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Misaki Endo,1,2 Miki Ono,1 Ayaka Deguchi,1 Yoshio Iwata,1 Yu Tamada,1,3 Jiro Masuya,1 Hajime Tanabe,4 Naoki Hashimoto,5 Takeshi Inoue,1 Mina Honyashiki1 1Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; 2Department of Psychiatry, Saitama Prefectural Psychiatric Hospital, Saitama, Japan; 3Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; 4Faculty of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan; 5Department of Psychiatry, Hokkaido University, Sapporo, JapanCorrespondence: Miki Ono, Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan, Tel +81-3-3342-6111, Email mikky@tokyo-med.ac.jpBackground: Subjective social status influences anxiety, but at present, the mechanism is not fully understood. It has been reported that negative childhood experiences, such as abuse, can influence depressive symptoms through subjective social status and personality traits, such as self-esteem. A similar mechanism is presumed to underlie anxiety symptoms in adulthood. Therefore, we hypothesized that subjective social status and self-esteem are intermediate factors in the indirect effects of childhood abuse on state anxiety in adulthood, and analyzed the indirect effects via these factors using a path analysis.Subjects and Methods: Child Abuse and Trauma Scale, Subjective Social Status, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory Form Y questionnaires were administered in a self-report format to 404 adult volunteers from January 2014 to August 2014. In addition, a path analysis was conducted to determine whether subjective social status and self-esteem are associated with the indirect effects of childhood abuse on anxiety symptoms in adulthood.Results: Childhood abuse did not directly affect state anxiety in adulthood, but affected state anxiety via subjective social status and self-esteem. Subjective social status affected state anxiety via self-esteem. This model explained 25.2% of the variation in state anxiety in adult volunteers.Conclusion: The present study demonstrated that childhood abuse affects anxiety in adulthood through subjective social status and self-esteem. Therefore, interventions that enhance subjective social status and self-esteem for adults who experienced childhood abuse may help reduce their anxiety.Keywords: childhood abuse, subjective social status, self-esteem, anxiety

Jiro Masuya,1,* Masahiko Ichiki,1,* Chihiro Morishita,1 Motoki Higashiyama,1 Miki Ono,1 Mina Honyashiki,1 Yoshio Iwata,1 Hajime Tanabe,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan; 2Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, Japan*These authors contributed equally to this workCorrespondence: Jiro Masuya, Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan, Tel +81-3-3342-6111, ext. 5754, Fax +81-3-3340-4499, Email j-masuya@tokyo-med.ac.jpBackground: When assessing patients with depressive and anxiety disorders in psychiatric clinical practice, it is common to encounter children and adolescents who have experienced abuse and victimization. To date, it has been clarified that experiences of “childhood abuse” and “childhood victimization” lead to “neuroticism”, and that neuroticism leads to “adult depressive symptoms”. In this study, we analyzed how these four factors are interrelated.Subjects and Methods: The following self-administered questionnaire surveys were conducted in 576 adult volunteers: Patient Health Questionnaire-9, Eysenck Personality Questionnaire-revised shortened version, Child Abuse and Trauma Scale, and Childhood Victimization Rating Scale. For statistical analysis, Pearson correlation coefficient analysis, t-test, multiple regression analysis, and covariance structure analysis (path analysis) were performed.Results: Path analysis showed that the indirect effects of childhood abuse and childhood victimization on depressive symptoms through neuroticism were statistically significant. In addition, the indirect effects of childhood abuse on neuroticism through childhood victimization were statistically significant. Finally, the indirect effects of childhood abuse on depressive symptoms through the combined paths of childhood victimization and neuroticism were statistically significant.Conclusion: Our results suggest that “childhood abuse (A)” induces changes in the personality trait of “neuroticism (C)” with “childhood victimization (B)” as a mediator, and that these adversities affect the expression of “depressive symptoms in adulthood (D)” through “neuroticism (C)” as a mediator. In other words, to our knowledge, this is the first study to clarify that these four factors are not only individually associated with each other but also cause a chain reaction of A to B to C to D.Keywords: childhood abuse, childhood victimization, neuroticism, depressive symptoms, path analysis

