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The construction and results of a multiple-reader multiple-case prostate MRI study are described and reported to illustrate recommendations for how to standardize artificial intelligence (AI) prostate studies per the review constituting Part I 1. Our previously reported approach was applied to review and report an IRB approved, HIPAA compliant multiple-reader multiple-case clinical study of 150 bi-parametric prostate MRI studies across 9 readers, measuring physician performance both with and without the use of the recently FDA cleared CADe/CADx software ProstatID. Unassisted reader AUC values ranged from 0.418 – 0.759, with AI assisted AUC values ranging from 0.507 – 0.787. This represented a statistically significant AUC improvement of 0.045 (α = 0.05). A free-response ROC (FROC) analysis similarly demonstrated a statistically significant increase in θ from 0.405 to 0.453 (α = 0.05). The standalone performance of ProstatID performed across all prostate tissues demonstrated an AUC of 0.929, while the standalone lesion level performance of ProstatID at all biopsied locations achieved an AUC of 0.710. This study applies and illustrates suggested reporting and standardization methods for prostate AI studies that will make it easier to understand, evaluate and compare between AI studies. Providing radiologists with the ProstatID CADe/CADx software significantly increased diagnostic performance as assessed by both ROC and free-response ROC metrics. Such algorithms have the potential to improve radiologist performance in the detection and localization of clinically significant prostate cancer. [ABSTRACT FROM AUTHOR]

MRI has firmly established itself as a mainstay for the detection, staging and surveillance of prostate cancer. Despite its success, prostate MRI continues to suffer from poor inter-reader variability and a low positive predictive value. The recent emergence of Artificial Intelligence (AI) to potentially improve diagnostic performance shows great potential. Understanding and interpreting the AI landscape as well as ever-increasing research literature, however, is difficult. This is in part due to widely varying study design and reporting techniques. This paper aims to address this need by first outlining the different types of AI used for the detection and diagnosis of prostate cancer, next deciphering how data collection methods, statistical analysis metrics (such as ROC and FROC analysis) and end points/outcomes (lesion detection vs. case diagnosis) affect the performance and limit the ability to compare between studies. Finally, this work explores the need for appropriately enriched investigational datasets and proper ground truth, and provides guidance on how to best conduct AI prostate MRI studies. Published in parallel, a clinical study applying this suggested study design was applied to review and report a multiple-reader multiple-case clinical study of 150 bi-parametric prostate MRI studies across nine readers, measuring physician performance both with and without the use of a recently FDA cleared Artificial Intelligence software. 1 [ABSTRACT FROM AUTHOR]

Objetivo: este trabalho objetiva estudar de que forma, em uma perspectiva não apenas teórica, mas especialmente prática, mercados de trabalho podem ser considerados na análise de atos de concentração econômica submetidos à aprovação da autoridade antitruste brasileira, o Cade. Método: são apresentados parâmetros a serem adotados, pelo Cade, para a avaliação de efeitos concorrenciais voltados à dimensão trabalho dos mercados relevantes, a partir da análise clássica de operações detalhadas no Guia para Análise de Atos de Concentração Horizontal elaborado pelo Cade e de estudos que abordam aspectos concorrenciais voltados a mercados de trabalho. Ao longo do artigo, são apresentadas propostas relacionadas à avaliação das próprias características das operações (a definição de mercado relevante; os fatores capazes de influenciar a probabilidade do exercício de poder de monopsônio; o debate sobre eventuais eficiências econômicas; e o desenho de remédios a serem considerados para sanar preocupações), como também sugestões que perpassam ajustes à redação da Resolução Cade nº 33/2022, a necessidade de atualização de guias, a regulamentação de cláusulas restritivas à concorrência, a celebração de acordo de cooperação técnica com o MTE e o incentivo à maior participação de sindicatos na análise de operações. Conclusões: não é necessária qualquer modificação na legislação concorrencial brasileira para que aspectos voltados a mercados de trabalho possam ser considerados no âmbito do controle de estruturas do Cade. De todo modo, foram apresentadas ao final propostas a serem implementadas no sentido de facilitar a abordagem do tema nos próximos anos.

Contexto: o presente artigo trata da grande fusão que marcou o início da década de 1990 entre as grandes marcas de higiene bucal, à época, no Brasil: a Colgate-Palmolive Company e a Kolynos do Brasil S/A. Objetivo: possui por objetivo verificar a importância e a atuação do Cade no processo de fusão entre as empresas Colgate-Palmolive Company e a Kolynos do Brasil S/A. Método: utilizou-se do método indutivo, por meio de pesquisas bibliográficas e de artigos eletrônicos e legislação. Conclusões: após estudo dos impasses surgidos à época da fusão, demonstrou o papel importante do Cade, para assegurar a livre concorrência e manter o equilíbrio social, garantindo uma adequada tutela dos consumidores.

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to review the available evidence and provide expert commentary on the current landscape of artificial intelligence in the evaluation and management of colorectal polyps. This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This Expert Commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors who are experienced endoscopists with expertise in the field of artificial intelligence and colorectal polyps. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) systems based on deep learning have evolved in the past decade, and their applications in the field of gastrointestinal endoscopy have expanded exponentially. Gastrointestinal endoscopy relies primarily on images for diagnosis and treatment decisions. By using convolutional neural networks and training them with large numbers of examples from databases, They can be used to assist in diagnosis during endoscopy, or what is called computer-aided detection (CADe), and to determine the nature of lesions, or what is called computer-aided characterization (CADx). Artificial intelligence systems have been used to detect and classify colonic polyps, detect and evaluate the depth of early gastric cancer, detect dysplasia in Barrett’s esophagus, determine the severity of inflammatory bowel diseases, in addition to detecting various abnormalities in capsule endoscopy. Through these systems, it was possible to improve the detection rate and quality of endoscopy. We still need multicenter, randomized trials to better evaluate the use of AI in real-time endoscopy. This review aims to discuss the available studies related to artificial intelligence in gastrointestinal endoscopy, discuss its clinical applications, and point out future directions in this field.

