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Grapevine leaves are utilized worldwide in a vast range of traditional cuisines. As their price and flavor differ from kind to kind, recognizing various species of grapevine leaves is becoming an essential task. In addition, the differentiation between grapevine leaf types by human sense is difficult and time-consuming. Thus, building a machine learning model to automate the grapevine leaf classification is highly beneficial. Therefore, this is the primary focus of this work. This paper uses a CNN-based model to classify grape leaves by adapting DenseNet201. This study investigates the impact of layer freezing on the performance of DenseNet201 throughout the fine-tuning process. This work used a public dataset consist of 500 images with 5 different classes (100 images per class). Several data augmentation methods used to expand the training set. The proposed CNN model, named DenseNet-30, outperformed the existing grape leaf classification work that the dataset borrowed from by achieving 98% overall accuracy.

Background Motor impairment after stroke is due not only to direct tissue loss but also to disrupted connectivity within the motor network. Mixed results from studies attempting to enhance motor recovery with Transcranial Magnetic Stimulation (TMS) highlight the need for a better understanding of both connectivity after stroke and the impact of TMS on this connectivity. This study used TMS-EEG to map the causal information flow in the motor network of healthy adult subjects and define how stroke alters these circuits. Methods Fourteen stroke patients and 12 controls received TMS to two sites (bilateral primary motor cortices) during two motor tasks (paretic/dominant hand movement vs. rest) while EEG measured the cortical response to TMS pulses. TMS-EEG based connectivity measurements were derived for each hemisphere and the change in connectivity (ΔC) between the two motor tasks was calculated. We analyzed if ΔC for each hemisphere differed between the stroke and control groups or across TMS sites, and whether ΔC correlated with arm function in stroke patients. Results Right hand movement increased connectivity in the left compared to the right hemisphere in controls, while hand movement did not significantly change connectivity in either hemisphere in stroke. Stroke patients with the largest increase in healthy hemisphere connectivity during paretic hand movement had the best arm function. Conclusions TMS-EEG measurements are sensitive to movement-induced changes in brain connectivity. These measurements may characterize clinically meaningful changes in circuit dynamics after stroke, thus providing specific targets for trials of TMS in post-stroke rehabilitation.

Current guidelines regarding treatment for germ-cell tumors (GCTs) emphasizes cautious progression focusing on stage-specific treatments. Presented herein is the case of a 30-year-old man who, through monitoring of serum alpha-fetoprotein (AFP) levels and surveillance imaging, avoided excessive treatment. This case demonstrates how an experienced clinician, familiar with natural history of GCTs, can appropriately classify level of risk and allow a patient to preserve natural fertility. Furthermore, we highlight the potential for miRNA analysis in staging and management of GCTs. This case serves to underscore the importance of acting with caution in the pursuit of the best outcome for our patients.

Objective Primary objective is to determine the rate of intubation with inappropriately sized endotracheal tubes (ETTs) in a pediatric intensive care unit (PICU) in El Salvador. Secondary objective is to determine effectiveness of a video-based curriculum to teach local providers on pediatric advanced airway management and surgical approach to patients requiring airway reconstruction. Methods Data for 296 intubated pediatric patients was collected over a six month period in a 16-bed PICU in El Salvador. Results of a learning behavior assessment survey completed by local healthcare workers informed a curriculum to complement on-site education during annual surgical airway mission trips. The video-based curriculum addressed proper sizing and use of cuffed endotracheal tubes, care of the intubated child and perioperative considerations of the surgical airway patient. Providers completed pre and post-curriculum quizzes to measure knowledge acquisition. Results Over 6-months, 281 patients were intubated. Sixty-three percent had improperly sized ETTs. Thirty-one percent had a failed or accidental extubation. All-cause mortality was 24%. One hundred and fifty-nine Salvadorian providers completed a learning behavior survey informing a video-based curriculum. Sixty-four providers completed the curriculum. Post-curriculum quiz scores increased by 18.7%. Surgeons, anesthesiologist, intensivists and speech pathologists demonstrated significant improvement (p Conclusion Nearly two-thirds of intubated patients in a PICU in El Salvador have improperly sized ETTs and one-third require reintubation following planned or accidental extubation. The development of this first of its kind video-based curriculum for critical care and surgical training regarding how to properly care for the intubated child is coupled with the development of a longitudinal database to record pediatric airway related morbidity and mortality in the largest pediatric hospital in El Salvador. This model and system can be used to track the reduction in airway related morbidity and mortality directly related to a systems based intervention both in El Salvador and then elsewhere.

The lateral prefrontal cortex, a region with both structural and functional connectivity to the amygdala, has been consistently implicated in the downregulation of subcortical-generated emotional responses. Although previous work has demonstrated that the ventral lateral prefrontal cortex (vlPFC) is important to emotion processing, no study has interrupted vlPFC function in order to test is role in emotion perception. In the current study, we acutely disrupted vlPFC function in twenty healthy adult participants by administering sham stimulation and transcranial magnetic stimulation (TMS), in randomized order, during performance of an emotional perception task. During sham stimulation, participants demonstrated increased perceptual sensitivity for happy faces compared to angry faces. Disruption of the vlPFC eliminated this difference: in this condition, perceptual sensitivity did not differ between happy and angry faces. Reaction times and response bias did not differ between emotions or TMS conditions. This pattern of perceptual bias is consistent with effects observed in a wide range of affective disorders, in which vlPFC dysfunction has also been reported. This study provides insight into a possible mechanism through which the vlPFC may contribute to emotion perception.

This paper discusses the role of technology in overcoming existing barriers to education and employment faced by people with specific learning disabilities and illustrates the discussion by the example of the Learnmaths toolbox for people with specific learning disabilities in mathematics. The context of the toolbox is respect for equality and diversity and consequently the recognition that different approaches to learning are equally valid and that the cognitive processes of people with specific learning disabilities can lead to creativity and innovation.

The authors address the following two fundamental questions in the theory of exact aggregation: (1) What restrictions, if any, need to be imposed on the vector of aggregates in order that the aggregate demand functional representation be nontrivial and economically interesting? (2) What economic restrictions, if any, does exact aggregation impose on demand functions, both at the ind ividual and aggregate levels? The answer to the first question involv es the information censored or masked by the aggregates. The answer t o the second question involves a condition known as the finite basis property, and its implications for Engel curve similarity across pric es, commodities, and consumers. Copyright 1988 by Economics Department of the University of Pennsylvania and the Osaka University Institute of Social and Economic Research Association.

Platelet agonists and subendothelial extra-cellular matrix (ECM) induce morphological and biochemical changes in animal megakaryocytes, reminiscent of the response of platelets to the same substances. We have examined the behavior of human megakaryocytes exposed for up to 36 hours to the ECM produced by cultured bovine corneal endothelial cells. By phase contrast and scanning electron microscopy these megakaryocytes demonstrated non-reversible adherence and flattening with formation of long filopodia, thus confirming that human megakaryocytes acquire platelet functional capacities. In addition, megakaryocyte fragmentation into prospective platelets was apparently induced by the ECM. Up to 50% of the adherent megakaryocytes underwent spontaneous fragmentation into small particles which individually reacted like platelets on the ECM. The interaction of the megakaryocytes with the ECM was specific since no adherence, flattening or fragmentation occured upon incubation of the megakaryocytes on regular tissue culture plastic or glutaraldehyde fixed ECM. Thus we have demonstrated platelet like behaviour of human megakaryocytes in response to this physiological basement membrane and a possible role of the subendothelium in platelet production which may occur in vivo as megakaryocytes cross the sinusoid walls and enter the blood stream.