Purpose: The present study aimed to develop 2 deep learning (DL) systems incorporating detection functions for the diagnosis of carotid artery calcifications (CACs) on panoramic radiographs and to compare their diagnostic performances using CAC-based, side-based, and patient-based evaluations. Materials and Methods: Panoramic radiographs from 290 patients with CACs and 290 control patients without CACs were used to develop 2 detection models: one designed to detect individual CACs across the entire radiograph (System 1) and another designed to detect CACs within the limited bilateral cervical areas (System 2). CAC-based performance was evaluated using recall, precision, and F1-score. Side-based and patient-based performances were assessed usingsensitivity, specificity, positive predictive value, negative predictive value, accuracy, and the area under the receiveroperating characteristic curve (AUC). Results: For System 1, CAC-based recall, precision, and F1-score were 0.81, 0.68, and 0.74, respectively. For System 2,the corresponding values were 0.90, 0.67, and 0.77. Side-based sensitivity, specificity, and AUC were 0.87, 0.80, and 0.83 for System 1, and 0.93, 0.84, and 0.89 for System 2. Patient-based sensitivity, specificity, and AUC were 0.93, 0.73,and 0.83 for System 1, and 0.95, 0.70, and 0.83 for System 2. Although a relatively large number of false positives were observed in CAC-based assessments, side-based and patient-based performances showed improvement. Conclusion Side-based and patient-based performances were sufficient when calculated on the basis of CAC-basedevaluations for diagnosing CACs on panoramic radiographs. When conducting studies of this type, performance assessments should include side-based and patient-based evaluations in addition to CAC-based analyses.

Introduction : With the increase in proportion of female physicians in Japan, breaks in their career associated with life events have become more apparent. We are making efforts to improve the program of work-life balance for female students at Jichi Medical University (JMU) who have a 9-year obligation to practice in a rural area following graduation. The purpose of this study is to research the needs for career development and work-life balance programs desired by female students at JMU.
Methods : A questionnaire was distributed to all 187 female students enrolled at JMU.
Results : The proportions of those wanting to marry and give birth during their 9-year obligation term were 71% and 68.6%, respectively. The proportions of those feeling anxious about childbirth and work-life balance after graduation were 80.0% and 78.1%, respectively. Over 80% of subjects answered that they wanted to attend lectures by female physicians and group meetings with such physicians, and to receive information regarding support systems and career development.
Conclusion : Female students at JMU tend to have greater concerns about life-events, but have an advantage in having opportunities for contact with female physicians who have contributed to rural practice. Clarifying role models for female medical students appears to be an expectation that our students have from our work-life balance programs.

We collected and analyzed large-scale data concerning the fall of stroke inpatients in convalescent rehabilitation wards. Three hundred seventy-four of 1,107 inpatients experienced one fall or more, and 16 factors associated with falls were clarified by the chi-square test. To extract the significant item from a multifactor, the logistic regression analysis of 16 factors was carried out, and we developed an assessment sheet for the risk degree of first fall prediction in stroke inpatients. We selected eight variables as the items on the assessment sheet : history of previous falls, central paralysis, visual impairment, sensory disturbance, urinary incontinence, use of psychotropic medicines, mode of locomotion, and cognitive impairment. The total score of the assessment sheet was ranged from 0 to 10 and the mean score of fallers (6.4±1.5) among subjects was significantly higher than that of non-fallers (5.1±1.9) (p <0.001). When the subjects were classified into three groups, a significant difference (p<0.001) in the tendency of fall incidence in term of days after admission was found among the three groups on the basis of the Kaplan-Meier survival curve.

Dialysis hypotension is one of the most common complications observed during hemodialysis. As it may be due to vasodilatation, vasoconstrictors are usually given to patients to control blood pressure. Howerver, there are some patients who are resistant to the medication with vasoconstrictors. Recently, it has been reported that as one of the treatments of dialysis hypotension, the cooling of dialysate is effective in inducing vasoconstriction via stimulating the sympathetic nerve system. Also, the application of the interaction of citrus juices with some kinds of drugs to the treatment of dialysis hypotension has been reported effective. In the present study, we examined the effectiveness of those two methods in nine hemodialysis patients in whom dialysis hypotension had not been improved with vasoconstrictors. Dialysate temperatures were lowered from 36.0 to 35.0 C during hemodialysis and/or 100m1 of citrus juice (grapefruit juice) were given to the patients before hemodialysis in addition to vasoconstrictors. Lowering dialysate temperaturse reduced the incidence of intradialytic hypotension and helped improve the patients' quality of life after hemodialysis therapy. Body temperature remained unchanged between before and after hemodialysis. However, we observed cramps in two patients and an impairment of consciousness in one patient during hemodialysis. Thus, we concluded due caution should be exercise against the side effects during hemodialysis when dialysate temperatures are lowered. Meanwhile, the intake of grapefruit juice before hemodialysis was not effective for the improvement of intradialytic hypotension and the patients' quality of life.