Analysis of (sub-)Riemannian PDE-G-CNNs

Group equivariant convolutional neural networks (G-CNNs) have been successfully applied in geometric deep learning. Typically, G-CNNs have the advantage over CNNs that they do not waste network capacity on training symmetries that should have been hard-coded in the network. The recently introduced framework of PDE-based G-CNNs (PDE-G-CNNs) generalises G-CNNs. PDE-G-CNNs have the core advantages that they simultaneously 1) reduce network complexity, 2) increase classification performance, and 3) provide geometric interpretability. Their implementations primarily consist of linear and morphological convolutions with kernels. In this paper we show that the previously suggested approximative morphological kernels do not always accurately approximate the exact kernels accurately. More specifically, depending on the spatial anisotropy of the Riemannian metric, we argue that one must resort to sub-Riemannian approximations. We solve this problem by providing a new approximative kernel that works regardless of the anisotropy. We provide new theorems with better error estimates of the approximative kernels, and prove that they all carry the same reflectional symmetries as the exact ones. We test the effectiveness of multiple approximative kernels within the PDE-G-CNN framework on two datasets, and observe an improvement with the new approximative kernels. We report that the PDE-G-CNNs again allow for a considerable reduction of network complexity while having comparable or better performance than G-CNNs and CNNs on the two datasets. Moreover, PDE-G-CNNs have the advantage of better geometric interpretability over G-CNNs, as the morphological kernels are related to association fields from neurogeometry.Comment: 29 pages, 21 figure

Fear expression is suppressed by tyrosine administration

Animal studies have demonstrated that catecholamines regulate several aspects of fear conditioning. In humans, however, pharmacological manipulations of the catecholaminergic system have been scarce, and their primary focus has been to interfering with catecholaminergic activity after fear acquisition or expression had taken place, using L-Dopa, primarily, as catecholaminergic precursor. Here, we sought to determine if putative increases in presynaptic dopamine and norepinephrine by tyrosine administered before conditioning could affect fear expression. Electrodermal activity (EDA) of 46 healthy participants (24 placebo, 22 tyrosine) was measured in a fear instructed task. Results showed that tyrosine abolished fear expression compared to placebo. Importantly, tyrosine did not affect EDA responses to the aversive stimulus (UCS) or alter participants' mood. Therefore, the effect of tyrosine on fear expression cannot be attributed to these factors. Taken together, these findings provide evidence that the catecholaminergic system influences fear expression in humans

Identifying risk factors for Jihadist terrorist offenders committing homicide: An explorative analysis using the European Database of Terrorist offenders

Although many studies have examined various aspects of terrorism, relatively little is known about risk indicators associated with specific types of terrorist offences. To partly fill this void, this study explores differences on risk indicators of the Violent Extremism Risk Assessment tool (VERA-2R) between 21 Jihadist offenders who were convicted for homicide and a comparison group of 30 Jihadist offenders convicted for other Jihadist terrorist offences. In doing so, we use judicial data from the European Database of Terrorist offenders (EDT). The results reveal that a number of risk and protective indicators differ between both groups. Both terrorist offender groups often expressed grievances about perceived injustice, but the homicide group more frequently expressed anger, moral outrage, or hatred in response to the perceived injustice than the comparison group. The homicide group also identified their attacks more often than the comparison group, and were more actively engaged in planning and preparation them. Additionally, the homicide group was less often motivated to commit their terrorist offences by group belonging compared with the non-homicide group. With respect to the protective indicators, persons in the comparison group more often reject violence as a means to achieve goals. Although further research is necessary, the results from this study indicate that a differentiated approach might be needed for risk assessment and risk management of the terrorist offender population

Evaluatie indicatiestelling PIJ-maatregel

The juvenile custodial measure 'Institutional Placement Order' will be administered by the court if for a crime a precautionary detention is warranted, if the general safety of individuals or materials requires such a measure, and if the measure is in the best interest of the future development of the youth involved.Bij het opleggen van de (voorwaardelijke) PIJ-maatregel (Plaatsting in een Inrichting voor Jongeren) door de rechter en de tenuitvoerlegging van de PIJ-maatregel in justitiële jeugdinstellingen, is in theorie een belangrijke rol weggelegd voor de pro Justitia rapportage. Dit onderzoek beoogt meer zicht te geven op de rol van de pro Justitia rapportage in de praktijk

