This short presentation gives brief overview of the A02 group titled “Computer Aided Diagnosis and Computer Aided Surgery Systems Based on Multidisciplinary Computational Anatomy,” which is designed to develop technologies for building clinical application systems that enables to utilize MDCA model and fundamental techniques investigated by A01. This group aims to develop decision making assistance systems in diagnosis and surgical processes by fully integrating multimodality images with A03. A02-1 project focuses on diagnostic and surgical assistance system based on multidimensional-space navigation. Seamless navigation in MDCA space will assist critical clinical decision. A02-2 aims to develop systems for cancer diagnosis and prognosis assistance based on MDCA. This project applies the MDCA models to the discovery of imaging biomarkers. A02-3 tries to integrate functional parameters for achieving diagnostic assistance system based on MDCA. CAD systems with MD information are expected to contribute to the society by enabling super-early detection and prevention of diseases. These researches are performed under tight collaboration within the MDCA project.

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The objective of our group A03, are to provide clinical database required for modeling to other groups A01 and A02 and to apply multidisciplinary computational anatomy (MCA) to diagnosis, treatment and biomedical engineering. The group A03 consists of three subgroups A03-1, A03-2 and A03-3. Subgroup A03-1 establishes animal model with tumor and its imaging system for clinical application of MCA to surgery. Now, the subgroup focus on pancreatic tumor and will present several image data using animal model. The subgroup A3-2 develops a database for multidisciplinary computational anatomy and collects variety of clinical images based on space, time, function and pathology axis. With other groups, the subgroup will evaluate clinical applications of MCA and will feedback their results. The subgroup A3-3 constructs the patient specific model combining with intraoperative biological information and multidisciplinary computational anatomy. Also the subgroup propose highly intelligent surgical robot to property approach the affected area based on the multidisciplinary information. Results of the group A03 will be expected to improve the credibility of application of MCA collaborating with other groups.

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Brain machine interfaces (BMIs) using intracranial electroencephalograms (electrocorticograms) are a promising candidate of the clinical application of high performance BMIs. We demonstrated that high frequency band activity is an excellent feature to decode movement onset and type, independent of the severity of motor dysfunction. Using the decoding features, real time control of a robotic arm was successfully performed by the patients that brain surface electrodes were placed to treat intractable epilepsy or intractable pain. We started a clinical trial in severe ALS patients using a wired BMI system involving the temporary placement of newly-developed personalized electrodes. A fully implantable wireless system is indispensable for clinical application of invasive BMIs to reduce infection risk. We are now developing the implantable system, which includes a 128-ch integrated amplifier circuit, 3D personalized high density electrodes, a wireless data transfer system and a wireless battery charger. We aim to put the implantable system to clinical use as soon as possible.

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How the brain responds in real-world social tasks remains largely unknown. Our goal was to determine cortical responses related to social interaction using fMRI, fNIRS and other physiological measures including heart rate variability (HRV). We investigated two naturalistic social tasks, guitar playing and a cooperative puzzle game. For guitar, we contrasted frontal lobe activity recorded using fNIRS during improvised blues to pentatonic scales, while for the cooperative game, we compared differences in affect, HRV and ability to cooperate across individuals and culture. Results show areas localized to creativity and affect are recruited significantly higher in improvised guitar compared to scales. Results of the cooperative game indicate the temporal-parietal junction, considered a social nexus area, displays increased activity during poor cooperation compared to good. Increased affect and decreased HRV was found in Japanese compared to Americans at the game while Japanese had a significantly higher success rate. These results suggest a multimodal approach to studies of brain function may be useful to determine detailed brain responses in naturalistic social environments.

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The gamma-band activities in the parietal and the visual cortices play a crucial role in manipulating mental representation of 3-D objects. However, it is not fully characterized whether individual changes in the gamma-band activity are correlated with the individual difference in the performance of mental image processing required both during the cognitive task in the lab setting and during the everyday life such as vehicle driving. Here, we measured EEG responses during the 3-D mental rotation task. The subjects' performance of vehicle driving was also evaluated in the simulated environment.Increase in 30 Hz gamma-band power at the occipital and the superior parietal areas were significantly correlated with the mental rotation task performance, which suggests that the efficient binding of visual features represented in these regions leads to better performance. Also, the gamma-band power was significantly correlated with the performance of vehicle driving as evaluated by stability of lane keeping under lower visibility condition. The findings suggest the possibility of predicting the driving capability from the cognitive task performance corrected offline.

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The Brain-Machine Interface (BMI) is an interface technology that utilizes neurophysiological signals from the brain to control external machines or computers. We have developed EEG-based BMI systems. We first applied the P300 paradigm for communication and environmental control. We prepared a green/blue flicker matrix, and showed that the new matrix was associated with a better subjective feeling of comfort than was the conventional white/gray flicker matrix, and we also found that the new matrix was associated with better performance (Takano, et al., 2009). We also prepared a steady-state visual evoked potential-based BMI using flickering visual stimuli at frequencies greater than the critical flicker frequency (Sakurada, et al., in press). For clinical purposes, we have developed an in-house environmental control system. We also developed peripheral devices: a non-adhesive solid-gel EEG electrode (Toyama, et al., 2012) and a soft cap with electrode holders. The BMI system was successfully operated by patients with amyotrophic lateral sclerosis (Ikegami, et al., 2014). Researches along these lines may help persons with disabilities to expand the range of activities.

