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关键词： Gastric cancer   Clinical staging   Diagnostic discordance   Tumor localization  

摘要： Purpose Diagnosing early gastric cancer (EGC) or advanced gastric cancer (AGC) according to T-category is important for optimal GC treatment;however, the clinical and pathological diagnosis of tumor depths can sometimes vary. This study investigated the accuracy of clinical diagnosis of the tumor depth from the viewpoint of tumor localization and prognosis of patients with GC with discordance between clinical and pathological findings. Methods This study enrolled 741 patients with primary GC who underwent curative gastrectomy. Based on the clinical and pathological diagnosis of T-category, the patients were classified into four groups: Early-look EGC, Early-look AGC, Advanced-look EGC, and Advanced-look AGC. Tumor localization was classified longitudinally (the upper [U], middle [M], and lower [L] parts and cross-sectionally (the anterior [Ant] and posterior [Post] walls, and the lesser [Less] and greater [Gre] curvatures). Results Of the 462 clinical EGC cases, 52 were Early-look AGC cases that exhibited a significant association of tumor localization with the Post and Less in the U and M locations (UM-PL;p = 0.037). An Advanced-look EGC (p = 0.031) and Advanced-look AGC (p = 0.025) were independent prognostic factors for relapse-free survival each in pathological EGC and AGC, respectively. Conclusions Patients with clinically diagnosed EGC but with pathologically diagnosed AGC more frequently presented tumor in the UM-PL than in any other location. Selection of therapeutic strategy according to the clinical diagnosis might be critical;however, it should be also considered that the accuracy of preoperative assessments varies with tumor localization.

关键词： Breast density   Benchmarking dataset   SE-Attention   CNN  

摘要： Background and objective: Breast density (BD) is an independent predictor of breast cancer risk factor. The automatic classification of BD has yet to resolve. In this paper, we propose an improved convolutional neural network (CNN) framework that integrates innovative SE-Attention mechanism to learn discriminative features, aiming for automatic BD classification in mammography. Methods: A new benchmarking dataset was constructed from 18157 BD images, manually segmented into 4 levels based on Breast Imaging and Reporting Data System (BI-RADS): A (fatty), B (fibro-glandular), C (heterogeneously dense) and D (extremely dense). The proposed method consists of three main phases: (i) data enhancement and normalization of breast images (ii) SE-Attention training for feature re-calibration and fusion to better classify density and (iii) designing the auxiliary loss. We adopt an attention approach where SE-Attention mechanism is used to learn the density features, which is different from previous works. Results: Experimental results demonstrate that the proposed framework obtains higher classification accuracy than the original network, such as Inception-V4, ResNeXt, DenseNet, increasing the performance from 89.97% to 92.17%, 89.64% to 91.57%, 89.20% to 91.79% respectively. Among them, improved Inception-V4 possesses the highest accuracy meanwhile DenseNet improves in the largest extent, both the original and improved methods are more effective than other state-of-the-art image descriptors regarding classification. Conclusions: We insist that our method will help radiologists provide reliable BD diagnostic services at the expert level, allowing them to focus on patients who are really in need. (C) 2020 Elsevier B.V. All rights reserved.

摘要： The article discusses the lipids and fatty liver including scoring system performing best in assessing fatty liver related fibrosis in diabetes and serum hyaluronic acid improving the performance of the fibrosis-4 index in the identification of advanced liver disease in type 2 diabetes.

摘要： The article presents the discussion on inpatient care. Topics include measuring inpatient diabetes related staff satisfaction using a SurveyMonkey questionnaire; effectiveness of a five-minute insulin safety video on healthcare professionals knowledge and inpatient insulin errors; and reducing insulin administration errors and hypoglycaemia in inpatients using a selfadministration of insulin protocol.

摘要： Discourses of languagelessness that suggest that Latinxs are not fully proficient in either English or Spanish have a long history in the United States. These discourses produce raciolinguistic categories that frame the bilingualism of Latinxs as deficient and in need of remediation. In this article, the researchers examine one such raciolinguistic category: students in dual language programs who are classified as both English learnersandfirst language (L1) users of English. The authors offer case studies of three students who fit this linguistic profile. They examine the ways that teachers working with these students struggle to make sense of this raciolinguistic category and often resort to discourses of languagelessness as an explanation. The researchers document the ways that these discourses negatively impact the educational supports provided to the students. The authors end with a call for developing new conceptualizations of the language practices of Latinx students in these programs that resist discourses of languagelessness and, instead, frame the fluid bilingualism of these students as a resource for learning.

