A recent study by Nishizawa et al presented significant findings regarding the advantages of next-generation colonoscopes,specifically the CF-XZ1200 and CFEZ1500 models,in enhancing the adenoma and sessile serrated le...A recent study by Nishizawa et al presented significant findings regarding the advantages of next-generation colonoscopes,specifically the CF-XZ1200 and CFEZ1500 models,in enhancing the adenoma and sessile serrated lesion detection rates.As colorectal cancer remains a leading cause of cancer-related mortality globally,the implications of improved detection rates are substantial.This letter advocated the adoption of advanced colonoscopy technology,emphasizing the robust methodology of the study,including propensity score matching,which enhanced the validity of its conclusions.Notable improvements in image quality,facilitated by innovations such as 4 K resolution and texture enhancement imaging,enable endoscopists to identify even the smallest lesions,ultimately leading to improved patient outcomes.Given the compelling evidence presented,it is imperative for healthcare institutions to prioritize the integration of these advanced scopes into routine practice to enhance screening efficacy and reduce the burden of colorectal cancer.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
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
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
Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at...Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over 50.Our aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion rates.Methods:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December 2009.The main outcome measurements were ADR and colonoscopy completion rates to the cecum.Results:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor preparation.Colonoscopy completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼0.06.All the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair preparation.On multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ADR.Conclusions:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation.However,there was no difference in ADR between the different grades of preparation.展开更多
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
Existing literature indicates that prolonged insertion time is associated with procedural complexity and may influence adenoma detection.Xu et al recently reported that longer insertion time correlates with lower aden...Existing literature indicates that prolonged insertion time is associated with procedural complexity and may influence adenoma detection.Xu et al recently reported that longer insertion time correlates with lower adenoma detection,but this effect can be mitigated by sufficient withdrawal duration.Insertion time should not be regarded merely as a numeric variable but rather as a multidimensional marker of technical difficulty.Integrating the insertion-to-withdrawal ratio with composite indicators such as looping or bowel preparation quality may enhance predictive models of colonoscopy performance.Conceptualizing insertion time in this way provides a more nuanced understanding of its role in adenoma detection and highlights the need for improved frameworks that link procedural complexity with quality outcomes.展开更多
BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdr...BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.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
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
Objective:To investigate the detection rate and sonographic characteristics of color Doppler ultrasound in the diagnosis of papillary thyroid microcarcinoma(PTMC).Methods:A retrospective analysis was conducted on 50 c...Objective:To investigate the detection rate and sonographic characteristics of color Doppler ultrasound in the diagnosis of papillary thyroid microcarcinoma(PTMC).Methods:A retrospective analysis was conducted on 50 cases of PTMC confirmed by postoperative pathology from January 2020 to December 2024,all of which underwent preoperative color Doppler ultrasound examination.The detection rate was calculated,and the two-dimensional ultrasound characteristics and CDFI manifestations were analyzed.Results:Among the 50 cases of PTMC confirmed by pathology,the detection rate of color Doppler ultrasound was 88.00%,and the diagnostic accuracy rate was 96.00%.Two-dimensional ultrasound characteristics:The mean lesion size was(6.83±1.51)mm;42 cases(84.00%)had irregular shapes;45 cases(90.00%)had unclear boundaries;46 cases(92.00%)had hypoechoic lesions;38 cases(76.00%)exhibited microcalcifications;and 40 cases(80.00%)had an aspect ratio≥1.CDFI characteristics:The highest proportion was grade Ⅱ,with 23 cases(46.00%);39 cases(78.00%)had an RI≥0.7,and the average RI value was(0.75±0.06).Conclusion:Color Doppler ultrasound demonstrates a high detection rate for PTMC,with typical features including hypoechogenicity,irregular shape,microcalcifications,and high RI,making it the preferred imaging modality for early clinical diagnosis of PTMC.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
