Springer Science and Business Media LLC Acta Medica Okayama 2210-6014 15 1 2025 Relationship Between Heated Tobacco Products and Placental Abruption: A Prospective Cohort Study Using Online Questionnaire 30 EN Hikaru Ooba Center for Innovative Clinical Medicine, Okayama University Hospital Jota Maki Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takahiro Tabuchi Division of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine Hisashi Masuyama Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: Placental abruption (PA) is a critical obstetric complication, with maternal smoking recognized as a key risk factor. Despite the increased use of heated tobacco products (HTPs), the impact of HTPs remains unclear. This study investigated whether pregnant women using HTPs are at a higher risk of PA than non-users. Methods: We analyzed data from “the Japan COVID-19 and Society Internet Survey,” a prospective, self-reported online survey cohort. Questionnaires were randomly distributed between July 28, 2021, and August 30, 2021. Pregnant respondents in 2021 were invited to complete an additional survey from February 14, 2022, to February 28, 2022. We set the outcome as the absolute risk difference (aRD) and relative risk ratio (rRR) of PA incidence due to smoking HTPs in the first trimester of pregnancy. The sample size included 12 836 participants. We calculated outcomes using a generalized linear model (GLM) and inverse probability of treatment weighting (IPTW). We also performed a Bayesian approach and multiple-bias analysis for sensitivity analysis. Results: We found the robust aRD of 0.07 (95% confidence interval (CI): 0.06, 0.09) and the rRR of 11.3 (95% CI: 7.5, 17.0). Multiple bias analyses showed that unmeasurable confounders would need to have at least an rRR = 14 relationship with both exposure and outcome to disprove the observed association. There has not been post hoc analysis or secondary use of data. Conclusion: Early pregnancy use of HTPs is associated with an increased risk of PA. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2212-5345 63 3 2025 Practical Guidelines for Asthma Management (PGAM): Digest edition 405 421 EN Jun Tamaoki Department of Respiratory Medicine, Tokyo Women's Medical University Hiroyuki Nagase Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine Hiroyuki Sano Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine Takeshi Kaneko Department of Pulmonology, Yokohama City University Graduate School of Medicine Yasuhiro Gon Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine Nobuaki Miyahara Department of Allergy and Respiratory Medicine, Okayama University Hospital Hironori Sagara Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University Akihiko Tanaka Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University Takahiko Horiguchi Department of Respiratory Medicine, Toyota Regional Medical Center Etsuko Tagaya Department of Respiratory Medicine, Tokyo Women's Medical University Tomohiro Akaba Department of Respiratory Medicine, Tokyo Women's Medical University Yuji Tohda Kindai University Hospital The international and national guidelines for asthma management are typically comprehensive and designed for respiratory specialists, making them less practical for primary care physicians who handle most asthma cases. Recognizing the need for more accessible guidelines, the Japan Asthma Society developed the Practical Guidelines for Asthma Management (PGAM). PGAM aims to provide a concise summary of key asthma management principles, increasing awareness, education, and support among nonspecialists and patients alike. It includes user-friendly tables and lists outlining common symptoms, triggers, diagnostic criteria, and basic management strategies, along with frequently encountered treatable traits and comorbidities. These elements are presented through simple, clinically relevant algorithms. A notable feature of PGAM is the “Basic Roadmap for Asthma Management,” which outlines a clear sequence for patient assessment, diagnosis, and treatment from initial consultation onward, offering an easy-to-follow visual guide. Additionally, the guidelines include methods for assessing airway inflammation, enabling patient phenotyping and endotyping. This supports a personalized treatment approach, particularly with biologics, aimed at achieving clinical remission. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2168-8184 18 6 2026 Routine Generative AI Use and Acceptance of Medical AI: A Cross-Sectional Survey of Healthcare Workers and the Public in Japan e110118 EN Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Medical Development Field, Okayama University Background Acceptance of medical artificial intelligence (AI) is critical for successful implementation, yet its acceptance may vary by clinical application and stakeholder group. Whether routine use of generative AI (GAI) is associated with acceptance of medical AI remains unclear. Methods A cross-sectional web survey was conducted in Japan in November 2025 using web-panel convenience sampling from an online research panel. The small analytic sample comprised 200 participants aged 20-69 years, including 100 healthcare workers and 100 non-healthcare workers. GAI use was assessed using two five-point items (GAI use at work and in daily life) and dichotomized as at least monthly use in either daily life or work versus less than monthly use in both settings, based on prespecified criteria. Acceptance of medical AI was measured for five scenario-based applications - AI-assisted imaging interpretation, AI-based health risk prediction, AI-based treatment recommendations, AI-enabled triage guidance, and AI-assisted robotic surgery - using a four-point acceptability scale; responses were dichotomized as acceptable versus not acceptable. Calibration weights were constructed to approximate Japanese internet users by raking on sex-by-age group and household income, normalized to the analytic sample size, and truncated at prespecified bounds. Adjusted prevalence ratios (aPRs) were estimated using modified Poisson regression with robust standard errors, stratified by occupation; covariates were selected a priori using a modified disjunctive cause criterion. This study was exploratory; therefore, adjustments for multiple comparisons were not performed. Results Among healthcare workers, the lower-use group had a higher prevalence of non-acceptance of AI-based health risk prediction (aPR 6.980, 95% CI 1.412-34.506) and AI-based treatment recommendations (aPR 4.364, 95% CI 1.331-14.305), whereas estimates for imaging interpretation, triage guidance, and robotic surgery remained statistically uncertain. Among non-healthcare workers, the lower-use group had a higher prevalence of non-acceptance of AI-assisted imaging interpretation (aPR 13.906, 95% CI 1.624-119.052), AI-based health risk prediction (aPR 4.861, 95% CI 1.133-20.862), AI-based treatment recommendations (aPR 6.288, 95% CI 1.386-28.530), and AI-assisted robotic surgery (aPR 6.173, 95% CI 1.435-26.561); the adjusted estimate for AI-enabled triage guidance was not statistically supported (aPR 1.840, 95% CI 0.521-6.505). Several estimates had wide confidence intervals, indicating substantial imprecision. Conclusions In this small exploratory web-panel convenience sample, lower-frequency GAI use was associated with higher non-acceptance of several medical AI applications. Associations were observed across more applications among non-healthcare workers than among healthcare workers. Because the study was cross-sectional, used convenience sampling, and included imprecise estimates with wide confidence intervals, the findings should not be interpreted causally. Larger studies using longitudinal or interventional designs are needed to clarify temporality and mechanisms. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 58 1 2026 ライブラリ・スキーマによる大学図書館構造の可視化と知識創造 ―共有認知の形成に基づく研究枠組みの構築― 1 19 EN Kensuke Kobayashi Satoru Miyazaki 10.18926/OER/70973 　This study proposes a theoretical framework for understanding the relationship between the structural representation of university libraries and knowledge creation. In recent years, university libraries have experienced significant transformations due to the digitization of scholarly information, the expansion of research data management, and the increasing importance of learning support services. As their functions diversify, it has become increasingly difficult to comprehensively understand the structure and roles of university libraries. 　To address this issue, this study focuses on the concept of a library schema, which represents the structural relationships among the elements that constitute a library, including people, resources, services, and activities. While previous research has discussed methods for organizing library components, little attention has been paid to how structural understanding of libraries contributes to knowledge creation and service value. 　Drawing on schema theory, shared cognition in organizational studies, and the knowledge creation theory of Nonaka and Takeuchi, this study constructs a conceptual framework linking library schema visualization, shared cognition, interaction, knowledge creation processes, and library service value. The framework proposes that visualization of library structure through a library schema promotes shared cognition among librarians and users, which in turn facilitates interactions that activate knowledge creation processes. These processes ultimately contribute to the creation of library service value that supports learning and research activities. 　Furthermore, the framework introduces two moderating factors: schema representation methods and operational constraints of library management. Based on this framework, six research propositions are presented. 　By integrating concepts from library and information science with knowledge management theory, this study contributes to the theoretical understanding of university libraries as knowledge infrastructures and provides a foundation for future empirical research on knowledge creation in library environments. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 3 2026 Oral Eicosapentaenoic Acid and Paclitaxel-Associated Peripheral Neuropathy: A Retrospective Study at Okayama University Hospital 179 184 EN Ayako Morita Center for Clinical Oncology, Okayama University Hospital Hideki Katayama Center for Clinical Oncology, Okayama University Hospital Eiki Ichihara Center for Clinical Oncology, Okayama University Hospital Yoshinobu Maeda Department of Hematology and Oncology, Okayama University Hospital Original Article 10.18926/AMO/70853 This retrospective study investigated whether eicosapentaenoic acid (EPA) reduces paclitaxel-associated chemotherapy-induced peripheral neuropathy (CIPN) and acute neuropathic pain in dyslipidemic cancer patients. The medical records of cancer patients treated with paclitaxel or nab-paclitaxel at Okayama University Hospital between January 2018 and December 2022 were reviewed. Patients receiving concomitant therapy for dyslipidemia were categorized as EPA users or non-EPA users. Numbness and pain severity were extracted from medical records. The primary endpoint was the change from baseline in Common Terminology Criteria for Adverse Events (CTCAE) grade for peripheral neuropathy and pain; groups were analyzed using the Mann–Whitney U test. Of 184 eligible patients, 18 received EPA. Bleeding events were more frequent in the EPA group; however, changes in numbness and pain did not differ significantly between groups at any time point. Overall, EPA did not show a preventive effect on paclitaxel-associated CIPN or acute neuropathic pain. Future studies should evaluate EPA in combination with other neuroprotective agents to better define its potential role in CIPN prevention. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2026 A Study of Flutter Programming Learning Assistant System with User Interface Validation and Home Garden Monitoring Application EN SOE THANDAR AUNG Graduate School of Environmental, Life, Natural Science and Technology, Okayama University No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2410-387X 9 4 2025 Role-Based Efficient Proactive Secret Sharing with User Revocation 80 EN Yixuan He Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Interdisciplinary Education and Research Field, Okayama University Proactive secret sharing (PSS), an extension of secret-sharing schemes, safeguards sensitive data in dynamic distributed networks by periodically refreshing shares to counter adversarial attacks. In our previous work, we constructed a non-interactive proactive secret scheme by integrating threshold homomorphic encryption (ThHE) while reducing the communication complexity to 𝑂(𝑛). Not only is refreshing shares important but revoking the shares of users who have left the system is also essential in practical dynamic membership scenarios. However, the previous work was insufficient for supporting explicit user revocation. This study strengthens the description of roles for authorized users and proposes a scheme to achieve non-interactive share refresh and dynamic user management. In each epoch, authorized users are classified into three roles: retain, newly join, and rejoin, and they receive a broadcast of the compact ciphertext encoding both the refresh information and the revocation instructions from the trusted center (dealer). Authorized users independently derive new shares through homomorphic computations, whereas revoked users are unable to generate new shares. Hash functions are used to bind revocation parameters to the cryptographic hashes of valid users in order to guarantee integrity during revocation, allowing for effective verification without compromising non-interactivity. Our new scheme not only extends the revocation structure but also preserves the 𝑂(𝑛) communication complexity. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1424-8220 25 21 2025 Integrated Authentication Server Design for Efficient Kerberos–Blockchain VANET Authentication 6651 EN Maya Rahayu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Md. Biplob Hossain Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Interdisciplinary Education and Research Field, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Vehicular Ad Hoc Network (VANET) is a fundamental component of the intelligent transportation systems (ITS), providing critical road information to users. However, the volatility of VANETs creates significant vulnerabilities from malicious actors. Thus, verifying joining entities is crucial to maintaining the VANET’s communication security. Authentication delays must stay below 100 ms to meet VANET requirements, posing a major challenge for security. Our previous research introduced a Kerberos–Blockchain (KBC) authentication system that contains two main components separately: Authentication Server (AS) and Ticket Granting Server (TGS). However, this KBC architecture required an additional server to accommodate increasing vehicle volumes in urban environments, leading to higher infrastructure costs. This paper presents an integrated authentication server that merges AS and TGS into a Combined Server (CBS) while retaining blockchain security. We evaluate it using OMNeT++ with SUMO for traffic simulation and Ganache for blockchain implementation. Results show that CBS removes the need for an extra server while keeping authentication delays under 100 ms. It also improves throughput by 104% and reduces signaling overhead by 45% compared to KBC. By optimizing authentication without compromising security, the integrated server greatly enhances the cost-effectiveness and efficiency of VANET systems. No potential conflict of interest relevant to this article was reported.

岡山大学大学院ヘルスシステム統合科学研究科 Acta Medica Okayama 2436-3227 6 2026 The effects of cold compresses on itching in patients with atopic dermatitis: A cross-over controlled pilot trial 1 6 EN Yuki HIRAMI Former Department of Nursing, Graduate School of Health Sciences, Okayama University Nahoko HARADA Department of Nursing Science, Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama University Miho ONO Department of Nursing, Faculty of Health, Kagawa Prefectural University of Health Sciences Masahide KODA Co-learning Community Healthcare Re-innovation Office, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kiyoko FUKAI Professor Emeritus, Okayama University, Graduate School of Nursing, The Jikei University School of Medicine 10.18926/interdisciplinary/70325 This cross-over controlled trial aimed to evaluate the effectiveness and safety of two types of cold compresses (towels and ice packs) in alleviating itching among patients with atopic dermatitis. The study recruited 19 participants diagnosed with atopic dermatitis and suffering from chronic itching for over 6 months. Each participant received both types of cold compress interventions. Itching sensations were assessed repeatedly using a visual analogue scale before and after the application of the cold compress. The mean and standard deviation of itching scores for the towel intervention were 16.9 ± 19.1 (baseline) and 11.4 ± 16.1 (post-application). For the ice pack intervention, the scores were 13.6 ± 14.7 (baseline) and 6.2 ± 9.8 (post-application). Although there was a reduction in mean itching scores following the application of cold compresses, the differences were not statistically significant for either intervention. Despite the lack of statistical significance, this study suggests that cold compresses, which are user-friendly and inexpensive, may safely reduce subjective itching in patients with atopic dermatitis without causing pain or discomfort. However, further research with a larger sample size is needed to confirm these findings. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2688-4526 7 2 2026 Safety and efficacy of Rezūm water vapour energy therapy in BPH patients receiving antithrombotic therapy: A Japanese single‐centre experience e70170 EN Takatoshi Moriwake Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yusuke Tominaga Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Satoshi Katayama Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Haruki Kaku Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ichiro Tsuboi Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kasumi Yoshinaga Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tomoaki Yamanoi Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tatsushi Kawada Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takuya Sadahira Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takehiro Iwata Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shingo Nishimura Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kensuke Bekku Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasuhiro Katayama Department of Urology, Okamura Isshindo Hospital Motoo Araki Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives: The objective of this study is to evaluate the safety and efficacy of Rezūm water vapour energy therapy (WAVE) in Japanese patients with benign prostatic hyperplasia (BPH) continuing antithrombotic therapy and to validate the Okayama University Modified Clavien-Dindo classification (OU-mCD) for perioperative hematuria. Patients and Methods: We retrospectively analysed 80 consecutive patients who underwent WAVE from August 2023 to July 2024, including 37 (46.2%) continuing antithrombotic therapy perioperatively. Hematuria within 30 days was graded using conventional Clavien-Dindo classification and the OU-mCD, a novel classification focusing on intervention necessity. We assessed clinically significant hematuria (Grade ≥ Ib), catheter-free rate, prostate volume reduction and haemoglobin change. Results: Clinically significant hematuria occurred in 21.6% (8/37) of patients continuing antithrombotic therapy versus 4.7% (2/43) without (p = 0.038). All 10 Grade ≥ Ib cases occurred during hospitalization with the catheter in place and were managed conservatively with continuous bladder irrigation (median 1 day); none required transfusion or surgical reintervention. Only one patient required temporary drug discontinuation. Treatment efficacy did not differ by antithrombotic status: 86.2% achieved PVR < 50 ml with 44% mean prostate volume reduction. Multivariate analysis identified antithrombotic therapy as the sole independent risk factor for Grade ≥ Ib hematuria (OR 5.46, 95% CI 1.06–28.16, p = 0.042). Conclusion: WAVE can be safely performed with continued antithrombotic therapy. Whereas Grade ≥Ib hematuria occurred in 25% of antiplatelet/anticoagulant users (vs. 5% without), 75% had no significant bleeding, and all complications were managed conservatively without transfusion. The OU-mCD provides precise complication stratification. These findings suggest outpatient procedures may be feasible with appropriate patient selection. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1424-8220 26 4 2026 A Generative AI–Based Technical Data Extraction Tool for IoT Application Systems 1081 EN Dezheng Kong Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Information and Communication Systems, Okayama University I Nyoman Darma Kotama Department of Information and Communication Systems, Okayama University Zihao Zhu Department of Information and Communication Systems, Okayama University Alfiandi Aulia Rahmadani Department of Information and Communication Systems, Okayama University Nowadays, Internet of Things (IoT) application systems play an essential role in smart cities, industry, healthcare, agriculture, and smart homes. For non-expert users, designing and implementing IoT application systems remains challenging, especially when configuring sensors, edge devices, and server platforms. To support configuration tasks of IoT application systems, we have developed an AI-based setup assistance tool. However, AI models still fail to reliably support newly released or previously unseen devices, sometimes producing incomplete or erroneous outputs that may lead to configuration failures. Incorporating their technical-document information into Retrieval-Augmented Generation (RAG) is an effective way to supplement AI knowledge and improve reliability. In this paper, we propose a generative AI-based technical data extraction tool to address the challenges. It extracts essential technical information using the schema-based extraction from given PDF or HTML datasheets and converts it into a structured format suitable for AI-supported configurations. A local vector database is used to enable semantic similarity retrieval and provide document-grounded evidence for RAG-based answering, ensuring consistent support for previously unseen IoT devices. For evaluations, we applied the proposal to several sensor and device datasheets and compared extracted specifications with ground-truth values to measure accuracy and completeness. Then, we compared end-to-end configuration QA reliability against a commercial baseline (ChatPDF) using the golden benchmark. The results show that the proposed tool reliably acquires key specifications and significantly improves end-to-end configuration QA reliability. Across 960 golden QA pairs, the proposed method improves Recall from 0.636 to 0.926 and Accuracy from 0.595 to 0.807 compared with ChatPDF. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1999-4893 19 2 2026 A Slide Annotation System with Multimodal Analysis for Video Presentation Review 110 EN Amma Liesvarastranta Haz Department of Information and Communication Systems, Okayama University Komang Candra Brata Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Information and Communication Systems, Okayama University Evianita Dewi Fajrianti Human Centric Multimedia Research Laboratory, Department of Informatic and Computer Engineering, Politeknik Elektronika Negeri Surabaya Sritrusta Sukaridhoto Human Centric Multimedia Research Laboratory, Department of Informatic and Computer Engineering, Politeknik Elektronika Negeri Surabaya With the rapid growth of online presentations, there has been an increasing need for efficient review of recorded materials. In typical presentations, speakers verbally elaborate on each slide, providing details not captured in the slides themselves. Automatically extracting and embedding these verbal explanations at their corresponding slide locations can greatly enhance the review process for audiences. This paper presents a Slide Annotation System that employs a robust hybrid two-stage detector to identify slide boundaries, extracts slide text through Optical Character Recognition (OCR), transcribes narration, and employs a multimodal Large Language Model (LLM) to generate concise, context-aware annotations that are added to their corresponding slide locations. For evaluations, the technical performance was validated on five recorded presentations, while the user experience was assessed by 37 participants. The results showed that the system achieved a macro-average 𝐹1 score of 0.879 (𝑆𝐷=0.024, 95% 𝐶𝐼[0.849,0.909]) for slide segmentation and 90.0% accuracy (95% 𝐶𝐼[74.4%,96.5%]) for annotation alignment. Subjective evaluations revealed high annotation validity and usefulness as rated by presenters, and a high System Usability Scale (SUS) score of 80.5 (𝑆𝐷=6.7, 95% 𝐶𝐼[78.3,82.7]). Qualitative feedback further confirmed that the system effectively streamlined the review process, enabling users to locate key information more efficiently than standard video playback. These findings demonstrate the strong potential of the proposed system as an effective automated annotation system. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1748-3735 21 1 2025 Japanese Adult Day Service Nurses' Bathing Decisions for Persons Requiring Long‐Term Care: A Focused Ethnography e70052 EN Kanako Miyoshi Graduate School of Health Sciences, Okayama University Keiko Mori Graduate School of Health Sciences, Okayama University Introduction: Adult day services in Japan operate under the Long-Term Care Insurance Law, and care is provided mainly by caregivers. However, because doctors are often not on site, nurses manage the health of the person requiring long-term care. Adult day services provide bathing and functional training; however, although Japanese-style bathing relieves fatigue and brings a sense of well-being, it also entails the risk of bathing accidents for those in need of care. To continue living at home, those in need of care who have difficulty bathing at home must be provided with safe bathing during adult day services and supported in returning home safely. Nurses are responsible for accurately assessing the health status of users and implementing safe bathing. This study aimed to identify how nurses working in adult day services make bathing decisions for home-dwelling persons requiring long-term care. Method: Qualitative manifest and latent content analyses were performed using a focused ethnography. Findings: Six themes were identified: ‘gather information to compare with baseline’, ‘make observations based on information from others to understand the big picture’, ‘give persons time to get in shape’, ‘consideration of life at home’, ‘determining the need for medical institutions’ and ‘devise ways to communicate to promote collaboration’. Conclusions: Adult day service nurses' decisions about whether to bathe persons requiring care are characterised by their emphasis on information from others, consideration of the home living conditions of persons requiring care and their wishes regarding bathing. In addition, based on their observations, they determine the need for cooperation with medical institutions and communicate this information to family members and multiple professions. No potential conflict of interest relevant to this article was reported.

