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Abstract Interstitial fibrosis assessment by renal pathologists lacks good agreement, and we aimed to investigate its hidden properties and infer possible clinical impact. Fifty kidney biopsies were assessed by 9 renal pathologists and evaluated by intraclass correlation coefficients (ICCs) and kappa statistics. Probabilities of pathologists’ assessments that would deviate far from true values were derived from quadratic regression and multilayer perceptron nonlinear regression. Likely causes of variation in interstitial fibrosis assessment were investigated. Possible misclassification rates were inferred on reported large cohorts. We found inter-rater reliabilities ranged from poor to good (ICCs 0.48 to 0.90), and pathologists’ assessments had the worst agreements when the extent of interstitial fibrosis was moderate. 33.5% of pathologists’ assessments were expected to deviate far from the true values. Variation in interstitial fibrosis assessment was found to be correlated with variation in interstitial inflammation assessment (r2 = 32.1%). Taking IgA nephropathy as an example, the Oxford T scores for interstitial fibrosis were expected to be misclassified in 21.9% of patients. This study demonstrated the complexity of the inter-rater reliability of interstitial fibrosis assessment, and our proposed approaches discovered previously unknown properties in pathologists’ practice and inferred a possible clinical impact on patients.

Abstract Interstitial inflammation scoring is incorporated into the Banff Classification of Renal Allograft Pathology and is essential for the diagnosis of T-cell mediated rejection. However, its reproducibility, including inter-rater and intra-rater reliabilities, has not been carefully investigated. In this study, eight renal pathologists from different hospitals independently scored 45 kidney allograft biopsies with varying extents of interstitial inflammation. Inter-rater reliabilities and intra-rater reliabilities were investigated by kappa statistics and conditional agreement probabilities. Individual pathologists’ scoring patterns were examined by chi-squared tests and proportions tests. The mean pairwise kappa values for inter-rater reliability were 0.27, 0.30, and 0.26 for the Banff i score, ti score, and i-IFTA, respectively. No rater pair performed consistently better or worse than others on all three scorings. After dichotomizing the scores into two groups (none/mild and moderate/severe inflammation), the averaged conditional agreements ranged from 47.1% to 50.0%. The distributions of the scores differed, but some pathologists persistently scored higher or lower than others. Given the important role of interstitial inflammation scoring in the diagnosis of T-cell mediated rejection, transplant practitioners should be aware of the possible clinical implications of the far-from-optimal reproducibility.

Measurement(s) Therapeutic Effect Technology Type(s) Artificial Intelligence Factor Type(s) whole slide image Sample Characteristic - Environment pathologic primary tumor stage for ovary according to AJCC 7th edition

Abstract Every year cervical cancer affects more than 300,000 people, and on average one woman is diagnosed with cervical cancer every minute. Early diagnosis and classification of cervical lesions greatly boosts up the chance of successful treatments of patients, and automated diagnosis and classification of cervical lesions from Papanicolaou (Pap) smear images have become highly demanded. To the authors’ best knowledge, this is the first study of fully automated cervical lesions analysis on whole slide images (WSIs) of conventional Pap smear samples. The presented deep learning-based cervical lesions diagnosis system is demonstrated to be able to detect high grade squamous intraepithelial lesions (HSILs) or higher (squamous cell carcinoma; SQCC), which usually immediately indicate patients must be referred to colposcopy, but also to rapidly process WSIs in seconds for practical clinical usage. We evaluate this framework at scale on a dataset of 143 whole slide images, and the proposed method achieves a high precision 0.93, recall 0.90, F-measure 0.88, and Jaccard index 0.84, showing that the proposed system is capable of segmenting HSILs or higher (SQCC) with high precision and reaches sensitivity comparable to the referenced standard produced by pathologists. Based on Fisher’s Least Significant Difference (LSD) test (P < 0.0001), the proposed method performs significantly better than the two state-of-the-art benchmark methods (U-Net and SegNet) in precision, F-Measure, Jaccard index. For the run time analysis, the proposed method takes only 210 seconds to process a WSI and is 20 times faster than U-Net and 19 times faster than SegNet, respectively. In summary, the proposed method is demonstrated to be able to both detect HSILs or higher (SQCC), which indicate patients for further treatments, including colposcopy and surgery to remove the lesion, and rapidly processing WSIs in seconds for practical clinical usages.

