BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial ...BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial variation raises concerns about missed lesions and post-colonoscopy colorectal cancer.This study investigates determinants associated with SSL-DR variation in regional Australia.AIM To study how patient,clinical,and colonoscopy factors are associated with SSL detection in a regional Australian practice.We aimed to contribute high-detection data to the literature by analyzing the association of SSL detection with various determinants.METHODS This retrospective,cross-sectional analysis examined 1450 colonoscopies performed at Port Macquarie Gastroenterology during 2023.Sigmoidoscopies and repeat procedures were excluded.Multivariate logistic regression analyzed associations between SSL detection and patient demographics,clinical indications,procedural factors,and comorbidities.RESULTS The overall SSL-DR was 30.7%.Multivariate analysis identified several independent predictors:Clinical indication,bowel preparation quality,inflammatory bowel disease status,and serrated polyposis syndrome.The faecal occult blood test positive(FOBT)(+)cohort showed the highest predicted SSL detection probability(39.8%),while clinical symptoms showed the lowest(22.3%).After adjustment,SSL detection odds were 2.3 times greater among FOBT(+)patients than those with clinical symptoms(adjusted odds ratio=2.30,95%confidence interval:1.20-4.40,P=0.004).CONCLUSION SSL-DR as a quality indicator requires contextualization regarding clinical indications,bowel preparation quality,and comorbidities.There was a significantly higher prevalence of SSLs in FOBT(+)patients.Despite comprehensive adjustment,this study cannot fully explain the wide SSL-DR variation in Australia,highlighting the need for standardized detection protocols and further research to ensure optimal cancer prevention outcomes.展开更多
Screening colonoscopy with adenoma removal is the gold standard strategy to reduce colorectal cancer(CRC)incidence.Nevertheless,it remains an imperfect tool as nearly Twenty-five percent of adenomas can be missed duri...Screening colonoscopy with adenoma removal is the gold standard strategy to reduce colorectal cancer(CRC)incidence.Nevertheless,it remains an imperfect tool as nearly Twenty-five percent of adenomas can be missed during inspection by experienced endoscopists.Missed lesions are one of the primary reasons for post colonoscopy CRC and are associated with a significant variability in adenoma detection rate(ADR),which is the most important quality indicator for colonoscopy.Increasing ADR unquestionably decreases carcinoma miss rate.Simple measures to improve ADR include among others slower withdrawal time and position change.The introduction of optical imaging innovations has improved mucosal visualization.Moreover,auxiliary devices attached to the colonoscope tip have been introduced,aiming to improve lumen visualization by flattening the folds and revealing lesions hidden in blind spots,thereby increasing ADR.Digital image analysis using artificial intelligence is the latest approach to polyp detection.All of the above approaches have been separately evaluated concerning their effect in ADR;however,it has not been thoroughly investigated whether any benefit exists from their combined use.We aim to review the available data on the efficacy of each technique/technology and whether their combination offers any additional benefit while remaining cost-effective.展开更多
BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,...BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,ADR can vary significantly among endoscopists,leading to missed polyps or cancer.Artificial intelligence(AI)has shown promise in improving ADR by assisting in real-time polyp identification or diagnosis.While multiple randomized controlled trials(RCTs)and metanalyses highlight the benefits of AI in increasing detection rates and reducing missed polyps,concerns remain about its real-world applicability,impact on procedure time,and cost-effectiveness.AIM To explore the current status of AI assistance colonoscopy in adenoma detection and improving quality of colonoscopy.METHODS This systematic review followed PRISMA guidelines,both PubMed and Web of Science databases were used for articles search.Metanalyses and systematic reviews that assessed AI's role during colonoscopy.English article only published between January 2000 and January 2025 were included.Articles related to nonadenoma indications were excluded.Data extraction was independently performed by two researchers for accuracy and consistency.RESULTS 22 articles met the inclusion criteria,with significant heterogeneity(I2=28%-91%)observed in multiple studies.The number of studies per metanalysis ranged from 5 to 33,with higher heterogeneity in analyses involving more than 18 RCTs.AI demonstrated improvement in ADR,with an approximate 20%increase across multiple studies.However,its effectiveness in detecting flat or serrated adenomas remains unproven.Endoscopists with low ADR benefit more from AI-colonoscopies,while expert endoscopists outperformed AI in ADR,adenoma miss rate,and the identification of advanced lesions.No significant change in withdrawal time was observed when comparing AI-assisted colonoscopy to conventional endoscopy.CONCLUSION While AI-assisted colonoscopy has been shown to improve procedural quality,particularly for junior endoscopists and those with lower ADR,its performance decreases when compared to expert endoscopists in real-time clinical practice.This is especially evident in non-randomized studies,where AI demonstrates limited real-world benefits despite its benefit in controlled settings.Furthermore,no meta-analyses have specifically examined AI's impact on the learning experience of fellows and residents.Some experts caution that reliance on AI may prevent trainees from developing essential observational skills,potentially leading to less thorough examinations.Further research is needed to determine the actual benefits of AI-colonoscopy,particularly its role in cancer prevention.As technology advances,improved outcomes are expected,especially in detecting small,flat,and lesions at difficult anatomical locations.展开更多
BACKGROUND Colon capsule endoscopy(CCE)is a modern,non-invasive method for large bowel visualization,offering a less invasive alternative to traditional colonoscopy(TC).While TC remains the gold standard for comprehen...BACKGROUND Colon capsule endoscopy(CCE)is a modern,non-invasive method for large bowel visualization,offering a less invasive alternative to traditional colonoscopy(TC).While TC remains the gold standard for comprehensive large bowel assessment,including the detection and treatment of various conditions,the effectiveness of CCE in detecting polyps is less established.AIM To systematically review and compare the polyp detection rates(PDR)of CCE and TC.METHODS A systematic literature search was conducted using four scientific databases:CINAHL,MEDLINE via EBSCO,Cochrane Library,and MEDLINE/PubMed.A standardized search command was utilized to ensure consistency.Full papers were retrieved if they compared PDR between CCE and TC and involved patients over 18 years old.A meta-analysis was then conducted using the meta package in R software.RESULTS Initially,339 articles were identified,with 128 duplicates and 15 non-English articles excluded,leaving 196 for screening.After further exclusions,9 articles were included in the review.The meta-analysis revealed minimal differences in PDR between CCE and TC.The pooled PDR for TC was 0.61(95%CI:0.48–0.72),and for CCE,it was 0.61(95%CI:0.48–0.73).The overall comparison of the pooled PDR of both methods was 0.96(95%CI:0.90–1.02),indicating that CCE is noninferior to TC.CONCLUSION CCE has emerged as a modern and safe diagnostic alternative to TC for polyp detection,demonstrating noninferiority when compared to the conventional method.展开更多
BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(...BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(TXI)or computer-aided detection system(CAD)has been reported.AIM To investigate the effects of the scope on the detection of adenomas and sessile serrated lesions(SSLs).METHODS The subjects were patients who underwent pancolonic chromoendoscopy using the EVIS X1 video system center between May 2023 and October 2024.The patients were divided into the new(CF-XZ1200/CF-EZ1500)and 290 series(CF-HQ290Z/PCF-H290Z)groups.Propensity score matching was performed for age,sex,examination purpose,endoscopist,preparation,TXI use,and CAD use.The effects of the scope were analyzed in terms of the ADR,SSL detection rate(SDR),and mean number of adenomas per colonoscopy(APC).RESULTS Of the 7014 patients enrolled,2138 pairs were extracted by propensity score matching(mean age 55.4 years,45.5%male).The new scopes group had a significantly higher ADR than the 290 series group[51.5%vs 45.5%,odds ratio(OR)=1.27,95%CI:1.13-1.43,P<0.001].Similarly,the new scopes group had significantly higher SDR(7.8%vs 5.7%,OR=1.41,95%CI:1.11-1.80,P=0.005)and APC(0.90 vs 0.76,OR=1.11,95%CI:1.05-1.17,P<0.001)than the 290 series group.CONCLUSION In conclusion,the new scope(CF-XZ1200/CF-EZ1500)enhanced the detection of adenomas and SSLs compared to the old ones(290 series).展开更多
Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or inc...Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance.With an incidence rate of 3.6%to 9.3%,PCCRC remains a significant concern,highlighting the limitations of colonoscopy in CRC screening—not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions.A range of clinical,endoscopic,and biological factors has been associated with an increased risk of PCCRC.Identifying these factors can help stratify high-risk patients,enabling earlier detection and improving preventive strategies for interval CRC.Reducing PCCRC should be a top priority for every endoscopy unit.While technological advancements will enhance polyp detection,minimize missed lesions,prevent incomplete resections,and improve overall procedural quality,the most impactful strategy remains internal self-assessment within each unit.This review should evaluate key performance metrics,including cecal intubation rate,adenoma detection rate,withdrawal time,PCCRC incidence,and incomplete resections—both at the individual endoscopist level and across the entire unit.展开更多
Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screeni...Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screening methods include non-invasive tests,such as the fecal immunochemical test(FIT),as well as diagnostic procedures like colonoscopy.Colonoscopy remains the gold standard for detec-ting and treating precancerous polyps and early-stage cancer,regardless of whe-ther it is used as the first screening test or the second test following a positive FIT.However,its effectiveness can be affected by factors such as operator skill,patient variability,and limited lesion visibility,resulting in a significant rate of missed lesion rates and highlighting the need for more efficient and accurate screening techniques.This review is aimed to assess the current challenges of traditional screening methods with the impact of artificial intelligence(AI)in the diagnostic flow.The literature on AI-powered tools for colorectal cancer screening,including novel applications,emerging programs,and recent guidelines,has been reviewed to highlight both the advantages and limitations of implementing this technology in healthcare.Recent advances in AI have introduced soft AI colonoscopy,with the purpose of improving lesion recognition(computer-aided detection)and/or improving optical diagnosis(computer-aided diagnosis).AI-powered colono-scopy systems employ deep learning algorithms to analyze real-time endoscopic images,enhancing detection rates for adenomas,serrated lesions and cancer by reducing human error.AI-assisted colonoscopy enhances adenoma detection,enabling earlier intervention and improved patient outcomes.The benefits are particularly pronounced for less-experienced practitioners,as the detection rates for AI-assisted colonoscopy are similar to experts.AI integration also helps in the teaching process,in developing standardized procedures,and improving screening procedure accuracy and efficiency across different healthcare providers.However,there are challenges and limitations,such as the cost of AI implementation,data privacy concerns,and the need for extensive clinical validation.As AI technology continues to evolve,its transformation of the colorectal cancer screening system could revolutionize the field,making early detection more accessible and reducing mortality,on the condition that the above issues are addressed before widespread use.展开更多
AIMTo define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.METHODSSmall-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lom...AIMTo define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.METHODSSmall-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings). Groups were compared for age, gender, small-bowel transit time, type of instrument, modality of capsule performance (outpatients vs inpatients), bowel cleanliness, and center volume.RESULTSWe retrieved and scrutinized 1,433 out of 2,295 capsule endoscopy records (62.4%) fulfilling the inclusion criteria. Patients were 67 ± 15 years old, and 815 (57%) were males. In comparison with patients in the P0-1 group, those in the P2 group (n = 776, 54%) were older (P < 0.0001), had a longer small-bowel transit time (P = 0.0015), and were more frequently examined in low-volume centers (P < 0.001). Age and small-bowel transit time were correlated (P < 0.001), with age as the sole independent predictor on multivariable analysis. Findings of the P2 group were artero-venous malformations (54.5%), inflammatory (23.6%) and protruding (10.4%) lesions, and luminal blood (11.5%).CONCLUSIONIn this selected, prospectively collected cohort of small-bowel capsule endoscopy performed for obscure gastrointestinal bleeding, a longer small-bowel transit time was associated with a higher detection rate of significant lesions, along with age and a low center volume, with age serving as an independent predictor.展开更多
Colonoscopy remains the standard strategy for screening for colorectal cancer around the world due to its efficacy in both detecting adenomatous or precancerous lesions and the capacity to remove them intra-procedural...Colonoscopy remains the standard strategy for screening for colorectal cancer around the world due to its efficacy in both detecting adenomatous or precancerous lesions and the capacity to remove them intra-procedurally.Computeraided detection and diagnosis(CAD),thanks to the brand new developed innovations of artificial intelligence,and especially deep-learning techniques,leads to a promising solution to human biases in performance by guarantying decision support during colonoscopy.The application of CAD on real-time colonoscopy helps increasing the adenoma detection rate,and therefore contributes to reduce the incidence of interval cancers improving the effectiveness of colonoscopy screening on critical outcome such as colorectal cancer related mortality.Furthermore,a significant reduction in costs is also expected.In addition,the assistance of the machine will lead to a reduction of the examination time and therefore an optimization of the endoscopic schedule.The aim of this opinion review is to analyze the clinical applications of CAD and artificial intelligence in colonoscopy,as it is reported in literature,addressing evidence,limitations,and future prospects.展开更多
AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroente...AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.展开更多
To determine the effect of sedation with propofol on adenoma detection rate (ADR) and cecal intubation rates (CIR) in average risk screening colonoscopies compared to moderate sedation. METHODSWe conducted a retrospec...To determine the effect of sedation with propofol on adenoma detection rate (ADR) and cecal intubation rates (CIR) in average risk screening colonoscopies compared to moderate sedation. METHODSWe conducted a retrospective chart review of 2604 first-time average risk screening colonoscopies performed at MD Anderson Cancer Center from 2010-2013. ADR and CIR were calculated in each sedation group. Multivariable regression analysis was performed to adjust for potential confounders of age and body mass index (BMI). RESULTSOne-third of the exams were done with propofol (n = 874). Overall ADR in the propofol group was significantly higher than moderate sedation (46.3% vs 41.2%, P = 0.01). After adjustment for age and BMI differences, ADR was similar between the groups. CIR was 99% for all exams. The mean cecal insertion time was shorter among propofol patients (6.9 min vs 8.2 min; P < 0.0001). CONCLUSIONDeep sedation with propofol for screening colonoscopy did not significantly improve ADR or CIR in our population of average risk patients. While propofol may allow for safer sedation in certain patients (e.g., with sleep apnea), the overall effect on colonoscopy quality metrics is not significant. Given its increased cost, propofol should be used judiciously and without the implicit expectation of a higher quality screening exam.展开更多
Colorectal cancer(CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the d...Colorectal cancer(CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the disease and it is mostly performed by colonoscopy. Anyway, effectiveness of endoscopic screening for CRC strictly depends on adequate detection and removal of potentially precancerous lesions, and accuracy of colonoscopy in detection of adenomas is still suboptimal. For this reason, several technological advances have been implemented in order to improve the diagnostic sensitivity of colonoscopy in adenoma detection. Among these:(1) Visual technologies such as chromoendoscopy and narrow band imaging;(2) optical innovation as high definition endoscopy, full-spectrum endoscopy or Third Eye Retroscope; and(3) mechanical advances as Cap assisted colonoscopy, Endocuff, Endoring and G-Eye endoscope. All these technologies advances have been tested over time by clinical studies with mixed results. Which of them is more likely to be successful in the next future?展开更多
In recent decades,many software reliability growth models（SRGMs） have been proposed for the engineers and testers in measuring the software reliability precisely.Most of them is established based on the non-homogene...In recent decades,many software reliability growth models（SRGMs） have been proposed for the engineers and testers in measuring the software reliability precisely.Most of them is established based on the non-homogeneous Poisson process（NHPP）,and it is proved that the prediction accuracy of such models could be improved by adding the describing of characterization of testing effort.However,some research work indicates that the fault detection rate（FDR） is another key factor affects final software quality.Most early NHPPbased models deal with the FDR as constant or piecewise function,which does not fit the different testing stages well.Thus,this paper first incorporates a multivariate function of FDR,which is bathtub-shaped,into the NHPP-based SRGMs considering testing effort in order to further improve performance.A new model framework is proposed,and a stepwise method is used to apply the framework with real data sets to find the optimal model.Experimental studies show that the obtained new model can provide better performance of fitting and prediction compared with other traditional SRGMs.展开更多
Heart rate is an important vital characteristic which indicates physical and mental health status.Typically heart rate measurement instruments require direct contact with the skin which is time-consuming and costly.Th...Heart rate is an important vital characteristic which indicates physical and mental health status.Typically heart rate measurement instruments require direct contact with the skin which is time-consuming and costly.Therefore,the study of non-contact heart rate measurement methods is of great importance.Based on the principles of photoelectric volumetric tracing,we use a computer device and camera to capture facial images,accurately detect face regions,and to detect multiple facial images using a multi-target tracking algorithm.Then after the regional segmentation of the facial image,the signal acquisition of the region of interest is further resolved.Finally,frequency detection of the collected Photo-plethysmography(PPG)and Electrocardiography(ECG)signals is completed with peak detection,Fourier analysis,and a Waveletfilter.The experimental results show that the subject’s heart rate can be detected quickly and accurately even when monitoring multiple facial targets simultaneously.展开更多
The rate of adenoma detection is the most reliable quality indicator of colonoscopy.Studies have reported that colonoscopy performed in morning has a higher adenoma detection rate(ADR)than that performed in the aftern...The rate of adenoma detection is the most reliable quality indicator of colonoscopy.Studies have reported that colonoscopy performed in morning has a higher adenoma detection rate(ADR)than that performed in the afternoon.These studies have explained that several physician-related factors such as undergoing an emergency procedure the night before colonoscopy,accumulated workload,and increased fatigue level in the afternoon might have led to such finding.However,several opposing articles have indicated that the time of day and ADR is not quite related.Complex confounding factors can impact study results.Colonoscopy withdrawal time and bowel preparation quality are key factors.However,queue list numbers,participation of academic fellows,nurses'assistance,and the number of colonoscopies allocated per hour are also notable factors.Recently,an attempt has been made to homogenize the ADR in the morning and afternoon through artificial intelligence-assisted colonoscopy.This review article introduces the history of this long-debated topic,discusses points to consider in real-world practice,and suggests new ideas for planning future research.By understanding this issue,the rate of adenoma detection during colonoscopy is expected to be improved further.展开更多
In this paper,an energy-harvesting cognitive radio(CR) is considered,which allows the transmitter of the secondary user(SU) to harvest the primary signal energy from the transmitter of the primary user(PU) when the pr...In this paper,an energy-harvesting cognitive radio(CR) is considered,which allows the transmitter of the secondary user(SU) to harvest the primary signal energy from the transmitter of the primary user(PU) when the presence of the PU is detected.Then the harvested energy is converted into the electrical power to supply the transmission of the SU at the detected absence of the PU.By adopting the periodic spectrum sensing,the average total transmission rate of the SU is maximized through optimizing the sensing time,subject to the constraints of the probabilities of false alarm and detection,the harvested energy and the interference rate control.The simulation results show that there deed exists an optimal sensing time that maximizes the transmission rate,and the maximum transmission rate of the energy-harvesting CR can better approach to that of the traditional CR with the increasing of the detection probability.展开更多