Springer Nature Switzerland Acta Medica Okayama 0302-9743 2025 Effects of Visual Stimuli on Perceived Sound Volume in Virtual Reality Spaces 286 299 EN Yuki Matsuda Okayama University Toma Kobayashi Nara Institute of Science and Technology Hiroki Watanabe Future University Hakodate Keiichi Yasumoto Nara Institute of Science and Technology With the proliferation of affordable and high-performance virtual reality (VR) devices, VR content such as games and the metaverse is becoming increasingly widespread. In VR environments, users experience various sensory stimuli, primarily through visual and auditory cues. However, subjective perception of these stimuli varies based on user context. Existing studies have shown that auditory perception can be influenced by visual stimuli, however, most of them have focused on congruent audiovisual stimuli, leaving the effects of non-congruent pairings unexplored. This study investigates how visual stimuli, specifically color and crowdedness, influence perceived sound volume in VR. In the experiment that participants experienced VR environments with different room colors while listening to test tones, the results showed that warm colors led to higher perceived volume at low sound levels. Also, in the experiment that participants viewed VR scenes with varying crowd densities while hearing announcements, less crowded environments resulted in higher perceived sound volume. These findings suggest that visual context impacts auditory perception, providing insights for optimizing hearable devices and enhancing VR auditory experiences. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1471-2369 26 1 2025 Risk of malignant neoplasms of tacrolimus in kidney transplant patients: a retrospective cohort study conducted using the Japanese National Database of Health Insurance Claims 491 EN Risa Kubota Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ken-Ei Sada Department of Clinical Epidemiology, Kochi Medical School, Kochi University Moto Tokunaga Department of Urology, National Hospital Organization Okayama Medical Center Kasumi Yoshinaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoaki Yamanoi Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tatsushi Kawada Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusuke Tominaga Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takuya Sadahira Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takehiro Iwata Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shingo Nishimura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kensuke Bekku Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kohei Edamura Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoko Kobayashi Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Nakagawa Department of Urology, Juntendo University Graduate School of Medicine Naotsugu Ichimaru Department of Urology, Kinki Central Hospital Koichiro Wada Department of Urology, Shimane University Faculty of Medicine Motoo Araki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: Although the long-term survival of kidney transplant recipients has significantly improved, malignant neoplasms remain one of the leading causes of death in this population. The recipients face a 1.8-fold increased risk of developing malignant neoplasms compared with the general population. This risk increases with time after transplantation. Tacrolimus (TAC) is preferred over cyclosporine A (CyA) in terms of efficacy against organ rejection, but evidence on the risk of malignant neoplasms is lacking. We aimed to describe the incidence and types of malignant neoplasms in kidney transplant recipients and evaluate the association between malignant neoplasms development and the type of prescribed CNI. Methods: This retrospective cohort study was conducted using the Japanese National Database of Health Insurance Claims, including data covering 99% of kidney transplant patients in Japan. Patients who underwent kidney transplantation and were prescribed TAC or CyA between April and June 2011 were included. The primary outcome included the incidence of malignant neoplasms, and secondary outcomes included overall survival and graft survival. Results: A total of 7,590 patients were included, with 11.0% developing malignant neoplasms during the follow-up period. The most common malignant neoplasms were in the digestive organs and urinary tract. No statistically significant difference in malignant neoplasms incidence was observed between TAC and CyA users (hazards ratio: 0.97, 95% CI: 0.84 to 1.12; estimated average treatment effect: －24.05, 95% CI: －184.90 to 136.80). The patient and graft survival rates were also comparable between the groups. Conclusions: This large study suggests that TAC is not associated with an increased risk of malignant neoplasms compared to CyA in the late post-transplant period. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers (IEEE) Acta Medica Okayama 1932-4537 22 5 2025 Topology-Driven Configuration of Emulation Networks With Deterministic Templating 3933 3946 EN Satoru Kobayashi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Ryusei Shiiba Department of Informatics, School of Multidisciplinary Sciences, The Graduate University of Advanced Studies, Sokendai Shinsuke Miwa StarBED Technology Center, Testbed Research, Development and Operations Laboratory, National Institute of Information and Communications Technology Toshiyuki Miyachi Strategic Planning Department, Strategic Planning Office, National Institute of Information and Communications Technology Kensuke Fukuda Department of Informatics, School of Multidisciplinary Sciences, The Graduate University of Advanced Studies, Sokendai Network emulation is an important component of a digital twin for verifying network behavior without impacting on the service systems. Although we need to repeatedly change network topologies and configuration settings as a part of trial and error for verification, it is not easy to reflect the change without failures because the change affects multiple devices, even if it is as simple as adding a device. We present topology-driven configuration, an idea to separate network topology and generalized configuration to make it easy to change them. Based on this idea, we aim to realize a scalable, simple, and effective configuration platform for emulation networks. We design a configuration generation method using simple and deterministic config templates with a new network parameter data model, and implement it as dot2net. We evaluate three perspectives, scalability, simplicity, and efficacy, of the proposed method using dot2net through measurement and user experiments on existing test network scenarios. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2624-831X 6 3 2025 An Extension of Input Setup Assistance Service Using Generative AI to Unlearned Sensors for the SEMAR IoT Application Server Platform 52 EN I Nyoman Darma Kotama Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Yohanes Yohanie Fridelin Panduman Graduate School of Information Science and Technology, The University of Osaka Komang Candra Brata Graduate School of Natural Science and Technology, Okayama University Anak Agung Surya Pradhana Graduate School of Natural Science and Technology, Okayama University Noprianto Graduate School of Natural Science and Technology, Okayama University Nowadays, Internet of Things (IoT) application systems are broadly applied to various sectors of society for efficient management by monitoring environments using sensors, analyzing sampled data, and giving proper feedback. For their fast deployment, we have developed Smart Environmental Monitoring and Analysis in Real Time (SEMAR) as an integrated IoT application server platform and implemented the input setup assistance service using prompt engineering and a generative AI model to assist connecting sensors to SEMAR with step-by-step guidance. However, the current service cannot assist in connections of the sensors not learned by the AI model, such as newly released ones. To address this issue, in this paper, we propose an extension to the service for handling unlearned sensors by utilizing datasheets with four steps: (1) users input a PDF datasheet containing information about the sensor, (2) key specifications are extracted from the datasheet and structured into markdown format using a generative AI, (3) this data is saved to a vector database using chunking and embedding methods, and (4) the data is used in Retrieval-Augmented Generation (RAG) to provide additional context when guiding users through sensor setup. Our evaluation with five generative AI models shows that OpenAI’s GPT-4o achieves the highest accuracy in extracting specifications from PDF datasheets and the best answer relevancy (0.987), while Gemini 2.0 Flash delivers the most balanced results, with the highest overall RAGAs score (0.76). Other models produced competitive but mixed outcomes, averaging 0.74 across metrics. The step-by-step guidance function achieved a task success rate above 80%. In a course evaluation by 48 students, the system improved the student test scores, further confirming the effectiveness of our proposed extension. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2078-2489 16 8 2025 A Phrase Fill-in-Blank Problem in a Client-Side Web Programming Assistant System 709 EN Huiyu Qi Department of Information and Communication Systems, Okayama University Zhikang Li Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Information and Communication Systems, Okayama University Wen Chung Kao Department of Electrical Engineering, National Taiwan Normal University Mastering client-side Web programming is essential for the development of responsive and interactive Web applications. To support novice students’ self-study, in this paper, we propose a novel exercise format called the phrase fill-in-blank problem (PFP) in the Web Programming Learning Assistant System (WPLAS). A PFP instance presents a source code with blanked phrases (a set of elements) and corresponding Web page screenshots. Then, it requests the user to fill in the blanks, and the answers are automatically evaluated through string matching with predefined correct answers. By increasing blanks, PFP can come close to writing a code from scratch. To facilitate scalable and context-aware question creation, we implemented the PFP instance generation algorithm in Python using regular expressions. This approach targets meaningful code segments in HTML, CSS, and JavaScript that reflect the interactive behavior of front-end development. For evaluations, we generated 10 PFP instances for basic Web programming topics and 5 instances for video games and assigned them to students at Okayama University, Japan, and the State Polytechnic of Malang, Indonesia. Their solution results show that most students could solve them correctly, indicating the effectiveness and accessibility of the generated instances. In addition, we investigated the ability of generative AI, specifically ChatGPT, to solve the PFP instances. The results show 86.7% accuracy for basic-topic PFP instances. Although it still cannot fully find answers, we must monitor progress carefully. In future work, we will enhance PFP in WPLAS to handle non-unique answers by improving answer validation for flexible recognition of equivalent responses. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2078-2489 16 7 2025 A Map Information Collection Tool for a Pedestrian Navigation System Using Smartphone 588 EN Kadek Suarjuna Batubulan Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Komang Candra Brata Graduate School of Natural Science and Technology, Okayama University I Nyoman Darma Kotama Graduate School of Natural Science and Technology, Okayama University Htoo Htoo Sandi Kyaw Graduate School of Natural Science and Technology, Okayama University Shintami Chusnul Hidayati Department of Informatics, Institut Teknologi Sepuluh Nopember Nowadays, a pedestrian navigation system using a smartphone has become popular as a useful tool to reach an unknown destination. When the destination is the office of a person, a detailed map information is necessary on the target area such as the room number and location inside the building. The information can be collected from various sources including Google maps, websites for the building, and images of signs. In this paper, we propose a map information collection tool for a pedestrian navigation system. To improve the accuracy and completeness of information, it works with the four steps: (1) a user captures building and room images manually, (2) an OCR software using Google ML Kit v2 processes them to extract the sign information from images, (3) web scraping using Scrapy (v2.11.0) and crawling with Apache Nutch (v1.19) software collects additional details such as room numbers, facilities, and occupants from relevant websites, and (4) the collected data is stored in the database to be integrated with a pedestrian navigation system. For evaluations of the proposed tool, the map information was collected for 10 buildings at Okayama University, Japan, a representative environment combining complex indoor layouts (e.g., interconnected corridors, multi-floor facilities) and high pedestrian traffic, which are critical for testing real-world navigation challenges. The collected data is assessed in completeness and effectiveness. A university campus was selected as it presents a complex indoor and outdoor environment that can be ideal for testing pedestrian navigations in real-world scenarios. With the obtained map information, 10 users used the navigation system to successfully reach destinations. The System Usability Scale (SUS) results through a questionnaire confirms the high usability. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2504-446X 9 9 2025 Application of LMM-Derived Prompt-Based AIGC in Low-Altitude Drone-Based Concrete Crack Monitoring 660 EN Shijun Pan Shenzhen Institute for Advanced Study, UESTC, University of Electronic Science and Technology of China Zhun Fan Shenzhen Institute for Advanced Study, UESTC, University of Electronic Science and Technology of China Keisuke Yoshida Graduate School of Environmental and Life Science, Okayama University Shujia Qin Shenzhen Academy of Robotics Takashi Kojima TOKEN C.E.E. Consultants Co., Ltd. Satoshi Nishiyama Graduate School of Environmental and Life Science, Okayama University In recent years, large multimodal models (LMMs), such as ChatGPT 4o and DeepSeek R1―artificial intelligence systems capable of multimodal (e.g., image and text) human–computer interaction―have gained traction in industrial and civil engineering applications. Concurrently, insufficient real-world drone-view data (specifically close-distance, high-resolution imagery) for civil engineering scenarios has heightened the importance of artificially generated content (AIGC) or synthetic data as supplementary inputs. AIGC is typically produced via text-to-image generative models (e.g., Stable Diffusion, DALL-E) guided by user-defined prompts. This study leverages LMMs to interpret key parameters for drone-based image generation (e.g., color, texture, scene composition, photographic style) and applies prompt engineering to systematize these parameters. The resulting LMM-generated prompts were used to synthesize training data for a You Only Look Once version 8 segmentation model (YOLOv8-seg). To address the need for detailed crack-distribution mapping in low-altitude drone-based monitoring, the trained YOLOv8-seg model was evaluated on close-distance crack benchmark datasets. The experimental results confirm that LMM-prompted AIGC is a viable supplement for low-altitude drone crack monitoring, achieving >80% classification accuracy (images with/without cracks) at a confidence threshold of 0.5. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2227-7080 13 4 2025 An Implementation of Creep Test Assisting System with Dial Gauge Needle Reading and Smart Lighting Function for Laboratory Automation 139 EN Dezheng Kong Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Shihao Fang Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Noprianto Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Mitsuhiro Okayasu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Pradini Puspitaningayu Department of Electrical Engineering, Universitas Negeri Surabaya For decades, analog dial gauges have been essential for measuring and monitoring data at various industrial instruments including production machines and laboratory equipment. Among them, we focus on the instrument for creep test in a mechanical engineering laboratory, which evaluates material strength under sustained stress. Manual reading of gauges imposes significant labor demands, especially in long-duration tests. This burden further increases under low-lighting environments, where poor visibility can lead to misreading data points, potentially compromising the accuracy of test results. In this paper, to address the challenges, we implement a creep test assisting system that possesses the following features: (1) to save the installation cost, a web camera and Raspberry Pi are employed to capture images of the dial gauge and automate the needle reading by image processing in real time, (2) to ensure reliability under low-lighting environments, a smart lighting mechanism is integrated to turn on a supplementary light when the dial gauge is not clearly visible, and (3) to allow a user to stay in a distant place from the instrument during a creep test, material break is detected and the corresponding message is notified to a laboratory staff using LINE automatically. For evaluations, we install the implemented system into a material strength measuring instrument at Okayama University, Japan, and confirm the effectiveness and accuracy through conducting experiments under various lighting conditions. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1341-9625 30 11 2025 Neutrophil-to-lymphocyte ratio affects the impact of proton pump inhibitors on efficacy of immune checkpoint inhibitors in patients with non‑small-cell lung cancer 2266 2276 EN Tomoki Hori Department of Pharmacy, Nara Prefecture General Medical Center Kazuhiro Yamamoto Department of Integrated Clinical and Basic Pharmaceutical Science, Okayama University Takefumi Ito Department of Respiratory Medicine, Nara Prefecture General Medical Center Shigeki Ikushima Department of Pharmacy, Nara Prefecture General Medical Center Tomohiro Omura Department of Pharmacy, Kobe University Hospital Ikuko Yano Department of Pharmacy, Kobe University Hospital Background The neutrophil-to-lymphocyte ratio (NLR) at the initiation of immune checkpoint inhibitor (ICI) therapy is a known predictor of prognosis. Proton pump inhibitors (PPIs) reportedly attenuate the therapeutic efficacy of ICIs. However, the attenuation effects are not consistently observed across all patients. This study aimed to evaluate whether NLR serves as a stratification factor to determine the impact of PPI on the efficacy of ICI. Methods This retrospective study was conducted in patients with NSCLC treated with ICI monotherapy. Patients were stratified into two groups (higher NLR (≥ 4) and lower NLR (< 4)). PPI use was defined as the administration of PPIs within 30 days before or after ICI initiation. The primary outcome was progression-free survival (PFS) and the secondary outcome was overall survival (OS). Results Among the 132 patients included, PPI users exhibited significantly shorter median PFS and OS than non-PPI users. In the higher NLR group (n = 61), PPI users had a markedly shorter PFS and OS than non-PPI users (median PFS: 1.6 vs. 8.2 months; p < 0.01, median OS: 3.3 vs. 19.6 months; p = 0.015). Conversely, in the lower NLR group (n = 71), no significant difference in PFS and OS was observed between PPI users and non-PPI users (median PFS: 2.8 vs. 7.3 months, p = 0.83, median OS: 17.6 vs. 24.4 months, p = 0.40). Conclusion NLR may be a significant stratification factor for evaluating the impact of PPI on PFS and OS in patients with NSCLC undergoing ICI monotherapy. No potential conflict of interest relevant to this article was reported.

Korean Association for the Study of Intestinal Diseases Acta Medica Okayama 1598-9100 2025 Health-related quality of life, work productivity, and persisting challenges in treated ulcerative colitis patients: a Japanese National Health and Wellness Survey EN Sakiko Hiraoka Department of Gastroenterology, Okayama University Zhezhou Huang Cerner Enviza Fei Qin Cerner Enviza Fatima Megala Nathan Arokianathan Oracle Life Sciences Kiran Davé Bristol Myers Squibb Shweta Shah Bristol Myers Squibb Hyunchung Kim Bristol Myers Squibb Background/Aims Despite available treatments for ulcerative colitis (UC), unmet needs persist among patients in Japan. This study explored the health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), indirect cost, and unmet needs among treated UC patients in Japan. Methods This cross-sectional, observational study utilized data from the online 2017, 2019, and 2021 Japan National Health and Wellness Survey. Respondents were aged ≥ 18 years and had undergone or were on UC treatment (5-aminosalicylic acid, steroids, immunomodulators/immunosuppressants, biologics/Janus kinase inhibitors [JAKi]). Demographic, general health, and clinical characteristics, medication adherence, HRQoL, WPAI, and indirect cost were collected and analyzed. Results Among 293 treated UC patients, 83.6% were non-biologic/JAKi users, 29.0% had UC ≥ 15 years, 34.8% had moderate-to-severe disease severity, 55.3% experienced ≥ 1 persisting UC symptom, and 91.5% reported UC as bothersome to an extent. Patients reported EuroQoL visual analog scale score of 68.1 and ≥ 35% reported anxiety and depression. Mean work productivity loss was 29.3%, resulting in an annual mean indirect loss of 1.1 million JPY (45.3 thousand USD) per person. Higher WPAI (impairment) was associated with being male, moderate-to-severe disease severity, and low treatment adherence (P<0.05). Biologics/JAKi users had higher work impairment, and IM/IS users had higher activity impairment than 5-aminosalicylic acid users (P<0.05). Conclusions Despite treatment, Japanese UC patients experienced high disease burden and persistent disease-related challenges. Overall HRQoL were lower than the mean healthy population and work productivity impairment led to high indirect costs. The findings suggest the importance of new interventions for optimizing UC outcomes. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2024 kdMonitor: Kernel Data Monitor for Detecting Kernel Memory Corruption 66 73 EN Hiroki Kuzuno Graduate School of Engineering, Kobe University Toshihiro Yamauchi Okayama University,Faculty of Environmental, Life, Natural Science and Technology Privilege escalation attacks through memory corruption via kernel vulnerabilities pose significant threats to operating systems. Although the extended Berkley Packet Filter has been employed to trace kernel code execution by inserting interrupts before and after kernel code invocations, it does not track operations before and after kernel data writes, thus hindering effective kernel data monitoring. In this study, we introduce a kernel data monitor (kdMonitor), which is a novel security mechanism designed to detect unauthorized alterations in the monitored kernel data of a dedicated kernel page. The kdMonitor incorporates two distinct methods. The first is periodic monitoring which regularly outputs the monitored kernel data of the dedicated kernel pages. The second is dynamic monitoring, which restricts write access to a dedicated kernel page, supplements any write operations with page faults, and outputs the monitored kernel data of dedicated kernel pages. kdMonitor enables real-time tracking of specified kernel data of the dedicated kernel page residing in the kernel's virtual memory space from the separated machine. Using kdMonitor, we demonstrated its capability to pinpoint tampering with user process privileged information stemming from privilege escalation attacks on the kernel. Through an empirical evaluation, we validated the effectiveness of kdMonitor in detecting privilege escalation attacks by user processes on Linux. Performance assessments revealed that kdMonitor achieved an attack detection time of 0.83 seconds with an overhead of 0.726 %. No potential conflict of interest relevant to this article was reported.

Springer Nature Switzerland Acta Medica Okayama 0302-9743 2023 vkTracer: Vulnerable Kernel Code Tracing to Generate Profile of Kernel Vulnerability 222 234 EN Hiroki Kuzuno Graduate School of Engineering, Kobe University Toshihiro Yamauchi Faculty of Natural Science and Technology, Okayama University Vulnerable kernel codes are a threat to an operating system kernel. An adversary’s user process can forcefully invoke a vulnerable kernel code to cause privilege escalation or denial of service (DoS). Although service providers or security operators have to determine the effect of kernel vulnerabilities on their environment to decide the kernel updating, the list of vulnerable kernel codes are not provided from the common vulnerabilities and exposures (CVE) report. It is difficult to identify the vulnerable kernel codes from the exploitation result of the kernel which indicates the account information or the kernel suspension. To identify the details of kernel vulnerabilities, this study proposes a vulnerable kernel code tracer (vkTracer), which employs an alternative viewpoint using proof-of-concept (PoC) code to create a profile of kernel vulnerability. vkTracer traces the user process of the PoC code and the running kernel to hook the invocation of the vulnerable kernel codes. Moreover, vkTracer extracts the whole kernel component’s information using the running and static kernel image and debug section. The evaluation results indicated that vkTracer could trace PoC code executions (e.g., privilege escalation and DoS), identify vulnerable kernel codes, and generate kernel vulnerability profiles. Furthermore, the implementation of vkTracer revealed that the identification overhead ranged from 5.2683 s to 5.2728 s on the PoC codes and the acceptable system call latency was 3.7197 μs. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 57 1 2025 イノベーションの発生源研究の再検討 1 20 EN Qi Huang Daiji Fujii 10.18926/OER/69001 　本論文は，イノベーションの発生源に関する先行研究を振り返り，「いつ」「どこで」「誰によって」イノベーションが生み出されるのかを理論的に考察することを目的とする。考察の結果，「B to B」の文脈においては，イノベーションの発生源が企業ユーザーへ移行するメカニズムとして，取引コスト理論，期待利益仮説，情報粘着性の仮説，企業内部の独自能力（吸収能力），および外部の産業構造（製品アーキテクチャ・エコシステム）といった複数の要素からなる経済的合理性の観点から分析されていることが明らかになった。一方，「B to C」の文脈では，エンドユーザーがイノベーションに向かう動機として，「ニッチ市場に対するメーカーの消極的な対応」「創造的活動の楽しさ」「ユーザーコミュニティとの繋がり」「知識・スキルの向上」など多種多様な要素が存在し，中でも創造的活動の楽しさが根源的な動機づけの1つであると確認された。一方で，イノベーターを突き動かす心理的要因をブラックボックス化したまま放置することは，単なる知的好奇心の問題に留まらず，社会科学としての経営学にとっても重要な問題であると考えられる。今後のイノベーションの発生源研究においては，起業家をはじめとするイノベーター個人の心理的側面にいかに目を向け，創造的活動におけるポジティブな感情が働くメカニズムをイノベーションの発生メカニズムにいかに位置づけるか，その研究アプローチの提示が求められる。 No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0910-6340 2025 Innovations in paper-based analytical devices and portable absorption photometers for onsite analysis EN Sasikarn Seetasang Department of Chemistry, Faculty of Science and Technology, Thammasat University Mika I. Umeda Department of Chemistry, Okayama University Jianchao Ren Department of Chemistry, Okayama University Takashi Kaneta Department of Chemistry, Okayama University Two types of analytical instruments and devices―one sophisticated high-performance instrument and another portable device―have been the focus of recent trends in analytical science. The necessity of point-of-care testing and onsite analysis has accelerated the advancement of high-performance, user-friendly portable analytical devices such as paper-based analytical devices (PADs) and light-emitting diode-based portable photometers. In this review, we summarize our achievements in the study of PADs and portable photometers. Several types of PADs are capable of performing titrations, metal ion analysis, and food analysis, while photometers, which consist of paired emitter–detector light-emitting diode (PEDD) photometers, are used for thiocyanate and herbicide analysis. These PADs and photometers permit the onsite determination of real environmental, body fluid, and food samples when an equipped laboratory is unavailable. No potential conflict of interest relevant to this article was reported.

Springer Nature Switzerland Acta Medica Okayama 2367-4512 2025 Investigation Towards Detecting Landing Websites for Fake Japanese Shopping Websites 107 119 EN Daigo Michishita Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Satoru Kobayashi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Toshihiro Yamauchi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Recently, the number of victims of fake shopping websites that imitate legitimate ones to defraud people has been increasing. It has been shown that fake shopping websites use legitimate defaced landing websites as their leading paths. Therefore, if the detection of landing websites for fake shopping websites can be achieved, it can assist in addressing these websites and reduce the opportunities for users to be redirected to fake shopping websites. In this study, we collect and investigate existing landing websites that redirect users to fake Japanese shopping websites and identify effective features for detecting them. We identified effective search terms for collecting landing websites for fake Japanese shopping websites and found that using Google searches with queries of top-level domain and product names was effective. We also investigated the conditions for activating analytical evasion functions in the collected landing websites for fake Japanese shopping websites and clarified the differences in search results between crawlers and users. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2025 Nicotine dependence based on the Tobacco Dependence Screener among heated tobacco products users in Japan, 2022-2023: the JASTIS Study EN Takuma KITAJIMA Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2227-7080 13 4 2025 An Implementation of Creep Test Assisting System with Dial Gauge Needle Reading and Smart Lighting Function for Laboratory Automation 139 EN Dezheng Kong Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Shihao Fang Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Mitsuhiro Noprianto Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Mitsuhiro Okayasu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Pradini Puspitaningayu Department of Electrical Engineering, Universitas Negeri Surabaya For decades, analog dial gauges have been essential for measuring and monitoring data at various industrial instruments including production machines and laboratory equipment. Among them, we focus on the instrument for creep test in a mechanical engineering laboratory, which evaluates material strength under sustained stress. Manual reading of gauges imposes significant labor demands, especially in long-duration tests. This burden further increases under low-lighting environments, where poor visibility can lead to misreading data points, potentially compromising the accuracy of test results. In this paper, to address the challenges, we implement a creep test assisting system that possesses the following features: (1) to save the installation cost, a web camera and Raspberry Pi are employed to capture images of the dial gauge and automate the needle reading by image processing in real time, (2) to ensure reliability under low-lighting environments, a smart lighting mechanism is integrated to turn on a supplementary light when the dial gauge is not clearly visible, and (3) to allow a user to stay in a distant place from the instrument during a creep test, material break is detected and the corresponding message is notified to a laboratory staff using LINE automatically. For evaluations, we install the implemented system into a material strength measuring instrument at Okayama University, Japan, and confirm the effectiveness and accuracy through conducting experiments under various lighting conditions. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-4893 18 3 2025 A Hair Drawing Evaluation Algorithm for Exactness Assessment Method in Portrait Drawing Learning Assistant System 143 EN Yue Zhang Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Erita Cicilia Febrianti Department of Electrical Engineering, Politeknik Elektronika Negeri Surabaya Amang Sudarsono Department of Electrical Engineering, Politeknik Elektronika Negeri Surabaya Chenchien Hsu Department of Electrical Engineering, National Taiwan Normal University Nowadays, portrait drawing has become increasingly popular as a means of developing artistic skills and nurturing emotional expression. However, it is challenging for novices to start learning it, as they usually lack a solid grasp of proportions and structural foundations of the five senses. To address this problem, we have studied Portrait Drawing Learning Assistant System (PDLAS) for guiding novices by providing auxiliary lines of facial features, generated by utilizing OpenPose and OpenCV libraries. For PDLAS, we have also presented the exactness assessment method to evaluate drawing accuracy using the Normalized Cross-Correlation (NCC) algorithm. It calculates the similarity score between the drawing result and the initial portrait photo. Unfortunately, the current method does not assess the hair drawing, although it occupies a large part of a portrait and often determines its quality. In this paper, we present a hair drawing evaluation algorithm for the exactness assessment method to offer comprehensive feedback to users in PDLAS. To emphasize hair lines, this algorithm extracts the texture of the hair region by computing the eigenvalues and eigenvectors of the hair image. For evaluations, we applied the proposal to drawing results by seven students from Okayama University, Japan and confirmed the validity. In addition, we observed the NCC score improvement in PDLAS by modifying the face parts with low similarity scores from the exactness assessment method. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-5903 17 3 2025 Facial Privacy Protection with Dynamic Multi-User Access Control for Online Photo Platforms 124 EN Andri Santoso Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Green Innovation Center, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University In the digital age, sharing moments through photos has become a daily habit. However, every face captured in these photos is vulnerable to unauthorized identification and potential misuse through AI-powered synthetic content generation. Previously, we introduced SnapSafe, a secure system for enabling selective image privacy focusing on facial regions for single-party scenarios. Recognizing that group photos with multiple subjects are a more common scenario, we extend SnapSafe to support multi-user facial privacy protection with dynamic access control designed for online photo platforms. Our approach introduces key splitting for access control, an owner-centric permission system for granting and revoking access to facial regions, and a request-based mechanism allowing subjects to initiate access permissions. These features ensure that facial regions remain protected while maintaining the visibility of non-facial content for general viewing. To ensure reproducibility and isolation, we implemented our solution using Docker containers. Our experimental assessment covered diverse scenarios, categorized as "Single", "Small", "Medium", and "Large", based on the number of faces in the photos. The results demonstrate the system's effectiveness across all test scenarios, consistently performing face encryption operations in under 350 ms and achieving average face decryption times below 286 ms across various group sizes. The key-splitting operations maintained a 100% success rate across all group configurations, while revocation operations were executed efficiently with server processing times remaining under 16 ms. These results validate the system's capability in managing facial privacy while maintaining practical usability in online photo sharing contexts. No potential conflict of interest relevant to this article was reported.

