Search

This study presents a novel two-step optimization method that incorporates explainable neural networks into topology optimization. The deep neural network (DNN) is trained to infer the torque performance from the input image of the motor cross section. The sensitive region that has a significant influence on the average torque is extracted using gradient-weighted class activation mapping (Grad-CAM) constructed from the DNN. Then, the optimization with respect to the torque ripple is performed only in the incentive region with little influence on the average torque. The proposed method is shown to increase the average torque of an interior permanent magnet (IPM) motor by 14% and reduce the torque ripple by 79% compared with the original model. [ABSTRACT FROM AUTHOR]

The computational cost of topology optimization based on the stochastic algorithm is shown to be greatly reduced by deep learning. In the learning phase, the cross-sectional image of an interior permanent magnet motor, represented in RGB, is used to train a convolutional neural network (CNN) to infer the torque properties. In the optimization phase, all the individuals are approximately evaluated by the trained CNN, while finite element analysis for accurate evaluation is performed only for a limited number of individuals. It is numerically shown that the computational cost for the topology optimization can be reduced without the loss of optimization quality. [ABSTRACT FROM AUTHOR]

This paper presents the fast topology optimization methods for rotating machines based on deep learning. The cross-sectional image of electric motors and their performances obtained during a multi-objective topology optimization based on the finite-element method and genetic algorithm (GA) is used for training of the convolutional neural network (CNN). Two different approaches are proposed: 1) CNN trained by preliminary optimization with a small population for GA is used for the main optimization with a large population and 2) CNN is used for screening of torque performances in the optimization with respect to the motor efficiency. [ABSTRACT FROM AUTHOR]

This paper presents a new topology optimization of interior permanent magnet (IPM) motors using the genetic algorithm with aid of the deep leaning. The data composed of the rotor shape of an IPM motor and its performance, obtained by a prior topology optimization process, is input to a convolutional neural network (CNN). After the learning process, CNN is shown to provide fairly accurate estimate of the motor performance. During the posterior topology optimization, the finite element analysis (FEA) is carried out only for the limited number of individuals; probability that FEA is performed increases with the motor performance evaluated by CNN. It is shown that the computing time is reduced to about 1/10 without deterioration of the optimization performance with aid of the deep learning. [ABSTRACT FROM AUTHOR]

This paper presents a new topology optimization method based on basis functions for design of rotating machines. In this method, the core shape of a given rotating machine is represented by the linear combination of the basis functions. The shape is then freely deformed by changing the weighting coefficients to the basis functions to find the optimal shape. The proposed method is compared with the conventional shape optimization based on polygon morphing. The former is shown to outperform the latter in both interior permanent magnet and synchronous motor models. [ABSTRACT FROM AUTHOR]

Background The most common treatment for congenital lacrimal duct obstruction is standard probing without dacryoendoscopy. However, the lacrimal duct cannot be observed in this procedure. If the probing procedure allows the observation of the lacrimal duct, it could be more successful and safer. To use endoscopic probing to view the lacrimal duct in cases of congenital lacrimal duct obstruction 6 months post-surgery and to evaluate the condition of the lumen while simultaneously performing direct endoscopic probing. Design This is a retrospective, non-comparative case series. Participants The study participants were 10 children aged 14-74 months, including three children with bilateral obstruction. In total, 13 congenital lacrimal duct obstruction were probed. Methods The patients underwent direct endoscopic probing with dacryoendoscopy instead of blind probing, that is, standard probing without dacryoendoscopy under brief total anaesthesia. Main Outcome Measures During the procedure, outcomes were assessed as the endoscope reached the nasal cavity. A successful probing outcome was defined as an absence of tearing and discharge. Results Twelve congenital lacrimal duct obstruction were successfully treated by direct endoscopy, whereas one was not. There were various sites of obstruction and various conditions such as oedematous thickening of the mucosa of the lacrimal duct and fibrous tissue because of chronic inflammation. The subjective outcome from their parents by telephonic interview was obtained. Epiphora disappeared in 12/13 (92.3%) of the eyes treated by endoscopy; however, 5/13 (38.5%) of the patients reported occasional discharge from the eyes. Conclusions Direct endoscopic probing is effective and safe to treat cases of congenital lacrimal duct obstruction in children. [ABSTRACT FROM AUTHOR]