Background: The few previous studies that focused on the effects of compression garments (CG) on distance running performance have simultaneously measured electromyogram, physiological, and perceptual parameters. Therefore, this study investigated the effects of CG on muscle activation and median frequency during and after distance running, as well as blood-lactate concentration and rating of perceived exertion (RPE) during distance running. Methods: Eight healthy male recreational runners were recruited to randomly perform two 40 min treadmill running trials, one with CG, and the other with control garment made of normal cloth. The RPE and the surface electromyography (EMG) of 5 lower extremity muscles including gluteus maximus (GM), rectus femoris (RF), semitendinosus (ST), tibialis anterior (TA), and gastrocnemius (GAS) were measured during the running trial. The blood-lactate levels before and after the running trial were measured. Results: Wearing CG led to significant lower muscle activation (p 0.05). Conclusion: Wearing CG was associated with significantly lower muscle activation and higher median frequency in the running-related key muscles during distance running. This finding suggested that wearing CG may improve muscle function, which might enhance running performance and prevent muscle fatigue.

Background and Aims: Running can induce advantageous cardiovascular effects such as improved arterial stiffness and blood-supply perfusion. However, the differences between the vascular and blood-flow perfusion conditions under different levels of endurance-running performance remains unclear. The present study aimed to assess the vascular and blood-flow perfusion conditions among 3 groups (44 male volunteers) according to the time taken to run 3 km: Level 1, Level 2, and Level 3. Methods: The radial blood pressure waveform (BPW), finger photoplethygraphy (PPG), and skin-surface laser-Doppler flowmetry (LDF) signals of the subjects were measured. Frequency-domain analysis was applied to BPW and PPG signals; time- and frequency-domain analyses were applied to LDF signals. Results: Pulse waveform and LDF indices differed significantly among the three groups. These could be used to evaluate the advantageous cardiovascular effects provided by long-term endurance-running training, such as vessel relaxation (pulse waveform indices), improvement in blood supply perfusion (LDF indices), and changes in cardiovascular regulation activities (pulse and LDF variability indices). Using the relative changes in pulse-effect indices, we achieved almost perfect discrimination between Level 3 and Level 2 (AUC = 0.878). Furthermore, the present pulse waveform analysis could also be used to discriminate between the Level-1 and Level-2 groups. Conclusions: The present findings contribute to the development of a noninvasive, easy-to-use, and objective evaluation technique for the cardiovascular benefits of prolonged endurance-running training.

Abstract We describe a case of human herpes virus‐8‐associated primary effusion lymphoma (PEL) in a patient initially presented with fever, non‐productive cough and exertional dyspnoea. Physical examination revealed oral thrush, diminished breath sounds and dullness on percussion over the left hemithorax. A thoracic computed tomography (CT) revealed left‐sided massive pleural effusion without tumour masses or lymphadenopathy. The effusion was drained and cytology showed medium to large lymphoid cells, with prominent nucleoli and irregular nuclear contours. Meanwhile, his HIV was tested positive. Cell block immunostaining of the pleural effusion revealed these cells were CD45 (+), CD30 (+), MUM1 (melanoma‐associated antigen [mutated] 1) (+), LANA (latency‐associated nuclear antigen) (+) and EBER (Epstein–Barr virus‐encoded small RNAs) in situ hybridization (−). This case highlights the learning point that PEL in the setting of HIV/AIDS should be added in the differential diagnosis of patients with unexplained oropharyngeal candidiasis and malignant lymphomatous pleural effusion without a clear primary site.

Abstract Background Gastric cancer is the fourth most common malignant disease worldwide, with lower one-third gastric cancer the most common type. Distal gastrectomy with D2 lymph node dissection was recommended as a standard surgery for distal gastric cancer patients. However, some controversy remains about the anastomosis of the residual stomach and the intestine. The objectives of this trial are to test the hypothesis that uncut Roux-en-Y anastomosis can reduce postoperative complications and improve nutritional status more effectively than Billroth II anastomosis in gastric cancer patients after D2 gastrectomy. Methods/design This multi-center, prospective, phase III, randomized controlled trial will compare the efficacy of uncut Roux-en-Y anastomosis versus Billroth II anastomosis in phase I–III patients with initial treatment of radical distal gastrectomy. Patients will be randomized to undergo either the intervention (uncut Roux-en-Y anastomosis) or the control (Billroth II anastomosis). We will recruit 832 patients who meet the trial eligibility criteria and will follow the patients after surgery to observe postoperative complications and nutrition status for 5 years. The primary assessment indices of the study are reflux gastritis, esophagitis, bile regurgitation, and anastomotic ulcer. The secondary assessment indices are nutritional status, quality of life, perioperative complications, overall survival rate, and others. When the number of cases reaches 400, an interim analysis will be performed to identify any evidence of definite superiority of the experimental intervention. Discussion We aim to test the hypothesis that uncut Roux-en-Y anastomosis can reduce postoperative complications and improve nutritional status more than Billroth II anastomosis in gastric cancer patients after D2 gastrectomy. The results of the trial will contribute to the best evidence on which to base the reconstruction of distal gastrectomy. Trial registration Chinese Southern Gastric Cancer Conference CSGC002 Trial. ClinicalTrials.gov, NCT02763878. Registered on 5 May 2016.

