Estimation of population affinity using proximal femoral measurements based on computed tomographic images in the Japanese and western Australian populations.

The present study analyzes morphological differences femora of contemporary Japanese and Western Australian individuals and investigates the feasibility of population affinity estimation based on computed tomographic (CT) data. The latter is deemed to be of practical importance because most anthropological methods rely on the assessment of aspects of skull morphology, which when damaged and/or unavailable, often hampers attempts to estimate population affinity. The study sample comprised CT scans of 297 (146 females; 151 males) Japanese and 330 (145 females; 185 males) Western Australian adult individuals. A total of 10 measurements were acquired in two-dimensional CT images of the left and right femora; two machine learning methods (random forest modeling [RFM]) and support vector machine [SVM]) were then applied for population affinity classification. The accuracy of the two-way (sex-specific and sex-mixed) model was between 71.38 and 82.07% and 76.09-86.09% for RFM and SVM, respectively. Sex-specific (female and male) models were slightly more accurate compared to the sex-mixed models; there were no considerable differences in the correct classification rates between the female- and male-specific models. All the classification accuracies were higher in the Western Australian population, except for the male model using SVM. The four-way sex and population affinity model had an overall classification accuracy of 74.96% and 79.11% for RFM and SVM, respectively. The Western Australian females had the lowest correct classification rate followed by the Japanese males. Our data indicate that femoral measurements may be particularly useful for classification of Japanese and Western Australian individuals.

Population affinity estimation using pelvic measurements based on computed tomographic data acquired from Japanese and Western Australian populations.

The present study analyzes morphological differences in the pelvis of Japanese and Western Australian individuals and investigates the feasibility of population affinity classification based on computed tomography (CT) data. The Japanese and Western Australian samples comprise CT scans of 207 (103 females; 104 males) and 158 (78 females; 80 males) adult individuals, respectively. Following volumetric reconstruction, a total of 19 pelvic landmarks were obtained on each sample, and 11 measurements, including two angles, were calculated. Machine learning methods (random forest modeling [RFM] and support vector machine [SVM]) were used to classify population affinity. Classification accuracy of the two-way models was approximately 80% for RFM: the two-way sex-specific and sex-mixed models for SVM achieved > 90% and > 85%, respectively. The sex-specific models had higher accurate classification rates than the sex-mixed models, except for the Japanese male sample. The classification accuracy of the four-way sex and population affinity model had an overall classification accuracy of 76.71% for RFM and 87.67% for SVM. All the correct classification rates were higher in the Japanese relative to the Western Australian sample. Our data suggest that pelvic morphology is sufficiently distinct between Japanese and Western Australian individuals to facilitate the accurate classification of population affinity based on measurements acquired in CT images. To the best of our knowledge, this is the first study investigating the feasibility of population affinity estimation based on CT images of the pelvis, which appears as a viable supplement to traditional approaches based on cranio-facial morphology.

Estimation of ancestry from cranial measurements based on MDCT data acquired in a Japanese and Western Australian population.

The estimation of ancestry is important not only towards establishing identity but also as a required precursor to facilitating the accurate estimation of other attributes such as sex, age at death, and stature. The present study aims to analyze morphological variation in the crania of Japanese and Western Australian individuals and test predictive models based on machine learning for their potential forensic application. The Japanese and Western Australian samples comprise computed tomography (CT) scans of 230 (111 female; 119 male) and 225 adult individuals (112 female; 113 male), respectively. A total of 18 measurements were calculated, and machine learning methods (random forest modeling, RFM; support vector machine, SVM) were used to classify ancestry. The two-way unisex model achieved an overall accuracy of 93.2% for RFM and 97.1% for SVM, respectively. The four-way sex and ancestry model demonstrated an overall classification accuracy of 84.0% for RFM and 93.0% for SVM. The sex-specific models were most accurate in the female samples (♀ 95.1% for RFM and 100% for SVM; ♂91.4% for RFM and 97.4% for SVM). Our findings suggest that cranial measurements acquired in CT images can be used to accurately classify Japanese and Western Australian individuals into their respective population. This is the first study to assess the feasibility of ancestry estimation using three-dimensional CT images of the skull.

Expression of ALDH1A Isozymes in Human Endometrium with and without Endometriosis and in Ovarian Endometrioma.

