Facilities In Japan Research Articles

Changes and factors in the geographical distribution of botanical garden-related facilities in Japan after the Meiji era, as seen in the members of the Japan Association of Botanical Gardens

Changes and factors in the geographical distribution of botanical garden-related facilities in Japan after the Meiji era, as seen in the members of the Japan Association of Botanical Gardens

Current status of the Tohoku microbeam system at Tohoku University and other facilities

We developed two microbeam lines, MB-I and MB-II, which both have quadrupole lenses and slits on heavy, rigid, anti-vibration tables. The MB-I beam diameter of 400 nm was achieved by reducing the parasitic magnetic field. MB-II is a simpler version of MB-I; both beamlines have various applications, and both are controlled by LabVIEW-based software and a programable logic controller (PLC). The beam scanners are downstream of the quadrupole lenses and controlled by a CompactRIO system. An automatic beam-focusing and focal guidance system reduces the time required for experimental configuration; this system is in routine use by researchers at Tohoku University. Microbeam experiments can easily be performed using this system. To further expand the applications, we developed MB-II-AQUA, which is based on MB-II but has advanced modularization and packaging. MB-II-AQUA is commercially available and retains the performance of MB-II, but is easier to use. A control system for the quadrupole lens and slit has been installed at the Takasaki Advanced Radiation Research Institute, which is a leading microbeam research facility in Japan.

Modifikasi Struktur Jetty Pelat Beton Pracetak Konvensional menjadi Pelat Beton Pracetak Hollow Core Slab

The wharf is where the ships are moored in the harbour. In addition, the pier is also the place where loading and unloading of goods takes place and passengers boarding and falling from and to the ship. The wharf is also the activity location for refueling ships, supplying ships with drinking water, clean water, and arranging channels for dirty/waste water to be further processed at the port. So that optimum planning is needed so that the performance of the building can meet safety and comfort standards
 This research modifies conventional precast floor slabs into hollow core slab precast slabs with 2 span variations. Dead loads are calculated based on specific gravity, live loads and traffic loads are calculated by "Loading for Bridges" (SNI 1725-2016), crane loads use the Ship to Shore Gantry Cranes Brand Liebherr specifications with a capacity of 50 tons, ship berthing loads and mooring loads ships are calculated based on the Technical standards and commentaries for port and harbor facilities in Japan, OCDI, 2020, while earthquake loads are calculated by "Bridge planning against earthquake loads" (SNI 2833:2016). Steel piles are calculated by "specifications for structural steel buildings" (SNI 1729:2015) and reinforced concrete structures are calculated by “Structural concrete requirements for buildings and explanations” (SNI 2847 2019). Structural analysis for structures is carried out using the help of SAP2000 software.
 From the research, it was obtained the results of modification of conventional precast floor slabs with hollow core slab precast floor plates with a span of 5.2 meters and a thickness of 350 mm. is an increase in the iron ratio of 38.57% and a decrease in the shear capacity of the punch by 56.57%. For a span of 10.4 meters, a plate with a thickness of 500 mm was used so that the result was an increase in the ratio of iron by 114.60% and a decrease in the shear capacity of the punch by 74.06%.

Patterns of visiting nurse services for older adults in Japanese residential facilities: A latent class analysis.

To examine the patterns of the visiting nurse services provided to older adults in a type of residential facility in Japan and to identify associated factors. This secondary analysis used past survey data from visiting nurse service agencies providing services to older adults in residential facilities with few nurses, known as non-specified facilities in Japan. Approximately 515 cases were used to determine the patterns of visiting nurse services using latent class analysis. Multinomial logistic regression analysis examined the relationships between identified classes, residents' characteristics, facilities, and services provided by visiting nurses. Three service patterns were identified as follows: Class 1, observational and follow-up care (37.1%); Class 2, chronic disease care (35.7%); and Class 3, end-of-life care (27.2%). Class 1 comprised fewer nursing services than the other classes and primarily involved the observation of medical conditions, whereas Classes 2 and 3 involved higher care-need levels and provided diverse nursing care support. Specifically, Class 3 was associated with the inclusion of family (odds ratio: 2.42) and a visiting nurse at the attached facility (odds ratio: 4.88). The three identified classes describe the older residents' healthcare needs. Additionally, the factors associated with the end-of-life care class suggest that older residents with these factors may have difficulty accessing end-of-life care by visiting nurses. Geriatr Gerontol Int 2023; 23: 326-333.

