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Background Emergency medical technicians (EMTs) may be subjected to emotional stress during patient treatment/transport. In Japan, dispatched EMTs must attempt resuscitation in all cases of out-of-hospital cardiac arrest (OHCA), including patients with “do not attempt resuscitation” (DNAR) orders and patients whose families do not support resuscitation. We described the characteristics, prevalence, and outcomes of OHCA/DNAR patients, and aimed to identify factors associated with EMT stress when treating them. Methods We included OHCA patients transported by EMTs in the city of Okayama from 2015 to 2019. We identified patients with DNAR orders based on emergency medical service (EMS) records, then EMTs completed questionnaires regarding the management of those patients and EMTs’ emotions. Results Among 3079 eligible OHCA patients, 122 patients (4%) had DNAR orders (DNAR group), and 2957 (96%) patients had no DNAR orders (no DNAR group). Based on responses from 243 EMT participants involved in OHCA/DNAR transports, we divided EMTs into high stress (73/243, 30%) and low stress (170/243, 70%) groups. EMTs experienced emotional stress from treating patients with family physician orders to transport (AOR: 4.74, 95% CI: 2.35–9.56) and those for whom prehospital defibrillation was performed (AOR: 20.7, 95% CI: 3.10–137.9). Conclusions Approximately 30% of EMTs providing resuscitation to OHCA/DNAR patients experienced high levels of stress. Establishment of a prehospital emergency system incorporating physician medical direction and updated guidelines for treating patients with DNAR orders may reduce the psychosocial stress of EMTs.

Purpose The incidence of gastric neoplasms in Helicobacter pylori (Hp)-naïve patients has recently increased due to a remarkable decrease in the Hp–infected population in Japan. We investigated the clinicopathologic differences between patients with Hp-infected gastric neoplasms (HpIGNs) and those with Hp-naïve gastric neoplasms (HpNGNs) that have not been fully elucidated so far. Methods This retrospective study investigated 887 patients with 1010 gastric dysplasia or cancers who underwent endoscopic or surgical treatment for the recent decade. Clinical and neoplastic features were compared between HpIGN and HpNGN cases. Results HpNGNs accounted for 4.5% (45/1010) of all gastric neoplasm cases, but were found concentratedly in the latter five-years. Nine hundred sixty-five HpIGNs included 774 differentiated-type and 191 undifferentiated-type. Forty-five HpNGNs included 4 undifferentiated type, 5 fundic-gland type, 32 foveolar type, 3 intestinal type, and 1 other differentiated type. HpNGNs occurred in significantly younger patients (59.9 vs. 71.8 years, pConclusions HpNGN occurrence has recently been increasing along with an increase in Hp-naïve population and in knowledge about this type of tumor, though with a lower grade of biological malignancy regardless of histologic type.

Tissue‐clearing technology is an emerging imaging technique currently utilized not only in neuroscience research but also in cancer research. In our previous reports, tissue‐clearing methods were used for the detection of metastatic tumors. Here, we showed that the cell cycles of primary and metastatic tumors were visualized by tissue‐clearing methods using a reporter system. First, we established cancer cell lines stably expressing fluorescent ubiquitination‐based cell cycle indicator (Fucci) reporter with widely used cancer cell lines A549 and 4T1. Fluorescence patterns of the Fucci reporter were investigated in various tumor inoculation models in mice. Interestingly, fluorescence patterns of the Fucci reporter of tumor colonies were different between various organs, and even among colonies in the same organs. The effects of antitumor drugs were also evaluated using these Fucci reporter cells. Of the three antitumor drugs studied, 5‐fluorouracil treatment on 4T1‐Fucci cells resulted in characteristic fluorescent patterns by the induction of G2/M arrest both in vitro and in vivo. Thus, the combination of a tissue‐clearing method with the Fucci reporter is useful for analyzing the mechanisms of cancer metastasis and drug resistance., Monitoring the Fucci patterns in vivo with 4T1‐Fucci cells. A, B, 3D and 2D images of 4T1 cells inoculated orthotopically into the mammary fat‐pad. C, 3D and 2D images of 4T1‐Fucci cells in experimental lung metastasis.