Contexto: Os cartéis em licitações públicas estão entre as infrações mais graves à ordem econômica previstas na Lei de Defesa da Concorrência (LDC) e têm ganhado maior relevância nos últimos anos. Dentre as penas previstas na LDC para infrações à ordem econômica está a proibição de participar em licitações públicas por período não inferior a 5 anos, prevista em seu art. 38, II. Objetivo: O artigo analisou a jurisprudência do Conselho Administrativo de Defesa Econômica (Cade), com o objetivo de identificar quais foram os critérios utilizados para justificar a aplicação dessa sanção nas decisões proferidas, bem como a forma pela qual esses critérios foram empregados. A partir disso, buscou-se constatar se há coerência e segurança jurídica na jurisprudência do Tribunal do Cade quanto aos critérios discutidos na aplicação dessa pena. Método: O artigo foi estruturado a partir de uma análise de jurisprudência, com enfoque nos elementos das decisões analisadas. O recorte jurisprudencial foi temático e temporal, considerando as condenações pela proibição de licitar determinadas pelo Cade entre os anos 2007 e 2022. A pesquisa de casos foi feita por meio de busca textual na página de pesquisa pública do Cade, no Sistema Eletrônico de Informações (SEI), e de pedidos de acesso à informação feitos por meio do Serviço de Informação ao Cidadão (SIC). Conclusão: Como resultado, foi possível identificar que apenas 55% das decisões pela aplicação dessa pena foram acompanhadas de algum critério, não havendo uniformidade nos critérios empregados nas decisões. Foram identificados 7 critérios diferentes, que podem ser classificados como positivos ou negativos. Alguns deles trazem ainda problemas e questões relevantes na maneira em que foram aplicados.

Summary: Background: Cervical squamous cell carcinoma (CSCC) and adenocarcinoma (CAde) are two major pathological types of cervical cancer (CC), but their high-resolution heterogeneity of tumor and immune microenvironment remains elusive. Methods: Here, we performed single-nucleus RNA sequencing (snRNA-seq) from five CSCC and three CAde samples, and systematically outlined their specific transcriptome atlas. Findings: We found CD8+ T cells in CSCC were more cytotoxic but lower exhausted compared to those in CAde, and phagocytic MRC1+ macrophages were specifically enriched in CSCC. Interestingly, we discovered that pro-tumoral cancer-associated myofibroblasts (myoCAFs) and cancer-associated vascular-fibroblasts (vCAFs) were more abundant in CSCC, and further verified their pro-metastatic roles in vitro. Furthermore, we also identified some specific chemotherapy drugs for CSCC (Dasatinib and Doramapimod) and CAde (Pyrimethamine and Lapatinib) by revealing their heterogeneity in transcriptomic profiles of malignant epithelial cells, and further verified their specific sensitivity in cell lines and constructed CC-derived organoids. Cell–cell communication networks revealed that the pathways of NRG1-ERBB2, and FN1-ITAG3 were specific for CAde and CSCC, respectively, which may partly explain the specificities of identified chemotherapy drugs. Interpretation: Our study described the immune heterogeneity and specific cellular interactions between CSCC and CAde, which could provide insights for uncovering pathogenesis and designing personalized treatment. Fundings: National Key R&D Program of China (2021YFC2701201), National Natural Science Foundation of China (82072895, 82141106, 82103134, 81903114).

This paper examines the roots of the Association for Media and Technology in Education (AMTEC) in Canada and its connections to global educational technology and media organizations including the Association for Educational Communications and Technology (AECT). The AMTEC History Project, which is preserving memories, voices and documents related to the field of educational technology in Canada, celebrates the 50th anniversary of AMTEC in the context of the 100th anniversary of AECT. Generations of AECT leaders had a substantive influence on the history of AMTEC. Interviews with memory keepers as part of this history project revealed the importance of communication, collaboration, networking, persistence, and a learning mindset for those engaged as educational technologists, as they navigated change. Students, academics, and practitioners of educational technology may benefit from lessons learned by the Canadian pioneers of multi-media instruction and research collected in this project. [ABSTRACT FROM AUTHOR]

In this research a public dataset of recordings of EEG signals of healthy subjects and epileptic patients was used to build three simple classifiers with low time complexity, these are decision tree, random forest and AdaBoost algorithm. The data was initially preprocessed to extract short waves of electrical signals representing brain activity. The signals are then used for the selected models. Experimental results showed that random forest achieved the best accuracy of detection of the presence/absence of epileptic seizure in the EEG signals at 97.23% followed by decision tree with accuracy of 96.93%. The least performing algorithm was the AdaBoost scoring accuracy of 87.23%. Further, the AUC scores were 99% for decision tree, 99.9% for random forest and 95.6% for AdaBoost. These results are comparable to state-of-the-art classifiers which have higher time complexity.