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In order to facilitate further understanding of the brain, we need an infrastructure to share the efforts such as sharing experimental data, analysis tools and computational models in interdisciplinary field. The Neuroinformatics (NI) Team established in April 2002 at RIKEN BSI aiming for the development of the Japanese NI and opened the “Visiome Platform”, the first public NI platform in Japan developed by the “NI Research in Vision” project (PI: S. Usui, 1999-2004). Meanwhile, the INCF was established in 2005, following the recommendation of the OECD MegaScience Forum. The NIJC (NI Japan Center) was then opened at RIKEN BSI as the INCF Japan-node. To further facilitate and encourage utilization of the NI databases, we developed a cloud-based “Simulation Platform”. This allows users to test more than hundreds of models with just a web browser. To construct a large scale model, the tested models can also be connected using a model integration environment called “PLATO”. As an application of the PLATO, we have developed a large scale visual system model on the K-computer. We believe that these achievements contribute to the next generation of neuroscience research including Medical and Biological Engineering.

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Under the INCF Japan-node, we now have 12 brain and neuroscience related Platform(PF)s which are operating in collaboration with 55 universities and institutes. The PFs promote sharing and integrating neuroscientific data over the Internet. The primary function of the PFs is to improve the reproducibility of published research. For example, Visiome PF provides original digital resources such as a single neuron model, visual system models, Matlab scripts for processing vision science data, and users even can download for test and/or reuse the published results for their own research. The PF also provides contents to learn vision science by watching tutorials, e.g., Visiome channel on YouTube and Visual illusion site which open not only for research-oriented but also for education-oriented uses. Simulation-PF has been developed to archive and browse the PF contents under a user friendly cloud-based simulation environment via a web browser. Simulation-PF users can learn computer operating skills and programming skills as well as basic neurosience field for utilizing downloaded contents on the PFs. We discuss the future role of the platforms through some representative works.

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Even insect brains have simple structure compare to vertebrate brains, they control various complex behaviors of insects. The brain functions were regulated by neuronal properties, structures and their connectivity. So simple insect brains could be a useful model system to investigate brain mechanisms from neuron to whole brain. In our study, we focused on the neuronal circuit generating pheromone triggered walking in silkworm moth, Bombyx mori. Neuronal structure on the information pathway was extracted from brain images obtained by the laser-scanning microscope. Segmented neurons were registered into the standard brain for normalizing size and location. The ionic channel distributions were estimated from neuronal response to the current injection. Neuronal connectivity was estimated from the distance among the dendritic tips of registered neurons. The possible neuronal connection was also estimated by the regeneration of response patterns of neurons by the optimization technique. A neuronal network model is implementing on the K computer (RIKEN, AICS), to conduct real time simulation for investigating the effect of environmental changing caused by the animal movement [HPCI-ID:hp120263/hp140151].

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To develop a large scale model of brain or organs of living matter, collaboration of neuroscientists specialized in those fields and integration of multiple lines of evidence into a large scale model are necessary. To implement this strategy, we have been developed PLATO (latform for the collaborative brain system modeling) where the neuroscientists enable to collaboratively make a large scale model. The PLATO consists of data management tool to search and gather resources for model development from neuroinformatics platforms in the world, the data-oriented model integration library with a graphical user interface editor, and simulation agent. The PLATO enables users to integrate and to reuse newly developing and existing sub-system models by minimum changes in the program codes with plug-in/out way for development and simulation of a large scale model. Here we introduce the features of the PLATO, a use case in a large scale modeling of visual system, and its simulation results intended for the effect of miniature eye movement on retinal signal processing using the K computer. From those results, we discuss the state of a large scale modeling in near future in the symposium.

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Cardiac implantable electric devices (CIEDs) systems are indispensable for today's cardiac treatment. Most of CIEDs systems consist of device and leads like the pacemaker system. The implantable cardioverter - defibrillator (ICD) was developed to use the patch electrode unlike the pacemaker lead. Finally, today's ICD equipped transvenous shock lead. The transvenous lead system has a large advantage in the implantation procedure. For patients who need the CIEDs, the transvenous approach is less invasive and less risk in the operation than the open chest surgery. Therefore, the development of the transvenous system is significant improvement for CIEDs. Recently CIEDs system infection and the longevity of the lead are focused as the new risk of the CIEDs system. When some troubles are found in the transvenous system, the most miserable scenario is the total system extraction, which involves large risks. Even if the total system extraction is not required, at least it is necessary to replace the leads to the new ones. It is true that the developments of the transvenous lead system have enabled to implant more easily and the transvenous CIEDs system have disseminated the CIEDs therapy. However, the transvenous system is one of the risk factors of the CIEDs therapy.
The recent development of the lead-less pacemakers and subqutaneous ICDs are one of the solution against these risks.
The LV pacing with the conventional epicardial lead has many limitations in the longevity, e.g. lead fracture and threshold rising. The development of the transvenous LV lead was one of the evolutions for the CIEDs therapy. For the resynchronize therapy, stable LV pacing is the most important factor. The development of the transvenous LV lead has achieved the safe and effective treatment for the chronic heart failure patients. On the other hand, the nerve stimulation is developed for the treatment of the intractable pain. Sympathetic or parasympathetic nerve stimulation for chronic heart failure patients was tried using new implantable devices. All these devices has not been accepted with clinical evidences. However, these devices are still improving and renewing.
The CIEDs is not only the therapy device, but also the diagnostic device. The device equipped the Holter ECG function. The pacemaker is able to record the number of the arithmetic events and EGM. The implantable loop recorder (ILR) is the first implantable device for diagnosis. ILR has not therapy function. Recently many implantable diagnostic devices have been developed. Most of them are to observe the cardiac function for chronic heart failure patients. In this session, new implantable therapy devices will be introduced in the first part. Then, new implantable diagnostic devices will be also introduced in the second part.

