A robotic simulator for elderly caregiver training has an important role with the continuous increase in the proportion of the elderly in the society. Caregivers or therapists, especially the ...novices, need training in caregiving skills. While one of the best methods is to practice the skills with a real elderly person, there are obstacles such as recruitment of subjects and the fatigue experienced by them from repeated training sessions. To improve the effectiveness of caregiver training, we developed an elderly joint simulator of a body part for training purposes. In this study, three experts with years of experience in elderly care participated in the acquisition of data, such as elbow joint angle, force torque, and pressure value, while performing the range of motion exercise using the proposed elderly elbow joint robot for comparison with those from novices. Furthermore, experiments were conducted as pre-evaluation, post-evaluation I (after 30 min), and post-evaluation II (after 1 month). For quantitative assessment of caregiver training, two parameters as the mean of range of elbow joint angle and the mean of range of force torque were extracted, and the results of the experts and trainees were compared. The comparison showed a statistically significant difference between pre- and post-evaluation. Hence, in this study, we conclude that our proposed approach can potentially improve caregiving and nursing skills, after further research.
It is unclear whether laparoscopic distal gastrectomy for locally advanced gastric cancer is oncologically equivalent to open distal gastrectomy. The noninferiority of laparoscopic subtotal ...gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer compared with open surgery in terms of 3-year relapse-free survival rate was evaluated.
A phase III, open-label, randomized controlled trial was conducted for patients with histologically proven locally advanced gastric adenocarcinoma suitable for distal subtotal gastrectomy. The primary end point was the 3-year relapse-free survival rate; the upper limit of the hazard ratio (HR) for noninferiority was 1.43 between the laparoscopic and open distal gastrectomy groups.
From November 2011 to April 2015, 1,050 patients were randomly assigned to laparoscopy (n = 524) or open surgery (n = 526). After exclusions, 492 patients underwent laparoscopic surgery and 482 underwent open surgery and were included in the analysis. The laparoscopy group, compared with the open surgery group, suffered fewer early complications (15.7%
23.4%, respectively;
= .0027) and late complications (4.7%
9.5%, respectively;
= .0038), particularly intestinal obstruction (2.0%
4.4%, respectively;
= .0447). The 3-year relapse-free survival rate was 80.3% (95% CI, 76.0% to 85.0%) for the laparoscopy group and 81.3% (95% CI, 77.0% to 85.0%; log-rank
= .726) for the open group. Cox regression analysis after stratification by the surgeon revealed an HR of 1.035 (95% CI, 0.762 to 1.406; log-rank
= .827;
for noninferiority = .039). When stratified by pathologic stage, the HR was 1.020 (95% CI, 0.751 to 1.385; log-rank
= .900;
for noninferiority = .030).
Laparoscopic distal gastrectomy with D2 lymphadenectomy was comparable to open surgery in terms of relapse-free survival for patients with locally advanced gastric cancer. Laparoscopic distal gastrectomy with D2 lymphadenectomy could be a potential standard treatment option for locally advanced gastric cancer.
The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 system has been widely used for nuclear DNA editing to generate mutations or correct specific disease alleles. Despite its ...flexible application, it has not been determined if CRISPR/Cas9, originally identified as a bacterial defense system against virus, can be targeted to mitochondria for mtDNA editing. Here, we show that regular FLAG-Cas9 can localize to mitochondria to edit mitochondrial DNA with sgRNAs targeting specific loci of the mitochondrial genome. Expression of FLAG-Cas9 together with gRNA targeting Cox1 and Cox3 leads to cleavage of the specific mtDNA loci. In addition, we observed disruption of mitochondrial protein homeostasis following mtDNA truncation or cleavage by CRISPR/Cas9. To overcome nonspecific distribution of FLAG-Cas9, we also created a mitochondria-targeted Cas9 (mitoCas9). This new version of Cas9 localizes only to mitochondria; together with expression of gRNA targeting mtDNA, there is specific cleavage of mtDNA. MitoCas9-induced reduction of mtDNA and its transcription leads to mitochondrial membrane potential disruption and cell growth inhibition. This mitoCas9 could be applied to edit mtDNA together with gRNA expression vectors without affecting genomic DNA. In this brief study, we demonstrate that mtDNA editing is possible using CRISPR/Cas9. Moreover, our development of mitoCas9 with specific localization to the mitochondria should facilitate its application for mitochondrial genome editing.
The study aims to develop a robotic mood transition for a patient robot with emotional expression abilities in care education. The RU-FEMOIN database is utilized for the emotional expressions of the ...robot, which contains facial expression images of 41 Japanese people divided into different age groups. The primary objectives of the study are to provide feedback to caregivers to react immediately to the emotions felt by the robot during care training and to establish seamless communication of emotions between caregivers and the robot. This method ensures that the user’s emotions are reflected in the robot’s emotions, and the robot can express continuous mood transitions. A robot’s mood transition is generated based on the user’s current facial expression, according to the RU-FEMOIN database, to achieve interaction between the patient robot and caregivers. The study presents an advanced patient robotic system based on human–robot interaction on the CNT using the robot’s facial expression method.
•The paper presents a system of the robotic mood transition of patient robots.•The objective is to develop the novel database of facial expression in Japanese.•The robotic mood transition can be expressed emotional states in care education.•This system provides facial expression-based feedback for care training.