Contextualização: Agências reguladoras e autoridades concorrenciais possuem uma posição de poder com relação aos regulados e agentes econômicos, vez que têm o poder de controlar o acesso a um mercado específico, alterar comportamentos, proporcionar concessões, etc. Observa-se, pois, a exploração desse leverage para atingir outros objetivos/obter vantagens, dentro ou fora da sua competência de atuação, que talvez fosse inviável ou requeresse recorrer a outras ferramentas mais caras ou arriscadas, não fosse a utilização dessa influência. Objetivo: Analisar em que medida o instituto do leverage regulatório do CADE é compatível com a sua atuação na promoção da defesa da concorrência no Brasil. Método: A pesquisa analisou o uso (ou tentativa) do leveraging do CADE mediante aos poderes de gatekeeper atrelados as suas atribuições, à luz da teoria dos atos administrativos, especificamente mediante o cumprimento dos requisitos de competência e finalidade do ato administrativo. Resultados: Identificou-se 3 (três) casos em que o CADE utilizou (ou tentou utilizar) seus poderes de gatekeeper, inerentes às suas funções preventivas e repressivas, para obtenção de objetivos adicionais ou mais amplos. Em 1 (um) dos casos, a autarquia atingiu a competência de outra autoridade ao tentar utilizar o poder de gatekeeper de imposição unilateral de restrições, visando tão-somente operacionalizar um ato de concentração inviável – mesmo agindo para maximizar um objetivo inerente à defesa da livre concorrência. Já nos outros 2 (dois) casos, o leverage regulatório do CADE parece ter sido utilizado de forma correta, pois a autarquia celebrou os acordos no exercício legítimo da sua competência, e impôs obrigação mais ampla que àquele atribuído à celebração de TCC pela lei concorrencial de forma coerente com as finalidades do antitruste brasileiro. Conclusões: Como o leverage regulatório não é regulamentado, seu uso desgovernado pode transformar o CADE em um executor secundário de um conjunto potencialmente grande de outras leis. Portanto, por ora, seu exercício deve estar aos objetivos do direito antitruste brasileiro (mesmo que os objetivo sejam difusos) e ao escopo de atuação da autarquia de acordo com as suas atribuições, sob pena de incorrer em algum tipo de abuso de poder. Caso haja interesse em expandir seu uso para além da zona de atuação da autarquia, ou visando atingir objetivos alheios àqueles consagrados na legislação concorrencial, é fundamental que sua legitimação se dê de forma expressa.

Simple Summary: In recent years, there has been an exponential rise in artificial intelligence-based technology. Artificial intelligence has been applied to several medical disciplines, such as gastroenterology. In the field of endoscopy, a wide variety of applications for artificial intelligence algorithms have been developed or are in a process of improvement. Computer-aided polyp detection and characterization are two of the most studied applications. In addition, there are several reports of other potential applications, such as the assessment of bowel preparation quality, while another future prospect is the prediction of cancer invasion depth. However, certain concerns remain, such as the universal use of this technology in clinical practice, impact on the incidence of interval colorectal cancer, cost-effectiveness, workload and patient burden. Growing evidence indicates that artificial intelligence (AI) applied to medicine is here to stay. In gastroenterology, AI computer vision applications have been stated as a research priority. The two main AI system categories are computer-aided polyp detection (CADe) and computer-assisted diagnosis (CADx). However, other fields of expansion are those related to colonoscopy quality, such as methods to objectively assess colon cleansing during the colonoscopy, as well as devices to automatically predict and improve bowel cleansing before the examination, predict deep submucosal invasion, obtain a reliable measurement of colorectal polyps and accurately locate colorectal lesions in the colon. Although growing evidence indicates that AI systems could improve some of these quality metrics, there are concerns regarding cost-effectiveness, and large and multicentric randomized studies with strong outcomes, such as post-colonoscopy colorectal cancer incidence and mortality, are lacking. The integration of all these tasks into one quality-improvement device could facilitate the incorporation of AI systems in clinical practice. In this manuscript, the current status of the role of AI in colonoscopy is reviewed, as well as its current applications, drawbacks and areas for improvement. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has the potential to assist in endoscopy and improve decision making, particularly in situations where humans may make inconsistent judgments. The performance assessment of the medical devices operating in this context is a complex combination of bench tests, randomized controlled trials, and studies on the interaction between physicians and AI. We review the scientific evidence published about GI Genius, the first AI-powered medical device for colonoscopy to enter the market, and the device that is most widely tested by the scientific community. We provide an overview of its technical architecture, AI training and testing strategies, and regulatory path. In addition, we discuss the strengths and limitations of the current platform and its potential impact on clinical practice. The details of the algorithm architecture and the data that were used to train the AI device have been disclosed to the scientific community in the pursuit of a transparent AI. Overall, the first AI-enabled medical device for real-time video analysis represents a significant advancement in the use of AI for endoscopies and has the potential to improve the accuracy and efficiency of colonoscopy procedures. [ABSTRACT FROM AUTHOR]

In this research a public dataset of recordings of EEG signals of healthy subjects and epileptic patients was used to build three simple classifiers with low time complexity, these are decision tree, random forest and AdaBoost algorithm. The data was initially preprocessed to extract short waves of electrical signals representing brain activity. The signals are then used for the selected models. Experimental results showed that random forest achieved the best accuracy of detection of the presence/absence of epileptic seizure in the EEG signals at 97.23% followed by decision tree with accuracy of 96.93%. The least performing algorithm was the AdaBoost scoring accuracy of 87.23%. Further, the AUC scores were 99% for decision tree, 99.9% for random forest and 95.6% for AdaBoost. These results are comparable to state-of-the-art classifiers which have higher time complexity. [ABSTRACT FROM AUTHOR]

Following an international trend, Brazil's National Competition Authority (NCA), the Administrative Council for Economic Defense (CADE), has been devoting more attention to potential anticompetitive conducts in the digital economy. This article discusses a set of cases involving unilateral conducts in the digital economy, assessing CADE's decision-making practice, enforcement challenges, and tools used. Building from CADE's case law, we single out some relevant aspects of the Brazilian experience, including (1) the cautious approach taken by CADE when evaluating effects of unilateral conducts in final decisions, (2) the use of interim measures to intervene in early stages of investigations, and (3) the use of settlements to reach quick solutions with negotiated remedies. A brief conclusion discusses possible future trends given the experience discussed in the article. [ABSTRACT FROM AUTHOR]

