Miami Classification for Probe-Based Confocal Laser Endomicroscopy

An essential element for any new advanced imaging technology is standardization of indications, terminology, categorization of images, and research priorities. In this review, we propose a state-of-the-art classification system for normal and pathological states in gastrointestinal disease using probe-based confocal laser endomicroscopy (pCLE). The Miami classification system is based on a consensus of pCLE users reached during a meeting held in Miami, Florida, in February 2009

Interobserver variability in organ delineation on radiotherapy treatment planning for nasopharyngeal carcinoma: A dosimetric and prognostic analysis

Background and purposeThis study aimed to analyze the impact of interobserver variability (IOV) on clinical dosimetry and prognosis, specifically investigating the correlation between IOV and clinical prognosis in the context of intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Materials and methodsTwelve NPC patients who underwent IMRT were selected. Four radiotherapy physicians from two different-tier cancer centers independently delineated target volumes and organs at risk (OARs) for each patient. These delineations were compared against gold standard structures from a regional cancer center. The IOV among physicians and its effect on clinical and prognosis were analyzed. The relationships between the IOV, dosimetry, and prognosis were investigated using spearman’s correlation analysis.ResultsThe target volume and OARs delineation differed significantly among physicians. This variability led to reduced prescription dose coverage (PDC) of the planning target volume (PTV) and increased doses to OARs, impacting tumor control probability (TCP) and normal tissue complication probability (NTCP). Compared to standard delineations, all four physicians showed decreased TCPs (average decrease in ΔTCP >1%) and a significant increase in NTCPs of OARs. The relative volume difference (ΔV) of target volumes correlated strongly with ΔPDC (R=0.686) and ΔTCP (R=0.703). Moreover, in the validation set, ΔV also strongly correlated with ΔTCP (R = 0.778).ConclusionSubstantial IOV in delineating NPC target volumes and OARs for IMRT was observed. This variability affects plan optimization, dose distribution, and clinical prognosis. ΔV can serve as a risk predictor for assessing delineation variability in NPC radiotherapy treatment planning

Spatiotemporal consistency analysis of cerebral small vessel disease: an rs-fMRI study

IntroductionCerebral small vessel disease (SVD) affects older adults, but traditional approaches have limited the understanding of the neural mechanisms of SVD. This study aimed to explore the effects of SVD on brain regions and its association with cognitive decline using the four-dimensional (spatiotemporal) consistency of local neural activity (FOCA) method.MethodsMagnetic resonance imaging data from 42 patients with SVD and 38 healthy controls (HCs) were analyzed using the FOCA values. A two-sample t test was performed to compare the differences in FOCA values in the brain between the HCs and SVD groups. Pearson correlation analysis was conducted to analyze the association of various brain regions with SVD scores.ResultsThe results revealed that the FOCA values in the right frontal_inf_oper, right temporal_pole_sup, and default mode network decreased, whereas those in the temporal_inf, hippocampus, basal ganglia, and cerebellum increased, in patients with SVD. Most of these varying brain regions were negatively correlated with SVD scores.DiscussionThis study suggested that the FOCA approach might have the potential to provide useful insights into the understanding of the neurophysiologic mechanisms of patients with SVD

Application of the Mixed Teaching Model using Internet+ for Clinical Courses of Traditional Chinese Medicine

With the arrival of the Internet + era and the need for development and personnel training, the traditional teaching model of TCM (Traditional Chinese Medicine) needs to be transformed into a mixed teaching mode. In addition, the TCM English teaching resources from which learners can pick are restricted, and certain critical revised TCM material is not delivered on time. For high-quality delivery of service to TCM English learners, a system with materials and communication is considered extremely important. In this connection, “Internet +” provides both possibilities and problems for the advancement of TCM English instruction, which has considered a key to advanced TCM. Therefore, motivated by the development of “Internet +,” we try to establish a relevant analysis of the mixed teaching model and propose the implementation path and method of the mixed teaching model of traditional Chinese medicine: changing ideas and guiding students to enter into deep learning to build a teaching community; integration and reform of online teaching and classroom teaching of traditional Chinese medicine; emphasis on developmental evaluation. The evaluation is based on whether it provides students with meaningful Chinese medicine learning experience and deep learning status as the evaluation criteria.</jats:p

Integrated HPC OGV and Pre-Diffuser Design Optimization Using Kriging Surrogate Model

The integration of high compressor outlet guide vane (OGV) and combustor pre-diffuser requires some radial turning to be performed within the OGV passage. However, the enhanced loading of OGV leads to the increase in adverse pressure gradient within the OGV passage. Consequently, both the end-wall and blade boundary layers are thickened which could lead to boundary layers separation. In this work, an adaptive global optimization process is applied for the OGV/pre-diffuser system, which combines design of experiment (DOE), Kriging surrogate model and micro genetic algorithm. The meridional flow passage of OGV/pre-diffuser system is parameterized using Bezier curves with the combination of mean line and thickness distribution. In order to prevent the OGV corner separation, the bowed design is applied to the OGV to help delay flow separation. A composite curve combined with two straight lines and a conic Bezier curve is used to represent the OGV stacking line along circumference so that the bowed blades could be parameterized. Aerodynamic performance evaluations of the compressor are performed using a three dimensional Reynolds-averaged Navier-stokes computational fluid dynamics solver — NUMECA. In the optimization process, expected improvement sample criteria is adopted for balancing the exploration and exploitation with Kriging surrogate model. Reasonably high performance is confirmed by comparing the baseline and optimal designs. This study gives some insights into design optimization of an integrated OGV/Pre-diffuser for axial compressor.</jats:p