Ayaka Deguchi,1– 3 Jiro Masuya,1 Mayu Naruse,4 Chihiro Morishita,1 Motoki Higashiyama,1 Hajime Tanabe,5 Takeshi Inoue,1 Masahiko Ichiki1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan; 2Department of Psychiatry, Maruyamasou Hospital, Ishioka, Ibaraki, 315-0116, Japan; 3Department of Psychiatry, Deguchi Hospital, Nagasaki, Nagasaki, 851-1134, Japan; 4Department of Welfare Psychology, Tokyo International University, Kawagoe, Saitama, 350-1198, Japan; 5Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, JapanTel +81 3 3342 6111Fax +81 3 3340 4499Email tinoue@Tokyo-med.ac.jpBackground: Several psychological studies have shown that depressive rumination is associated with the onset and severity of depression. However, it is unclear how rumination interacts with other predisposing factors to cause depression. In this study, we hypothesized that rumination mediates the association between depression and two predisposing factors of depression, ie, childhood maltreatment and trait anxiety.Subjects and Methods: Between 2017 and 2018, 473 adult volunteers were surveyed using self-report questionnaires regarding the following: demographic information, rumination (Ruminative Responses Scale), trait anxiety (State-Trait Anxiety Inventory-Y), and the experience of childhood maltreatment (Child Abuse and Trauma Scale). The effects of these factors on depression (Patient Health Questionnaire-9) were analyzed by multiple regression and path analysis to analyze the mediating effects of rumination. This study was conducted with approval from the relevant ethics committee.Results: Multiple regression analysis using depression as a dependent variable demonstrated that trait anxiety, rumination, childhood maltreatment, and living alone were significantly associated with depression. Path analysis showed that childhood maltreatment had a positive effect on trait anxiety, rumination, and depression; trait anxiety had a positive effect on rumination and depression; and rumination had a positive effect on depression. Regarding indirect effects, the experience of childhood maltreatment increased rumination and depression indirectly via trait anxiety. Furthermore, the experience of childhood maltreatment increased depression indirectly via rumination, and trait anxiety significantly increased depression via rumination. In other words, rumination mediated the indirect effects of abusive experiences and trait anxiety on depression. This model accounted for 50% of the variance in depression in adult volunteers.Conclusion: Our results suggest that rumination mediates the association between childhood maltreatment, trait anxiety, and depression in adulthood.Keywords: rumination, trait anxiety, childhood maltreatment, depression, path analysis

Hiroshi Nakazawa,1 Jiro Masuya,1 Hajime Tanabe,2 Ichiro Kusumi,3 Takeshi Inoue,1 Masahiko Ichiki1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, 160-0023, Japan; 2Faculty of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka, 422-8529, Japan; 3Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, 060-8638, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, JapanTel +81 3 3342 6111Fax +81 3 3340 4499Email tinoue@tokyo-med.ac.jpBackground: Childhood maltreatment has long-lasting psychological effects, which often manifest in adulthood. Previous studies have suggested that the effects of childhood maltreatment are not only direct but also indirect, being mediated by other factors. In this study, we hypothesized that the effects of childhood maltreatment on state anxiety in adulthood are mediated by interpersonal sensitivity and the evaluation of life events, and investigated this possibility by covariance structure analysis.Subjects and Methods: Self-administered questionnaires (Child Abuse and Trauma Scale, State-Trait Anxiety Inventory Form Y, Life Experiences Survey, and Interpersonal Sensitivity Measure) were distributed to adult community volunteers in Japan, and 404 eligible responses were collected. A structural equation model was constructed to analyze the direct and indirect effects of childhood maltreatment on state anxiety, with interpersonal sensitivity and the evaluation of life events as potential mediators.Results: Our model showed that childhood maltreatment increases state anxiety in adulthood both directly and indirectly via interpersonal sensitivity. In addition, interpersonal sensitivity mediated the effects of childhood maltreatment on the negative evaluation of life events, and the negative evaluation of life events mediated the effects of interpersonal sensitivity on anxiety symptoms.Limitations: There may be possible recall bias owing to the self-administration of the questionnaire. In addition, this study had a cross-sectional design, and hence the results should be validated by a prospective study.Conclusion: The effects of childhood maltreatment on the state anxiety of adult volunteers are not only direct but are also mediated by interpersonal sensitivity. Our results suggest that assessing interpersonal sensitivity may help to determine optimal treatments for patients with anxiety who experienced maltreatment in childhood.Keywords: covariance structure analysis, child abuse and trauma scale, state-trait anxiety inventory form Y, interpersonal sensitivity measure, life experiences survey