Transvaginal vesicovaginal fistula closure: A retrospective study of 28 cases at a single facility in Japan.

We aimed to report the background of patients with vesicovaginal fistulas (VVFs) at our center, which has treated a relatively large number of such patients in Japan, as well as the ingenuity and outcomes of vesicovaginal fistula closure (VVFC). We also investigated the causes of VVFs. A retrospective review was performed for 28 patients with VVFs treated at our center. Age, body mass index, etiology, site of fistula, and postoperative outcomes were investigated. Twenty-one (75%) fistulas occurred following hysterectomy. The overall success rate of VVFC was 85.7%, and the success rate limited to the first attempt was 89.5%. In 68% of cases, no bladder injury suspected as the cause of VVF was noticed during the surgery. Energy devices were used in all 12 patients for whom information on the type of device used for hysterectomy was confirmed. To our knowledge, this is the first report to evaluate a relatively large number of VVFCs in Japan. Although VVF is thought to be caused by bladder injury during hysterectomy, delayed thermal damage might also result in this pathology, even if there is no apparent intraoperative bladder injury.

Fact-finding survey on the competencies and literacy of radiological technologists regarding radiation disasters.

Radiological technologists serve as risk communicators who aim to lessen patients' anxiety about radiation exposure, in addition to performing radiological examinations. We conducted a fact-finding survey on knowledge and awareness of radiation disasters among the radiological technologists to reveal their literacy and competencies regarding radiation disasters. A paper questionnaire was distributed to 1,835 radiological technologists at 166 National Hospital Organization facilities in Japan. The 28-item questionnaire covered knowledge and awareness of radiation protection and radiation disasters. Radiological technologists were divided into 2 groups by regionality: areas where a nuclear power station was present/nearby (NPS areas) and non-NPS areas. Completed questionnaires were returned from 148 facilities with a facility response rate of 89.2% and from 1,391 radiological technologists with a response rate of 75.8%. There were 1,290 valid responses with a valid response rate of 70.3%. The correct answer rate for knowledge of radiation protection and radiation disasters was high in the 24 NPS areas. There were no differences in awareness of radiation disasters between NPS and non-NPS areas. Establishing a nationwide, region-independent training system can be expected to improve literacy regarding radiation disasters among radiological technologists. Willingness to assist during disasters was high among radiological technologists irrespective of area, indicating that the competencies of radiological technologists represent a competency model for radiation disaster assistance.

The emerging threat of methicillin-resistant Staphylococcus aureus (MRSA) clone ST22-PT, carrying both Panton-Valentine leucocidin and toxic shock syndrome toxin 1 genes.

Some MRSA strains produce Panton-Valentine leucocidin (PVL) and/or toxic shock syndrome toxin 1 (TSST-1), which are associated with severe infectious diseases. Although PVL- or TSST-1-positive strains have been isolated worldwide, strains carrying both PVL and TSST-1 genes are rare and sporadic. The objective of this study was to characterize these strains from Japan. A total of 6433 MRSA strains isolated in Japan between 2015 and 2021 were analysed. Molecular epidemiological and comparative genomic analyses were conducted on PVL- and TSST-1-positive MRSA strains. A total of 26 strains from 12 healthcare facilities were PVL positive and TSST-1 positive, and all were classified as clonal complex (CC) 22. These strains exhibited similar genetic features to each other and were named as ST22-PT according to a previous report. Twelve and one of the ST22-PT strains were identified in patients with deep-seated skin infections and toxic shock syndrome-like symptoms, which are typical clinical features of PVL-positive and TSST-1-positive Staphylococcus aureus, respectively. Whole-genome comparative analysis revealed that the ST22-PT strains were highly similar to PVL- and TSST-1-positive CC22 strains isolated in several countries. Evaluation of the genome structure showed that ST22-PT possessed ΦSa2 harbouring PVL genes and a unique S. aureus pathogenicity island harbouring the TSST-1 gene. ST22-PT strains have recently emerged from several healthcare facilities in Japan, and ST22-PT-like strains have been identified in several countries. Our report highlights that the risk of international spread of PVL- and TSST-1-positive MRSA clone ST22-PT needs to be further investigated.

