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This paper reports medical informatics conference held in November 2020, which is under influence of CoVID-19, in hybrid way. The methods taken to ensure presenters, chairpersons, participants, supporting staffs, vendors seamless infrastructure regardless of on line or on site. This made question answer session rich as usual. Some other outcomes newly made possible are reported, such as demonstration shown on big personal screen, much better than slide projector screen, new participants who became able to participate over prefecture boundaries in challenged times.

This paper reports the history, background including politics, current status of Japan's health imaging study and other information sharing. Its realization was slow until the Ministry of Health, Labour and Welfare (MHLW) started paying digital image storage at the same rate as films in 2008. Information sharing was initiated in early 2010s, which was before vendors became ready for Integrating the Healthcare Enterprise (IHE) cross-enterprise document sharing (XDS), with the result that most of 34 large regional sharing systems are in non-standardized protocol. One standardized example is the Hamamatsu area where inexpensive online PDI (portable data for imaging) was introduced.

Multiple 24-hour urine collections are necessary to adequately assess sodium and potassium intake. Here, we assessed kidney function decline for four years after baseline in relation to seven-time averaged 24-hour urinary sodium and potassium excretion (UNaV, UKV), their UNaV/UKV ratio, and their categorical combination in outpatients with chronic kidney disease (CKD). This retrospective cohort study was based on 240 outpatients with baseline CKD stages 3-5, baseline age 20 years or more (median age 72.0 years), and a median follow-up (with interquartile range) of 2.9 (1.4–4.0) years. Outcome was the percentage change in annual slope of estimated glomerular filtration rate (delta eGFR per year). In linear mixed models, percentage changes in delta eGFR per year were -3.26% (95% confidence interval -5.85 to -0.60), +5.20% (2.34 to 8.14), and -5.20% (-7.64 to -2.69), respectively, per one standard deviation increase in the seven-time averaged UNaV and UKV, and their UNaV/UKV ratio. Additionally, percentage changes per year in delta eGFR per year were -16.27% (-23.57 to -8.27) in the middle-to-high UNaV and low UKV group, compared with the low UNaV and middle-to high UKV group. Thus, our study reinforces the observation of opposite associations between GFR decline and urinary excretion rates of sodium (positive) and potassium (negative), respectively. Whether changes in dietary sodium and potassium intake slow GFR decline still requires further study.

Background and Aims Prediction models for renal function decline has already been developed. However, few prediction models can suggest how to control clinical parameters to maintain renal function. The present study aimed to develop a prediction model for renal function decline that can suggest how to control clinical parameters to maintain renal function by an interpretable machine learning in Japanese outpatients with chronic kidney disease (CKD). Method The present study used a retrospective cohort design. The eligible criteria of the present study were outpatients with CKD stage 3, 4, and 5, treated in Daiko-Sunadabashi Clinic in Japan between 2005 and 2019. Among the patients, we analyzed patients whose 24-hour urine samples were collected 3 times and over between 6 and 36 months. The primary outcome was renal function decline defied by glomerular filtration rate (GFR) decreased by >30% from the baseline. As predictors, we used baseline CKD stage and baseline values and change rate from the baseline to the next-to-last observations of the following clinical parameters: urine volume, GFR, quantity of protein in urine, intake of protein and salt, and body mass index (BMI). We used a random forest model with actionable feature tweaking to develop the prediction model with suggesting how to control those clinical parameters. This method has been developed recently and to improve interpretability of the random forest method. This can suggest how to alter predictor values in order to change prediction results from bad to favorable outcome (e.g., changing from predicted decline to predicted maintenance of renal function). Predictability of the prediction model was assessed by accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in training and testing datasets. Results We analyzed 355 participants whose mean age (SD) was 69.2 (13.0) years old. Of the participants, 65.4% were men, 37.5%, 37.2% and 25.3% were CKD stage 3, 4, and 5, respectively. Of the participants, the 80% were included in the training dataset, and the 20% in the testing dataset. Predictability of the developed prediction model was summarized in Table 1, showing the prediction model had good predictability. The developed prediction model suggested that decreasing protein in urine and salt intake, and increasing GFR could be important to change from predicted decline to predicted maintenance of renal function. The prediction model could also suggest how to control those clinical parameters at individual-level (e.g., #53 and #67 patients in Figure 1). Conclusion The present study developed the prediction model for renal function decline with high predictability. The prediction model suggested that decreasing protein in urine and salt intake, and increasing GFR could be important to maintain renal function.