Background: Anticipatory chemotherapy-induced nausea and vomiting (CINV) is a conditioned response influenced by the severity and duration of previous emetic responses to chemotherapy. We aimed to evaluate the efficacy of non-pharmacologic interventions for anticipatory CINV among patients with cancer. Methods: We conducted a systematic search in databases, including PubMed, the Cochrane Library, CINAHL, and Ichushi-Web, from January 1, 1990, to December 31, 2020. Randomized controlled trials, non-randomized designs, observational studies, or case–control studies that utilized non-pharmacological therapies were included. The primary outcomes were anticipatory CINV, with an additional investigation into adverse events and the costs of therapies. The risk-of-bias for each study was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using Revman 5.4 software. Results: Of the 107 studies identified, six met the inclusion criteria. Three types of non-pharmacological treatments were identified: systematic desensitization (n = 2), hypnotherapy (n = 2), and yoga therapy (n = 2). Among them, systematic desensitization significantly improved anticipatory CINV as compared to that in the control group (nausea: risk ratio [RR] = 0.60, 95% confidence interval [CI] = 0.49–0.72, p < 0.00001; vomiting: RR = 0.54, 95% CI = 0.32–0.91, p = 0.02). However, heterogeneity in outcome measures precluded meta-analysis for hypnotherapy and yoga. Additionally, most selected studies had a high or unclear risk of bias, and adverse events were not consistently reported. Conclusions: Our findings suggest that systematic desensitization may effectively reduce anticipatory CINV. However, further research is warranted before implementation in clinical settings. [ABSTRACT FROM AUTHOR]

Background: The Japan Society of Clinical Oncology Clinical Practice Guidelines for Antiemesis 2023 was extensively revised to reflect the latest advances in antineoplastic agents, antiemetics, and antineoplastic regimens. This update provides new evidence on the efficacy of antiemetic regimens. Methods: Guided by the Minds Clinical Practice Guideline Development Manual of 2017, a rigorous approach was used to update the guidelines; a thorough literature search was conducted from January 1, 1990, to December 31, 2020. Results: Comprehensive process resulted in the creation of 13 background questions (BQs), 12 clinical questions (CQs), and three future research questions (FQs). Moreover, the emetic risk classification was also updated. Conclusions: The primary goal of the present guidelines is to provide comprehensive information and facilitate informed decision-making, regarding antiemetic therapy, for both patients and healthcare providers. [ABSTRACT FROM AUTHOR]

Combined oral cyclophosphamide and capecitabine (XC) chemotherapy is used for metastatic breast cancer (MBC) patients. We report herein two MBC patients who developed severe hemorrhagic cystitis after XC therapy. Case 1: A 67-year-old woman with MBC had received XC therapy for 2.5 years. After a sudden onset of lower abdominal pain and gross hematuria, cystoscopy revealed a urinary bladder mucosa showing diffuse dilation of the capillaries and a large blood clot. A total dose of 60.8 g cyclophosphamide had been given and the XC regimen was discontinued immediately. The patient experienced frequent episodes of bladder tamponade over 18 months and underwent continuous bladder irrigation and cystoscopic fulguration. Hyperbaric oxygen therapy (HBOT) provided only temporary relief and the patient subsequently developed hemorrhagic shock. A bilateral ureterostomy was eventually performed. Case 2: A 65-year-old woman with MBC was given XC for 3 years, but this was discontinued after she developed new lung lesions. The patient was given a total dose of 78.4 g of cyclophosphamide. A month later, the patient complained of intermittent gross hematuria, which progressed to persistent macroscopic hematuria for 1 week. She underwent continuous bladder irrigation with saline, without an improvement in her bladder tamponade. Subsequently, the bleeding ceased completely after HBOT. Some MBC cases can be controlled for a long time with XC therapy. For those cases, we need to realize that severe hemorrhagic cystitis may occur. Even at a low dose, requires testing periodically for occult blood in the urine to detect the early stages of cystitis. [ABSTRACT FROM AUTHOR]

