テキサスホールデム勝ち方

http://hdl.handle.net/10564/1475 博士論文 2024-05-18T02:25:48Z http://hdl.handle.net/10564/4239 タイトル: Anterior Quadratus Lumborum Block and Quadriceps Strength: A Prospective Cohort Study 著者: Kadoya, Yuma; Tanaka, Nobuhiro; Suzuka, Takanori; Yamanaka, Takayuki; Iwata, Masato; Ozu, Naoki; Kawaguchi, Masahiko 抄録: The decrease in quadriceps strength after anterior quadratus lumborum block (AQLB) has not been quantified. This prospective cohort study investigated the incidence of quadriceps weakness after AQLB. We enrolled patients undergoing robot-assisted partial nephrectomy, and AQLB was performed at the L2 level with 30 mL of 0.375% ropivacaine. We evaluated each quadriceps’ maximal voluntary isometric contraction using a handheld dynamometer preoperatively and postoperatively at 1 and 4 days. The incidence of muscle weakness was defined as a 25% reduction in muscle strength compared with the preoperative baseline, and “muscle weakness possibly caused by nerve block” was defined as a 25% reduction compared with the non-block side. We also assessed the numerical rating scale and quality of recovery-15 scores. Thirty participants were analyzed. The incidence of muscle weakness compared with preoperative baseline and the non-block side was 13.3% and 30.0%, respectively. Patients with a numerical rating scale ≥ 4 or quality of recovery-15 score < 122, which was classified as moderate or poor, had decreased muscle strength with relative risks of 1.75 and 2.33, respectively. All patients ambulated within 24 h after surgery. The incidence of quadriceps weakness possibly caused by nerve block was 13.3%; however, all patients could ambulate after 1 day. 内容記述: 権利情報：© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 2023-05-31T15:00:00Z http://hdl.handle.net/10564/4238 タイトル: Relationship between Effective Duration and Intelligibility of Japanese Monosyllables in Individuals with Sensorineural Hearing Loss 著者: Akasaka, Sakie; Nishimura, Tadashi; Shimokura, Ryota; Kitahara, Tadashi; Hosoi, Hiroshi 抄録: Among the temporal elements in the autocorrelation function, the effective duration (τe) is a useful indicator of speech recognition for patients with sensorineural hearing impairment. We assessed the influence of speech recognition performance on the relationship between the percentage of accurately perceived articulation and the median τe (τe-med) and the relationship between monosyllabic confusion and the τe-med. Significant correlations were observed between the articulation percentage and the average τe-med in groups with high, middle, and low speech recognition scores (SRSs). Two-factor mixed analysis of variance revealed significant main effects for the condition (presentation/response). There was no significant main effect for group (high-, middle-, or low-SRS) scores and no significant interaction between the groups. The average τe-med of the response was significantly longer than that of the presentation in all three groups. Monosyllables with short τe-med values tended to be misheard as monosyllables with a long τe-med when confusion occurred. The τe-med was useful for estimating monosyllables that patients with sensorineural hearing impairment find easy to listen to, independent of speech recognition performance. 内容記述: 権利情報：© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 2023-07-01T15:00:00Z http://hdl.handle.net/10564/4237 タイトル: Diagnosing psychiatric disorders from history of present illness using a large-scale linguistic model 著者: Otsuka, Norio; Kawanishi, Yuu; Doi, Fumimaro; Takeda, Tsutomu; Okumura, Kazuki; Yamauchi, Takahira; Yada, Shuntaro; Wakamiya, Shoko; Aramaki, Eiji; Makinodan, Manabu 抄録: Aim: Recent advances in natural language processing models are expected to provide diagnostic assistance in psychiatry from the history of present illness (HPI). However, existing studies have been limited, with the target diseases including only major diseases, small sample sizes, or no comparison with diagnoses made by psychiatrists to ensure accuracy. Therefore, we formulated an accurate