Development of innovative therapeutic modalities would address an unmet clinical need in the treatment of triple negative breast cancer (TNBC). Activation of retinoic acid‐inducible gene‐I (RIG‐I)‐like receptors (RLRs) such as melanoma differentiation‐associated gene 5 (MDA5) and RIG‐I in cancer cells is suggested to suppress tumor progression by inducing cell death. Transfection of polyI:C, a conventionally used synthetic double‐stranded RNA (dsRNA) analogue that activates RLRs, has been evaluated in clinical trials. However, detailed mechanisms of tumor suppression by RLRs, especially interactions with other signaling pathways, remain elusive. Here, we showed that transfection of polyI:C suppressed transforming growth factor‐β (TGF‐β) signaling in a MDA5‐ and RIG‐I‐dependent manner. We found that suppression of TGF‐β signaling by polyI:C promoted cancer cell death, which was attenuated by forced expression of constitutively active Smad3. More detailed analysis suggested that cell death by polyI:C transfection exhibited characteristics of pyroptosis, which is distinct from apoptosis. Therapeutic efficacy of polyI:C transfection was also demonstrated using a mouse model. These results indicated that intratumor administration of polyI:C and related dsRNA analogues may be promising treatments for TNBC through inhibition of the anti‐pyroptotic function of TGF‐β., The present study provides a new perspective of the treatment of triple negative breast cancer (TNBC) through the intracellular administration of polyI:C, a ligand for retinoic acid‐inducible gene‐I‐like receptors. PolyI:C induced the pyroptosis of TNBC cells, which was enhanced by its inhibitory role on the transforming growth factor‐β (TGF‐β)‐regulated anti‐pyroptotic functions.

Nitrogen (N) resorption from senescing leaves enables plants to reuse N, thereby making them less dependent on current N uptake from the environment. Therefore, N resorption is important for survival and fitness, particularly for plants growing under low N supply. We studied N resorption from senescing leaves of 25 legumes and 25 nonlegumes in a temperate region of Japan to test the hypothesis that high N resorption has not evolved in legumes that fix atmospheric N2. The extent of N resorption was quantified by N resorption proficiency that is measured as the level to which leaf N concentration was reduced during senescence, i.e., the lower the senesced leaf N concentration, the lower the N loss through leaf fall and higher the N resorption proficiency. In support of the hypothesis, senesced leaf N concentration was higher in legumes than in nonlegumes, but there was considerable overlap between the groups. The higher senesced leaf N concentration of legumes was associated with a lower proportion of leaf N resorbed during senescence, particularly in species with higher leaf N concentrations. According to a hierarchical partitioning analysis, there was a large contribution of species to the total variance in the senesced leaf N concentration as opposed to a minor contribution of functional group (legume/nonlegume). This study reveals that legumes are not proficient at resorbing N from senescing leaves but that N2-fixation might not be the single most important determinant of N resorption.

Objective Several scoring systems have been developed to identify patients who require massive transfusion (MT) after major trauma to improve survival. The primary goal of this study was to investigate the usefulness of enhanced computed tomography attenuation values (CTAVs) of major vessels to determine the need for MT in patients with major blunt trauma. Methods This single-center retrospective cohort study evaluated patients aged 16 years or older who underwent contrast-enhanced computed tomography scan of the torso after major blunt trauma. The CTAVs of six major vessel points in both the arterial and portal venous phases at initial computed tomography examination were assessed and compared between the MT and the no MT group. The capability of enhanced CTAVs to predict the necessity for MT was estimated based on the area under the receiver operating characteristic curve. Results Of the 254 eligible patients, 36 (14%) were in the MT group. Patients in the MT group had significantly higher CTAVs at all sites except the inferior vena cava in both the arterial and portal venous phases than that in the no MT group. The descending aorta in the arterial phase had the highest accuracy for predicting MT, with an AUROC of 0.901 (95% confidence interval, 0.855 to 0.947; P Conclusion Initial elevation of enhanced CTAV of the aorta is a predictor for the need for MT. A higher CTAV of the aorta should alert the trauma surgeon or emergency physician to activate their MT protocol.