Human endometrium is a highly regenerative and dynamic tissue that undergoes cyclic changes during menstrual cycle. It has been reported that endometrial epithelium contains a population of progenitor/stem cells. Increasing amount of evidence indicates that progenitor/stem cells are involved in the pathogenesis of endometriosis. Proteins belonging to the aldehyde dehydrogenase 1 (ALDH1A) family have been reported to be markers of normal tissue stem cells and cancer stem cells. In this study, by using immunohistochemistry, we examined the expression of ALDH1A isozymes in human endometrial tissue, including that affected by endometriosis, and in ovarian endometrioma. Positive staining for ALDH1A isozymes was observed in the stroma of the endometrium and in endometriotic ovarian tissue. In the glands, expression patterns were distinct for different ALDH1A isozymes. ALDH1A1 and ALDH1A3 were highly expressed in the epithelium of stratum basalis of the endometrium and in the epithelium of ovarian endometrioma irrespective of the menstrual cycle, whereas ALDH1A2 was highly expressed only in the epithelium of endometrioma. Furthermore, ALDH1A1 co-localized with N-cadherin, which is a marker of endometrial epithelial progenitor cells, in the glands of stratum basalis. These findings support and reinforce the notion about the presence of progenitor/stem cells in endometrial glands in stratum basalis and in endometriotic glands, suggesting that these cells are involved in the physiology of the endometrium and in the pathology of endometriosis.

A survey of public attitudes toward uterus transplantation, surrogacy, and adoption in Japan.

This study aimed to evaluate the attitudes of male and female members of the public toward uterus transplantation (UTx), surrogacy, and adoption in Japan via a web-based survey. One thousand six hundred participants were recruited with equal segregation of age (20s, 30s, 40s, and 50s) and gender. We assessed the association between ethical view and gender, age, infertility, and the knowledge level of UTx, using a questionnaire. The findings were as follows. First, 36.5% and 31.0% of respondents agreed that UTx and gestational surrogacy should be approved, respectively. Second, the respondents would potentially choose to receive UTx (34.4%), gestational surrogacy (31.9%), and adoption (40.3%), if they or their partners experienced absolute uterine factor infertility. Third, 10.1%, 5.8%, and 14.3% of the respondents chose UTx, gestational surrogacy, and adoption as the most favorable option, respectively. Fourth, if their daughters suffered from absolute uterine factor infertility, 32.3% of female respondents might want to be donors, and 36.7% of male respondents might ask their wives to be donors. These data were affected by age, gender, infertility, or the knowledge level of UTx. UTx was a more acceptable option than gestational surrogacy and adoption. The effects of gender, age, infertility, and the level of knowledge of UTx are important in understanding the attitude toward UTx. On the other hand, there were concerns about the safety of UTx for recipients, donors, and babies. It is important to continue to understand public attitudes to inform the development and safety of UTx, which will enhance the discussion on the ethical consensus on UTx.

Contralateral ovarian endometrioma recurrence after unilateral salpingo-oophorectomy.

BACKGROUND: The recurrence rate after unilateral salpingo-oophorectomy (USO) for unilateral endometrioma has not been reported. We evaluated the rate of and risk factors for endometrioma recurrence after USO. METHODS: In this retrospective observational study, we enrolled 110 women (age, 35-45 years) who underwent laparoscopic USO (n = 50) or cystectomy (n = 60) for unilateral ovarian endometrioma from January 2010 through December 2012. We compared patients' characteristics between patients who underwent USO and those who underwent cystectomy. We also compared patients with and without an endometrioma recurrence after USO using univariate and multivariate stepwise logistic regression models to identify recurrence risk factors. Endometrioma recurrence was defined as an ovarian cyst (> 2 cm) with features typical of an endometrioma identified by postoperative transvaginal sonography. RESULTS: Endometrioma recurred in 8 (16%) patients after USO (mean follow-up, 46.0 ± 12.9 months [range, 15-73]). The post-USO cumulative recurrence rates at 12, 24, 36, and 60 months were 8.0, 10.2, 12.7, and 24.7%, respectively (Kaplan-Meier analysis). In logistic regression analysis, a contralateral side adhesion score ≥ 4 was an independent risk factor for endometrioma recurrence after USO (odds ratio, 19.48, 95% confidence interval, 1.59-237.72). The post-USO cumulative recurrence rates at 12, 24, 36, and 57 months were 19.5, 24.1, 31.0, and 54.0%, respectively, in cases with contralateral side adhesion scores ≥4, and 0.0, 0.0, 0.0, and 5.9%, respectively, in cases with scores < 4 (log-rank test, P = 0.0023). CONCLUSIONS: To our knowledge, this is the first report on the recurrence rate and risk factors associated with recurrence after USO. Endometrioma recurrence rates were 24.7% during the first 5 years after USO. The post-USO recurrence rate increased significantly in cases with contralateral side adhesions. Our findings could improve the planning of USO and patient selection for postoperative hormonal therapy.