Clinical Practice for Nuclear Medicine Therapy; Part 1

Nuclear medicine therapy is the treatment method that delivers radiation from inside the lesion where the therapeutic agent has accumulated. This can be performed minimally invasively with high antitumor efficacy against metastatic lesions throughout the body. In 2021, Lu-177 DOTATATE for neuroendocrine tumors and I-131 MIBG for malignant pheochromocytoma were approved by insurance in Japan. In addition to conventional I-131 therapy, novel radionuclides such as Lu-177 and Ra-223 are changing the current status of nuclear medicine therapy. In addition, new therapeutic radionuclides, the alphaemitting radionuclide At-211 and Ac-225, beta-emitting radionuclides Cu-64 and Cu-67, can be produced at several facilities in Japan. With the advent of new therapeutic agents, the laws governing their treatment are being revised to reflect current conditions. On the clinical side, the combination of nuclear medicine therapy and diagnostic imaging, Radio-theranostics, is being implemented more frequently than ever before. In addition, a therapeutic agent for prostate cancer, Lu-177 PSMA, was approved by the FDA. In the immediate future, this is expected to further increase the clinical use of nuclear medicine agents by Radio-theranostics.

Occurrence and the potential ecological risk of veterinary antimicrobials in swine farm wastewaters in Japan: Seasonal changes, relation to purchased quantity and after termination of oxytetracycline usage

This study provides the first comprehensive investigation of the residual concentrations of eight classes of antimicrobial agents (AMs, 20 compounds) in 13 swine wastewater treatment facilities in Japan. These facilities implemented the aerobic activated sludge (AS) or its alternative methods. The maximum concentrations before treatment were found at the level of 7100, 6900, 6000, 3600, 3400, and 1400 µg/L for tilmicosin, oxytetracycline (OTC), chlortetracycline, lincomycin , sulfamethoxazole, and trimethoprim, respectively. The highest detection rate (96.3%) in influents was noted for the morantel, which was a feed additive. The seasonal difference in residual concentration was much greater for tetracyclines (TCs) and macrolides (MLs) when their residual concentrations were high, especially in the cold season. There was a positive correlation between the purchased quantity of TCs and fluoroquinolones (FQs) and their residue levels detected in the effluents (p < 0.01). The estimated removal rate of AMs was greater than 80%. In contrast, on a few occasions, it was diminished due to failing operating conditions, such as water temperature and AS rate in the aeration tank. The estimated ecological risks of AMs in effluents based on risk quotients (RQs) considered to enhance the selection pressure for drug resistance (RQs-AMR) were high for TCs and FQs, whereas ecotoxicological effects (RQs-ENV) to aquatic organisms were higher for sulfonamides and MLs. When OTC usage ceased, its concentration in wastewater decreased rapidly; however, it remained longer period in the effluents, probably due to OTC desorption from the AS. The concentrations (and respective RQs) of TCs were decreased by >99.8% and >92% in the influents and effluents, respectively. This data suggested that it is essential to reduce the amount used and introduce more efficient methods and operating conditions to constantly remove AMs during the treatment to reduce the risk of AM discharge from swine farms.