To develop a machine sound monitoring system, a method for detecting anomalous sound is proposed. Exact likelihood estimation using Normalizing Flows is a promising technique for unsupervised anomaly detection, but it can fail at out-of-distribution detection since the likelihood is affected by the smoothness of the data. To improve the detection performance, we train the model to assign higher likelihood to target machine sounds and lower likelihood to sounds from other machines of the same machine type. We demonstrate that this enables the model to incorporate a self-supervised classification-based approach. Experiments conducted using the DCASE 2020 Challenge Task2 dataset showed that the proposed method improves the AUC by 4.6% on average when using Masked Autoregressive Flow (MAF) and by 5.8% when using Glow, which is a significant improvement over the previous method., Comment: 5 pages, 1 figure, accepted in ICASSP 2021

BMP signaling has been found to have tumor-promoting as well as tumor-suppressing effects in different types of tumors. In this study, we investigated the effects of BMP signaling and of BMP inhibitors on ovarian cancer (OC) cells in vitro and in vivo. High expression of BMP receptor 2 (BMPR2) correlated with poor overall survival of OC patients in the TCGA dataset. Both BMP2 and BMPR2 enhanced OC cell proliferation, whereas BMP receptor kinase inhibitors inhibited OC cell growth in cell culture as well as in a mouse model. BMP2 also augmented sphere formation, migration, and invasion of OC cells, and induced EMT. High BMP2 expression was observed after chemotherapy of OC patients in the GSE109934 dataset. In accordance, carboplatin, used for the treatment of OC patients, increased BMP2 secretion from OC cells, and induced EMT partially via activation of BMP signaling. Our data suggest that BMP signaling has tumor-promoting effects in OC, and that BMP inhibitors might be useful therapeutic agents for OC patients. Considering that carboplatin treatment augmented BMP2 secretion, the possibility to use a combination of BMP inhibitors and carboplatin in the treatment of OC patients, would be worth exploring. De två sista författarna delar sistaförfattarskapet

As the labor force decreases, the demand for labor-saving automatic anomalous sound detection technology that conducts maintenance of industrial equipment has grown. Conventional approaches detect anomalies based on the reconstruction errors of an autoencoder. However, when the target machine sound is non-stationary, a reconstruction error tends to be large independent of an anomaly, and its variations increased because of the difficulty of predicting the edge frames. To solve the issue, we propose an approach to anomalous detection in which the model utilizes multiple frames of a spectrogram whose center frame is removed as an input, and it predicts an interpolation of the removed frame as an output. Rather than predicting the edge frames, the proposed approach makes the reconstruction error consistent with the anomaly. Experimental results showed that the proposed approach achieved 27% improvement based on the standard AUC score, especially against non-stationary machinery sounds., 5 pages, 8 figures, published in ICASSP 2020

We proposed a nitride semiconductor transverse quasi-phase-matched wavelength conversion device with a polarity inverted structure along the vertical direction formed by surface-activated bonding and etching processes. Inductively coupled plasma etching of a GaN layer with maintaining a root mean square roughness of less than 2 nm in a 100 μm square area was achieved even after deep etching of 1 μm using Cl2/Ar mixture gas and optimizing the antenna and bias powers. This smooth etching enabled surface-activated bonding of the ultrathin GaN layer with designed thickness. The fabrication process of the GaN polarity inverted channel waveguide was established.

This paper presents a location-independent multi-channel acoustic scene classification (ASC) system that avoids spatial overfitting. Generally, ASC suffers from noise and reverberation in real environments. In addition, the ASC performance is decreased by overfitting a dataset, which is the result of learning from acoustic transfer functions enclosed in the dataset. To resolve these problems, we present a location-independent multi-channel ASC system using blind dereverberation, blind sound source separation, pre-trained model-based classifiers, and model ensemble. Experimental results on the DCASE 2018 Task 5 dataset indicate that the proposed system, with an F1 score of 88.4%, outperforms the baseline system. Also, the results indicate that although no one specific function improves the performance dramatically, all functions complement each other through the model ensemble.