A survey of public attitudes towards third-party reproduction in Japan in 2014.

OBJECTIVE: The objective of this study was to examine public attitudes towards third-party reproduction and the disclosure of conception through third-party reproduction. METHODS: We conducted the web-based survey for the public attitude towards third-party reproduction in February 2014. Twenty-five hundred people were recruited with equal segregation of age (20s, 30s, 40s, and 50s) and gender. We analyzed the association between gender, age, infertility, and ethical view using a questionnaire regarding donor sperm, donor oocyte, donor embryo, gestational surrogacy, and disclosure to offspring. RESULTS: Of the respondents, 36.2% approved and 26.6% disapproved of gamete or embryo donation. The frequency of those who approved was lowest in females in the 50-59 year age group, and was significantly higher in males or females with infertility. Secondly, 40.9% approved and 21.8% disapproved of gestational surrogacy. The frequency of those who approved gestational surrogacy was higher in males or females with infertility. Thirdly, 46.3% of respondents agreed and 20.4% disagreed with "offspring have the right to know their origin". Those who disagreed were primarily in the 50-59 year age group of both genders, and disagreement was significantly higher in the infertility group compared with non-infertility group. CONCLUSION: In this study, public attitudes were affected by gender, age, and experience of infertility. These study findings are important in understanding the attitude towards third-party reproduction and disclosure to the offspring. Respondents having indecisive attitudes were >30%, which might indicate an increased requirement for information and education to enhance the discussion on the ethical consensus on third-party reproduction in Japan.

Long-term dienogest administration in patients with symptomatic adenomyosis.

AIM: Adenomyosis is a common gynecological disorder that causes dysmenorrhea, hypermenorrhea and metrorrhagia. Previously, we reported that 24 weeks of dienogest treatment is highly effective for pain in symptomatic adenomyosis. Up to present, there is no report that describes treatment of adenomyosis with long-term dienogest administration for more than 2 years. In this retrospective cohort study, we investigated the course of long-term dienogest treatment in patients with symptomatic adenomyosis. METHODS: This is a retrospective cohort study. Dienogest was continuously administered at a dose of 2 mg daily for patients with symptomatic adenomyosis. The outcome of long-term administration of dienogest was investigated, and the characteristics of patients were compared between discontinued cases and long-term administration cases. RESULTS: Two patients were excluded from this study because of transfer to another hospital or discontinuation due to infertility treatment. Twelve of 18 patients (66.7%) received dienogest until menopause or for a period of >80 months. Four cases (22.2%) discontinued dienogest treatment because of severe metrorrhagia. In the discontinued cases because of severe metrorrhagia, the pain score for dysmenorrhea and serum CA125 level at baseline significantly elevated, and the hemoglobin level at baseline and the frequency of type 2 adenomyosis significantly decreased, compared to those with long-term use. Moreover, long-term dienogest use did not decrease the serum estradiol level. CONCLUSION: Our report suggests that dienogest is tolerable for long-term use until menopause and can be an alternative treatment option in some patients, especially those with type 2 adenomyosis, to avoid hysterectomy.

Thoracic endometriosis syndrome: Comparison between catamenial pneumothorax or endometriosis-related pneumothorax and catamenial hemoptysis.

OBJECTIVES: To evaluate the clinical features of thoracic endometriosis syndrome (TES) represented by catamenial pneumothorax (CP), endometriosis-related pneumothorax (ERP), and catamenial hemoptysis (CH). STUDY DESIGN: In this retrospective study, we enrolled 25 patients with TES, 18 of whom had CP/ERP and 7 had CH, to investigate the clinical presentation, effectiveness of treatment, and recurrence rates in these disorders. RESULTS: The age at onset was significantly lower in patients with CH than in patients with CP/ERP (P < 0.05). In 94.4% of patients with CP/ERP, pneumothorax was observed on either the right side or bilaterally, however there was no tendency toward laterality of CH among our cases. In our study, patients with CP/ERP predominantly underwent surgical management and the recurrence rate during treatment was higher in patients with CP/ERP than in those with CH. We found that the recurrence frequency of CP/ERP was lowest under the combination therapy with thoracic surgery and postoperative hormonal therapy. CONCLUSION: Our findings suggest that CP/ERP and CH are different pathological conditions and CP/ERP is more difficult to manage than CH.