岡山大学教育推進機構 Acta Medica Okayama 1881-5952 2 2025 きびたんご ―アカデミック英単語学習プログラムの開発と実践報告― 71 80 EN Masumi IGARASHI Institute for Promotion of Education and Campus Life, Okayama University Masaru OGINO Institute for Promotion of Education and Campus Life, Okayama University Junko OTOSHI Institute for Promotion of Education and Campus Life, Okayama University Masako TERANISHI Institute for Promotion of Education and Campus Life, Okayama University Azumi YOSHIDA Institute for Promotion of Education and Campus Life, Okayama University Yoshi KENMOTSU Institute for Promotion of Education and Campus Life, Okayama University 10.18926/68454 岡山大学では学術英語の語彙力を伸ばすための自習教材として、「きびたんご」を開発し学生に提供している。2019年から開発のためのプロジェクトを開始し、学術雑誌から頻出単語を収集し1500語のリストを作成した。単語には意味・発音などの基礎情報以外に、プロジェクトメンバーによる解説や実際にどのように学術論文中に使用されているかの実例を付している。学生への提供は2022年度からで、登録した学生にメールで一日一単語配信し、専用ウェッブサイトで学習させるというシステムである。利用者も順調に増えている。開発開始から５年、提供から２年経過し、単語リストのアップデートや提供方法・システムの改善など課題も明らかになっている。 No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 16 2 2025 Implementation of Sensor Input Setup Assistance Service Using Generative AI for SEMAR IoT Application Server Platform 108 EN I. Nyoman Darma Kotama Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Yohanes Yohanie Fridelin Panduman Graduate School of Natural Science and Technology, Okayama University Komang Candra Brata Graduate School of Natural Science and Technology, Okayama University Anak Agung Surya Pradhana Graduate School of Natural Science and Technology, Okayama University Noprianto Graduate School of Natural Science and Technology, Okayama University I. Gusti Made Ngurah Desnanjaya Department of Computer System Engineering, Institute of Business and Technology Indonesia For rapid deployments of various IoT application systems, we have developed Smart Environmental Monitoring and Analytical in Real-Time (SEMAR) as an integrated server platform. It is equipped with rich functions for collecting, analyzing, and visualizing various data. Unfortunately, the proper configuration of SEMAR with a variety of IoT devices can be complex and challenging for novice users, since it often requires technical expertise. The assistance of Generative AI can be helpful to solve this drawback. In this paper, we present an implementation of a sensor input setup assistance service for SEMAR using prompt engineering techniques and Generative AI. A user needs to define the requirement specifications and environments of the IoT application system for sensor inputs, and give them to the service. Then, the service provides step-by-step guidance on sensor connections, communicating board configurations, network connections, and communication protocols to the user, which can help the user easily set up the configuration to connect the relevant devices to SEMAR. For evaluations, we applied the proposal to the input sensor setup processes of three practical IoT application systems with SEMAR, namely, a smart light, water heater, and room temperature monitoring system. In addition, we applied it to the setup process of an IoT application system for a course for undergraduate students at the Insitut Bisnis dan Teknologi (INSTIKI), Indonesia. The results demonstrate the effectiveness of the proposed service for SEMAR. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2073-431X 14 1 2025 An Investigation of Hand Gestures for Controlling Video Games in a Rehabilitation Exergame System 25 EN Radhiatul Husna Department of Information and Communication Systems, Okayama University Komang Candra Brata Department of Information and Communication Systems, Okayama University Irin Tri Anggraini Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Alfiandi Aulia Rahmadani Department of Electrical Engineering, State Polytechnic of Malang Chih-Peng Fan Department of Electrical Engineering, National Chung Hsing University Musculoskeletal disorders (MSDs) can significantly impact individuals' quality of life (QoL), often requiring effective rehabilitation strategies to promote recovery. However, traditional rehabilitation methods can be expensive and may lack engagement, leading to poor adherence to therapy exercise routines. An exergame system can be a solution to this problem. In this paper, we investigate appropriate hand gestures for controlling video games in a rehabilitation exergame system. The Mediapipe Python library is adopted for the real-time recognition of gestures. We choose 10 easy gestures among 32 possible simple gestures. Then, we specify and compare the best and the second-best groups used to control the game. Comprehensive experiments are conducted with 16 students at Andalas University, Indonesia, to find appropriate gestures and evaluate user experiences of the system using the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). The results show that the hand gestures in the best group are more accessible than in the second-best group. The results suggest appropriate hand gestures for game controls and confirm the proposal's validity. In future work, we plan to enhance the exergame system by integrating a diverse set of video games, while expanding its application to a broader and more diverse sample. We will also study other practical applications of the hand gesture control function. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2079-9292 14 2 2025 A Proposal of In Situ Authoring Tool with Visual-Inertial Sensor Fusion for Outdoor Location-Based Augmented Reality 342 EN Komang Candra Brata Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Yohanes Yohanie Fridelin Panduman Department of Information and Communication Systems, Okayama University Mustika Mentari Department of Information and Communication Systems, Okayama University Yan Watequlis Syaifudin Department of Information Technology, Politeknik Negeri Malang Alfiandi Aulia Rahmadani Department of Information Technology, Politeknik Negeri Malang In location-based augmented reality (LAR) applications, a simple and effective authoring tool is essential to create immersive AR experiences in real-world contexts. Unfortunately, most of the current tools are primarily desktop-based, requiring manual location acquisitions, the use of software development kits (SDKs), and high programming skills, which poses significant challenges for novice developers and a lack of precise LAR content alignment. In this paper, we propose an intuitive in situ authoring tool with visual-inertial sensor fusions to simplify the LAR content creation and storing process directly using a smartphone at the point of interest (POI) location. The tool localizes the user’s position using smartphone sensors and maps it with the captured smartphone movement and the surrounding environment data in real-time. Thus, the AR developer can place a virtual object on-site intuitively without complex programming. By leveraging the combined capabilities of Visual Simultaneous Localization and Mapping(VSLAM) and Google Street View (GSV), it enhances localization and mapping accuracy during AR object creation. For evaluations, we conducted extensive user testing with 15 participants, assessing the task success rate and completion time of the tool in practical pedestrian navigation scenarios. The Handheld Augmented Reality Usability Scale (HARUS) was used to evaluate overall user satisfaction. The results showed that all the participants successfully completed the tasks, taking 16.76 s on average to create one AR object in a 50 m radius area, while common desktop-based methods in the literature need 1–8 min on average, depending on the user’s expertise. Usability scores reached 89.44 for manipulability and 85.14 for comprehensibility, demonstrating the high effectiveness in simplifying the outdoor LAR content creation process. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2079-9292 13 24 2024 An Implementation of Web-Based Answer Platform in the Flutter Programming Learning Assistant System Using Docker Compose 4878 EN Lynn Htet Aung Department of Information and Communication Systems, Okayama University Soe Thandar Aung Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Computer and Information Science, Tokyo University of Agriculture and Technology Wen-Chung Kao Department of Electrical Engineering, National Taiwan Normal University Programming has gained significant importance worldwide as societies increasingly rely on computer application systems. To support novices in learning various programming languages, we have developed the Programming Learning Assistant System (PLAS). It offers several types of exercise problems with different learning goals and levels for step-by-step self-study. As a personal answer platform in PLAS, we have implemented a web application using Node.js and EJS for Java and Python programming. Recently, the Flutter framework with Dart programming has become popular, enabling developers to build applications for mobile, web, and desktop environments from a single codebase. Thus, we have extended PLAS by implementing the Flutter environment with Visual Studio Code to support it. Additionally, we have developed an image-based user interface (UI) testing tool to verify student source code by comparing its generated UI image with the standard one using the ORB and SIFT algorithms in OpenCV. For efficient distribution to students, we have generated Docker images of the answer platform, Flutter environment, and image-based UI testing tool. In this paper, we present the implementation of a web-based answer platform for the Flutter Programming Learning Assistant System (FPLAS) by integrating three Docker images using Docker Compose. Additionally, to capture UI images automatically, an Nginx web application server is adopted with its Docker image. For evaluations, we asked 10 graduate students at Okayama University, Japan, to install the answer platform on their PCs and solve five exercise problems. All the students successfully completed the problems, which confirms the validity and effectiveness of the proposed system. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2574-173X 45 1 2025 Nicotine dependence based on the tobacco dependence screener among heated tobacco products users in Japan, 2022-2023: The JASTIS study e12512 EN Takuma Kitajima Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takashi Hisamatsu Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideyuki Kanda Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takahiro Tabuchi Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine Heated tobacco products (HTPs) are nicotine-containing products similar to cigarettes and are widely used in Japan. However, there has been insufficient research on nicotine dependence associated with HTP use. This study investigated the association of the types of individuals who smoked with the prevalence of nicotine dependence. We utilized data from the Japan Survey on Tobacco and Health (JASTIS). A total of 7969 participants who currently smokes was selected from the 2022 and 2023 survey respondents for the analysis. Nicotine dependence was defined as a score of 5 or higher on the Tobacco Dependence Screener (TDS). The prevalence of nicotine dependence was 43.0% (3473/8077) among all participants who smoked, 42.9% (1479/3447) among those who used cigarettes, 44.2% (760/1720) among those who used two products, and 43.0% (1206/2802) among those who used HTPs. The prevalence of nicotine dependence was statistically higher in the participants who used two products than in cigarettes (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.04-1.33). When classified by temperature, participants who used of two products (high-temp and low-temp) and those using participants who used HTPs (high-temp) had higher ORs for prevalent nicotine dependence (OR, 1.31 [95% CI, 1.14-1.51]) and (OR, 1.12 [95% CI, 1.00-1.25], respectively) compared to participants who used cigarettes. Additionally, the ORs for prevalent nicotine dependence increased with the number of tobacco sticks smoked per day. These results suggest that HTP use, particularly high-temperature HTPs use, and a higher number of tobacco sticks smoked is associated with nicotine dependence. No potential conflict of interest relevant to this article was reported.

Lippincott, Williams & Wilkins Acta Medica Okayama 0025-7974 103 50 2024 Relevance of oxidative stress for small intestinal injuries induced by nonsteroidal anti-inflammatory drugs: A multicenter prospective study e40849 EN Yuki Baba Department of Internal Medicine, Japanese Red Cross Himeji Hospital Seiji Kawano Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akinobu Takaki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshiyasu Kono Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Joichiro Horii Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center Sakuma Takahashi Department of Gastroenterology, Kagawa Prefectural Central Hospital Daisuke Kawai Department of Internal Medicine, Okayama Saiseikai General Hospital Sayo Kobayashi Department of Internal Medicine, Fukuyama City Hospital Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Several reports revealed that oxidative stress was involved in the mouse model of nonsteroidal anti-inflammatory drug (NSAIDs)-induced small intestinal mucosal injuries. Thus, we aimed to investigate in the prospective clinical study, that the relevance of oxidative stress balance in small intestinal mucosal injury in NSAIDs users. We prospectively included 60 patients who had been taking NSAIDs continuously for more than 3 months and exhibited obscure gastrointestinal bleeding (number UMIN 000011775). Small intestinal mucosal injuries were assessed by capsule endoscopy (CE), and reactive oxygen metabolites (d-ROMs) levels and oxidant capacity (OXY) adsorbent test were performed to investigate the relevance of oxidative stress balance. More than half of the patients (N = 32, 53%) had small intestinal mucosal injuries by CE, and 14 patients (24%) had ulcers. The incidence of ulcers was relatively higher in nonaspirin users. Serum OXY levels were significantly lower in the mucosal injury group (P = .02), and d-ROM levels were significantly higher in the ulcer group (P < .01). In aspirin users, d-ROM and OXY levels did not differ significantly with respect to mucosal injuries or ulcers. However, in nonaspirin users, OXY level was significantly lower in the mucosal injury group (P = .04), and d-ROM levels were significantly higher in the ulcer group (P = .02). Nonaspirin NSAIDs-induced intestinal mucosal injury is associated with antioxidant systems, resulting in increased oxidative stress. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 15 12 2024 A Yoga Pose Difficulty Level Estimation Method Using OpenPose for Self-Practice System to Yoga Beginners 789 EN Cheng-Liang Shih Department of Electrical Engineering, National Chung Hsing University Jun-You Liu Department of Electrical Engineering, National Chung Hsing University Irin Tri Anggraini Department of Electrical and Communication Engineering, Okayama University Yanqi Xiao Department of Electrical and Communication Engineering, Okayama University Nobuo Funabiki Department of Electrical and Communication Engineering, Okayama University Chih-Peng Fan Department of Electrical Engineering, National Chung Hsing University Yoga is an exercise preferable for various users at different ages to enhance physical and mental health. To help beginner yoga self-practitioners avoid getting injured by selecting difficult yoga poses, the information of the difficulty level of yoga poses is very important to provide an objective metric to assist yoga self-practitioners in selecting appropriate exercises on the basis of their skill level by using the yoga self-practice system. To enhance the developed yoga self-practice system, the yoga difficulty level estimation function will enable users to clearly understand whether the selected yoga poses are suitable for them. In this paper, the newest difficulty level estimation method of yoga poses is proposed by using and analyzing OpenPose two-dimensional (2D) human body keypoints. The proposed method effectively uses the selected six keypoints areas of the upper and lower body, body support types, center of gravity calculations, and body tilt angles and slopes to produce estimations. Firstly, the method calculates the weighted centers of the upper and lower human body for each pose by using keypoints. Secondly, it refers the slope of the centroid line between the two centers and infers the body's balance state. Lastly, the system estimates the difficulty level by additionally considering the keypoints of the body to contact the ground. For evaluations of the proposal, more than one hundred yoga poses are collected from the Internet and applied to classify them into five difficulty levels. Through comparisons with subjective levels from one instructor and 10 users, the validity of the estimation results is confirmed, a comparison is performed with existing designs, and it is implemented in embedded systems. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1424-8220 24 23 2024 The Design and Implementation of Kerberos-Blockchain Vehicular Ad-Hoc Networks Authentication Across Diverse Network Scenarios 7428 EN Maya Rahayu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Md. Biplob Hossain Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Green Innovation Center, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Md. Arshad Ali Faculty of CSE, Hajee Mohammad Danesh Science and Technology University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Vehicular Ad-Hoc Networks (VANETs) play an essential role in the intelligent transportation era, furnishing users with essential roadway data to facilitate optimal route selection and mitigate the risk of accidents. However, the network exposure makes VANETs susceptible to cyber threats, making authentication crucial for ensuring security and integrity. Therefore, joining entity verification is essential to ensure the integrity and security of communication in VANETs. However, to authenticate the entities, authentication time should be minimized to guarantee fast and secure authentication procedures. We propose an authentication system for VANETs using blockchain and Kerberos for storing authentication messages in a blockchain ledger accessible to Trusted Authentication Servers (TASs) and Roadside Units (RSUs). We evaluate the system in three diverse network scenarios: suburban, urban with 1 TAS, and urban with 2 TASs. The findings reveal that this proposal is applicable in diverse network scenarios to fulfill the network requirements, including authentication, handover, and end-to-end delay, considering an additional TAS for an increasing number of vehicles. The system is also practicable in storing the authentication message in blockchain considering the gas values and memory size for all scenarios. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2024 A Study of Uniform Job Assignment Algorithms to Workers in User-PC Computing System EN XUDONG ZHOU Graduate School of Natural Science and Technology, Okayama university No potential conflict of interest relevant to this article was reported.

情報処理学会 Acta Medica Okayama 1882-7764 65 10 2024 非特定テレビ視聴履歴データの放送局間統合手法 1488 1500 EN Hiroki Matsuda Nara Institute of Science and Technology Taichi Sakakibara Yomiuri Telecasting Corporation Daiki Mayumi Nara Institute of Science and Technology Yuki Matsuda Okayama University Teruhiro Mizumoto Chiba Institute of Technology Keiichi Yasumoto Nara Institute of Science and Technology 近年，各テレビ放送局において，個人を特定しない形式で，インターネット接続されたテレビから視聴開始時刻や視聴終了時刻等を含む非特定視聴履歴データを収集し，利活用する取り組みが進められている．しかし，各放送局は自局の非特定視聴履歴データしか利用できないため，膨大なデータを蓄積しているにもかかわらず，有用な知見を得るまでに至っていないのが現状である．さらに，非特定視聴履歴データの収集方式やデータ粒度は，各局各様となっており，各局が蓄積したデータを統合し，利用することもできていない．そこで本論文では，各局が独自の方式で取得している非特定視聴履歴データを放送局間で統合する手法を提案し，評価するためのシミュレータ設計と実装を行い，提案手法の評価を行う． 提案手法では，各局の視聴履歴データのうち，共通しているIPアドレス・郵便番号・メーカID・ブラウザメジャーバージョン・ブラウザマイナーバージョンの5項目でテレビ受像機を分離処理する．そして，分離された中でこれらの5項目が一致するテレビのうち，さらにチャンネル遷移時刻が一致するテレビを同一テレビと推定する．また，視聴者行動を再現するシミュレータを設計し，そのシミュレータから合成された視聴履歴データに対して，本手法を適用した結果，生成された250万台分のデータのうち約241万台のテレビIDのマッチングに成功し，再現率96.5%であることを示した． No potential conflict of interest relevant to this article was reported.

