Endoscopic features of esophageal high-grade intraepithelial neoplasia dominated by cytological atypia

Little is known about esophageal high-grade intraepithelial neoplasia dominated by cytological atypia (HGINc). We aimed to elucidate the endoscopic features of HGINc compared with esophageal high-grade intraepithelial neoplasia dominated by architectural atypia (HGINa). All patients pathologically diagnosed as esophageal high-grade intraepithelial neoplasia after endoscopic submucosal dissection at our center between January 2018 and December 2019 were included in this study. According to the pathological diagnosis, the patients were divided into two groups: HGINa group and HGINc group. Basic characteristics and endoscopic information were collected in detail. Data were analyzed statistically. Binary logistic regression was performed and a predictive model for HGINc was established. Then we evaluated its predictive value and built a nomogram for clinical application. A total of 175 patients were included in this study (126 with HGINa and 49 with HGINc). Among 228 lesions found in all patients, there were 148 HGINa and 80 HGINc. The independent relevant factors for HGINc were tobacco and alcohol usage, color, and gross type. To predict risk of HGINc, a three-factor model (TFM) was established with a highest area under curve (AUC) as 0.869 (95% CI, 0.852, 0.939). When the cut-off value was set as 0.3569184, the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for HGINc was 81.14%, 88.75%, 77.03%, 67.62%, and 92.68%, respectively. HGINc differs greatly in endoscopic features from HGINa in our study. It’s important to reduce misdiagnosis that our model was established with good predictive value for clinical application.     

面向元数据服务的国防科技管理大数据资源体系架构设计

在研究参考《美国国防部体系结构框架》（DoDAF）2.0版数据规划技术基础上,理清了国防科技管理大数据的需求线和数据结构,设计了国防科技管理大数据资源的总体框架体系。借鉴DoDAF 2.0版中的元模型构建思想,重点研究了国防科技管理大数据的元数据技术及元数据交换规范,以推进我国国防科技大数据体系的建设,提高我军基于数据的精准管理和决策能力。     

The use of drawings to explore young people's views of a service for those affected by parental alcohol misuse

Background: As services for young people affected by parental substance misuse evolve, it is important that young people are invited to express their views on the service they receive.

Method: As part of the evaluation of a new service for young people living with parental alcohol misuse, a self-report drawing method was used with 11 young people to elicit their views of the service.

Findings: The most common changes noted were: feeling happier and less confused, and having a more harmonious family life with families spending more time together. Many of the young people placed parental alcohol misuse centrally in their drawings.

Conclusions: Self-report drawing enabled the young people to reflect on change, and thus is a powerful tool for further research in this area.     

Digital atlas of the zebra finch (Taeniopygia guttata) brain: A high‐resolution photo atlas

We describe a set of new comprehensive, high‐quality, high‐resolution digital images of histological sections from the brain of male zebra finches (Taeniopygia guttata) and make them publicly available through an interactive website ( http://zebrafinch.brainarchitecture.org/ ). These images provide a basis for the production of a dimensionally accurate and detailed digital nonstereotaxic atlas. Nissl‐ and myelin‐stained brain sections are provided in the transverse, sagittal, and horizontal planes, with the transverse plane approximating the more traditional Frankfurt plane. In addition, a separate set of brain sections in this same plane is stained for tyrosine hydroxylase, revealing the distribution of catecholaminergic neurons (dopaminergic, noradrenergic, and adrenergic) in the songbird brain. For a subset of sagittal sections we also prepared a corresponding set of drawings, defining and annotating various nuclei, fields, and fiber tracts that are visible under Nissl and myelin staining. This atlas of the zebra finch brain is expected to become an important tool for birdsong research and comparative studies of brain organization and evolution. J. Comp. Neurol. 521:3702–3715, 2013. © 2013 Wiley Periodicals, Inc.     

From photos to sketches - how humans and deep neural networks process objects across different levels of visual abstraction

Line drawings convey meaning with just a few strokes. Despite strong simplifications, humans can recognize objects depicted in such abstracted images without effort. To what degree do deep convolutional neural networks (CNNs) mirror this human ability to generalize to abstracted object images? While CNNs trained on natural images have been shown to exhibit poor classification performance on drawings, other work has demonstrated highly similar latent representations in the networks for abstracted and natural images. Here, we address these seemingly conflicting findings by analyzing the activation patterns of a CNN trained on natural images across a set of photographs, drawings, and sketches of the same objects and comparing them to human behavior. We find a highly similar representational structure across levels of visual abstraction in early and intermediate layers of the network. This similarity, however, does not translate to later stages in the network, resulting in low classification performance for drawings and sketches. We identified that texture bias in CNNs contributes to the dissimilar representational structure in late layers and the poor performance on drawings. Finally, by fine-tuning late network layers with object drawings, we show that performance can be largely restored, demonstrating the general utility of features learned on natural images in early and intermediate layers for the recognition of drawings. In conclusion, generalization to abstracted images, such as drawings, seems to be an emergent property of CNNs trained on natural images, which is, however, suppressed by domain-related biases that arise during later processing stages in the network.     