To solve the problem of poor detection and limited application range of current intrusion detection methods,this paper attempts to use deep learning neural network technology to study a new type of intrusion detection...To solve the problem of poor detection and limited application range of current intrusion detection methods,this paper attempts to use deep learning neural network technology to study a new type of intrusion detection method.Hence,we proposed an intrusion detection algorithm based on convolutional neural network(CNN)and AdaBoost algorithm.This algorithm uses CNN to extract the characteristics of network traffic data,which is particularly suitable for the analysis of continuous and classified attack data.The AdaBoost algorithm is used to classify network attack data that improved the detection effect of unbalanced data classification.We adopt the UNSW-NB15 dataset to test of this algorithm in the PyCharm environment.The results show that the detection rate of algorithm is99.27%and the false positive rate is lower than 0.98%.Comparative analysis shows that this algorithm has advantages over existing methods in terms of detection rate and false positive rate for small proportion of attack data.展开更多
Quantized fault detection for sensor/actuator faults of networked control systems （NCSs） with time delays both in the sensor-to-controller channel and controller-to-actuator channel is concerned in this paper. A fau...Quantized fault detection for sensor/actuator faults of networked control systems （NCSs） with time delays both in the sensor-to-controller channel and controller-to-actuator channel is concerned in this paper. A fault model is set up based on the possible cases of sensor/atuator faults. Then, the model predictive control is used to compensate the time delay. When the sensors and actuators are healthy, an H stability criterion of the state predictive observer is obtained in terms of linear matrix inequality. A new threshold computational method that conforms to the actual situation is proposed. Then, the thresholds of the false alarm rate （FAR） and miss detection rate （MDR） are presented by using our proposed method, which are also compared with the ones given in the existin~ literatures. Finally, some numerical simulations are shown to demonstrate the effectiveness of the proposed method.展开更多
BACKGROUND Improved adenoma detection at colonoscopy has decreased the risk of developing colorectal cancer.However,whether image-enhanced endoscopy(IEE)further improves the adenoma detection rate(ADR)is controversial...BACKGROUND Improved adenoma detection at colonoscopy has decreased the risk of developing colorectal cancer.However,whether image-enhanced endoscopy(IEE)further improves the adenoma detection rate(ADR)is controversial.AIM To compare IEE with white-light imaging(WLI)endoscopy for the detection and identification of colorectal adenoma.METHODS This was a multicenter,randomized,controlled trial.Participants were enrolled between September 2019 to April 2021 from 4 hospital in China.Patients were randomly assigned to an IEE group with WLI on entry and IEE on withdrawal(n=2113)or a WLI group with WLI on both entry and withdrawal(n=2098).The primary outcome was the ADR.The secondary endpoints were the polyp detection rate(PDR),adenomas per colonoscopy,adenomas per positive colonoscopy,and factors related to adenoma detection.RESULTS A total of 4211 patients(966 adenomas)were included in the analysis(mean age,56.7 years,47.1%male).There were 2113 patients(508 adenomas)in the IEE group and 2098 patients(458 adenomas)in the WLI group.The ADR in two group were not significantly different[24.0%vs 21.8%,1.10,95%confidence interval(CI):0.99-1.23,P=0.09].The PDR was higher with IEE group(41.7%)than with WLI group(36.1%,1.16,95%CI:1.07-1.25,P=0.01).Differences in mean withdrawal time(7.90±3.42 min vs 7.85±3.47 min,P=0.30)and adenomas per colonoscopy(0.33±0.68 vs 0.28±0.62,P=0.06)were not significant.Subgroup analysis found that with narrowband imaging(NBI),between-group differences in the ADR,were not significant(23.7%vs 21.8%,1.09,95%CI:0.97-1.22,P=0.15),but were greater with linked color imaging(30.9%vs 21.8%,1.42,95%CI:1.04-1.93,P=0.04).the second-generation NBI(2G-NBI)had an advantage of ADR than both WLI and the first-generation NBI(27.0%vs 21.8%,P=0.01;27.0%vs 21.2.0%,P=0.01).CONCLUSION This prospective study confirmed that,among Chinese,IEE didn’t increase the ADR compared with WLI,but 2G-NBI increase the ADR.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
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
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
文摘A recent study by Nishizawa et al presented significant findings regarding the advantages of next-generation colonoscopes,specifically the CF-XZ1200 and CFEZ1500 models,in enhancing the adenoma and sessile serrated lesion detection rates.As colorectal cancer remains a leading cause of cancer-related mortality globally,the implications of improved detection rates are substantial.This letter advocated the adoption of advanced colonoscopy technology,emphasizing the robust methodology of the study,including propensity score matching,which enhanced the validity of its conclusions.Notable improvements in image quality,facilitated by innovations such as 4 K resolution and texture enhancement imaging,enable endoscopists to identify even the smallest lesions,ultimately leading to improved patient outcomes.Given the compelling evidence presented,it is imperative for healthcare institutions to prioritize the integration of these advanced scopes into routine practice to enhance screening efficacy and reduce the burden of colorectal cancer.
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.