To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODSWe...To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODSWe performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparation quality. RESULTSA total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7% (P = 0.001), and for third year fellows it was 35.4% vs 30.7% (aOR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1% (P = 0.0003) and 45.7% vs 40.1% (aOR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level (P for trend < 0.05). CONCLUSIONThere is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.展开更多
Heart rate is an important data reflecting human vital characteristics and an important reference index to describe human physical and mental state.Currently,widely used heart rate measurement devices require direct c...Heart rate is an important data reflecting human vital characteristics and an important reference index to describe human physical and mental state.Currently,widely used heart rate measurement devices require direct contact with a person’s skin,which is not suitable for people with burns,delicate skin,newborns and the elderly.Therefore,the research of non-contact heart rate measurement method is of great significance.Based on the basic principle of Photoplethysmography,we use the camera of computer equipment to capture the face image,detect the face region accurately,and detect multiple faces in the image based on multi-target tracking algorithm.Then the region segmentation of the face image is carried out to further realize the signal acquisition of the region of interest.Finally,peak detection,Fourier analysis and wavelet analysis were used to detect the frequency of PPG and ECG signals.The experimental results show that the heart rate information can be quickly and accurately detected even in the case of monitoring multiple face targets.展开更多
Objective: to analyze the detection rate and role of tumor markers in gastric cancer and pathological examination. Methods: a total of 156 patients were selected from June 2019 to June 2020. 78 patients clinically dia...Objective: to analyze the detection rate and role of tumor markers in gastric cancer and pathological examination. Methods: a total of 156 patients were selected from June 2019 to June 2020. 78 patients clinically diagnosed with gastric cancer were included in the observation group, and 78 patients diagnosed with benign gastric lesions during the same period were included in the control group. Tumor markers and pathological examinations were performed for all patients. The positive detection rate of vascular endothelial growth factor and serum tumor markers were compared between the two groups, and the function of tumor markers was analyzed using pathological examination as the standard. Results: the positive rate of VASCULAR endothelial growth factor in the observation group was 91.03%, which was significantly higher than that in the control group (66.07%) (P<0.05). The clinical stage, histological differentiation and lymph node metastasis of gastric cancer in the observation group were not statistically significant compared with pathological examination by tumor markers (P > 0.05). Serum CEA, VEGF, CA125 and CA724 in observation group were significantly higher than those in control group (P<0.05). Conclusion: the application of tumor markers in the examination of gastric cancer can be used to determine the biochemical components and characteristics of different tissues, which is close to the results of pathological examination and has high application value. The combination of the two markers can improve the accuracy of clinical diagnosis of gastric cancer.展开更多
Objective: to analyze the value and detection rate of dynamic video electroencephalogram in epilepsy monitoring. Methods: the study was carried out from November 2019 to October 2021. Seventy patients with epilepsy ad...Objective: to analyze the value and detection rate of dynamic video electroencephalogram in epilepsy monitoring. Methods: the study was carried out from November 2019 to October 2021. Seventy patients with epilepsy admitted to our hospital were included in the study. All patients were examined by routine electroencephalogram and dynamic video electroencephalogram, and the results were comprehensively evaluated. Results: clinical seizures and abnormal discharges were detected in 31.4% and 98.6% of the patients in the observation group and 5.7% and 55.7% of the patients in the control group. The detection rates of clinical seizures and abnormal discharges in the observation group were higher than those in the control group (P < 0.05). The detection rate of mild seizure in the observation group was lower than that in the control group, and the positive detection rate of moderate seizure, severe seizure and epilepsy in the observation group was higher than that in the control group (P < 0.05). Dynamic video-electroencephalogram confirmed that the epileptic seizure types were facial tonic-clonic seizure, absence seizure, myoclonic seizure, tonic seizure and dystonic seizure, accounting for 28.6%, 21.4%, 15.7%, 21.4% and 12.9% respectively;In the examination of the onset position of epilepsy by dynamic video-electroencephalogram, 40 cases of onset position were detected, and the others were not clear. 8 cases were found in frontal region, 13 cases in temporal region, 10 cases in temporal frontal region, 5 cases in occipital-temporal posterior region and 4 cases in frontal center. Conclusion: compared with routine ECG, the detection rate of dynamic video electroencephalogram is higher in epilepsy detection. It can also clarify the type and initial location of epileptic seizures and the severity of epilepsy, which can provide a basis for clinical diagnosis and treatment of the disease.展开更多
文摘BACKGROUND Sessile serrated lesions(SSLs)are premalignant polyps implicated in up to 30%of colorectal cancers.Australia reports high SSL detection rates(SSL-DRs),yet with marked variability(3.1%-24%).This substantial variation raises concerns about missed lesions and post-colonoscopy colorectal cancer.This study investigates determinants associated with SSL-DR variation in regional Australia.AIM To study how patient,clinical,and colonoscopy factors are associated with SSL detection in a regional Australian practice.We aimed to contribute high-detection data to the literature by analyzing the association of SSL detection with various determinants.METHODS This retrospective,cross-sectional analysis examined 1450 colonoscopies performed at Port Macquarie Gastroenterology during 2023.Sigmoidoscopies and repeat procedures were excluded.Multivariate logistic regression analyzed associations between SSL detection and patient demographics,clinical indications,procedural factors,and comorbidities.RESULTS The overall SSL-DR was 30.7%.Multivariate analysis identified several independent predictors:Clinical indication,bowel preparation quality,inflammatory bowel disease status,and serrated polyposis syndrome.The faecal occult blood test positive(FOBT)(+)cohort showed the highest predicted SSL detection probability(39.8%),while clinical symptoms showed the lowest(22.3%).After adjustment,SSL detection odds were 2.3 times greater among FOBT(+)patients than those with clinical symptoms(adjusted odds ratio=2.30,95%confidence interval:1.20-4.40,P=0.004).CONCLUSION SSL-DR as a quality indicator requires contextualization regarding clinical indications,bowel preparation quality,and comorbidities.There was a significantly higher prevalence of SSLs in FOBT(+)patients.Despite comprehensive adjustment,this study cannot fully explain the wide SSL-DR variation in Australia,highlighting the need for standardized detection protocols and further research to ensure optimal cancer prevention outcomes.
