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Repeated hospitalization for heart failure (HF) is a strong predictor of mortality among HF patients. While recent cardiac electrical implantable devices (CIEDs) can detect worsening HF through remote monitoring1,2, there is no early detection system for HF progression in patients at home without a CIED. We therefore developed an artificial intelligence-based HF detection system that uses single-lead electrocardiograms (ECGs) recorded at home. Our convolutional neural network (CNN) model calculated a novel HF-index from the estimated NYHA grades as a quantitative indicator of HF severity. Retrospective data revealed a strong correlation between HF-indexes and plasma BNP levels (R=0.91).A prospective clinical study confirmed the accuracy of the HF severity judged from the estimated HF-index using a portable single-lead ECG monitor at home.We have thus successfully constructed a novel, at-home HF monitoring system for a portable single-lead ECG device, which enables early detection and early medical intervention in HF.

The purpose of this study was to clarify the relationship between the cleavage of bone fragments and the stability of osseous healing after performing sagittal split ramus osteotomy (SSRO).The subjects were 11 patients with mandibular prognathism who underwent SSRO on both sides (22 rami). These rami were studied immediately after surgery, 6 months thereafter, and 1 year after surgery by computed tomography. The plane passing through the mandibular foramen was designated as the upper plane, while the plane passing through the root furcation of the first and second molars of the mandible was designated as the lower plane. Examining the cleavage at the anterior and posterior borders of distal and proximal bone fragments, the cleaved planes were classified into three types (smooth, stairway, concave) by a modification of the methods of Nemoto T, et al.(J Jpn Stomatol Soc 50: 227-241, 2001).Many of the concave type anterior borders changed to the stairway type between 6 months to 1 year after surgery, but few changed to the smooth type. Almost all of the stairway and concave type of posterior borders changed to the smooth type between 6 months to 1 year after surgery. Regarding the posterior borders at 1 year after surgery, the cleavage of distal and proximal bone fragments demonstrated stable osseous healing (smooth type) in cases in which the length and width between the bone fragments were large. In order to achieve a stable state of osseous healing at the anterior border, it is therefore important to consider the length between the bone fragments and delete the projection of the distal bone fragment. On the other hand, in order to achieve a stable state of osseous healing of the posterior border, it is important to carefully consider the width between the bone fragments. Sufficient bone contact is necessary for the cleavage of distal and proximal bone fragments in both the anterior and posterior border.The increased distance of the mandibular ramus due to the posterior movement of the SSRO and the clear absorption of the projection of both distal and proximal bone fragments was not observed from 6 months to 1 year after surgery. Therefore, the remodeling in the cleavage between the bone fragments is considered to play a major role in the osseous healing which occurs after SSRO.

伝統的に頭蓋と歯の形態中心に研究されてきた化石ヒト上科は, 近年の四肢骨資料増加により全体像が徐々に明らかにされつつある。多くの中新世 dental ape には尾はないようだが, 他の骨格は現生類人猿よりも, 古典的な狭鼻猿類に類似している。そこで, 共有派生形質の解釈次第でさまざまな系統関係が提唱されており, 現生類人猿放散以前にほとんどの化石ヒト上科が分岐した可能性も示唆されている。一方, 現生大型類人猿は, 遺伝, 形態, 行動生態の示す変異パターンがいままで考えられてきたよりも複雑であることが明らかになってきた。各分野を総合的に検討することで,種独特と考えられてきた行動や形態の適応的意義などを改めて問い直す必要がある。長い歴史を経たヒト上科研究だが, データの増加に伴い, ますます難解でかつ魅力的な生物進化を認識させられる。