Encouraging choice,serendipity and experimentation: experiences from Griffith University library (G11) extension and Gumurrii Centre

Abstract

The refurbishment and extension of existing university buildings is a critical consideration for many universities. This article details an architect’s perspective of an innovative and collaborative design approach to transforming an existing library into a futuristic and student-centric interactive learning environment. The design is responsive to people, place, the community and the environment, due, in part, to the enhanced physical permeability of the building. Associated user-group forums comprised the end user client, the university’s facilities body, the builder, lead architectural consultants, the Centre for Indigenous Students (Gumurrii Centre) and architectural sub-consultants. This article discusses five key design moves – “triangulate”, “unique geometries and spaces”, “learning aviary”, “sky lounge” and “understanding flexibility”. It goes on to discuss these elements in relation to designing spaces to enhance interprofessional education and collaboration. In summary, this article identifies how it is possible to maximise the value and characteristics of an existing library whilst creating a series of innovative spaces that offer choice, encourage serendipity and embrace experimentation.     

Chronic Widespread Pain Drawn on a Body Diagram is a Screening Tool for Increased Pain Sensitization,Psycho‐Social Load,and Utilization of Pain Management Strategies

The aim of this study was to investigate the hypothesis that chronic widespread pain, (CWP) drawn by patients on a body diagram, could be used as a screening tool for increased pain sensitization, psycho‐social load, and utilization of pain management strategies. The triage questionnaires of 144 adults attending a chronic pain outpatients' clinic were audited and the percentage pain surface area (PPSA) drawn on their body diagrams was calculated using the “rule of nines” (RON) method for burns area assessment. Outcomes were measured using the painDETECT Questionnaire (PD‐Q) and other indices and compared using a nonrandomized, case–control method. It was found that significantly more subjects with CWP (defined as a PPSA ≥ 20%) reported high (≥ 19) PD‐Q scores (suggesting pain “sensitization” or neuropathic pain) (P = 0.0002), “severe” or “extremely severe” anxiety scores on the Depression, Anxiety and Stress Scale‐21 Items Questionnaire (P = 0.0270), ≥ 5 psycho‐social stressors (P = 0.0022), ≥ 5 significant life events (P = 0.0098), and used ≥ 7 pain management strategies (PMS) (P < 00001), compared to control subjects with a lower PPSA. A Widespread Pain Index score ≥ 7 (OR = 11.36), PD‐Q score ≥ 19 (OR = 4.46) and use of ≥ 7 PMS (OR = 5.49) were independently associated with CWP. This study demonstrates that calculating PPSA on a body diagram (using the RON method) is a valid and convenient “snapshot” screening tool to identify patients with an increased likelihood of pain sensitization, psycho‐social load, and utilizing pain management resources.     

Severely disturbed children's human figure drawings: are they unusual or just poor drawings?

 Previous research has shown that the human figure drawings of severely disturbed children contain more emotional indicators than those of well-adjusted children, whether the well-adjusted children are of the same chronological age or are younger but of the same mental age as the severely disturbed children. This finding suggests that the disturbed children's drawings may be different rather than merely immature. A problem with previous research, however, is that groups have not been matched for drawing ability. In study 1 of this paper each drawing of 44 severely disturbed boys was matched with that of a normal boy according to its score on the Goodenough–Harris scoring system. There was no significant difference between the groups in the number of emotional indicators included in the drawings. Furthermore, in study 2, judges could not discriminate the drawings of the two groups. It was concluded that the differences noted in previous research were most likely due to the poorer drawing ability of the severely disturbed children rather than unusual features in their drawings. Accepted: 9 May 2000     

宝鸡市医院消毒供应中心(室)建筑布局调查

目的对宝鸡市医院消毒供应中心(室)建筑布局进行调查,针对问题提出整改建议。方法以《医院消毒供应中心管理规范》和相关行业规定为标准,设计调查表,汇总分析结果。结果医院消毒供应中心(室)建筑布局方面存在的主要问题是:1/3医院消毒供应中心(室)选址欠妥。三级、二级医院的消毒供应中心(室)建筑布局较合理,功能区域划分科学,一级医院消毒供应室普遍设置不合理、建设标准低。建议各级医院管理者加大对消毒供应中心(室)投入;一级医院消毒供应室在改、扩建时应结合实际,充分论证,做到科学合理;二级医院消毒供应室应向消毒供应中心转型。结论通过一系列改进措施的实施,有效确保医院医疗质量安全。     

Availability and need of home adaptations for personal mobility among individuals with spinal cord injury

Objective: To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI).

Design: Cross-sectional study.

Setting: Swiss Spinal Cord Injury Community Survey 2012.

Participants: Individuals aged 16 or older with chronic SCI living in Switzerland.

Interventions: Not applicable.

Outcome measures: The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, SCI severity, SCI etiology and time since SCI. The unmet need (self-report of not having a HA but needing it) of HAs was analyzed by financial hardship.

Results: Among the 482 study participants (mean age 55.2 years, standard deviation 15.0 years, 71.6% males), 85.1% had at least one HA. The most frequent HA was a wheelchair accessible shower (62.7%). Availability of HAs markedly varied with indoor mobility (e.g. 38.4% of participants using a wheelchair had a stair lift compared to 17.4% of those walking) and with SCI severity (e.g. 54.8% of those with complete paraplegia had a wheelchair accessible kitchen worktop compared to 26.0% of those with incomplete paraplegia). Unmet need was highest for adjustable kitchen worktops (78.7% of those with a need) and adjustable kitchen cabinets (75.7%) and lowest for wheelchair accessible showers (9.4%) and grab bars next to the toilet (8.5%). No significant differences in unmet need were found when stratifying for financial hardship.

Conclusion: Availability of HAs is dependent on indoor mobility and SCI severity. There is a considerable degree of unmet need for selected HAs, which couldn't be explained by financial hardship.