文摘Screening colonoscopy with adenoma removal is the gold standard strategy to reduce colorectal cancer(CRC)incidence.Nevertheless,it remains an imperfect tool as nearly Twenty-five percent of adenomas can be missed during inspection by experienced endoscopists.Missed lesions are one of the primary reasons for post colonoscopy CRC and are associated with a significant variability in adenoma detection rate(ADR),which is the most important quality indicator for colonoscopy.Increasing ADR unquestionably decreases carcinoma miss rate.Simple measures to improve ADR include among others slower withdrawal time and position change.The introduction of optical imaging innovations has improved mucosal visualization.Moreover,auxiliary devices attached to the colonoscope tip have been introduced,aiming to improve lumen visualization by flattening the folds and revealing lesions hidden in blind spots,thereby increasing ADR.Digital image analysis using artificial intelligence is the latest approach to polyp detection.All of the above approaches have been separately evaluated concerning their effect in ADR;however,it has not been thoroughly investigated whether any benefit exists from their combined use.We aim to review the available data on the efficacy of each technique/technology and whether their combination offers any additional benefit while remaining cost-effective.
文摘BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,ADR can vary significantly among endoscopists,leading to missed polyps or cancer.Artificial intelligence(AI)has shown promise in improving ADR by assisting in real-time polyp identification or diagnosis.While multiple randomized controlled trials(RCTs)and metanalyses highlight the benefits of AI in increasing detection rates and reducing missed polyps,concerns remain about its real-world applicability,impact on procedure time,and cost-effectiveness.AIM To explore the current status of AI assistance colonoscopy in adenoma detection and improving quality of colonoscopy.METHODS This systematic review followed PRISMA guidelines,both PubMed and Web of Science databases were used for articles search.Metanalyses and systematic reviews that assessed AI's role during colonoscopy.English article only published between January 2000 and January 2025 were included.Articles related to nonadenoma indications were excluded.Data extraction was independently performed by two researchers for accuracy and consistency.RESULTS 22 articles met the inclusion criteria,with significant heterogeneity(I2=28%-91%)observed in multiple studies.The number of studies per metanalysis ranged from 5 to 33,with higher heterogeneity in analyses involving more than 18 RCTs.AI demonstrated improvement in ADR,with an approximate 20%increase across multiple studies.However,its effectiveness in detecting flat or serrated adenomas remains unproven.Endoscopists with low ADR benefit more from AI-colonoscopies,while expert endoscopists outperformed AI in ADR,adenoma miss rate,and the identification of advanced lesions.No significant change in withdrawal time was observed when comparing AI-assisted colonoscopy to conventional endoscopy.CONCLUSION While AI-assisted colonoscopy has been shown to improve procedural quality,particularly for junior endoscopists and those with lower ADR,its performance decreases when compared to expert endoscopists in real-time clinical practice.This is especially evident in non-randomized studies,where AI demonstrates limited real-world benefits despite its benefit in controlled settings.Furthermore,no meta-analyses have specifically examined AI's impact on the learning experience of fellows and residents.Some experts caution that reliance on AI may prevent trainees from developing essential observational skills,potentially leading to less thorough examinations.Further research is needed to determine the actual benefits of AI-colonoscopy,particularly its role in cancer prevention.As technology advances,improved outcomes are expected,especially in detecting small,flat,and lesions at difficult anatomical locations.
文摘BACKGROUND Colon capsule endoscopy(CCE)is a modern,non-invasive method for large bowel visualization,offering a less invasive alternative to traditional colonoscopy(TC).While TC remains the gold standard for comprehensive large bowel assessment,including the detection and treatment of various conditions,the effectiveness of CCE in detecting polyps is less established.AIM To systematically review and compare the polyp detection rates(PDR)of CCE and TC.METHODS A systematic literature search was conducted using four scientific databases:CINAHL,MEDLINE via EBSCO,Cochrane Library,and MEDLINE/PubMed.A standardized search command was utilized to ensure consistency.Full papers were retrieved if they compared PDR between CCE and TC and involved patients over 18 years old.A meta-analysis was then conducted using the meta package in R software.RESULTS Initially,339 articles were identified,with 128 duplicates and 15 non-English articles excluded,leaving 196 for screening.After further exclusions,9 articles were included in the review.The meta-analysis revealed minimal differences in PDR between CCE and TC.The pooled PDR for TC was 0.61(95%CI:0.48–0.72),and for CCE,it was 0.61(95%CI:0.48–0.73).The overall comparison of the pooled PDR of both methods was 0.96(95%CI:0.90–1.02),indicating that CCE is noninferior to TC.CONCLUSION CCE has emerged as a modern and safe diagnostic alternative to TC for polyp detection,demonstrating noninferiority when compared to the conventional method.
基金Ethics Committee of the Certified Institutional Review Board of the Yoyogi Mental Clinic(No.RKK227).