MYU K.K. Acta Medica Okayama 0914-4935 36 10 2024 Mobile Augmented Reality Interface for Instruction-based Disaster Preparedness Guidelines 4585 4606 EN Sergio De León Aguilar Graduate School of Information Science, Nara Institute of Science and Technology Yuki Matsuda Faculty of Environmental, Life, Natural Science and Technology, Okayama University Keiichi Yasumoto Graduate School of Information Science, Nara Institute of Science and Technology Disaster preparedness guidelines help citizens protect themselves against disasters. Nonetheless, the general public has been found not to read them. Augmented reality (AR) interfaces are known to improve knowledge transfer in studies of education, industry, and elderly assistance. However, this is achieved this by creating specific interfaces for users, not the general public. To test the performance of these interfaces for general public guidance, we designed and implemented a novel AR-assisted disaster prevention guideline that leverages object detection models to identify targets of disaster preparedness advice. We then had a diverse-age audience compare our design against a real traditional paper-based preparedness guide in a room arranged as a common remote work bedroom. By testing their usability, task load, and capacity to make users aware of their environmental hazards, we gained important insights into the performance of different age groups following media developed for the general public. Regardless of different age groups achieving similar usability scores, we found minors improving their performance scores with our novel interface and adults from 20 to 49 years old seemingly performing better than other age groups. In this study, we highlight the importance of guidance alternatives for the young and the less-technology-aware population, contributing to the under-explored area of AR interfaces for the general public. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers Acta Medica Okayama 2169-3536 12 2024 Detecting Unintended Redirects to Malicious Websites on Android Devices Based on URL-Switching Interval 153285 153294 EN Toshihiro Yamauchi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Rintaro Orito Graduate School of Natural Science and Technology, Okayama University Koji Ebisu Graduate School of Natural Science and Technology, Okayama University Masaya Sato Faculty of Computer Science and Systems Engineering, Okayama Prefectural University Website clicks that redirect Android-phone users to malicious websites with fake virus alerts or phishing attacks are increasing exponentially. Although a uniform resource locator (URL) blocklist is considered a suitable countermeasure to such attacks, it is difficult to efficiently identify malicious websites. To the best of our knowledge, no research has focused on detecting attacks that redirect Android-phone users to malicious websites. Therefore, we propose a redirect-detection method that focuses on the URL bar-switching interval of Android-based Google Chrome browser. The proposed method, which can be easily installed as an Android application, uses the Android accessibility service to detect unintended redirects to malicious websites without collecting information about these websites in advance. This paper details the design, implementation, and evaluation results of the proposed application on an actual Android device. We determined the threshold values for the number of times the URL bar switches and the elapsed time to determine redirects to malicious websites for the proposed method. Based on the results, we investigated the causes of false-positive detection of redirects to benign websites and offer solutions on handling them. We also present the threshold values that can minimize the false positive and negative rates, as well as the detection accuracy of the proposed method based on these threshold values. Additionally, we present the evaluations results based on the access logs of actual users participating in the WarpDrive project experiment, which indicate that the proposed method minimizes false positives and successfully detects most redirects to malicious websites. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 15 10 2024 An Independent Learning System for Flutter Cross-Platform Mobile Programming with Code Modification Problems 614 EN Safira Adine Kinari Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Soe Thandar Aung Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Khaing Hsu Wai Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Mustika Mentari Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Pradini Puspitaningayu Department of Electrical Engineering, Universitas Negeri Surabaya Nowadays, with the common use of smartphones in daily lives, mobile applications have become popular around the world, which will lead to a rise in Flutter framework. Developed by Google, Flutter with Dart programming provides a cross-platform development environment to create visually appealing and responsive user interfaces across mobile, web, and desktop platforms using a single codebase. However, due to time and staff limitations, the Flutter/Dart programming course is not included in curricula, even in IT departments in universities. Therefore, independent learning environments for students are essential to meet this growing popularity. Previously, we have developed programming learning assistant system (PLAS) as a web-browser-based self-learning platform for novice students. PLAS offers various types of exercise problems designed to cultivate programming skills step-by-step through a lot of code reading and code writing practices. Among them, one particular type is the code modification problem (CMP), which asks to modify the given source code to satisfy the new specifications. CMP is expected to be solved by novices with little effort if they have knowledge of other programming languages. Thus, PLAS with CMP will be an excellent platform for independent learning. In this paper, we present PLAS with CMP for the independent learning of Flutter/Dart programming. To improve the readability of the source code by students, we provided rich comments on grammar or behaviors. Besides, the code can be downloaded so that students can check and run it on an IDE. For evaluations, we generated 38 CMP instances for basic and multimedia/storage topics in Flutter/Dart programming and assigned them to 21 master students at Okayama University, Japan, who have never studied it. The results confirm the validity of the proposal. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers Acta Medica Okayama 2169-3536 12 2024 MUSIC Spectrum Based Interference Detection, Localization, and Interference Arrival Prediction for mmWave IRS-MIMO System 142592 142605 EN Yafei Hou Faculty of Environmental, Life, Natural Science and Technology, Okayama University Kazuto Yano Wave Engineering Laboratories, Advanced Telecommunications Research Institute International Norisato Suga Wave Engineering Laboratories, Advanced Telecommunications Research Institute International Julian Webber Wave Engineering Laboratories, Advanced Telecommunications Research Institute International Satoshi Denno Faculty of Environmental, Life, Natural Science and Technology, Okayama University Toshikazu Sakano Wave Engineering Laboratories, Advanced Telecommunications Research Institute International For a millimeter wave (mmWave) intelligent re-configurable surface (IRS)-MIMO system, if it can correctly detect the interference occurrence and their locations, the patterns of interference signal can be collected and learned using machine learning for the prediction of interference arrival. With the information of interference location and activity pattern, the capacity of the system can be largely improved using many techniques such as beamforming, interference cancellation, and transmission scheduling. This paper aims to detect interference occurrence using a low-complexity MUSIC (MUSIC: multiple signal classification) spectrum-based method, and then localize their sources for mmWave IRS-MIMO system. The MUSIC spectrum of wireless system can be regarded as somehow the 'signature' related to the signals transmitted from different users or interference. We utilize such property to detect the occurrence of interference, and then localize their sources in a low-complexity way. Finally, the pattern of interference occurrence can be learned to predict the interference arrival from the collected data. This paper also proposed an efficient probabilistic neural network (PNN)-based predictor for the interference arrival prediction and showed its prediction accuracy. From simulated results, our proposed method can achieve the correct results with the accuracy near to 100% when the fingerprint samples is over 10. In addition, the localization error can be within 1 m with more than 65% and 43% for Y-axis and X-axis, respectively. Finally, based on the results of the interference occurrence, the proposed PNN-based predictor for the interference arrival prediction can capture correctly the similar distribution function of the coming continuous idle status. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2673-8732 4 3 2024 A User Location Reset Method through Object Recognition in Indoor Navigation System Using Unity and a Smartphone (INSUS) 295 312 EN Evianita Dewi Fajrianti Graduate School of Natural Science and Technology, Okayama University Yohanes Yohanie Fridelin Panduman Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Amma Liesvarastranta Haz Graduate School of Natural Science and Technology, Okayama University Komang Candra Brata Graduate School of Natural Science and Technology, Okayama University Sritrusta Sukaridhoto Department of Informatic and Computer, Politeknik Elektronika Negeri Surabaya To enhance user experiences of reaching destinations in large, complex buildings, we have developed a indoor navigation system using Unity and a smartphone called INSUS. It can reset the user location using a quick response (QR) code to reduce the loss of direction of the user during navigation. However, this approach needs a number of QR code sheets to be prepared in the field, causing extra loads at implementation. In this paper, we propose another reset method to reduce loads by recognizing information of naturally installed signs in the field using object detection and Optical Character Recognition (OCR) technologies. A lot of signs exist in a building, containing texts such as room numbers, room names, and floor numbers. In the proposal, the Sign Image is taken with a smartphone, the sign is detected by YOLOv8, the text inside the sign is recognized by PaddleOCR, and it is compared with each record in the Room Database using Levenshtein distance. For evaluations, we applied the proposal in two buildings in Okayama University, Japan. The results show that YOLOv8 achieved mAP@0.5 0.995 and mAP@0.5:0.95 0.978, and PaddleOCR could extract text in the sign image accurately with an averaged CER% lower than 10%. The combination of both YOLOv8 and PaddleOCR decreases the execution time by 6.71s compared to the previous method. The results confirmed the effectiveness of the proposal. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 15 8 2024 An Image-Based User Interface Testing Method for Flutter Programming Learning Assistant System 464 EN Soe Thandar Aung Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Lynn Htet Aung Department of Information and Communication Systems, Okayama University Safira Adine Kinari Department of Information and Communication Systems, Okayama University Khaing Hsu Wai Department of Information and Communication Systems, Okayama University Mustika Mentari Department of Information and Communication Systems, Okayama University Flutter has become popular for providing a uniform development environment for user interfaces (UIs) on smart phones, web browsers, and desktop applications. We have developed the Flutter programming learning assistant system (FPLAS) to assist its novice students' self-study. We implemented the Docker-based Flutter environment with Visual Studio Code and three introductory exercise projects. However, the correctness of students' answers is manually checked, although automatic checking is necessary to reduce teachers' workload and provide quick responses to students. This paper presents an image-based user interface (UI) testing method to automate UI testing by the answer code using the Flask framework. This method produces the UI image by running the answer code and compares it with the image made by the model code for the assignment using ORB and SIFT algorithms in the OpenCV library. One notable aspect is the necessity to capture multiple UI screenshots through page transitions by user input actions for the accurate detection of changes in UI elements. For evaluations, we assigned five Flutter exercise projects to fourth-year bachelor and first-year master engineering students at Okayama University, Japan, and applied the proposed method to their answers. The results confirm the effectiveness of the proposal. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2079-9292 13 14 2024 A Reference Paper Collection System Using Web Scraping 2700 EN Inzali Naing Department of Information and Communication Systems, Okayama University Soe Thandar Aung Department of Information and Communication Systems, Okayama University Khaing Hsu Wai Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Collecting reference papers from the Internet is one of the most important activities for progressing research and writing papers about their results. Unfortunately, the current process using Google Scholar may not be efficient, since a lot of paper files cannot be accessed directly by the user. Even if they are accessible, their effectiveness needs to be checked manually. In this paper, we propose a reference paper collection system using web scraping to automate paper collections from websites. This system can collect or monitor data from the Internet, which is considered as the environment, using Selenium, a popular web scraping software, as the sensor; this examines the similarity against the search target by comparing the keywords using the Bert model. The Bert model is a deep learning model for natural language processing (NLP) that can understand context by analyzing the relationships between words in a sentence bidirectionally. The Python Flask is adopted at the web application server, where Angular is used for data presentations. For the evaluation, we measured the performance, investigated the accuracy, and asked members of our laboratory to use the proposed method and provide their feedback. Their results confirm the method’s effectiveness. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 15 4 2024 A Study of Learning Environment for Initiating Flutter App Development Using Docker 191 EN Soe Thandar Aung Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Lynn Htet Aung Department of Information and Communication Systems, Okayama University Safira Adine Kinari Department of Information and Communication Systems, Okayama University Mustika Mentari Department of Information and Communication Systems, Okayama University Khaing Hsu Wai Department of Information and Communication Systems, Okayama University The Flutter framework with Dart programming allows developers to effortlessly build applications for both web and mobile from a single codebase. It enables efficient conversions to native codes for mobile apps and optimized JavaScript for web browsers. Since utilizing a wide range of widgets in Flutter ensures consistent experiences on various devices for users, it becomes crucial in programming education by providing a unified environment for learning app development while reducing the need for platform-specific knowledge. However, the setup of the Flutter environment is challenging for novice students due to its multiple steps, such as installing dependencies and configuring environments. To support independent learning for these students, it is essential to simplify the setup by providing user-friendly instructions and automated tools. In this paper, we present a Docker-based environment for Flutter app developments across Windows, Linux, and Mac through Visual Studio Code, ensuring a unified learning experience. This paper aims to simplify complex configurations and address the obstacles encountered by students when initiating Flutter projects. For the evaluation, we prepared three simple Flutter projects along with the setup environment in a Docker container. Then, we asked 24 Master's students at Okayama University, Japan, to install the environment and modify the source codes in the projects independently by following the given instructions. The results show that all the students successfully completed the assignments, which confirms the efficiency and validity of our proposal. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 78 2 2024 The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community 171 184 EN Aya Kuramoto Graduate School of Health Sciences, Okayama University Shinya Saito Graduate School of Health Sciences, Okayama University Kumi Watanabe School of Nursing, Faculty of Medicine, Kagawa University Original Article 10.18926/AMO/66926 We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1865-7257 17 3 2024 Calcium polystyrene sulfonate-induced rectal ulcer causing E. coli native-valve infective endocarditis 472 476 EN Shinnosuke Fukushima Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Honda Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoharu Ishida Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryohei Shoji Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kou Hasegawa Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Escherichia coli-associated native-valve infective endocarditis is a rare disease that affects elderly patients with underlying risk factors such as diabetes mellitus, malignancy, and renal failure. Long-term use of calcium polystyrene sulfonate is a potential risk factor for gastrointestinal mucosal damage or even colorectal ulcers. Herein, we describe a fatal case of a 66-year-old Japanese man with diabetes mellitus and renal failure who was prescribed calcium polystyrene sulfonate (CPS) for 11 years and developed a CPS-induced rectal ulcer, leading to E. coli native-valve infective endocarditis. The patient was admitted to our hospital due to acute-onset impaired consciousness. As a result of the systemic investigation, he was diagnosed with E. coli bacteremia accompanied by multiple cerebral infarctions and an acute hemorrhagic rectal ulcer. Transesophageal echocardiography revealed a 20-mm vegetative structure on the mitral valve, resulting in a final diagnosis of E. coli-associated infective endocarditis. After rectal resection, mitral valve replacement surgery was performed; however, the patient died shortly after surgery. Pathological findings of the resected rectum showed deposition of a basophilic crystalline material suggesting the presence of CPS. Our case highlights the potential risk of colorectal ulcers in a long-term CPS user, which can trigger bacterial translocation and endocarditis as fatal complications. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2397-9070 8 1 2023 Clinical significance of gastrointestinal bleeding history in patients who undergo left atrial appendage closure e13009 EN Tatsuya Kikuchi Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshiyasu Kono Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koji Nakagawa Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hiroyuki Okada Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Masakazu Miyamoto Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoichi Takaya Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shoichiro Hirata Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shoko Inoo Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Sakiko Kuraoka Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shotaro Okanoue Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Katsunori Matsueda Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takuya Satomi Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kenta Hamada Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Masaya Iwamuro Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Seiji Kawano Department of Gastroenterology and Hepatology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshiro Kawahara Department of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background and Aim: Anticoagulant users with nonvalvular atrial fibrillation (NVAF) sometimes suffer from gastrointestinal bleeding (GIB) and have difficulty continuing the medication. Left atrial appendage closure (LAAC) has been developed for such situations. We aimed to clarify the clinical significance of a history of GIB in comparison to other factors in patients who had undergone LAAC. Methods: From October 2019 to September 2023, patients with NVAF who underwent LAAC at our hospital were enrolled. We investigated the percentage of patients with a history of GIB who underwent LAAC and compared the incidence of post-LAAC bleeding in these patients compared to those with other factors. Results: A total of 45 patients were included. There were 19 patients (42%) with a history of GIB who underwent LAAC. In a Kaplan–Meier analysis, the cumulative incidence of bleeding complications after LAAC was significantly higher in patients with a history of GIB in comparison to patients with other factors. There were eight cases of post-LAAC bleeding in total, and seven cases had GIB. Conclusions: We need to recognize that GIB is a significant complication in patients who undergo LAAC. The management of GIB by gastroenterologists is essential to the success of LAAC. No potential conflict of interest relevant to this article was reported.

Optica Publishing Group Acta Medica Okayama 1094-4087 31 23 2023 Optical multi-context scrubbing operation on a redundant system 38529 38539 EN Kakeru Ando Graduate School of Natural Science and Technology, Okayama University Minoru Watanabe Faculty of Environmental, Life, Natural Science and Technology, Okayama University Nobuya Watanabe Faculty of Environmental, Life, Natural Science and Technology, Okayama University This paper presents a proposal of the world-first optical multi-context scrubbing operation on a redundant system that can maintain the state of a sequential circuit and the operation continuously without any interruption on a radiation-hardened optically reconfigurable gate array even after a permanent failure suddenly happens on the sequential circuit or a flip-flop by radiation. Up to now, a high-speed optical scrubbing operation has been demonstrated on a radiation-hardened optically reconfigurable gate array. In addition, a multi-context scrubbing operation based on the high-speed optical scrubbing operation has already been demonstrated. Although the multi-context scrubbing operation presents the benefit that it can treat both soft errors and permanent failures caused by radiation simultaneously, the conventional contributions have never presented how to maintain the state of a sequential circuit after a permanent failure occurs on flip-flops. Therefore, in the conventional multi-context scrubbing operation, all the operations must be restarted from the initial condition each time a permanent failure occurs on a programmable gate array. As a result, conventional multi-context scrubbing operations could not be applied for real-time systems. The proposed optical multi-context scrubbing method that can solve the issue has been experimentally evaluated on a radiation-hardened optically reconfigurable gate array. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 6 2023 Cochlear Implantation in the Poorer-Hearing Ear Is a Reasonable Choice 589 593 EN Ryotaro Omichi Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shin Kariya Department of Otolaryngology-Head and Neck Surgery, Kawasaki Medial University Yukihide Maeda Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kunihiro Fukushima Hayashima Clinic of Otolaryngology and Dermatology Yuko Kataoka Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Akiko Sugaya Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazunori Nishizaki Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mizuo Ando Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/66150 Choosing the optimal side for cochlear implantation (CI) remains a major challenge because of the lack of evidence. We investigated the choice of the surgery side for CI (i.e., the better- or poorer-hearing ear) in patients with asymmetric hearing. Audiological records of 74 adults with a unilateral hearing aid who had undergone surgery at Okayama University Hospital were reviewed. The definition of ‘better-hearing ear’ was the aided ear, and the unaided ear was considered the poorer-hearing ear. We performed a multiple regression analysis to identify potential predictors of speech recognition performance after unilateral CI in the patients. Fifty-two patients underwent CI in the poorer-hearing ear. The post-Ci bimodal hearing rate was far higher in the poorer-ear group (77.8% vs. 22.2%). A multivariate analysis revealed that prelingual hearing loss and the patient’s age at CI significantly affected the speech recognition outcome (beta coefficients: 24.6 and －0.33, 95% confidence intervals [11.75-37.45] and [－0.58 to －0.09], respectively), but the CI surgery side did not (－6.76, [－14.92-1.39]). Unilateral CI in the poorer-hearing ear may therefore be a reasonable choice for adult patients with postlingual severe hearing loss, providing a greater opportunity for postoperative bimodal hearing. No potential conflict of interest relevant to this article was reported.

Fuji Technology Press Ltd. Acta Medica Okayama 1883-8049 34 2 2022 Development of a Spiral Shaped Soft Holding Actuator Using Extension Type Flexible Pneumatic Actuators 373 381 EN So Shimooka Graduate School of Natural Science and Technology, Okayama University Tetsuya Akagi Department of Intelligent Mechanical Engineering, Okayama University of Science Shujiro Dohta Department of Intelligent Mechanical Engineering, Okayama University of Science Takashi Shinohara Design and Manufacturing Center, Organization for Research Development and Outreach, Okayama University of Science Takumi Kobayashi Department of Intelligent Mechanical Engineering, Okayama University of Science Recently, several pneumatic soft actuators have been applied to wearable and welfare devices to provide nursing care and physical support for the elderly and disabled. In this study, as a wearable soft actuator for holding body, a spiral shaped soft holding actuator that can wrap a user according to their body shape was proposed and tested. The construction and operating principle of the tested soft actuator with circumferential restraint mechanism using three extension type flexible pneumatic actuators (EFPAs) has been discussed. As a result, it was found that the tested actuator could hold elbows and knees when the joint is in motion. An analytical model of the spiral actuator was also proposed to achieve an optimal design. It can be confirmed that the proposed analytical model can predict the shape of the actuator when various EFPAs are pressurized. No potential conflict of interest relevant to this article was reported.

Public Library of Science Acta Medica Okayama 1932-6203 18 7 2023 Augmented reality-based affective training for improving care communication skill and empathy e0288175 EN Atsushi Nakazawa Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Miyuki Iwamoto Department of Advanced Fibro-Science, Kyoto Institute of Technology Ryo Kurazume Faculty of Information Science and Electrical Engineering, Kyushu University Masato Nunoi School of Human Sciences, Sugiyama Jogakuen University Masaki Kobayashi Division of geriatric medicine, Rochester Regional Health System Miwako Honda Division of Geriatric Research, National Hospital Organization Tokyo Medical Center It is important for caregivers of people with dementia (PwD) to have good patient communication skills as it has been known to reduce the behavioral and psychological symptoms of dementia (BPSD) of PwD as well as caregiver burnout. However, acquiring such skills often requires one-on-one affective training, which can be costly. In this study, we propose affective training using augmented reality (AR) for supporting the acquisition of such skills. The system uses see-through AR glasses and a nursing training doll to train the user in both practical nursing skills and affective skills such as eye contact and patient communication. The experiment was conducted with 38 nursing students. The participants were assigned to either the Doll group, which only used a doll for training, or the AR group, which used both a doll and the AR system. The results showed that eye contact significantly increased and the face-to-face distance and angle decreased in the AR group, while the Doll group had no significant difference. In addition, the empathy score of the AR group significantly increased after the training. Upon analyzing the correlation between personality and changes of physical skills, we found a significant positive correlation between the improvement rate of eye contact and extraversion in the AR group. These results demonstrated that affective training using AR is effective for improving caregivers' physical skills and their empathy for their patients. We believe that this system will be beneficial not only for dementia caregivers but for anyone looking to improve their general communication skills. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 14 7 2023 INSUS: Indoor Navigation System Using Unity and Smartphone for User Ambulation Assistance 359 EN Evianita Dewi Fajrianti Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Sritrusta Sukaridhoto Department of Informatic and Computer, Politeknik Elektronika Negeri Surabaya Yohanes Yohanie Fridelin Panduman Graduate School of Natural Science and Technology, Okayama University Kong Dezheng Graduate School of Natural Science and Technology, Okayama University Fang Shihao Graduate School of Natural Science and Technology, Okayama University Anak Agung Surya Pradhana Indonesian Institute of Business and Technology (INSTIKI) Currently, outdoor navigation systems have widely been used around the world on smartphones. They rely on GPS (Global Positioning System). However, indoor navigation systems are still under development due to the complex structure of indoor environments, including multiple floors, many rooms, steps, and elevators. In this paper, we present the design and implementation of the Indoor Navigation System using Unity and Smartphone (INSUS). INSUS shows the arrow of the moving direction on the camera view based on a smartphone's augmented reality (AR) technology. To trace the user location, it utilizes the Simultaneous Localization and Mapping (SLAM) technique with a gyroscope and a camera in a smartphone to track users' movements inside a building after initializing the current location by the QR code. Unity is introduced to obtain the 3D information of the target indoor environment for Visual SLAM. The data are stored in the IoT application server called SEMAR for visualizations. We implement a prototype system of INSUS inside buildings in two universities. We found that scanning QR codes with the smartphone perpendicular in angle between 60 degrees and 100 degrees achieves the highest QR code detection accuracy. We also found that the phone's tilt angles influence the navigation success rate, with 90 degrees to 100 degrees tilt angles giving better navigation success compared to lower tilt angles. INSUS also proved to be a robust navigation system, evidenced by near identical navigation success rate results in navigation scenarios with or without disturbance. Furthermore, based on the questionnaire responses from the respondents, it was generally found that INSUS received positive feedback and there is support to improve the system. No potential conflict of interest relevant to this article was reported.

The Editorial Office of Gut and Liver Acta Medica Okayama 1976-2283 17 3 2022 Postoperative Bleeding Risk after Gastric Endoscopic Submucosal Dissection in Patients Receiving a P2Y12 Receptor Antagonist 404 411 EN Ryosuke Hirai Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Seiji Kawano Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shoko Inoo Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Sakiko Kuraoka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shotaro Okanoue Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takuya Satomi Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kenta Hamada Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshiyasu Kono Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiromitsu Kanzaki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshiro Kawahara Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background/Aims: The safety of gastric endoscopic submucosal dissection (ESD) in users of a P2Y12 receptor antagonist (P2Y12RA) under current guidelines has not been verified. Methods: Patients treated by gastric ESD at Okayama University Hospital between January 2013 and December 2020 were registered. The postoperative bleeding rates of patients (group A) who did not receive any antithrombotic drugs; patients (group B) receiving aspirin or cilostazol monotherapy; and P2Y12RA users (group C) those on including monotherapy or dual antiplatelet therapy were compared. The risk factors for post-ESD bleeding were examined in a multivariate analysis of patient background, tumor factors, and antithrombotic drug management. Results: Ultimately, 1,036 lesions (847 patients) were enrolled. The bleeding rates of group B and C were significantly higher than that of group A (p=0.012 and p<0.001, respectively), but there was no significant difference between group B and C (p=0.11). The postoperative bleeding rate was significantly higher in dual antiplatelet therapy than in P2Y12RA monotherapy (p=0.014). In multivariate analysis, tumor diameter ≥12 mm (odds ratio [OR], 4.30; 95% confidence interval [CI], 1.99 to 9.31), anticoagulant use (OR, 4.03; 95% CI, 1.64 to 9.86), and P2Y12RA use (OR, 3.40; 95% CI, 1.07 to 10.70) were significant risk factors for postoperative bleeding. Conclusions: P2Y12RA use is a risk factor for postoperative bleeding in patients who undergo ESD even if receiving drug management according to guidelines. Dual antiplatelet therapy carries a higher risk of bleeding than monotherapy. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 14 6 2023 An Edge Device Framework in SEMAR IoT Application Server Platform 312 EN Yohanes Yohanie Fridelin Panduman Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Sho Ito Graduate School of Natural Science and Technology, Okayama University Radhiatul Husna Graduate School of Natural Science and Technology, Okayama University Minoru Kuribayashi Graduate School of Natural Science and Technology, Okayama University Mitsuhiro Okayasu Graduate School of Natural Science and Technology, Okayama University Junya Shimazu Graduate School of Natural Science and Technology, Okayama University Sritrusta Sukaridhoto Department of Informatic and Computer, Politeknik Elektronika Negeri Surabaya Nowadays, the Internet of Things (IoT) has become widely used at various places and for various applications. To facilitate this trend, we have developed the IoT application server platform called SEMAR (Smart Environmental Monitoring and Analytical in Real-Time), which offers standard features for collecting, displaying, and analyzing sensor data. An edge device is usually installed to connect sensors with the server, where the interface configuration, the data processing, the communication protocol, and the transmission interval need to be defined by the user. In this paper, we proposed an edge device framework for SEMAR to remotely optimize the edge device utilization with three phases. In the initialization phase, it automatically downloads the configuration file to the device through HTTP communications. In the service phase, it converts data from various sensors into the standard data format and sends it to the server periodically. In the update phase, it remotely updates the configuration through MQTT communications. For evaluations, we applied the proposal to the fingerprint-based indoor localization system (FILS15.4) and the data logging system. The results confirm the effectiveness in utilizing SEMAR to develop IoT application systems. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2078-2489 14 6 2023 A Web-Based Docker Image Assistant Generation Tool for User-PC Computing System 300 EN Lynn Htet Aung Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Soe Thandar Aung Graduate School of Natural Science and Technology, Okayama University Xudong Zhou Graduate School of Natural Science and Technology, Okayama University Xu Xiang Graduate School of Natural Science and Technology, Okayama University Wen-Chung Kao Department of Electrical Engineering, National Taiwan Normal University Currently, we are developing the user-PC computing (UPC) system based on the master-worker model as a scalable, low-cost, and high-performance computing platform. To run various application programs on personal computers (PCs) with different environments for workers, it adopts Docker technology to bundle every necessary software as one image file. Unfortunately, the Docker file/image are manually generated through multiple steps by a user, which can be the bottleneck. In this paper, we present a web-based Docker image assistant generation (DIAG) tool in the UPC system to assist or reduce these process steps. It adopts Angular JavaScript for offering user interfaces, PHP Laravel for handling logic using RestAPI, MySQL database for storing data, and Shell scripting for speedily running the whole program. In addition, the worker-side code modification function is implemented so that a user can modify the source code of the running job and update the Docker image at a worker to speed up them. For evaluations, we collected 30 Docker files and 10 OpenFOAM jobs through reverse processing from Docker images in Github and generated the Docker images using the tool. Moreover, we modified source codes for network simulations and generated the Docker images in a worker five times. The results confirmed the validity of the proposal. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 3 2023 Endocrinological Changes after Anamorelin Administration in Patients with Gastrointestinal Cancer 235 241 EN Sakiko Kuraoka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takuya Satomi Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tatsuhiro Yamazaki Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kenta Hamada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshiyasu Kono Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiromitsu Kanzaki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hironari Kato Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/65488 Changes in hormone levels in patients with cancer cachexia after anamorelin administration have not been fully investigated. This study aimed to determine how anamorelin affects the endocrine system in patients with gastrointestinal cancer and cachexia. We prospectively enrolled 13 patients and comprehensively investigated their body weight and levels of serum albumin, hemoglobin A1c (HbA1c), and hormones before (week 0) and 3 and 12 weeks after anamorelin administration. The variables were evaluated at week 3 in 9 patients and at week 12 in 5 patients. At week 3, anamorelin administration resulted in body weight gain and increased the levels of growth hormone and HbA1c, as well as insulin-like growth factor-1 standard deviation scores (IGF-1 SD scores). At the same time, negative correlations were observed between ΔIGF-1 SD score and Δthyroidstimulating hormone (TSH) and between ΔIGF-1 SD score and Δfree testosterone. ΔBody weight and ΔIGF-1 SD score correlated positively at week 12. These results suggest that TSH and free testosterone levels can be affected 3 weeks after anamorelin administration; however, those variables tend to return to a state of equilibrium, and anabolic effects of anamorelin appear in long-term (≥ 12 weeks) users. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2023 A Study of Job-Worker Assignment Algorithms Considering CPU Core Usage for User-PC Computing System EN KAMOYEDJI ARIEL ELIE ASSEREHOU Graduate School of Natural Science and Technology, Okayama university No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2023 Do Complementary and Alternative Medicine Users Also Use Conventional Medicine? A Repeated Cross-Sectional Study in Japan from 1995 to 2013 EN Nobuyoshi MATSUKI Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 134 2 2022 岡山県内における新型コロナウイルス感染症クラスターの発生時期別特徴について 86 91 EN Tomoka Kadowaki Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Saori Irie Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yukari Takahashi Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiromasa Yakushiji Yakushiji jikei Hospital Soshi Takao Deportment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takashi Yorifuji Deportment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University 　Coronavirus disease 2019 has spread worldwide and has yet to be contained. The Japanese government has taken measures against the occurrence of clusters. However, there has little evaluation of the occurrence of the clusters and their changes. Therefore, we investigated the occurrence of the clusters in medical institutions and elderly care facilities in Okayama Prefecture. 　We compared the characteristics of the clusters that occurred in each of the wave between October 21, 2020, and September 30, 2021, by using the data published that interval. As a case study, we also evaluated the characteristics of positive patients at a medical institution over where a cluster occurred in case the fourth wave. 　The overall number of cluster outbreaks decreased with the spread of vaccination. In the fourth wave, there was a period in which the vaccination of staff members at medical institutions became widespread, while patients or facility users were unvaccinated, resulting in a longer convergence period and an increase in the number of positive cases among patients relative to the number of staff members. 　The impact of the spread of vaccination and the duration of immunity acquired after vaccination on the occurrence of clusters should be closely monitored in the future. No potential conflict of interest relevant to this article was reported.