Diagnostic Value of Adding Magnifying Chromoendoscopy to Magnifying Narrow-Band Imaging Endoscopy for Colorectal Polyps

This study examined the additional value of magnifying chromoendoscopy (MCE) on magnifying narrow-band imaging endoscopy (M-NBI) in the optical diagnosis of colorectal polyps. A multicenter prospective study was conducted at 9 facilities in Japan and Germany. Patients with colorectal polyps scheduled for resection were included. Optical diagnosis was performed by M-NBI first, followed by MCE. Both diagnoses were made in real time. MCE was performed on all type 2B lesions classified according to the Japan NBI Expert Team classification and other lesions at the discretion of endoscopists. The diagnostic accuracy and confidence of M-NBI and MCE for colorectal cancer (CRC) with deep invasion (≥T1b) were compared on the basis of histologic findings after resection. In total, 1173 lesions were included between February 2018 and December 2020, with 654 (5 hyperplastic polyp/sessile serrated lesion, 162 low-grade dysplasia, 403 high-grade dysplasia, 97 T1 CRCs, and 32 ≥T2 CRCs) examined using MCE after M-NBI. In the diagnostic accuracy for predicting CRC with deep invasion, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for M-NBI were 63.1%, 94.2%, 61.6%, 94.5%, and 90.2%, respectively, and for MCE they were 77.4%, 93.2%, 62.5%, 96.5%, and 91.1%, respectively. The sensitivity was significantly higher in MCE (P < .001). However, these additional values were limited to lesions with low confidence in M-NBI or the ones diagnosed as ≥T1b CRC by M-NBI. In this multicenter prospective study, we demonstrated the additional value of MCE on M-NBI. We suggest that additional MCE be recommended for lesions with low confidence or the ones diagnosed as ≥T1b CRC. Trials registry number: UMIN000031129.

BAYONET trial: A multicenter phase II trial of staged combination with encorafenib + binimetinib + cetuximab following encorafenib + cetuximab in patients with BRAF V600E-mutant metastatic colorectal cancer.

TPS271 Background: While the triplet combination of encorafenib (ENCO) + binimetinib (BINI) + cetuximab (CET) indicated higher response rate compared to the doublet combination of ENCO + CET, no significant survival benefits of the triplet combination were observed in patients with BRAF V600E-mutant metastatic colorectal cancer (mCRC) according to BEACON CRC study. Although ENCO + CET is the standard 2nd-line therapy in the United States and European Union, poor prognoses are expected after disease progression. As resistant mechanisms of BRAF + EGFR blockage, several MAPK pathway alternations, including RAS and RAF mutations were reported, which suggests the additional blockade of MAPK signaling may be an effective strategy for ENCO + CET refractory mCRC. In addition, the preclinical study suggested BRAF inhibitor + anti-EGFR antibody resistant BRAF V600E-mutant colorectal cancer cell-lines were sensitive to the combination of BRAF inhibitor + MEK inhibitor + anti-EGFR antibody (Oddo D, et al. Cancer Res. 2016). Methods: BAYONET is a single-arm multicenter phase II trial to evaluate the efficacy and safety of the staged combination with ENCO + BINI + CET for patients with BRAF V600E-mutant mCRC who were refractory to ENCO + CET. The main eligibility criteria are as follows; RAS wild-type/ BRAF V600E-mutant mCRC; age ≥ 20; ECOG PS 0 or 1; within 4 weeks from the last administration of previous ENCO or CET; no administration of other systemic therapy after refractoriness to ENCO + CET; complete response, partial response, or ≥4 months of stable disease were observed in the previous ENCO + CET. Included patients receive the combination treatment of ENCO (300mg once a day) + BINI (45mg twice a day) + CET (400mg/m2 initial dose and then 250mg/m2 once a week) in a 28 day-cycle as a study treatment. The primary endpoint of this trial is 12-week progression-free survival (PFS) rate. The secondary endpoints include PFS, overall survival, objective response rate, disease control rate, time to treatment failure, and the incidence of adverse events. The targeted sample size was calculated to be 30 on the basis of a power of 80%, a significant level of 10% (one-sided), the threshold 12-week PFS rate of 20%, and the expected 12-week PFS rate of 40%. As a translational analysis, circulating tumor DNA for next-generation sequencing using Guardant360 is collected at twice time points (before and after study treatment) to investigate the resistance mechanisms. Enrollment started from Jan 2022 and is ongoing at 25 facilities in Japan. As of Sep 20, 2022, 9 patients were enrolled. Clinical trial information: jRCTs031210510 .

