Langconnolly9367
Processes such as residual block, attention connections, and hard mining were used to optimize the model while strategies of random cropping, flipping and rotation for data augmentation. In the test phase, the current model was compared with those in previously reported studies. In the verification set, the detection effectiveness of detection model was evaluated. In the classification phase, multiple convolutional layers and fully-connected layers were applied to set up a classification model, aiming to identify whether the nodule was malignancy.
Our detection model yielded a sensitivity of 91% and 1.92 false positive subjects per automatically scanned imaging. The classification model achieved a sensitivity of 87.0%, a specificity of 88.0% and an accuracy of 87.5%.
Deep CNN combined with ABUS maybe a promising tool for easy detection and accurate diagnosis of breast nodule.
Deep CNN combined with ABUS maybe a promising tool for easy detection and accurate diagnosis of breast nodule.
The Type D Personality (TDP) has been specifically linked to acute myocardial infarction (AMI). However, the impact on prehospital delay of AMI patients is unclear. The aim of this study was to assess the relationship between TDP and pre-hospital delay time (PHT) in a Chinese population.
A total of 256 AMI patients (47 women and 209 men) were taken from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) study. Sociodemographic and psycho-behavioral characteristics were assessed by bedside interviews and questionnaires. TDP was evaluated according to the Type D Personality Scale (DS14) subdivided in social inhibition (SI) and negative affectivity (NA). Based on a significant interaction analysis of TDP and sex on PHT, all analyses were stratified by sex.
PHT of female patients with TDP were substantially shorter compared to non-TDP female patients (108
281 min, P=0.029). In male patients, no effect of TDT on PHT was found. Spearman correlation analysis suggests that NA was negatively correlated with PHT (r=-0.358, P=0.014). Further age-adjusted logistic regression analyses showed that female patients with TDP were generally less likely to prehospital delay compared with non-TDP patients (OR =0.28; 95% CI, 0.08-0.98) and had a lower risk of PHT >360 minutes (OR =0.10; 95% CI, 0.01-0.91). However, statistical significance disappeared after adjustment for psychological factors (anxiety, depression, suboptimal wellbeing, cardiac denial and stress event).
TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.
TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.
A number of treatment modalities are available to patients with early non-small cell lung cancer (NSCLC) but there is inconsistency regarding their effects on survival. The associated survival of each treatment modality is crucial for patients in making informed treatment decisions. We aimed to examine the change in treatment modality and trends in survival for patients with stage I NSCLC and assess the association between treatment modality and survival.
All patients diagnosed with stage I NSCLC in the Canadian province of Ontario between 2007 and 2015 were included in this population-based study. We used a flexible parametric model to estimate the trends in survival rate.
Overall, 11,910 patients were identified of which 7,478 patients (62.8%) received surgical resection and 2,652 (22.3%) radiation only. The proportion of patients who received radiation only increased from 13.2% in 2007 to 28.0% in 2015 (P-for-trend <0.001). Survival increased for all treatment modalities from 2007 to 2015. The increase in 5-year survival was more than 20% for all surgical groups and more than 35% for radiation-only group.
The survival of patients with stage I NSCLC increased for all treatment modalities over the study period, most distinctly in elderly patients, which coincided with a rise in the use of radiation therapy. While surgical resection was associated with the best chance of 5-year survival, radiation therapy is a safe and effective treatment for medically inoperable patients with early disease.
The survival of patients with stage I NSCLC increased for all treatment modalities over the study period, most distinctly in elderly patients, which coincided with a rise in the use of radiation therapy. While surgical resection was associated with the best chance of 5-year survival, radiation therapy is a safe and effective treatment for medically inoperable patients with early disease.
Minimally invasive esophagectomy (MIE) can reduce various complications compared with conventional thoracotomic esophagectomy. However, several reports suggested that MIE promoted incidence of post-operative hiatal hernia (HH). In current reports, we retrospectively analyzed incidence and risk factors of HH development after MIE.
A total of 113 patients undergoing MIE (McKeown esophagectomy) at our institute from April 2009 to December 2015 were included in this study. Patients with clinical stage II and III received neoadjuvant chemotherapy (NAC).
Eleven of 113 patients (9.7%) undergoing MIE developed HH. Four of them were female and the ratio of female among the patient with HH was higher than that among the patient without HH after MIE (36.4%
13.7%, P=0.05). Sixty-six patients (58.4%) during the study period were administered NAC and 10 of 11 patients with HH (90.9%) received NAC according to the clinical stage, which was significantly more than in the non-HH group (P=0.02). Type and route of graft organ were not related to HH development. Moreover, the fixation of the conduit organ at the hiatus does not contribute to post-operative HH.
In the current study, we showed that NAC was a major risk factor of HH development after MIE.
In the current study, we showed that NAC was a major risk factor of HH development after MIE.
While there is an increasing number of early-stage non-small cell lung cancer (NSCLC) patients with chronic obstructive pulmonary disease (COPD), there are no specific clinical guidelines for treating them. This study aims to evaluate different treatment modalities and corresponding clinical outcomes among early-stage NSCLC patients with COPD.