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In Japan it was decided to be held in Tokyo Olympic and Paralympic in 2020. Movement aiming at the visit to Japan of the tourist from the foreign countries of 15 million becomes active in Japan. Many of the foreigners who do not speak well the Japanese and English are expected to come to the hospitals , clinics and pharmacies. There is a growing need of various foreign language and Japanese bilingual in the medical field. However, automatic translation system is not reached yet sufficient level in the medical field. Automatic translation system is still insufficient in input by characters. Input by voice cannot be further satisfied. In the hospital, the correspondence at the reception, conversations with doctors in the examination room, treatment with co-medical, and medication guidance by pharmacist, there are a variety of situations. In the medical field, healthcare workers must be in contact with the foreign personsuch as multidisciplinary various circumstances. So for future research, we have to understand the current state of multi-language translation system in the medical field in Japan and overseas. We report a case of considering the challenges of multi-language translation system research in the medical field.

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Becoming ill in a foreign country can be very worrisome for patients with the lack of knowledge about the medical system in the country and the difficulties in understanding the language. I have personally experienced visiting an emergency unit of a hospital in Bangkok. Fortunately, I was helped by a Japanese interpreter and a physician with experience studying in Japan despite of the fact that it was nighttime, and was still able to receive medical care without much difficulty. In Japan, however, there are only a few hospitals that have such system of treating foreign patients.The number of foreign patients at our hospital has increased recently. Due to the difficulty in communication, medical consultations as well as other patient care have become more complicated and stressful. Our hospital has also started accepting patients visiting Japan for medical tourism, and not all of them have interpreters. In addition, considering the 2020 Olympic Games in Tokyo, our hospital has decided to actively practice medical care for foreign athletes and visitors. Thus, it has become necessary for us to develop a communication-assisting tool for smooth multilingual translation.

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Recently, we have greater opportunities to provide medical care to foreign people who can't speak Japanese. In fact, not all of our medical staff can treat them with foreign languages although we are required to give them proper medical care even with language problems. Although we consider the treatment with an interpreter for foreign patients, it is very difficult to do such things all the time. However, it is imperative for nurses who take care of patients with 24-hour observation to communicate with them promptly.Actual conversation samples is being collected at the moment.It is necessary to create database picking up good conversation samples which help us to understand patient's condition and enable us to explain how it is. Creating translation system in consideration of differences between foreign people and Japanese in terms of cultures, religions and semantic baggages would make it possible to provide better medical environment to foreign patients. Also, we need to create another type of system with visual and audio for hearing-impaired patients and visually-impaired patients.

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It is necessary to communicate with foreign workers when implementing health checkups in companies. Therefore, commissioned by our client companies, we provides health checkups and health management services in English for their workers. We create a special website to provide information about the checkup program as well as to receive health checkup reservations from them. The people on the lists provided by the companies are sent an email in both Japanese and English pointing them to our website, where they can choose either language and select the date and time when they wish to undergo the health checkup.In what concerns the health inquiry sheets and the contents of the health checkup, services are smoothly delivered to them through the introduction of panel displays and the use of Japanese-English translation manuals.In this report, we present the contents of our services and also highlight some challenges ahead of us regarding the English support in health management services. We intend to continue developing this system by using smart devices for multilingual communications in health inquiries and explanations.

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We have no doubt that the number of foreign visitors will go on increasing due partly to Tokyo's winning as the candidate of the 2020 Summer Olympic site . Medical treatment is expected to be provided appropriately to foreigners who don't speak Japanese in the same way that Japanese patients are treated. Considering the possibility that there's insufficiency of medical services due to the differences of cultures, religions, and medical system between foreign people's home countries and Japan in addition to language problems, we have developed ICT system, that is available to foreigners so that they would feel free to visit a pharmacy or a drugstore without having to worry about language difficulties. The system is designed to support foreigner who visit a pharmacy to fill a prescription written by Japanese medical institution. It is also available to people who need to buy non-prescription drug such as cold medicine. Here's the report regarding what kind of system we have developed and the result of the demonstration experiment conducted in cooperation with Japanese pharmaceutical chemist and foreigners who speak English, Chinese, Taiwanese, Korean, Portuguese, and Spanish.

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Although there is a growing emergence of translating and interpreting services for non-Japanese speakers recently, the reality is that quality varies greatly. Yet such services in the field of medical care must be high in quality, for they are concerned with one's health and life. Therefore, the author conducted a usability testing of a pharmacy translating application that is being developed in six languages to find the necessary procedures and perspectives for guaranteeing quality when developing translating services in the field of medical care. In the test, six non-Japanese subjects were asked to test out the application. They were audio and video recorded, which were analyzed alongside interviews which were conducted to find reasons for the problems they experienced. The results suggested that the greatest factor behind their dissatisfaction was the difference in culture and medical systems between Japan and that of the subjects' native country. The author concludes that it is essential to listen to opinions from non-Japanese speakers and recognize such differences to guarantee quality when developing translating services in the field of medical care.

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The arterial baroreflex system is an important negative feedback system to regulate arterial pressure (AP). This system may be analyzed by dividing it into a controller subsystem (the neural arc) and a plant subsystem (the peripheral arc). The former determines SNA in response to baroreceptor input pressure, and the latter determines AP in response to SNA. We have employed a framework of an open-loop analysis to identify the neural and peripheral arc characteristics. With respect to dynamic characteristics, the neural arc shows derivative characteristics whereas the peripheral arc shows low-pass characteristics. The fast neural arc compensates for the slow peripheral arc to accelerate the total reflex arc. With respect to static characteristics, the neural arc has inverse-sigmoidal relation between input pressure and SNA whereas the peripheral arc has more linear relation between SNA and AP. A baroreflex equilibrium diagram can be obtained by plotting the two arcs on a pressure-SNA plane. By using the baroreflex equilibrium diagram, we can schematically understand how changes in the neural arc, peripheral arc, or both of them, affect the operating point of the arterial baroreflex.