Evaluating the effect of the incidence angle of ALOS-2 PALSAR-2 on detecting aquaculture facilities for sustainable use of coastal space and resources.

Driven by the growing world population, aquaculture plays a key role in meeting the increasing demand for food. However, aquaculture facilities in Japan are widely installed in coastal waters where natural disasters, such as typhoons and tsunamis, might wash these facilities away, thereby interfering with maritime navigation safety. Therefore, it is imperative to efficiently monitor the state of aquaculture facilities daily, particularly after a disaster in real time. To this end, several new space-borne L-band synthetic aperture radars (SARs) continue to be launched now and in the future, whose utilizations are expected to increase nationally and internationally. An example is the Japan Aerospace Exploration Agency, currently operating a SAR that can be operated day and night, and even under cloudy conditions, called ALOS-2 PALSAR-2. Based on the above facts, this study evaluated the effect of the incidence angle of ALOS-2 PALSAR-2 HH single-polarization data, using 3 m spatial resolution, on aquaculture raft detection. As the study site, we selected Ago Bay, located on the Pacific coast of Mie Prefecture in central Japan since the Nankai Trough Megathrust Earthquake and tsunamis have been predicted to occur in the future around this area. Then, we analyzed the sigma zero (backscattering coefficient) of aquaculture rafts and their surrounding sea surfaces, including the relationships between satellite orbits and aquaculture raft directions. Investigations revealed that the optimum incidence angle for detecting aquaculture rafts in this study was 33.8°-45.1°. Differences in the sigma zero values existed between the ascending and descending orbits. However, the incidence angles differed on the orbits. Then, differences in the median sigma zero values across a range of incidence angles were evaluated under the descending orbit. In addition, when the directions of the aquaculture rafts were closely perpendicular to the satellite orbit, aquaculture rafts tended to show the highest values of sigma zero due to Bragg resonance scattering. Hence, this knowledge may allow for the rapid detection of aquaculture rafts during an emergency without going on-site.

Manufacturing results of tisagenlecleucel for acute lymphoblastic leukemia: a survey by the CAR-T cell therapy taskforce of the Japan Society of Transfusion Medicine and Cell Therapy

The frequency of the manufacturing failure of chimeric antigen receptor (CAR)-T cell therapy in clinical practice is unknown. To clarify the current state of how likely CAR-T cell production is to succeed or fail for B-cell acute lymphoblastic leukemia (B-ALL), we analyzed cases in which the production of tisagenlecleucel was performed for patients with B-ALL at 15 facilities in Japan from October 2019 to March 2022. Total 81 patients (47 males and 34 females) were analyzed. The median age at apheresis was 13 years (1-25) with a median number of prior treatments of 4 (1-9). The numbers of patients with histories of allogeneic transplantation, inotuzumab ozogamicin, or blinatumomab treatments were 51 (63.0%), 26 (32.1%), and 37 (45.7%), respectively. The median blast percentage and CD3+ cell counts in peripheral blood were 0% (0-91.5), and 611/µl (35-4,210) at apheresis, and the median number of CD3+ cells shipped was 2.2×109 (0.5-8.3). While cases with a history of heavy prior treatment before apheresis were included, no manufacturing failures were observed. Continuing to monitor the status of manufacturing failures is necessary as the number of B-ALL cases treated with CAR-T cell therapy increases.

Toward the Realization of Concrete Floating Structures for Offshore Wind Power Generation in Japan

In this paper, an overview of the contents of the Design and Construction Guidelines for Concrete Floating Offshore Wind Power Facilities in Japan was provided. According to the guideline, a case study of a concrete floating structure supporting 10MW wind turbines was presented. The structural safety and durability were assessed based on stresses and strains obtained from nonlinear FE analysis even if the design load case applied in this study was limited. It is expected that further detailed examinations of concrete floating structures ultimately contribute to adoption and promotion of concrete floating structures in the world.

Safety and Effectiveness of Ustekinumab for Crohn's Disease in Japanese Post-marketing Surveillance in Biologic-Naive and -Experienced Conriemed.

