Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on l...Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.展开更多
BACKGROUND Although the spasm provocation test(SPT)can diagnose coronary spasms,it would be helpful if it could also predict their occurrence.AIM To investigate whether coronary spasms can be predicted using changes i...BACKGROUND Although the spasm provocation test(SPT)can diagnose coronary spasms,it would be helpful if it could also predict their occurrence.AIM To investigate whether coronary spasms can be predicted using changes in intracoronary artery pressure measured using a pressure wire during the SPT.METHODS Seventy patients underwent SPTs with pressure-wire measurement of intracoronary artery pressure.During each SPT,the pressure wire was advanced into the distal portion of the right coronary artery(RCA)and left anterior descending coronary artery,and the ratio of intracoronary pressure to aortic pressure(Pd/Pa)was monitored.Coronary spasm was defined as an arterial narrowing of>90%in response to the administration of acetylcholine(ACh),with chest symptoms and/or ischemic electrocardiographic changes.ACh was administered to the RCA at low,moderate,or high doses of 20,50,or 80μg,respectively,and to the left coronary artery(LCA)at low,moderate,or high doses of 50,100,or 200μg,respectively.Coronary arteries with coronary spasms at low doses of ACh were defined as group L,and those with coronary spasms at moderate or high doses were defined as group MH.Those who did not occur coronary spasms at any ACh dose were designated as group N.RESULTS Among the 132 coronary arteries assessed using a pressure wire,there were 49 in group N,25 in group L,and 58 in group MH.Baseline Pd/Pa was the lowest in group L(P=0.001).The decrease in the Pd/Pa between baseline to low doses of ACh was lower in group MH than in group N(P<0.001).A receiver-operating characteristics analysis showed that the cutoff baseline Pd/Pa value for predicting group L was 0.95,with a sensitivity of 0.600(15/25)and a specificity of 0.713(76/107)and that the cutoff value of Pd/Pa from baseline to low doses of ACh for predicting group MH was−0.04,with a sensitivity of 0.741(43/58)and a specificity of 0.694(34/49).CONCLUSION These findings suggest that indices of intracoronary pressure during SPT may be useful means for predicting the occurrence of coronary spasms.展开更多
Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom wr...Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom writing assessments.The present mixed-methods study used Shaw and Weir’s(2007)sociocognitive writing test validation framework to examine the scoring and consequential validity evidence of CB and PB writing tests in EFL classroom assessment in higher education.Original handwritten and word-processed texts of 38 EFL university students were transcribed to their opposite format and assessed by three language lecturers(N=456 texts,152 per teacher)to examine the scoring validity of CB and PB tests.The teachers’perceptions of text quality and preferences for assessment modality accounted for the consequential validity evidence of both tests.Findings revealed that the assessment modality impacted teachers’scorings,perceptions,and preferences.The teachers awarded higher scores to original and transcribed handwritten texts,particularly text organization and language use.The teachers’perceptions of text quality differed from their ratings,and physical,psychological,and experiential characteristics influenced their preferences for assessment modality.The results have implications for the validity and fairness of CB and PB writing tests and teachers’assessment practices.展开更多
