Incidence of Secondary Lip Correction for Children With Unilateral Cleft Lip: A Single-Center Retrospective Study.

BACKGROUND: Numerous reports have described the incidence of secondary lip correction for patients with cleft lip (CL), and this incidence broadly varies among centers. The purpose of this study was to determine this revision rate for a reasonably large number of patients in our center and identify the clinical factors that contribute to the revision rate. METHODS: A retrospective chart review was conducted for all infants with unilateral CL with or without cleft palate who underwent primary cheiloplasty at our cleft center from 2006 to 2012. Four surgeons were in charge of almost all operations. We investigated how many children underwent lip revisions by the end of 2017. RESULTS: In total, 490 infants underwent primary lip repair, and 47 underwent revision surgery by the age of 8 years. Half of them (24 children) underwent revisions at the age of 5 or 6 years. There was no significant difference in the revision rate by sex or cleft side. The revision rate in children with CL only tended to be lower than that in children with alveolar cleft or cleft palate, but it was not significantly associated with the cleft type. The revision rate ranged from 2.8% to 15.2% among surgeons. CONCLUSIONS: The overall revision rate was 9.6%, which is relatively lower than that in other cleft centers. However, the repair technique and cleft care program should not be evaluated using the revision rate only. Various factors, including surgeons' preference, contribute to the indications for revision, and these factors can change with age. We plan to follow up the patients until our completion of the cleft care program and report the final revision rate.

KOTOBAKARI Study: Using Natural Language Processing of Patient Short Narratives to Detect Cancer Related Cognitive Impairment.

BACKGROUND: Recent reports of some studies have described that the cognitive function of cancer patients often declines by a phenomenon designated as cancer related cognitive impairment (CRCI). For patients' decision-making, detecting CRCI is important. To do so, this study uses language-based CRCI screening to examine participants' language ability. OBJECTIVE: This study was conducted to ascertain whether a Natural Language Processing (NLP) based system can detect CRCI, or not. MATERIALS AND METHODS: We obtained materials of two types from cancer patients (n = 116): (1) speech samples on three topics, and (2) cognitive function level test scores from Hasegawa's Dementia Scale - Revised (HDS-R), a test used in Japan for dementia patients. The test is similar to the Mini-Mental State Examination. RESULTS AND DISCUSSION: Cancer patients with lower HDS-R scores showed a significantly lower Type Token Ratio (TTR). CONCLUSION: This result demonstrates the feasibility of the proposed speech-language-based CRCI screening method.

Nasolabial Growth in Individuals With Unilateral Cleft Lip and Palate: A Preliminary Study of Longitudinal Observation Using Three-Dimensional Stereophotogrammetry.

There are limited numbers of studies comparing the preoperative and postoperative facial features of infants with unilateral cleft lip and palate (UCLP) using three-dimensional (3D) stereophotogrammetry. The authors attempted an anthropometric analysis of nasolabial asymmetry 1 year after primary lip repair using a handheld 3D imaging system. Five different nasolabial dimensions in 24 infants with UCLP were measured using 3D images captured during primary lip repair and again, 1 year after the repair. The nasal and upper-lip elements of the cleft side were significantly changed after primary lip repair, and nasolabial asymmetry was anthropometrically improved. This is a preliminary longitudinal observation of nasolabial growth in individuals with UCLP using 3D stereophotogrammetric technique. The authors would like to follow these children until adulthood, capturing 3D images at every intervention.

Vocabulary Size in Speech May Be an Early Indicator of Cognitive Impairment.

Little is known about the relationship between mild cognitive impairment (MCI) and changes to language abilities. Here, we used the revised Hasegawa Dementia Scale (HDS-R) to identify suspected MCI in elderly individuals. We then analyzed written and spoken narratives to compare the language abilities between study participants with and without MCI in order to explore the relationship between cognitive and language abilities, and to identify a possible indicator for the early detection of MCI and dementia. We recruited 22 people aged 74 to 86 years (mean: 78.32 years; standard deviation: 3.36). The participants were requested to write and talk about one of the happiest events in their lives. Based on HDS-R scores, we divided the participants into 2 groups: the MCI Group comprised 8 participants with a score of 26 or lower, while the Healthy Group comprised 14 participants with a score of 27 or higher. The transcriptions of both written and spoken samples for each participant were used in the measurement of NLP-based language ability scores. Our analysis showed no significant differences in writing abilities between the 2 groups in any of the language ability scores. However, analysis of the spoken narrative showed that the MCI Group had a significantly larger vocabulary size. In addition, analysis of a metric that signified the gap in content between the spoken and written narratives also revealed a larger vocabulary size in the MCI Group. Individuals with early-stage MCI may be engaging in behavior to conceal their deteriorating cognition, thereby leading to a temporary increase in their active spoken vocabulary. These results indicate the possible detection of early stages of reduced cognition before dementia onset through the analysis of spoken narratives.

Allergy Risk Finder: Hypothesis Generation System for Allergy Risks via Web Service.

This study's aim was to build a web service that automatically collects and tests hypotheses for possible allergy risks. We crowdsourced for unknown allergy risks, and obtained odds ratios. By using the collected hypotheses, we built a web service that estimates allergy risks from a questionnaire (consisting of 10 questions that we gathered from the crowdsourcing task), and at the end, we asked the users their new hypotheses on possible allergy risks. The web service also asked the users to send their original hypotheses to contribute to find the cause of allergy. In the near future, clinical trials to validate the hypotheses found in this study are desired.

Mind the Gap: The Discrepancies between Patient Self-Reported Quality of Life and Medical Staff-Estimated Quality of Life.

Information on patient quality of life (QOL) is essential to many clinical decisions. Therefore, studies that aim to extract QOL information from patient narratives are increasingly drawing attention. Also, several studies have noted that web services for patients, such as patient social networking services, may represent promising resources for QOL research. However, it is still unclear whether patient narrative text contains corresponding amounts of QOL information as self-reported QOL. This study investigates if medical staff can accurately estimate patient QOL from only patient narrative texts. We analyzed (1) QOL of cancer patients estimated by medical staff from patient autobiographical texts and (2) self-reported QOL scores of cancer patients. We compared patients from the following 3 disease groups: (1) gastrointestinal cancer, (2) breast cancer, and (3) lymphoma. The SF-36v2™ Health Survey was used to measure patient QOL in both materials, and the QOLs were compared. We found significant differences between self-reported QOL and estimated QOL in breast cancer patients and lymphoma patients, but not in gastrointestinal cancer patients. In particular, the medical staff tended to underestimate physical QOL scores. Medical staff may underestimate several aspects of QOL scores. On the basis of these results, we may be able to achieve more precise QOL estimation from patient narratives.