文摘BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(TXI)or computer-aided detection system(CAD)has been reported.AIM To investigate the effects of the scope on the detection of adenomas and sessile serrated lesions(SSLs).METHODS The subjects were patients who underwent pancolonic chromoendoscopy using the EVIS X1 video system center between May 2023 and October 2024.The patients were divided into the new(CF-XZ1200/CF-EZ1500)and 290 series(CF-HQ290Z/PCF-H290Z)groups.Propensity score matching was performed for age,sex,examination purpose,endoscopist,preparation,TXI use,and CAD use.The effects of the scope were analyzed in terms of the ADR,SSL detection rate(SDR),and mean number of adenomas per colonoscopy(APC).RESULTS Of the 7014 patients enrolled,2138 pairs were extracted by propensity score matching(mean age 55.4 years,45.5%male).The new scopes group had a significantly higher ADR than the 290 series group[51.5%vs 45.5%,odds ratio(OR)=1.27,95%CI:1.13-1.43,P<0.001].Similarly,the new scopes group had significantly higher SDR(7.8%vs 5.7%,OR=1.41,95%CI:1.11-1.80,P=0.005)and APC(0.90 vs 0.76,OR=1.11,95%CI:1.05-1.17,P<0.001)than the 290 series group.CONCLUSION In conclusion,the new scope(CF-XZ1200/CF-EZ1500)enhanced the detection of adenomas and SSLs compared to the old ones(290 series).
文摘Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance.With an incidence rate of 3.6%to 9.3%,PCCRC remains a significant concern,highlighting the limitations of colonoscopy in CRC screening—not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions.A range of clinical,endoscopic,and biological factors has been associated with an increased risk of PCCRC.Identifying these factors can help stratify high-risk patients,enabling earlier detection and improving preventive strategies for interval CRC.Reducing PCCRC should be a top priority for every endoscopy unit.While technological advancements will enhance polyp detection,minimize missed lesions,prevent incomplete resections,and improve overall procedural quality,the most impactful strategy remains internal self-assessment within each unit.This review should evaluate key performance metrics,including cecal intubation rate,adenoma detection rate,withdrawal time,PCCRC incidence,and incomplete resections—both at the individual endoscopist level and across the entire unit.
文摘Colorectal cancer is a major cause of cancer-related mortality worldwide,under-scoring the importance of early and effective colorectal cancer screening to im-prove survival rates.Traditional colorectal cancer screening methods include non-invasive tests,such as the fecal immunochemical test(FIT),as well as diagnostic procedures like colonoscopy.Colonoscopy remains the gold standard for detec-ting and treating precancerous polyps and early-stage cancer,regardless of whe-ther it is used as the first screening test or the second test following a positive FIT.However,its effectiveness can be affected by factors such as operator skill,patient variability,and limited lesion visibility,resulting in a significant rate of missed lesion rates and highlighting the need for more efficient and accurate screening techniques.This review is aimed to assess the current challenges of traditional screening methods with the impact of artificial intelligence(AI)in the diagnostic flow.The literature on AI-powered tools for colorectal cancer screening,including novel applications,emerging programs,and recent guidelines,has been reviewed to highlight both the advantages and limitations of implementing this technology in healthcare.Recent advances in AI have introduced soft AI colonoscopy,with the purpose of improving lesion recognition(computer-aided detection)and/or improving optical diagnosis(computer-aided diagnosis).AI-powered colono-scopy systems employ deep learning algorithms to analyze real-time endoscopic images,enhancing detection rates for adenomas,serrated lesions and cancer by reducing human error.AI-assisted colonoscopy enhances adenoma detection,enabling earlier intervention and improved patient outcomes.The benefits are particularly pronounced for less-experienced practitioners,as the detection rates for AI-assisted colonoscopy are similar to experts.AI integration also helps in the teaching process,in developing standardized procedures,and improving screening procedure accuracy and efficiency across different healthcare providers.However,there are challenges and limitations,such as the cost of AI implementation,data privacy concerns,and the need for extensive clinical validation.As AI technology continues to evolve,its transformation of the colorectal cancer screening system could revolutionize the field,making early detection more accessible and reducing mortality,on the condition that the above issues are addressed before widespread use.
文摘AIMTo define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.METHODSSmall-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings). Groups were compared for age, gender, small-bowel transit time, type of instrument, modality of capsule performance (outpatients vs inpatients), bowel cleanliness, and center volume.RESULTSWe retrieved and scrutinized 1,433 out of 2,295 capsule endoscopy records (62.4%) fulfilling the inclusion criteria. Patients were 67 ± 15 years old, and 815 (57%) were males. In comparison with patients in the P0-1 group, those in the P2 group (n = 776, 54%) were older (P < 0.0001), had a longer small-bowel transit time (P = 0.0015), and were more frequently examined in low-volume centers (P < 0.001). Age and small-bowel transit time were correlated (P < 0.001), with age as the sole independent predictor on multivariable analysis. Findings of the P2 group were artero-venous malformations (54.5%), inflammatory (23.6%) and protruding (10.4%) lesions, and luminal blood (11.5%).CONCLUSIONIn this selected, prospectively collected cohort of small-bowel capsule endoscopy performed for obscure gastrointestinal bleeding, a longer small-bowel transit time was associated with a higher detection rate of significant lesions, along with age and a low center volume, with age serving as an independent predictor.
文摘Colonoscopy remains the standard strategy for screening for colorectal cancer around the world due to its efficacy in both detecting adenomatous or precancerous lesions and the capacity to remove them intra-procedurally.Computeraided detection and diagnosis(CAD),thanks to the brand new developed innovations of artificial intelligence,and especially deep-learning techniques,leads to a promising solution to human biases in performance by guarantying decision support during colonoscopy.The application of CAD on real-time colonoscopy helps increasing the adenoma detection rate,and therefore contributes to reduce the incidence of interval cancers improving the effectiveness of colonoscopy screening on critical outcome such as colorectal cancer related mortality.Furthermore,a significant reduction in costs is also expected.In addition,the assistance of the machine will lead to a reduction of the examination time and therefore an optimization of the endoscopic schedule.The aim of this opinion review is to analyze the clinical applications of CAD and artificial intelligence in colonoscopy,as it is reported in literature,addressing evidence,limitations,and future prospects.
