研究者詳細 - 増山　寿

Voice analysis and deep learning for detecting mental disorders in pregnant women: a cross-sectional study. 国際誌

Hikaru Ooba, Jota Maki, Hisashi Masuyama

Discover mental health 5 ( 1 ) 12 - 12 2025年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Perinatal mental disorders are prevalent, affecting 10-20% of pregnant women, and can negatively impact both maternal and neonatal outcomes. Traditional screening tools, such as the Edinburgh Postnatal Depression Scale (EPDS), present limitations due to subjectivity and time constraints in clinical settings. Recent advances in voice analysis and machine learning have shown potential for providing more objective screening methods. This study aimed to develop a deep learning model that analyzes the voices of pregnant women to screen for mental disorders, thereby offering an alternative to the traditional tools. METHODS: A cross-sectional study was conducted among 204 pregnant women, from whom voice samples were collected during their one-month postpartum checkup. The audio data were preprocessed into 5000 ms intervals, converted into mel-spectrograms, and augmented using TrivialAugment and context-rich minority oversampling. The EfficientFormer V2-L model, pretrained on ImageNet, was employed with transfer learning for classification. The hyperparameters were optimized using Optuna, and an ensemble learning approach was used for the final predictions. The model's performance was compared to that of the EPDS in terms of sensitivity, specificity, and other diagnostic metrics. RESULTS: Of the 172 participants analyzed (149 without mental disorders and 23 with mental disorders), the voice-based model demonstrated a sensitivity of 1.00 and a recall of 0.82, outperforming the EPDS in these areas. However, the EPDS exhibited higher specificity (0.97) and precision (0.84). No significant difference was observed in the area under the receiver operating characteristic curve between the two methods (p = 0.759). DISCUSSION: The voice-based model showed higher sensitivity and recall, suggesting that it may be more effective in identifying at-risk individuals than the EPDS. Machine learning and voice analysis are promising objective screening methods for mental disorders during pregnancy, potentially improving early detection. CONCLUSION: We developed a lightweight machine learning model to analyze pregnant women's voices for screening various mental disorders, achieving high sensitivity and demonstrating the potential of voice analysis as an effective and objective tool in perinatal mental health care.

DOI： 10.1007/s44192-025-00138-0

CD63 as a potential biomarker for patients with ovarian cancer. 国際誌

Keiichiro Nakamura, Naoyuki Ida, Akira Hirasawa, Kazuhiro Okamoto, Thuy Ha Vu, Dao Thi Hai Ly, Hisashi Masuyama

European journal of obstetrics, gynecology, and reproductive biology 306 87 - 93 2025年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Exosomes play an important role in regulating physiological processes and mediating the systemic dissemination of various types of cancer. We investigated the association of exosomal tetraspanins CD9, CD63, and CD81 in patients with ovarian cancer (OC). MATERIAL AND METHODS: We measured the plasma tetraspanins CD9, CD63, and CD81 by enzyme-linked immunosorbent assay in 91 patients who underwent treatment for OC between April 2018 and March 2024. Additionally, we analyzed clinical pathologic factors, chemotherapy response, and prognosis. RESULTS: In terms of stages, CD63 expression was significantly higher in patients with stage IV compared to those with stage I OC (p = 0.003). In terms of histological type, CD63 expression was significantly higher in high-grade serous carcinoma (HGSC) than in clear cell carcinoma (CCC) with OC (p = 0.009). Furthermore, CD63 levels were significantly higher in advanced-stage, HGSC than in patients with early-stage, non-HGSC and early-stage, HGSC OC (p = 0.045 and p = 0.002, respectively). In the Neoadjuvant chemotherapy (NAC) of 12 patients with OC assessed as having either a partial response (PR) or complete response (CR), CD63 was significantly decreased (p = 0.043), whereas perforin was significantly increased (p = 0.001). In the NAC of 16 patients with OC, CD63 of the response rate to chemotherapy tended to differ between the progressive disease (PD) and PR/CR groups (p = 0.056). A moderate inverse correlation was observed between CD63 and perforin levels (R = 0.638, R2 = 0.428, p = 0.008). CONCLUSIONS: CD63 could be a potential biomarker for all types of OC patients.

