A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B

Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy,20%-30%have a fatal outcome.In this report,we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid.In both cases,rapid reductions in serum hepatitis B virus(HBV)-DNA levels were observed,and corticosteroid was stopped after serum HBV-DNA levels became undetectable.Entecavir treatment was continued.Generally,entecavir treatment reduced serum HBV-DNA levels rapidly,although the improvement in liver function was delayed by a few weeks.During this time lag,liver cell injury continued and the disease progressed.Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration.A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B.

A case of hepatic angiomyolipoma difficult to distinguish from hepatocellular carcinoma

We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma.

Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy

Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice.Recently,therapeutic endoscopic retrograde cholangiopancreatography(ERCP) using double-balloon enteroscopy(DBE) has been shown to be feasible and effective,even in patients with surgically altered anatomies.On the other hand,endoscopic partial stent-in-stent(PSIS) placement of selfexpandable metallic stents(SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible,safe and effective.We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success.This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization,even in patients with surgically altered anatomies.

Successful biliary drainage using a metal stent through the gastric stoma

We report a case of biliary drainage for malignant stricture using a metal stent with an ultrathin endoscope through the gastric stoma. A 78-year-old female was referred to our hospital for jaundice and fever. She had undergone percutaneous endoscopic gastrostomy(PEG) for esophageal obstruction after radiation therapy for cancer of the pharynx. Abdominal contrast-enhanced computed tomography showed a 3-cm enhanced mass in the middle bile duct and dilatation of the intrahepatic bile duct. We initially performed endoscopic retrograde cholangiopancreatography(ERCP) with a trans-oral approach. However, neither the side-viewing endoscope nor the ultrathin endoscope passed through the esophageal orifice. Thus, we eventually performed ERCP via the PEG stoma using an ultrathin endoscope. We performed biliary drainage with a 6F introducer selfexpanding metal stent. The cytology findings obtained by brush cytology showed malignancy. Her laboratory results were restored to normal levels after drainage and no complication occurred.

Emotion Analysis on Social Big Data

In this paper,we describe a method of emotion analysis on social big data.Social big data means text data that is emerging on Internet social networking services.We collect multilingual web corpora and annotated emotion tags to these corpora for the purpose of emotion analysis.Because these data are constructed by manual annotation,their quality is high but their quantity is low.If we create an emotion analysis model based on this corpus with high quality and use the model for the analysis of social big data,we might be able to statistically analyze emotional sensesand behavior of the people in Internet communications,which we could not know before.In this paper,we create an emotion analysis model that integrate the highquality emotion corpus and the automaticconstructed corpus that we created in our past studies,and then analyze a large-scale corpus consisting of Twitter tweets based on the model.As the result of time-series analysis on the large-scale corpus and the result of model evaluation,we show the effectiveness of our proposed method.

The Optimization of Humanoid Robot’s Dialog in Improving Communication between Humanoid Robot and Older Adults

Older adults with dementia are increasing in Japan. Because of this, “communication robots” are being introduced into nursing settings to substitute for the shortage of nurses and other care workers. Our research group is currently developing a humanoid nursing robot with caring function (HNR), specifically for the functional and practical use of older adults with dementia. The purpose of this study was to clarify improvement points of the current function of humanoid robot’s (Pepper) (SoftBank Robotics) dialog pattern for improving optimal communication between humanoid robot and older adults. Dialog programs were installed in the humanoid robot Pepper, including the application program Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) that was made by Xing Company, Japan. Dialogues between older adults and Pepper-CPGE were recorded by video camera. Data from transcriptions of the conversations captured from video and from field notes were analyzed focusing on human-robot interaction. From the recorded scenes and conversations, the following were points to be improved: 1) Intonation of the words vocalized by Pepper-CPGE was different from that expected by the older adult resulted in inappropriate responses by the older adult;2) The timing between Pepper’s questions and the responses of the older adult were not timely and did not match (differences in the question-response time), which lead to confusion among the older adults;and 3) Other surroundings older adults were interested in the dialogue with Pepper-CPGE. However, Pepper-CPGE cannot communicate with multiple older adults. ImprovingPepper-CPGE’s ability to communicate with multiple older adults as an older adult’s dialogue with Pepper-CPGE can cause other older adults to also interact not only with the older adult that Pepper-CPGE is interacting with but also with Pepper-CPGE. This study shows that transactive relations among humanoid robots and older adults can be facilitated. Improving communication between humanoid robots and the older adults by optimizing a structured dialogue is needed to enhance appropriate engagement and participation. It is necessary to create a “Caring dialogue Database” for HNRs in order to know the patient/client and to share the aesthetic experiences of human-robot interactions. Also, it is important to develop a dialog pattern that enables humanoid robots to sympathize with older adults.

Gastric linitis plastica with autoimmune pancreatitis diagnosed by an endoscopic ultrasonography-guided fine-needle biopsy: A case report

BACKGROUND Gastric linitis plastica(GLP)is a subset of gastric cancer with a poor prognosis.It is difficult to obtain a definitive diagnosis by endoscopic mucosal biopsies,and the usefulness of an endoscopic ultrasonography-guided fine-needle biopsy(EUSFNB)for GLP has been recently reported.Meanwhile,autoimmune diseases are occasionally known to coexist with malignant tumors as paraneoplastic syndrome.We herein report the usefulness of an EUS-FNB for detecting GLP and the possibility of paraneoplastic syndrome coexisting with GLP.CASE SUMMARY An 81-year-old man was admitted to our hospital for a 1-mo history of epigastric pain that increased after eating.His laboratory data revealed high levels of serum carbohydrate antigen 19-9 and immunoglobulin-G4.Endoscopic examinations showed giant gastric folds and reddish mucosa;however,no epithelial changes were observed.The gastric lumen was not distensible by air inflation,suggesting GLP.Computed tomography showed the thickened gastric wall,the diffuse enlargement of the pancreas,and the peripancreatic rim,which suggested autoimmune pancreatitis(AIP)coexisting with GLP.Because the pathological findings of the endoscopic biopsy showed no malignancy,he underwent an EUSFNB and was diagnosed with GLP.He received chemotherapy for unresectable gastric cancer due to peritoneal metastasis,after which both the gastric wall thickening and diffuse enlargement of the pancreas were improved.CONCLUSION An EUS-FNB for GLP with a negative endoscopic biopsy is useful,and AIP may develop as a paraneoplastic syndrome.