Computer-aided polyp detection (CADe) may become a standard for polyp detection during colonoscopy. Several systems are already commercially available. We report on a video-based benchmark technique for the first preclinical assessment of such systems before comparative randomized trials are to be undertaken. Additionally, we compare a commercially available CADe system with our newly developed one. ENDOTEST consisted in the combination of two datasets. The validation dataset contained 48 video-snippets with 22,856 manually annotated images of which 53.2% contained polyps. The performance dataset contained 10 full-length screening colonoscopies with 230,898 manually annotated images of which 15.8% contained a polyp. Assessment parameters were accuracy for polyp detection and time delay to first polyp detection after polyp appearance (FDT). Two CADe systems were assessed: a commercial CADe system (GI-Genius, Medtronic), and a self-developed new system (ENDOMIND). The latter being a convolutional neuronal network trained on 194,983 manually labeled images extracted from colonoscopy videos recorded in mainly six different gastroenterologic practices. On the ENDOTEST, both CADe systems detected all polyps in at least one image. The per-frame sensitivity and specificity in full colonoscopies was 48.1% and 93.7%, respectively for GI-Genius; and 54% and 92.7%, respectively for ENDOMIND. Median FDT of ENDOMIND with 217 ms (Inter-Quartile Range(IQR)8–1533) was significantly faster than GI-Genius with 1050 ms (IQR 358–2767, p = 0.003). Our benchmark ENDOTEST may be helpful for preclinical testing of new CADe devices. There seems to be a correlation between a shorter FDT with a higher sensitivity and a lower specificity for polyp detection. [ABSTRACT FROM AUTHOR]

Contexto: Análise antitruste dos casos que já apresentaram alguma decisão do CADE no contexto das plataformas digitais. Objetivo: Avaliar como os casos anticoncorrenciais envolvendo o mercado de plataformas digitais foram analisados pelo CADE. Método: Foi realizada uma pesquisa bibliográfica e documental. Conclusões: O CADE ainda não faz uma distinção entre as plataformas digitais e os casos envolvendo outros mercados. Ainda, em diversos dos casos analisados, por questões inerentes do próprio caso, a análise chegou a sequer definir o mercado relevante. Seria interessante, para casos de maior complexidade que venham a surgir, estudar a possibilidade de adoção de uma metodologia própria para análise destes casos.

Tagua (Phytelephas aequatorialis Spruce) is a dioecious palm endemic to the forests and pastures of western Ecuador. Ethnobotanical studies from the early 20th century have described the market–based ecosystem services derived from its seed, known as vegetable ivory, but little is known about its non–market ecosystem services. In this paper, we investigate the local knowledge associated with all ecosystem services provided by the palm through focus group discussions within three communities in the Manabí Province of western Ecuador. We used a computer–assisted qualitative analysis to transcribe, analyze, and classify the transcripts using reports of use types. Participants identified a total of 28 ecosystem services: 13 provisioning, 7 regulating, 6 cultural, and 2 supporting services. The use type with the most frequent reports by respondents were plant–animal interactions (36), thatch roofs (19), and cultural identity (17). Generally, the results reveal that local people value tagua for its role as a key species supporting local fauna, the uses of their leaves in the traditional architecture, and as a natural resource that allows them to identify with their traditions. We discuss concerns reported by participants regarding the tagua trade, harvest hazards, and the loss of traditions associated with tagua. [ABSTRACT FROM AUTHOR]

Growing evidence indicates that artificial intelligence (AI) applied to medicine is here to stay. In gastroenterology, AI computer vision applications have been stated as a research priority. The two main AI system categories are computer-aided polyp detection (CADe) and computer-assisted diagnosis (CADx). However, other fields of expansion are those related to colonoscopy quality, such as methods to objectively assess colon cleansing during the colonoscopy, as well as devices to automatically predict and improve bowel cleansing before the examination, predict deep submucosal invasion, obtain a reliable measurement of colorectal polyps and accurately locate colorectal lesions in the colon. Although growing evidence indicates that AI systems could improve some of these quality metrics, there are concerns regarding cost-effectiveness, and large and multicentric randomized studies with strong outcomes, such as post-colonoscopy colorectal cancer incidence and mortality, are lacking. The integration of all these tasks into one quality-improvement device could facilitate the incorporation of AI systems in clinical practice. In this manuscript, the current status of the role of AI in colonoscopy is reviewed, as well as its current applications, drawbacks and areas for improvement.

Objetivo. Este artigo informativo analisa o papel da OCDE no aprimoramento da política de defesa da concorrência no Brasil, por ocasião dos eventos comemorativos dos 10 anos de vigência da Lei nº 12.529/2011. Método. O artigo buscou analisar o processo de estreitamento dos laços institucionais entre as duas instituições. Resultados. Os resultados demonstram que é notável processo de estreitamento dos laços institucionais entre as duas instituições, o que contribuiu para o desenho normativo definido na Lei nº 12.529/2011. Conclusões. O artigo conclui com algumas reflexões sobre perspectivas futuras, tendo em vista o processo de acessão do Brasil à OCDE. Palavras-chave: CADE; OCDE; cooperação internacional; aprimoramento de políticas públicas; Lei nº 12.529/2011.