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The arterial baroreflex system may be analyzed by dividing it into neural arc and peripheral arc subsystems. The central and peripheral effects of a given drug can be assessed by changes in the neural and peripheral arcs, respectively. First generation dihydropyridine calcium blockers (DHPs) exert a strong and rapid arterial pressure (AP)-lowering effect via vasodilatation but may evoke baroreflex-mediated sympathetic excitation, leading to increased heart rate (HR). Second and third generation DHPs have slow-onset and reduce AP while either maintaining or actually decreasing HR, indicating possible sympathoinhibitory effect. We examined the acute effect of intravenous nifedipine, cilnidipine, and azelnidipine (1st, 2nd, and 3rd generation DHP, respectively) on sympathetic nerve activity (SNA) in anesthetized Wistar Kyoto rats. When the baroreceptor input pressure was controlled at predefined pressure levels, nifedipine, cilnidipine, and azelnidipine did not significantly affect the SNA response. The acute hypotensive effects of intravenous DHPs may be chiefly attributable to the peripheral vasodilator action but not to the direct inhibition of the sympathetic outflow.

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We examined the dynamic baroreflex characteristics of myelinated (A-fiber) and unmyelinated (C-fiber) baroreceptor central pathways in anesthetized Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). The left aortic depressor nerve was electrically stimulated with two binary white noise signals to activate either A-fibers (A-BRx) or C-fibers (C-BRx). In WKY, the central arc transfer function estimated by A-BRx showed strong derivative characteristics with the slope of the dynamic gain (Gslope) of 13.9±1.1 dB/decade. In contrast, the central arc transfer function estimated by C-BRx exhibited non-derivative characteristics with Gslope of -0.6±1.4 dB/decade. This indicates that A-fibers are involved in fast regulation while C-fibers are vital for sustained changes by the baroreflex. The Gslope of the central arc transfer functions estimated by both A-BRx (18.4±0.8 dB/decade, P<0.01) and C-BRx (8.2±0.9 dB/decade, P<0.001) were higher in SHR compared with WKY. In conclusion, the dynamic baroreflex characteristics of the C-fiber central pathway in SHR more closely resembled A-fiber central pathway characteristics than the distinctly different characteristics observed in WKY.

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Although the link between the autonomic nervous system and inflammatory response is well known, it remains unknown how the inflammation affects the baroreflex control of sympathetic nervous activity (SNA). To examine the effect of inflammation on the open-loop static characteristics of the carotid sinus baroreflex, we isolated the bilateral carotid sinuses and controlled intra-sinus pressure (CSP) in Sprague-Dawley rats (380～407 g). Inflammation was induced by intravenous lipopolysaccharide (LPS, 10 mg/kg). Changes in SNA and aortic pressure (AP) in response to CSP input were examined in the presence or the absence of the vagal nerve (N = 4 each). At 3 hours after injection, LPS markedly moved the baroreflex neural arc (CSP-SNA relation) upward by more than 3 times, while shifted the peripheral arc (SNA-AP relation) downward. Vagotomy pronounced these changes with an increase in the peak elevation of TNF-α. In conclusions, LPS-induced inflammation markedly increased SNA via the resetting of the baroreflex neural arc, while decreased the vascular response to SNA. The presence of vagal nerve not only attenuated the inflammatory response but also inhibited sympatho-excitation in the LPS model.

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The vestibular system is sensing posture or direction of the gravity. It has been known that it is playing important roles not only posture control, but also cardiovascular dynamics via the autonomic nervous system as output. The control system is playing important roles for controlling arterial pressure during posture change in human subjects. Changing the posture from supine to standing, body fluid shifts footward, and venous return or cardiac output is decreased. Without any control, arterial pressure should be decreased, but it is not changed largely in healthy subjects. However, arterial pressure is decreased when vestibular input is confused with galvanic vestibular stimulation (GVS). Thus, vestibular system is playing an important role for arterial at the onset of this standing. The change in arterial pressure at the onset of standing is correlated with balance of otolith function. Furthermore, GVS increases high frequency component which is a marker of parasympathetic nerve activity in heart rate variability. The increase is also correlated with change in arterial pressure at the onset of standing. The results suggest a presence of vestibulo-parasympathetic pathway.

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To investigate the brain mechanism of embodied cognition, bodily illusion has been intensively studied. Several works in the bodily illusion have identified the neural activities in specific brain regions related to the embodied cognition. However dynamic relationship among them has not yet been well understood. In this study, we investigate the functional connectivity among those brain areas under a bodily illusion condition by using functional near-infrared spectroscopy (fNIRS).

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BCI (Brain Computer Interface) is a system that controls machines and devices by extracting neural information from human brain activity and inputting it to machines. This study use the BCI system to feedback the brain activity level to users so that they can control their brain activity easily, which is called neurofeedback(NFB). The NFB training is expected to apply to mental healthcare. We developed portable NIRS-based BCI system for mental healthcare. The developed system is provided with a monitor display that became increasingly red with rising oxy-Hb and increasingly blue with declining oxy-Hb. A user was able to activate his or her brain activity by observing the monitor display. The developed system can also control a toy car and video game character for maintain motivation of NFB training. To evaluate effectiveness of the developed system, we conducted experiments of NFB training for three healthy participants and four ASD participants. We confirmed that the brain activity and the result of POMS were improved by the NFB training using the developed system. This result shows that the developed portable NIRS-based BCI is effective for mental healthcare.