Lung cancer is the biggest cause of cancer-related death worldwide. An accurate nodal staging is critical for the determination of treatment strategy for lung cancer patients. Endobronchial-ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has revolutionized the field of pulmonology and is considered to be extremely sensitive, specific, and secure for lung cancer staging through rapid on-site evaluation (ROSE), but manual visual inspection on the entire slide of EBUS smears is challenging, time consuming, and worse, subjective, on a large interobserver scale. To satisfy ROSE’s needs, a rapid, automated, and accurate diagnosis system using EBUS-TBNA whole-slide images (WSIs) is highly desired to improve diagnosis accuracy and speed, minimize workload and labor costs, and ensure reproducibility. We present a fast, efficient, and fully automatic deep-convolutional-neural-network-based system for advanced lung cancer staging on gigapixel EBUS-TBNA cytological WSIs. Each WSI was converted into a patch-based hierarchical structure and examined by the proposed deep convolutional neural network, generating the segmentation of metastatic lesions in EBUS-TBNA WSIs. To the best of the authors’ knowledge, this is the first research on fully automated enlarged mediastinal lymph node analysis using EBUS-TBNA cytological WSIs. We evaluated the robustness of the proposed framework on a dataset of 122 WSIs, and the proposed method achieved a high precision of 93.4%, sensitivity of 89.8%, DSC of 82.2%, and IoU of 83.2% for the first experiment (37.7% training and 62.3% testing) and a high precision of 91.8 ± 1.2, sensitivity of 96.3 ± 0.8, DSC of 94.0 ± 1.0, and IoU of 88.7 ± 1.8 for the second experiment using a three-fold cross-validation, respectively. Furthermore, the proposed method significantly outperformed the three state-of-the-art baseline models, including U-Net, SegNet, and FCN, in terms of precision, sensitivity, DSC, and Jaccard index, based on Fisher’s least significant difference (LSD) test (p<0.001). For a computational time comparison on a WSI, the proposed method was 2.5 times faster than U-Net, 2.3 times faster than SegNet, and 3.4 times faster than FCN, using a single GeForce GTX 1080 Ti, respectively. With its high precision and sensitivity, the proposed method demonstrated that it manifested the potential to reduce the workload of pathologists in their routine clinical practice.

Background: The utility of urinary extracellular vesicles (uEVs) to faithfully represent the changes of renal tubular protein expression remains unclear. We aimed to evaluate renal tubular sodium (Na+) or potassium (K+) associated transporters expression from uEVs and kidney tissues in patients with Gitelman syndrome (GS) caused by inactivating mutations in SLC12A3.Methods: uEVs were isolated by ultracentrifugation from 10 genetically-confirmed GS patients. Membrane transporters including Na+-hydrogen exchanger 3 (NHE3), Na+/K+/2Cl− cotransporter (NKCC2), NaCl cotransporter (NCC), phosphorylated NCC (p-NCC), epithelial Na+ channel β (ENaCβ), pendrin, renal outer medullary K1 channel (ROMK), and large-conductance, voltage-activated and Ca2+-sensitive K+ channel (Maxi-K) were examined by immunoblotting of uEVs and immunofluorescence of biopsied kidney tissues. Healthy and disease (bulimic patients) controls were also enrolled.Results: Characterization of uEVs was confirmed by nanoparticle tracking analysis, transmission electron microscopy, and immunoblotting. Compared with healthy controls, uEVs from GS patients showed NCC and p-NCC abundance were markedly attenuated but NHE3, ENaCβ, and pendrin abundance significantly increased. ROMK and Maxi-K abundance were also significantly accentuated. Immunofluorescence of the representative kidney tissues from GS patients also demonstrated the similar findings to uEVs. uEVs from bulimic patients showed an increased abundance of NCC and p-NCC as well as NHE3, NKCC2, ENaCβ, pendrin, ROMK and Maxi-K, akin to that in immunofluorescence of their kidney tissues.Conclusion: uEVs could be a non-invasive tool to diagnose and evaluate renal tubular transporter adaptation in patients with GS and may be applied to other renal tubular diseases.