基金Supported by(in part) National Center for Advancing Translational Sciences of the National Institutes of Health,No.UL1TR000454
文摘AIM To investigate changes in polyp detection throughout fellowship training, and estimate colonoscopy volume required to achieve the adenoma detection rate(ADRs) and polyp detection rate(PDRs) of attending gastroenterologists.METHODS We reviewed colonoscopies from July 1, 2009 to June 30, 2014. Fellows' procedural logs were used to retrieve colonoscopy procedural volumes, and these were treated as the time variable. Findings from screening colonoscopies were used to calculate colonoscopy outcomes for each fellow for the prior 50 colonoscopies at each time point. ADR and PDR were plotted against colonoscopy procedural volumes to produce individual longitudinal graphs. Repeated measures linear mixed effects models were used to study the change of ADR and PDR with increasing procedural volume.RESULTS During the study period, 12 fellows completed full three years of training and were included in the analysis. The average ADR and PDR were, respectively, 31.5% and 41.9% for all fellows, and 28.9% and 38.2% for attendings alone. There was a statistically significant increase in ADR with increasing procedural volume(1.8%/100 colonoscopies, P = 0.002). Similarly, PDR increased 2.8%/100 colonoscopies(P = 0.0001), while there was no significant change in advanced ADR(0.04%/100 colonoscopies, P = 0.92). The ADR increase was limited to the right side of the colon, while the PDR increased in both the right and left colon. The adenoma per colon and polyp per colon also increased throughout training. Fellows reached the attendings' ADR and PDR after 265 and 292 colonoscopies, respectively.CONCLUSION We found that the ADR and PDR increase with increasing colonoscopy volume throughout fellowship. Our findings support recent recommendations of ≥ 275 colonoscopies for colonoscopy credentialing.
基金Supported by the National Cancer Institute of the National Institutes of Health(in part),No.K07CA160753 to Pande M
文摘To determine the effect of sedation with propofol on adenoma detection rate (ADR) and cecal intubation rates (CIR) in average risk screening colonoscopies compared to moderate sedation. METHODSWe conducted a retrospective chart review of 2604 first-time average risk screening colonoscopies performed at MD Anderson Cancer Center from 2010-2013. ADR and CIR were calculated in each sedation group. Multivariable regression analysis was performed to adjust for potential confounders of age and body mass index (BMI). RESULTSOne-third of the exams were done with propofol (n = 874). Overall ADR in the propofol group was significantly higher than moderate sedation (46.3% vs 41.2%, P = 0.01). After adjustment for age and BMI differences, ADR was similar between the groups. CIR was 99% for all exams. The mean cecal insertion time was shorter among propofol patients (6.9 min vs 8.2 min; P < 0.0001). CONCLUSIONDeep sedation with propofol for screening colonoscopy did not significantly improve ADR or CIR in our population of average risk patients. While propofol may allow for safer sedation in certain patients (e.g., with sleep apnea), the overall effect on colonoscopy quality metrics is not significant. Given its increased cost, propofol should be used judiciously and without the implicit expectation of a higher quality screening exam.
文摘Colorectal cancer(CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the disease and it is mostly performed by colonoscopy. Anyway, effectiveness of endoscopic screening for CRC strictly depends on adequate detection and removal of potentially precancerous lesions, and accuracy of colonoscopy in detection of adenomas is still suboptimal. For this reason, several technological advances have been implemented in order to improve the diagnostic sensitivity of colonoscopy in adenoma detection. Among these:(1) Visual technologies such as chromoendoscopy and narrow band imaging;(2) optical innovation as high definition endoscopy, full-spectrum endoscopy or Third Eye Retroscope; and(3) mechanical advances as Cap assisted colonoscopy, Endocuff, Endoring and G-Eye endoscope. All these technologies advances have been tested over time by clinical studies with mixed results. Which of them is more likely to be successful in the next future?
基金supported by the National Natural Science Foundation of China(61070220)the Anhui Provincial Natural Science Foundation(1408085MKL79)
文摘In recent decades,many software reliability growth models（SRGMs） have been proposed for the engineers and testers in measuring the software reliability precisely.Most of them is established based on the non-homogeneous Poisson process（NHPP）,and it is proved that the prediction accuracy of such models could be improved by adding the describing of characterization of testing effort.However,some research work indicates that the fault detection rate（FDR） is another key factor affects final software quality.Most early NHPPbased models deal with the FDR as constant or piecewise function,which does not fit the different testing stages well.Thus,this paper first incorporates a multivariate function of FDR,which is bathtub-shaped,into the NHPP-based SRGMs considering testing effort in order to further improve performance.A new model framework is proposed,and a stepwise method is used to apply the framework with real data sets to find the optimal model.Experimental studies show that the obtained new model can provide better performance of fitting and prediction compared with other traditional SRGMs.
基金supported by the National Nature Science Foundation of China(Grant Number:61962010).
文摘Heart rate is an important vital characteristic which indicates physical and mental health status.Typically heart rate measurement instruments require direct contact with the skin which is time-consuming and costly.Therefore,the study of non-contact heart rate measurement methods is of great importance.Based on the principles of photoelectric volumetric tracing,we use a computer device and camera to capture facial images,accurately detect face regions,and to detect multiple facial images using a multi-target tracking algorithm.Then after the regional segmentation of the facial image,the signal acquisition of the region of interest is further resolved.Finally,frequency detection of the collected Photo-plethysmography(PPG)and Electrocardiography(ECG)signals is completed with peak detection,Fourier analysis,and a Waveletfilter.The experimental results show that the subject’s heart rate can be detected quickly and accurately even when monitoring multiple facial targets simultaneously.
文摘The rate of adenoma detection is the most reliable quality indicator of colonoscopy.Studies have reported that colonoscopy performed in morning has a higher adenoma detection rate(ADR)than that performed in the afternoon.These studies have explained that several physician-related factors such as undergoing an emergency procedure the night before colonoscopy,accumulated workload,and increased fatigue level in the afternoon might have led to such finding.However,several opposing articles have indicated that the time of day and ADR is not quite related.Complex confounding factors can impact study results.Colonoscopy withdrawal time and bowel preparation quality are key factors.However,queue list numbers,participation of academic fellows,nurses'assistance,and the number of colonoscopies allocated per hour are also notable factors.Recently,an attempt has been made to homogenize the ADR in the morning and afternoon through artificial intelligence-assisted colonoscopy.This review article introduces the history of this long-debated topic,discusses points to consider in real-world practice,and suggests new ideas for planning future research.By understanding this issue,the rate of adenoma detection during colonoscopy is expected to be improved further.