Speech Encoding Scheme for the Extra-Cochlear Pulsed Electrical Stimulation System

An extra-cochlear stimulation system has been investigated as a less invasive alternative to conventional cochlear implant;however, the system is used primarily as a speech-reading aid. The purpose of this study was to develop a speech encoding scheme for the extra-cochlear stimulation system to convey intelligible speech. A click-modulated speech sound (CMS) was created as a simulation of the extra-cochlear stimulation system. The CMS is a repetitive click with a repetition rate similar to the formant frequency transition of an original sound. Seven native Japanese speakers with normal hearing participated in the experiment. After listening to the CMS, synthesized from low familiarity Japanese words, the subjects reported their perceptions. The results showed that the rates of correctly identified vowels and consonants were significantly higher than those of the control stimulus, suggesting that the CMS can generate at least partially intelligible vowel and consonant perceptions. In all, the speech encoding scheme could be applied to the extra-cochlear stimulation system to restore speech perception.

An Improvement of Pedestrian Detection Method with Multiple Resolutions

In object detection, detecting an object with 100 pixels is substantially different from detecting an object with 10 pixels. Many object detection algorithms assume that the pedestrian scale is fixed during detection, such as the DPM detector. However, detectors often give rise to different detection effects under the circumstance of different scales. If a detector is used to perform pedestrian detection in different scales, the accuracy of pedestrian detection could be improved. A multi-resolution DPM pedestrian detection algorithm is proposed in this paper. During the stage of model training, a resolution factor is added to a set of hidden variables of a latent SVM model. Then, in the stage of detection, a standard DPM model is used for the high resolution objects and a rigid template is adopted in case of the low resolution objects. In our experiments, we find that in case of low resolution objects the detection accuracy of a standard DPM model is lower than that of a rigid template. In Caltech, the omission ratio of a multi-resolution DPM detector is 52% with 1 false positive per image (1FPPI);and the omission ratio rises to 59% (1FPPI) as far as a standard DPM detector is concerned. In the large-scale sample set of Caltech, the omission ratios given by the multi-resolution and the standard DPM detectors are 18% (1FPPI) and 26% (1FPPI), respectively.

Slang feature extraction by analysing topic change on social media

Recently,the authors often see words such as youth slang,neologism and Internet slang on social networking sites(SNSs)that are not registered on dictionaries.Since the documents posted to SNSs include a lot of fresh information,they are thought to be useful for collecting information.It is important to analyse these words(hereinafter referred to as‘slang’)and capture their features for the improvement of the accuracy of automatic information collection.This study aims to analyse what features can be observed in slang by focusing on the topic.They construct topic models from document groups including target slang on Twitter by latent Dirichlet allocation.With the models,they chronologically the analyse change of topics during a certain period of time to find out the difference in the features between slang and general words.Then,they propose a slang classification method based on the change of features.

Methodology for Developing a Nursing Administration Analysis System

Nursing administration requires a large volume of wide-ranging information, and nurse administrators are limited in their ability to compile and analyze information for nursing administration. The purpose of this study is to create methodology for developing a nursing administration analysis system to aid nurse administrators in performing outcome analysis. In this methodology, information required for nursing administration in the PSYCHOMS? (Psychiatric Outcome Management System, registered trademark) database is analyzed according to the individual needs of nurse administrators. It features a combination of a classification method and an extraction method for obtaining quantitative and qualitative data as information required for nursing administration, and enables nurse administrators to easily obtain analysis results that they directly need. This methodology converts the time required nurse administrators to collect and organize information into time for making considerations in order to devise strategies for improving the quality of nursing care services, and can improve the quality and efficiency of nursing administration. This may lead to an increase of the quality of nursing care services at psychiatric hospitals. This methodology is highly versatile as it can be applied in information management, not only for nursing, but for the entire psychiatric hospital.

Reliability Verification and Practical Effectiveness Evaluation of the Nursing Administration Analysis Formulae Based on PSYCHOMS^(■)

In psychiatric hospitals, the ratios between patients versus physician and patients versus nurse are low as compared to those in general hospitals. Furthermore, usages of electronic medical records are also low so that nurse administrators are limited in their ability to compile, analyze, and generate patient care staffing information for their administrative use. Psychiatric nurse administrators anticipate the development of a nursing administration analysis system that could perform personnel data simulation, manage information on nursing staff, and manage ward/ practice operations. Responding to this situation, the authors developed a nursing administration analysis system utilizing formulae from the Psychiatric Outcome Management System, PSYCHOMS®to aid nurse administrators. Such formulae are awaiting patent approval. The purpose of this study was to examine the validity of the formulae and the Structured Query Language (SQL) statement, and its practical effectiveness of analyzing data. The study findings showed that two kinds of computation expressions—a classification and extraction were able to display required information desired by nurse administrators. Moreover, significant information critical to assigning staff was validated to ensure high quality of nursing care according to the function and characteristic of the hospital ward.