Endometrial carcinoma (EC) is the most common gynecological cancer. However, there is currently no routinely used biomarker for differential diagnosis of malignant and premalignant endometrial lesions. Ten-eleven translocation (TET) proteins, especially TET1, were found to play a significant role in DNA demethylation, via conversion of 5-methylcytosine (5-mC) to 5-hydroxymethylcytosine (5-hmC). TET1, 5-mC, and 5-hmC expression profiles in endometrial carcinogenesis are currently unclear. We conducted a hospital-based retrospective review of the immunohistochemical expression of TET1, 5-mC, and 5-hmC in 181 endometrial samples. A “high” TET1 and 5-hmC expression score was observed in all cases of normal endometrium (100.0% and 100.0%, respectively) and in most samples of endometrial hyperplasia without atypia (90.9% and 78.8%, respectively) and atypical hyperplasia (90.6% and 93.8%, respectively), but a “high” score was found in only less than half of the EC samples (48.8% and 46.5%, respectively). The TET1 and 5-hmC expression scores were significantly higher in normal endometrium and premalignant endometrial lesions than in ECs (p < 0.001). A “high” 5-mC expression score was observed more frequently for ECs (81.4%) than for normal endometrium (40.0%), endometrial hyperplasia without atypia (51.5%), and atypical hyperplasia (53.1%) (p < 0.001). We also found that TET1 mRNA expression was lower in ECs compared to normal tissues (p = 0.0037). TET1 immunohistochemistry (IHC) scores were highly proportional to the TET1 mRNA levels and we summarize that the TET1 IHC scoring can be used for biomarker determinations. Most importantly, a higher TET1 score in EC cases was associated with a good overall survival (OS) rate, with a hazard ratio (HR) of 0.31 for death (95% confidence interval: 0.11–0.84). Our findings suggest that TET1, 5-mC, and 5-hmC expression is a potential histopathology biomarker for the differential diagnosis of malignant and premalignant endometrial lesions. TET1 is also a potential prognostic marker for EC.

Rhizoctonia solani (Rs), a soil-borne fungal pathogen, can result in rice sheath blight (ShB), which causes yield loss. To prevent outbreaks of ShB and enhance the sustainability of rice production, it is critical to develop a rapid ShB detection method for specific, fast, and on-site disease management. In this study, a reagent for the rapid extraction of this pathogen was developed for on-site detection. The specificity and sensitivity of a novel SMS RS1-F/SMS RS1-R primer set and a ITS1/GMRS-3 reference primer set were tested, while four different extraction protocols for ShB were developed. Moreover, intraday and interday assays were performed to evaluate the reproducibility of the detection methods developed. The results indicated that all of the developed protocols are suitable for use in detecting ShB. In addition, all the samples of infected rice yielded positive Rs detection results when subjected to TaqMan probe-based real-time PCR and SYBR green-based real-time PCR (SMS RS1-F/SMS RS1-R) tests in which automatic magnetic bead-based DNA extraction was performed. These results indicated that the two molecular detection protocols were suitable for the field diagnosis of ShB for all asymptomatic and symptomatic rice samples.

Cardiac complications caused by metastatic gastric cancer are rarely reported. Here, we report a 58-year old woman who presented with chronic cough and intermittent shortness of breath for weeks. Chest radiographs showed a cardiac silhouette sign and a small amount of pleural effusion. After serial examinations including biopsy of the pericardium, ovarian and stomach, metastatic strong HER2/neu expressive signet-ring cell carcinoma of the stomach was diagnosed. Despite aggressive management with best supportive care and intravenous administration of trastuzumab, the patient died of respiratory failure and refractory pleural effusion. Through this case, we demonstrate that HER2/neu positive metastatic gastric cancer can initially present with these unusual cardiac and systemic manifestations. Primary clinical physicians should be aware of this unusual manifestation of gastric cancer.