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We have previously proved prefrontal hemodynamic change in autism spectrum disorder (ASD) subjects according to switching task using near infrared spectroscopy (NIRS) lacks synchronizing evoke of oxygenated hemoglobin, although the task performance rates were almost equivalent to the controls. Therefore, next we have applied the neurofeedback (NFB) system using NIRS for ASD subjects to establish their task-related PFC activity control. The NFB system using wireless NIRS was preliminarily applied to 4 ASD individuals with a session consists of 7 consecutive trials. They partially showed improvement in PFC blood oxygenation response to the self-stimulation of neurofeedback by plotting oxy-Hb and d(oxy-Hb)dt and detect barycentric points appearance. Additionally, the average data of working memory and non-working memory switching task, stroop test, anxiety test, self-evaluation test, and mood test, were all improved during the NFB training , as well as follow-up check. These results suggests us that it might be possible to apply NIRS as a non-invasive sub diagnostic tool as well as active supporting tool for ASD subjects.

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When the human being watches actual object closely and appreciates it, the physical exercise and the ocular-motility are compounded and try to get the visual information of the object but a cerebral feature about the relation between the visual-function and the three-dimensional image (the following 3D) isn't sufficiently made clear yet.It reports because it compared the image of 3D image and the two dimensions image (the following 2 D) this time and it evaluated it about the load which accompanies the nervous activity which places a cerebral feature.

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An overview of methods that use adaptive filters to cancel out the periodic interference appearing in biomedical signals is presented. Periodic interference frequently disturbs the measurement of small signals and causes problems. This issue is particularly critical when measuring bioelectric signals such as EEG and ECG signals using electrodes attached to the surface of the human body. Especially, in the case of electroretinogram (ERG), the periodic interference included in the signal presents a significant hindrance, because the electric potential of the response is minute and includes the fundamental frequency of the AC power source and its several harmonic frequencies. Although the commonly used notch-filter cancels such periodic interference, it also destroys the objective signal. Adaptive filters are thought to have the potential to cancel such interference with less damage to objective signals. However, we have pointed out that adaptive filters may also produce a “self-cancelling component.” Thus, the cancellation of periodic interference is still an open problem. Some specific solutions have been given so far. We review several practical applications using such new technologies.

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Several non-invasive tests to evaluate the degree of arteriosclerosis (DA) are utilized for the diagnosis. However, the DA estimated by a test cannot be verified because it is difficult to measure the elasticity of artery extracted anatomically from subjects who are received the non-invasive test. Conventionally, the validity of a new test developed for estimating the DA has to been evaluated by examining cross-correlation between DA estimated by the new test and other similarly unverified test, or dependency of the measured DA on age of subjects. We focus on carotid ultrasonography, one of tests for evaluating the DA. By observing carotid artery in ultrasonography, if the magnitude of carotid diameter changes accompanied with heart beat normalized by difference of systolic and diastolic blood pressures becomes smaller, it is considered that carotid artery is more elastic, i.e., arteriosclerosis is more progressing. We pointed out that the elasticity of carotid artery is estimated higher for a subject who has more elastic surrounding tissues around carotid artery because the tissues suppress the movement of artery.

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Oculomotor system has been a popular model system in neuroscience to study motor control and learning. Eye movements have also attracted much attention in medicine, ergonomics, and engineering as many brain areas are involved in oculomotor control and their activities are reflected in different ways in various types of eye movements. In this talk, I will introduce our study on adaptive robot control by a realistic neuronal network model of the cerebellum that were configured based upon neuroanatomical evidence on adaptive eye movement control revealed by our monkey and goldfish behavioral and electrophysiological experiments. The model implemented on LabVIEW was registered to International Neuroinformatics Coordinating Facility Japan Node, Cerebellar Platform, and publicly available. I will also talk about an application of reflexive eye movements to detect and predict sleepiness of car drivers. This application was inspired by behavioral experiments in monkeys in which simple reflexive eye movements called the vestibuloocular reflex were found to be less responsive and more variable when they were sleepy than when they were alert.

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It has been a focus of constant attention on “Mobile Healthcare” services utilizing wearable healthcare devices and smartphone/tablet. They are used for promotion of good health and prevention of diseases.The users are able to understand their health condition and easily aware of any changes of the condition. As a result, the users use these Mobile Healthcare services to adjust their lifestyle for improving their health condition.This paper reports essential technology components of Mobile Healthcare services such as device, network, contents and platform by introducing the latest service cases.It also covers recent trend of Mobile Healthcare service user's profile and attribution which are derived by analyzing healthcare data gathered by docomo Healthcare, Inc.Lastly, we discuss about the future of Mobile Healthcare services together with the issues to be solved. 1.Outline of Mobile Healthcare 2.Example of Mobile Healthcare Services 3.Current Stage of Mobile Healthcare Technology Components 4.User Profile and Use Cases of Health Data 5.Future of Mobile Healthcare and Issues

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Measurement of cardiovascular dynamics is valuable for diagnosis of the cardiovascular system. High frame rate ultrasound, which was introduced in the 1980s [1], is a promising technique for such purposes. This technique uses unfocused transmit beams and creates multiple focused receiving beams in each transmission. High frame rate ultrasound was first applied to the measurement of the displacement distribution in tissue induced by acoustic radiation force for assessment of viscoelasticity [2]. Recently, we have shown that high frame rate ultrasound is also useful for B-mode, tissue strain, and blood flow imaging [3]. Currently, various methods based on high frame rate ultrasound have been developed for measurement of cardiovascular dynamics [4-8]. In this presentation, recent development in high frame rate ultrasound and its application to measurement of cardiovascular dynamics are shown.