Factory machinery is prone to failure or breakdown, resulting in significant expenses for companies. Hence, there is a rising interest in machine monitoring using different sensors including microphones. In the scientific community, the emergence of public datasets has led to advancements in acoustic detection and classification of scenes and events, but there are no public datasets that focus on the sound of industrial machines under normal and anomalous operating conditions in real factory environments. In this paper, we present a new dataset of industrial machine sounds that we call a sound dataset for malfunctioning industrial machine investigation and inspection (MIMII dataset). Normal sounds were recorded for different types of industrial machines (i.e., valves, pumps, fans, and slide rails), and to resemble a real-life scenario, various anomalous sounds were recorded (e.g., contamination, leakage, rotating unbalance, and rail damage). The purpose of releasing the MIMII dataset is to assist the machine-learning and signal-processing community with their development of automated facility maintenance. The MIMII dataset is freely available for download at: https://zenodo.org/record/3384388, 5 pages, to appear in DCASE 2019 Workshop

Bone morphogenetic protein (BMP) signaling plays important roles in glioblastoma multiforme (GBM), a lethal form of brain tumor. BMP reduces GBM tumorigenicity through its differentiation‐ and apoptosis‐inducing effects on glioma‐initiating cells (GIC). However, some GIC do not respond to the tumor suppressive effects of BMP. Using a phosphoreceptor tyrosine kinase array, we found that EPHA6 (erythropoietin‐producing hepatocellular carcinoma receptor A6) phosphorylation was regulated by BMP‐2 signaling in some GIC. Analysis of The Cancer Genome Atlas showed that EPHA6 expression was lower in patients with GBM than in the normal brain, and that high EPHA6 expression was correlated with better prognosis. EPHA6 receptor increased the susceptibility of both sensitive and resistant GIC to BMP‐2‐induced apoptosis. The cooperative effect on apoptosis induction depended on the kinase activity of BMP type I receptor but was independent of EPHA6 kinase function. Overexpression of the EPHA6 receptor in GIC resulted in the formation of a protein complex of EPHA6 receptor and the BMP type I receptor ALK‐2, which was associated with BMP‐induced apoptosis in GIC. Intracranial injection of GIC into nude mice showed that gain‐of‐function of EPHA6 together with BMP‐2 pretreatment slowed GBM tumor progression in the mouse brain and promoted mouse survival. In summary, EPHA6 together with BMP‐2 signaling led to apoptotic cell death in GIC, and thus is a putative tumor suppressor in GBM.

To develop a sound-monitoring system for checking machine health, a method for detecting anomalous sounds is proposed. In real environments such as factories, reverberation and background noise are mixed in an observed signal, so detection performance is degraded. It can be expected that detection performance will be improved by using a front-end algorithm for acoustic signal processing such as dereverberation and denoising. However, any algorithm has pros and cons, so it is not possible to choose the best front-end algorithm only. To solve this problem, the proposed method is based on a front-end ensemble consisting of a blind-dereverberation algorithm and multiple anomalous-sound-extraction algorithms. Experimental results indicate that the proposed method improves detection performance significantly.

Background and study aims: Light-emitting diodes (LEDs) are used widely for their high luminous efficiency and durability. We developed a novel prototype high definition endoscope with white LEDs and evaluated the image quality it produced against a commercial endoscope with conventional light source. Patients and methods: The specifications of both colonoscopes were identical, except for the LED light source at the tip of the prototype. We examined 20 patients with rectal or sigmoid colon lesions and the image quality was evaluated in 40 images (one image from the LED colonoscope and one from the conventional colonoscope for each lesion) by three endoscopists. We additionally evaluated the 17 videos recorded with the LED colonoscope that were available. Image quality, mucosal and vascular color, and luminous distribution and intensity were scored on a 5-point scale. Results: The mean score for vascular color given by one evaluator was significantly higher using the LED colonoscope than using the conventional colonoscope. The mean scores for mucosal color and luminous intensity from another evaluator were significantly lower with the LED colonoscope than with the conventional colonoscope. There were no significant differences in the luminous distribution scores for any of the evaluators. The image quality of the videos was evaluated as being similar with both colonoscopes. Conclusions: Image quality from the LED and conventional colonoscopes were similar, although the luminous intensity of the LEDs is inferior to that of the conventional light source at the present time.