Benefits of computer-aided detection (CADe) in detecting colorectal neoplasia were shown in many randomized trials in which endoscopists' behavior was strictly controlled. However, the effect of CADe on endoscopists' performance in less-controlled setting is unclear. This systematic review and meta-analyses were aimed at clarifying benefits and harms of using CADe in real-world colonoscopy. We searched MEDLINE, EMBASE, Cochrane, and Google Scholar from inception to August 20, 2023. We included nonrandomized studies that compared the effectiveness between CADe-assisted and standard colonoscopy. Two investigators independently extracted study data and quality. Pairwise meta-analysis was performed utilizing risk ratio for dichotomous variables and mean difference (MD) for continuous variables with a 95% confidence interval (CI). Eight studies were included, comprising 9782 patients (4569 with CADe and 5213 without CADe). Regarding benefits, there was a difference in neither adenoma detection rate (44% vs 38%; risk ratio, 1.11; 95% CI, 0.97 to 1.28) nor mean adenomas per colonoscopy (0.93 vs 0.79; MD, 0.14; 95% CI, –0.04 to 0.32) between CADe-assisted and standard colonoscopy, respectively. Regarding harms, there was no difference in the mean non-neoplastic lesions per colonoscopy (8 studies included for analysis; 0.52 vs 0.47; MD, 0.14; 95% CI, –0.07 to 0.34) and withdrawal time (6 studies included for analysis; 14.3 vs 13.4 minutes; MD, 0.8 minutes; 95% CI, –0.18 to 1.90). There was a substantial heterogeneity, and all outcomes were graded with a very low certainty of evidence. CADe in colonoscopies neither improves the detection of colorectal neoplasia nor increases burden of colonoscopy in real-world, nonrandomized studies, questioning the generalizability of the results of randomized trials. [Display omitted] [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has the potential to assist in endoscopy and improve decision making, particularly in situations where humans may make inconsistent judgments. The performance assessment of the medical devices operating in this context is a complex combination of bench tests, randomized controlled trials, and studies on the interaction between physicians and AI. We review the scientific evidence published about GI Genius, the first AI-powered medical device for colonoscopy to enter the market, and the device that is most widely tested by the scientific community. We provide an overview of its technical architecture, AI training and testing strategies, and regulatory path. In addition, we discuss the strengths and limitations of the current platform and its potential impact on clinical practice. The details of the algorithm architecture and the data that were used to train the AI device have been disclosed to the scientific community in the pursuit of a transparent AI. Overall, the first AI-enabled medical device for real-time video analysis represents a significant advancement in the use of AI for endoscopies and has the potential to improve the accuracy and efficiency of colonoscopy procedures.

Goals and background: Studies analyzing artificial intelligence (AI) in colonoscopies have reported improvements in detecting colorectal cancer (CRC) lesions, however its utility in the realworld remains limited. In this systematic review and meta-analysis, we evaluate the efficacy of AI-assisted colonoscopies against routine colonoscopy (RC). Study: We performed an extensive search of major databases (through January 2021) for randomized controlled trials (RCTs) reporting adenoma and polyp detection rates. Odds ratio (OR) and standardized mean differences (SMD) with 95% confidence intervals (CIs) were reported. Additionally, trial sequential analysis (TSA) was performed to guard against errors. Results: Six RCTs were included (4996 participants). The mean age (SD) was 51.99 (4.43) years, and 49% were females. Detection rates favored AI over RC for adenomas (OR 1.77; 95% CI: 1.570–2.08) and polyps (OR 1.91; 95% CI: 1.68–2.16). Secondary outcomes including mean number of adenomas (SMD 0.23; 95% CI: 0.18–0.29) and polyps (SMD 0.23; 95% CI: 0.17–0.29) detected per procedure favored AI. However, RC outperformed AI in detecting pedunculated polyps. Withdrawal times (WTs) favored AI when biopsies were included, while WTs without biopsies, cecal intubation times, and bowel preparation adequacy were similar. Conclusions: Colonoscopies equipped with AI detection algorithms could significantly detect previously missed adenomas and polyps while retaining the ability to self-assess and improve periodically. More effective clearance of diminutive adenomas may allow lengthening in surveillance intervals, reducing the burden of surveillance colonoscopies, and increasing its accessibility to those at higher risk. TSA ruled out the risk for false-positive results and confirmed a sufficient sample size to detect the observed effect. Currently, these findings suggest that AI-assisted colonoscopy can serve as a useful proxy to address critical gaps in CRC identification. [ABSTRACT FROM AUTHOR]

Objectives: Recently, CAD EYE (Fujifilm, Tokyo, Japan), an artificial intelligence for the lesion recognition (CADe) and the optical diagnosis (CADx) of colorectal polyps, was released. We evaluated the function of CADe and CADx of CAD EYE. Methods: In this single-center retrospective study, we examined consecutive polyps ≤ 10 mm detected from March to April 2021 to determine whether CAD EYE could recognize them live with both normal- and high-speed observation using white-light imaging (WLI) and linked-color imaging (LCI). We then examined whether the polyps were neoplastic or hyperplastic live with magnified or non-magnified blue-laser imaging (BLI-LASER) or blue-light imaging (BLI-LED) under CAD EYE, comparing the retrospective evaluations with 5 experts and 5 trainees using still images. All polyps were histopathologically examined. Results: We analyzed 100 polyps (mean size 3.9 ± 2.6 mm; 55 neoplastic and 45 hyperplastic lesions) in 25 patients. Regarding CADe, the respective detection rates of CAD EYE with normal- and high-speed observation were 85.0% and 67.0% for WLI (p = 0.002) and 89.0% and 75.0% for LCI (p = 0.009). Regarding CADx for differentiating neoplastic and hyperplastic lesions, the diagnostic accuracy values of CAD EYE with non-magnified and magnified BLI-LASER/LED were 88.8% and 87.8%. Regarding magnified BLI-LASER/LED, the diagnostic accuracy value of CAD EYE was not significantly different from that of experts (92.0%, p = 0.17), but that of trainees (79.0%, p = 0.04). We also found no significant differences in CADe or CADx between LED (53 lesions) and LASER (47 lesions). Conclusions: CAD EYE was a helpful tool for CADe and CADx in clinical practice. [ABSTRACT FROM AUTHOR]

O objetivo do texto consiste em ressaltar a importância da deferência judicial para o equilíbrio dos poderes constituídos, sendo analisada a partir de pedidos revisionais que questionam decisões proferidas pelo Conselho Administrativo de Defesa Econômica – CADE. A discussão é conduzida tendo por ponto de partida precedente do Supremo Tribunal Federal (Recurso Extraordinário nº 1.083.955-DF), cujo teor sinaliza a favor dessa postura. Parte-se do pressuposto de que a expertise técnica confere condições à extração de sentido mais acurado na aplicação da norma antitruste, privilegiando uma abordagem de discussão do assunto pela prática de concretização do direito. A revisão judicial se justificaria, portanto, somente para correção de ilegalidades ou abusos evidentes, sem envolver um juízo revisional amplo substitutivo às decisões do CADE. Conclui-se favoravelmente à postura de deferência judicial como atitude institucional de um desejado equilíbrio no exercício entre os poderes constituídos. Palavras-chave: Revisão judicial – CADE – Deferência – Expertise – Instituições.