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Recently, not only conventional two-dimensional (2D) image but also real time three-dimensional (3D) image is used for echocardiographic diagnosis. It has become possible to acquire and to display the image of the heart by using 3D electronic scan in real time. Also, echocardiography is increasingly used as a tool for analysis of cardiac function and as an aid to assessment of ischemia, dyssynchrony, heart failure and other cardiac conditions. Especially myocardial strain is getting a lot of attention as a promising parameter for this purpose. Myocardial strain is obtained by pattern matching process to track regional motion of myocardium with using ultrasound cine data also commonly known as speckle tracking. We developed 3D Wall Motion Tracking (WMT) for a 3D image data as well as developed 2D WMT for a 2D image data, and these applications have been provided on Artida ^TM as speckle tracking analysis. In this presentation, features and definition of some wall motion parameters based on WMT are explained. Also, some results of validation and clinical study with using WMT are reported. Finally, the latest technology about WMT is presented.

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In echocardiography, various indices are obtained to assess cardiac function. Although these indices should be measured in the images of the same heartbeat, practically, they are measured on different heartbeats on the assumption that the R-R interval of the electrocardiogram is substantially constant. Dual Gate Doppler technique enables us to observe Pulsed Doppler waveform on the different two positions, so it is useful not only for sinus rhythm but also for atrial fibrillation patients. There are two types of Pulsed Doppler, blood flow waveform acquisition and tissue motion waveform acquisition. Dual Gate Doppler can be used in arbitrary combination of two types of Pulsed Doppler. However, it is concerned that by transmitting the beam in two directions, the upper limit of the velocity range is reduced in comparison with the conventional one direction Doppler. Typically, the velocity required for the PW mode is 1.0～1.5m/s.In order to solve this problem, the PRT and the velocity range of the transmission in two sample volumes are constantly optimized. As a result, we have realized a sufficient velocity range for observing blood flow in echocardiography.

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Objective: We investigated right (RV) and left ventricular (RV and LV) function, dyssynchrony and ventricular interdependence in acute and chronic RV pressure overload (RVPO). Methods: RV and LV functions were analyzed by speckle-tracking echocardiography in APTE (n =37), CPAH (n =36), and Controls (n =33). The standard deviation of the heart rate-corrected time-to-peak regional systolic strain (PSS-dyssynchrony) and displacement (PSD-dyssynchrony) was used to quantify RV and LV dyssynchrony. Results: Both the APTE and CPAH groups had impaired RV and LV myocardial strain and large dyssynchrony compared with the Control group. RV and LV myocardial performance indices (MPI) were also abnormally high both in the APTE and CPAH groups. Pulmonary vascular resistance in the APTE group and RV global PSS in the CPAH group were independently associated with RV MPI, and LV longitudinal PSD-dyssynchrony in the APTE group and eccentricity index and heart rate in the CPAH group were independently associated with LV MPI. Conclusion: RVPO reduces ventricular function and generates dyssynchrony in the both ventricles. Pathophysiological mechanisms that regulate ventricular interdependence are different in acute and chronic RVPO.

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It is a strongly desirable issue to know the information of actual blood flow direction and velocity in the left ventricle. Until now one could see the intraventricular flow as components of flow velocity vectors just toward and away from the transducer using conventional color Doppler imaging. However, using a novel technology, Vector Flow Mapping (VFM TM, Hitachi-Aloka Medical), blood flow velocity vectors and blood flow streamlines in the left ventricle could be visualized on the 2D images. For the VFM, one needs to obtain the blood velocity data toward and away from the transducer in left ventricular (LV) chamber using conventional Color Doppler imaging and also needs to know the LV endocardial wall motion velocity in the transverse direction using speckle tracking imaging. From these data, blood flow directions are computed using a polar continuity equation. Using the concept of VFM, vortices can be visualized in the LV chamber with the information of rotational direction. The strength of rotation can be calculated as vorticity. Typical VFM images in normal volunteers and patients with various kinds of cardiac diseases will be presented in the session.

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Assessing left ventricular (LV) filling pressure (pulmonary capillary wedge pressure, PCWP) is essential in the care of patients with heart failure (HF). Physicians use right ventricular (RV) filling pressure such as central venous pressure (CVP) to predict PCWP. However, the use of this method is limited because discordance between CVP and PCWP is sometimes observed. Our theoretical analysis indicated that PCWP can be predicted by CVP corrected by the relation between RV and LV function, provided by the ratio of tissue-Doppler systolic velocity of tricuspid annulus (ST) to that of mitral annulus (SM) (CVP·ST/SM). In 16 HF dogs, a stronger correlation was observed between CVP·ST/SM and PCWP than between CVP and PCWP. This was also confirmed in 98 HF patients. Furthermore, when ultrasonic dimension of inferior vena cava (IVCD) was used as a noninvasive alternative to CVP in the HF patients, a stronger correlation was observed between IVCD·ST/SM and PCWP than between the early diastolic transmitral inflow to mitral annular velocity ratio (E/e') and PCWP. RV filling pressure or its noninvasive surrogate such as IVCD corrected by ST/SM may be useful to predict PCWP in HF patients.

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Each hospital has created the rule about use of a mobile phone with referring to the guideline which Electromagnetic Compatibility Conference Japan (EMCC) released in 1997, and taking the problem of manners into consideration comprehensively.Today, patient environment have drastically changed, such as the penetration of mobile phones into daily life, the termination of second-generation mobile phone services, and the improvement of medical electrical equipment for electromagnetic immunity. Therefore, EMCC published the new version of “Guidelines for use of mobile phones and other devices in hospitals” in August, 2014.New guidelines were created based on the survey results of current status of the mobile phones use in hospitals and the impact assessment results of the mobile phones to medical electrical equipment. The new guidelines enabled to expand the area in which mobile phone can be used, while requiring to keep “a separation distance” between medical electrical equipment and the mobile phones. New guidelines are also asking for hospitals to deploy “EMC managers” to manage electromagnetic environment properly. We describe the background and outline of the new guidelines.