Optica Publishing Group Acta Medica Okayama 1094-4087 31 2 2023 High-sensitivity low-noise photodetector using a large-area silicon photomultiplier 1943 1957 EN Takahiko Masuda Research Institute for Interdisciplinary Science, Okayama University Ayami Hiramoto Research Institute for Interdisciplinary Science, Okayama University Daniel G. Ang Department of Physics, Harvard University Cole Meisenhelder Department of Physics, Harvard University Cristian D. Panda Department of Physics, University of California Noboru Sasao Research Institute for Interdisciplinary Science, Okayama University Satoshi Uetake Research Institute for Interdisciplinary Science, Okayama University Xing Wu 2Department of Physics, Harvard University David P. DeMille James Franck Institute and Department of Physics, University of Chicago John M. Doyle Research Institute for Interdisciplinary Science, Okayama University Gerald Gabrielse Center for Fundamental Physics, Department of Physics and Astronomy, Northwestern University Koji Yoshimura Research Institute for Interdisciplinary Science, Okayama University The application of silicon photomultiplier (SiPM) technology for weak-light detection at a single photon level has expanded thanks to its better photon detection efficiency in comparison to a conventional photomultiplier tube (PMT). SiPMs with large detection area have recently become commercially available, enabling applications where the photon flux is low both temporarily and spatially. On the other hand, several drawbacks exist in the usage of SiPMs such as a higher dark count rate, many readout channels, slow response time, and optical crosstalk; therefore, users need to carefully consider the trade-offs. This work presents a SiPM-embedded compact large-area photon detection module. Various techniques are adopted to overcome the disadvantages of SiPMs so that it can be generally utilized as an upgrade from a PMT. A simple cooling component and recently developed optical crosstalk suppression method are adopted to reduce the noise which is more serious for larger-area SiPMs. A dedicated readout circuit increases the response frequency and reduces the number of readout channels. We favorably compare this design with a conventional PMT and obtain both higher photon detection efficiency and larger-area acceptance. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-4893 16 1 2023 Three Diverse Applications of General-Purpose Parameter Optimization Algorithm 45 EN Yuanzhi Huo Department of Information and Communication Systems, Okayama University Pradini Puspitaningayu Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Kazushi Hamazaki Department of Information and Communication Systems, Okayama University Minoru Kuribayashi Department of Information and Communication Systems, Okayama University Yihan Zhao Department of Mechanical Engineering, Shonan Institute of Technology Kazuyuki Kojima Department of Mechanical Engineering, Shonan Institute of Technology Parameters often take key roles in determining the accuracy of algorithms, logics, and models for practical applications. Previously, we have proposed a general-purpose parameter optimization algorithm, and studied its applications in various practical problems. This algorithm optimizes the parameter values by repeating small changes of them based on a local search method with hill-climbing capabilities. In this paper, we present three diverse applications of this algorithm to show the versatility and effectiveness. The first application is the fingerprint-based indoor localization system using IEEE802.15.4 devices called FILS15.4 that can detect the location of a user in an indoor environment. It is shown that the number of fingerprints for each detection point, the fingerprint values, and the detection interval are optimized together, and the average detection accuracy exceeds 99%. The second application is the human face contour approximation model that is described by a combination of half circles, line segments, and a quadratic curve. It is shown that the simple functions can well approximate the face contour of various persons by optimizing the center coordinates, radii, and coefficients. The third application is the computational fluid dynamic (CFD) simulation to estimate temperature changes in a room. It is shown that the thermal conductivity is optimized to make the average temperature difference between the estimated and measured 0.22 ℃. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2022 A design and implementation of user-PC computing system platform using Docker EN HEIN HTET Graduate School of Natural Science and Technology, Okayama university No potential conflict of interest relevant to this article was reported.

IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC Acta Medica Okayama 2169-3536 10 2022 Effectiveness of Tactile Warning and Voice Command for Enhancing Safety of Drivers 93854 93866 EN Atsuo Murata Department of Intelligent Mechanical Systems, Graduate School of Natural Science and Technology, Okayama University Toshihisa Doi Department of Living Environment Design, Graduate School of Human Life and Ecology, Osaka Metropolitan University Waldemar Karwowski Engineering and Management Systems, University of Central Florida (Life Senior Member, IEEE) Safety is impaired when drivers are required to perform main driving task (tracking of own car, distance maintenance between own car and a leading car, and response to target objects) and secondary task simultaneously, for example, responding to target cars on the road while operating in-vehicle equipment. A two-factor (presence or absence of tactile warning by input modality (no secondary task, voice command for a secondary task, and manual input for a secondary task)) within-subject design of ten licensed males was used to investigate how to compensate for safety impairments (decreased performance of a main and a secondary task such as increased tracking error during driving or increased reaction time to target cars on the road). We investigated whether the use of tactile warnings transmitted via left and right thighs for detecting road objects and voice command to operate in-vehicle equipment could compensate for safety impairments such as the increased reaction time to target cars on the road, the increase of detection error of target cars, or increased tracking error in driving. The accuracy and speed of responses to target cars encountered during driving were reduced when a driver was asked to perform the main and the secondary task simultaneously compared to situations performing only the main driving task (tracking, distance maintenance, and response to target cars). The availability of a tactile warning system for road objects compensated for these diminished performance measures, including slower response times and the increased detection error of target cars. Likewise, voice command contributed to enhanced performance of the main driving task such as decrease of tracking error. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-4893 15 10 2022 A Static Assignment Algorithm of Uniform Jobs to Workers in a User-PC Computing System Using Simultaneous Linear Equations 369 EN Xudong Zhou Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Hein Htet Graduate School of Natural Science and Technology, Okayama University Ariel Kamoyedji Graduate School of Natural Science and Technology, Okayama University Irin Tri Anggraini Graduate School of Natural Science and Technology, Okayama University Yuanzhi Huo Graduate School of Natural Science and Technology, Okayama University Yan Watequlis Syaifudin Information Technology Department, State Polytechnic of Malang Currently, the User-PC computingsystem (UPC) has been studied as a low-cost and high-performance distributed computing platform. It uses idling resources of personal computers (PCs) in a group. The job-worker assignment for minimizing makespan is critical to determine the performance of the UPC system. Some applications need to execute a lot of uniform jobs that use the identical program but with slightly different data, where they take the similar CPU time on a PC. Then, the total CPU time of a worker is almost linear to the number of assigned jobs. In this paper, we propose a static assignment algorithm of uniform jobs to workers in the UPC system, using simultaneous linear equations to find the lower bound on makespan, where every worker requires the same CPU time to complete the assigned jobs. For the evaluations of the proposal, we consider the uniform jobs in three applications. In OpenPose, the CNN-based keypoint estimation program runs with various images of human bodies. In OpenFOAM, the physics simulation program runs with various parameter sets. In code testing, two open-source programs run with various source codes from students for the Android programming learning assistance system (APLAS). Using the proposal, we assigned the jobs to six workers in the testbed UPC system and measured the CPU time. The results show that makespan was reduced by 10% on average, which confirms the effectiveness of the proposal. No potential conflict of interest relevant to this article was reported.

Nature Portfolio Acta Medica Okayama 2045-2322 12 1 2022 Impact of the cervical cancer awareness months on public interest in Japan: A Google Trends analysis, 2012-2021 15391 EN Hideharu Hagiya Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The immunization and screening rates for human papillomavirus in Japan are lower than those in other countries. We aimed to evaluate the impact of cervical cancer awareness months on public attention using Google Trends analysis. Between 2012 and 2021, we analyzed the trends in relative search volumes (RSVs) for "Shikyuu-keigan" (cervical cancer in English) in Japan, during the cervical cancer awareness month (CCAM) in January and cervical cancer prevention awareness enhancement month (CCPAEM) in November. We performed a joinpoint regression analysis to identify a statistically significant trend change point. Additionally, we compared the mean RSVs of each awareness month with the rest of the year. Significant trend change points were observed, but none were found in CCAM and CCPAEM periods. Comparison of mean RSVs among CCAM, CCPAEM, and the rest of the months did not suggest any significant increases in RSVs during these awareness periods. In conclusion, CAM and CCPAEM did not raise public interest in cervical cancer in Japan. Although the results are based on internet users, the findings might suggest a need to develop a more effective and attractive approach to achieve the 90-70-90 targets of cervical cancer prevention by 2030. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1424-8220 22 17 2022 Design and Implementation of SEMAR IoT Server Platform with Applications 6436 EN Yohanes Yohanie Fridelin Panduman Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University Pradini Puspitaningayu Graduate School of Natural Science and Technology, Okayama University Minoru Kuribayashi Graduate School of Natural Science and Technology, Okayama University Sritrusta Sukaridhoto Department of Informatic and Computer, Politeknik Elektronika Negeri Surabaya Wen-Chung Kao Department of Electrical Engineering, National Taiwan Normal University Nowadays, rapid developments of Internet of Things (IoT) technologies have increased possibilities of realizing smart cities where collaborations and integrations of various IoT application systems are essential. However, IoT application systems have often been designed and deployed independently without considering the standards of devices, logics, and data communications. In this paper, we present the design and implementation of the IoT server platform called Smart Environmental Monitoring and Analytical in Real-Time (SEMAR) for integrating IoT application systems using standards. SEMAR offers Big Data environments with built-in functions for data aggregations, synchronizations, and classifications with machine learning. Moreover, plug-in functions can be easily implemented. Data from devices for different sensors can be accepted directly and through network connections, which will be used in real-time for user interfaces, text files, and access to other systems through Representational State Transfer Application Programming Interface (REST API) services. For evaluations of SEMAR, we implemented the platform and integrated five IoT application systems, namely, the air-conditioning guidance system, the fingerprint-based indoor localization system, the water quality monitoring system, the environment monitoring system, and the air quality monitoring system. When compared with existing research on IoT platforms, the proposed SEMAR IoT application server platform offers higher flexibility and interoperability with the functions for IoT device managements, data communications, decision making, synchronizations, and filters that can be easily integrated with external programs or IoT applications without changing the codes. The results confirm the effectiveness and efficiency of the proposal. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers (IEEE) Acta Medica Okayama 2169-3536 9 2021 Mitigation of Kernel Memory Corruption Using Multiple Kernel Memory Mechanism 111651 111665 EN Hiroki Kuzuno 1Intelligent Systems Laboratory, SECOM Company Ltd. Toshihiro Yamauchi 2Graduate School of Natural Science and Technology, Okayama University Operating systems adopt kernel protection methods (e.g., mandatory access control, kernel address space layout randomization, control flow integrity, and kernel page table isolation) as essential countermeasures to reduce the likelihood of kernel vulnerability attacks. However, kernel memory corruption can still occur via the execution of malicious kernel code at the kernel layer. This is because the vulnerable kernel code and the attack target kernel code or kernel data are located in the same kernel address space. To gain complete control of a host, adversaries focus on kernel code invocations, such as function pointers that rely on the starting points of the kernel protection methods. To mitigate such subversion attacks, this paper presents multiple kernel memory (MKM), which employs an alternative design for kernel address space separation. The MKM mechanism focuses on the isolation granularity of the kernel address space during each execution of the kernel code. MKM provides two kernel address spaces, namely, i) the trampoline kernel address space, which acts as the gateway feature between user and kernel modes and ii) the security kernel address space, which utilizes the localization of the kernel protection methods (i.e., kernel observation). Additionally, MKM achieves the encapsulation of the vulnerable kernel code to prevent access to the kernel code invocations of the separated kernel address space. The evaluation results demonstrated that MKM can protect the kernel code and kernel data from a proof-of-concept kernel vulnerability that could lead to kernel memory corruption. In addition, the performance results of MKM indicate that the system call overhead latency ranges from 0.020 μs to 0.5445 μs, while the web application benchmark ranges from 196.27 μs to 6, 685.73 μs for each download access of 100,000 Hypertext Transfer Protocol sessions. MKM attained a 97.65% system benchmark score and a 99.76% kernel compilation time. No potential conflict of interest relevant to this article was reported.

Group of Wild Plant Science, Institute of Plant Science and Resources, Okayama University Acta Medica Okayama 2021 Naturalized plants in Japan : Seed-Image database EN Jun Yamashita Institute of Plant Science and Resources, Okayama University 10.48696/63011 Naturalized Plants in Japan Seed-Image database is an image database of naturalized alien plant seeds recorded in Japan. This database contains plant images, information on morphological features of seeds and the name list of naturalized alien plants, as well as seed images. Seeds are categorized into 5 groups based on morphological features such as reticulation (wrinkles or projections), ridges, edges and achene fruit. Users can search seed images by family names, species names and those features. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2020 Method of Generating a Blacklist for Mobile Devices by Searching Malicious Websites 20489448 EN Takashi Ishihara Graduate School of Natural Science and Technology, Okayama University Masaya Sato Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University As mobile devices have become more popular, malware and attacks directed at them have significantly increased. One of the methods to attack mobile devices is redirecting a user to unwanted websites by unwanted page transition. One of the countermeasures against such attacks is to generate a blacklist of URLs and hostnames, which can prevent access to malicious websites. To generate a blacklist, first, malicious websites are collected in the web space. Then, URLs and hostnames of the malicious websites are added to the blacklist. However, URLs of the malicious websites are typically changed frequently; thus, it is necessary to keep track of the malicious websites and update the blacklist in a timely manner. In this study, we proposed a method to generate blacklists for mobile devices by searching malicious websites. The method collects many HTML files from the web space using a crawler and searches for HTML files that are highly likely to be malicious using keywords extracted from the known malicious websites to discover the new ones. Thus, new malicious websites can be added to the blacklist in a timely manner. Using the proposed method, we discovered malicious websites that were not detected by Google Safe Browsing. Moreover, the blacklist generated using the method had a high detection rate for certain malicious websites. This paper reports the design process and the results of the evaluation of the new method. No potential conflict of interest relevant to this article was reported.

ACM Acta Medica Okayama 2018 Web access monitoring mechanism for Android webview 1 EN Yuta Imamura Okayama University, Okayama, Japan Hiroyuki Uekawa Okayama University, Okayama, Japan Yasuhiro Ishihara Okayama University, Okayama, Japan Masaya Sato Okayama University, Okayama, Japan Toshihiro Yamauchi Okayama University Okayama, Japan In addition to conventional web browsers, WebView is used to display web content on Android. WebView is a component that enables the display of web content in mobile applications, and is extensively used. As WebView displays web content without having to redirect the user to web browsers, there is the possibility that unauthorized web access may be performed secretly via Web-View, and information in Android may be stolen or tampered with. Therefore, it is necessary to monitor and analyze web access via WebView, particularly because attacks exploiting WebView have been reported. However, there is no mechanism for monitoring web access viaWebView. In this work, the goals are to monitor web access via WebView and to analyze mobile applications using Web-View. To achieve these goals, we propose a web access monitoring mechanism for Android WebView. In this paper, the design and implementation of a mechanism that does not require any modifications to the Android Framework and Linux kernel are presented for the Chromium Android System WebView app. In addition, this paper presents evaluation results for the proposed mechanism. No potential conflict of interest relevant to this article was reported.

Information Processing Society of Japan Acta Medica Okayama 1882-6652 26 2018 Access Control Mechanism to Mitigate Cordova Plugin Attacks in Hybrid Applications 396 405 EN Naoki Kudo Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Thomas H. Austin San Jose State University Hybrid application frameworks such as Cordova are more and more popular to create platform-independent applications (apps) because they provide special APIs to access device resources in a platform-agonistic way. By using these APIs, hybrid apps can access device resources through JavaScript. In this paper, we present a novel app-repackaging attack that repackages hybrid apps with malicious code; this code can exploit Cordova's plugin interface to steal and tamper with device resources. We address this attack and cross-site scripting attacks against hybrid apps. Since these attacks need to use plugins to access device resources, we refer to both of these attacks as Cordova plugin attacks. We further demonstrate a defense against Cordova plugin attacks through the use of a novel runtime access control mechanism that restricts access based on the mobile user's judgement. Our mechanism is easy to introduce to existing Cordova apps, and allows developers to produce apps that are resistant to Cordova plugin attacks. Moreover, we evaluate the effectiveness and performance of our mechanism. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2076-3417 11 15 2021 A New Method for Haptic Shape Discriminability Detection 7049 EN Yulong Liu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Jiajia Yang Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Yinghua Yu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Yiyang Yu Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Wu Wang The School of Psychological and Cognitive Sciences, Peking University Huazhi Li Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Satoshi Takahashi Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Yoshimichi Ejima Cognitive Neuroscience Laboratory, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Qiong Wu Department of Psychology, Suzhou University of Science and Technology, Jinglong Wu Research Center for Medical Artificial Intelligence, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences Touch shape discrimination is not only closely related to tactile mechanoreceptors but also higher cognitive function. However, previous shape discrimination methods are difficult to complete in a short time, and the devices are complicated to operate and not user-friendly for nonprofessionals. Here, we propose a new method, the evaluation quantity of which is the angle discrimination threshold. In addition, to make this method easy to use for nonprofessionals, we designed a haptic angle sorting system, including the device and software. To evaluate this method, the angle sorting and two-angle discrimination experiments were compared, and it was found that participants spent significantly less time in the former experiment than in the latter. At the same time, there is a strong correlation between the performance of angle sorting and two-angle discrimination, which shows that the angle threshold obtained by the new method can also be used to evaluate the ability of touch discrimination. Moreover, the angle sorting results of different age groups also further demonstrate the feasibility of the method. The efficiency of this new method and the effectiveness of the system also provide a convenient means for evaluating haptic shape discrimination, which may have potential clinical application value in the early diagnosis of peripheral neuropathy and even in the evaluation of cognitive function. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2076-3417 11 15 2021 Usability Textual Data Analysis: A Formulaic Coding Think-Aloud Protocol Method for Usability Evaluation 7047 EN Toshihisa Doi Department of Intelligent Mechanical Systems, Okayama University Think-aloud protocols are among the most standard methods for usability evaluation, which help to discover usability problems and to examine improvements because they provide direct information on a user's thinking and cognitive processes; however, it is often difficult to determine how to analyze the data to identify usability problems because there is no formulaic analysis procedure for textual data. Therefore, the analysis is time-consuming, and the quality of the results varies depending on an analyst's skills. In the present study, the author proposes a formulaic analysis think-aloud protocol method that specifies the procedure for analyzing participants' verbal responses during usability tests. The aim of the proposed think-aloud protocol method was to deliver an explicit procedure using step coding (SCAT) and 70 design items for textual data analysis, and then, the method was applied to a case study of usability evaluation to confirm that the method could extract the target system's problems. By using step coding and 70 design items, the process of extracting usability problems from textual data was made explicit, and the problems were extracted analytically. In other words, the proposed method was less ambiguous. Once a formulaic analysis procedure was established, textual data analysis could be performed easily and efficiently. The analysis could be performed without hesitation after data acquisition, and there were fewer omissions. In addition, it is expected that the procedure would be easy to use, even for novice designers. No potential conflict of interest relevant to this article was reported.

Information Processing Society of Japan Acta Medica Okayama 1882-6652 24 5 2016 Design of Function for Tracing Diffusion of Classified Information for IPC on KVM 781 792 EN Shota Fujii Graduate School of Natural Science and Technology, Okayama University Masaya Sato Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Hideo Taniguchi Graduate School of Natural Science and Technology, Okayama University The leaking of information has increased in recent years. To address this problem, we previously proposed a function for tracing the diffusion of classified information in a guest OS using a virtual machine monitor (VMM). This function makes it possible to grasp the location of classified information and detect information leakage without modifying the source codes of the guest OS. The diffusion of classified information is caused by the file operation, child process creation, and inter-process communication (IPC). In a previous study, we implemented the proposed function for a file operation and child process creation excluding IPC using a kernel-based virtual machine (KVM). In this paper, we describe the design of the proposed function for IPC on a KVM without modifying the guest OS. The proposed function traces the local and remote IPCs inside the guest OS from the outside so as to trace the information diffusion. Because IPC with an outside computer might cause an information leakage, tracing the IPCs enables the detection of such a leakage. We also report the evaluation results including the traceability and performance of the proposed function. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1615-5289 22 1 2021 Effective highlighting modes of graphical user interfaces in visual information search 111 119 EN Toshihisa Doi Okayama University This study discusses the preferred highlighting mode for graphical user interface (GUI) design. The study investigated the effects of different highlighting modes on the search time and accuracy of the element on the screen. The experimental factors were the type of highlighting (color, bold, or color and bold), the target highlighting (highlighted or not highlighted), and the number of elements on GUI (few or many). The participants had to search for a predetermined target on the screen. The evaluation measures were the reaction time and percentage correctly identified. The statistical analysis result shows that bold highlighting had the shortest search time, and color highlighting had the worst accuracy. Under the conditions of this experiment, bold highlighting should contribute to the design of the screen for an easier search of information in terms of both search speed and accuracy. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2073-8994 13 5 2021 Effects of Asymmetry between Design Models and User Models on Subjective Comprehension of User Interface 795 EN Toshihisa Doi Department of Intelligent Mechanical Systems, Okayama University This study attempted to discuss the design principles for enhancing usability in terms of asymmetry of mental models between users and designers. If the user model is asymmetrical to the design model, i.e., the degree of agreement between models is low and the user's mental model is not compatible with the actual system, the user cannot operate the system properly, which may cause errors. The aim of this study was to investigate the characteristics of users who have asymmetrical mental models and identify what such users did not understand. Twenty-four subjects participated in an experiment that involved a digital camera operation task and mental model tests that measure the level of the agreement of the mental model construction in terms of functional and structural models. Initially, the participants were grouped based on mental model test scores: symmetrical mental model group (n = 17) and asymmetrical mental model group (n = 7). Then, the groups were compared in terms of performance and subjective comprehension. The comparison indicated that the symmetrical mental model group performed more quickly and accurately than the asymmetrical group. The results also confirmed that the asymmetrical mental model group had a lower level of comprehension in terms of understanding the device status, detecting and responding to device status changes, and understanding the hierarchical structure of the screen. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers Acta Medica Okayama 2169-3536 9 2021 Capacity Loss From Localization Error in MIMO Channel Using Leaky Coaxial Cable 15929 15938 EN Junjie Zhu Graduate School of Natural Science and Technology, Okayama University Yafei Hou Graduate School of Natural Science and Technology, Okayama University Kenta Nagayama Graduate School of Natural Science and Technology, Okayama University Satoshi Denno Graduate School of Natural Science and Technology, Okayama University Leaky coaxial (LCX) cable has been employed as antennas for wireless traffic over many linear-cell scenarios such as railway station, tunnels and shopping malls. In addition, LCX can be used for user localization and wireless power transfer (WPT). Compared with the equal power allocation method, the power allocation method for LCX system using positional information (PI) can improve its capacity with the same level of computational complexity. In this paper, we will investigate the level of capacity loss on the 2.4 GHz and 5 GHz band for the conventional equal power (EP) allocation method, the water-filling (WF) based power allocation, and our proposed low-complexity power allocation method for LCX system with PI. The results show that LCX system with our proposed method using PI can reduce the capacity loss due to localization error than that of others. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 1615-5262 20 2021 Web access monitoring mechanism via Android WebView for threat analysis 833 847 EN Yuta Imamura Graduate School of Natural Science and Technology, Okayama University Rintaro Orito Graduate School of Natural Science and Technology, Okayama University Hiroyuki Uekawa Graduate School of Natural Science and Technology, Okayama University Kritsana Chaikaew Faculty of Engineering, Kasetsart University Pattara Leelaprute Faculty of Engineering, Kasetsart University Masaya Sato Graduate School of Natural Science and Technology Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Many Android apps employ WebView, a component that enables the display of web content in the apps without redirecting users to web browser apps. However, WebView might also be used for cyberattacks. Moreover, to the best of our knowledge, although some countermeasures based on access control have been reported for attacks exploiting WebView, no mechanism for monitoring web access via WebView has been proposed and no analysis results focusing on web access via WebView are available. In consideration of this limitation, we propose a web access monitoring mechanism for Android WebView to analyze web access via WebView and clarify attacks exploiting WebView. In this paper, we present the design and implementation of this mechanism by modifying Chromium WebView without any modifications to the Android framework or Linux kernel. The evaluation results of the performance achieved on introducing the proposed mechanism are also presented here. Moreover, the result of threat analysis of displaying a fake virus alert while browsing websites on Android is discussed to demonstrate the effectiveness of the proposed mechanism. No potential conflict of interest relevant to this article was reported.

