BACKGROUND Cholangiocarcinoma is a highly lethal disease that had been underestimated in the past two decades. Many risk factors are well documented for in cholangiocarcinoma, but the impacts of advanced biliary inter...BACKGROUND Cholangiocarcinoma is a highly lethal disease that had been underestimated in the past two decades. Many risk factors are well documented for in cholangiocarcinoma, but the impacts of advanced biliary interventions, like endoscopic sphincterotomy(ES), endoscopic papillary balloon dilatation(EPBD),and cholecystectomy, are inconsistent in the previous literature.AIM To clarify the risks of cholangiocarcinoma after ES/EPBD, cholecystectomy or no intervention for cholelithiasis using the National Health Insurance Research Database(NHIRD).METHODS From data of NHIRD 2004-2011 in Taiwan, we selected 7938 cholelithiasis cases as well as 23814 control group cases(matched by sex and age in a 1:3 ratio). We compared the previous risk factors of cholangiocarcinoma and cholangiocarcinoma rate in the cholelithiasis and control groups. The incidences of total and subsequent cholangiocarcinoma were calculated in ES/EPBD patients, cholecystectomy patients, cholelithiasis patients without intervention,and groups from the normal population.RESULTS In total, 537 cases underwent ES/EPBD, 1743 cases underwent cholecystectomy,and 5658 cholelithiasis cases had no intervention. Eleven(2.05%), 37(0.65%), and7(0.40%) subsequent cholangiocarcinoma cases were diagnosed in the ES/EPBD,no intervention, and cholecystectomy groups, respectively, and the odds ratio for subsequent cholangiocarcinoma was 3.13 in the ES/EPBD group and 0.61 in the cholecystectomy group when compared with the no intervention group.CONCLUSION In conclusion, symptomatic cholelithiasis patients who undergo cholecystectomy can reduce the incidence of subsequent cholangiocarcinoma, while cholelithiasis patients who undergo ES/EPBD are at a great risk of subsequent cholangiocarcinoma according to our findings.展开更多
BACKGROUND Barrett’s esophagus(BE),which has increased in prevalence worldwide,is a precursor for esophageal adenocarcinoma.Although there is a gap in the detection rates between endoscopic BE and histological BE in ...BACKGROUND Barrett’s esophagus(BE),which has increased in prevalence worldwide,is a precursor for esophageal adenocarcinoma.Although there is a gap in the detection rates between endoscopic BE and histological BE in current research,we trained our artificial intelligence(AI)system with images of endoscopic BE and tested the system with images of histological BE.AIM To assess whether an AI system can aid in the detection of BE in our setting.METHODS Endoscopic narrow-band imaging(NBI)was collected from Chung Shan Medical University Hospital and Changhua Christian Hospital,resulting in 724 cases,with 86 patients having pathological results.Three senior endoscopists,who were instructing physicians of the Digestive Endoscopy Society of Taiwan,independently annotated the images in the development set to determine whether each image was classified as an endoscopic BE.The test set consisted of 160 endoscopic images of 86 cases with histological results.RESULTS Six pre-trained models were compared,and EfficientNetV2B2(accuracy[ACC]:0.8)was selected as the backbone architecture for further evaluation due to better ACC results.In the final test,the AI system correctly identified 66 of 70 cases of BE and 85 of 90 cases without BE,resulting in an ACC of 94.37%.CONCLUSION Our AI system,which was trained by NBI of endoscopic BE,can adequately predict endoscopic images of histological BE.The ACC,sensitivity,and specificity are 94.37%,94.29%,and 94.44%,respectively.展开更多
Rates of heavy drinking, tobacco use and illicit substance use peak among college students between 18 and 25 years of age. Attitudes, personal characteristics, and behaviors that are called protective factors could pl...Rates of heavy drinking, tobacco use and illicit substance use peak among college students between 18 and 25 years of age. Attitudes, personal characteristics, and behaviors that are called protective factors could play a role in reducing college students’ use of alcohol and drugs. We studied the relationships between selected protective factors and alcohol consumption in college students from a public commuter university in New Orleans, Louisiana pre-and post-Hurricane Katrina utilizing the Core Alcohol and Drug Survey (CADS) Long Form. We applied Hirschi’s social control theory to examine the relationships between drinking and the identified protective factors. Three research questions with null and alternative hypotheses were tested to explore the impact of Hurricane Katrina