O presente trabalho busca investigar a origem do Devedor Contumaz no sistema positivo e suas interações com o Direito Tributário e o Direito Concorrencial. A discussão acima tem especial repercussão nas relações jurídicas que envolvam não só o Direito Tributário, como também as normas de proteção da Ordem Econômica e as especificidades do Direito Concorrencial. A morosidade e a ineficiência dos entes fiscais contribuem para a criação da figura do Devedor Contumaz e os mecanismos de reprovação tributário parecem não demonstrar devida efetividade no combate a tal sujeito. Surge o Direito Concorrencial como uma forma de combate ao Devedor Contumaz, sobretudo mediante a atuação do CADE.

O artigo trata da aplicação de teorias do dano concorrencial a plataformas digitais. A revisão da literatura e a experiência internacional apontam a necessidade de novas teorias do dano típicas de mercado digitais, para evitar aumentos de preços não monetários, redução da qualidade e efeitos deletérios à inovação. A análise da jurisprudência da autoridade brasileira desde 2012 revela que, de forma incipiente, o CADE reconhece a importância de tais teorias, mas ainda não as aplica sistematicamente na forma de testes. O artigo defende, ainda, que teorias do dano, como categorias chave de análise, têm um papel inovador no próprio antitruste.

The effect of computer-aided polyp detection (CADe) on adenoma detection rate (ADR) among endoscopists-in-training remains unknown. We performed a single-blind, parallel-group, randomized controlled trial in Hong Kong between April 2021 and July 2022 (NCT04838951). Eligible subjects undergoing screening/surveillance/diagnostic colonoscopies were randomized 1:1 to receive colonoscopies with CADe (ENDO-AID[OIP-1]) or not (control) during withdrawal. Procedures were performed by endoscopists-in-training with <500 procedures and <3 years' experience. Randomization was stratified by patient age, sex, and endoscopist experience (beginner vs intermediate level, <200 vs 200–500 procedures). Image enhancement and distal attachment devices were disallowed. Subjects with incomplete colonoscopies or inadequate bowel preparation were excluded. Treatment allocation was blinded to outcome assessors. The primary outcome was ADR. Secondary outcomes were ADR for different adenoma sizes and locations, mean number of adenomas, and non-neoplastic resection rate. A total of 386 and 380 subjects were randomized to CADe and control groups, respectively. The overall ADR was significantly higher in the CADe group than in the control group (57.5% vs 44.5%; adjusted relative risk, 1.41; 95% CI, 1.17–1.72; P <.001). The ADRs for <5 mm (40.4% vs 25.0%) and 5- to 10-mm adenomas (36.8% vs 29.2%) were higher in the CADe group. The ADRs were higher in the CADe group in both the right colon (42.0% vs 30.8%) and left colon (34.5% vs 27.6%), but there was no significant difference in advanced ADR. The ADRs were higher in the CADe group among beginner (60.0% vs 41.9%) and intermediate-level (56.5% vs 45.5%) endoscopists. Mean number of adenomas (1.48 vs 0.86) and non-neoplastic resection rate (52.1% vs 35.0%) were higher in the CADe group. Among endoscopists-in-training, the use of CADe during colonoscopies was associated with increased overall ADR. (ClinicalTrials.gov , Number: NCT04838951). [Display omitted] [ABSTRACT FROM AUTHOR]

Propósito – O presente artigo tem por objetivo evidenciar a necessidade de abertura conceitual do direito da concorrência para valores outros que não estritamente econômicos e, ao mesmo tempo, analisar se, do ponto de vista institucional, o CADE apresenta mecanismos adequados para a efetiva consideração de tais valores. Metodologia/abordagem/design – Por meio da teoria processual administrativa, o estudo avalia o ambiente institucional do processo decisório do CADE a partir de diversos institutos previstos em sua lei de regência (Lei no 12.529/2011). Resultados – Observou-se que, ao menos do ponto de vista normativo, o CADE já apresenta, em tese, amplo espaço para manifestação de qualquer interessado em seus processos, além de já contar com um aparato institucional que lhe confere substancial autonomia. Todavia, observou-se que os mecanismos de participação e de intervenção de terceiros são ainda timidamente utilizados. Implicações práticas – Primeiramente, o estudo destaca a abertura de valores que devem ser considerados no processo decisório do CADE. Em segundo lugar, o estudo busca apontar algumas perspectivas para que se incentive a participação de terceiros, contribuindo para um processo decisório mais sofisticado.

Artificial intelligence (AI) has been attracting considerable attention as an important scientific topic in the field of medicine. Deep‐leaning (DL) technologies have been applied more dominantly than other traditional machine‐learning methods. They have demonstrated excellent capability to retract visual features of objectives, even unnoticeable ones for humans, and analyze huge amounts of information within short periods. The amount of research applying DL‐based models to real‐time computer‐aided diagnosis (CAD) systems has been increasing steadily in the GI endoscopy field. An array of published data has already demonstrated the advantages of DL‐based CAD models in the detection and characterization of various neoplastic lesions, regardless of the level of the GI tract. Although the diagnostic performances and study designs vary widely, owing to a lack of academic standards to assess the capability of AI for GI endoscopic diagnosis fairly, the superiority of CAD models has been demonstrated for almost all applications studied so far. Most of the challenges associated with AI in the endoscopy field are general problems for AI models used in the real world outside of medical fields. Solutions have been explored seriously and some solutions have been tested in the endoscopy field. Given that AI has become the basic technology to make machines react to the environment, AI would be a major technological paradigm shift, for not only diagnosis but also treatment. In the near future, autonomous endoscopic diagnosis might no longer be just a dream, as we are witnessing with the advent of autonomously driven electric vehicles. [ABSTRACT FROM AUTHOR]

