed to identify the determinants and causal relationships that affect quality of life (QOL) in breast cancer patients before adjuvant systemic therapy for improving pharmacist counseling and guidance. This study analyzed 93 postoperative patients with breast cancer before pharmacist counseling for adjuvant systemic therapy. Patients were asked to complete questionnaires to assess QOL (the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 [EORTC QLQ-C30] and its breast cancer module [EORTC QLQ-BR23]) before pharmacist counseling. We analyzed factors affecting QOL by stepwise multiple linear regression analysis and evaluated causal association using path analysis. In the multiple linear regression model using variables selected by stepwise analysis, the factors affecting global health status (GHS)/QOL included fatigue, emotional functioning, systemic therapy side effects, future perspectives, and appetite loss. In the path analysis model, GHS/QOL were strongly influenced by fatigue directly; and emotional functioning, directly and indirectly via other factors. Our results indicated that fatigue and emotional functioning are strong factors affecting QOL. These factors may be able to predict poor QOL before initiating adjuvant systemic therapy. Thus, our findings suggest that these factors may be potentially useful for pharmacist counseling at the beginning of adjuvant systemic therapy.

The in vitro response of peripheral blood mononuclear cells (PBMCs) to the suppressive effects of calcineurin inhibitors is known to correlate with the clinical efficacy of drugs used in renal transplantations. The present study was conducted to examine the differences of PBMC responses to calcineurin inhibitors between chronic renal failure (CRF) patients awaiting renal transplantation and cirrhosis patients awaiting liver transplantation. The study included 99 CRF patients awaiting renal transplantation and 27 cirrhosis patients awaiting liver transplantation. Twenty milliliters of venous blood was taken 1–7 days before transplantation. The in vitro drug concentrations giving 50% inhibition of PBMC blastogenesis stimulated with concanavalin A (IC50s) were calculated. The suppressive effects of tacrolimus against PBMC blastogenesis were more than 10–100 times stronger than those of cyclosporine. The median IC50value for cyclosporine against the CRF PBMCs was not significantly different from the median IC50value against the cirrhosis PBMCs. In contrast, tacrolimus sensitivity in cirrhosis PBMCs is approximately seven times higher than that in CRF PBMCs. The median IC50value for tacrolimus against cirrhosis PBMCs was significantly lower and therefore the effect was stronger in comparison to the CRF PBMCs ( p < 0.001). These data suggest that the PBMCs of cirrhosis patients, in comparison to those of CRF patients, are highly sensitive to the suppressive effect of tacrolimus. However, PBMC sensitivity to cyclosporine was not significantly different between the CRF and cirrhosis patients. These observations raise the possibility that treatment with tacrolimus, rather than cyclosporine, may therefore be a better choice to reduce the risks of allograft rejection in liver transplantation.

The six-year curriculum has been introduced into all pharmacy schools in Japan since April 2006. Those schools are currently preparing for an additional two years of pharmacy education and are in the process of reading the necessary educational infrastructure. However, students' expectations of the new curriculum and understanding of the professional roles of a pharmacist have yet to be investigated. Therefore we surveyed the first group of students on their expectations of the new curriculum and on their understandings of the newly emerging roles of pharmacists in general. Our questionnaire consisted of six questions, and we further had the students conduct self-evaluations using the admission interview items of a pharmacy school from the USA. Of the 440 first-year students, 89.1% responded. Based on the results of the survey, we found that the majority of students did not believe that pharmacists will have a respected role in multidisciplinary teams or in public. Approximately half of the students also said that they had no confidence in taking leadership roles or thinking logically when compared with the average person. We therefore believe that schools and pharmacy educators need to teach students pharmaceutical care and the various roles pharmacists can play in the future. Schools and pharmacy educators should also support students by providing training and introducing new methods of learning to develop their professional attitude and leadership skills.

When providing customers with a personalized shopping experience, there is tremendous value in understanding and applying social data shared by those consumers. Understanding this data and how best to generate business value from it is the core challenge of many businesses today. Friends, family, and experts alike influence consumers in their shopping preferences and purchase decisions. Yet, the ability of a business to analyze data on such influence, and recommend products and services that best respond to its customers' needs or aspirations, is typically limited by fragmented capabilities; a business relies heavily on the use of spreadsheets, manual market analysis, isolated software, or reactive messaging. This paper offers a solution to this fragmentary approach by introducing a social analytics platform for smarter commerce. This platform provides a holistic understanding of the customer by making use of social and enterprise data to present recommendations and related opinions, and to isolate influencers so as to ultimately provide customers with a personalized shopping experience. The functionality described in this paper is in the context of the retail industry but can be applied to other industries. The paper describes the architecture of the social analytics platform and the various analytics components currently implemented as part of the platform.