In this study, we propose a fast topology optimization (TO) method based on a deep neural network (DNN) that predicts the current-dependent motor torque characteristics using its cross-sectional image. The trained DNN is shown to provide the current condition that provides the maximum torque under the assumed motor control method. The proposed method helps perform TO with a reduced number of field computations while maintaining a high search capability. [ABSTRACT FROM AUTHOR]

We conducted a multicenter prospective study on whether a comprehensive geriatric assessment (CGA) can predict the adverse events (AEs) of chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL). Patients aged ≥ 65 years with newly diagnosed DLBCL underwent a pretreatment baseline CGA consisting of six assessment tools: activities of daily living (ADL), instrumental ADL (IADL), mood, nutritional status, comorbidities, and cognitive function. An attending physician chose each patient's treatment but was blind to CGA results. Patients were grouped as "dependent" or "independent" according to the CGA. The primary endpoint was to evaluate the association between chemotherapy-induced grade 3–4 toxicity and CGA. Of 86 patients, 78 completed the designated CGA. The median age was 79 years (65–89). Seventy-two patients were treated with a cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP-like) regimen, and six were treated with low-toxicity regimens. Forty-one patients were classified as dependent and 37 as independent. In multivariate analysis, an impairment of IADL was independently associated with grade 3–4 leukopenia (odds ratio [OR] 0.63; 95% confidence interval [CI] 0.43–0.92, p = 0.017) and anemia (OR 0.67; 95% CI 0.50–0.90, p = 0.008). The presence of a comorbidity was also associated with grade 3–4 non-hematological toxicity (OR 2.17; 95% CI 1.37–3.43, p = 0.001). The 4-year survival rate tended to be longer in the independent (72.7%) compared to dependent (56.9%) group. Overall, a CGA may be a useful tool for predicting serious AEs associated with chemotherapy in elderly patients with DLBCL. [ABSTRACT FROM AUTHOR]

Summary: 'Monitoring of immune responses following mogamulizumab‐containing treatment in patients with adult T‐cell leukaemia–lymphoma (ATL)' (MIMOGA) is a multicentre prospective clinical study (UMIN000008696). In the MIMOGA study, we found that a lower percentage of CD2−CD19+ B cells in peripheral blood mononuclear cells (PBMC) was a significant unfavourable prognostic factor for overall survival (OS). Accordingly, we then analysed the immunoglobulin G (IgG) heavy‐chain repertoire in PBMC by high‐throughput sequencing. Of the 101 patients enrolled in the MIMOGA study, for 81 a sufficient amount of PBMC RNA was available for repertoire sequencing analysis. Peripheral IgG B cells in patients with ATL had a restricted repertoire relative to those in healthy individuals. There was a significant positive correlation between the Shannon–Weaver diversity index (SWDI) for the IgG repertoire and proportions of B cells in the PBMC of the patients. Multivariate analysis identified two variables significantly affecting OS: a higher serum soluble interleukin‐2 receptor level, and a lower SWDI for the IgG repertoire [hazard ratio, 2·124; 95% confidence interval, 1·114–4·049; n = 44]. The present study documents the importance of humoral immune responses in patients receiving mogamulizumab‐containing treatment. Further investigation of strategies to enhance humoral immune responses in patients with ATL is warranted. [ABSTRACT FROM AUTHOR]