Yumi Wakatsuki,1 Takeshi Inoue,2 Naoki Hashimoto,1 Yota Fujimura,2 Jiro Masuya,2 Masahiko Ichiki,2 Hajime Tanabe,3 Ichiro Kusumi1 1Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan; 2Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 3Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka 422-8529, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel +81-3-3342-6111Fax +81-3-3340-4499Email tinoue@tokyo-med.ac.jpBackground: Previous studies have shown that childhood maltreatment is associated with premenstrual dysphoric disorder (PMDD). In this study we analyzed how multiple factors, such as childhood maltreatment, affective temperaments, and adult life events influence the severity of premenstrual mental (PMM) symptoms in nonclinical adult volunteers from the community.Methods: A total of 204 participants were recruited and administered the following self-administered questionnaire surveys: PMDD scale, visual analogue scale, Patient Health Questionnaire-9, Life Experience Survey, Temperament Evaluation of Memphis, Pisa, Paris, and San Diego autoquestionnaire version, and the Child Abuse and Trauma scale. In addition to single and multiple regression analyses, structural equation modeling was used for the statistical analyses.Results: A history of neglect indirectly predicted PMM symptoms through affective temperaments in nonclinical adult volunteers. Three affective temperaments (irritable, cyclothymic, and anxious) directly predicted PMM symptoms.Conclusion: This study is the first to report that childhood maltreatment, particularly neglect, indirectly predicted PMM symptoms through affective temperaments. The results of our study suggest that affective temperament is a mediator of the influence of childhood maltreatment on PMM symptoms.Keywords: premenstrual mental symptoms, neglect, childhood maltreatment, affective temperament, TEMPS-A, structural equation modeling

Motoki Higashiyama,1 Taito Hayashida,1 Keisuke Sakuta,1 Yota Fujimura,2 Jiro Masuya,3 Masahiko Ichiki,1 Hajime Tanabe,4 Ichiro Kusumi,5 Takeshi Inoue11Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 2Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo 193-0998, Japan; 3Department of Psychiatry, Tokyo Medical University Ibaraki Medical Center, Ibaraki 300-0395, Japan; 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka 422-8529, Japan; 5Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, JapanCorrespondence: Takeshi InoueDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel +81 33 342 6111Fax +81 33 340 4499Email tinoue@tokyo-med.ac.jpBackground: How subjective social status is associated with childhood abuse and affective temperament in the mechanism of depressive symptom exacerbation remains unknown. In this study, we investigated how the complex effects of subjective social status, childhood abuse, and affective temperament influence depressive symptoms in adulthood.Methods: Self-report questionnaires were distributed to 853 adult volunteers between January and August 2014. Of them, 404 people gave full consent and returned complete anonymous responses. The following five questionnaires were analyzed: demographic information, Patient Health Questionnaire-9, subjective social status, Child Abuse and Trauma Scale, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire. The associations between the scores were analyzed by structural equation modeling. This study was conducted with approval from the ethics committees of Tokyo Medical University and Hokkaido University Hospital.Results: Covariance structure analysis demonstrated that childhood abuse and subjective social status did not have a direct effect on adulthood depressive symptoms. Childhood abuse had direct effects on subjective social status and affective temperament and childhood abuse indirectly affected adulthood depressive symptoms through subjective social status and affective temperament. Subjective social status also affected depressive symptoms through an effect on affective temperament. This model explained 43% of the variability in depressive symptoms and the fitness of this model was good.Conclusion: Regarding childhood abuse and adulthood depressive symptoms, subjective social status as well as affective temperament may be mediators. The results of this study are expected to contribute to the elucidation of the mechanism of depression.Keywords: childhood abuse, subjective social status, affective temperament, depression, covariance structure analysis