The Institute of Electronics, Information and Communication Engineers Acta Medica Okayama 1745-1361 E98D 4 2015 Access Control to Prevent Malicious JavaScript Code Exploiting Vulnerabilities of WebView in Android OS 807 811 EN Jing Yu Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Android applications that using WebView can load and display web pages. Interaction with web pages allows JavaScript code within the web pages to access resources on the Android device by using the Java object, which is registered into WebView. If this WebView feature were exploited by an attacker, JavaScript code could be used to launch attacks, such as stealing from or tampering personal information in the device. To address these threats, we propose an access control on the security-sensitive APIs at the Java object level. The proposed access control uses static analysis to identify these security-sensitive APIs, detects threats at runtime, and notifies the user if threats are detected, thereby preventing attacks from web pages. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2013 Access Control to Prevent Attacks Exploiting Vulnerabilities of WebView in Android OS 1628 1633 EN Jing Yu Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Android applications that using WebView can load and display web pages. Furthermore, by using the APIs provided in WebView, Android applications can interact with web pages. The interaction allows JavaScript code within the web pages to access resources on the Android device by using the Java object, which is registered into WebView. If this WebView feature were exploited by an attacker, JavaScript code could be used to launch attacks, such as stealing from or tampering personal information in the device. To address these threats, we propose a method that performs access control on the security-sensitive APIs at the Java object level. The proposed method uses static analysis to identify these security-sensitive APIs, detects threats at runtime, and notifies the user if threats are detected, thereby preventing attacks from web pages. No potential conflict of interest relevant to this article was reported.

Springer, Dordrecht Acta Medica Okayama 2013 DroidTrack: Tracking Information Diffusion and Preventing Information Leakage on Android 243 251 EN Syunya Sakamoto Graduate School of Natural Science and Technology, Okayama University An app in Android can collaborate with other apps and control personal information by using the Intent or user’s allowing of permission. However, users cannot detect when they communicate. Therefore, users might not be aware information leakage if app is malware. This paper proposes DroidTrack, a method for tracking the diffusion of personal information and preventing its leakage on an Android device. DroidTrack alerts the user of the possibility of information leakage when an app uses APIs to communicate with outside. These alerts are triggered only if the app has already called APIs to collect personal information. Users are given the option to refuse the execution of the API if it is not appropriate. Further, by illustrating how their personal data is diffused, users can have the necessary information to help them decide whether the API use is appropriate. No potential conflict of interest relevant to this article was reported.

Institute of Electronics, Information and Communication Engineers Acta Medica Okayama 0916-8532 E103.D 8 2020 An Algorithm for Automatic Collation of Vocabulary Decks Based on Word Frequency 1865 1874 EN Zeynep Yücel Okayama University Parisa Supitayakul Okayama University Akito Monden Okayama University Pattara Leelaprute Department of Computer Engineering, Faculty of Engineering, Kasetsart University This study focuses on computer based foreign language vocabulary learning systems. Our objective is to automatically build vocabulary decks with desired levels of relative difficulty relations. To realize this goal, we exploit the fact that word frequency is a good indicator of vocabulary difficulty. Subsequently, for composing the decks, we pose two requirements as uniformity and diversity. Namely, the difficulty level of the cards in the same deck needs to be uniform enough so that they can be grouped together and difficulty levels of the cards in different decks need to be diverse enough so that they can be grouped in different decks. To assess uniformity and diversity, we use rank-biserial correlation and propose an iterative algorithm, which helps in attaining desired levels of uniformity and diversity based on word frequency in daily use of language. In experiments, we employed a spaced repetition flashcard software and presented users various decks built with the proposed algorithm, which contain cards from different content types. From users' activity logs, we derived several behavioral variables and examined the polyserial correlation between these variables and difficulty levels across different word classes. This analysis confirmed that the decks compiled with the proposed algorithm induce an effect on behavioral variables in line with the expectations. In addition, a series of experiments with decks involving varying content types confirmed that this relation is independent of word class. No potential conflict of interest relevant to this article was reported.

Cambridge University Press Acta Medica Okayama 2048-7703 9 2020 A study for 2-D indoor localization using multiple leaky coaxial cables e20 EN Junjie Zhu Graduate School of Natural Science and Technology, Okayama University Pengcheng Hou Graduate School of Natural Science and Technology, Okayama University Yafei Hou Graduate School of Natural Science and Technology, Okayama University Satoshi Denno Graduate School of Natural Science and Technology, Okayama University Minoru Okada Division of Information Science, Nara Institute of Science and Technology Indoor localization technology, which can provide the location information of the target object or stochastic things, is becoming essential requirement for many applications and services such as Internet-of-Things (IoT), real-time control in the development of Fifth-generation (5G) technology. Leaky coaxial cable which can be used as antennas is able to detect the location of the user in a simple way due to its potential property. In this paper, we proposes a simple method to improve the localization accuracy of 2-D indoor localization using multiple LCX cables. In addition, we also evaluate the channel capacity loss due to the localization error of the LCX-MIMO using our proposed method. No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 1064-8046 29 3 2020 Value-Centered Design Process for User Experience Enhancement: A Case Study in the Development of a Notebook PC 26 31 EN Toshihisa Doi Dept. of Intelligent Mechanical Systems, Okayama University Since 2000, in the planning and development of products and services, providing users with a better experience when using products and services has become essential, resulting in a growing need for value-centered design that focuses on providing users with more attractive experience values. In this article, we introduce the value-centered product development process that has been used in the planning and development of notebook PCs, focusing on the experience value provided to the user. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 2020 Improvement and Evaluation of a Function for Tracing the Diffusion of Classified Information on KVM 338 349 EN Hideaki Moriyama National Institute of Technology, Ariake College Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University Masaya Sato Graduate School of Natural Science and Technology, Okayama University Hideo Taniguchi Graduate School of Natural Science and Technology, Okayama University The increasing amount of classified information currently being managed by personal computers has resulted in the leakage of such information to external computers, which is a major problem. To prevent such leakage, we previously proposed a function for tracing the diffusion of classified information in a guest operating system (OS) using a virtual machine monitor (VMM). The tracing function hooks a system call in the guest OS from the VMM, and acquiring the information. By analyzing the information on the VMM side, the tracing function makes it possible to notify the user of the diffusion of classified information. However, this function has a problem in that the administrator of the computer platform cannot grasp the transition of the diffusion of classified processes or file information. In this paper, we present the solution to this problem and report on its evaluation. No potential conflict of interest relevant to this article was reported.

Taylor and Francis Acta Medica Okayama 1044-7318 36 16 2020 Estimating Level of Engagement from Ocular Landmarks 1527 1539 EN Zeynep Yucel Department of Computer Science, Division of Industrial Innovation Sciences, Okayama University Serina Koyama Department of Computer Science, Division of Industrial Innovation Sciences, Okayama University Akito Monden Department of Computer Science, Division of Industrial Innovation Sciences, Okayama University Mariko Sasakura Department of Computer Science, Division of Industrial Innovation Sciences, Okayama University E-learning offers many advantages like being economical, flexible and customizable, but also has challenging aspects such as lack of – social-interaction, which results in contemplation and sense of remoteness. To overcome these and sustain learners’ motivation, various stimuli can be incorporated. Nevertheless, such adjustments initially require an assessment of engagement level. In this respect, we propose estimating engagement level from facial landmarks exploiting the facts that (i) perceptual decoupling is promoted by blinking during mentally demanding tasks; (ii) eye strain increases blinking rate, which also scales with task disengagement; (iii) eye aspect ratio is in close connection with attentional state and (iv) users’ head position is correlated with their level of involvement. Building empirical models of these actions, we devise a probabilistic estimation framework. Our results indicate that high and low levels of engagement are identified with considerable accuracy, whereas medium levels are inherently more challenging, which is also confirmed by inter-rater agreement of expert coders. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 74 3 2020 Effect of Vonoprazan on Delayed Bleeding after Endoscopic Submucosal Dissection for Gastric Neoplasia among Antithrombotic Drug Users: A Single-Center, Single-Arm Prospective Observational Case Control Study 245 250 EN Shumpei Yamamoto Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroshi Takayama Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Yuichi Shimodate Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Rio Takezawa Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Naoyuki Nishimura Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Akira Doi Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Hirokazu Mouri Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Kazuhiro Matsueda Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Motowo Mizuno Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/59958 Antithrombotic therapy is a major risk factor for delayed bleeding after endoscopic submucosal dissection (ESD) for gastric neoplasia. A potassium-competitive acid blocker, vonoprazan, is expected to prevent delayed bleeding better than conventional proton pomp inhibitors (PPIs), but the evidence is controversial. We sought to clarify the efficacy of vonoprazan for prevention of delayed bleeding after gastric ESD in patients under antithrombotic therapy. We prospectively registered 50 patients who underwent gastric ESD while receiving antithrombotic therapy and vonoprazan in our institution between October 2017 and September 2018. The incidence of delayed bleeding was compared with that in a historical control group of 116 patients treated with conventional PPI. We also evaluated risk factors associated with delayed bleeding. Delayed bleeding was observed in 8 of 50 patients (16.0%), which was not dissimilar from the incidence in the historical control group (12.1%) (p=0.49). In the univariate analysis, age (> 70 years) (p=0.034), multiple antithrombotic drug use (p<0.01), procedure time (> 200 min) (p=0.038) and tumor size (> 40 mm) (p<0.01) were associated with delayed bleeding after gastric ESD, but vonoprazan was not (p=0.49). Vonoprazan may not be more effective than conventional PPIs in preventing delayed bleeding after gastric ESD in patients receiving antithrombotic therapy. No potential conflict of interest relevant to this article was reported.

Emerald Acta Medica Okayama 17440084 16 1 2019 A proposal of Android Programming Learning Assistant System with implementation of basic application learning 115 135 EN Yan Watequlis Syaifudin Department of Electrical and Communication Engineering, Okayama University Nobuo Funabiki Department of Electrical and Communication Engineering, Okayama University Minoru Kuribayashi Department of Electrical and Communication Engineering, Okayama University Wen-Chung Kao National Taiwan Normal University Purpose With rapid increase of Android devices and application systems, there is a strong demand for Android application programmers. A lot of schools are offering Android programming courses to meet this demand. However, Android programming can be different from the conventional one because it needs interactive functions through interfaces with users, which makes the study more difficult. This paper aims to propose an Android Programming Learning Assistance System, namely, APLAS, to assist the Java-based Android programming study and education. Design/methodology/approach By adopting the test-driven development method, APLAS is designed to achieve independent learning without the presence of teachers. Using JUnit and Robolectric, the answers from the students are automatically marked in APLAS. To cover extensive materials in Android programming, APLAS offers four stages where each stage involves several topics. Findings To evaluate the effectiveness of APLAS, we implemented the Unit Converter assignment that covers the first two topics, namely, Basic user interface in the first stage and basic activity in the second stage. Through solving the assignment, it is expected to learn basic application development. Forty novice students of an IT department in Indonesia were asked to solve both topics separately. Originality/value The results show that APLAS is useful and helpful for the self-study of Android programming, as they could complete codes with good execution performances. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 2 2019 Thyroid Function Decline and Diet in Female High School Long-distance Runners 127 133 EN Yukari Iwasaki Graduate School of Health Sciences, Okayama University Kimiko Miyahara Faculty of Health Care, Department of Nutrition, Kiryu University Nobuyuki Miyatake Department of Hygiene, Faculty of Medicine, Kagawa University Mikiya Nakatsuka Graduate School of Health Sciences, Okayama University Original Article 10.18926/AMO/56648 We aimed to clarify the state of thyroid function in female high school long-distance runners. We evaluated the associations between thyroid function and menstrual condition, bone mineral density (BMD), nutritious status, and body composition. The subjects’ height and weight were measured, along with fat percentage, fat mass, muscle mass, and BMD with dual-energy X-ray absorptiometry. A nutrition and dietary survey measured the subjects’ intake of energy and nutrients based on meals provided at the subjects’ dorm for 3 days in July of 2016 and 2017. Blood parameters including thyroid hormone and estradiol were measured. Most of the subjects (81.3%) were underweight (body mass index <18.5). The thyroid hormone free T3 value was decreased, but TSH was not increased and was similar to that observed in individuals with anorexia nervosa. In our subjects, thyroid hormone was associated with BMD and nutritional intake. To improve the menstruation abnormality of female athletes and to increase their bone density, the athletes’ weight should be managed by proper nutrient intake and the maintenance of their thyroid function. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 73 2 2019 Unintentional Injury Deaths among Children: A Descriptive Study Using Medico-legal Documents in Okayama Prefecture, Japan (2001－2015) 117 125 EN Yukie Yamasaki Department of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nanako Tamiya Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Hideki Yamamoto Graduate School of Public Health, Teikyo University Satoru Miyaishi Department of Legal Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/56647 According to the World Health Organization’s World Report, approx. 950,000 children and young people < 18 years old die from an injury each year, and unintentional injury deaths account for a large portion of these cases. Here we used medico-legal documents to epidemiologically analyze the cases of unintentional injury deaths among children < 5 years old in Okayama Prefecture, Japan from 2001 to 2015. Age, sex, manner/cause of death, and various circumstances of the incident were investigated. There were 73 unintentional injury deaths during the study period. Drowning (n=29), suffocation (n=24), and transport accidents (n=13) were the major categories of unintentional injury deaths. Twenty-two cases (30.1%) were autopsied. Differences in the characteristics of the unintentional injury deaths by age were observed. Information which cannot be obtained from Vital Statistics was available from medico-legal documents, and detailed characteristics of unintentional injury deaths among children < 5 years old were elucidated. Investigating medico-legal information is one of the meaningful measures for the prevention of unintentional injury deaths among children in Japan. No potential conflict of interest relevant to this article was reported.

IJNC Editorial Committee Acta Medica Okayama 2185-2839 7 2 2017 A Channel Assignment Extension of Active Access-Point Configuration Algorithm for Elastic WLAN System and Its Implementation Using Raspberry Pi 248 270 EN Md. Selim Al Mamun Okayama University Nobuo Funabiki Okayama University Kyaw Soe Lwin Okayama University Md. Ezharul Islam Okayama University Wen-Chung Kao National Taiwan Normal University Recently, Wireless Local-Area Network (WLAN) has become prevailing as it provides flexible Internet access to users with low cost through installation of several types of access points (APs) in the network. Previously, we proposed the active AP configuration algorithm for the elastic WLAN system using heterogeneous APs, which dynamically optimizes the configuration by activating or deactivating APs based on traffic demands. However, this algorithm assumes that any active AP may use a different channel from the other ones to avoid interferences, although the number of non-interfered channels in IEEE 802.11 protocols is limited. In this paper, we propose the extension of the AP configuration algorithm to consider the channel assignment to the active APs under this limitation. Besides, AP associations of the hosts are modified to improve the network performance by averaging loads among channels. The effectiveness of our proposal is evaluated using the WIMNET simulator in two topologies. Finally, the elastic WLAN system including this proposal is implemented using Raspberry Pi for the AP. The feasibility and performance of the implementation are verified through experiments using the testbed. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 49 3 2018 岡山大学留学生相談室と接触のあった公的機関・民間団体・個人等の学外者に関する分析 1 18 EN Masumi Oka Mariko Uzuka Yoko Hirota 10.18926/OER/55742 　　In this paper, the authors examine the reasons why outsiders such as the staff of public and private sector organizations as well as individuals made contact with the International Students Advisory Office（ ISAO） at Okayama University during the period from November 1999 to March 201₇. At ISAO 80% of the visitors are the students, staff and faculty of Okayama University, and the rest, 20%, are non-university people. Because of its name, people assume that ISAO visitors are only university-related people. However, advising and supporting international students cannot be done only on-campus, but also requires support and help from people outside of the university. The purpose of this paper is to focus on this 20% of ISAO visitors and to analyze the reasons for and frequencies of their inquiries. 　A total number of ₆,808 queries were made from outside the campus during the 1₇ year and ₅ month period under study. ₇8% of these were from Japanese and 22% were from foreigners. ₇₆% were residents of Okayama Prefecture. 　As for their affiliation, ₃9% were individuals; 20%, the staff of educational institutions; 18%, NPO’s and other private groups; 1₇%, government officials; ₆%, company workers and managers. As for the reasons for contacting the office, the majority, ₅1%, were related to exchange/support; while 2₇%, daily life-related matters; 8%, information exchange with other students advisors; ₆%, study-related matters; and ₅%, university admission related. 　In the discussion, the authors examine the inquiries by other universities, foreign governments and mass media, and analyze their meaning and characteristics. The authors also point out the typical problems pertaining to“ cultural exchanges” with schools. Finally, they look at issues related to the alumni and alumna who return as continuous users of ISAO. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 71 6 2017 The Incidence of Oral and Oropharyngeal Cancers in Betel Quid-Chewing Populations in South Myanmar Rural Areas 519 524 EN Nobuyoshi Mizukawa Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Hospital Swe Swe Win Myanmar Dental Association Zaw Moe Thein Department of Oral Medicine, University of Dental Medicine, Yangon Moe Thida Htwe Department of Oral Medicine, University of Dental Medicine, Mandalay Yohsuke Yoshioka Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Kimata Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Seiji Iida Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Myo Khin NPO Myanmar-Japan Collaboration Project for Fostering Medical Human Resources Shigeru Okada NPO Myanmar-Japan Collaboration Project for Fostering Medical Human Resources Than Sein People’s Health Foundation, Myanmar Original Article 10.18926/AMO/55589 Oral cancer is a very common disease in South and Southeast Asia. Betel quid (BQ)- chewing and tobaccosmoking habits are etiological factors for oral cancer patients in these regions. We conducted an oral cancer screening in BQ-chewing endemic rural areas in South Myanmar for the early detection of oral cancer in BQ-chewing and smoking individuals. We examined 105 subjects who were at high risk of oral cancer due to their oral habits (BQ users and/or smokers). Three carcinoma cases were detected, and there were 8 dysplasia cases. The carcinoma detection rate was 2.9%, and the carcinoma and precancerous lesion detection rate was 10.5%. In Myanmar, oral cancer screening has been conducted sporadically on a voluntary basis, and nationwide surveys have never been performed. There are also few reports of oral cancer screening for high-risk groups among the general population in Myanmar. Our present findings highlight the need for further screening and surveys. Education on betel quid chewing- and tobacco- related oral diseases and screening for the early detection of oral cancer are of the utmost importance in the control and prevention of oral cancer. No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 38 2016 地球環境問題と環境マネジメント 1 1 EN Shin-ichi Nishimura No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 129 1 2017 第47回　岡山リウマチ研究会 65 68 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 第7 回日本血液学会（IJH）国際シンポジウム報告 243 244 EN Mitsune Tanimoto Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 高梁市国民健康保険成羽病院 241 242 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 バイオバンク 237 239 EN Mizuki Morita Department of Biorepository Research and Networking, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinichi Toyooka Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 薬物相互作用（37―新規Ｃ型肝炎治療薬の相互作用） 231 235 EN Masashi Miyamoto Department of Pharmacy, Okayama University Hospital Satoru Esumi Department of Pharmacy, Okayama University Hospital Yoshihisa Kitamura Department of Pharmacy, Okayama University Hospital Toshiaki Sendo Department of Pharmacy, Okayama University Hospital No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 Q12・Q13・Q14 227 229 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 模擬患者（SP）参加型教育の実践 221 225 EN Toshiko Yoshida Center for the Development of Medical and Health Care Education（ Dental Education）, Okayama University No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 総合診療棟（Ⅱ期）新営工事に伴う臨床研究中核病院（医療法上）に向けた整備について 217 220 EN Yasutomo Nasu The Office for Innovative Medicine, Organization for Research Promotion & Collaboration, Okayama University No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 リンパ節転移を伴う甲状腺癌を疑ったIgG4関連甲状腺炎（準確診群）の1 切除例 213 216 EN Kenta Kobashi Department of Surgery, Saiseikai Saijo Hospital Hiroshi Ishii Department of Surgery, Saiseikai Saijo Hospital Kanako Nishiyama Breast Center, Ehime University Hospital Yuki Matsumi Department of Surgery, Saiseikai Saijo Hospital Masahide Hatano Department of Surgery, Saiseikai Saijo Hospital Masamitsu Fujiwara Department of Surgery, Imabariishikaishimin Hospital Tatsuo Kurokawa Department of Surgery, Saiseikai Saijo Hospital Kensuke Tsunemitsu Department of Surgery, Saiseikai Saijo Hospital 　We present a case of probably IgG4-related thyroiditis with lymphadenopathy. The patient was a 70-year-old Japanese female who was undergoing hemodialysis and had undergone a right hemi-thyroidectomy in 1989 due to carcinoma. In December 2010, an ultrasonography study revealed a hypoechoic small lesion in thyroid gland. When the patient was admitted to our hospital in November 2013, the lesion and regional lymph nodes had enlarged and we suspected that they were metastatic thyroid cancer. We performed a residual total thyroidectomy and regional lymph node dissection in August 2014. At that time, lymphoplasmacytic infiltration and fibrosis were observed histopathologically in thyroid tissue. Immunohistochemical studies revealed infiltrated lymphocytes and plasma cells were markedly IgG-positive, and the ratio of IgG4-positive to IgG-positive cells was over 40%. We therefore diagnosed the patient with IgG4-related thyroiditis. The cervical lymph nodes were metastases of papillary carcinoma from 25 years earlier. The patient remains well without any recurrences 33 months after the surgery. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 集学的治療により長期生存が得られた食道神経内分泌癌の2 例 207 212 EN Tatsuhiro Gotoda Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Seiji Kawano Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Yoshiyasu Kono Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Kou Miura Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Hiromitsu Kanzaki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Yoshiro Kawahara Department of Endoscopy, Okayama University Hospital Takehiro Tanaka Department of Pathology, , Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Tadashi Yoshino Department of Pathology, , Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Yasuhiro Shirakawad Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Masahiro Tabata Department of Hematology and Oncology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Mitsune Tanimoto Department of Hematology and Oncology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine， Dentistry and Pharmaceutical Sciences 　Esophageal neuroendocrine carcinoma （ECC） is rare and has a poor prognosis when presenting with vascular invasion and distant metastasis from an early stage. Multidisciplinary therapy with surgery, chemotherapy, and radiation therapy may prolong survival in patients with advanced ECC, but there is as yet no standard therapy for advanced ECC. We treated two patients who have achieved long-term survival （＞ 4 years） who underwent multidisciplinary therapy, including chemotherapy, for ECC. Our experience with these two cases suggests that multidisciplinary therapy, including chemotherapy, may be effective for treating ECC at an advanced stage. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 3 年間の内視鏡所見の変化を観察できた食道異所性皮脂腺の1 例 201 205 EN Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Keita Harada Department of Endoscopy, Okayama University Hospital Hiromitsu Kanzaki Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Keisuke Hori Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masahide Kita Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Seiji Kawano Department of Endoscopy, Okayama University Hospital Yoshiro Kawahara Department of Endoscopy, Okayama University Hospital Takehiro Tanaka Department of Pathology, Okayama University Hospital Kazuhide Yamamoto Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences A 43-year-old Japanese woman was diagnosed with ectopic sebaceous glands in the esophagus by esophagogastroduodenoscopy and biopsy. At the age of 46, typical ectopic sebaceous glands were recognized in the upper esophagus, whereas yellowish white granules were faintly observed in the lower esophagus. Esophagogastroduodenoscopy examinations were repeated when she was 47 and again at 50 years old, and the lesions in the lower esophagus had become more evident over the ensuing 3 years. Esophageal ectopic sebaceous glands are relatively infrequent, and there have been few case reports describing the progression of the endoscopic features. We also report the clinical and endoscopic features of the five similar cases with pathologically proven ectopic sebaceous glands in the esophagus. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 プレガバリン内服困難となった後にリドカイン塩酸塩静注が奏功した転移性癌浸潤による神経障害性疼痛の一例 197 199 EN Mitsuhisa Kunisue Tsubasa Clinic Okayama The concomitant administration of adjuvant analgesics is recommended for neuropathic pain due to metastatic invasive cancer, because such pain may respond poorly to analgesic agents such as non-opioid analgesics and opioids. We report the case of a 44-year-old female patient with severe pain caused by a lumbosacral plexus injury associated with a failure of oral pregabalin（ 200 mg daily for 2 weeks）. We administered lidocaine hydrochloride（ drip infusion 960 mg/day）, which successfully relieved the pain. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 岡山大学病院頭頸部がんセンターにおける医科歯科合同手術の現状解析とその意義 191 196 EN Nobuyoshi Mizukawa Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Tomoo Onoda Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Hiroshi Matsumoto Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Seiko Takeda Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Youhei Noda Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Satoshi Onoda Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Mai Fukushima Departments of Oral and Maxillofacial Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Munechika Tsumura Departments of Otorhinolaryngology, Head and Neck Surgery, Head and Neck Cancer Center, Okayama University Hospital Tetsuo Takeuchi Departments of Dental Laboratory, Head and Neck Cancer Center, Okayama University Hospital Narushi Sugiyama Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital Yoshihiro Kimata Departments of Plastic and Reconstructive Surgery, Head and Neck Cancer Center, Okayama University Hospital 　　We have been collaborating with head and neck surgeons, plastic surgeons and oral surgeons in surgeries for many patients with head and neck carcinomas（ especially oral carcinomas） since 2006（ fiscal year 2005）. The Head and Neck Cancer Center was established at Okayama University Hospital in 2012. 　This Center was the first of its kind at a national university hospital in Japan. 　At the Center, 174 operations on head and neck carcinomas and 96 reconstructive operations were performed in 2014（ fiscal year）. 　Medical and dental collaborative operations have been increasing almost every year since the 2005 fiscal year. There were 45 collaborative operations in the 2014 fiscal year, which included 30 cases of bone or metal plate reconstruction or plate reinforcement of the jaws. 　There were 76 medical and dental collaborative operations in the 7 years before the establishment of the Center, with a mean of 10.9 operations per year. Since the establishment of the Center, there have been 112 cases over 3 years with a mean of 37.3 operations per year. The number of surgeries has been markedly increased by the establishment of the Head and Neck Cancer Center. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 脳波：小児てんかんにおける古くて新しい検査 183 189 EN Katsuhiro Kobayashi Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 平成27年度岡山医学会賞がん研究奨励賞（林原賞・山田賞） 179 182 EN Kunitoshi Shigeyasu Baylor University Medical Center No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 平成27年度岡山医学会賞脳神経研究奨励賞（新見賞） 175 178 EN Ryoichi Mizoue Emergency Center and Critical Care Unit, Tsuyama Chuo Hospital No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 平成27年度岡山医学会賞胸部・循環研究奨励賞（砂田賞） 171 174 EN Nobuyuki Nosaka Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 3 2016 平成27年度岡山医学会賞総合研究奨励賞（結城賞） 165 169 EN Hideaki Fujiwara University of Michigan No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2045-2322 5 2015 The molecular mechanism of photochemical internalization of cell penetrating peptide-cargo-photosensitizer conjugates. 18577 18577 EN Takashi Ohtsuki Department of Medical Bioengineering, Okayama University Shunya Miki Department of Medical Bioengineering, Okayama University Shouhei Kobayashi Advanced ICT Research Institute Kobe, NICT Tokuko Haraguchi Advanced ICT Research Institute Kobe, NICT Eiji Nakata Institute of Advanced Energy, Kyoto University Kazutaka Hirakawa Department of Applied Chemistry and Biochemical Engineering, Graduate School of Engineering, Shizuoka University Kensuke Sumita Department of Medical Bioengineering, Okayama University Kazunori Watanabe Department of Medical Bioengineering, Okayama University Shigetoshi Okazaki Department of Medical Spectroscopy, Hamamatsu University School of Medicine In many drug delivery strategies, an inefficient transfer of macromolecules such as proteins and nucleic acids to the cytosol often occurs because of their endosomal entrapment. One of the methods to overcome this problem is photochemical internalization, which is achieved using a photosensitizer and light to facilitate the endosomal escape of the macromolecule. In this study, we examined the molecular mechanism of photochemical internalization of cell penetrating peptide-cargo (macromolecule)-photosensitizer conjugates. We measured the photophysical properties of eight dyes (photosensitizer candidates) and determined the respective endosomal escape efficiencies using these dyes. Correlation plots between these factors indicated that the photogenerated (1)O2 molecules from photosensitizers were highly related to the endosomal escape efficiencies. The contribution of (1)O2 was confirmed using (1)O2 quenchers. In addition, time-lapse fluorescence imaging showed that the photoinduced endosomal escape occurred at a few seconds to a few minutes after irradiation (much longer than (1)O2 lifetime), and that the pH increased in the endosome prior to the endosomal escape of the macromolecule. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2041-1723 7 2016 Phototriggered protein syntheses by using (7-diethylaminocoumarin-4-yl)methoxycarbonyl-caged aminoacyl tRNAs 12501 12501 EN Takashi Ohtsuki Department of Biomedical Engineering, Okayama University Shigeto Kanzaki Department of Biomedical Engineering, Okayama University Sae Nishimura Department of Biomedical Engineering, Okayama University Yoshio Kunihiro Department of Biomedical Engineering, Okayama University Masahiko Sisido Department of Biomedical Engineering, Okayama University Kazunori Watanabe Department of Biomedical Engineering, Okayama University The possibility of spatiotemporally photocontrolling translation holds considerable promise for studies on the biological roles of local translation in cells and tissues. Here we report caged aminoacyl-tRNAs (aa-tRNAs) synthesized using a (7-diethylaminocoumarin-4-yl)methoxycarbonyl (DEACM)-cage compound. DEACM-caged aa-tRNA does not spontaneously deacylate for at least 4 h in neutral aqueous solution, and does not bind to the elongation factor Tu. On irradiation at ∼405 nm at 125 mW cm(-2), DEACM-aa-tRNA is converted into active aa-tRNA with a half-life of 19 s. Notably, this rapid uncaging induced by visible light does not impair the translation system. Translation is photoinduced when DEACM-aa-tRNA carrying a CCCG or a CUA anticodon is uncaged in the presence of mRNAs harbouring a CGGG four-base codon or a UAG amber codon, respectively. Protein synthesis is phototriggered in several model systems, including an in vitro translation system, an agarose gel, in liposomes and in mammalian cells. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 2 2016 特定医療法人竹下会竹下病院 149 150 EN No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2016 Sound collection systems using a crowdsourcing approach to construct sound map based on subjective evaluation EN Sunao Hara Graduate school of Natural Science and Technology, Okayama University Shota Kobayashi Graduate school of Natural Science and Technology, Okayama University Masanobu Abe Graduate school of Natural Science and Technology, Okayama University This paper presents a sound collection system that uses crowdsourcing to gather information for visualizing area characteristics. First, we developed a sound collection system to simultaneously collect physical sounds, their statistics, and subjective evaluations. We then conducted a sound collection experiment using the developed system on 14 participants. We collected 693,582 samples of equivalent Aweighted loudness levels and their locations, and 5,935 samples of sounds and their locations. The data also include subjective evaluations by the participants. In addition, we analyzed the changes in sound properties of some areas before and after the opening of a large-scale shopping mall in a city. Next, we implemented visualizations on the server system to attract users’ interests. Finally, we published the system, which can receive sounds from any Android smartphone user. The sound data were continuously collected and achieved a specified result. No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 裏表紙 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 奥付 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 編集後記 56 56 EN Yasushi Mori No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 教職員名簿 55 55 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 投稿規定 54 54 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 平成26年度業務報告 47 53 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 対外活動報告 44 46 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 教育・研究活動報告 27 43 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 音と色との関わりを意識した季節感の比較表現に関する学際的授業（冬を挟む日本の季節進行の非対称性に注目して） 16 26 EN Kuranoshin Kato Haruko Kato Rikako Akagi Yoshihiko Inada This study is a part of the activity to develop an interdisciplinary class on the climate environment around the Japan Islands and the “seasonal feeling”, succeeding to Kato et al. (2014). In the class at the Faculty of Education, Okayama University in 2014, the comparative expression of the seasonal feelings between early winter and early spring was made, with attention to the asymmetric seasonal march from autumn to the next spring pointed out by Kato et al. (2013). The students tried the expression firstly with combination of the colored papers based on the Johannes Itten’s (1888-1967) exercise, next with use of the small percussion instruments, and finally with the colored papers again. Analyses of the students’ works suggested the deepening of the expressions on different seasonal feelings between early winter and early spring by the interaction of the art and music activities with each other, such as the music expressions with imaging colors or superposition of the tones at the second activity, the art expressions influenced by the music works in selecting the configurations or combination of the colored papers at the third activity, and so on. It is also interesting that the students’ expressions of the seasonal feelings seem to be reflected by not only the mean seasonal state but also some specified factors in the seasonal march. No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 平成27 年度環境管理センター公開講演会「地球温暖化と気候変動が関わるリスク」 3 15 EN Yasuhiko Benino No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 有害物質に対する「制御」を考える 1 2 EN Katsuya Kawamoto No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 目次 EN No potential conflict of interest relevant to this article was reported.