on protective factors and drinking utilizing linear/ logistic and multivariate regression models to test the hypotheses. We found that post-Katrina students were on average about 1.5 years older and drank approximately 1.5 more drinks per week than pre-Katrina students. Both pre and post Katrina age, gender, and race/ethnicity were significantly related to drinking among these groups of college students such that older students, women, and non-Whites tended to have reduced odds of drinking. There were no statistically significant relationships between individual protective factors or any group of protective factors and drinking after controlling for age, gender, and race/ethnicity indicating that these 3 individual characteristics that cannot be altered were stronger predictors of drinking than any other factors we tested.展开更多
Rice production in China’s coastal areas is frequently affected by typhoons,since the associated severe storms,with heavy rain and the strong winds,lead directly to the rice plants becoming flooded or lodged.Long-ter...Rice production in China’s coastal areas is frequently affected by typhoons,since the associated severe storms,with heavy rain and the strong winds,lead directly to the rice plants becoming flooded or lodged.Long-term flooding and lodging can cause a substantial reduction in rice yield or even destroy the harvest completely.It is therefore urgent to obtain accurate information about paddy rice flooding and lodging as soon as possible after the passing of the storm.This paper proposes a workflow in Google Earth Engine(GEE)for mapping the flooding and lodging area of paddy rice in Wenzhou City,Zhejiang,following super typhoon Maria(Typhoon No.8 in 2018).First,paddy rice in the study area was detected by multi-temporal Sentinel-1 backscatter data combined with Sentinel-2-derived Normalized Difference Vegetation Index(NDVI)using the Random Forests(RFs)algorithm.High classification accuracies were achieved,whereby rice detection accuracy was calculated at 95%(VH+NDVI-based)and 87%(VV+NDVI-bastd).Secondly,Change Detection(CD)based Rice Normalized Difference Flooded Index(RNDFI)and Rice Normalized Difference Lodged Index(RNDLI)were proposed to detect flooding and lodged paddy rice.Both RNDFI and RNDLI were tested based on four different remote sensing data sets,including the Sentinel-1-derived VV and VH backscattering coefficient,Sentinel-2-derived NDVI and Enhanced Vegetation Index(EVI).Overall agreement regarding detected area between the each two different data sets was obtained,with values of 79%to 93%in flood detection and 64%to 88%in lodging detection.The resulting flooded and lodged paddy rice maps have potential to reinforce disaster emergency assessment systems and provide an important resource for disaster reduction and emergency departments.展开更多
基金Chung Shan Medical University Hospital research program,Taichung,Taiwan,No.CSH-2013-C-032
文摘BACKGROUND Cholangiocarcinoma is a highly lethal disease that had been underestimated in the past two decades. Many risk factors are well documented for in cholangiocarcinoma, but the impacts of advanced biliary interventions, like endoscopic sphincterotomy(ES), endoscopic papillary balloon dilatation(EPBD),and cholecystectomy, are inconsistent in the previous literature.AIM To clarify the risks of cholangiocarcinoma after ES/EPBD, cholecystectomy or no intervention for cholelithiasis using the National Health Insurance Research Database(NHIRD).METHODS From data of NHIRD 2004-2011 in Taiwan, we selected 7938 cholelithiasis cases as well as 23814 control group cases(matched by sex and age in a 1:3 ratio). We compared the previous risk factors of cholangiocarcinoma and cholangiocarcinoma rate in the cholelithiasis and control groups. The incidences of total and subsequent cholangiocarcinoma were calculated in ES/EPBD patients, cholecystectomy patients, cholelithiasis patients without intervention,and groups from the normal population.RESULTS In total, 537 cases underwent ES/EPBD, 1743 cases underwent cholecystectomy,and 5658 cholelithiasis cases had no intervention. Eleven(2.05%), 37(0.65%), and7(0.40%) subsequent cholangiocarcinoma cases were diagnosed in the ES/EPBD,no intervention, and cholecystectomy groups, respectively, and the odds ratio for subsequent cholangiocarcinoma was 3.13 in the ES/EPBD group and 0.61 in the cholecystectomy group when compared with the no intervention group.CONCLUSION In conclusion, symptomatic cholelithiasis patients who undergo cholecystectomy can reduce the incidence of subsequent cholangiocarcinoma, while cholelithiasis patients who undergo ES/EPBD are at a great risk of subsequent cholangiocarcinoma according to our findings.