We retrospectively reviewed 692 patients with stage I and II NSCLC and COPD from January 2012 to June 2014. Patients were categorized into four groups according to primary treatment modality surgery only group (n=442), surgery with adjuvant treatment group (n=157), radiotherapy (RT) group (n=48), and supportive care (SC)-only group (n=45).
Overall, mortality rate was the highest in the SC-only group (35.7 deaths per 100 person-years), followed by RT group (21.5 deaths per 100 person-years), surgery with adjuvant treatment group (8.9 deaths per 100 person-years) and surgery only group (7.2 deaths per 100 person-years). The adjusted hazard ratios (HR) for all-cause arly-stage NSCLC and COPD.
mutant non-small cell lung cancer (NSCLC) is a heterogeneous disease. The treatment for frequent
mutations relies on tyrosine kinase inhibitors (TKIs); the clinical and therapeutic significance of uncommon EGFR mutations is uncertain.
This is a single-center retrospective study of patients with
-mutant lung cancer (2009-2017). learn more Molecular analyses of
exons 18-21 were performed. Only patients with uncommon mutations were included (p.Glu709X, p.Gly719X, p.Ala767_Val769 dup, p.Ser768Ile, and p.Leu861Gln).
Among 6,747 tumor samples, 95 out 820 patients (11.6%) harbored 113 uncommon
mutations. There were 50 metastatic NSCLC patients for whom the median OS was 18.0 months (95% CI 15, 32). In this population, the p.Leu861Gln uncommon exon 21
mutation was associated with poor prognosis (HR 2.96, 95% CI 1.39, 6.31; P=0.003). Among those harboring a single uncommon
mutation, median OS was 27.6 months (95% CI 10.8, not attained) in patients who were treated by chemotherapy only (n=13) versus 6.0 moncommon mutations and such patients should be treated accordingly.
The pandemic of COVID-19 caused confusion in medical settings because of increased patient load, and caused many infections among medical staff which occurred through exposure to bio-particles discharged from patients. The risk of exposure became maximum at the examination of patients, particularly in the collection of respiratory specimens. Effective interventions to reduce the risk are needed.
A one-person booth consisting of curtain walls, frames, and fan-HEPA filter-unit (FFU) was designed. Using the airstream from/to FFU, it has dual functions as a positive/negative pressure machine to prevent pathogens in patient's cough to reach the medical staff inside/outside the booth, respectively. The curtain walls and positioning of the patient and staff were aerodynamically optimized for the best control of the airstream.
The positive pressure booth is to isolate a staff inside to safely deal with a surge in the number of patients in situations like influenza pandemics. The negative pressure booth is to isdical staff due to an aerodynamically designed airstream from the FFU and curtains surrounding it. It could be applied to cases of not only COVID-19 or influenza but also of other dangerous, contagious respiratory diseases.
Surgical manipulation of a tumor can lead to shedding of tumor cells that can enter the circulation and lead to metastasis. The present study evaluated the clinical relevance of circulating tumor cells (CTCs) that were identified immediately after non-small cell lung cancer resection in patients without preoperative CTCs, and whether postoperative CTC detection was associated with recurrence.
Immediate preoperative testing for CTCs was performed for 147 patients with pulmonary nodules. This study included 81 lung cancer patients (55.1%) with negative preoperative results for CTCs and who completed postoperative testing for CTCs. The clinical relevance of postoperative CTC detection was evaluated based on the clinicopathological characteristics and recurrence patterns.
Among the eligible patients, the postoperative CTC results were none detected in 58 patients (71.6%, "Group N"), only a single CTC detected in 6 patients (7.4%, "Group S"), and CTC clusters detected in 17 patients (21.0%, "Group C"). The presence of postoperative CTCs was associated with tumor vessel invasion, lymph duct invasion, and pleural invasion. Distant metastasis was very common in cases with postoperatively detected CTC clusters. The 2-year recurrence-free survival rates were 94.6% for Group N, 62.5% for Group S, and 52.9% for Group C (P<0.01). Multivariate analysis revealed that recurrence was independently related to the postoperative detection of single CTCs and CTC clusters.
In cases without preoperative CTCs, we postoperatively detected CTCs and the postoperative CTC results were an independent predictor of recurrence.
In cases without preoperative CTCs, we postoperatively detected CTCs and the postoperative CTC results were an independent predictor of recurrence.
The present study evaluated Korean women with lung cancer and compared the clinical characteristics of ever-smoker and never-smoker groups using the National Lung Cancer Registry.
In affiliation with the Korean Central Cancer Registry, the Korean Association for Lung Cancer constructed a registry into which 10% of the lung cancer cases in Korea were registered. Female lung cancer patients with valid smoking history were evaluated.
Among 735 female lung cancer patients, 643 (87.5%) were never-smokers and 92 (12.5%) were smokers. The median survival was significantly longer in the never-smoker group (28
14 months; P<0.001). Among 683 patients with non-small cell lung cancer (NSCLC), the never-smoker group showed significantly longer median survival (29
14 months; P=0.002) and a higher proportion of stage I cancer (40.3%
25.7%; P<0.001). Survival analysis of the NSCLC patients showed that smoking status, receiving only supportive care, EGFR mutation status, lung cancer stage, and forced vital capacity (FVC) (%) were significantly associated with mortality in the multivariate analysis (P=0.
