Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists

Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted kappa values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders

Evaluation of single tooth loss to maxillary sinus and surrounding bone anatomy with cone-beam computed tomography: A multicenter study

Background: Posterior maxillary tooth loss may complicate the implant treatment due to the alterations in alveolar anatomy and maxillary sinus pneumatization. This study aimed to comprehensively examine the anatomical structure of this region from cone-beam computed tomography (CBCT) images. Materials and Methods: The posterior maxilla regions with single tooth loss were analyzed by dividing the variables into 3 subgroups from images of 597 patients chosen from 1160 CBCTs. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height (ABH) and width (RW), posterior superior alveolar artery (PSAA), and adjacent roots were evaluated. Results: The majority of the patients demonstrated 0 to 5 mm membrane thickness. Irregular SM thickening was lower for female patients. While females showed higher number of narrow sinus, males had higher RW than females. Sinus augmentation classification showed negative correlation with ABH, root-tip sinus floor and edentulous site classification. Posterior septa height was correlated with number of septa and ABH. PSAA diameter and location were also correlated between each other. Conclusion: The present results define formation of a sinus space with 11 mm coronal and 16 mm apical width after single tooth loss. A flat or semispherical thickening around 4 mm is usual in most cases with 51% possibility of anterior septum existence. A ridge anatomy, around 7.5 mm ABH and 7.2 to 9 .3 RW from coronal to apical, complements this anatomy. Further studies are needed to clarify the reasons behind the SM and crestal anatomy variations between genders

Early Rumour Detection with Temporal Bidirectional Graph Convolutional Networks

Automatic rumour detection has drawn significant research attention and deep learning models are proposed. It is shown that misinformation propagates further and wider on social networks. Existing research has focused on using the information propagation pattern for rumour detection. But the temporal propagation pattern for rumours has been largely ignored. This paper addresses this gap. We propose a temporal Bi-directional Graph Convolutional Network (tBi-GCN) model to learn representations for rumour propagation and rumour dispersion by encoding the temporal information for local graph structures and nodes. Specifically, we constructed a time-weighted adjacency matrix to represent the effect of time delay between nodes on information dissemination. Experimental results across five events of the PHEME dataset show that tBi-GCN can achieve a comparable performance in comparison with several state-of-the-art models for early rumour detectio

A new rank sensitivity metric for decision support

Assessing the change in the relative performance of competing systems across a factor space generated by a combination of input variables is a common problem in decision making. We propose a new metric to assess the sensitivity of the performance rankings of a set of options when input variables are changed. The proposed metric is useful in foreseeing the impact of changing values of input variables on an output metric in complex systems through computer simulation experiments. Numerical characteristics of the proposed metric are illustrated and discussed and an application is provided to illustrate use of our metric in decision support

A current analysis of caregivers' approaches to fever and antipyretic usage

Introduction: The aim of this survey was to investigate the current knowledge, attitudes, and practices of febrile children's caregivers about fever, antipyretic usage, and temperature measurement methods in a tertiary care hospital. Methodology: A 41-item questionnaire was administered to a convenience sample of febrile children's caregivers in face-to-face interviews by two research assistants from January 2012 through June 2012 in an urban region of Turkey. Results: A total of 1,032 caregivers completed the interview. Approximately one-third of caregivers considered a temperature of less than 37.8 degrees C (100 degrees F) to be a fever, and 13% of all respondents would give antipyretics for a body temperature <= 37.8 degrees C. Furthermore, 76% of parents would wake their children from sleep to administer antipyretics. Although a high proportion (89.5%) of respondents believed that fever had harmful effects, 10.5% considered fever to be beneficial. Alternating use of acetaminophen and ibuprofen (44%) and giving antipyretics routinely (71%) before and after immunizations were common parental practices and generally advised by pediatricians. Parents with higher levels of education were more likely to consider fever to be beneficial and to treat fever with antipyretics, and less likely to seek medical attention for mild fever. Most caregivers stated that they were unsure about the right site (90%) and thermometer type (95%) for temperature measurement. Conclusions: Persistent fever anxiety and excessive antipyretic usage may be heightened by the lack of knowledge regarding accurate temperature measurement methods with digital thermometers in our population. Parental education may positively affect the approach to fever and antipyretic usage

The neurotoxic effects of intrathecal midazolam and neostigmine in rabbits

In parallel with improvements in understanding pain neurophysiology, many chemicals have recently been investigated for spinal anaesthesia and analgesia. However, studies discussing the effects of these drugs on neural tissue indicate that knowledge about some aspects of neurotoxicity is limited. Forty-nine New Zealand albino rabbits, weighing 2.2+/-0.2 kg, were randomly assigned to seven groups of seven animals each. Single dose groups received intrathecally through the atlantooccipital membrane 0.9% saline 1.5 ml; midazolam 100 mu g/kg (low dose midazolam group) or 500 mu g/kg (high dose midazolam group); neostigmine 10 mu g/kg (low dose neostigmine group) or 50 mu g/kg (high dose neostigmine group). Two groups had seven days of repeated dosing with either midazolam 100 mu g/kg/day (repeat midazolam group) or 10 mu g/kg/day neostigmine (repeat neostigmine group). The animals were sacrificed on day 8, and two spinal cord sections from the fourth cervical level and fourth lumbar level were removed and prepared for histopathological study. Transmission electron microscopic evaluations were performed on transverse spinal cord sections by a neuropathologist blinded to the group allocation. Twenty myelinated axons and neurones in the cervical and lumbar sections were investigated for the histopathological study. This study indicates that midazolam and neostigmine have different neurotoxic effects that depend on the dose and the repetition of dosing when these drugs arc, administered intrathecally

Maxillary Sinus and Surrounding Bone Anatomy with Cone Beam Computed Tomography after Multiple Teeth Loss: A Retrospective Multicenter Clinical Study

Purpose:The aim of this multicenter study was to examine the residual alveolar bone anatomy and sinus mucosa pattern at maxillary sinus regions in multiple teeth loss.Materials and Methods:This study was conducted with cone beam computed tomography images of 518 patients (267 females and 251 males) with multiple posterior maxillary teeth loss. Variables associated with sinus membrane (SM), sinus dimensions, ostium, septa, sinus neighborhood, alveolar bone height and ridge width, posterior superior alveolar artery, and adjacent roots were evaluated.Results:No (58.2%) or flat (19.3%) thickening morphology was detected at most of the SMs. Membrane thickening and mucosal-like morphology was more prevalent for male patients (P = 0.005). The mean sinus width was relatively low (3.64 ± 3.33 mm) at the 5-mm level and showed an expected increase toward upper levels. Most of the sinus spaces were dimensionally average (39.5%) or wide (44.7%), and no effect of gender was observed in terms of sinus dimensions (P > 0.05).Conclusion:Multiple teeth loss plays a role in creating an imaginary sinus anatomy constituted of a relatively narrow space compared with single-Tooth loss cases, from 3.6-mm mean coronal width to 11.3 mm in the apical portion