BACKGROUND Artificial intelligence(AI)has potential in the optical diagnosis of colorectal polyps.AIM To evaluate the feasibility of the real-time use of the computer-aided diagnosis system(CADx)AI for ColoRectal Poly...BACKGROUND Artificial intelligence(AI)has potential in the optical diagnosis of colorectal polyps.AIM To evaluate the feasibility of the real-time use of the computer-aided diagnosis system(CADx)AI for ColoRectal Polyps(AI4CRP)for the optical diagnosis of diminutive colorectal polyps and to compare the performance with CAD EYE^(TM)(Fujifilm,Tokyo,Japan).CADx influence on the optical diagnosis of an expert endoscopist was also investigated.METHODS AI4CRP was developed in-house and CAD EYE was proprietary software provided by Fujifilm.Both CADxsystems exploit convolutional neural networks.Colorectal polyps were characterized as benign or premalignant and histopathology was used as gold standard.AI4CRP provided an objective assessment of its characterization by presenting a calibrated confidence characterization value(range 0.0-1.0).A predefined cut-off value of 0.6 was set with values<0.6 indicating benign and values≥0.6 indicating premalignant colorectal polyps.Low confidence characterizations were defined as values 40%around the cut-off value of 0.6(<0.36 and>0.76).Self-critical AI4CRP’s diagnostic performances excluded low confidence characterizations.RESULTS AI4CRP use was feasible and performed on 30 patients with 51 colorectal polyps.Self-critical AI4CRP,excluding 14 low confidence characterizations[27.5%(14/51)],had a diagnostic accuracy of 89.2%,sensitivity of 89.7%,and specificity of 87.5%,which was higher compared to AI4CRP.CAD EYE had a 83.7%diagnostic accuracy,74.2%sensitivity,and 100.0%specificity.Diagnostic performances of the endoscopist alone(before AI)increased nonsignificantly after reviewing the CADx characterizations of both AI4CRP and CAD EYE(AI-assisted endoscopist).Diagnostic performances of the AI-assisted endoscopist were higher compared to both CADx-systems,except for specificity for which CAD EYE performed best.CONCLUSION Real-time use of AI4CRP was feasible.Objective confidence values provided by a CADx is novel and self-critical AI4CRP showed higher diagnostic performances compared to AI4CRP.展开更多
Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic st...Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.展开更多
目的研究正在高效联合抗反转录病毒治疗(highly active antiretroviral therapy,HAART)治疗AIDS患者因不同因素引起的股骨颈骨折人工髋关节置换手术治疗效果及并发症分析,为AIDS患者股骨颈骨折手术治疗的术前评估、手术治疗效果及并发...目的研究正在高效联合抗反转录病毒治疗(highly active antiretroviral therapy,HAART)治疗AIDS患者因不同因素引起的股骨颈骨折人工髋关节置换手术治疗效果及并发症分析,为AIDS患者股骨颈骨折手术治疗的术前评估、手术治疗效果及并发症的预防提供可靠的参考依据。方法分析2015年6月—2019年6月期间河南省传染病医院收治的正在HAART治疗152例因不同因素(摔倒跌伤、交通事故伤、高处坠落伤、非暴力伤)引起的股骨颈骨折AIDS患者,进行人工全髋关节置换术治疗,观察术后关节活动功能及并发症发生情况,回顾性分析所有患者的随访资料。结果入组AIDS患者共152例,均采取围手术期规范化处理,均采取标准的人工全髋关节置换术。术后随访平均12个月,术后离床活动时间平均为(2±1.5)天,优良率97.4%。无关节假体松动及断裂出现,未发现症状性静脉血栓发生,97例患者出现围手术期血红蛋白(Hb)与出血量、输血量等预算明显不一致,称之为不对称性贫血,21例出现低蛋白血症及电解质紊乱,出现3例血培养均为大肠埃希氏菌菌血症,3例出现肺部感染(1例为流感嗜血杆菌、2例为肺炎克雷伯杆菌),而无切口感染,依据临床经验和药物敏感性试验,给予敏感抗菌药物抗感染治疗,均得到完全治愈,所有患者术后疼痛迅速消失,关节功能迅速恢复,均恢复正常的日常生活及工作。结论AIDS患者股骨颈骨折人工全髋关节置换手术治疗取得满意的疗效,安全有效,重视和加强AIDS患者骨科围手术期处理,积极采取有效措施,使患者机体内环境接近正常状态,降低围手术期严重并发症,才能保障AIDS患者围手术期安全。展开更多
基金the Key Project of Zhejiang Provincial Natural Science Foundation under Grants LD21F020001,Z20F020022the National Natural Science Foundation of China under Grants 62072340,62076185the Major Project of Wenzhou Natural Science Foundation under Grants 2021HZSY0071,ZS2022001.
