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ing SHAP analysis.
At present, numerous challenges exist in the diagnosis of pancreatic SCNs and MCNs. After the emergence of artificial intelligence (AI), many radiomics research methods have been applied to the identification of pancreatic SCNs and MCNs.
A deep neural network (DNN) model termed Multi-channel-Multiclassifier-Random Forest-ResNet (MMRF-ResNet) was constructed to provide an objective CT imaging basis for differential diagnosis between pancreatic serous cystic neoplasms (SCNs) and mucinous cystic neoplasms (MCNs).
This study is a retrospective analysis of pancreatic unenhanced and enhanced CT images in 63 patients with pancreatic SCNs and 47 patients with MCNs (3 of which were mucinous cystadenocarcinoma) confirmed by pathology from December 2010 to August 2016. Different image segmented methods (single-channel manual outline ROI image and multi-channel image), feature extraction methods (wavelet, LBP, HOG, GLCM, Gabor, ResNet, and AlexNet) and classifiers (KNN, Softmax, Bayes, random forest classifier, and Majority Voting rule method) are used to classify the nature of the lesion in each CT image (SCNs/MCNs). Then, the comparisons of classification results were made based on sensitivity, specificity, precision, accuracy, F1 score, and area under the receiver operating characteristic curve (AUC), with pathological results serving as the gold standard.
Multi-channel-ResNet (AUC 0.98) was superior to Manual-ResNet (AUC 0.91).CT image characteristics of lesions extracted by ResNet are more representative than wavelet, LBP, HOG, GLCM, Gabor, and AlexNet. Compared to the use of three classifiers alone and Majority Voting rule method, the use of the MMRF-ResNet model exhibits a better evaluation effect (AUC 0.96) for the classification of the pancreatic SCNs and MCNs.
The CT image classification model MMRF-ResNet is an effective method to distinguish between pancreatic SCNs and MCNs.
The CT image classification model MMRF-ResNet is an effective method to distinguish between pancreatic SCNs and MCNs.
To compare the ability of a clinical-computed tomography (CT) model vs. 2D and 3D radiomics models for predicting occult peritoneal metastasis (PM) in patients with advanced gastric cancer (AGC).
In this retrospective study, we included 49 patients with occult PM and 49 control patients (without PM) who underwent preoperative CT and subsequent surgery between January 2016 and December 2018. Clinical information and CT semantic features were collected, and CT radiomics features were extracted. A predictive clinical-CT model was created using multivariate logistic regression. The least absolute shrinkage and selection operator algorithm and logistic regression were used for constructing 2D and 3D radiomics models.These models were validated with an external cohort (n = 30). Receiver operating characteristics curve with area under the curve (AUC), sensitivity, and specificity were used to evaluate predictive performance.
Tumor size, mild ascites, and serum CA125 were independent factors predictive of occult PM. The clinical-CT model of these independent factors showed better diagnostic performance than 2D and 3D radiomics models. In the external validation cohort, the AUCs of different models were as follows-clinical-CT model 0.853 (sensitivity, 66.7%; specificity, 93.3%); 2D radiomics model 0.622 (sensitivity, 80.0%; specificity, 46.7%); and 3D radiomics model 0.676 (sensitivity, 60.0%; specificity, 86.0%). The clinical-CT model nomogram showed good clinical predictive efficiency to assess occult PM.
The clinical-CT model was better than the radiomics models in predicting occult PM in AGC.
The clinical-CT model was better than the radiomics models in predicting occult PM in AGC.
The POPular Risk Score (PRiS), a pharmacogenetic-driven algorithm consisting of CYP2C19 genotype, platelet reactivity, and clinical risk factors, is developed to evaluate ischemic risk and guide dual antiplatelet therapy (DAPT). This study aimed to evaluate the efficacy and safety of DAPT in accordance with the PRiS in patients undergoing drug-eluting stent (DES) implantation.
A total of 1757 patients recruited in this cohort study were divided into four groups according to the PRiS and type of P2Y12 receptor inhibitor treatment at discharge. The primary endpoint was major adverse cardiovascular events (MACE, a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis, and target vessel revascularization) during 1-year follow-up. The safety endpoints were defined by Bleeding Academic Research Consortium (BARC) criteria as major bleeding (BARC 3a, 3b, 3c, and 5) and clinically relevant bleeding (BARC 2, 3a, 3b, 3c, and 5).
Among 1046 patients with PRiS < 2urther randomized controlled trials are required to provide more evidence for PRiS-guided DAPT.
Tailored DAPT based on the PRiS could assist in improving the prognosis of patients undergoing DES implantation. Further randomized controlled trials are required to provide more evidence for PRiS-guided DAPT.
Liposuction is the most accepted technique for treatment of gynecomastia at present with or without residual gland tissue excision. Conventional liposuction uses incisions for introduction of cannula, made usually at the inframammary crease or axilla resulting in consequent scars. Cross-chest liposuction technique was introduced to avoid these additional scars and improve the aesthetic outcome. This study aimed to evaluate the difference between aesthetic outcome of conventional liposuction and cross-chest liposuction in treatment of gynecomastia.