There are a few reports suggesting that rituximab (RTX) might be a risk for interstitial pneumonitis (IP). We also experienced such patients in the era of RTX. Here, we reviewed all the patients with non-Hodgkin lymphoma who were treated with RTX-CHOP-like regimen (R-CHOP) to determine the risk of developing IP. One of 59 (1.7%) patients who received CHOP alone and 8 of 129 (6.2%) patients who were treated with R-CHOP experienced IP (p=0.28). Furthermore, three of eight patients who have had IP during R-CHOP were confirmed having Pneumocystis jirovecii pneumonia (PCP). PCP occurred during the fourth, sixth, and seventh cycle of chemotherapy, respectively. Among the patients treated by R-CHOP, 3 of 32 (9%) patients whose lymphocyte counts were <1000/µL before chemotherapy developed PCP, while 70 patients whose lymphocyte counts were >1000/µL did not (p=0.03). In four of eight patients, IP occurred during the administration of granulocyte-colony stimulating factor. RTX seems to have a certain risk to induce IP including PCP. Patients with lymphoma who were treated by R-CHOP regimen, might be considered as PCP prophylactic, especially if the number of lymphocytes is low at the beginning of chemotherapy. [ABSTRACT FROM AUTHOR]

Abstract: Adult T-cell leukemia (ATL) is a fatal malignancy caused by infection with human T lymphotropic virus type-1 (HTLV-1). To search for a new biomarker of ATL, we analyzed sera from ATL patients using 1ys. The spectral comparison of ATL patients with HTLV-1 carriers and healthy volunteers showed that the intensities of five peaks (1779, 1866, 2022, 4467, and 8930m/z) were significantly increased in ATL, while those of four peaks (4067, 4151, 8130, and 8597m/z) were decreased. From these differentially expressed peaks, we chose peaks of 1779, 1866, and 2022m/z as biomarker candidates of ATL. MS/MS ion search using tandem mass spectrometry and immunoprecipitation assay using anti-C3 antibody showed that factors derived from these candidate peaks were identified as C3f, which is a component of the complement system and a fragment of complement C3. These results indicate that the complement system was activated in ATL. Further analysis of markers specific to the activation pathways (classical, alternative, and lectin pathways) in the complement system showed that the serum concentration of the marker of the lectin pathway was significantly higher in ATL patients. These results suggest that activation of the complement system in ATL occurs mainly through the lectin pathway. [Copyright &y& Elsevier]

For the oncogenesis of many malignancies, it is crucial to prevent the shortening of the telomeres by the action of telomerase. In this study, clinical data and disease outcomes were analyzed in conjunction with the telomerase activity (TA) and telomere length (TL) of peripheral blood mononuclear cells. The study was carried out in 22 patients with adult T-cell leukemia (ATL) (7 chronic and 15 acute types) and in 13 asymptomatic human T-lymphotropic virus type 1 (HTLV-1) carriers. The mean values of TA in acute and chronic type patients were 13.8 and 1.6 total product generated (TPG) units, respectively, as determined by telomeric repeat amplification assays. The mean TA values in HTLV-1 carriers and healthy volunteers were 1.8 and 0.7 TPG, respectively. The mean TA value in acute type patients was significantly higher than in the three other subject groups. The mean TL values in patients with acute and chronic types were 5.39 and 4.38 Kb, respectively, while the mean TL values in HTLV-1 carriers and healthy volunteers were 7.69 and 7.06 Kb, respectively. The mean TL values in all ATL patients and in non-ATL subjects were 5.2 and 7.3 Kb, respectively. The former value is significantly shorter than the latter ( p  < 0.01). Neither TA nor TL of ATL cells showed any significant association with the number of ATL cells, serum soluble interleukin-2 receptor, or serum lactate dehydrogenase in the peripheral blood of acute type patients. This suggests that the levels of TA and TL did not reflect the ATL tumor load. The median survival period of acute ATL patients with high TA and shortened TL was 0.47 years, however, which was significantly shorter than that of acute ATL patients with low TA and normal TL (4.21 years) ( p  < 0.002). These data suggest that high TA and shortened TL were associated with poorer prognosis, and that TA and TL may be novel markers for the prognosis of ATL patients. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) is a single-strand RNA virus. The association of lichen planus with chronic HCV infection has been reported, as has been cryoglobulinemic purpura, psoriasis, urticaria, and porphyria cutanea tarda. However, the cause of lichen planus is unclear. Objectives: To investigate whether genomic- and/or anti-genomic-strand HCV RNAs are present in the lichen planus lesions of chronic hepatitis C patients and to elucidate the pathogenesis of lichen planus. Methods: Reverse transcription-polymerase chain reaction (RT-PCR) followed by nested-PCR was carried out to detect HCV RNA using RNA samples from lichen planus lesions of three patients with chronic hepatitis C. Since it is well known that commonly there is relatively dense inflammatory cell infiltration mainly in the upper dermis in lichen planus, the same RT-PCR procedure was performed using RNA from peripheral blood leukocytes from the same patients. In addition, in one patient, the same procedure was also performed using an RNA sample from normal skin. Results: Bands of the appropriate size (161 base pairs corresponding to region 98–258 of HCV RNA) in the nested-PCR products for both genomic- and anti-genomic-strands were detected in lichen planus lesions as well as in peripheral blood leukocytes in all the cases. Conclusion: To the best of our knowledge, this is the first report showing the presence of anti-genomic- as well as genomic-strand HCV RNAs in lichen planus lesions in patients with chronic hepatitis C; suggesting that HCV-associated lichen planus lesions may be sites of HCV replication. [Copyright &y& Elsevier]