文摘BACKGROUND Barrett’s esophagus(BE),which has increased in prevalence worldwide,is a precursor for esophageal adenocarcinoma.Although there is a gap in the detection rates between endoscopic BE and histological BE in current research,we trained our artificial intelligence(AI)system with images of endoscopic BE and tested the system with images of histological BE.AIM To assess whether an AI system can aid in the detection of BE in our setting.METHODS Endoscopic narrow-band imaging(NBI)was collected from Chung Shan Medical University Hospital and Changhua Christian Hospital,resulting in 724 cases,with 86 patients having pathological results.Three senior endoscopists,who were instructing physicians of the Digestive Endoscopy Society of Taiwan,independently annotated the images in the development set to determine whether each image was classified as an endoscopic BE.The test set consisted of 160 endoscopic images of 86 cases with histological results.RESULTS Six pre-trained models were compared,and EfficientNetV2B2(accuracy[ACC]:0.8)was selected as the backbone architecture for further evaluation due to better ACC results.In the final test,the AI system correctly identified 66 of 70 cases of BE and 85 of 90 cases without BE,resulting in an ACC of 94.37%.CONCLUSION Our AI system,which was trained by NBI of endoscopic BE,can adequately predict endoscopic images of histological BE.The ACC,sensitivity,and specificity are 94.37%,94.29%,and 94.44%,respectively.
文摘Rates of heavy drinking, tobacco use and illicit substance use peak among college students between 18 and 25 years of age. Attitudes, personal characteristics, and behaviors that are called protective factors could play a role in reducing college students’ use of alcohol and drugs. We studied the relationships between selected protective factors and alcohol consumption in college students from a public commuter university in New Orleans, Louisiana pre-and post-Hurricane Katrina utilizing the Core Alcohol and Drug Survey (CADS) Long Form. We applied Hirschi’s social control theory to examine the relationships between drinking and the identified protective factors. Three research questions with null and alternative hypotheses were tested to explore the impact of Hurricane Katrina on protective factors and drinking utilizing linear/ logistic and multivariate regression models to test the hypotheses. We found that post-Katrina students were on average about 1.5 years older and drank approximately 1.5 more drinks per week than pre-Katrina students. Both pre and post Katrina age, gender, and race/ethnicity were significantly related to drinking among these groups of college students such that older students, women, and non-Whites tended to have reduced odds of drinking. There were no statistically significant relationships between individual protective factors or any group of protective factors and drinking after controlling for age, gender, and race/ethnicity indicating that these 3 individual characteristics that cannot be altered were stronger predictors of drinking than any other factors we tested.
基金This study was supported by the National Basic Research Program of China(No.2015CB452806),the National Natural Science Foundation of China(Grant No.41271055)the Shanghai Agriculture Applied Technology Development Program(No.G2014070402)Shanghai Science and Technology Committee(No.17DZ1205300).The computation was supported by the ECNU Multifunctional Platform for Innovation(001).Prof.Jiong Shu is thanked for many valuable suggestions in the revision of the manuscript.
文摘Rice production in China’s coastal areas is frequently affected by typhoons,since the associated severe storms,with heavy rain and the strong winds,lead directly to the rice plants becoming flooded or lodged.Long-term flooding and lodging can cause a substantial reduction in rice yield or even destroy the harvest completely.It is therefore urgent to obtain accurate information about paddy rice flooding and lodging as soon as possible after the passing of the storm.This paper proposes a workflow in Google Earth Engine(GEE)for mapping the flooding and lodging area of paddy rice in Wenzhou City,Zhejiang,following super typhoon Maria(Typhoon No.8 in 2018).First,paddy rice in the study area was detected by multi-temporal Sentinel-1 backscatter data combined with Sentinel-2-derived Normalized Difference Vegetation Index(NDVI)using the Random Forests(RFs)algorithm.High classification accuracies were achieved,whereby rice detection accuracy was calculated at 95%(VH+NDVI-based)and 87%(VV+NDVI-bastd).Secondly,Change Detection(CD)based Rice Normalized Difference Flooded Index(RNDFI)and Rice Normalized Difference Lodged Index(RNDLI)were proposed to detect flooding and lodged paddy rice.Both RNDFI and RNDLI were tested based on four different remote sensing data sets,including the Sentinel-1-derived VV and VH backscattering coefficient,Sentinel-2-derived NDVI and Enhanced Vegetation Index(EVI).Overall agreement regarding detected area between the each two different data sets was obtained,with values of 79%to 93%in flood detection and 64%to 88%in lodging detection.The resulting flooded and lodged paddy rice maps have potential to reinforce disaster emergency assessment systems and provide an important resource for disaster reduction and emergency departments.