The use of a real-time computer-aided detection system for visible lesions in the Barrett's esophagus during live endoscopic procedures:a pilot study (with video)

Background and Aims: This pilot study evaluated the performance of a recently developed computer-aided detection (CADe) system for Barrett's neoplasia during live endoscopic procedures. Methods: Fifteen patients with a visible lesion and 15 without were included in this study. A CAD-assisted workflow was used that included a slow pullback video recording of the entire Barrett's segment with live CADe assistance, followed by CADe-assisted level-based video recordings every 2 cm of the Barrett's segment. Outcomes were per-patient and per-level diagnostic accuracy of the CAD-assisted workflow, in which the primary outcome was per-patient in vivo CADe sensitivity. Results: In the per-patient analyses, the CADe system detected all visible lesions (sensitivity 100%). Per-patient CADe specificity was 53%. Per-level sensitivity and specificity of the CADe-assisted workflow were 100% and 73%, respectively. Conclusions: In this pilot study, detection by the CADe system of all potentially neoplastic lesions in Barrett's esophagus was comparable to that of an expert endoscopist. Continued refinement of the system may improve specificity. External validation in larger multicenter studies is planned. (Clinical trial registration number: NCT05628441.)</p

Procalcitonin as a potent marker of bacterial infection in febrile Afro-Caribbean patients at the emergency department

Procalcitonin (PCT) has been shown to be of additional value in the work-up of a febrile patient. This study is the first to investigate the additional value of PCT in an Afro-Caribbean febrile population at the emergency department (ED) of a general hospital. Febrile patients were included at the ED. Prospective, blinded PCT measurements were performed in patients with a microbiologically or serologically confirmed diagnosis or a strongly suspected diagnosis on clinical grounds. PCT analysis was performed in 93 patients. PCT levels differentiated well between confirmed bacterial and confirmed viral infection (area under the curve [AUC] of 0.82, sensitivity 85%, specificity 69%, cut-off 0.24 ng/mL), between confirmed bacterial infection and non-infectious fever (AUC of 0.84, sensitivity 90%, specificity 71%, cut-off 0.21 ng/mL) and between all bacterial infections (confirmed and suspected) and non-infectious fever (AUC of 0.80, sensitivity 85%, specificity 71%, cut-off 0.21 ng/mL). C-reactive protein (CRP) levels were shown to be less accurate when comparing the same groups. This is the first study showing that, in a non-Caucasian febrile population at the ED, PCT is a more valuable marker of bacterial infection than CRP. These results may improve diagnostics and eventually decrease antibiotic prescriptions in resource-limited settings

Non-intersecting squared Bessel paths at a hard-edge tacnode

The squared Bessel process is a 1-dimensional diffusion process related to the squared norm of a higher dimensional Brownian motion. We study a model of $n$ non-intersecting squared Bessel paths, with all paths starting at the same point $a>0$ at time $t=0$ and ending at the same point $b>0$ at time $t=1$. Our interest lies in the critical regime $ab=1/4$, for which the paths are tangent to the hard edge at the origin at a critical time $t^*\in (0,1)$. The critical behavior of the paths for $n\to\infty$ is studied in a scaling limit with time $t=t^*+O(n^{-1/3})$ and temperature $T=1+O(n^{-2/3})$. This leads to a critical correlation kernel that is defined via a new Riemann-Hilbert problem of size $4\times 4$. The Riemann-Hilbert problem gives rise to a new Lax pair representation for the Hastings-McLeod solution to the inhomogeneous Painlev\'e II equation $q"(x) = xq(x)+2q^3(x)-\nu,$ where $\nu=\alpha+1/2$ with $\alpha>-1$ the parameter of the squared Bessel process. These results extend our recent work with Kuijlaars and Zhang \cite{DKZ} for the homogeneous case $\nu = 0$.Comment: 54 pages, 13 figures. Corrected error in Theorem 2.