DOI： 10.1016/j.ejogrb.2025.01.011

フォンタン術後女性の周産期管理について

三島桜子, 衛藤英理子, 増山寿

日本成人先天性心疾患学会雑誌 14 ( 1 ) 88 - 88 2025年1月

A case of fetal myocardial calcification with hyperechoic area in fetal echocardiography. 国際誌

Takeshi Sato, Yosuke Washio, Hotaka Kawai, Kenji Baba, Eriko Eto, Hisashi Masuyama, Hirokazu Tsukahara

Pediatrics international : official journal of the Japan Pediatric Society 67 ( 1 ) e15868 2025年

自然妊娠後に発症した正所異所同時妊娠の1例

高谷優, 大平安希子, 栗山千晶, 坂田周治郎, 大石恵一, 末森彩乃, 中藤光里, 大羽輝, 三苫智裕, 加藤正和, 三島桜子, 桐野智江, 牧尉太, 衛藤英理子, 増山寿

現代産婦人科 73 ( 1 ) 97 - 101 2024年12月

記述言語：日本語出版者・発行元：中国四国産科婦人科学会

正所異所同時妊娠(HP;Heterotopic Pregnancy)は,子宮内妊娠と異所性妊娠が共存している状態である。生殖補助医療(ART)が要因の1つと考えられているが,自然妊娠後に発生したHPの1例を経験したので報告する。症例は30歳,4妊1産。自然妊娠にて妊娠成立し前医で妊娠管理していた。妊娠8週2日に急激な右下腹部痛が出現し前医に救急搬送された。子宮内に週数相当の胎芽と,ダグラス窩に液体貯留,右卵巣周囲に血腫像が疑われ,一時的に血圧低下を認めたため当院へ転院。卵巣出血に対して保存的加療を開始した。しかし翌日に血圧低下と腹腔内出血の増悪を認め,循環血液量減少性ショックと診断し緊急手術となった。術中所見より右卵管膨大部妊娠破裂と診断,右卵管切除術が施行された。術後経過良好で術後5日目に退院となった。その後の妊娠経過は良好であり,妊娠40週6日に経腟分娩にて男児を出産した。正所異所同時妊娠は子宮内妊娠の存在により子宮外の嚢胞を黄体嚢胞と間違えやすく,診断が困難である。ART後妊娠の他に骨盤内炎症性疾患,卵管手術歴,卵巣刺激などが正所異所同時妊娠のリスク因子と考えられているが,本症例は該当せず診断に苦慮した1例であった。妊娠初期に子宮内妊娠を確認した後の急性腹症,循環血液量減少性ショックの原因として,正所異所同時妊娠の可能性を考慮する必要があると考えられた。(著者抄録)

胎児超音波検査にて臍帯ヘルニアと両大血管右室起始を認め,出生後にheteropagus twinsと診断した一例

杉原百芳, 谷和祐, 大羽輝, 三苫智裕, 三島桜子, 大平安希子, 桐野智江, 牧尉太, 衛藤英理子, 早田桂, 増山寿

現代産婦人科 73 ( 1 ) 91 - 95 2024年12月

記述言語：日本語出版者・発行元：中国四国産科婦人科学会

【緒言】Heteropagus twinsは,双胎の一児(自生体)に不完全な個体である他の児(寄生体)が結合したもので,100万出生に1例の頻度とされている極めてまれな先天異常である。今回,胎児超音波検査にて臍帯ヘルニアと両大血管右室起始を認め,出生後にheteropagus twinsと診断した一例を経験したため報告する。【症例】33歳女性,2妊1産。超音波検査にて臍帯ヘルニア及び胎児心構築異常が疑われ妊娠26週に当院紹介となった。妊娠27週時の羊水検査は46,XY正常核型,妊娠34週にMRI施行,肝および腸管の一部が脱出した臍帯ヘルニア,両大血管右室起始,心室中隔欠損症の胎内診断となった。妊娠38週3日に選択的帝王切開を施行した。2764g,Apgar score6点/8点の男児で上腹部に寄生体を認めた。出生時MRI検査等の精査を行い,臍帯ヘルニアと両大血管右室起始,心室中隔欠損症,肺動脈弁狭窄症に加えheteropagus twinsの診断となった。寄生体は下肢,陰茎,陰嚢,精巣様の構造物を有し,日齢11に結合双胎切除術および臍帯ヘルニアに対して一期的閉鎖術を施行した。日齢78に術後経過良好で退院となった。【考案】結合双胎の出生前診断は非常に困難である。しかし多くの症例では臓器や主要な血管の共有は少ないため外科手術は一般的に容易であり,予後は良好である。本症例では出生前診断には至らなかったが,各科と連携していたことで出生後の慎重な管理や家族のサポートが可能であった。非常に稀な疾患ではあるが,臍帯ヘルニアや心構築異常を合併し,染色体異常を伴わない場合にはheteropagus twinsを含めた希少な疾患も念頭に置き,慎重な評価をすることが重要である。(著者抄録)