Reduction–volatilization of arsenic from a denitration catalyst obtained from a coal-fired power plant using a gaseous reducing agent was investigated to develop a dry arsenic removal process. Methanol vapour showed higher reactivity for the reduction of the arsenic species in the catalyst than solid carbon. When the catalyst was heated under a methanol atmosphere at temperatures above 350 °C, arsenic was quickly volatilized but the catalytic activity was drastically reduced. In that case, the denitration activity of the methanol-treated catalyst could be completely recovered by adding active vanadium species. It was confirmed that arsenic could be successfully removed with no decline in the catalytic activity by heating the catalyst under a methanol atmosphere in the temperature range from 250 to 275 °C.

Genome-wide association studies (GWASs) have identified >100 susceptibility loci for schizophrenia (SCZ) and demonstrated that SCZ is a polygenic disorder determined by numerous genetic variants but with small effect size. We conducted a GWAS in the Japanese (JPN) population (a) to detect novel SCZ-susceptibility genes and (b) to examine the shared genetic risk of SCZ across (East Asian [EAS] and European [EUR]) populations and/or that of trans-diseases (SCZ, bipolar disorder [BD], and major depressive disorder [MDD]) within EAS and between EAS and EUR (trans-diseases/populations). Among the discovery GWAS subjects (JPN-SCZ GWAS: 1940 SCZ cases and 7408 controls) and replication dataset (4071 SCZ cases and 54479 controls), both comprising JPN populations, 3 novel susceptibility loci for SCZ were identified: SPHKAP (P(best) = 4.1 × 10(−10)), SLC38A3 (P(best) = 5.7 × 10(−10)), and CABP1-ACADS (P(best) = 9.8 × 10(−9)). Subsequent meta-analysis between our samples and those of the Psychiatric GWAS Consortium (PGC; EUR samples) and another study detected 12 additional susceptibility loci. Polygenic risk score (PRS) prediction revealed a shared genetic risk of SCZ across populations (P(best) = 4.0 × 10(−11)) and between SCZ and BD in the JPN population (P ~ 10(−40)); however, a lower variance-explained was noted between JPN-SCZ GWAS and PGC-BD or MDD within/across populations. Genetic correlation analysis supported the PRS results; the genetic correlation between JPN-SCZ and PGC-SCZ was ρ = 0.58, whereas a similar/lower correlation was observed between the trans-diseases (JPN-SCZ vs JPN-BD/EAS-MDD, r(g) = 0.56/0.29) or trans-diseases/populations (JPN-SCZ vs PGC-BD/MDD, ρ = 0.38/0.12). In conclusion, (a) Fifteen novel loci are possible susceptibility genes for SCZ and (b) SCZ “risk” effect is shared with other psychiatric disorders even across populations.

Depressive symptoms are a serious problem in workplaces. Hospital staff members, such as newly licensed registered nurses (NLRNs), are at particularly increased risk of these symptoms owing to their limited experience. Previous studies have shown that a brief program-based cognitive behavioral therapy program (CBP) can offer effective treatment. Here, we conducted a longitudinal observational study of 683 NLRNs (CBP group, n = 522; no-CBP group, n = 181) over a period of 1 year (six times surveys were done during this period). Outcomes were assessed on the basis of surveys that covered the Beck Depression Inventory-I (BDI). The independent variables were CBP attendance (CBP was conducted 3 months after starting work), personality traits, personal stressful life events, workplace adversity, and pre-CBP change in BDI in the 3 months before CBP (ΔBDIpre-CBP). All factors were included in Cox proportional hazards models with time-dependent covariates for depressive symptoms (BDI ≥10), and we reported hazard ratios (HRs). Based on this analysis, we detected that CBP was significantly associated with benefit for depressive symptoms in all NLRNs (Puncorrected = 0.0137, HR = 0.902). To identify who benefitted most from CBP, we conducted a subgroup analysis based on the change in BDI before CBP (ΔBDIpre-CBP). The strongest association was when BDI scores were low after starting work and increased before CBP (Puncorrected = 0.00627, HR = 0.616). These results are consistent with previous findings, and indicate that CBP may benefit the mental health of NLRNs. Furthermore, selective prevention based on the pattern of BDI change over time may be important in identifying who should be offered CBP first. Although CBP is generally effective for all nurses, such a selective approach may be most appropriate where cost-effectiveness is a prominent concern.