A prospective comparative study between 2 groups with 15 patients in each was conducted, one with conventional and the other cross-chest liposuction. Excision of residual gland tissue was performed through circum-areolar incision in both the groups. Aesthetic outcome was evaluated in both the groups using Likert scale and compared.
The mean age of the patients was 22.6years and the mean duration of presentation was 8.13years. Satisfaction rate with conventionaratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.Metacommunity theory dictates that a microbial community is supported both by local ecological processes and the dispersal of microbes between neighboring communities. P505-15 supplier Studies that apply this perspective to human-associated microbial communities are thus far limited to the gut microbiome. Yet, the skin serves as the primary barrier between the body and the external environment, suggesting frequent opportunities for microbial dispersal to the variable microbial communities that are housed across skin sites. This paper applies metacommunity theory to understand the dispersal of microbes to the skin from the physical and social environment, as well as between different skin sites on an individual's body. This includes highlighting the role of human behavior in driving microbial dispersal, as well as shaping physiological properties of skin that underscore local microbial community dynamics. By leveraging data from research on the skin microbiomes of amphibians and other animals, this paper provides recommendations for future research on the skin microbial metacommunity, including generating testable predictions about the ecological underpinnings of the skin microbiome.
Fear of falling (FOF) contributes to activity restriction and institutionalization among older adults, and exercise interventions are linked to reduction in FOF. Adhering to exercise principles and adapting optimal exercise parameters are fundamental to optimizing the effectiveness of exercise interventions. The purpose of this review was to describe FOF exercise interventions in community-dwelling older adults, evaluate the extent to which these interventions followed the exercise principles and reported exercise parameters, and quantify the effect of these interventions on reducing FOF.
Randomized controlled trials (RCTs) of FOF exercise interventions in older adults (≥65years) were identified from 4 databases. The methodological quality of RCTs was assessed using the PEDro scale. A random-effect model was used in the meta-analysis.
Seventy-five RCTs were included in this review. With regard to reporting exercise principles, specificity was reported in 92% of trials, progression in 72%, reversibility exercise programs to facilitate evidence-based practice.
The aim of this study was to investigate whether there is evidence of bilateral upper limb strength deficits in individuals with unilateral lateral elbow tendinopathy (LET).
The electronic databases Medline via Ovid, PubMed, and Scopus were searched from inception to March 2020. Included studies encompassed maximal strength outcomes of any upper limb and appendicular musculature in individuals with LET and an asymptomatic comparator. Study quality was rated using a modified version of the Epidemiological Appraisal Instrument. Hedges g effect sizes (ES) and 95% CIs were calculated for comparisons of maximal strength in the LET group and an asymptomatic control group. Meta-analysis using a random-effects model was performed when possible.
Fourteen studies were included. Quality appraisal resulted in a mean Epidemiological Appraisal Instrument score of 46% (SD = 10%). Meta-analysis revealed strength deficits in shoulder abduction (pooled ES = -0.37 [95% CI = -0.62 to -0.12]) and shoulder external rotation w. Your physical therapist can help you strengthen these areas.
The objectives of this review were to determine the relationship between muscle strength of the affected leg and walking speed after stroke and whether this relationship varied according to muscle group or level of walking disability.
This systematic review with meta-analysis focused on observational studies of adult survivors of stroke. Muscle strength had to be measured as maximum voluntary force production during an isometric contraction of the affected leg. Walking had to be measured as walking speed. Studies had to report correlations between muscle strength and walking speed.
Thirty studies involving 1001 participants were included. Pooled mean correlations between muscle strength of the affected leg and walking speed was 0.51 (95% CI = 0.45 to 0.57). Pooled correlations between the strength of individual muscle groups and walking speed ranged from 0.42 (for the hip abductors) to 0.57 (for the ankle dorsiflexors). The correlation between level of walking disability and the mean correlation between is highly associated with the muscle strength of their affected leg. In people whose walking speed is severely affected, this association is stronger, and the physical therapist might focus on strengthening that leg so the patient can walk faster.
To gain insight into the changes in psychological factors during rehabilitation after Achilles tendon rupture (ATR) and to explore the association between psychological factors during rehabilitation and functional outcome 12months after ATR.
Fifty patients clinically diagnosed with ATR were invited to visit the hospital 3, 6, and 12months after injury for data collection. They completed questionnaires assessing psychological factors psychological readiness to return to sport (Injury Psychological Readiness to Return to Sport Questionnaire), kinesiophobia (Tampa Scale for Kinesiophobia), expectations, motivation, and outcome measures related to symptoms and physical activity (Achilles Tendon Total Rupture Score), and sports participation and performance (Oslo Sports Trauma Research Centre Overuse Injury Questionnaire). To determine whether psychological factors changed over time, generalized estimating equation analyses were performed. Multivariate regression analyses were used to study the association between psychological factors at 3, 6, and 12months and outcome measures at 12months after ATR.
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