Tailored for Real-World: A Whole Slide Image Classification System Validated on Uncurated Multi-Site Data Emulating the Prospective Pathology Workload.

Standard of care diagnostic procedure for suspected skin cancer is microscopic examination of hematoxylin & eosin stained tissue by a pathologist. Areas of high inter-pathologist discordance and rising biopsy rates necessitate higher efficiency and diagnostic reproducibility. We present and validate a deep learning system which classifies digitized dermatopathology slides into 4 categories. The system is developed using 5,070 images from a single lab, and tested on an uncurated set of 13,537 images from 3 test labs, using whole slide scanners manufactured by 3 different vendors. The system\u27s use of deep-learning-based confidence scoring as a criterion to consider the result as accurate yields an accuracy of up to 98%, and makes it adoptable in a real-world setting. Without confidence scoring, the system achieved an accuracy of 78%. We anticipate that our deep learning system will serve as a foundation enabling faster diagnosis of skin cancer, identification of cases for specialist review, and targeted diagnostic classifications

Associations of health-related quality of life, fear of falling and objective measures of physical function with bone health in postmenopausal women with low bone mass

Health-related quality of life (HRQoL) and physical function deteriorate with age and may adversely impact bone health in older adults. We determined associations of objective measures of physical function and HRQoL with bone health in postmenopausal women with low areal bone mineral density (aBMD). Fifty postmenopausal women (64.4 ± 7.7 years old, mean ± standard deviation) with low spine, hip or femoral neck aBMD (T- or Z-score < −1.0) on dual-energy X-ray absorptiometry (DXA) participated. Femoral surface BMD, trabecular, integral and cortical volumetric BMD (vBMD) measurements were obtained using 3D-SHAPER software on DXA. Distal tibial vBMD and microarchitecture were assessed using high-resolution peripheral quantitative computed tomography (HRpQCT). Participants completed self-administered EuroQol-5D (EQ-5D) and modified falls efficacy scale (MFES) questionnaires, and physical function assessments. Stair climb power was positively associated with bone parameters at the hip, femoral neck, and distal tibia (all p < 0.05) in multivariable linear regression. EQ-5D demonstrated no significant associations with bone parameters and MFES was positively associated only with distal tibial cortical vBMD and cortical von Mises stress (both p < 0.05). Objective measures of physical function, particularly muscle power, are more consistently associated with bone parameters compared with self-administered HRQoL questionnaires

Application of frequency ratio, statistical index, and weights-of-evidence models and their comparison in landslide susceptibility mapping in Central Nepal Himalaya

The Mugling–Narayanghat road section falls within the Lesser Himalaya and Siwalik zones of Central Nepal Himalaya and is highly deformed by the presence of numerous faults and folds. Over the years, this road section and its surrounding area have experienced repeated landslide activities. For that reason, landslide susceptibility zonation is essential for roadside slope disaster management and for planning further development activities. The main goal of this study was to investigate the application of the frequency ratio (FR), statistical index (SI), and weights-of-evidence (WoE) approaches for landslide susceptibility mapping of this road section and its surrounding area. For this purpose, the input layers of the landslide conditioning factors were prepared in the first stage. A landslide inventory map was prepared using earlier reports, aerial photographs interpretation, and multiple field surveys. A total of 438 landslide locations were detected. Out these, 295 (67 %) landslides were randomly selected as training data for the modeling using FR, SI, and WoE models and the remaining 143 (33 %) were used for the validation purposes. The landslide conditioning factors considered for the study area are slope gradient, slope aspect, plan curvature, altitude, stream power index, topographic wetness index, lithology, land use, distance from faults, distance from rivers, and distance from highway. The results were validated using area under the curve (AUC) analysis. From the analysis, it is seen that the FR model with a success rate of 76.8 % and predictive accuracy of 75.4 % performs better than WoE (success rate, 75.6 %; predictive accuracy, 74.9 %) and SI (success rate, 75.5 %; predictive accuracy, 74.6 %) models. Overall, all the models showed almost similar results. The resultant susceptibility maps can be useful for general land use planning

Hepatocellular carcinomas in native livers from patients treated with orthotopic liver transplantation: Biologic and therapeutic implications