To present the real-world evidence on the safety and effectiveness of ustekinumab (UST) through 52-week treatment for Crohn's disease (CD) under an analysis of post-market surveillance data in Japan. This prospective, post-marketing surveillance study was conducted in 341 patients from 91 medical facilities in Japan. Patients received UST 90 mg injected subcutaneously once every 12 weeks (or every 8 weeks if patients show weak effectiveness) after an induction dose given intravenously. Clinical response (100-point decrease in Crohn's Disease Activity Index [CDAI] score), clinical remission (CDAI score of <150), steroid-free clinical remission, C-reactive protein, endoscopy, physician global assessment, and adverse drug reactions (ADRs) were evaluated through 52 weeks. The overall rate of clinical remission was 49.2% at week 8 and 56.0% at week 52. The rate of clinical remission in biologic-naive patients was 75.9% and 66.7% at weeks 8 and 52, respectively, whereas the rate in biologic-experienced patients was 41.4% and 52.6% at weeks 8 and 52, respectively. For 52 weeks, the overall incidence of ADRs and serious adverse drug reactions (SADRs) was 11.7% and 6.7%, respectively. The most frequently reported SADRs was worsening of CD (1.8%). In multivariate analysis, ADRs incidence was significantly lower in patients with ileal involvement of CD (odds ratio = 0.25, 95% CI 0.07-0.85, P = .026), although disease location has no association with effectiveness of UST. The present study identified no new safety concerns and effectiveness for CD in Japanese patients treated with UST.

Photoneutron cross section measurements on 208Pb

Photoneutron reactions on 208Pb in the Giant Dipole Resonance (GDR) energy range have been investigated at the γ-ray beam line of the NewSUBARU synchrotron radiation facility in Japan. Making use of quasi-monochromatic laser Compton scattering (LCS) γ-ray beams and of a novel flat-efficiency neutron detection system along with associated neutron-multiplicity sorting method, total and partial (γ,xn) photoneutron cross sections with x = 1 to 4 have been measured for 208Pb in a broad energy range covering the neutron threshold up to 38 MeV.

The relationship between performance feedback from supervisors and subordinates' work engagement among employees in elderly care facilities: structural equation modeling.

Despite the increasing need for nursing care services, the turnover rate of care workers is high in Japan. Since the most common reason for quitting nursing care jobs was problems with interpersonal relationships at work, creating psychosocially safe working environments is urgent. This study aimed to investigate the mediating effects of trust in supervisors (TS) on the association between positive feedback (PF)/negative feedback (NF) and work engagement (WE) based on the job demands-resources theory and conservation of resources theory. We conducted anonymous cross-sectional surveys of 469 employees at elderly care facilities in Japan. Structural equation modeling was used to investigate the causal relationships between the variables. The results showed that PF had significant positive effects on WE, directly and indirectly through TS. By contrast, NF had a nonsignificant positive effect on TS or WE. Tucker-Lewis Index [TLI] was 0.917, Comparative Fit Index [CFI] was 0.927, Root Mean Squared Error of Approximation [RMSEA] was 0.096, and Standardized Root Mean squared Residual [SRMR] was 0.042. The study results indicate that sufficient PF is needed to improve subordinates' WE through TS in elderly care facilities.

Study on ventilation issues in urban nursery facilities: Long-term field survey in Yokohama, Japan

In many urban nursery facilities in Japan, daily ventilation behavior is restricted, and poor indoor air quality has been an issue of concern. However, the lack of specific common standards for indoor environments, including ventilation in nursery facilities, has left the issue unresolved in Japan. The purpose of this study is to clarify ventilation issues at nursery facilities in urban areas and indicate future measures. To this end, indoor air quality was analyzed using data from intermittent measurements taken between 2014 and 2022 at 21 nursery facilities in Yokohama City. As a result, the nursery facilities were classified into three categories based on nursery teachers’ ventilation behavior: “window-ventilation type,” “mechanical-ventilation type,” and “combined-ventilation type.” There was a significant difference (p-value &lt;0.001) in the mean CO2 concentration between the window-ventilation type and the mechanical-ventilation type, and between the window-ventilation type and the combined-ventilation type, confirming the difference indoor air quality due to the difference in ventilation behavior. It was clear that the mechanical-ventilation type and combined-ventilation type had significantly lower compliance rates with the minimum ventilation rate required by the Japanese Building Standard Law (20 m3/h), which buildings must have at a minimum.

