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The results also demonstrate that the more explicit the evidence extracted from CEMRs, the better the performance. The RNKN gradually reveals the interpretation of knowledge embeddings as the number of training epochs increases. In this paper, we propose a novel method for the detection of small lesions in digital medical images. Our approach is based on a multi-context ensemble of convolutional neural networks (CNNs), aiming at learning different levels of image spatial context and improving detection performance. The main innovation behind the proposed method is the use of multiple-depth CNNs, individually trained on image patches of different dimensions and then combined together. In this way, the final ensemble is able to find and locate abnormalities on the images by exploiting both the local features and the surrounding context of a lesion. Experiments were focused on two well-known medical detection problems that have been recently faced with CNNs microcalcification detection on full-field digital mammograms and microaneurysm detection on ocular fundus images. To this end, we used two publicly available datasets, INbreast and E-ophtha. Statistically significantly better detection performance were obtained by the proposed ensemble with respect to other approaches in the literature, demonstrating its effectiveness in the detection of small abnormalities. OBJECTIVE Medical knowledge graph (KG) is attracting attention from both academic and healthcare industry due to its power in intelligent healthcare applications. In this paper, we introduce a systematic approach to build medical KG from electronic medical records (EMRs) with evaluation by both technical experiments and end to end application examples. MATERIALS AND METHODS The original data set contains 16,217,270 de-identified clinical visit data of 3,767,198 patients. The KG construction procedure includes 8 steps, which are data preparation, entity recognition, entity normalization, relation extraction, property calculation, graph cleaning, related-entity ranking, and graph embedding respectively. We propose a novel quadruplet structure to represent medical knowledge instead of the classical triplet in KG. A novel related-entity ranking function considering probability, specificity and reliability (PSR) is proposed. Besides, probabilistic translation on hyperplanes (PrTransH) algorithm is used to learn grlue. The reliability value can measure how reliable is the relationship between Si and Oij. The reason for the definition is the higher value of Nco(Si, Oij), the relationship is more reliable. However, the reliability values of the two relationships should not have a big difference if both of their co-occurrence numbers are very big. In our study, we finally set Ncomin = 10 and R = 1 after some experiments. For instance, if co-occurrence numbers of three relationships are 1, 100 and 10000, their reliability values are 1, 2.96 and 5 respectively. AIMS To systematically review the diagnostic value of the central vein sign (CVS) in multiple sclerosis (MS) and to meta-analyse the proportion of positive lesions for CVS needed to distinguish MS from non-MS mimics. MATERIALS AND METHODS A literature review was performed and a proportion meta-analysis was performed to examine the proportion of the CVS in MS lesions. Studies reporting a threshold of the CVS containing lesions with 100% diagnostic accuracy were included in the meta-analysis. This was compared to MS mimics in order to establish the discriminative value of the CVS. RESULTS The CVS was found to be viable at lower field strengths (3 T and 1.5 T) and automated analysis is currently less accurate than manual counting. Five studies were included for the proportional meta-analysis. From the analysis, a proportion of 45% of lesions having the CVS was suggested given that the findings that the weighted proportion was 46.4% (95% confidence interval [CI] of 40.3%-52.6%) with low heterogeneity (I2 = 0.0%; p=0.5). CONCLUSION Although the CVS is a clinically relevant and viable sign, further work is needed to integrate this into the existing diagnostic criteria. As manual determination is a time-consuming process, the development of automated methods will be beneficial. With improvements in computational imaging techniques, the CVS will have an important role in the diagnosis and differentiation of MS. BACKGROUND The aim of this study was to evaluate the accuracy of mitral regurgitation (MR) volume quantified on three-dimensional (3D) color Doppler transesophageal echocardiography (TEE) using new semiautomated software compared with conventional two-dimensional (2D) proximal isovelocity surface area (PISA) transthoracic echocardiography (TTE) and TEE and cardiac magnetic resonance imaging (CMR). METHODS Fifty-one patients (mean age, 63 ± 16 years; 35 men) prospectively underwent TTE, TEE, and CMR for MR evaluation. T3activator Regurgitant volume (RVol) by 3D MR flow quantification was compared with 2D TTE, TEE, and CMR, and the accuracy of evaluation of severe MR by 3D MR flow quantification was compared against guideline criteria by TEE. RESULTS Twenty-nine patients had severe MR, 16 had moderate MR, and six had mild MR. Three-dimensional MR flow quantification was feasible in all patients, including prolapse (n = 37), restriction (n = 9), functional MR (n = 5), and eccentric or multiple jects (n = 41). RVol on 3D MR ISA TTE and TEE. Cardiovascular imaging has an important role in the assessment and management of aortic root and thoracic aorta ectasia and aneurysms. Sinus of Valsalva aneurysms are