ADAR1 could be a potential diagnostic target for intrauterine infection patients. 国際誌

Keiichiro Nakamura, Kunitoshi Shigeyasu, Thuy Ha Vu, Jota Maki, Kazuhiro Okamoto, Hisashi Masuyama

Scientific reports 14 ( 1 ) 29419 - 29419 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Intrauterine infection (IUI) is mainly an ascending infection in which vaginal and cervical pathogens ascend to the uterus and can affect the fetus. Until now, there is still no effective diagnostic biomarker for IUI, such as chorioamnionitis (CAM) and funisitis (FUN). Deoxyribonucleic acid (DNA)/Ribonucleic acid (RNA) editing molecules such as apolipoprotein-B mRNA-editing complex (APOBEC) 3 families and Adenosine deaminase family acting on RNA (ADAR)1 were examined in chorioamniotic membranes and umbilical cord of 83 patient samples. Furthermore, Ureaplasma parvum induced ADAR1 was investigated in human HTR-8/SVneo EVT cell line. ADAR1 had a significantly higher area under the curve (AUC) (0.721 and 0.745) than other APOBEC3s or cytokines in CAM and FUN patients. In vitro, ureaplasma parvum was demonstrated to activate ADAR1 (p = 0.025) and reduce RIG-I, IRF3, IFN-[Formula: see text], and IFN-β expression in EVT cell line (p = 0.005, p = 0.010, p < 0.001, and p = 0.018, respectively). High expression of ADAR1 was strongly associated with CAM and FUN patients (multivariate analyses; p = 0.035 and p = 0.002). ADAR1 could be a potential diagnostic target for IUI, such as CAM and FUN patients.

DOI： 10.1038/s41598-024-81097-4

Vascular dysfunction in women with recurrent pregnancy loss: Possible association with antiphospholipid antibodies. 国際誌

Titi Yang, Emi Okada, Maho Todoroki, Siyu Liu, Rukmali Athurupana, Kumie Kataoka, Chiaki Kashino, Takashi Mitsui, Toru Hasegawa, Yasuhiko Kamada, Hisashi Masuyama, Mikiya Nakatsuka

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVE: Antiphospholipid antibodies (aPL) are recognized to have a pivotal role in recurrent pregnancy loss (RPL) and cardiovascular disease. Therefore, we assessed the vascular function of women with RPL and examined the association with each type of aPL. METHODS: In this retrospective study, 569 women with RPL and 55 healthy women who had never experienced pregnancy loss were recruited. We performed blood tests for aPL and acceleration plethysmography (APG) to evaluate peripheral vascular function. RESULTS: The differential pulse wave index (DPI), indicating vascular elasticity, was significantly lower in women with RPL (115.6 ± 4.1) compared to the control group (117.0 ± 2.3). DPI in RPL women with anti-β2 glycoprotein I (aβ2GPI) IgG was significantly lower than those without. Remained blood volume (RBV), indicating post-vasoconstriction blood content, was significantly higher in RPL women with aβ2GI IgG than in those without. Regression analysis showed aβ2GPI IgG and body mass index (BMI) linked negatively with DPI. CONCLUSION: Women with RPL have subclinical vascular dysfunction even at reproductive age. It is possible that aβ2GPI IgG is associated with vascular dysfunction in RPL women.

DOI： 10.1002/ijgo.16051

In vitro fertilization and long-term child health and development: nationwide birth cohort study in Japan 国際誌

Naomi Matsumoto, Takashi Mitsui, Tomoka Kadowaki, Toshiharu Mitsuhashi, Tomoya Hirota, Hisashi Masuyama, Takashi Yorifuji

European Journal of Pediatrics 184 ( 1 ) 24 - 24 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

The aim of this study is to compare long-term health outcomes between IVF-conceived children and non-IVF-conceived children in Japan, in the context of strong recommendation for single embryo transfer. Using data from a nationwide birth cohort linked with perinatal database, this study analyzed 2140 children born in Japan in May 2010. It compared child health and development outcomes up to 9 years of age between IVF-conceived and non-IVF-conceived children (binary exposure). A Poisson regression with robust variance to estimate the risk ratios for the association between IVF and various long-term child health and developmental outcomes. After adjusting for confounding factors, no significant differences were observed between IVF-conceived and naturally conceived children for most outcomes, including hospitalization, obesity, and developmental milestones. IVF-conceived children showed a slightly lower risk of attention problems at 8 years (adjusted Risk Ratio [aRR]: 0.73, 95% CI: 0.53–1.00). In subgroup analyses, IVF-conceived term children and singletons demonstrated reduced risk of cognitive delays at 5.5 years (aRR: 0.31, 95% CI: 0.10–0.96 and aRR: 0.37, 95% CI: 0.14–0.98, respectively).