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Background and aim:Adequate bowel preparation is important for safe and effective colonoscopy.Quality indicators(QI)for colonoscopy include achieving at least 95%completion rate and an adenoma detection rate(ADR)of at least 25%in average-risk men and 15%in average-risk women aged over 50.Our aim was to investigate the impact of bowel preparation on ADR and colonoscopy completion rates.Methods:This retrospective cohort study included patients who underwent colonoscopy between January 2008 and December 2009.The main outcome measurements were ADR and colonoscopy completion rates to the cecum.Results:A total of 2519 patients was included;1030(41.0%)had excellent preparation,1145(45.5%)good-,240(9.5%)fair-,and 104(4.1%)poor preparation.Colonoscopy completion rates were significantly lower in patients with poor or fair preparation(72.1%and 75.4%,respectively)than in those with good and excellent preparation(99.7%and 99.9%,respectively;P<0.001),and significantly lower than the QI of 95%(P<0.001).ADR in men and women combined was similar in all four grades of preparation(excellent,good,fair and poor)at 24.2%vs.26.8%vs.32.1%vs.22.1%,respectively;P¼0.06.All the groups had ADR above the QI(25%for men and 15%for women)with evidence of significantly higher ADR in the women with excellent or good preparation and in men with excellent,good or fair preparation.On multivariate analysis,male gender was significantly associated with increased ADR(P<0.001),while the quality of bowel preparation did not influence ADR.Conclusions:Patients with fair and poor standards of preparation have significantly lower colonoscopy completion rates than those with excellent and good preparation.However,there was no difference in ADR between the different grades of preparation.
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Existing literature indicates that prolonged insertion time is associated with procedural complexity and may influence adenoma detection.Xu et al recently reported that longer insertion time correlates with lower adenoma detection,but this effect can be mitigated by sufficient withdrawal duration.Insertion time should not be regarded merely as a numeric variable but rather as a multidimensional marker of technical difficulty.Integrating the insertion-to-withdrawal ratio with composite indicators such as looping or bowel preparation quality may enhance predictive models of colonoscopy performance.Conceptualizing insertion time in this way provides a more nuanced understanding of its role in adenoma detection and highlights the need for improved frameworks that link procedural complexity with quality outcomes.
基金Supported by the Young and Middle-Aged Talents Program of Wuxi Health Commission,No.BJ2020011Cohort Research Program of Wuxi Medical Center,Nanjing Medical University,No.WMCC202314Wuxi People’s Hospital 2024“Wild Goose Array Talent”Reserve Discipline Leader,No.2024-YZ-HBDTR-YC-2024.
文摘BACKGROUND Adenoma detection rate(ADR),a key colonoscopy quality metric,varies with patient demographics and procedural factors.AIM To identify independent predictors of≥25%ADR,develop a risk model,and propose withdrawal durations based on different insertion times.METHODS We retrospectively analyzed 830 cases using logistic regression and identified four key factors,validated in a prospective cohort of 5699 patients.Their importance was confirmed using random forest(RF),extreme gradient boosting(XGBoost)and light gradient boosting machine(LightGBM).Attempts to determine targetachieving withdrawal time by grouping cases based on insertion time and Cox regression were inconclusive.Using the 5699-case dataset,we developed a predictive model combining support vector machine(SVM)with XGBoost.We built a Shiny app using this model for clinical application.RESULTS Multivariate logistic regression identified age[odds ratio(OR)=1.05;95%confidence interval(CI):1.03-1.08;P<0.001],male(OR=1.79;95%CI:1.32-2.41;P=0.005),higher endoscopist experience(OR=1.79;95%CI:1.20-2.68;P=0.005),and longer withdrawal time(P<0.001)as independent risk factors for colorectal adenoma.A nomogram demonstrated strong discrimination[area under the curve(AUC)=0.720],with robust calibration and decision-curve performance.Feature importance via RF,XGBoost,and LightGBM confirmed key predictors.A hybrid model combining SVM regression for withdrawal-time estimation and XGBoost classification achieved stable results,with XGBoost reporting AUCs of 0.640 in training and 0.610 in testing,and similar validation outcomes.Deployed via a Shiny app for clinical use.However,model discrimination was modest(AUC:0.61-0.64),suggesting that clinical utility requires further refinement.CONCLUSION A hybrid SVM-XGBoost model using four key endoscopic factors was independently validated and is available as a Shiny app,delivering real-time decision support to streamline endoscopy and enhance clinical outcomes.
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Objective:To investigate the detection rate and sonographic characteristics of color Doppler ultrasound in the diagnosis of papillary thyroid microcarcinoma(PTMC).Methods:A retrospective analysis was conducted on 50 cases of PTMC confirmed by postoperative pathology from January 2020 to December 2024,all of which underwent preoperative color Doppler ultrasound examination.The detection rate was calculated,and the two-dimensional ultrasound characteristics and CDFI manifestations were analyzed.Results:Among the 50 cases of PTMC confirmed by pathology,the detection rate of color Doppler ultrasound was 88.00%,and the diagnostic accuracy rate was 96.00%.Two-dimensional ultrasound characteristics:The mean lesion size was(6.83±1.51)mm;42 cases(84.00%)had irregular shapes;45 cases(90.00%)had unclear boundaries;46 cases(92.00%)had hypoechoic lesions;38 cases(76.00%)exhibited microcalcifications;and 40 cases(80.00%)had an aspect ratio≥1.CDFI characteristics:The highest proportion was grade Ⅱ,with 23 cases(46.00%);39 cases(78.00%)had an RI≥0.7,and the average RI value was(0.75±0.06).Conclusion:Color Doppler ultrasound demonstrates a high detection rate for PTMC,with typical features including hypoechogenicity,irregular shape,microcalcifications,and high RI,making it the preferred imaging modality for early clinical diagnosis of PTMC.