Background Evidence of eribulin therapy for metastatic breast cancer ( MBC) in clinical practice is not well documented. Methods We retrospectively analyzed the safety and efficacy of eribulin in 29 MBC patients from 2011 to 2016 at Fukuoka University Hospital. Results The median patient age, number of courses, total dose, and relative dose intensity were as follows: 65 years, five courses, 8.6 mg/m2, and 75%, respectively. One patient achieved a complete response, ( CR) six a partial response ( PR), eight stable disease ( SD) and 14 patients exhibited progressive disease. The objective response rate ( ORR: CR + PR) was 24.1%, and the clinical benefit rate ( CBR: CR + PR + SD) was 51.7%. The median progression-free survival was 90 days (95% confidence interval [ CI] 67-126) and median overall survival was 264 days (95% CI 198-357). In patients who previously received 2-4 regimens, the ORR was 28.5% and the CBR was 57.1%. In patients who received 5-12 regimens, the ORR was 20% and the CBR was 45%. Chemotherapy was administered to 20 patients (69%) after eribulin administration, and the median overall survival rate of cases that achieved greater than a PR was 1088 days. The most frequent treatment-related grade 3/4 adverse events were neutropenia (55.2%), and febrile neutropenia (20.1%). Grade 3 peripheral neuropathy occurred in 13.8% of patients, but was not exacerbated even if present before treatment. Conclusion Eribulin is effective for MBC patients who have received multiple chemotherapies. Neutropenia and febrile neutropenia may develop after heavy prior therapy. [ABSTRACT FROM AUTHOR]

The purpose of this article is to disseminate the standard of antiemetic therapy for Japanese clinical oncologists. On the basis of the Appraisal of Guidelines for Research and Evaluation II instrument, which reflects evidence-based clinical practice guidelines, a working group of the Japanese Society of Clinical Oncology (JSCO) reviewed clinical practice guidelines for antiemesis and performed a systematic review of evidence-based domestic practice guidelines for antiemetic therapy in Japan. In addition, because health-insurance systems in Japan are different from those in other countries, a consensus was reached regarding standard treatments for chemotherapy that induce nausea and vomiting. Current evidence was collected by use of MEDLINE, from materials from meetings of the American Society of Clinical Oncology National Comprehensive Cancer Network, and from European Society of Medical Oncology/Multinational Association of Supportive Care in Cancer guidelines for antiemesis. Initially, 21 clinical questions (CQ) were selected on the basis of CQs from other guidelines. Patients treated with highly emetic agents should receive a serotonin (5-hydroxytryptamine; 5HT) receptor antagonist, dexamethasone, and a neurokinin 1 receptor antagonist. For patients with moderate emetic risk, 5HT receptor antagonists and dexamethasone were recommended, whereas for those receiving chemotherapy with low emetic risk dexamethasone only is recommended. Patients receiving high-emetic-risk radiation therapy should also receive a 5HT receptor antagonist. In this paper the 2010 JSCO clinical practice guidelines for antiemesis are presented in English; they reveal high concordance of Japanese medical circumstances with other antiemetic guidelines that are similarly based on evidence. [ABSTRACT FROM AUTHOR]