基金supported by the National Natural Science Foundation of China under Grant Nos.61201143,61402416,611301132and 61471194the Natural Science Foundation of Jiangsu Province under Grant No.BK20140828+2 种基金the Natural Science Foundation of Zhejiang Province under Grant No.LQ14F010003the Chinese Postdoctoral Science Foundation under Grant No.2015M580425the Scientific Research Foundation for the Returned Overseas Chinese Scholars of State Education Ministry
文摘In this paper,an energy-harvesting cognitive radio(CR) is considered,which allows the transmitter of the secondary user(SU) to harvest the primary signal energy from the transmitter of the primary user(PU) when the presence of the PU is detected.Then the harvested energy is converted into the electrical power to supply the transmission of the SU at the detected absence of the PU.By adopting the periodic spectrum sensing,the average total transmission rate of the SU is maximized through optimizing the sensing time,subject to the constraints of the probabilities of false alarm and detection,the harvested energy and the interference rate control.The simulation results show that there deed exists an optimal sensing time that maximizes the transmission rate,and the maximum transmission rate of the energy-harvesting CR can better approach to that of the traditional CR with the increasing of the detection probability.
文摘To investigate whether adenoma and polyp detection rates (ADR and PDR, respectively) in screening colonoscopies performed in the presence of fellows differ from those performed by attending physicians alone. METHODSWe performed a retrospective review of all patients who underwent a screening colonoscopy at Grady Memorial Hospital between July 1, 2009 and June 30, 2015. Patients with a history of colon polyps or cancer and those with poor colon preparation or failed cecal intubation were excluded from the analysis. Associations of fellowship training level with the ADR and PDR relative to attendings alone were assessed using unconditional multivariable logistic regression. Models were adjusted for sex, age, race, and colon preparation quality. RESULTSA total of 7503 colonoscopies met the inclusion criteria and were included in the analysis. The mean age of the study patients was 58.2 years; 63.1% were women and 88.2% were African American. The ADR was higher in the fellow participation group overall compared to that in the attending group: 34.5% vs 30.7% (P = 0.001), and for third year fellows it was 35.4% vs 30.7% (aOR = 1.23, 95%CI: 1.09-1.39). The higher ADR in the fellow participation group was evident for both the right and left side of the colon. For the PDR the corresponding figures were 44.5% vs 40.1% (P = 0.0003) and 45.7% vs 40.1% (aOR = 1.25, 95%CI: 1.12-1.41). The ADR and PDR increased with increasing fellow training level (P for trend < 0.05). CONCLUSIONThere is a stepwise increase in ADR and PDR across the years of gastroenterology training. Fellow participation is associated with higher adenoma and polyp detection.
文摘Heart rate is an important data reflecting human vital characteristics and an important reference index to describe human physical and mental state.Currently,widely used heart rate measurement devices require direct contact with a person’s skin,which is not suitable for people with burns,delicate skin,newborns and the elderly.Therefore,the research of non-contact heart rate measurement method is of great significance.Based on the basic principle of Photoplethysmography,we use the camera of computer equipment to capture the face image,detect the face region accurately,and detect multiple faces in the image based on multi-target tracking algorithm.Then the region segmentation of the face image is carried out to further realize the signal acquisition of the region of interest.Finally,peak detection,Fourier analysis and wavelet analysis were used to detect the frequency of PPG and ECG signals.The experimental results show that the heart rate information can be quickly and accurately detected even in the case of monitoring multiple face targets.
文摘Objective: to analyze the detection rate and role of tumor markers in gastric cancer and pathological examination. Methods: a total of 156 patients were selected from June 2019 to June 2020. 78 patients clinically diagnosed with gastric cancer were included in the observation group, and 78 patients diagnosed with benign gastric lesions during the same period were included in the control group. Tumor markers and pathological examinations were performed for all patients. The positive detection rate of vascular endothelial growth factor and serum tumor markers were compared between the two groups, and the function of tumor markers was analyzed using pathological examination as the standard. Results: the positive rate of VASCULAR endothelial growth factor in the observation group was 91.03%, which was significantly higher than that in the control group (66.07%) (P<0.05). The clinical stage, histological differentiation and lymph node metastasis of gastric cancer in the observation group were not statistically significant compared with pathological examination by tumor markers (P > 0.05). Serum CEA, VEGF, CA125 and CA724 in observation group were significantly higher than those in control group (P<0.05). Conclusion: the application of tumor markers in the examination of gastric cancer can be used to determine the biochemical components and characteristics of different tissues, which is close to the results of pathological examination and has high application value. The combination of the two markers can improve the accuracy of clinical diagnosis of gastric cancer.
文摘Objective: to analyze the value and detection rate of dynamic video electroencephalogram in epilepsy monitoring. Methods: the study was carried out from November 2019 to October 2021. Seventy patients with epilepsy admitted to our hospital were included in the study. All patients were examined by routine electroencephalogram and dynamic video electroencephalogram, and the results were comprehensively evaluated. Results: clinical seizures and abnormal discharges were detected in 31.4% and 98.6% of the patients in the observation group and 5.7% and 55.7% of the patients in the control group. The detection rates of clinical seizures and abnormal discharges in the observation group were higher than those in the control group (P < 0.05). The detection rate of mild seizure in the observation group was lower than that in the control group, and the positive detection rate of moderate seizure, severe seizure and epilepsy in the observation group was higher than that in the control group (P < 0.05). Dynamic video-electroencephalogram confirmed that the epileptic seizure types were facial tonic-clonic seizure, absence seizure, myoclonic seizure, tonic seizure and dystonic seizure, accounting for 28.6%, 21.4%, 15.7%, 21.4% and 12.9% respectively;In the examination of the onset position of epilepsy by dynamic video-electroencephalogram, 40 cases of onset position were detected, and the others were not clear. 8 cases were found in frontal region, 13 cases in temporal region, 10 cases in temporal frontal region, 5 cases in occipital-temporal posterior region and 4 cases in frontal center. Conclusion: compared with routine ECG, the detection rate of dynamic video electroencephalogram is higher in epilepsy detection. It can also clarify the type and initial location of epileptic seizures and the severity of epilepsy, which can provide a basis for clinical diagnosis and treatment of the disease.