AIMS Recent studies have revealed that the interplay between polygenic risk scores (PRS) and large copy number variants (CNV; >500kb) is essential for the etiology of schizophrenia (SCZ). To replicate previous findings, including those for smaller CNV (>10kb), the PRS between SCZ patients with and without CNV were compared. METHODS The PRS were calculated for 724 patients with SCZ and 1178 healthy controls (HC), genotyped using array-based comparative genomic hybridization and single nucleotide polymorphisms chips, and comparisons were made between cases and HC, or between subjects with and without 'clinically significant' CNV. RESULTS First, we replicated the higher PRS in patients with SCZ compared to that in HC (without taking into account the CNV). For clinically significant CNV, as defined by the American College of Medical Genetics ('pathogenic' and 'uncertain clinical significance, likely pathogenic' CNV), 66 patients with SCZ carried clinically significant CNV, whereas 658 SCZ patients had no such CNV. In the comparison of PRS between cases with/without the CNV, despite no significant difference in PRS, significant enrichment of the well-established risk CNV (22q11.2 deletion and 47,XXY/47,XXX) was observed in the lowest decile of PRS in SCZ patients with the CNV. CONCLUSION Although the present study failed to replicate the significant difference in PRS between SCZ patients with and without clinically significant CNV, SCZ patients with well-established risk CNV tended to have a lower PRS. Therefore, we speculate that the CNV in SCZ patients with lower PRS may contain 'genuine' risk; PRS is a possible tool for prioritizing clinically significant CNV because the power of the CNV association analysis is limited due to their rarity.

We investigated the clinical effectiveness of subcutaneous (SC) administration of recombinant feline interferon-omega (rFeIFN-ω) at a dose of 1 M unit (MU)/kg body weight (bw) for the treatment of feline chronic gingivitis-stomatitis (FCGS) in cats infected with feline calicivirus (FCV). Among the 17 cats used in this study, there were 13 FCV-positive cats (FCVI group), which were subcutaneously injected with rFeIFN-ω. The remaining four FCV-positive cats (FCVC group) were treated with SC corticosteroid. SC injection of rFeIFN-ω was given once daily on days 1, 2, 3, 7, 8, 9, 14, and 21. Corticosteroid was subcutaneously injected at a dose of 1.0 mg/kg bw, at the same intervals as rFeIFN-ω. Clinical symptoms (salivation, pain at opening the mouth, halitosis, mandibular lymphadenopathy, and all four symptoms combined [defined as “total clinical symptoms”]) and stomatitis (the degree and extent of inflammation, bleeding from the lesion, and all three items combined [defined as “total stomatitis”]) were scored on days 0, 7, 14, 21, and 28. FCV RNAs was quantified by real-time polymerase chain reaction and the percent increase in viral copy numbers was calculated using the values on days 0 and 28. In the FCVI group, significant differences were observed in the score for clinical symptom (salivation) score and in the total clinical symptom score within the group (P = 0.018 and 0.008, respectively). Significant differences within the group were also observed in the scores for the degree and extent of inflammation in stomatitis and in the total stomatitis score (P = 0.003, 0.007, and 0.003, respectively). The total score, defined as the clinical score plus the stomatitis score, was on days 7, 14, 21 and 28 than on day 0 (p = 0.006, .0003, 0.002 and 0.002, respectively). In the FCVI group, significant difference was observed between on days 0 and on 21 (p = 0.023). The percentage change in the number of polymerase chain reaction cycles required to amplify the viral RNA was positive (indicating viral reduction) in the FCVI group, but was negative in the FCVC group. These results demonstrate that SC administration of rFeIFN-ω under the current protocol improves stomatitis by inhibiting FCV proliferation in FCV-positive cats with FCGS.

The selective deprotection of a benzoyl group was very important methodology in the field of organic synthesis. Various methods for debenzoylation were investigated and developed in the past six decades, but more useful and selective strategies are now being strongly desired. In response to this strong demand, we developed the novel and selective deprotection of a benzoyl group by use of samarium(II) dibromide and a proton source. This deprotective reaction proceeded smoothly and the desired compound was obtained in good to excellent yields. In this paper, we will report the details of this deprotective reaction.

Measurements of glycated proteins such as serum fructosamine, glycated hemoglobin, and glycated albumin (GA) are increasingly used to complement serum glucose concentration for better management of diabetes mellitus. For example, the degree of glycemic control in diabetic cats can be determined by evaluating fructosamine concentration. Unfortunately, fructosamine tests are currently not performed in Japan, and as such, the measurement of GA may serve as a replacement test. The objectives of the current study were 2-fold. First, serum GA and fructosamine level were evaluated for positive correlation in cats as a preliminary gauge on whether serum GA use is applicable. Second, a GA percentage reference range was determined from healthy control cats for possible future diagnostic use. A positive correlation was determined for fructosamine and GA in both normal and diabetic cats. Moreover, the serum GA percentage reference interval based on control cats was determined to be 7.5–13.9% (95% nonparametric interfractile interval). Interestingly, no significant difference in serum GA percentages was observed between samples from diabetic cats with excellent glycemic control and control cats. However, good, fair, and poor glycemic control diabetic cats resulted in a significant increase in serum GA percentages in comparison to control cats. Therefore, these results indicate that serum GA may be a useful glycemic control indicator that could substitute for fructosamine to monitor glycemic control in diabetic cats.