Assesses the chromosomal and comparative genomics of human herpes virus 8-negative primary effusion lymphoma (PEL) in HIV-negative patients in Japan. Classification of PEL; Detection of Epstein-barr virus; Abnormality in structures of chromosome 8.

Background Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) is the standard treatment regimen for malignant lymphoma. CHOP-induced neutropenia is a common clinical complication that often develops into life-threatening febrile neutropenia (FN). The incidence rate of FN in malignant lymphoma patients receiving a CHOP + rituximab regimen is approximately 10%–20% in clinical trials. Assessing FN-related factors in an individual hospital is an important step towards ensuring appropriate treatment. Therefore, we aimed to evaluate the incidence, risk factors, and clinical features related to FN in our institution and to determine the rate of treatment success in FN patients receiving antibiotics. Methods FN-related characteristics were investigated in 182 malignant lymphoma patients who were treated with the CHOP regimen between January 2013 and December 2018. All data were retrospectively collected from the electronic medical record system. Categorical factors were compared using the Fisher's exact test and Mann-Whitney U test. Logistic regression analysis was used to analyze FN-related risk factors. Results Among 182 patients, 79 (43.4%) were men. Median age was 67 years. Most patients (90.7%) had an Eastern Cooperative Oncology Group performance status (PS) of 0–2. We noted 80 FN episodes in 60 patients (33.0%). On multivariate analysis, lack of granulocyte colony stimulating factor (G-CSF) prophylaxis in cycle 1 and poor PS were significantly associated with FN occurrence. Documented infections were observed in case of 35 FN episodes (43.8%), and median fever duration was 3 days. Treatment was successful without any modifications in case of 64 episodes (80%). No deaths were observed. Conclusion FN incidence was 33.3% at our institution. Lack of G-CSF prophylaxis and poor performance status were risk factors for FN in this setting. Use of G-CSF prophylaxis in patients with poor PS may help in decreasing FN incidence. [ABSTRACT FROM AUTHOR]

Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) is the standard treatment regimen for malignant lymphoma. CHOP-induced neutropenia is a common clinical complication that often develops into life-threatening febrile neutropenia (FN). The incidence rate of FN in malignant lymphoma patients receiving a CHOP + rituximab regimen is approximately 10%–20% in clinical trials. Assessing FN-related factors in an individual hospital is an important step towards ensuring appropriate treatment. Therefore, we aimed to evaluate the incidence, risk factors, and clinical features related to FN in our institution and to determine the rate of treatment success in FN patients receiving antibiotics. FN-related characteristics were investigated in 182 malignant lymphoma patients who were treated with the CHOP regimen between January 2013 and December 2018. All data were retrospectively collected from the electronic medical record system. Categorical factors were compared using the Fisher's exact test and Mann-Whitney U test. Logistic regression analysis was used to analyze FN-related risk factors. Among 182 patients, 79 (43.4%) were men. Median age was 67 years. Most patients (90.7%) had an Eastern Cooperative Oncology Group performance status (PS) of 0–2. We noted 80 FN episodes in 60 patients (33.0%). On multivariate analysis, lack of granulocyte colony stimulating factor (G-CSF) prophylaxis in cycle 1 and poor PS were significantly associated with FN occurrence. Documented infections were observed in case of 35 FN episodes (43.8%), and median fever duration was 3 days. Treatment was successful without any modifications in case of 64 episodes (80%). No deaths were observed. FN incidence was 33.3% at our institution. Lack of G-CSF prophylaxis and poor performance status were risk factors for FN in this setting. Use of G-CSF prophylaxis in patients with poor PS may help in decreasing FN incidence. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor, on causes of acute hepatic failure.