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It is well-documented establishing electromagnetic compatibility (EMC) is important for using medical device in hospitals. We measured the electric field intensity in new hospital in before any patients came into the hospital for the very first time and 6 months after the opening of the hospital. FM radio signals, UHF TV signals, and cell-phone system base stations were strongly detected at the windows of the upper floors. There was no great difference in measured levels between before and after the opening of the hospital. There were no cell-phone unit signals before the hospital opened its doors to patients, but were very strongly detected 6 months thereafter. In this study, the maximum electrical intensity was 0.28 V/m from cell-phone system base stations. This value was lower than the EMC marginal value of the general electronic medical device specified in IEC 60601-2-2 (3 V/m). However, there were no cell-phone system base station signals in some area. Measurements 6 months after the opening of the hospital revealed very strong cell-phone unit radio waves in the hospital. To promote greater EMC safety, the hospital should prepare countermeasures to improve these conditions.

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The Electromagnetic Compatibility Conference Japan announced in August, 2014 its reforms to the 1997 “Guidelines for use of mobile phones and other devices in hospitals.” The main purposes of the old guideline were to prevent the Electromagnetic Interference (EMI) with medical devices resulting from the electromagnetic field which a cell phone terminal induced. In this amendment, regulation was loosened from the viewpoint of preventing EMI. But, new guidelines presented the notes from new viewpoints, such as manners, patient safety, and data protection. Also, the new guidelines are asking to manage electromagnetic environment. Management of electromagnetic environment will contribute to safe introduction of wireless communication.The report which explains the guidelines and includes three advanced examples was also published. One example is Shimane University Hospital, with examples of the ICT introduction which is possible immediately. Another is Fukui University Hospital showing the directivity which will progress from now on. One which remains has published wireless-communications technology applicable to the hospital by Allied Telesis Inc.

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X-ray dark field imaging (XDFI)[1] comprises a monochromator-collimator, specimen and a Laue angle analyzer (LAA). This optics uses a specified thickness of LAA for the specified x-ray energy. This has been applied to 2D images of human soft tissues and it was extended to 3D images of soft breast tissues by creation of algorithm [2] applicable to refraction based x-ray imaging. The XDFI technique can be used in clinical regular check and since this technique can visualize tissue in 3D mode by creative algorithms [3,4] this can assist pathological work. Recently all images of human typical soft tissues were published [5]. A chapter “Medical Application” is in press [6]. Furthermore we are developing a system for clinical use and for pathological use.

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Analyzer-based phase-contrast computed tomography (CT) can image biological soft tissues and soft materials at a high contrast, which cannot be clearly depicted by contemporary CT based on absorption contrast. It reconstructs a distribution of refractive index from projections, whose data each is an angular deviation from incident direction due to refraction by an object, and is acquired by imaging methods using an angular analyzer, e.g., DEI (diffraction enhance imaging), or DFI (dark field imaging). So far, some kinds of reconstruction algorithms to obtain a refractive-index distribution have been proposed. In this talk, we introduce the outline of their fundamental concepts.

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Refraction-contrast X-ray computed tomography (RCT) can significantly increase the contrast-resolution of conventional attenuation-contrast imaging, especially for soft-tissue structures that have very similar attenuation. Just as in attenuation-based tomography, RCT requires a linear dependence of aggregate beam direction on the incremental direction alteration caused by individual voxels along the path of the X-ray beam. Dense objects such as calcifications in biological specimens violate this condition. There are extensive beam deflection artefacts in the vicinity of such structures because they result in large distortion of wave front due to the large difference of refractive index; for such large changes in beam direction, the transmittance of the silicon analyzer crystal saturates and is no longer linearly dependent on the angle of refraction. We propose a RCT reconstruction algorithm by which these non-linear effects can be overcome and excellent soft-tissue contrast of RCT can be preserved in the vicinity of such artefact-producing structures.

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When x-rays pass through an object, they are absorbed, refracted, and scattered. We have utilized only the contrast due to the difference of x-ray absorption in the clinical field. In the meantime, various techniques have been developed to extract an object's x-ray absorption, refraction (phase shift), and scatter, either separately or in some combination thereof during the past 20 years. Refraction-contrast, which is based on the difference in x-ray refraction, has been proved to be good at depicting soft tissues by many researchers. Besides, some researchers have reported the studies on the image contrast due to ultra-small-angle X-ray scattering (USAXS) using Bragg case analyzer (reflection type).
We tried USAXS imaging utilizing Laue case analyzer (transmission type). The experiment was performed at Beamline BL14B using synchrotron x-ray from the vertical wiggler of the Photon Factory in Tsukuba, Japan. The diffracted x-ray beams were acquired as images. The degree of USAXS was estimated from the expanse of the intensity curve of the each local pixel during Laue case analyzer rotated within the range of diffraction. We will report the preliminary results at this session.

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Recently Brain-Machine Interface (BMI) is expected as one of the treatment methods for patients with paralysis or limb amputation. However, changes in the nervous system that occur in the course of adaptation to a BMI system are not known in detail. It is very important to investigate the details towards the clinical application. We constructed an experimental system to study plastic changes in the nervous system in a BMI environment based on electrocorticogram (ECoG) using rats. Then, we have confirmed the utility of this experimental system in preliminary experiments. In this system we used power in high gamma band of the signal recorded by one channel of electrode (from 32 channels on the probe) as a trigger to provide the reward of water. Rats didn't know how to get the reward. However, the rats adapted to this system and they could gain the reward. Moreover, the change showed a tendency to converge on the channel that we used as the trigger. Also we are analyzing the changes of neural population responses in surrounding channels and in other frequency bands.