Yoshihiro Uchida,1–3 Toshinao Takahashi,1,3 Shigemasa Katayama,1,3 Jiro Masuya,1,2 Masahiko Ichiki,1 Hajime Tanabe,4 Ichiro Kusumi,5 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan; 2Department of Psychiatry, Ibaraki Medical Center, Tokyo Medical University, Ami-machi, Inashiki-gun, Ibaraki 300-0395, Japan; 3Department of Psychiatry, Seijin Hopital, Adachi-ku, Tokyo 121-0815, Japan; 4Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Suruga-ku, Shizuoka 422-8529, Japan; 5Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo 060-8638, Japan Background: Various personality traits mediate the association between childhood stress and depressive symptoms in adulthood. The aim of this study was to clarify the indirect effects of the experience of child maltreatment on depressive symptoms and appraisal of life events in adulthood through trait anxiety. Subjects and methods: A total of 404 participants who were volunteer subjects from the community were studied using the following self-administered questionnaire surveys: Patient Health Questionnaire-9, which measures depressive symptoms; State-Trait Anxiety Inventory Form Y, which measures trait anxiety; the Child Abuse and Trauma Scale, which measures child maltreatment; and Life Experiences Survey, which measures negative and positive appraisal of adulthood life events. Results: Structural equation modeling demonstrated that the experience of child maltreatment increased depressive symptoms in adulthood as well as the negative appraisal of life events in adulthood through an increase in trait anxiety. Furthermore, trait anxiety affected depressive symptoms in adulthood through its influence on the negative appraisal of adulthood life events. The following indirect effect was also significant: the experience of child maltreatment increased the negative appraisal of adulthood life events via trait anxiety and subsequently influenced adult depressive symptoms. Limitations: The subjects of this study are volunteer subjects from the community including healthy people, and hence the results may not be generalizable to major depressive patients. Recall bias should be considered when interpreting the results. Because this study is a cross-sectional study, the causality between the experience of child maltreatment and depression is not clear. Conclusion: This study suggests that trait anxiety may play a mediating role in the influence of the experience of child maltreatment on depressive symptoms in adulthood and negative appraisal of adulthood life events. Keywords: child maltreatment, covariance structure analysis, depression, STAI-Y, trait anxiety, life events

Kotaro Ono,1 Yoshikazu Takaesu,1 Yukiei Nakai,2 Akiyoshi Shimura,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Yasunori Matsumoto,1 Hajime Tanabe,3 Ichiro Kusumi,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo, 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, 3Department of Clinical Human Sciences, Graduate school of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods: A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire – Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. Results: Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations: There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion: This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms. Keywords: childhood abuse, depression, neuroticism, stressful life events, structural equation modeling

Hiroyuki Toda,1 Takeshi Inoue,2,3 Tomoya Tsunoda,1 Yukiei Nakai,2 Masaaki Tanichi,1 Teppei Tanaka,1 Naoki Hashimoto,2 Yasuya Nakato,2 Shin Nakagawa,2 Yuji Kitaichi,2 Nobuyuki Mitsui,2 Shuken Boku,4 Hajime Tanabe,5 Masashi Nibuya,1 Aihide Yoshino,1 Ichiro Kusumi2 1Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan; 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; 4Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan; 5Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Previous studies have shown the interaction between heredity and childhood stress or life events on the pathogenesis of a major depressive disorder (MDD). In this study, we tested our hypothesis that childhood abuse, affective temperaments, and adult stressful life events interact and influence the diagnosis of MDD. Patients and methods: A total of 170 healthy controls and 98 MDD patients were studied using the following self-administered questionnaire surveys: the Patient Health Questionnaire-9 (PHQ-9), the Life Experiences Survey, the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire, and the Child Abuse and Trauma Scale (CATS). The data were analyzed with univariate analysis, multivariable analysis, and structural equation modeling. Results: The neglect scores of the CATS indirectly predicted the diagnosis of MDD through cyclothymic and anxious temperament scores of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire in the structural equation modeling. Two temperaments – cyclothymic and anxious – directly predicted the diagnosis of MDD. The validity of this result was supported by the results of the stepwise multivariate logistic regression analysis as follows: three factors – neglect, cyclothymic, and anxious temperaments – were significant predictors of MDD. Neglect and the total CATS scores were also predictors of remission vs treatment-resistance in MDD patients independently of depressive symptoms. Limitations: The sample size was small for the comparison between the remission and treatment-resistant groups in MDD patients in multivariable analysis. Conclusion: This study suggests that childhood abuse, especially neglect, indirectly predicted the diagnosis of MDD through increased affective temperaments. The important role as a mediator of affective temperaments in the effect of childhood abuse on MDD was suggested. Keywords: neglect, major depressive disorder, affective temperament, mediator