岡山大学環境管理センター Acta Medica Okayama 0917-1533 37 2016 表紙 EN No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2016 Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of　Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study EN Yoshiyasu Kono No potential conflict of interest relevant to this article was reported.

Macmillan Publishers Limited. Acta Medica Okayama 2045-2322 6 2016 Chemical control of xylem differentiation by thermospermine, xylemin, and auxin 21487 EN Kaori Yoshimoto Hiroyoshi Takamura Isao Kadota Hiroyasu Motose Department of Biological Science, Graduate School of Natural Science and Technology, Okayama University Taku Takahashi The xylem conducts water and minerals from the root to the shoot and provides mechanical strength to the plant body. The vascular precursor cells of the procambium differentiate to form continuous vascular strands, from which xylem and phloem cells are generated in the proper spatiotemporal pattern. Procambium formation and xylem differentiation are directed by auxin. In angiosperms, thermospermine, a structural isomer of spermine, suppresses xylem differentiation by limiting auxin signalling. However, the process of auxin-inducible xylem differentiation has not been fully elucidated and remains difficult to manipulate. Here, we found that an antagonist of spermidine can act as an inhibitor of thermospermine biosynthesis and results in excessive xylem differentiation, which is a phenocopy of a thermospermine-deficient mutant acaulis5 in Arabidopsis thaliana. We named this compound xylemin owing to its xylem-inducing effect. Application of a combination of xylemin and thermospermine to wild-type seedlings negates the effect of xylemin, whereas co-treatment with xylemin and a synthetic proauxin, which undergoes hydrolysis to release active auxin, has a synergistic inductive effect on xylem differentiation. Thus, xylemin may serve as a useful transformative chemical tool not only for the study of thermospermine function in various plant species but also for the control of xylem induction and woody biomass production. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 6 2016 Insufficiency of phosphatidylethanolamine N-methyltransferase is risk for lean non-alcoholic steatohepatitis 21721 EN Atsuko Nakatsuka Makoto Matsuyama Satoshi Yamaguchi Akihiro Katayama Jun Eguchi Kazutoshi Murakami Sanae Teshigawara Daisuke Ogawa Nozomu Wada Tetsuya Yasunaka Fusao Ikeda Akinobu Takaki Eijiro Watanabe Jun Wada 　Although obesity is undoubtedly major risk for non-alcoholic steatohepatitis (NASH), the presence of lean NASH patients with normal body mass index has been recognized. Here, we report that the insufficiency of phosphatidylethanolamine N-methyltransferase (PEMT) is a risk for the lean NASH. The Pemt－/－ mice fed high fat-high sucrose (HFHS) diet were protected from diet-induced obesity and diabetes, while they demonstrated prominent steatohepatitis and developed multiple liver tumors. Pemt exerted inhibitory effects on p53-driven transcription by forming the complex with clathrin heavy chain and p53, and Pemt－/－ mice fed HFHS diet demonstrated prominent apoptosis of hepatocytes. Furthermore, hypermethylation and suppressed mRNA expression of F-box protein 31 and hepatocyte nuclear factor 4α resulted in the prominent activation of cyclin D1. PEMT mRNA expression in liver tissues of NASH patients was significantly lower than those with simple steatosis and we postulated the distinct clinical entity of lean NASH with insufficiency of PEMT activities. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2015 A Spoken Dialog System with Redundant Response to Prevent User Misunderstanding 223 226 EN Masaki Yamaoka Sunao Hara Masanobu Abe We propose a spoken dialog strategy for car navigation systems to facilitate safe driving. To drive safely, drivers need to concentrate on their driving; however, their concentration may be disrupted due to disagreement with their spoken dialog system. Therefore, we need to solve the problems of user misunderstandings as well as misunderstanding of spoken dialog systems. For this purpose, we introduced a driver workload level in spoken dialog management in order to prevent user misunderstandings. A key strategy of the dialog management is to make speech redundant if the driver’s workload is too high in assuming that the user probably misunderstand the system utterance under such a condition. An experiment was conducted to compare performances of the proposed method and a conventional method using a user simulator. The simulator is developed under the assumption of two types of drivers: an experienced driver model and a novice driver model. Experimental results showed that the proposed strategies achieved better performance than the conventional one for task completion time, task completion rate, and user’s positive speech rate. In particular, these performance differences are greater for novice users than for experienced users. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 6 2016 Molecular evolution of gas cavity in [NiFeSe] hydrogenases resurrected in silico 19742 EN Takashi Tamura Naoki Tsunekawa Michiko Nemoto Kenji Inagaki Toshiyuki Hirano Fumitoshi Sato Oxygen tolerance of selenium-containing [NiFeSe] hydrogenases (Hases) is attributable to the high reducing power of the selenocysteine residue, which sustains the bimetallic Ni–Fe catalytic center in the large subunit. Genes encoding [NiFeSe] Hases are inherited by few sulphate-reducing δ-proteobacteria globally distributed under various anoxic conditions. Ancestral sequences of [NiFeSe] Hases were elucidated and their three-dimensional structures were recreated in silico using homology modelling and molecular dynamic simulation, which suggested that deep gas channels gradually developed in [NiFeSe] Hases under absolute anaerobic conditions, whereas the enzyme remained as a sealed edifice under environmental conditions of a higher oxygen exposure risk. The development of a gas cavity appears to be driven by non-synonymous mutations, which cause subtle conformational changes locally and distantly, even including highly conserved sequence regions. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 5 2015 Beneficial impact of Gpnmb and its significance as a biomarker in nonalcoholic steatohepatitis 16920 EN Akihiro Katayama Atsuko Nakatsuka Jun Eguchi Kazutoshi Murakami Sanae Teshigawara Motoko Kanzaki Tomokazu Nunoue Kazuyuki Hida Nozomu Wada Tetsuya Yasunaka Fusao Ikeda Akinobu Takaki Kazuhide Yamamoto Hiroshi Kiyonari Hirofumi Makino Jun Wada Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Gpnmb is classified as a type 1 membrane protein and its soluble form is secreted by ADAM10-mediated cleavage. Gpnmb mRNA was found in the Kupffer cells and white adipose tissues (WATs) and its upregulation in obesity was recently found. Here, we generated aP2 promoter-driven Gpnmb transgenic (Tg) mice and the overexpression of Gpnmb ameliorated the fat accumulation and fibrosis of the liver in diet-induced obesity model. Soluble form of Gpnmb in sera was elevated in Gpnmb Tg mice and Gpnmb concentrated in hepatic macrophages and stellate cells interacted with calnexin, which resulted in the reduction of oxidative stress. In the patients with non-alcoholic steatohepatitis, serum soluble GPNMB concentrations were higher compared with the patients with simple steatosis. The GPNMB is a promising biomarker and therapeutic target for the development and progression of NAFLD in obesity. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 5 2015 Metamaterial Absorbers for Infrared Detection of Molecular Self-Assembled Monolayers 12570 EN Atsushi Ishikawa Takuo Tanaka The emerging field of plasmonic metamaterials has introduced new degree of freedom to manipulate optical field from nano to macroscopic scale, offering an attractive platform for sensing applications. So far, metamaterial sensor concepts, however, have focused on hot-spot engineering to improve the near-field enhancement, rather than fully exploiting tailored material properties. Here, we present a novel spectroscopic technique based on the metamaterial infrared (IR) absorber allowing for a low-background detection scheme as well as significant plasmonic enhancement. Specifically, we experimentally demonstrate the resonant coupling of plasmonic modes of a metamaterial absorber and IR vibrational modes of a molecular self-assembled monolayer. The metamaterial consisting of an array of Au/MgF2/Au structures exhibits an anomalous absorption at ~3000 cm－1, which spectrally overlaps with C-H stretching vibrational modes. Symmetric/asymmetric C-H stretching modes of a 16-Mercaptohexadecanoic acid monolayer are clearly observed as Fano-like anti-resonance peaks within a broad plasmonic absorption of the metamaterial. Spectral analysis using Fano line-shape fitting reveals the underlying resonant interference in plasmon-molecular coupled systems. Our metamaterial approach achieves the attomole sensitivity with a large signal-to-noise ratio in the far-field measurement, thus may open up new avenues for realizing ultrasensitive IR inspection technologies. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 5 2015 Peptide-modified Substrate for Modulating Gland Tissue Growth and Morphology In Vitro 11468 EN Hiroaki Taketa Ara Sathi Gulsan Farahat Mahmoud Anisur Rahman Kazi Takayoshi Sakai Yoshiaki Hirano Takuo Kuboki Yasuhiro Torii Takuya Matsumoto In vitro fabricated biological tissue would be a valuable tool to screen newly synthesized drugs or understand the tissue development process. Several studies have attempted to fabricate biological tissue in vitro. However, controlling the growth and morphology of the fabricated tissue remains a challenge. Therefore, new techniques are required to modulate tissue growth. RGD (arginine-glycine-aspartic acid), which is an integrin-binding domain of fibronectin, has been found to enhance cell adhesion and survival; it has been used to modify substrates for in vitro cell culture studies or used as tissue engineering scaffolds. In addition, this study shows novel functions of the RGD peptide, which enhances tissue growth and modulates tissue morphology in vitro. When an isolated submandibular gland (SMG) was cultured on an RGD-modified alginate hydrogel sheet, SMG growth including bud expansion and cleft formation was dramatically enhanced. Furthermore, we prepared small RGD-modified alginate beads and placed them on the growing SMG tissue. These RGD-modified beads successfully induced cleft formation at the bead position, guiding the desired SMG morphology. Thus, this RGD-modified material might be a promising tool to modulate tissue growth and morphology in vitro for biological tissue fabrication. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2041-1723 5 2014 TRPV2 is critical for the maintenance of cardiac structure and function in mice 3932 EN Yuki Katanosaka Keiichiro Iwasaki Yoshihiro Ujihara Satomi Takatsu Koki Nishitsuji Motoi Kanagawa Atsushi Sudo Tatsushi Toda Kimiaki Katanosaka Satoshi Mohri Keiji Naruse The heart has a dynamic compensatory mechanism for haemodynamic stress. However, the molecular details of how mechanical forces are transduced in the heart are unclear. Here we show that the transient receptor potential, vanilloid family type 2 (TRPV2) cation channel is critical for the maintenance of cardiac structure and function. Within 4 days of eliminating TRPV2 from hearts of the adult mice, cardiac function declines severely, with disorganization of the intercalated discs that support mechanical coupling with neighbouring myocytes and myocardial conduction defects. After 9 days, cell shortening and Ca2+ handling by single myocytes are impaired in TRPV2-deficient hearts. TRPV2-deficient neonatal cardiomyocytes form no intercalated discs and show no extracellular Ca2+-dependent intracellular Ca2+ increase and insulin-like growth factor (IGF-1) secretion in response to stretch stimulation. We further demonstrate that IGF-1 receptor/PI3K/Akt pathway signalling is significantly downregulated in TRPV2-deficient hearts, and that IGF-1 administration partially prevents chamber dilation and impairment in cardiac pump function in these hearts. Our results improve our understanding of the molecular processes underlying the maintenance of cardiac structure and function. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 5 2015 A subset of ocular adnexal marginal zone lymphomas may arise in association with IgG4-related disease 13539 EN Ohno Kyotaro Sato Yasuharu Ohshima Koh-ichi Takata Katsuyoshi Miyata-Takata Tomoko Takeuchi Mai Gion Yuka Tachibana Tomoyasu Orita Yorihisa Ito Toshihiro H. Swerdlow Steven Yoshino Tadashi We previously suggested a relationship between ocular immunoglobulin (Ig)G4-related disease (IgG4-RD) and marginal zone lymphomas (MZLs). However, the cytokine background associated with these disorders and whether it differs between ocular adnexal MZLs with (IgG4-associated MZL) and without (IgG4-negative MZL) numerous IgG4+ plasma cells are unknown. In this study, we identified the mRNA expression pattern of Th2 and regulatory T-cell (Treg) cytokines in IgG4-RD and in IgG4-associated MZL and IgG4-negative MZL using real-time polymerase chain reaction analysis. Ocular IgG4-RD and IgG4-associated MZL exhibited significantly higher expression ratios of interleukin (IL)-4/β-actin, IL-10/β-actin, IL-13/β-actin, transforming growth factor (TGF) β1/β-actin, and FOXP3/β-actin than did IgG4-negative MZL (p < 0.05). This finding further supports our prior observations that a significant subset of ocular MZLs arises in the setting of IgG4-RD. Furthermore, the presence of a different inflammatory background in IgG4-negative MZLs suggests that IgG4-associated MZLs may have a different pathogenesis. No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2045-2322 5 2015 Regulation of the unfolded protein response via S-nitrosylation of sensors of endoplasmic reticulum stress 14812 EN Nakato Ryosuke Ohkubo Yu Konishi Akari Shibata Mari Kaneko Yuki Iwawaki Takao Nakamura Tomohiro Lipton Stuart A. Uehara Takashi Protein S-nitrosylation modulates important cellular processes, including neurotransmission, vasodilation, proliferation, and apoptosis in various cell types. We have previously reported that protein disulfide isomerase (PDI) is S-nitrosylated in brains of patients with sporadic neurodegenerative diseases. This modification inhibits PDI enzymatic activity and consequently leads to the accumulation of unfolded/misfolded proteins in the endoplasmic reticulum (ER) lumen. Here, we describe S-nitrosylation of additional ER pathways that affect the unfolded protein response (UPR) in cell-based models of Parkinson's disease (PD). We demonstrate that nitric oxide (NO) can S-nitrosylate the ER stress sensors IRE1α and PERK. While S-nitrosylation of IRE1α inhibited its ribonuclease activity, S-nitrosylation of PERK activated its kinase activity and downstream phosphorylation/inactivation or eIF2α. Site-directed mutagenesis of IRE1α(Cys931) prevented S-nitrosylation and inhibition of its ribonuclease activity, indicating that Cys931 is the predominant site of S-nitrosylation. Importantly, cells overexpressing mutant IRE1α(C931S) were resistant to NO-induced damage. Our findings show that nitrosative stress leads to dysfunctional ER stress signaling, thus contributing to neuronal cell death. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 2 2015 佐藤病院 159 160 EN No potential conflict of interest relevant to this article was reported.