Conclusion: In this Japanese cohort, IVF conception was not associated with adverse long-term health or developmental outcomes. These findings provide reassurance about the safety of IVF, particularly in the context of single embryo transfer policies. Further research is needed to explore specific IVF protocols and subgroups.

<table><tbody> <tr> <td colspan="2">What is known:• Long-term health and developmental outcomes of IVF-conceived children remain inconsistent across studies and populations, despite the widespread use of this technology.</td> </tr> <tr> <td colspan="2">What is new:• A nationwide population-based cohort study in Japan did not show adverse effects of IVF on long-term child health and development through age 9.• These findings provide reassurance about the safety of IVF, while indicating the need for careful monitoring in specific subgroups such as preterm and multiple births.</td> </tr> </tbody></table>

DOI： 10.1007/s00431-024-05883-y

その他リンク： https://link.springer.com/article/10.1007/s00431-024-05883-y/fulltext.html

Lymphadenectomy and chemotherapy are effective treatments for patients with 2023 international federation of gynecology and obstetrics stage IIC-high risk endometrial cancer in Japan.

Yoshinori Tani, Keiichiro Nakamura, Masae Yorimitsu, Noriko Seki, Mie Nakanishi, Hironori Itou, Miyuki Shimizu, Dan Yamamoto, Etsuko Takahara, Hisashi Masuyama

International journal of clinical oncology 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: In early-stage endometrial cancer (EC), the treatment of aggressive histological subtypes (endometrioid carcinoma grade 3, serous carcinoma, clear-cell carcinoma, undifferentiated carcinoma, mixed carcinoma, and carcinosarcoma) is controversial. We aimed to investigate the treatment of patients with International Federation of Gynecology and Obstetrics (FIGO) stage IC and stage IIC EC according to the 2023 classification. METHODS: We retrospectively identified patients with FIGO 2023 stage IC, IIC-intermediate risk (IIC-I), and IIC-high risk (IIC-H) EC who underwent adjuvant therapy or observation after surgery at eight medical institutions from 2004 to 2023. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier estimates and univariate and multivariate analyses. RESULTS: The PFS and OS were significantly worse in patients with FIGO 2023 stage IIC-H EC than in those with FIGO 2023 stage IIC-I EC (PFS: p = 0.008 and OS: p = 0.006). According to the FIGO 2023 stage IIC-H classification, lymphadenectomy and chemotherapy resulted in better prognoses regarding both PFS and OS (p < 0.001 for both) than other treatments. Our findings suggest that lymphadenectomy and chemotherapy effectively reduced vaginal stump and lymph node metastases in FIGO 2023 stage IIC-H EC (p < 0.001 and p = 0.008, respectively). Furthermore, in the multivariate analysis, not undergoing lymphadenectomy or chemotherapy were independent predictors of recurrence and poor prognoses in patients with FIGO 2023 stage IIC-H EC (p < 0.001 and p = 0.031, respectively). CONCLUSION: Lymphadenectomy and chemotherapy resulted in better prognoses regarding both recurrence and survival in patients with FIGO 2023 stage IIC high-risk EC.

DOI： 10.1007/s10147-024-02647-4

【DOHaDと周産期医療】DOHaDと周産期医療母体合併症・管理とDOHaD 妊娠高血圧症候群

三島桜子, 衛藤英理子, 増山寿

周産期医学 54 ( 11 ) 1511 - 1514 2024年11月

記述言語：日本語出版者・発行元：(株)東京医学社

＜文献概要＞妊娠高血圧症候群におけるDOHaD 妊娠高血圧症候群(hypertensive disorders of Pregnancy:HDP)は,全妊娠の5～10%に発症し,母体・胎児ともに重篤な合併症を引き起こすおそれがある。近年,HDPの母体から出生した児が将来,代謝性疾患や心血管疾患に罹患するリスクが高いことを示す研究が増加している。長期疫学研究により,子宮内で妊娠高血圧腎症に曝露した児は,内分泌疾患または代謝性疾患を発症するリスクが高く,若年成人時の高血圧および肥満のリスクが2～3倍上昇することが示されている。HDPと児のその後の代謝性疾患および心血管疾患リスクとを結びつける根本的な機序は,まだ完全には解明されていない。しかしながらこれらの変化は,胎内でのHDPへの曝露による胎児期のプログラミング,疾患に対する共通の遺伝的感受性,出生後の生活習慣要因(食生活,喫煙,アルコール,ストレス,身体活動)など,さまざまな要因に起因すると考えられる。