文摘Various deep learning models have been proposed for the accurate assisted diagnosis of early-stage Alzheimer’s disease(AD).Most studies predominantly employ Convolutional Neural Networks(CNNs),which focus solely on local features,thus encountering difficulties in handling global features.In contrast to natural images,Structural Magnetic Resonance Imaging(sMRI)images exhibit a higher number of channel dimensions.However,during the Position Embedding stage ofMulti Head Self Attention(MHSA),the coded information related to the channel dimension is disregarded.To tackle these issues,we propose theRepBoTNet-CESA network,an advanced AD-aided diagnostic model that is capable of learning local and global features simultaneously.It combines the advantages of CNN networks in capturing local information and Transformer networks in integrating global information,reducing computational costs while achieving excellent classification performance.Moreover,it uses the Cubic Embedding Self Attention(CESA)proposed in this paper to incorporate the channel code information,enhancing the classification performance within the Transformer structure.Finally,the RepBoTNet-CESA performs well in various AD-aided diagnosis tasks,with an accuracy of 96.58%,precision of 97.26%,and recall of 96.23%in the AD/NC task;an accuracy of 92.75%,precision of 92.84%,and recall of 93.18%in the EMCI/NC task;and an accuracy of 80.97%,precision of 83.86%,and recall of 80.91%in the AD/EMCI/LMCI/NC task.This demonstrates that RepBoTNet-CESA delivers outstanding outcomes in various AD-aided diagnostic tasks.Furthermore,our study has shown that MHSA exhibits superior performance compared to conventional attention mechanisms in enhancing ResNet performance.Besides,the Deeper RepBoTNet-CESA network fails to make further progress in AD-aided diagnostic tasks.
文摘BACKGROUND Although the spasm provocation test(SPT)can diagnose coronary spasms,it would be helpful if it could also predict their occurrence.AIM To investigate whether coronary spasms can be predicted using changes in intracoronary artery pressure measured using a pressure wire during the SPT.METHODS Seventy patients underwent SPTs with pressure-wire measurement of intracoronary artery pressure.During each SPT,the pressure wire was advanced into the distal portion of the right coronary artery(RCA)and left anterior descending coronary artery,and the ratio of intracoronary pressure to aortic pressure(Pd/Pa)was monitored.Coronary spasm was defined as an arterial narrowing of>90%in response to the administration of acetylcholine(ACh),with chest symptoms and/or ischemic electrocardiographic changes.ACh was administered to the RCA at low,moderate,or high doses of 20,50,or 80μg,respectively,and to the left coronary artery(LCA)at low,moderate,or high doses of 50,100,or 200μg,respectively.Coronary arteries with coronary spasms at low doses of ACh were defined as group L,and those with coronary spasms at moderate or high doses were defined as group MH.Those who did not occur coronary spasms at any ACh dose were designated as group N.RESULTS Among the 132 coronary arteries assessed using a pressure wire,there were 49 in group N,25 in group L,and 58 in group MH.Baseline Pd/Pa was the lowest in group L(P=0.001).The decrease in the Pd/Pa between baseline to low doses of ACh was lower in group MH than in group N(P<0.001).A receiver-operating characteristics analysis showed that the cutoff baseline Pd/Pa value for predicting group L was 0.95,with a sensitivity of 0.600(15/25)and a specificity of 0.713(76/107)and that the cutoff value of Pd/Pa from baseline to low doses of ACh for predicting group MH was−0.04,with a sensitivity of 0.741(43/58)and a specificity of 0.694(34/49).CONCLUSION These findings suggest that indices of intracoronary pressure during SPT may be useful means for predicting the occurrence of coronary spasms.
文摘Little is known about how the assessment modality,i.e.,computer-based(CB)and paper-based(PB)tests,affects language teachers’scorings,perceptions,and preferences and,therefore,the validity and fairness of classroom writing assessments.The present mixed-methods study used Shaw and Weir’s(2007)sociocognitive writing test validation framework to examine the scoring and consequential validity evidence of CB and PB writing tests in EFL classroom assessment in higher education.Original handwritten and word-processed texts of 38 EFL university students were transcribed to their opposite format and assessed by three language lecturers(N=456 texts,152 per teacher)to examine the scoring validity of CB and PB tests.The teachers’perceptions of text quality and preferences for assessment modality accounted for the consequential validity evidence of both tests.Findings revealed that the assessment modality impacted teachers’scorings,perceptions,and preferences.The teachers awarded higher scores to original and transcribed handwritten texts,particularly text organization and language use.The teachers’perceptions of text quality differed from their ratings,and physical,psychological,and experiential characteristics influenced their preferences for assessment modality.The results have implications for the validity and fairness of CB and PB writing tests and teachers’assessment practices.