Nature Publishing Group Acta Medica Okayama 2041-1723 6 2015 AtPHT4;4 is a chloroplast-localized ascorbate transporter in Arabidopsis EN Takaaki Miyaji Takashi Kuromori Yu Takeuchi Naoki Yamaji Kengo Yokosho Atsushi Shimazawa Eriko Sugimoto Hiroshi Omote Jian Feng Ma Kazuo Shinozaki Yoshinori Moriyama Ascorbate is an antioxidant and coenzyme for various metabolic reactions in vivo. In plant chloroplasts, high ascorbate levels are required to overcome photoinhibition caused by strong light. However, ascorbate is synthesized in the mitochondria and the molecular mechanisms underlying ascorbate transport into chloroplasts are unknown. Here we show that AtPHT4;4, a member of the phosphate transporter 4 family of Arabidopsis thaliana, functions as an ascorbate transporter. In vitro analysis shows that proteoliposomes containing the purified AtPHT4;4 protein exhibit membrane potential- and Cl-dependent ascorbate uptake. The AtPHT4;4 protein is abundantly expressed in the chloroplast envelope membrane. Knockout of AtPHT4;4 results in decreased levels of the reduced form of ascorbate in the leaves and the heat dissipation process of excessive energy during photosynthesis is compromised. Taken together, these observations indicate that the AtPHT4;4 protein is an ascorbate transporter at the chloroplast envelope membrane, which may be required for tolerance to strong light stress. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 平成26年度岡山医学会賞が決まる 83 85 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 第45回　岡山リウマチ研究会 79 82 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 第９回臨床ストレス応答学会大会開催報告 73 74 EN Heiichiro Udono No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 藤井病院 67 68 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 薬物相互作用 (32―新規経口抗凝固薬における薬物相互作用） 59 61 EN Hiromi Ida Yoshihisa Kitamura Toshiaki Sendo No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 鼻アレルギー診療ガイドライン―通年性鼻炎と花粉症― 55 57 EN Seiichiro Makihara Mitsuhiro Okano No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 岡山大学医療教育統合開発センターの医療教育に対する取り組み 51 54 EN Naoki Shiba No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 REIC/Dkk-3遺伝子発現アデノウイルスベクターを用いた悪性胸膜中皮腫に対する遺伝子治療 47 50 EN Shinichi Toyooka No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 アンメットメディカルニーズを克服するためのプロジェクト「進行・再発乳癌に対するドセタキセル100㎎/㎡の第Ⅰ相試験」 41 45 EN Taizo Hirata No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 胆嚢十二指腸瘻に対し合併症なく手術を行えた発作性夜間血色素尿症の１例 35 39 EN Takuya Kato Hiroyoshi Matsukawa Shigehiro Shiozaki Tomokazu Fuji Yasuhiro Fujiwara Motoki Ninomiya 　In cases of paroxysmal nocturnal hemoglobinuria (PNH), attention must be paid to potential complications such as thrombosis and hemolysis due to perioperative stress and infection from complement activation. Here we present the case of a 61-year-old Japanese woman with PNH. We made the diagnosis of PNH when she was 28 years old, and we administered repeated steroid medication and erythrocyte transfusion. The patient's cholecystocholedocholithiasis with a cholecystoduodenal fistula was diagnosed based on a survey of the right hypochondriac pain. We performed endoscopic nasobiliary drainage (ENBD) for the prophylaxis of perioperative infection, plus a cholecystectomy and fistulectomy. There were no complications, including hemolysis attack, infection, thrombosis with irrigation erythrocyte transfusion, steroid cover, or the need for heparin administration during the perioperative period. The reduction of the complement activation is necessary in the perioperative management of PNH patients. The prevention of the development of acidosis and hypoxemia, the selection of washed red blood cells, steroid use, appropriate infection measures and thrombosis prophylaxis are all important for the prevention of complications. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 恥骨上腹壁瘢痕ヘルニアに対して腹腔鏡下修復術を施行した１例 31 34 EN Kanyu Nakano Hitoshi Idani Shinya Asami Hiro Ookawa Masashi Yoshimoto Atene Ito Kazuteru Monden Yohei Kurose Masayoshi Hioki Tatsuhiro Ishii Hiroshi Sadamori Satoshi Oono Hitoshi Kin Norihisa Takakura 　　Laparoscopic repair of a suprapubic hernia typically carries a high risk of recurrence, because fixation of the mesh in the peripubic area is difficult. We herein report a patient undergoing laparoscopic repair of a suprapubic hernia, along with a description of the surgical techniques employed. 　A 78-year-old woman visited our hospital with a chief complaint of swelling at the median hypogastric incision site after surgery for an ovarian cyst performed at age 25 years. Laparoscopic examination revealed the hernia orifice to be 3.5×3.0 cm in size and that the distance between the caudal margin of the hernia orifice and the pubis was 2.5 cm. Parietex composite mesh was used for fixation through all layers of the abdominal wall with non-absorbable sutures and tack fixation. On the pubic side, after the pubis had been exposed by separating it from the bladder, we performed mesh fixation through all layers of the abdominal wall immediately above the pubis with the sutures placed inside the mesh, combined with tack mesh fixation directly to the pubis. This procedure enabled definite fixation of the mesh. Six days after surgery, she was discharged without complications. To date, two years and five months after surgery, no recurrence has been observed. No potential conflict of interest relevant to this article was reported.

岡山大学農学部 Acta Medica Okayama 2186-7755 104 2015 施設栽培における潜熱利用に関するコンピュータ利用技術の開発 49 53 EN Ken-ichiro Yasuba 　In protected horticulture, cooling techniques with latent heat has been effective for improving the growth of various kinds of plants in the summer season. It was necessary to understand special knowledge of the VETH diagrammatic drawing for effective operation of cooling with latent heat. In order to obtain the information from VETH diagrammatic drawing, it was necessary to perform a lot of calculations. It was difficult to obtain such information simply. So, a device and software were developed for getting effective information in order to manage cooling of latent heat. The developed device and software were run on the Ubiquitous Environment Control System (UECS). The rules for controlling the environment of UECS was were set up on a web site, and an information communication technique was used for controlling the environment. The developed ventilation calculated node gathered the necessary information from the other nodes via LAN automatically. The node calculated valuable information for cooling with latent heat, including the ventilation rate, and sent the calculated values, after entering the constant parameters using an http server, which was installed in the node. The developed software was run on a personal computer. The software could be used after describing various information for calculating ventilation rate and evaporation rate at the setting file. It calculated these values, and users were shown the data using graphs and text files. As a result, we could get effective information concerning cooling latent heat fairly easily by using of the developed node and the software. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2045-2322 4 2014 A novel, visible light-induced, rapidly cross-linkable gelatin scaffold for osteochondral tissue engineering EN Tetsuro Mazaki Yasuyuki Shiozaki Kentaro Yamane Aki Yoshida Mariko Nakamura Yasuhiro Yoshida Di Zhou Takashi Kitajima Masato Tanaka Yoshihiro Ito Toshifumi Ozaki Akihiro Matsukawa Osteochondral injuries remain difficult to repair. We developed a novel photo-cross-linkable furfurylamine-conjugated gelatin (gelatin-FA). Gelatin-FA was rapidly cross-linked by visible light with Rose Bengal, a light sensitizer, and was kept gelled for 3 weeks submerged in saline at 37 degrees C. When bone marrow-derived stromal cells (BMSCs) were suspended in gelatin-FA with 0.05% Rose Bengal, approximately 87% of the cells were viable in the hydrogel at 24 h after photo-cross-linking, and the chondrogenic differentiation of BMSCs was maintained for up to 3 weeks. BMP4 fusion protein with a collagen binding domain (CBD) was retained in the hydrogels at higher levels than unmodified BMP4. Gelatin-FA was subsequently employed as a scaffold for BMSCs and CBD-BMP4 in a rabbit osteochondral defect model. In both cases, the defect was repaired with articular cartilage-like tissue and regenerated subchondral bone. This novel, photo-cross-linkable gelatin appears to be a promising scaffold for the treatment of osteochondral injury. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 3 2014 小児急性中耳炎診療ガイドライン 241 243 EN Yuko Kataoka Kazunori Nishizaki No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 3 2014 慢性頭痛の診療ガイドライン 237 239 EN Tohru Matsuura Koji Abe No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2045-2322 4 2014 Functional tooth restoration by next-generation bio-hybrid implant as a bio-hybrid artificial organ replacement therapy EN Masamitsu Oshima Kaoru Inoue Kei Nakajima Tetsuhiko Tachikawa Hiromichi Yamazaki Tomohide Isobe Ayaka Sugawara Miho Ogawa Chie Tanaka Masahiro Saito Shohei Kasugai Teruko Takano-Yamamoto Takashi Inoue Katsunari Tezuka Takuo Kuboki Akira Yamaguchi Takashi Tsuji Bio-hybrid artificial organs are an attractive concept to restore organ function through precise biological cooperation with surrounding tissues in vivo. However, in bio-hybrid artificial organs, an artificial organ with fibrous connective tissues, including muscles, tendons and ligaments, has not been developed. Here, we have enveloped with embryonic dental follicle tissue around a HA-coated dental implant, and transplanted into the lower first molar region of a murine tooth-loss model. We successfully developed a novel fibrous connected tooth implant using a HA-coated dental implant and dental follicle stem cells as a bio-hybrid organ. This bio-hybrid implant restored physiological functions, including bone remodelling, regeneration of severe bone-defect and responsiveness to noxious stimuli, through regeneration with periodontal tissues, such as periodontal ligament and cementum. Thus, this study represents the potential for a next-generation bio-hybrid implant for tooth loss as a future bio-hybrid artificial organ replacement therapy. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2045-2322 4 2014 Identification of a mammalian vesicular polyamine transporter EN Miki Hiasa Takaaki Miyaji Yuka Haruna Tomoya Takeuchi Yuika Harada Sawako Moriyama Akitsugu Yamamoto Hiroshi Omote Yoshinori Moriyama Spermine and spermidine act as neuromodulators upon binding to the extracellular site(s) of various ionotropic receptors, such as N-methyl-d-aspartate receptors. To gain access to the receptors, polyamines synthesized in neurons and astrocytes are stored in secretory vesicles and released upon depolarization. Although vesicular storage is mediated in an ATP-dependent, reserpine-sensitive fashion, the transporter responsible for this process remains unknown. SLC18B1 is the fourth member of the SLC18 transporter family, which includes vesicular monoamine transporters and vesicular acetylcholine transporter. Proteoliposomes containing purified human SLC18B1 protein actively transport spermine and spermidine by exchange of H+. SLC18B1 protein is predominantly expressed in the hippocampus and is associated with vesicles in astrocytes. SLC18B1 gene knockdown decreased both SLC18B1 protein and spermine/spermidine contents in astrocytes. These results indicated that SLC18B1 encodes a vesicular polyamine transporter (VPAT). No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 68 5 2014 A New Classification System for Evaluating Patients with Severe Trauma Using B-type Natriuretic Peptide Levels and Estimated Glomerular Filtration Rate 285 290 EN Sunao Morisada Toyomu Ugawa Nobuyuki Nosaka Yoshihito Ujike Original Article 10.18926/AMO/52897 Current systems for the evaluation of trauma severity are tedious and difficult to apply in an actual emergency setting. We aimed to develop and assess the accuracy of a more efficient severity evaluation system, termed the Ugawa classification, using brain-type natriuretic peptide (BNP) measurement and the estimated glomerular filtration rate (eGFR). Two-hundred trauma patients were divided into 2 groups using an eGFR cut-off value of 90ml/min/1.73m2 as an indicator of normal renal function and 2 additional groups according to whether the BNP values were greater or less than the age in years. This resulted in 4 subject groups with different combinations of eGFR and BNP. The mean SOFA score, injury severity scores (ISS), trauma and injury severity scores (TRISS), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of the groups were compared by Kruskal-Wallis test, and the mortality rate after 90 days was calculated. Significant intergroup differences were found in SOFA scores, ISS scores, and APACHE II-predicted mortality rates. Although no significant differences were found in the mortality rate after 90 days or TRISS-predicted mortality rate among the 4 groups, there was a trend toward increasing trauma severity from group 1 to 4. Thus, the Ugawa classification is as accurate as existing systems, has greater efficiency, and is user-friendly. No potential conflict of interest relevant to this article was reported.

安全工学会 Acta Medica Okayama 0570-4480 53 5 2014 安全教育のため手の甲によるバルブ速度測定画像認識法 295 302 EN Hirotsugu MINOWA Yoshiomi MUNESAWA Kohei HASHIMOTO 　人的要因の事故を防止する為，仮想現実感を利用した訓練の実現が期待されている．仮想環境での訓練の利点は実環境に近い環境で訓練できる点にある．しかし，プラント内で基本操作であるバルブの操作をシステムへ伝えるユーザ・インタフェース（UIと省略）は現在なく，実環境に即した訓練ができない問題がある．　そこで本研究では，仮想環境におけるバルブ開操作訓練を実現するバルブ操作UI開発のため，バルブの丸ハンドルの回転速度を測定する画像認識手法を提案する．本手法はバルブの丸ハンドルを回す手から取得した光学的自然特徴点を利用する．本バルブ開操作UIはPC，Webカメラといった一般的な製品を用い平易に実現できる利点がある．　本手法は，評価実験で22.5-90deg/sを測定できる事を確認できたため，発火危険を想定したバルブ操作訓練のためのUIに適用できる事が明らかとなった． No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2045-2322 4 2014 Effects of hydrogen-rich water on aging periodontal tissues in rats EN Takaaki Tomofuji Yuya Kawabata Kenta Kasuyama Yasumasa Endo Toshiki Yoneda Mayu Yamane Tetsuji Azuma Daisuke Ekuni Manabu Morita Oxidative damage is involved in age-related inflammatory reactions. The anti-oxidative effects of hydrogen-rich water suppress oxidative damage, which may aid in inhibiting age-related inflammatory reactions. We investigated the effects of drinking hydrogen-rich water on aging periodontal tissues in healthy rats. Four-month-old male Fischer 344 rats (n = 12) were divided into two groups: the experimental group (hydrogen-rich water treatment) and the control group (distilled water treatment). The rats consumed hydrogen-rich water or distilled water until 16 months of age. The experimental group exhibited lower periodontal oxidative damage at 16 months of age than the control group. Although protein expression of interleukin-1 beta did not differ, gene expression of Nod-like receptor protein 3 inflammasomes was activated in periodontal tissues from the experimental group as compared with the control group. Drinking hydrogen-rich water is proposed to have anti-aging effects on periodontal oxidative damage, but not on inflammatory reactions in healthy rats. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 2 2014 舌下免疫療法 165 166 EN Mitsuhiro Okano No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 2 2014 慢性呼吸器疾患（COPD，気管支拡張症，陳旧性肺結核等）の気道感染症治療ガイドライン 151 153 EN Yasushi Tanimoto No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 2 2014 平成25年度岡山医学会賞胸部・循環研究奨励賞（砂田賞） 95 98 EN Atsuko Nakatsuka No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 平成25年度岡山医学会賞が決まる 79 80 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 第44回　岡山リウマチ研究会 75 77 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 第10回日本中性子捕捉療法学会学術大会報告 73 74 EN Hideki Matsui No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 日本鋼管福山病院 71 72 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 医療法人専心会西条市立周桑病院 69 70 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 重症熱性血小板減少症候群 65 67 EN Tokiko Watanabe Nobuchika Kusano Keiji Iwatsuki No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 薬物相互作用(29―ステロイドの薬物相互作用） 59 63 EN Youko Hayashi Hideki Nawa Yoshihisa Kitamura Toshiaki Sendo No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 てんかん治療ガイドラインについて 55 58 EN Nobutoshi Morimoto Koji Abe No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 白血病および白血病類縁疾患における分子標的治療 49 54 EN Yoshinobu Maeda Mitsune Tanimoto No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 腸重積で発症した結腸脂肪腫の１例 35 38 EN Takayuki Ninomiya Yasutomo Ojima Masao Harano Satoshi Ohno Shigehiro Shiozaki Motoki Ninomiya 　An 84-year-old man, who had been found to have a submucosal tumor in the ascending colon two years before, was admitted to our hospital for right lower quadrant abdominal pain and melena. An abdominal computed tomography (CT) scan showed intussusception in the ascending colon, resulting from a fat-density tumor. The intussusception was located by colonoscopy. Since the colonic tumor was enlarged in comparison with two years ago and had an ulcer at the top of the tumor, there was the possibility of malignancy and recurrence of intussusception. He underwent a laparoscopy-assisted right colectomy with lymph node dissection. Pathologically, the tumor of the ascending colon was a benign lipoma. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 著明な貧血と血小板減少と末梢血の異常細胞で発見された転移性乳癌の１例 31 34 EN Seisuke Ota Akinori Kasahara Shoma Mizuno Haruka Fukatsu Osamu Kinoshita Toshio Noguchi Nobuyasu Kishimoto Tadashi Matsumura 　Worldwide, breast cancer accounts for 22.9% of all cancers excluding non-melanoma skin cancers in women. More than 80% of breast cancer cases are discovered when a woman discovers a lump that feels different from the rest of the breast tissue. We report the case of a 60-year-old woman who had been treated for one year at a psychiatric hospital for suspected schizophrenia, and was referred to our hospital on March 23, 2011 for consultation regarding complete blood count abnormalities: hemoglobin, 4.8g/㎗ ; Plt, 1.9×104/μl ; WBC, 12,700/μl with 18.5% abnormal cells. Computed tomography revealed an enhanced, irregular mass in her right breast as well as right axillary lymph node swelling, suggestive of breast cancer. BM biopsy confirmed the presence of abnormal, keratin-positive cells, suggesting metastasis to the bone. CA15-3 was 300U/㎖ (normal range ＜25). The patient died on April 11, 2011, post-admission day 20. We found a rare case of terminal breast cancer that presented with peripheral blood abnormality. Breast cancer in patients who do not notice breast abnormality can present with peripheral blood abnormality. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 早期乳癌におけるOne-step Nucleic Acid Amplification(OSNA)法によるセンチネルリンパ節転移診断の検討 25 30 EN Taeko Mizoo Tadahiko Shien Maiko Ito Tomohiro Nogami Takayuki Iwamoto Takayuki Motoki Naruto Taira Junji Matsuoka Hiroyoshi Doihara 　Introduction: The one-step nucleic acid amplification (OSNA) assay is a new method to detect sentinel lymph node (SLN) metastases using cytokeratin 19 (CK19) mRNA in early breast cancer. Here we retrospectively analyzed the advantages and disadvantages of the OSNA assay. 　Methods: In a trial period, SLNs were divided into two sections, and we examined one side using the OSNA assay. The other side was examined by pathologists. After this period, we examined whole SLNs using only the OSNA assay. The patients with positive nodes by OSNA assay and/or pathology required axillary dissection. 　Results: We examined 27 primary breast cancer patients (36 SLNs) during the trial period. The overall concordance rate between the OSNA assay and pathology results was 91%. In the later period, 157 patients (217 SLNs) were examined. The CK19-positive rate obtained by the OSNA assay was 16.5% (macrometastases OSNA (++) : 7.2%, micrometastases OSNA (+) : 9.2%). The non-SLN positive rate among the CK19-positivecases was 23%. The OSNA assay's false negative was one case in which the expression of CK-19 on the primary tumor and lymph node was not detected. 　Conclusions: Our OSNA assay results were comparable to those obtained using a conventional pathological technique. Pathologists and laboratory technicians could save time and effort by using the OSNA assay when seeking the precise diagnosis during surgery. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 膵・胆管合流異常症―その概念と治療― 17 24 EN Takuo Noda No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 PET/CT SUVmaxは子宮体癌の予後不良因子になりうる 11 15 EN Keiichiro Nakamura Ikuo Joja Chikako Fukushima Tomoko Haruma Chiaki Hayashi Tomoyuki Kusumoto Noriko Seki Atsushi Hongo Yuji Hiramatsu No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 自己集合性ペプチドハイドロゲル内で三次元培養された細胞への機械刺激 7 10 EN Yusuke Nagai Hidenori Yokoi Keiko Kaihara Keiji Naruse No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 1 2014 糖尿病の腎臓においてcholecystokininはマクロファージに対する抗炎症作用を介した新規の保護効果を発揮する 1 6 EN Satoshi Miyamoto Kenichi Shikata Kyoko Miyasaka Shinichi Okada Motofumi Sasaki Ryo Kodera Daisho Hirota Nobuo Kajitani Tetsuharu Takatsuka Hitomi Kataoka Usui Shingo Nishishita Chikage Horiguchi Sato Akihiro Funakoshi Hisakazu Nishimori Haruhito Adam Uchida Daisuke Ogawa Hirofumi Makino No potential conflict of interest relevant to this article was reported.

Oxford University Press Acta Medica Okayama 0305-1048 38 2010 NBRP databases: databases of biological resources in Japan D26 D32 EN Yukiko Yamazaki Ryo Akashi Yutaka Banno Takashi Endo Hiroshi Ezura Kaoru Fukami-Kobayashi Kazuo Inaba Tadashi Isa Katsuhiko Kamei Fumie Kasai Masatomo Kobayashi Nori Kurata Makoto Kusaba Tetsuro Matuzawa Shohei Mitani Taro Nakamura Yukio Nakamura Norio Nakatsuji Kiyoshi Naruse Hironori Niki Eiji Nitasaka Yuichi Obata Hitoshi Okamoto Moriya Okuma Kazuhiro Sato Tadao Serikawa Toshihiko Shiroishi Hideaki Sugawara Hideko Urushibara Masatoshi Yamamoto Yoshio Yaoita Atsushi Yoshiki Yuji Kohara The National BioResource Project (NBRP) is a Japanese project that aims to establish a system for collecting, preserving and providing bioresources for use as experimental materials for life science research. It is promoted by 27 core resource facilities, each concerned with a particular group of organisms, and by one information center. The NBRP database is a product of this project. Thirty databases and an integrated database-retrieval system (BioResource World: BRW) have been created and made available through the NBRP home page (http://www.nbrp.jp). The 30 independent databases have individual features which directly reflect the data maintained by each resource facility. The BRW is designed for users who need to search across several resources without moving from one database to another. BRW provides access to a collection of 4.5-million records on bioresources including wild species, inbred lines, mutants, genetically engineered lines, DNA clones and so on. BRW supports summary browsing, keyword searching, and searching by DNA sequences or gene ontology. The results of searches provide links to online requests for distribution of research materials. A circulation system allows users to submit details of papers published on research conducted using NBRP resources. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 100 11-12 1988 喀血に対する気管支動脈塞栓術 ―Stainless Steel Coilを用いて― 1035 1043 EN Motoomi Ohkawa Kazuhiro Sakamoto Tsutomu Miyamoto Shinsuke Matsuno Nobuyuki Hosokawa Hiroyuki Seo Kanji Kojima Katashi Satoh Yukiko Kawasaki Hitoshi Takashima Toyosato Tamai Masatada Tanabe Kenji Nakamura Four patients with hemoptysis were treated by bronchial artery embolization, using only stainless steel coils 5mm or 3mm in diameter as the embolic material. Immediate control of hemoptysis was achieved in 3 of the 4 patients without any significant complication. Two of these patients are alive without recurrent hemoptysis, one of them 3 months and the other two years one month after the embolization. One of these patient died of renal failure 5 days after embolization. Recurrent hemoptysis occurred in 1 of the 4 patients with incomplete embolization. A second attempt at embolization failed because the coil fell down through the aorta into the iliac artery. The coil was surgically removed under fluoroscopy. Since the stainless steel coil is a non-absorbable embolic material, if carefully used, longer therapeutic results can be achieved for patients with hemoptysis. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 稀少難治性皮膚疾患に関する調査研究班　平成25年度　公開シンポジウム見えてきた難治性皮膚疾患の病態と治療の展望 275 279 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 第19回日本遺伝子治療学会学術集会学会報告 271 273 EN Toshiyoshi Fujiwara No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 医療法人清幸会土肥病院 269 270 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 吉備高原医療リハビリテーションセンター 267 268 EN No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 IVR 263 265 EN Susumu Kanazawa No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 薬物相互作用 (28―過活動膀胱治療薬の薬物相互作用） 259 262 EN Yusuke Haruta Yoichi Kawasaki Yoshihisa Kitamura Toshiaki Sendo No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 細菌性髄膜炎の治療ガイドライン 257 258 EN Yoshio Ikeda Koji Abe No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 抗菌薬TDMガイドライン 251 255 EN Masatoshi Okazaki Toshiaki Sendo No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 乳癌と分子標的薬 243 250 EN Hiroyoshi Doihara No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 3 2013 虫垂腫瘍と術前診断し腹腔鏡下手術を行った虫垂仮性憩室症の１例 239 242 EN Takayuki Ninomiya Yasutomo Ojima Masao Harano Satoshi Ohno Shigehiro Shiozaki Motoki Ninomiya 　Appendiceal diverticulum is rare. We encountered a case of appendiceal diverticulum with chronic appendicitis. A 56-year-old man presented to our hospital with right lower abdominal pain. An abdominal computed tomography (CT) scan showed swelling of the appendix body and the wall thickness of the base of the appendix. Due to the possibility of appendiceal tumor, we performed a laparoscopy-assisted ileocecal resection with lymph node dissection. The appendix had a diverticulum with chronic inflammation, but it did not have a neoplastic lesion. No potential conflict of interest relevant to this article was reported.