The miss rate of flat advanced colorectal neoplasia is still unacceptably high, especially in the Western setting, notwithstanding the widespread implementation of quality improvement programs and training. It is well known that flat morphology is associated with miss rate of colorectal neoplasia, and that this subset of lesions often shows a more aggressive biological behaviour. Artificial intelligence (AI) applied to the detection of colorectal neoplasia has been shown to increase adenoma detection rate, consistently across all lesion sizes and locations in the colon. However, there is still uncertainty whether AI can reduce the miss rate of flat advanced neoplasia, mainly because all published trials report a low number of flat colorectal lesions in their training sets, and this could reduce AI accuracy for this subset of lesions. In addition, flat lesions have different morphologies with variable prevalence and potentially different accuracy in their detection. For example, the subtle appearance and rarer frequency of a non‐granular laterally spreading tumor (LST) could be much harder to identify than a granular mixed LST. In this review, we present a summary of the evidence on the role of AI in the identification of colorectal flat neoplasia, with a focus on data regarding presence of LSTs in the training/validation sets of the AI systems currently available on the market. [ABSTRACT FROM AUTHOR]

O presente artigo aborda os quatro tipos de acordos no direito da concorrência. Para tanto, parte de breves considerações sobre a evolução de mecanismos pró-consensuais dentro do Direito Administrativo e do Direito Concorrencial no Brasil. Em seguida, examina os acordos presentes no controle preventivo concreto junto ao Conselho Administrativo de Defesa Econômica: acordos em concentrações (ACC) e acordos de preservação de reversibilidade (APRO). Trata, então, dos acordos no controle repressivo do CADE: acordos de leniência (AL) e os compromissos de cessação de prática (TCC). E, ao final, traz conclusões sobre cada uma das espécies de acordo e as suas respectivas fases.

Este estudo escrutina o conflito de competência entre o Conselho Administrativo de Defesa Econômica, de agora em diante, CADE e o Banco Central do Brasil, BACEN, considerando como este fato impacta a livre concorrência no mercado brasileiro. A partir de uma análise histórica destas autarquias, suas implantações e perfis contemporâneos, faz-se um estudo do conflito de competência positivado e consequências desse embate no âmbito concorrencial. Faz-se um exame crítico, a partir de preceitos teóricos doutrinários e jurisprudenciais, tendo por paradigma o princípio da eficiência, a fim de interpretar como a Administração Pública lida com essa questão e fomentar o debate técnico acadêmico, em prol da otimização dos resultados institucionais almejados.

In Brazil, acts of corruption and money laundering ravage the country and the Public Administration itself, as a consequence, afflict society, which faces a series of problems related to health, education, security, raising taxes, among others, and the Judiciary is responsible for prosecuting and adjudicating these wrongdoings and deviations, however, it faces a series of challenges in solving the problem, demanding the search for effective instruments. The rules applicable to the Leniency Program, to combat corruption are set forth in Articles 16 and 17 of the Anti-Corruption Law. In the scope of the Federal Executive Power, the institute is regulated by articles 28 to 40, of Decree n. 8,420 / 2015 and Articles 27 to 37 of the Ordinance of the Federal Comptroller's Office (CGU) n. 910/2015. The purpose of this study is to address the effectiveness of the Leniency Agreement in light of Law no. 12,529 / 2011 and Law no. 12.846 / 2013, in its Chapter V - OF THE AGREEMENT OF LENIENCE, article 16 and 17. Method: This research was developed through literature review. The articles selected, the legislation and the works researched contributed to answer the identified problem. As a conclusion, all the Laws included in the Leniency Agreement are effective in attaining the objectives sought, identifying and punishing the guilty through the collaboration of one or more agents involved in the crime. [ABSTRACT FROM AUTHOR]

Propósito – O presente artigo pretende lançar luzes à incipiente discussão acerca da inserção do Conselho Administrativo de Defesa Econômica (CADE) no processo brasileiro de agencificação e debater sobre o reconhecimento da autarquia como agência reguladora no panorama institucional do Brasil. Metodologia/abordagem/design – Teorias regulatórias processuais e decisões do CADE. Resultados – O CADE exerce papel regulador nos casos que lhe são submetidos. Implicações práticas – O reconhecimento institucional do CADE como agência reguladora poderá ocasionar uma revisão do seu papel como formulador de políticas públicas e agregar conhecimento complementar e interdisciplinar aos demais campos da regulação. Originalidade/relevância do texto – O CADE tem sido cada vez mais exigido pela sociedade para realizar intervenções no domínio econômico a título de defesa da concorrência. As decisões do CADE são formas de intervenção do Estado no domínio econômico que nem sempre são vistas como regulação. O plano governamental brasileiro que abrange as agências reguladoras não inclui o CADE como agente fomentador da defesa da concorrência e como possível instrumento de regulação em searas mais delimitadas da economia. No entanto, nos casos em que o CADE recorre a remédios comportamentais e estruturais, tanto em controle de estruturas quanto em controle de condutas, a autoridade antitruste acaba fazendo uma regulação ad hoc. Tais intervenções acabam por modelar e, de certa forma, regular alguns mercados, sem que haja autorização ou proibição legal para que o CADE exerça esse papel regulatório. O reconhecimento do papel regulador do CADE pode significar a passagem de um auxiliar da estrutura regulatória brasileira para o de um efetivo agente formulador de políticas públicas, o que beneficia toda a sociedade.