rare entities. Unique complications associated with sinus of Valsalva aneurysms make them different from traditional aortic root aneurysms. Established guidelines on the diagnosis and management of sinus of Valsalva aneurysms are lacking. This article reviews the applications of multimodality cardiovascular imaging (echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging) for the dedicated assessment and imaging-guided management of sinus of Valsalva aneurysms. BACKGROUND Participatory art-based activities enhance the well-being and quality of life of patients. Few studies have examined the effects of these activities in community-dwelling older adults. This study aims to examine changes in well-being, quality of life and frailty associated with a weekly art-based activity, known as "Thursday at the Museum", performed at the Montreal Museum of Fine Arts (MMFA) in community-dwelling older adults. METHODS Based on a pre-post intervention, single-arm, prospective and longitudinal design, 130 community-dwelling older adults (mean age 71.6 ± 4.9, 91.5 % female) were enrolled and completed this experimental study. The intervention was a participatory art-based activity carried out at the MMFA. Groups of participants (30-45 individuals) met for 2.3 h once a week for a 12-week period (defining a session). Before and after the first (M0), the fifth (M1), the ninth (M2) and the twelfth (M3) workshops, well-being was assessed. Quality of life, frailty, physician visits and hospitalizations were also assessed. RESULTS The mean well-being score improved after each workshop compared with baseline (P ≤ 0.001), i.e., from M0 to M3. The magnitude of this change in well-being was significant at M3 when M0 was used as a reference value (coefficient of regression beta (ß) = 3.22 with P = 0.037). Quality of life gradually increased from M1 to M3 (ß increased from -0.50 to -2.1 with all P-values ≤0.003). The proportion of vigorous participants increased significantly, whereas the proportion of mild frail participants decreased at M3 only (ß=-0.70 with P = 0.001). CONCLUSION The MMFA participatory art-based activity session had multidimensional positive effects on mental and physical health outcomes. These results suggest that museums may become key partners in public health policy initiatives for health prevention in older populations. TRIALREGISTRATION NCT03557723. OBJECTIVES We investigated trends in end-of-life hospitalizations among nursing home residents (NHR) over 10 years and looked at differences between age groups and sexes as well as the length of terminal hospital stays. STUDY DESIGN Retrospective cohort study based on health insurance claims data of the AOK Bremen/Bremerhaven. All NHR aged 65 years or more who died between 2006 and 2015 were included. MAIN OUTCOME MEASURES We assessed the proportions of decedents who were in hospital on the day of death and during the last 3, 7, 14 and 30 days of life, stratified by two-year periods. Multiple logistic regressions were conducted to study changes over time, adjusting for covariates. RESULTS A total of 10,781 decedents were included (mean age 86.1 years, 72.1 % females). link2 Overall, 29.2 % died in hospital, with a slight decrease from 30.3 % in 2006-2007 to 28.3 % in 2014-2015 (OR 0.86; 95 % CI 0.75-0.98). Of the 3150 terminal hospitalizations, 35.5 % lasted up to 3 days and the mean length of stay decreased from 9.0 (2006-2007) to 7.5 days (2014-2015). When looking at the last 7, 14 and 30 days of life, no changes over time were found. Male sex and younger age were associated with a higher chance of end-of-life hospitalization in almost all analyses. CONCLUSIONS End-of-life hospitalizations of NHR are common in Germany. There has been a small decrease during recent years in the proportion of in-hospital deaths, but not of hospitalizations during the last 7, 14 and 30 days of life. This might be explained by shorter durations of hospital stays. OBJECTIVES The purpose of this study was to assess the association between fruit intake and abnormalities in body composition (bone, muscle, and adipose tissue) related to osteosarcopenic obesity (OSO) in postmenopausal women. STUDY DESIGN The data of 1420 postmenopausal women aged 50-64 years were collected from cross-sectional studies conducted by the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2010. MAIN OUTCOME MEASURES A dietary intake survey was administered using the 24-h dietary recall method, and intakes of nutrients and food groups were analyzed. Body composition was evaluated using dual-energy x-ray absorptiometry (DEXA). Body composition abnormalities include low bone mass (T-score less then -1.0), low muscle mass (weight-adjusted appendicular skeletal muscle mass below the mean reference value of healthy young adults), and obesity (waist circumference ≥85 cm). link3 The associations between nutrient intake and fruit groups and the number of abnormalities in body composition were tested by logistic regression analysis. RESULTS The intakes of vitamin C and potassium per 1000 kcal of total energy intake were significantly lower in women with a larger number of abnormalities in body composition (p = 0.0155 and p = 0.0037, respectively). After controlling for covariates, women with a high intake of fruit (≥257.4 g/d) had a significantly reduced likelihood of multiple abnormalities in body composition compared with women with no fruit intake (p for trend p less then 0.01 for those with one, two, or three abnormalities). CONCLUSIONS Intake of fruits rich in vitamin C and potassium may help to decrease OSO-related risks in middle-aged postmenopausal women.