文摘BACKGROUND Artificial intelligence(AI)has potential in the optical diagnosis of colorectal polyps.AIM To evaluate the feasibility of the real-time use of the computer-aided diagnosis system(CADx)AI for ColoRectal Polyps(AI4CRP)for the optical diagnosis of diminutive colorectal polyps and to compare the performance with CAD EYE^(TM)(Fujifilm,Tokyo,Japan).CADx influence on the optical diagnosis of an expert endoscopist was also investigated.METHODS AI4CRP was developed in-house and CAD EYE was proprietary software provided by Fujifilm.Both CADxsystems exploit convolutional neural networks.Colorectal polyps were characterized as benign or premalignant and histopathology was used as gold standard.AI4CRP provided an objective assessment of its characterization by presenting a calibrated confidence characterization value(range 0.0-1.0).A predefined cut-off value of 0.6 was set with values<0.6 indicating benign and values≥0.6 indicating premalignant colorectal polyps.Low confidence characterizations were defined as values 40%around the cut-off value of 0.6(<0.36 and>0.76).Self-critical AI4CRP’s diagnostic performances excluded low confidence characterizations.RESULTS AI4CRP use was feasible and performed on 30 patients with 51 colorectal polyps.Self-critical AI4CRP,excluding 14 low confidence characterizations[27.5%(14/51)],had a diagnostic accuracy of 89.2%,sensitivity of 89.7%,and specificity of 87.5%,which was higher compared to AI4CRP.CAD EYE had a 83.7%diagnostic accuracy,74.2%sensitivity,and 100.0%specificity.Diagnostic performances of the endoscopist alone(before AI)increased nonsignificantly after reviewing the CADx characterizations of both AI4CRP and CAD EYE(AI-assisted endoscopist).Diagnostic performances of the AI-assisted endoscopist were higher compared to both CADx-systems,except for specificity for which CAD EYE performed best.CONCLUSION Real-time use of AI4CRP was feasible.Objective confidence values provided by a CADx is novel and self-critical AI4CRP showed higher diagnostic performances compared to AI4CRP.
文摘Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.
文摘目的研究正在高效联合抗反转录病毒治疗(highly active antiretroviral therapy,HAART)治疗AIDS患者因不同因素引起的股骨颈骨折人工髋关节置换手术治疗效果及并发症分析,为AIDS患者股骨颈骨折手术治疗的术前评估、手术治疗效果及并发症的预防提供可靠的参考依据。方法分析2015年6月—2019年6月期间河南省传染病医院收治的正在HAART治疗152例因不同因素(摔倒跌伤、交通事故伤、高处坠落伤、非暴力伤)引起的股骨颈骨折AIDS患者,进行人工全髋关节置换术治疗,观察术后关节活动功能及并发症发生情况,回顾性分析所有患者的随访资料。结果入组AIDS患者共152例,均采取围手术期规范化处理,均采取标准的人工全髋关节置换术。术后随访平均12个月,术后离床活动时间平均为(2±1.5)天,优良率97.4%。无关节假体松动及断裂出现,未发现症状性静脉血栓发生,97例患者出现围手术期血红蛋白(Hb)与出血量、输血量等预算明显不一致,称之为不对称性贫血,21例出现低蛋白血症及电解质紊乱,出现3例血培养均为大肠埃希氏菌菌血症,3例出现肺部感染(1例为流感嗜血杆菌、2例为肺炎克雷伯杆菌),而无切口感染,依据临床经验和药物敏感性试验,给予敏感抗菌药物抗感染治疗,均得到完全治愈,所有患者术后疼痛迅速消失,关节功能迅速恢复,均恢复正常的日常生活及工作。结论AIDS患者股骨颈骨折人工全髋关节置换手术治疗取得满意的疗效,安全有效,重视和加强AIDS患者骨科围手术期处理,积极采取有效措施,使患者机体内环境接近正常状态,降低围手术期严重并发症,才能保障AIDS患者围手术期安全。