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 in part by the National Key R&D Program of China(No.2022YFB3904503)National Natural Science Foundation of China(No.62172418)。
文摘To solve the problem of poor detection and limited application range of current intrusion detection methods,this paper attempts to use deep learning neural network technology to study a new type of intrusion detection method.Hence,we proposed an intrusion detection algorithm based on convolutional neural network(CNN)and AdaBoost algorithm.This algorithm uses CNN to extract the characteristics of network traffic data,which is particularly suitable for the analysis of continuous and classified attack data.The AdaBoost algorithm is used to classify network attack data that improved the detection effect of unbalanced data classification.We adopt the UNSW-NB15 dataset to test of this algorithm in the PyCharm environment.The results show that the detection rate of algorithm is99.27%and the false positive rate is lower than 0.98%.Comparative analysis shows that this algorithm has advantages over existing methods in terms of detection rate and false positive rate for small proportion of attack data.
基金supported by National Natural Science Foundation of China(No.61074065)Natural Science Foundation of Hebei Province(No.F2012203184)Specialized Research Fund for the Doctoral Program of Higher Education of China(No.20111333120009)
文摘Quantized fault detection for sensor/actuator faults of networked control systems （NCSs） with time delays both in the sensor-to-controller channel and controller-to-actuator channel is concerned in this paper. A fault model is set up based on the possible cases of sensor/atuator faults. Then, the model predictive control is used to compensate the time delay. When the sensors and actuators are healthy, an H stability criterion of the state predictive observer is obtained in terms of linear matrix inequality. A new threshold computational method that conforms to the actual situation is proposed. Then, the thresholds of the false alarm rate （FAR） and miss detection rate （MDR） are presented by using our proposed method, which are also compared with the ones given in the existin~ literatures. Finally, some numerical simulations are shown to demonstrate the effectiveness of the proposed method.
基金Supported by the National Key R&D Program of China,No. 2018YFC1315005National Natural Science Foundation of China,No. 82002515+1 种基金Shanghai Sailing Program,No. 20YF1407200China Postdoctoral Science Foundation,No. 2020M681177
文摘BACKGROUND Improved adenoma detection at colonoscopy has decreased the risk of developing colorectal cancer.However,whether image-enhanced endoscopy(IEE)further improves the adenoma detection rate(ADR)is controversial.AIM To compare IEE with white-light imaging(WLI)endoscopy for the detection and identification of colorectal adenoma.METHODS This was a multicenter,randomized,controlled trial.Participants were enrolled between September 2019 to April 2021 from 4 hospital in China.Patients were randomly assigned to an IEE group with WLI on entry and IEE on withdrawal(n=2113)or a WLI group with WLI on both entry and withdrawal(n=2098).The primary outcome was the ADR.The secondary endpoints were the polyp detection rate(PDR),adenomas per colonoscopy,adenomas per positive colonoscopy,and factors related to adenoma detection.RESULTS A total of 4211 patients(966 adenomas)were included in the analysis(mean age,56.7 years,47.1%male).There were 2113 patients(508 adenomas)in the IEE group and 2098 patients(458 adenomas)in the WLI group.The ADR in two group were not significantly different[24.0%vs 21.8%,1.10,95%confidence interval(CI):0.99-1.23,P=0.09].The PDR was higher with IEE group(41.7%)than with WLI group(36.1%,1.16,95%CI:1.07-1.25,P=0.01).Differences in mean withdrawal time(7.90±3.42 min vs 7.85±3.47 min,P=0.30)and adenomas per colonoscopy(0.33±0.68 vs 0.28±0.62,P=0.06)were not significant.Subgroup analysis found that with narrowband imaging(NBI),between-group differences in the ADR,were not significant(23.7%vs 21.8%,1.09,95%CI:0.97-1.22,P=0.15),but were greater with linked color imaging(30.9%vs 21.8%,1.42,95%CI:1.04-1.93,P=0.04).the second-generation NBI(2G-NBI)had an advantage of ADR than both WLI and the first-generation NBI(27.0%vs 21.8%,P=0.01;27.0%vs 21.2.0%,P=0.01).CONCLUSION This prospective study confirmed that,among Chinese,IEE didn’t increase the ADR compared with WLI,but 2G-NBI increase the ADR.
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.
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.
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?