Comprehension of Japanese oral care-related terms among caregivers and nurses, as assessed using a newly developed instrument.

OBJECTIVES: (i) To assess comprehension of oral care-related terms among caregivers and nurses working at long-term care facilities, using a newly developed test; (ii) to analyse the effect of participant characteristics on their comprehension. BACKGROUND: Effective mutual communication between dental professionals and caregivers/nurses is essential for providing information on daily oral care for institutionalised elders. METHODS: A 36-item word-knowledge test in Japanese was developed to assess comprehension of oral care-related terms. The test was administered to a convenience sample of 236 nursing staff (198 caregivers and 38 nurses) at six long-term care facilities in Niigata City, Japan, and its reliability and validity were verified. Associations of participant characteristics with their responses were investigated by multiple regression analysis. RESULTS: Mean percentage of correct responses (accuracy rate) for nursing staff was approximately 62% (highest for oral care products and lowest for prosthodontic terms). Test internal reliability was high (Cronbach's alpha >0.8). Concurrent validity (test ability to distinguish between characteristically different groups) was confirmed. Mean accuracy rate was significantly higher among nurses (78.5 ± 19.3%) than among caregivers (58.7 ± 22.8%), and among respondents with interest in oral care (64.2 ± 21.1%) than among those with no such interest (51.5 ± 28.9%). CONCLUSION: The word-knowledge test was valid and reliable for nursing staff of six long-term care facilities in Niigata City. Their comprehension was low for perioral and intraoral structures, related symptom and disease names, and prosthodontics terms related to oral care. Understanding of oral care-related terms among the nursing staff was related to their occupation and interest in oral care.

Four Cases of Postoperative Pneumothorax Among 2814 Consecutive Laparoscopic Gynecologic Surgeries: A Possible Correlation Between Postoperative Pneumothorax and Endometriosis.

STUDY OBJECTIVES: To evaluate the frequency of pneumothorax after laparoscopic surgery and to identify possible correlations to endometriosis. DESIGN: Retrospective review. SETTING: Tokyo University Hospital between 2006 and 2013. PATIENTS: Four patients among a total of 2814 patients with a postoperative pneumothorax. INTERVENTION: Laparoscopic surgery for gynecologic benign disease. The main outcome was the clinical frequency and characteristics of the patients with postoperative pneumothorax. MEASUREMENTS AND MAIN RESULTS: We observed 4 (0.14%) cases of postoperative pneumothorax after laparoscopic surgery, all of whom were diagnosed with endometriomas and developed a right-sided pneumothorax. The incidence of postoperative pneumothorax in 1097 patients with endometriomas was 0.36%, which was significantly higher than those without endometriomas. CONCLUSION: The presence of endometrioma should be considered a risk factor for postoperative pneumothorax in gynecologic laparoscopic surgery.

Efficacy of dienogest in the treatment of symptomatic adenomyosis: a pilot study.

Adenomyosis is a common disorder in premenopausal women that causes dysmenorrhea, pelvic pain and menorrhagia. Considering that adenomyosis is an estrogen-dependent disease, the medical treatment is based on this hormone. Effective and well-tolerated medical treatments for symptomatic adenomyosis are needed. Dienogest, an oral progestin, has been extensively investigated in the treatment of endometriosis. In this report, we present the results on the efficacy and safety of dienogest in the treatment of symptomatic adenomyosis. Seventeen patients with symptomatic adenomyosis were included in this study, of which 15 continued dienogest for up to 24 weeks. Dienogest significantly reduced adenomyosis-associated pelvic pain as well as serum CA-125 and CA19-9 levels. It also demonstrated a modest suppression of estradiol (>50 pg/ mL), which is consistent with the findings of other reports. During treatment, five patients experienced worsening anemia because of metrorrhagia, which is the most frequent adverse effect associated with dienogest. This report suggests that dienogest is an effective and well-tolerated therapy for symptomatic adenomyosis.