Banana (Musa sp.) is cultivated worldwide and is one of the most popular fruits. The soil-borne fungal disease Fusarium wilt of banana (FWB), commonly known as Panama disease, is caused by Fusarium oxysporum f. sp. cubense (Foc) and is a highly lethal vascular fungal disease in banana plants. Raman spectroscopy, an emerging laser-based technology based on Raman scattering, has been used for the qualitative characterization of biological tissues such as foodborne pathogens, cancer cells, and melamine. In this study, we describe a Raman spectroscopic technique that could potentially be used as a method for diagnosing FWB. To that end, the Raman fingerprints of Foc (including mycelia and conidia) and Foc-infected banana pseudostems with varying levels of symptoms were determined. Our results showed that eight, eleven, and eleven characteristic surface-enhanced Raman spectroscopy peaks were observed in the mycelia, microconidia, and macroconidia of Foc, respectively. In addition, we constructed the Raman spectroscopic fingerprints of banana pseudostem samples with varying levels of symptoms in order to be able to differentiate Foc-infected bananas from healthy bananas. The rate at which FWB was detected in asymptomatic Foc-infected samples by using the spectral method was 76.2%, which was comparable to the rates previously reported for other FWB detection methods based on real-time PCR assays, suggesting that the spectral method described herein could potentially serve as an alternative tool for detecting FWB in fields. As such, we hope that the developed spectral method will open up new possibilities for the on-site diagnosis of FWB.

Background: Walking while performing cognitive and motor tasks simultaneously interferes with gait performance and may lead to falls in older adults with mild cognitive impairment (MCI). Executive function, which seems to play a key role in dual-task gait performance, can be improved by combined physical and cognitive training. Virtual reality (VR) has the potential to assist rehabilitation, and its effect on physical and cognitive function requires further investigation. The purpose of this study was to assess the effects of VR-based physical and cognitive training on executive function and dual-task gait performance in older adults with MCI, as well as to compare VR-based physical and cognitive training with traditional combined physical and cognitive training.Method: Thirty-four community-dwelling older adults with MCI were randomly assigned into either a VR-based physical and cognitive training (VR) group or a combined traditional physical and cognitive training (CPC) group for 36 sessions over 12 weeks. Outcome measures included executive function [Stroop Color and Word Test (SCWT) and trail making test (TMT) A and B], gait performance (gait speed, stride length, and cadence) and dual-task costs (DTCs). Walking tasks were performed during single-task walking, walking while performing serial subtraction (cognitive dual task), and walking while carrying a tray (motor dual task). The GAIT Up system was used to evaluate gait parameters including speed, stride length, cadence and DTCs. DTC were defined as 100 * (single-task gait parameters − dual-task gait parameters)/single-task gait parameters.Results: Both groups showed significant improvements in the SCWT and single-task and motor dual-task gait performance measures. However, only the VR group showed improvements in cognitive dual-task gait performance and the DTC of cadence. Moreover, the VR group showed more improvements than the CPC group in the TMT-B and DTC of cadence with borderline significances.Conclusion: A 12-week VR-based physical and cognitive training program led to significant improvements in dual-task gait performance in older adults with MCI, which may be attributed to improvements in executive function.

This study classified the gait patterns of normal and stroke participants by using time- and frequency-domain features obtained from data provided by an inertial measurement unit sensor placed on the subject’s lower back (L5). Twenty-three participants were included and divided into two groups: healthy group (young and older adults) and stroke group. Time- and frequency-domain features from an accelerometer were extracted, and a feature selection method comprising statistical analysis and signal-to-noise ratio (SNR) calculation was used to reduce the number of features. The features were then used to train four Support Vector Machine (SVM) kernels, and the results were subsequently compared. The quadratic SVM kernel had the highest accuracy (93.46%), as evaluated through cross-validation. Moreover, when different datasets were used on model testing, both the quadratic and cubic kernels showed the highest accuracy (96.55%). These results demonstrated the effectiveness of this study’s classification method in distinguishing between normal and stroke gait patterns, with only using a single sensor placed on the L5.

Silver particles were prepared by dewetting Ag films coated on glass using a fiber laser. The size of the particles was controlled in the range of 92 nm−1.2 μm by adjusting the thickness of the Ag film. The structural properties and surface roughness of the particles were evaluated by means of scanning electron microscopy. In addition, the antifungal activity of the Ag particles was examined using spore suspensions of Colletotrichum gloeosporioides. It is shown that particles with a size of 1.2 μm achieved 100% inhibition of conidia growth of C. gloeosporioides after a contact time of just 5 min. Furthermore, the smaller particles also achieved good antifungal activity given a longer contact time. Similar results were observed for spore germination and pathogenicity tests performed on mango fruit and leaves. Overall, the results confirm that Ag particles have an excellent antifungal effect on C. gloeosporioides.

