The detection of objects of interest in high-resolution digital pathological images is a key part of diagnosis and is a labor-intensive task for pathologists. In this paper, we describe a Faster R-CNN-based approach for the detection of glomeruli in multistained whole slide images (WSIs) of human renal tissue sections. Faster R-CNN is a state-of-the-art general object detection method based on a convolutional neural network, which simultaneously proposes object bounds and objectness scores at each point in an image. The method takes an image obtained from a WSI with a sliding window and classifies and localizes every glomerulus in the image by drawing the bounding boxes. We configured Faster R-CNN with a pretrained Inception-ResNet model and retrained it to be adapted to our task, then evaluated it based on a large dataset consisting of more than 33,000 annotated glomeruli obtained from 800 WSIs. The results showed the approach produces comparable or higher than average F-measures with different stains compared to other recently published approaches. This approach could have practical application in hospitals and laboratories for the quantitative analysis of glomeruli in WSIs and, potentially, lead to a better understanding of chronic glomerulonephritis.

Diet and fluid restrictions that need continuous self-management are among the most difficult aspects of dialysis treatment. Smartphone applications may be useful for supporting self-management. Our objective is to investigate the feasibility and usability of a novel smartphone-based self-management support system for dialysis patients. We developed the Self-Management and Recording System for Dialysis (SMART-D), which supports self-monitoring of three mortality-related factors that can be modified by lifestyle: interdialytic weight gain and predialysis serum potassium and phosphorus concentrations. Data is displayed graphically, with all data evaluated automatically to determine whether they achieve the values suggested by the Japanese Society for Dialysis Therapy guidelines. In a pilot study, 9 dialysis patients used SMART-D system for 2 weeks. A total of 7 of them completed questionnaires rating their assessment of SMART-D's usability and their satisfaction with the system. In addition, the Kidney Disease Quality of Life scale was compared before and after the study period. All 9 participants were able to use SMART-D with no major problems. Completion rates for body weight, pre- and postdialysis weight, and serum potassium and phosphorus concentrations were, respectively, 89% (SD 23), 95% (SD 7), and 78% (SD 44). Of the 7 participants who completed the usability survey, all were motivated by the sense of security derived from using the system, and 6 of the 7 (86%) reported that using SMART-D helped improve their lifestyle and self-management. Using SMART-D was feasible, and the system was well regarded by patients. Further study with larger scale cohorts and longer study and follow-up periods is needed to evaluate the effects of SMART-D on clinical outcomes and quality of life.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Comprehensive cancer genome profiling (CGP) has been nationally reimbursed in Japan since June 2019. Less than 10% of the patients have been reported to undergo recommended treatment. Todai OncoPanel (TOP) is a dual DNA–RNA panel as well as a paired tumor–normal matched test. Two hundred patients underwent TOP as part of Advanced Medical Care B with approval from the Ministry of Health, Labour and Welfare between September 2018 and December 2019. Tests were carried out in patients with cancers without standard treatment or when patients had already undergone standard treatment. Data from DNA and RNA panels were analyzed in 198 and 191 patients, respectively. The percentage of patients who were given therapeutic or diagnostic recommendations was 61% (120/198). One hundred and four samples (53%) harbored gene alterations that were detected with the DNA panel and had potential treatment implications, and 14 samples (7%) had a high tumor mutational burden. Twenty‐two samples (11.1%) harbored 30 fusion transcripts or MET exon 14 skipping that were detected by the RNA panel. Of those 30 transcripts, 6 had treatment implications and 4 had diagnostic implications. Thirteen patients (7%) were found to have pathogenic or likely pathogenic germline variants and genetic counseling was recommended. Overall, 12 patients (6%) received recommended treatment. In summary, patients benefited from both TOP DNA and RNA panels while following the same indication as the approved CGP tests. (UMIN000033647).