Glioblastoma (GBM) is a devastating and incurable brain tumour, with a median overall survival of fifteen months
. Identifying the cell of origin that harbours mutations that drive GBM could provide ...a fundamental basis for understanding disease progression and developing new treatments. Given that the accumulation of somatic mutations has been implicated in gliomagenesis, studies have suggested that neural stem cells (NSCs), with their self-renewal and proliferative capacities, in the subventricular zone (SVZ) of the adult human brain may be the cells from which GBM originates
. However, there is a lack of direct genetic evidence from human patients with GBM
. Here we describe direct molecular genetic evidence from patient brain tissue and genome-edited mouse models that show astrocyte-like NSCs in the SVZ to be the cell of origin that contains the driver mutations of human GBM. First, we performed deep sequencing of triple-matched tissues, consisting of (i) normal SVZ tissue away from the tumour mass, (ii) tumour tissue, and (iii) normal cortical tissue (or blood), from 28 patients with isocitrate dehydrogenase (IDH) wild-type GBM or other types of brain tumour. We found that normal SVZ tissue away from the tumour in 56.3% of patients with wild-type IDH GBM contained low-level GBM driver mutations (down to approximately 1% of the mutational burden) that were observed at high levels in their matching tumours. Moreover, by single-cell sequencing and laser microdissection analysis of patient brain tissue and genome editing of a mouse model, we found that astrocyte-like NSCs that carry driver mutations migrate from the SVZ and lead to the development of high-grade malignant gliomas in distant brain regions. Together, our results show that NSCs in human SVZ tissue are the cells of origin that contain the driver mutations of GBM.
Comparison between piezoelectric force microscopy images and current‐voltage data consecutively obtained using conductive atomic force microscopy below transition voltages for a highly oriented ...ferroelectric BiFeO3 nano‐island confirms that ferroelectric polarization reversal induces transitions of forward‐direction, and thus down‐ and up‐polarization is accompanied by positive‐ and negative‐forward diode‐like behavior, respectively.
Fully reversible emission color change is achieved by blending a thermoresponsive polymer with dye hybrids. The emission color can be tuned by changing the mixing ratio of each polymer–dye hybrid.
In treatments of solid tumors, adoptive transfer of ex vivo expanded natural killer (NK) cells has dawned as a new paradigm. Compared with cytotoxic T lymphocytes, NK cells take a unique position ...targeting tumor cells that evade the host immune surveillance by down-regulating self-antigen presentation. Recent findings highlighted that NK cells can even target cancer stem cells. The efficacy of allogeneic NK cells has been widely investigated in the treatment of hematologic malignancies. In solid tumors, both autologous and allogeneic NK cells have demonstrated potential efficacy. In allogeneic NK cell therapy, the mismatch between the killer cell immunoglobulin-like receptor (KIR) and human leukocyte antigen (HLA) can be harnessed to increase the antitumor activity. However, the allogeneic NK cells cause more adverse events and can be rejected by the host immune system after repeated injections. In this regard, the autologous NK cell therapy is safer. This article reviews the published results of clinical trials and discusses strategies to enhance the efficacy of the NK cell therapy. The difference in immunophenotype of the ex vivo expanded NK cells resulted from different culture methods may affect the final efficacy. Furthermore, currently available standard anticancer therapy, molecularly targeted agents, and checkpoint inhibitors may directly or indirectly enhance the efficacy of NK cell therapy. A recent study discovered that NK cell specific genetic defects are closely associated with the tumor immune microenvironment that determines clinical outcomes. This finding warrants future investigations to find the implication of NK cell specific genetic defects in cancer development and treatment, and NK cell deficiency syndrome should be revisited to enhance our understanding. Overall, it is clear that NK cell therapy is safe and promises a new paradigm for the treatment of solid tumors.
This study aims to propose a novel approach for gender recognition using best feature subset based on recursive feature elimination (RFE) in normal walking. This study has focused on the analysis of ...gait characteristics by distinguishing the gait phases as initial contact (IC), Mid-stance (MS), Pre-swing, and swing (SW), and collected the large number of gait to improve the reliability of quantitative assessment of natural variability associated with muscle activity during free walking. The gait system was designed using pressure and a tri-axis accelerometer sensor, and a 9-channel electromyography sensor for measuring the data. Gender recognition method was proposed using support vector machine (SVM) and random forest (RF) based on RFE to determine best feature subset. Statistical results show that effects of gender-based differences on gait characteristic including temporal, kinematics, and muscle activity were investigated. The temporal parameters of stride time and gait cycle (%) in the gait phases of IC, MS, and SW were significantly different between females and males (p<0.01). The females exhibited both a lower angle and a root mean square acceleration of the knee joint as compared to the males, and there was a clear gender-based difference with respect to knee angle movement. In addition, most muscle activation measurements in the females were larger than those of the males with respect to the gait phases. Gender classification result shows that SVM-RFE was 99.11% (SVM classifier) and RF-RFE was 98.89% (SVM and RF classifier), having powerful performance.
•The paper investigates the statistical effect of gender-based differences on gait.•The paper has focused to analysis gait characteristics in gait sub-phases.•A novel approach for gender classification is proposed using RFE.•The paper has the powerful performance for gender classification using SVMRFE.
Mutations in parkin lead to early-onset autosomal recessive Parkinson’s disease (PD) and inactivation of parkin is thought to contribute to sporadic PD. Adult knockout of parkin in the ventral ...midbrain of mice leads to an age-dependent loss of dopamine neurons that is dependent on the accumulation of parkin interacting substrate (PARIS), zinc finger protein 746 (ZNF746), and its transcriptional repression of PGC-1α. Here we show that adult knockout of parkin in mouse ventral midbrain leads to decreases in mitochondrial size, number, and protein markers consistent with a defect in mitochondrial biogenesis. This decrease in mitochondrial mass is prevented by short hairpin RNA knockdown of PARIS. PARIS overexpression in mouse ventral midbrain leads to decreases in mitochondrial number and protein markers and PGC-1α–dependent deficits in mitochondrial respiration. Taken together, these results suggest that parkin loss impairs mitochondrial biogenesis, leading to declining function of the mitochondrial pool and cell death.
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