This study is aimed at determining the effects of midsole thickness on movement characteristic during side cutting movement. Fifteen athletes performed side-step cutting while wearing shoes with varying midsole thicknesses. Temporal-spatial and ground reaction force variables as well as foot and ankle frontal kinematics were used to describe breaking and propulsive movement characteristics and modulation strategies. Regardless of midsole thickness, temporal-spatial variables and breaking and propulsive force during side cutting were statistically unchanged. Significantly greater peaks of ankle inversion and plantarflexion with a thicker sole and greater midtarsal pronation with a thinner sole were observed. Current results demonstrated that hypotheses formed solely based on material testing were insufficient to understand the adaptations in human movement because of the redundancy of the neuromusculoskeletal system. Participants were able to maintain temporal-spatial performance during side cutting while wearing shoes with midsoles of varying thicknesses. Increased pronation for a thinner sole might help reduce the force of impact but might be associated with an increased risk of excessive stress on soft tissue. Increased peak of ankle inversion and plantarflexion for a thicker sole may be unfavorable for the stability of ankle joint. Information provided in human movement testing is crucial for understanding factors associated with movement characteristics and injury and should be considered in the future development of shoe design.

Electromyography (EMG) sensors have been used to study the sequence of muscle contractions during sit-to-stand (STS) in post-stroke patients. However, the majority of the studies used wired sensors with a limited number of placements. Using the latest improved wearable technology with 16 sensors, the current study was a thorough investigation to evaluate the contraction sequences of eight key muscles on the trunk and bilateral limbs during STS in post-stroke patients, as it became feasible. Multiple wearable sensors for the detection of muscle contraction sequences showed that the post-stroke patients performed STS with abnormal firing sequences, not only in the primary mover on the sagittal plane during raising, but also in the tibialis anterior, which may affect anticipatory postural adjustment in the gluteus medius, which may affect balance control. The abnormal tibialis anterior contraction until the early ascending phase and the delayed firing of the gluteus muscles highlight the importance of whole-kinetic-chain monitoring of contraction sequences using wearable sensors. The findings can be helpful for the design of therapeutic exercises.

The aim of this study was to conduct a comprehensive analysis of the placement of multiple wearable sensors for the purpose of analyzing and classifying the gaits of patients with neurological disorders. Seven inertial measurement unit (IMU) sensors were placed at seven locations: the lower back (L5) and both sides of the thigh, distal tibia (shank), and foot. The 20 subjects selected to participate in this study were separated into two groups: stroke patients (11) and patients with neurological disorders other than stroke (brain concussion, spinal injury, or brain hemorrhage) (9). The temporal parameters of gait were calculated using a wearable device, and various features and sensor configurations were examined to establish the ideal accuracy for classifying different groups. A comparison of the various methods and features for classifying the three groups revealed that a combination of time domain and gait temporal feature-based classification with the Multilayer Perceptron (MLP) algorithm outperformed the other methods of feature-based classification. The classification results of different sensor placements revealed that the sensor placed on the shank achieved higher accuracy than the other sensor placements (L5, foot, and thigh). The placement-based classification of the shank sensor achieved 89.13% testing accuracy with the Decision Tree (DT) classifier algorithm. The results of this study indicate that the wearable IMU device is capable of differentiating between the gait patterns of healthy patients, patients with stroke, and patients with other neurological disorders. Moreover, the most favorable results were reported for the classification that used the combination of time domain and gait temporal features as the model input and the shank location for sensor placement.

This study aimed to find the correlation between conventional Arch Index (AI) measurements and our prototype of a simplified insole-based plantar pressure measurement system and to find out the effective plantar pressure sensor position. Twenty-one subjects participated in this study, which was divided into two groups: 10 subjects with flatfoot and 11 subjects with normal foot. Five force sensitive resistance sensors were used on this prototype using Arduino as the data acquisition device. Two types of trials, namely static and dynamic, were conducted to validate our system against the ink-type AI measurement as a golden standard. The results showed that in the static trial, there was a high linear correlation with the medial arch sensor configuration, while in the dynamic trial, there was a high linear correlation in the medial arch sensor configuration and sensor 5 configuration. This study showed that both static and dynamic tests using the self-developed device could effectively determine most of the flatfoot subjects and suggests that in the future, it can be applied in clinical applications because of its advantages when compared to the expensive-high tech graphic input board and conventional tools, like ink-type based measurements.

