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* Context.--RNA sequencing study has demonstrated that human epidermal growth factor receptor 2 (HER2) RNA levels influence anti-HER2 therapeutic efficacy. However, in situ HER2 RNA expression (isHRE), which evaluates HER2 RNA expression in tissue, has remained unclear in breast cancers (BCs) of various HER2 immunohistochemistry (IHC)/in situ hybridization (ISH) categories. Objective.--To correlate isHRE with all HER2 IHC/ fluorescence ISH (FISH) categories in BC. Design.--Formalin-fixed, paraffin-embedded tissue sections from 259 BCs, covering all IHC/FISH categories, were analyzed for isHRE by RNAscope. Results.--We validated HER2 RNAscope scoring as a semiquantitative method to evaluate isHRE and demonstrated significantly higher RNAscope scores in IHC 3+ than in IHC 2+ cases, and in IHC 2+ than in IHC 0/1 + cases. Among the 5 IHC 2+/FISH groups, group 1 (G1) cases had the highest scores. The scores in G3 cases were higher than those in G2, but not significantly different from those in G4 and G5. G4 cases had significantly higher scores than those in G2. Higher HER2 copy numbers and HER2:CEP 17 (centromere 17) copy number ratios were significantly correlated with higher isHRE in G1 cases, but not in G2 to G5 cases. RNAscope scores were significantly lower in HER2-negative (IHC 0) than in HER2-low (IHC 2+/FISH- and IHC 1+) BCs but were not different between IHC 0 and 1+ BCs when analyzed separately. Conclusions.--We demonstrate the HER2 RNA expression status among BCs of various HER2 IHC/FISH categories in tissue. Such information may be relevant for anti-HER2 treatment decisions considering the role of HER2 RNA expression in predicting anti-HER2 therapeutic efficacy., Approximately 15% of invasive breast cancers (BCs) are human epidermal growth factor receptor 2 (HER2) positive, defined as HER2 gene amplification or protein overexpression, (1) and such tumors are sensitive [...]

The recent attention garnered by Internet of Things (IoT) technology for its potential to alleviate challenges faced by healthcare systems, such as those resulting from an aging population and the rise in chronic illnesses, has underscored the significance of smart healthcare. Surprisingly, no bibliometric study has been conducted on this subject to date. Consequently, this investigation aims to provide a comprehensive overview of the longitudinal state and knowledge structure of IoT in smart healthcare. To achieve this, a content analysis tool is employed for academic research, facilitating the identification of key study themes, the growth trajectory of the research topic, the top journal sources, and the distribution of nations based on subject areas. The bibliometric evaluation encompasses 614 publications published in 14 journals spanning the period from 2016 to 2022. Employing bibliographic coupling analysis, the latest developments in IoT have been uncovered within the domain of smart healthcare. The findings reveal 11 primary research topic areas that have been the focus of scholarly discourse during this period. This study highlights that the computing paradigm and network connectivity emerge as the most prominent topics within this research domain. Blockchain-based security in healthcare closely follows as the second-largest topic discussed by scholars. Additionally, the analysis indicates a significant increase in total publications for the most popular topic, peaking around 2018.