Propósito – Analisar a possibilidade de parceria entre o Ministério Público (doravante “MP”) e o Centro de Defesa da Concorrência (doravante “CADE”) para incentivar uma melhor análise de efeitos de concentração em mercados relevantes de menor faturamento a partir da teoria da regulação responsiva. Metodologia/abordagem/design – Breve revisão bibliográfica da teoria de regulação responsiva à luz do atual estado do Sistema Brasileiro de Defesa da Concorrência (doravante “SBDC”) e possíveis inovações governamentais. Resultados – Há espaço de crescimento de parceria entre o MP e o CADE também nas análises de concentração econômica, comunicação e conscientização pública, não apenas na cooperação para combate a condutas, o que pode ser um bom espaço a ser explorado pelo Estado para implementação de políticas públicas. Implicações práticas – o entendimento de que há novas formas de parceria entre as instituições em debate levaria à possibilidade de mudanças na formação das diretrizes das políticas públicas dessas instituições, a fim de que houvesse uma maior inserção geográfica do SBDC em mercados relevantes hoje inalcançáveis. Originalidade/relevância do texto – o texto se mostra original ao iniciar um debate a respeito de quais caminhos podemos tomar para avançar no controle regulatório de mercados relevantes que hoje não recebem atenção.

O presente artigo analisa a questão gerada em decorrência dos incentivos fiscais dados por parte dos Estados que causam a chamada guerra fiscal. Aborda a possível lesão à livre concorrência protegida constitucionalmente, bem como a atuação do CADE - Conselho Administrativo de Defesa Econômica em prol da manutenção da concorrência no mercado. Para tanto, trata do conceito da “guerra fiscal” e da a análise das pendências, judiciais e legislativas, existentes acerca do tema. Por outro lado, destaca também à efetiva atuação do CADE diante das concessões dos benefícios fiscais, bem como as possibilidades dispostas legalmente para que o referido Conselho atue visando à manutenção da Concorrência. Diante deste panorama, discute-se a possibilidade de intervenção do CADE, analisando e julgando os atos que, em razão da concessão de incentivos fiscais pelos membros da federação, possam lesionar a livre concorrência.

The cartel is considered the most serious injury to competition among the anticompetitive conduct. Cartel is an agreement between competitors, whose goal is to eliminate competition, which may be through price fixing, production quotas, market division, among others. The cartel brings huge losses to the company, increasing the price of products and affecting their availability in the market. Harming consumers, economic development, and technological innovation, affecting considerably the social well-being, addressing the prosecution of cartels by antitrust authorities, highlighting the evidentiary means, especially the leniency program.

Background: Cervical squamous cell carcinoma (CSCC) and adenocarcinoma (CAde) are two major pathological types of cervical cancer (CC), but their high-resolution heterogeneity of tumor and immune microenvironment remains elusive., Methods: Here, we performed single-nucleus RNA sequencing (snRNA-seq) from five CSCC and three CAde samples, and systematically outlined their specific transcriptome atlas., Findings: We found CD8 + T cells in CSCC were more cytotoxic but lower exhausted compared to those in CAde, and phagocytic MRC1 + macrophages were specifically enriched in CSCC. Interestingly, we discovered that pro-tumoral cancer-associated myofibroblasts (myoCAFs) and cancer-associated vascular-fibroblasts (vCAFs) were more abundant in CSCC, and further verified their pro-metastatic roles in vitro. Furthermore, we also identified some specific chemotherapy drugs for CSCC (Dasatinib and Doramapimod) and CAde (Pyrimethamine and Lapatinib) by revealing their heterogeneity in transcriptomic profiles of malignant epithelial cells, and further verified their specific sensitivity in cell lines and constructed CC-derived organoids. Cell-cell communication networks revealed that the pathways of NRG1-ERBB2, and FN1-ITAG3 were specific for CAde and CSCC, respectively, which may partly explain the specificities of identified chemotherapy drugs., Interpretation: Our study described the immune heterogeneity and specific cellular interactions between CSCC and CAde, which could provide insights for uncovering pathogenesis and designing personalized treatment., Fundings: National Key R&D Program of China (2021YFC2701201), National Natural Science Foundation of China (82072895, 82141106, 82103134, 81903114)., Competing Interests: Declaration of interests The authors declare that they have no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Colorectal cancer (CRC) has become a severe global health concern, with the third‑high incidence and second‑high mortality rate of all cancers. The burden of CRC is expected to surge to 60% by 2030. Fortunately, effective early evidence‑based screening could significantly reduce the incidence and mortality of CRC. Colonoscopy is the core screening method for CRC with high popularity and accuracy. Yet, the accuracy of colonoscopy in CRC screening is related to the experience and state of operating physicians. It is challenging to maintain the high CRC diagnostic rate of colonoscopy. Artificial intelligence (AI)‑assisted colonoscopy will compensate for the above shortcomings and improve the accuracy, efficiency, and quality of colonoscopy screening. The unique advantages of AI, such as the continuous advancement of high‑performance computing capabilities and innovative deep‑learning architectures, which hugely impact the control of colorectal cancer morbidity and mortality expectancy, highlight its role in colonoscopy screening.

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Copyright of Ayer: Revista de Historia Contemporánea is the property of Asociacion de Historia Contemporanea and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Economia Contemporânea is the property of Revista de Economia Contemporanea and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In his treatise, The Right to the City, published in Paris just before the student riots of 1968, Henri Lefebvre claims that inhabitants have a 'right to the city' which supersedes the rights of property owners and advocates 're-appropriation' of the city, resulting in 'collective ownership and management of space'. Present-day movements such as the Occupy protests continue to cite Lefebvre's radical proposals as their inspiration. Shakespeare presents a nightmare counterpoint to this utopian dream. In 2 Henry VI, an analogue of 'the right to the city' appears as might be called 'the right to the commons'. The Jack Cade Rebellion, however, quickly degenerates into horrifying bloodshed. In Julius Caesar and Coriolanus, Shakespeare likewise seems to oppose anarchic populism. Shakespeare and Lefebvre share common ground, however, in their sense that mob violence is a response to subjective alienation. Like Hegel, they see the desire for recognition as the engine of political conflict. More than any material change in what Marx would call the 'conditions of production', Shakespeare's peasants and plebeians want to be recognised as worthy of respect; in the language of Coriolanus, they want their 'voices' to be heard. Riots and rebellions are their way of protecting that right. [ABSTRACT FROM AUTHOR]