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00621&link_issn=&doc_id=20241202080013&doc_link_id=%2Faq9syuse%2F2024%2F005411%2F012%2F1511-1514%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faq9syuse%2F2024%2F005411%2F012%2F1511-1514%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Apolipoprotein-B mRNA-editing complex 3B could be a new potential therapeutic target in endometriosis. 国際誌

Thuy Ha Vu, Keiichiro Nakamura, Kunitoshi Shigeyasu, Chiaki Kashino, Kazuhiro Okamoto, Kotaro Kubo, Yasuhiko Kamada, Hisashi Masuyama

Scientific reports 14 ( 1 ) 24968 - 24968 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

This study investigated the correlation of Apolipoprotein-B mRNA-editing complex 3B (APOBEC3B) expression with hypoxia inducible factor 1α (HIF-1α), Kirsten rat sarcoma virus (KRAS) and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) in endometriosis patients, and the inhibitory effects of APOBEC3B knockdown in a human endometriotic cell line. Here, APOBEC3B, HIF-1α, KRAS, and PIK3CA were examined in patients with and without endometriosis using reverse transcription polymerase chain reaction (RT-PCR). The apoptosis, cell proliferation, invasion, migration, and biological function of APOBEC3B knockdown were explored in 12Z immortalized human endometriotic cell line. We observed APOBEC3B, HIF-1α, KRAS and PIK3CA expressions were significantly higher in endometriosis patients (p < 0.001, p < 0.001, p = 0.029, p = 0.001). Knockdown of APOBEC3B increased apoptosis, which was 28.03% and 22.27% higher than in mock and control siRNA samples, respectively. APOBEC3B knockdown also decreased PIK3CA expression and increased Caspase 8 expression, suggesting a potential role in the regulation of apoptosis. Furthermore, knockdown of APOBEC3B significantly inhibited cell proliferation, invasion, and migration compared to mock and control siRNA. (Cell proliferation: mock: p < 0.001 and control siRNA: p = 0.049. Cell invasion: mock: p < 0.001 and control siRNA: p = 0.029. Cell migration: mock: p = 0.004, and control siRNA: p = 0.014). In conclusion, this study suggests that APOBEC3B may be a new potential therapeutic target for endometriosis.

DOI： 10.1038/s41598-024-76589-2

Decline in and recovery of fertility rates after COVID-19-related state of emergency in Japan. 国際誌

Tomohiro Mitoma, Jota Maki, Hikaru Ooba, Hisashi Masuyama

BMJ open 14 ( 10 ) e087657 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: The COVID-19 pandemic led to a decline in fertility rates worldwide. Although many regions have experienced a temporary drop in fertility rates with the spread of the infection, subsequent recovery has varied across countries. This study aimed to evaluate the impact of COVID-19 infection rates and regional sociodemographic factors on the recovery of fertility rates in Japan following the state of emergency. METHODS: This study examined prefectural fertility data from before the COVID-19 pandemic to forecast fertility rates up to 2022 using a seasonal autoregressive integrated moving average model. A regression analysis was conducted on fertility rates during the first state of emergency and the subsequent recovery rate with respect to the number of new COVID-19 cases and sociodemographic factors specific to each prefecture. RESULTS: During the first state of emergency, the monthly fertility rate decreased by an average of -13.8% (SD: 6.26, min: -28.78, max: 0.15) compared with the previous year. Over the following 22 months, the average fertility recovery rate was +2.31% (SD: 3.57; min: -8.55, max: 19.54). Multivariate analysis of the impact of the pandemic on fertility changes during the first emergency indicated a negative correlation between new COVID-19 cases per capita and the proportion of nuclear households. No significant correlation was found between fertility recovery rate and new COVID-19 cases or emergency duration. When classifying fertility rate fluctuation patterns before and after the emergency into four clusters, variations were noted in the proportion of the elderly population, marriage divorce rate and the number of internet searches related to pregnancy intentions across the clusters. CONCLUSIONS: No association was found between pregnancy intentions related to the spread of infection, such as the number of new cases and the fertility recovery rate following the first state of emergency. Differences in the patterns of decline and recovery during the pandemic were observed based on population composition and internet searches for infection and pregnancy across different prefectures.

DOI： 10.1136/bmjopen-2024-087657