The gross and histopathologic characteristics of 212 nonfibrolamellar hepatocellular carcinomas (HCCs) discovered in native livers removed at the time of liver transplantation were correlated with features of invasive growth and tumor-free survival. The results show that most HCCs begin as small well-differentiated tumors that have an increased proliferation rate and induce neovascularization, compared with the surrounding liver. But at this stage, they maintain a near-normal apoptosis/mitosis ratio and uncommonly show vascular invasion. As tumors enlarge, foci of dedifferentiation appear within the neoplastic nodules, which have a higher proliferation rate and show more pleomorphism than surrounding better-differentiated areas. Vascular invasion, which is the strongest predictor of disease recurrence, correlates significantly with tumor number and size, tumor giant cells and necrosis, the predominant and worst degree of differentiation, and the apoptosis/mitosis ratio. In the absence of macroscopic or large vessel invasion, largest tumor size (P <.006), apoptosis/mitosis ratio (P <.03), and number of tumors (P <.04) were independent predictors of tumor-free survival and none of 24 patients with tumors having an apoptosis/mitosis ratio greater than 7.2 had recurrence. A minority of HCCs (< 15%) quickly develop aggressive features (moderate or poor differentiation, low apoptosis/mitosis ratio, and vascular invasion) while still small, similar to flat carcinomas of the bladder and colon. In conclusion, hepatic carcinogenesis in humans is a multistep and multifocal process. As in experimental animal studies, aggressive biologic behavior (vascular invasion and recurrence) correlates significantly with profound alterations in the apoptosis/mitosis ratio and with architectural and cytologic alterations that suggest a progressive accumulation of multiple genetic abnormalities

Producing valid statistics when legislation, culture, and medical practices differ for births at or before the threshold of survival: Report of a European workshop

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Reflection 2 shifting research paradigms: urbanism and culture.

The themes of this book are important and timely, and reflect the increasingly cross-discipline manner in which challenges faced in the built environment must be addressed. This has been reflected of course in the calls and projects supported by major research funders, but one can argue that this in turn simply reflects a recognition in society that urban problems are complex, and require a response which draws on a diversity of expertise. The relationships between people and the constructed environment are dealt with using a range of participants and contexts, and the book serves to demonstrate how the academic and professional communities can work together

Superscaling in inclusive electron-nucleus scattering

We investigate the degree to which the scaling functions $F(\psi')$ derived from cross sections for inclusive electron-nucleus quasi-elastic scattering define the same function for different nuclei. In the region where the scaling variable $\psi'< 0$, we find that this superscaling is experimentally realized to a high degree.Comment: Corrected previously mislabeled figures and cross references; 9 pages, 4 color figures, using BoxedEPS and REVTeX; email correspondence to [email protected]

Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases.

Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, affect several million individuals worldwide. Crohn's disease and ulcerative colitis are complex diseases that are heterogeneous at the clinical, immunological, molecular, genetic, and microbial levels. Individual contributing factors have been the focus of extensive research. As part of the Integrative Human Microbiome Project (HMP2 or iHMP), we followed 132 subjects for one year each to generate integrated longitudinal molecular profiles of host and microbial activity during disease (up to 24 time points each; in total 2,965 stool, biopsy, and blood specimens). Here we present the results, which provide a comprehensive view of functional dysbiosis in the gut microbiome during inflammatory bowel disease activity. We demonstrate a characteristic increase in facultative anaerobes at the expense of obligate anaerobes, as well as molecular disruptions in microbial transcription (for example, among clostridia), metabolite pools (acylcarnitines, bile acids, and short-chain fatty acids), and levels of antibodies in host serum. Periods of disease activity were also marked by increases in temporal variability, with characteristic taxonomic, functional, and biochemical shifts. Finally, integrative analysis identified microbial, biochemical, and host factors central to this dysregulation. The study's infrastructure resources, results, and data, which are available through the Inflammatory Bowel Disease Multi'omics Database ( http://ibdmdb.org ), provide the most comprehensive description to date of host and microbial activities in inflammatory bowel diseases

Superscaling of Inclusive Electron Scattering from Nuclei

We investigate the degree to which the concept of superscaling, initially developed within the framework of the relativistic Fermi gas model, applies to inclusive electron scattering from nuclei. We find that data obtained from the low energy loss side of the quasielastic peak exhibit the superscaling property, i.e., the scaling functions f(\psi') are not only independent of momentum transfer (the usual type of scaling: scaling of the first kind), but coincide for A \geq 4 when plotted versus a dimensionless scaling variable \psi' (scaling of the second kind). We use this behavior to study as yet poorly understood properties of the inclusive response at large electron energy loss.Comment: 33 pages, 12 color EPS figures, LaTeX2e using BoxedEPSF macros; email to [email protected]