Search

Background: Automatic segmentation has recently been developed to yield objective data. Prediction of microvascular invasion (MVI) of hepatocellular carcinoma (HCC) using radiomics has been reported. Purpose: To develop a deep learning-based auto-segmentation algorithm (DL-AS) for the detection of HCC and to predict MVI using computed tomography (CT) texture analysis. Material and Methods: We retrospectively collected training data from 249 patients with HCC and validation set from 35 patients. Lesions of the training set were manually drawn by radiologist, in the delayed phase. 2D U-Net was selected as the DL architecture. Using the validation set, one radiologist manually drew 2D and 3D regions of interest twice, and the developed DL-AS was performed twice with a one-month time interval. The reproducibility was calculated using intraclass correlation coefficients (ICC). Logistic regression was performed to predict MVI. Results: ICC was in the range of 0.190–0.998/0.341–0.997 in the manual 3D/2D segmentation. In contrast, it was perfect in 3D/2D using DL-AS, with a success rate of 88.6% for the detection of HCC. For predicting MVI, sphericity was a significant parameter (odds ratio <0.001; 95% confidence interval <0.001–0.206; P = 0.020) for predicting MVI using 2D DL-AS. However, 3D DL-AS segmentation did not yield a predictive parameter. Conclusion: The auto-segmentation of HCC using DL-AS provides perfect reproducibility, although it failed to detect 11.4% (4/35). However, the extracted parameters yielded different important predictors of MVI in HCC. Sphericity was a significant predictor in 2D DL-AS and 3D manual segmentation, while discrete compactness was a significant predictor in 2D manual segmentation. [ABSTRACT FROM AUTHOR]

How and when do opportunities for political participation through courts change under authoritarianism? Although China is better known for tight political control than for political expression, the 2008 Open Government Information (OGI) regulation ushered in a surge of political-legal activism. We draw on an original dataset of 57,095 OGI lawsuits, supplemented by interview data and government documents, to show how a feedback loop between judges and court users shaped possibilities for political activism and complaint between 2008 and 2019. Existing work suggests that authoritarian leaders crack down on legal action when they feel politically threatened. In contrast, we find that courts minted, defined, and popularized new legal labels to cut off access to justice for the super-active litigants whose lawsuits had come to dominate the OGI docket. This study underscores the power of procedural rules and frontline judges in shaping possibilities for political participation under authoritarianism. [ABSTRACT FROM AUTHOR]

Background: Unnecessary prolonged treatment with biologic agents for Crohn's disease (CD) patients with endoscopic complete remission (CR) might increase the opportunistic infections. Purpose: To evaluate computed tomography enterography (CTE) findings obtained on CD patients achieving endoscopic CR after anti-tumor necrosis factor (TNF)-α therapy. Material and Methods: Thirty-six consecutive patients with CD who had received anti-TNF- α therapy and undergone pre-and post-therapy CTE and ileocolonoscopy were initially enrolled. CTE was performed with a standard-dose enteric-phase scan. Eleven patients were excluded due to a mismatch of follow-up intervals or a long interval (>2 weeks) between CTE and ileocolonoscopy; additionally, five patients were excluded due to surgical intervention during the follow-up period. Therefore, 20 patients finally were analyzed. Two blinded readers evaluated the pre-and post-therapy CTE images by consensus for active inflammation, i.e. mural hyperenhancement, mural thickening (thickness > 3 mm), mural stratification, and increased peri-enteric fat attenuation in the rectum, colon, and terminal ileum. Endoscopic CR indicated mucosal healing identified by ileocolonoscopy and served as the reference standard. Results: Nine patients with 16 bowel segments showed endoscopic CR. Ten of those segments showed residual abnormalities including mild mural hyperenhancement (9/16, P = 0.03), mild mural thickening (6/16, P < 0.001), and both findings (5/16, P < 0.001) on post-therapy CTE. The non-CR group (11 patients; 17 bowel segments) showed a higher concordance rate with post-therapy CTE (88%, 15/17) than did the CR group (38%, 6/16) (P = 0.004). Conclusion: Residual mild mural hyperenhancement and mild mural thickening were seen on post-therapy CTE in over half of the bowel segments showing endoscopic CR. [ABSTRACT FROM AUTHOR]

In the past, physical barriers such as geography and distance limited global communication. In this paper, we explore how young children in immigrant families engage in transnational literacy practices. Specifically, we explore the transnational funds of knowledge that result from those experiences. This three-year longitudinal collective case study involves ten children from immigrant families who have come to the United States from around the world. The students entered the study in four-year-old kindergarten, grade 1 or grade 2. Each year, we collected observations, spoken data and student-created artefacts (e.g. writing samples, maps, photographs). Data sources were designed to highlight the various spaces that the immigrant families occupy or have occupied over time (i.e. home/neighbourhood/ school; native country/country of residence). Our reading and rereading of coded data across the sample led us to focus on families' digital transnational practices and children's transnational awareness. We argue that these funds of knowledge should be recognized in classrooms and schools and that they have the potential to contribute to the nurturing of cosmopolitan perspectives for all children. [ABSTRACT FROM AUTHOR]

The present study aims to show if a skill-challenge balancing (SCB) instruction strategy can assist learners to motivationally engage in computer-based learning. Csikszentmihalyi's flow theory (self-control, curiosity, focus of attention, and intrinsic interest) was applied to an account of the optimal learning experience in SCB-based learning activities. Two empirical studies were carried out, where a group of learners were taught "Computer Networks" as part of a statutory curriculum at a tertiary institution. The empirical results suggested that a degree of self-control to compensate for the fully automatic SCB instruction strategy (i.e., competence and autonomy) would be of a greater value for learning motivation enhancement in adaptive computer-based learning systems. [ABSTRACT FROM AUTHOR]

Background Impaired sensory processing in migraine can reflect diminished habituation, increased activation, or even increased gain or amplification of activity from the primary synapse in the brainstem to higher cortical/subcortical brain regions. Methods We scanned 16 episodic migraine (interictal) and 16 healthy controls (cross-sectional study), and evaluated brain response to innocuous air-puff stimulation over the right forehead in the ophthalmic nerve (V1) trigeminal territory. We further evaluated habituation, and cortical/subcortical amplification relative to spinal trigeminal nucleus (Sp5) activation. Results Migraine subjects showed greater amplification from Sp5 to the posterior insula and hypothalamus. In addition, while controls showed habituation to repetitive sensory stimulation in all activated cortical regions (e.g. the bilateral posterior insula and secondary somatosensory cortices), for migraine subjects, habituation was not found in the posterior insula. Moreover, in migraine, the habituation slope was correlated with the amplification ratio in the posterior insula and secondary somatosensory cortex, i.e. greater amplification was associated with reduced habituation in these regions. Conclusions These findings suggest that in episodic migraine, amplified information processing from spinal trigeminal relay nuclei is linked to an impaired habituation response. This phenomenon was localized in the posterior insula, highlighting the important role of this structure in mechanisms supporting altered sensory processing in episodic migraine. [ABSTRACT FROM AUTHOR]