ObjectiveWheat, as one of the major global food crops, plays a key role in food production and food supply. Different influencing factors can lead to different types of wheat lodging, e.g., root lodging may be due to improper use of fertilizers. While stem lodging is mostly due to harsh environments, different types of wheat lodging can have different impacts on yield and quality. The aim of this study was to categorize the types of wheat lodging by unmanned aerial vehicle (UAV) image detection and to investigate the effect of UAV flight altitude on the classification performance.MethodsThree UAV flight altitudes (15, 45, and 91 m) were set to acquire images of wheat test fields. The main research methods contained three parts: an automatic segmentation algorithm, wheat classification model selection, and an improved classification model based on EfficientNetV2-C. In the first part, the automatic segmentation algorithm was used to segment the UAV to acquire the wheat test field at three different heights and made it into the training dataset needed for the classification model. The main steps were first to preprocess the original wheat test field images acquired by the UAV through scaling, skew correction, and other methods to save computation time and improve segmentation accuracy. Subsequently, the pre-processed image information was analyzed, and the green part of the image was extracted using the super green algorithm, which was binarized and combined with the edge contour extraction algorithm to remove the redundant part of the image to extract the region of interest, so that the image was segmented for the first time. Finally, the idea of accumulating pixels to find sudden value added was used to find the segmentation coordinates of two different sizes of wheat test field in the image, and the region of interest of the wheat test field was segmented into a long rectangle and a short rectangle test field twice, so as to obtain the structural parameters of different sizes of wheat test field and then to generate the dataset of different heights. In the second part, four machine learning classification models of support vector machine (SVM), K nearest neighbor (KNN), decision tree (DT), and naive bayes (NB), and two deep learning classification models (ResNet101 and EfficientNetV2) were selected. Under the unimproved condition, six classification models were utilized to classify the images collected from three UAVs at different flight altitudes, respectively, and the optimal classification model was selected for improvement. In the third part, an improved model, EfficientNetV2-C, with EfficientNetV2 as the base model, was proposed to classify and recognized the lodging type of wheat in test field images. The main improvement points were attention mechanism improvement and loss function improvement. The attention mechanism was to replace the original model squeeze and excitation (SE) with coordinate attention (CA), which was able to embed the position information into the channel attention, aggregate the features along the width and height directions, respectively, during feature extraction, and capture the long-distance correlation in the width direction while retaining the long-distance correlation in the length direction, accurate location information, enhancing the feature extraction capability of the network in space. The loss function was replaced by class-balanced focal loss (CB-Focal Loss), which could assign different loss weights according to the number of valid samples in each class when targeting unbalanced datasets, effectively solving the impact of data imbalance on the classification accuracy of the model.Results and DiscussionsFour machine learning classification results: SVM average classification accuracy was 81.95%, DT average classification accuracy was 79.56%, KNN average classification accuracy was 59.32%, and NB average classification accuracy was 59.48%. The average classification accuracy of the two deep learning models, ResNet101 and EfficientNetV2, was 78.04%, and the average classification accuracy of ResNet101 was 81.61%. Comparing the above six classification models, the EfficientNetV2 classification model performed optimally at all heights. And the improved EfficientNetV2-C had an average accuracy of 90.59%, which was 8.98% higher compared to the average accuracy of EfficientNetV2. The SVM classification accuracies of UAVs at three flight altitudes of 15, 45, and 91 m were 81.33%, 83.57%, and 81.00%, respectively, in which the accuracy was the highest when the altitude was 45 m, and the classification results of the SVM model values were similar to each other, which indicated that the imbalance of the input data categories would not affect the model's classification effect, and the SVM classification model was able to solve the problem of high dimensionality of the data efficiently and had a good performance for small and medium-sized data sets. The SVM classification model could effectively solve the problem of the high dimensionality of data and had a better classification effect on small and medium-sized datasets. For the deep learning classification model, however, as the flight altitude increases from 15 to 91 m, the classification performance of the deep learning model decreased due to the loss of image feature information. Among them, the classification accuracy of ResNet101 decreased from 81.57% to 78.04%, the classification accuracy of EfficientNetV2 decreased from 84.40% to 81.61%, and the classification accuracy of EfficientNetV2-C decreased from 97.65% to 90.59%. The classification accuracy of EfficientNetV2-C at each of the three altitudes. The difference between the values of precision, recall, and F1-Score results of classification was small, which indicated that the improved model in this study could effectively solve the problems of unbalanced model classification results and poor classification effect caused by data imbalance.ConclusionsThe improved EfficientNetV2-C achieved high accuracy in wheat lodging type detection, which provides a new solution for wheat lodging early warning and crop management and is of great significance for improving wheat production efficiency and sustainable agricultural development.