A deep learning system for detection of early Barrett's neoplasia:a model development and validation study

BACKGROUND: Computer-aided detection (CADe) systems could assist endoscopists in detecting early neoplasia in Barrett's oesophagus, which could be difficult to detect in endoscopic images. The aim of this study was to develop, test, and benchmark a CADe system for early neoplasia in Barrett's oesophagus.METHODS: The CADe system was first pretrained with ImageNet followed by domain-specific pretraining with GastroNet. We trained the CADe system on a dataset of 14 046 images (2506 patients) of confirmed Barrett's oesophagus neoplasia and non-dysplastic Barrett's oesophagus from 15 centres. Neoplasia was delineated by 14 Barrett's oesophagus experts for all datasets. We tested the performance of the CADe system on two independent test sets. The all-comers test set comprised 327 (73 patients) non-dysplastic Barrett's oesophagus images, 82 (46 patients) neoplastic images, 180 (66 of the same patients) non-dysplastic Barrett's oesophagus videos, and 71 (45 of the same patients) neoplastic videos. The benchmarking test set comprised 100 (50 patients) neoplastic images, 300 (125 patients) non-dysplastic images, 47 (47 of the same patients) neoplastic videos, and 141 (82 of the same patients) non-dysplastic videos, and was enriched with subtle neoplasia cases. The benchmarking test set was evaluated by 112 endoscopists from six countries (first without CADe and, after 6 weeks, with CADe) and by 28 external international Barrett's oesophagus experts. The primary outcome was the sensitivity of Barrett's neoplasia detection by general endoscopists without CADe assistance versus with CADe assistance on the benchmarking test set. We compared sensitivity using a mixed-effects logistic regression model with conditional odds ratios (ORs; likelihood profile 95% CIs).FINDINGS: Sensitivity for neoplasia detection among endoscopists increased from 74% to 88% with CADe assistance (OR 2·04; 95% CI 1·73-2·42; p&lt;0·0001 for images and from 67% to 79% [2·35; 1·90-2·94; p&lt;0·0001] for video) without compromising specificity (from 89% to 90% [1·07; 0·96-1·19; p=0·20] for images and from 96% to 94% [0·94; 0·79-1·11; ] for video; p=0·46). In the all-comers test set, CADe detected neoplastic lesions in 95% (88-98) of images and 97% (90-99) of videos. In the benchmarking test set, the CADe system was superior to endoscopists in detecting neoplasia (90% vs 74% [OR 3·75; 95% CI 1·93-8·05; p=0·0002] for images and 91% vs 67% [11·68; 3·85-47·53; p&lt;0·0001] for video) and non-inferior to Barrett's oesophagus experts (90% vs 87% [OR 1·74; 95% CI 0·83-3·65] for images and 91% vs 86% [2·94; 0·99-11·40] for video).INTERPRETATION: CADe outperformed endoscopists in detecting Barrett's oesophagus neoplasia and, when used as an assistive tool, it improved their detection rate. CADe detected virtually all neoplasia in a test set of consecutive cases.FUNDING: Olympus.</p

The Tissue Systems Pathology Test Outperforms Pathology Review in Risk Stratifying Patients With Low-Grade Dysplasia

BACKGROUND & AIMS: Low-grade dysplasia (LGD) is associated with an increased risk of progression in Barrett’s esophagus (BE); however, the diagnosis of LGD is limited by substantial interobserver variability. Multiple studies have shown that an objective tissue systems pathology test (TissueCypher Barrett’s Esophagus Test, TSP-9), can effectively predict neoplastic progression in patients with BE. This study aimed to compare the risk stratification performance of the TSP-9 test vs benchmarks of generalist and expert pathology. METHODS: A blinded cohort study was conducted in the screening cohort of a randomized controlled trial of patients with BE with community-based LGD. Biopsies from the first endoscopy with LGD were assessed by the TSP-9 test and independently reviewed by 30 pathologists from 5 countries per standard practice. The accuracy of the test and the diagnoses in predicting high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) were compared. RESULTS: A total of 154 patients with BE (122 men), mean age 60.9 ± 9.8 years were studied. Twenty-four patients progressed to HGD/EAC within 5 years (median time of 1.7 years) and 130 did not progress to HGD/EAC within 5 years (median 7.8 years follow-up). The TSP-9 test demonstrated higher sensitivity (71% vs mean 63%, range 33%–88% across 30 pathologists), than the pathology review in detecting patients who progressed (P = .01186). CONCLUSIONS: The TSP-9 test outperformed the pathologists in risk stratifying patients with BE with LGD. Care guided by the test can provide an effective solution to variable pathology review of LGD, improving health outcomes by upstaging care to therapeutic intervention for patients at high risk for progression, while reducing unnecessary interventions in low-risk patients