Gebin Li,1 Peter Lee,1 Nobuko Mori,1 Ichiro Yamamoto,1 Koh Kawasumi,1 Hisao Tanabe,2 Toshiro Arai11Department of Veterinary Science, School of Veterinary Medicine, Nippon Veterinary and Life Science University, 2Komazawa Animal Hospital, Tokyo, JapanBackground and methods: Currently, five-point body condition scoring (BCS) is widely used by veterinarians and clinicians to assess adiposity in dogs in Japan. However, BCS score assignment is subjective in nature, and most clinicians do not score with half points, instead preferring to round off values, thereby rendering less accurate assessments. Therefore, we sought to determine whether assessing body fat percentage using simple morphometric measurements and supplementing this with five-point BCS can have increased sensitivity for detecting increasing adiposity in overweight small-medium sized dog breeds via plasma metabolite validation.Results: Overall, lean body fat percentage was determined to be 15%–22% for male (non-neutered/neutered) dogs and 15%–25% for female (nonspayed/spayed). Dogs categorized as overweight by BCS had significantly higher levels of nonesterified fatty acids (P = 0.005), whereas animals categorized as overweight by BCS + body fat percentage were observed to have significantly higher levels of nonesterified fatty acids (P = 0.006), total cholesterol (P = 0.029), and triglycerides (P = 0.001) than lean animals. The increased sensitivity due to body fat percentage for gauging alterations in plasma metabolite levels may be due to increased correlation strength. Body fat percentage correlated positively with plasma insulin (r = 0.627, P = 0.002), nonesterified fatty acids (r = 0.674, P < 0.001), total cholesterol (r = 0.825, P < 0.0001), triglycerides (r = 0.5823, P < 0.005), blood urea nitrogen (r = 0.429, P < 0.05), creatinine (r = 0.490, P = 0.021), and total protein (r = 0.737, P< 0.0001) levels, which all tend to increase as a result of increasing adiposity.Conclusion: Supplementing body fat percentage with five-point BCS appears to increase the likelihood of validating overweight status in small-medium sized dog breeds by detecting changes in plasma metabolite levels, especially lipids, induced as a result of increasing adiposity.Keywords: body condition score, body fat percentage, cholesterol, dog, nonesterified fatty acid, triglycerides

In a Hilbert space X, we consider the abstract problem [Please download the PDF to view the mathematical expression] where L is a closed linear operator in X and M [member of] [??](X) is not necessarily invertible, z [member of] X. Given the additional information [PHI][My(t)] = g(t) with [PHI] [membr of] [X.sup.*], g [member of] [C.sup.1] ([0, [tau]]; [??]), we are concerned with the determination of the conditions under which we can identify f [member of] C([0,[tau]];C) such that y be a strict solution to the abstract problem, i.e., My [member of] [C.sup.1] ([0,[tau]]; X), Ly [member of] C([0,[tau]];X). A similar problem is considered for general second-order equations in time. Various examples of these general problems are given., CONTENTS 1. Introduction and Basic Notations 583 2. Equations of the First Order. The Multivalued Operators Approach 584 3. The General Case 588 4. Equations of the Second Order in [...]

The objective was to build a pelvic lymph node dissection support system using AI, evaluate the performance of the model, and verify whether this model provides an additional effect on physician organ recognition ability. This is a retrospective cohort study. Using image data from 263 cases of pelvic lymphadenectomy from a national multi-center surgical database (111 gynecology, 118 colorectal, 34 urology), totaling 19,301 images, we constructed four organ recognition models (ureter, obturator nerve, external iliac artery/vein) using Feature Pyramid Networks (FPN). Subsequently, total of 1,920 videos were then created, including videos with and without each organ present. Four obstetricians and gynecologists, two colorectal surgeons, two urologists. In the performance evaluation test, the accuracy of each organ was measured as Dice coefficient. In the additional evaluation test, surgeons were tested to determine the presence or absence of the organs and their locations in the videos without AI support. Next, the same test was conducted using videos with AI support. In the performance evaluation test, the Dice coefficients were: ureter 0.700, nerve 0.835, artery 0.864, vein 0.862. In the additional effect test, sensitivity increased significantly for all organs except the artery: ureter +20.0% (43.4% → 63.4%), nerve +7.2% (68.4% → 75.6%), artery +5.9% (69.7% → 75.6%), and vein +11.5% (69.1% → 80.6%). Specificity also improved: ureter +4.4% (86.9% → 91.3%), nerve +7.5% (85.3% → 92.8%), artery +1.9% (93.4% → 95.3%), and vein +7.9% (83.4% → 91.3%), with no decline due to AI support. The AI model showed a notable enhancement in surgeons' organ recognition ability. Future tests will involve surgeons of varying skill levels across three specialties to validate the model. [ABSTRACT FROM AUTHOR]

Abstract Acceleration of vascular smooth muscle cell (VSMC) proliferation is closely linked to the pathogenesis of vascular diseases. We, therefore, focused on traditional Japanese herbal medicines (Kampo medicines) used to [...]

Background: Some forms of gastric intestinal metaplasia (GIM) may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. Mucin staining, as a means of [...]