2,436 research outputs found
Performance of texture analysis in predicting tumoral response to neoadjuvant chemoradiotherapy in rectal cancer patients studied with 3T MR
No full textPurpose: To determine the performance of texture analysis (TA) in the prediction of tumoral response in Colon rectal Cancer (CRC) Patients. Material and methods: We prospectively enrolled 40 consecutive CRC patients, who underwent pre-treatment and post-treatment 3T MRI. A region of interest was drawn manually around the tumour on Unenhanced axial obliqueT2-weighted images and analysed using TA (TexRAD), evaluating first order statistical texture parameters (Skewness, Kurtosis). After CRT, all patients underwent complete surgical resection and the surgical specimen served as the gold standard. Moreover, receiver operating characteristic (ROC) curve analysis was performed to assess the discriminatory power of each quantitative parameter to predict complete response. Artificial Intelligence software (Weka) was used to evaluate the impact of machine learning algorithms on texture parameters in rectal cancer aimed to combine all texture parameters in order to improve diagnostic accuracy. Results: Entropy, Kurtosis and MPP showed significant differences before and after CRT in CR’s; PR/NR Entropy and Skewness showed significant differences before and after CRT (all p<0.05). Absolute changes among different texture parameters in CR and PR/NR patients before and after CRT showed significant differences in Entropy, Kurtosis and MPP (0.31±0.35, in CR, -0.02 ± 1.28 in PR/NR, (p=0.04); 1.87 ± 2.19, in CR, -0.06 ± 3.78 in PR/NR(p=0.0005); (107.91 ± 274.40, in CR, -28.33 ± 202.91 in PR/NR, (p=0.004), respectively). Kurtosis and Entropy seem to be the texture parameters able to predict CR. ROC curves showed the optimal cutoff value for pretreatment kurtosis, the best paremter, ≤ 3.29, resulting a sensitivity and specificity for pCR prediction of 81.5% and 61.5%, respectively. A decisional map was defined combining all texture parameters. Conclusion: TA from T2w images can potentially have an important role as imaging biomarkers of tumoral response to neoadjuvant CRT in rectal cancer. Machine learning software can be apply in this setting to combined efficiently all texture parameters in order to improve diagnostic accuracy
Indwelling biliary stent during Endoscopic Ultrasound-Guided Tissue Acquisition of pancreatic masses: Not necessarily a problem
No full textIn this issue of Journal of Clinical Ultrasound: Sonography and other Imaging Techniques, an interesting original research article by Constantinescu et al. addresses the impact of biliary stenting in EUS-TA in patients affected by pancreatic cancer, assessing and comparing the accuracy of sampling pancreatic malignant tissue by means of EUS-TA in patients who underwent prior ERCP with biliary stenting and patients in whom ERCP was not performed. A total of 243 patients with pancreatic cancer who underwent ERCP and EUS-TA, either with Fine-Needle Aspiration (FNA) or Fine-Needle Biopsy (FNB), were retrospectively evaluated
Endoscopic Ultrasound-Guided Antegrade Stenting as an Effective Alternative to Endoscopic Retrograde Colangio-Pancreatography-Based Biliary Drainage in the Management of Extra-Hepatic Malignant Biliary Obstruction: Current Perspectives and Limitations
No full textTrans-papillary biliary stenting under Endoscopic Retrograde Colangio-Pancreatography (ERCP) is the standard of care for the management of malignant biliary obstruction, providing biliary decompression and symptomatic relief. However, the success rate is reported to be hindered in up to 10% of cases, typically due to difficult selective biliary cannulation, surgically altered anatomy, gastro-duodenal obstruction, or duodenal stenosis. In such cases, surgical by-pass and Percutaneous Trans-Hepatic Biliary Drainage (PTBD) represent the conventional alternative rescue approaches. Nevertheless, these procedures are associated with high morbidity and a significantly reduced quality of life during the post-operative period. Endoscopic Ultrasound-Guided Biliary Drainage (EUS-BD) has recently been developed and reported as a novel reliable alternative biliary drainage procedure for cases in which ERCP is unsuccessful. In several EUS-BD techniques, EUS-Guided Antegrade Stenting (EUS-AGS) has been proposed as a useful approach
The Challenging Integration Paths of Migrant Health Professionals: The Case of Filipino and Indian Nurses in the UK
No full textThis article examines the role of institutional factors in shaping the integration paths of migrant health professionals. For this purpose, it draws on two studies focusing on Filipino and Indian nurses working in the UK, which rely on quantitative and qualitative methods, including a web survey and semi-structured interviews. The analysis shows that inequalities have arisen from differentiation processes induced by changes in the institutional settings. Furthermore, inequalities are often reflected in poor working conditions. The authors have identified restrictive rules on immigration and access to the profession as a source of uncertainty and reveal the differentiation of entry paths, with those arriving through an international recruitment agency more frequently disappointed with their working conditions
Le sfide del sindacato nel settore del credito : il caso Fisac Toscana
No full textL’articolo prende in esame i mutamenti nel settore del credito, cercando di coglierne i riflessi sulla rappresentanza del lavoro. Al fine di capire come sia affrontata la questione del cambiamento all’interno del sindacato, sono inoltre presentati i risultati di uno studio di caso su Fisac Toscana
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