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. 相似文献
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. 相似文献
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. 相似文献
AbstractThe 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. 相似文献
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. 相似文献
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 相似文献
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. 相似文献