PS-BPC01-6: DEEP LEARNING IS USEFUL FOR THE PATHOLOGICAL ANALYSES OF HUMAN KIDNEY BIOPSY IMAGES

Objective: The kidney plays a pivotal role in the maintenance of blood pressure. Non-neoplastic kidney biopsy images yield a great deal of diagnostic information, however, several studies have shown that there is room for improvement in pathological diagnostic reproducibility. Recently, deep learning has made major breakthroughs in various tasks. Therefore, we tried to analyze human kidney biopsy images using deep learning. Design and Method: We analyzed 5002 non-neoplastic kidney biopsy whole slide images (WSIs) obtained from 24 facilities in Japan using deep learning. Images of periodic acid-Schiff stained kidney sections were analyzed. Results: WSIs have billions of pixels, and deep neural networks (NNs) cannot accept such a huge image as an input. Therefore, we prepared 88 μm square 6,125,990 patch images (PIs) from the WSIs, and trained NNs with these PIs. We manually selected 259,682 typical PIs from the whole set of PIs, and annotated them into 56 classes. Using these annotated PIs, we trained EfficientNets B0-B7, whose network depth and width are carefully balanced for various input resolutions (224 to 600 pixels), and found that EfficientNetB4 (hereafter referred to CNN_Man) achieved the best F1 score. Using histological parameters obtained from renal biopsy reports made by nephrologists and pathologists at each facility, we confirmed the reliability of CNN_Man-based prediction. We also finely visualized histological features of WSIs based on CNN_Man prediction (Figure). In addition to these supervised histological analyses, we tried to extract disease features in a loosely supervised manner. In this loosely supervised learning, we tried to extract disease-related rather than histology-related glomerular features by training EfficientNetB4 using final diagnosis as true labels. It is noteworthy that the final-diagnosis-based training is not typical supervised learning because each disease class contains patch images with various histological features to varying degrees. We extracted glomerulus-related PIs by using CNN_Man, and then labeled these PIs into 20 final-diagnosis categories. EfficientNetB4 (hereafter CNN_Diag) was trained with the 20 class images in a 5-fold cross-validation manner. Using UMAP, we visualized the final layer parameters of CNN_Diag corresponding to each PI. This approach divided PIs from IgA nephropathy into many clusters, and each cluster reflected blood pressure, renal function, age, etc., even though they were not explicitly given as teacher labels. Conclusions: The analysis of kidney biopsy images using deep learning may be useful for the classification of renal diseases based on new perspectives.

Helicobacter delphinicola infection and the risk of gastric disease in common bottlenose dolphin.

Gastritis and gastric ulcers are well-recognized conditions in cetaceans; bacteria of the genus Helicobacter are considered the primary cause of these diseases. Dolphins have been shown to be susceptible to infection by at least 2 gastric species of Helicobacter, H. cetorum and H. delphinicola, both of which are closely related to the human pathogen H. pylori. In the present study, we evaluated the carriage rate and relationship to gastric disease of H. cetorum and H. delphinicola, based on a study population of 82 dolphins maintained at 21 facilities in Japan. Of these 82 dolphins, 79 (96.3%) and 45 (54.9%) were positive for H. cetorum and H. delphinicola, respectively; H. delphinicola infection was significantly associated with chronic gastric diseases (odds rate: 5.9; 95% CI: 2.1-16.9), but no such association was detected for H. cetorum. Of the 21 facilities, 20 (95%) and 11 (55%) housed H. cetorum- and H. delphinicola-positive dolphins, respectively, and our study suggested that the transmission between dolphins occurs quickly within pools. These findings indicate that methods will need to be established to prevent the transmission of Helicobacter infections within facilities housing dolphins.