This study developed a novel and inexpensive detection method based on a TaqMan probe-based insulated isothermal polymerase chain reaction (iiPCR) method for the rapid detection of Panama disease caused by Fusarium oxysporum f. sp. cubense (Foc) race 4, which is currently among the most serious fungal vascular diseases worldwide. By using the portable POCKIT™ device with the novel primer set iiFoc-1/iiFoc-2, the Foc race 4 iiPCR assay (including DNA amplification and signal monitoring) could be completed within one hour. The developed Foc race 4 iiPCR assay is thus a user-friendly and efficient platform designed specifically for the detection of Foc race 4. The detection limit of this optimized Foc iiPCR system was estimated to be 1 copy of the target standard DNA as well as 1 fg of the Foc genomic DNA. This approach can serve as a rapid detection method for in planta detection of Foc race 4 in field-infected banana. It was concluded that this molecular detection procedure based on iiPCR has good potential for use as an efficient detection method.

The intraarticular injection of lidocaine immediately before a physiotherapy session may relieve pain during the stretching and mobilization of the affected joint in patients with a frozen shoulder, thus enhancing the treatment effect. To compare the effects of intraarticular injection of lidocaine plus physiotherapy to that of physiotherapy alone in the treatment of a frozen shoulder, a prospective randomized controlled trial was conducted in the rehabilitation department of a private teaching hospital. Patients with a frozen shoulder were randomized into the physiotherapy group or the lidocaine injection plus physiotherapy (INJPT) group. The subjects in the INJPT group underwent injection of 3 ml of 1% lidocaine into the affected shoulder 10 to 20 minutes before each physiotherapy session. In each group, the treatment lasted 3 months. The primary outcome measures were the active and passive range of motion of the affected shoulder. The secondary outcome measures were the results of the Shoulder Disability Questionnaire, the Shoulder Pain and Disability Index, and the 36-item Short-Form Health Survey (SF-36). The outcome measures were evaluated before treatment and 1, 2, 3, 4, and 6 months after the start of treatment. The group comparisons showed significantly greater improvement in the INJPT group, mainly in active and passive shoulder range of motion in flexion and external rotation and improvements in pain and disability (P < 0.05); however, no significant group difference was seen in the SF-36 results. The intraarticular injection of lidocaine immediately before a physiotherapy session might be superior to physiotherapy alone in the treatment of a frozen shoulder. Trial registration: ClinicalTrials.gov NCT01817348.

To assess the clinical significance and risk factors of solitary lymph node metastasis (SLM) in gastric carcinoma and establish a more accurate method to evaluate the possibility of lymph node metastasis (LM).A total of 385 patients with gastric carcinoma who underwent D2 lymphadenectomy at the Cancer Center of Sun Yat-Sen University were included in this research. Then we used a group of data from Sun Yat-sen University Gastrointestinal Hospital (SYSUGIH) to validate the accuracy of our developed method. The χ2 test, Kaplan-Meier analysis, log-rank test, COX model, and discriminate analysis were used to analyze the data with SPSS13.0.We found that the LM number and pathological T staging were independent prognostic risk factors. CEA grading, LN status by CT, and T staging by CT were independent risk factors for LM in gastric carcinoma. In addition, we developed the equation Y = -5.0 + X1 + 1.8X3 + 0.7X4 (X1 = CEA grading, X3 = LN status by CT, X4 = T staging by CT) to evaluate the situation of LM. The data from SYSUGIH shows this equation has a better accuracy compared with CT.SLM is an independent risk factor in gastric cancer. And there was no survival difference between the skip metastasis group and the other SLM group (P = 0.659). It is inappropriate for the patient with SLM doing a standard D2 lymphadenectomy, due to the fact that LM rarely occurs in the splenic artery, splenic hilum. The risk factors for LM include CEA grading, LN status by CT, and T staging by CT. And we can use Y = -5.0 + X1 + 1.8X3 + 0.7X4 (X1, CEA grading, X3 = LN status by CT, X4 = T staging by CT, the critical value is 0.3) to estimate the possibility of LM, which has a better accuracy compared with CT.