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In this study, we target end-users who are disabled persons and healthy persons whose hands are occupied. We select a steady-state visually evoked potential (SSVEP) based interface that requires no user training. The user interface menu has six stimuli with different frequencies (20-30 Hz), and the intensities are modulated sinusoidally and presented on a liquid crystal display. To reduce the risk of photosensitive epileptic seizure, we select the middle-band range of frequencies. We introduce a commercial headset with 14 channels, which decreases the time needed to attach electrodes. To extract and remove ocular-movement related components in the EEG data, we used a previously obtained un-mixing matrix of independent component analysis. Further, we use the components to detect the eye-fixation points, where the decision making was considered to have been complete, and start the modulation of the stimuli. We calculate the mean SSVEP amplitudes obtained from two occipital regions by averaging EEG data using triggers that correspond to six frequencies. To determine the gazed stimuli using the Z-scored mean amplitudes, we propose a simple algorithm that requires no learning.

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A Brain-Computer Interface (BCI) is the interface which enables users who cannot move their own body freely due to amyotrophic lateral sclerosis to manipulate machines at their own intention. The BCI system has been developed in particular area, such as inputting characters or moving a wheelchair. In contrast, the system combined BCI with Augmented Reality (AR) links markers to real objects and enables users to solve tasks directly in real life, so the system is assumed to be used in many situations. In this study, we added auditory stimuli into the AR-BCI system, and we developed a multimodal AR-BCI system and evaluated efficacy of simultaneous visual and auditory stimuli. In detail, subjects were given only visual, only auditory or visual and auditory stimuli, and we measured P300 for attended and unattended stimuli. We focused on the measured electroencephalogram, and proposed simple evaluating method of BCI. Then, we conducted basic research using 3D-stereophonic sound as new auditory stimuli in an AR-BCI system, and we evaluated effects of 3D-stereophonic sound.

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We are developing fully implantable wireless brain-machine interface system, which is able to record up to 4096ch ECoG signals. In this system, ECoG signals are amplified and digitized by an LSI. The neural data are transmitted to a wireless devise. Then, they are transmitted from inside to outside of the body wirelessly. One problem of this system is that the parts between multi-channel electrodes and wireless transmitter are too large to implant in head. To miniaturize this part, we propose the direct integration of electrodes and LSIs. The purpose of this study is to make a prototype of 1024ch ECoG electrode array with LSIs, to complete the wireless BMI system and to evaluate its performance in vivo experiment. We designed a 64ch electrode using flexible printed circuit technology. The substrate of the electrode was made of flexible thin-film polyimide and a 64ch LSI was flip chip bonded to it. After the measurements of fundamental properties such as impedance, we united the sixteen 64ch electrodes with LSIs into one 1024ch electrode with LSIs. We are planning to evaluate the performance of the electrode by an acute animal experiment.

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Real-time functional MRI is a non-invasive technique that enables the real-time analysis of brain activation patterns. Coupled with machine learning algorithms such as support vector machines (SVM), it can be used to identify different brain states in real-time. In this work, we developed a real-time brain state decoder system. In our implementation, image volumes were immediately reconstructed after acquisition, then transferred over the network to an analysis server where the images were immediately processed and the brain state decoded using pre-trained SVMs. We also explored the feasibility of using the system as a brain machine interface (BMI). For this, we scanned two participants and asked them to control the movement of an arrow displayed on a projection screen by matching their ongoing brain activity to a pre-defined activation pattern. Only a correct match, determined by the SVM, would move the arrow. The system attained an overall processing time per image volume that is less than the scan repetition time set at 2s. Moreover, participants were able to successfully control the arrow's movement demonstrating the feasibility of the system as a BMI.

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Cognitive decline in task switching may cause serious accidents especially in older adults. We evaluated the potential utility of a new task switching paradigm using color/shape and phone/letters to investigate the effect of aging on the brain activity using fMRI. Seventeen young and 15 older subjects participated in this study. Behavioral data analysis (ANOVA, p<0.05) revealed that the switching cost (SC) of color/shape paradigm was significantly higher than that of phone/letter paradigm in older adults, and the SC of older adults was also higher than that of young subjects in color/shape paradigm. The mixing cost (MC) of color/shape paradigm was significantly higher than that of phone/letter paradigm in both groups. Functional image analysis using SPM8 (p<0.001, uncorrected) revealed the significant activations in bilateral BA 32, 40 and 46 in both age group. Contrast result of two-sample T test for young minus older shows significant differences in the bilateral DLPFC including BA 46. These results suggested that the frontal-parietal network declines depending on aging. Focusing on these areas, this study might be useful for detecting the effects of aging on task switching function in the clinical setting.

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This study attempted to design a simultaneous measurement of BOLD signal and the diameter of the pupil based on the task load-dependent physiological response model to further characterize the brain activation. Seven healthy male subjects (M = 23.65) performed a digit category judgment task in the fMRI. The mean standardized diameter of pupil during the task blocks was z = 0.05 (SD = 0.76) and that during rest blocks was z = -0.22 ±0.85 in the low-load condition (LL). In the high-load condition (HL), the mean standardized diameter during task blocks was z = 0.40 ±0.64 and that during rest blocks was z = -0.21 ±0.73. In both conditions, significant activation was observed in the DLPFC ([BA] 8, 9, 45, 46, 47), the SPL and the IPL ([BA] 5, 7, 39, 40) and perisylvian fissure involving the BA 22 in each hemisphere. The contrast LL against HL was detected in the SPL and the IPL in each hemisphere. In addition, significant statistical correlations were observed between the variation of diameter and the task load-dependent brain activation in bilateral MFG ([BA] 46) (all p < 0.001, uncorrected). Focusing on parietal areas might be useful for detecting the individual difference on working memory in the clinical setting.

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