关键词： disparity   morphospace   categorical data   geometric morphometrics   Osteostraci  

摘要： Morphological variation (disparity) is almost invariably characterized by two non-mutually exclusive approaches: (1) quantitatively, through geometric morphometrics;and (2) in terms of discrete, 'cladistic', or categorical characters. Uncertainty over the comparability of these approaches diminishes the potential to obtain nomothetic insights into the evolution of morphological disparity and the few benchmarking studies conducted so far show contrasting results. Here, we apply both approaches to characterizing morphology in the stem-gnathostome clade Osteostraci in order to assess congruence between these alternative methods as well as to explore the evolutionary patterns of the group in terms of temporal disparity and the influence of phylogenetic relationships and habitat on morphospace occupation. Our results suggest that both approaches yield similar results in morphospace occupation and clustering, but also some differences indicating that these metrics may capture different aspects of morphology. Phylomorphospaces reveal convergence towards a generalized 'horseshoe'-shaped cranial morphology and two strong trends involving major groups of osteostracans (benneviaspidids and thyestiids), which probably reflect adaptations to different lifestyles. Temporal patterns of disparity obtained from categorical and morphometric approaches appear congruent, however, disparity maxima occur at different times in the evolutionary history of the group. The results of our analyses indicate that categorical and continuous data sets may characterize different patterns of morphological disparity and that discrepancies could reflect preservational limitations of morphometric data and differences in the potential of each data type for characterizing more or less inclusive aspects of overall phenotype.

关键词： Categorization   Culture   reciprocal self-consciousness   Borders   Migration   Refugee  

摘要： This study incorporates insights from the cognitive approach to literature into postcolonial studies for the purpose of investigating the potential of the ongoing dialogue between these two fields. It analyzes the cognitive process of categorization intricate in the classification of people according to race, colour and culture, revealing how Fanon's idea of reciprocal consciousness challenges the fixity of borders between categories and goes with the nature of the human mind that is capable of adapting to and realizing the changeability and adjustability of categorical schemas. Thus, the activation of reciprocal self-consciousness generates intercategorical coexistence, pointing out the obsoleteness of colonially categorical mentality sustained by xenophobia. According to the resilient nature of the human mind, this paper proves that categories of cultures and race are overlapping and fuzzy, so artificial borders between them are inconsistent and penetrable allowing mobility and change in terms of membership and belonging. This study tackles Mohsin Hamid'sExit West(2017) in the light of Fanon's treatment of the Hegelian theory of reciprocal self-consciousness, exploring possible forms of intersubjectivity, cultural fusion, acculturation and means of transcendental self-representation as illustrated in characters who are capable of penetrating the categorical fixity of cultural difference or the self and the other.

关键词： Bipolar disorder   Neuroscience   Schizophrenia  

摘要： Neuroimaging studies of psychotic disorders have demonstrated abnormalities in structural and functional connectivity involving widespread brain networks. However, these group-level observations have failed to yield any biomarkers that can provide confirmatory evidence of a patient's current symptoms, predict future symptoms, or predict a treatment response. Lack of precision in both neuroanatomical and clinical boundaries have likely contributed to the inability of even well-powered studies to resolve these key relationships. Here, we employed a novel approach to defining individual-specific functional connectivity in 158 patients diagnosed with schizophrenia (n = 49), schizoaffective disorder (n = 37), or bipolar disorder with psychosis (n = 72), and identified neuroimaging features that track psychotic symptoms in a dimension- or disorder-specific fashion. Using individually specified functional connectivity, we were able to estimate positive, negative, and manic symptoms that showed correlations ranging fromr = 0.35 tor = 0.51 with the observed symptom scores. Comparing optimized estimation models among schizophrenia spectrum patients, positive and negative symptoms were associated with largely non-overlapping sets of cortical connections. Comparing between schizophrenia spectrum and bipolar disorder patients, the models for positive symptoms were largely non-overlapping between the two disorder classes. Finally, models derived using conventional region definition strategies performed at chance levels for most symptom domains. Individual-specific functional connectivity analyses revealed important new distinctions among cortical circuits responsible for the positive and negative symptoms, as well as key new information about how circuits underlying symptom expressions may vary depending on the underlying etiology and illness syndrome from which they manifest.