diagnostic model that covers all psychiatric disorders. Methods: HPIs and diagnoses were extracted from discharge summaries of 2,642 cases at the Nara Medical University Hospital, Japan, from 21 May 2007, to 31 May 31 2021. The diagnoses were classified into 11 classes according to the code from ICD-10 Chapter V. Using UTH-BERT pre-trained on the electronic medical records of the University of Tokyo Hospital, Japan, we predicted the main diagnoses at discharge based on HPIs and compared the concordance rate with the results of psychiatrists. The psychiatrists were divided into two groups: semi-Designated with 3–4 years of experience and Residents with only 2 months of experience. Results: The model’s match rate was 74.3%, compared to 71.5% for the semi-Designated psychiatrists and 69.4% for the Residents. If the cases were limited to those correctly answered by the semi-Designated group, the model and the Residents performed at 84.9% and 83.3%, respectively. Conclusion: We demonstrated that the model matched the diagnosis predicted from the HPI with a high probability to the principal diagnosis at discharge. Hence, the model can provide diagnostic suggestions in actual clinical practice. 内容記述: 権利情報：© 2023 The Authors.　Psychiatry and Clinical Neurosciences published by John Wiley & Sons Australia, Ltd on　behalf of Japanese Society of Psychiatry and Neurology.This is an open access article under the terms of the Creative　Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any　medium, provided the　original work is properly cited, the use is non-commercial and no modifications or adaptations are made. 2023-10-31T15:00:00Z http://hdl.handle.net/10564/4236 タイトル: Neovascularization From the Carotid Artery Lumen Into the Carotid Plaque Confirmed by Contrast-Enhanced Ultrasound and Histology 著者: Uchihara, Yuto; Saito, Kozue; Motoyama, Rie; Ishibashi-Ueda, Hatsue; Yamaguchi, Eriko; Hatakeyama, Kinta; Tanaka, Akito; Kataoka, Hiroharu; Iihara, Koji; Sugie, Kazuma; Koga, Masatoshi; Toyoda, Kazunori; Nagatsuka, Kazuyuki; Ihara, Masafumi 抄録: Objective: This study was aimed at assessing intraplaque neovessels, focusing on neovascularization from the vascular luminal side using contrast-enhanced ultrasound (CEUS) and determining that this contrast effect indicates that the neovessel is connected to the vessel lumen histopathologically. Whether plaque vulnerability can be assessed more accurately was also investigated. Methods: We enrolled consecutive patients with internal carotid artery stenosis who underwent carotid endarterectomy (CEA) and pre-operative CEUS with perflubutane of the carotid arteries. We graded the contrast effect semi-quantitatively from the vascular luminal and adventitial sides. We compared the contrast effect with the pathological findings, especially the neovascularization of the CEA specimens. Results: In total, 68 carotid arterial atheromatous plaques (47 symptomatic) were analyzed. Symptomatic plaques were significantly correlated with stronger contrast effects from the luminal side than from the adventitial side (p = 0.0095). Microbubbles from the luminal side appeared to flow mainly into the plaque shoulder. The contrast effect value for the plaque shoulder and neovessel density were significantly correlated (ρ = 0.35, p = 0.031). Neovessel density was significantly higher in symptomatic than in asymptomatic plaques (56.2 ± 43.7/mm2 and 18.1 ± 15.2/mm2, respectively, p < 0.0001). Serial histological sections of CEA specimens in a symptomatic plaque with a strong contrast effect from the luminal side revealed multiple neovessels fenestrated to the vessel lumen with endothelial cells, consistent with the CEUS findings. Conclusion: Contrast-enhanced ultrasound can be used to evaluate neovessels originating from the luminal side, histopathologically confirmed in serial sections. Symptomatic vulnerable plaque is correlated more significantly with intraplaque neovascularization from the luminal side than with neovascularization from the adventitia. 内容記述: 本文は発行元が定める公開猶予期間終了後に公開。 2023-07-31T15:00:00Z