Brain tumor grading diagnosis using transfer learning based on optical coherence tomography.

In neurosurgery, accurately identifying brain tumor tissue is vital for reducing recurrence. Current imaging techniques have limitations, prompting the exploration of alternative methods. This study validated a binary hierarchical classification of brain tissues: normal tissue, primary central nervous system lymphoma (PCNSL), high-grade glioma (HGG), and low-grade glioma (LGG) using transfer learning. Tumor specimens were measured with optical coherence tomography (OCT), and a MobileNetV2 pre-trained model was employed for classification. Surgeons could optimize predictions based on experience. The model showed robust classification and promising clinical value. A dynamic t-SNE visualized its performance, offering a new approach to neurosurgical decision-making regarding brain tumors.

Rapid On-Site AI-Assisted Grading for Lung Surgery Based on Optical Coherence Tomography.

The determination of resection extent traditionally relies on the microscopic invasiveness of frozen sections (FSs) and is crucial for surgery of early lung cancer with preoperatively unknown histology. While previous research has shown the value of optical coherence tomography (OCT) for instant lung cancer diagnosis, tumor grading through OCT remains challenging. Therefore, this study proposes an interactive human-machine interface (HMI) that integrates a mobile OCT system, deep learning algorithms, and attention mechanisms. The system is designed to mark the lesion's location on the image smartly and perform tumor grading in real time, potentially facilitating clinical decision making. Twelve patients with a preoperatively unknown tumor but a final diagnosis of adenocarcinoma underwent thoracoscopic resection, and the artificial intelligence (AI)-designed system mentioned above was used to measure fresh specimens. Results were compared to FSs benchmarked on permanent pathologic reports. Current results show better differentiating power among minimally invasive adenocarcinoma (MIA), invasive adenocarcinoma (IA), and normal tissue, with an overall accuracy of 84.9%, compared to 20% for FSs. Additionally, the sensitivity and specificity, the sensitivity and specificity were 89% and 82.7% for MIA and 94% and 80.6% for IA, respectively. The results suggest that this AI system can potentially produce rapid and efficient diagnoses and ultimately improve patient outcomes.

Intraoperative application of optical coherence tomography for lung tumor.

On-site instant determination of benign or malignant tumors for deciding the types of resection is crucial during pulmonary surgery. We designed a portable spectral-domain optical coherence tomography (SD-OCT) system to do real-time scanning intraoperatively for the distinction of fresh tumor specimens in the lung. A total of 12 ex vivo lung specimens from six patients were enrolled. Three patients were diagnosed with invasive adenocarcinoma (IA), while the others were benign. After OCT-imaged reconstruction, we compared the qualitative morphology of OCT and histology among malignant, benign, and normal tissues. In addition, through analysis of the quantitative data, a discrete difference in optical attenuation coefficients around the junctional surface was shown by our data processing. This study demonstrated a feasible OCT-assisted resection guide by a rapid on-site tumor diagnosis. The results indicate that future deep learning of OCT-captured image systems able to improve diagnostic and therapeutic efficiency is warranted.

Children's experiences of living with maternal breast cancer: A qualitative study.

AIMS: To investigate the experiences of Taiwanese school-aged children coping with maternal breast cancer. DESIGN: A qualitative interview study. METHODS: A cohort of 10 boys and 12 girls aged 6 to 13 years (mean age, 9.86 years) whose mothers were diagnosed with breast cancer in the last 2 years were recruited from patient networks in Taiwan. Data were collected from February to June 2019 via semi-structured individual interviews. Their responses were subjected to content analysis. RESULTS: Content analysis yielded six themes: (1) reluctance to share feelings with others; (2) recognizing changes in the tone of family life; (3) casting the cause of breast cancer onto oneself; (4) engaging in active coping; (5) maturing and gaining life lessons; and (6) family communication matters. CONCLUSION: The findings shed light on how family processes and cultural beliefs shape children's experiences. School-aged children came to terms with the significance of maternal breast cancer from a broad context of family experiences over time, and thus gained insights into their self-expectations and future aspirations. IMPACT: Healthcare professionals can help school-aged children develop a rational view of breast cancer pathogenesis. In addition, we suggest nursing interventions to support a family-oriented approach to coping. Such interventions should address changes in family processes to improve coping abilities of children and the entire family.

Maternal Experiences of Parenting Young Children While Battling Breast Cancer in Taiwan.

BACKGROUND: Western mothers with breast cancer find themselves struggling with parenting responsibilities. Because parenting is culturally shaped, literature on ill mothers' experiences of parenting young children from a collectivist culture is limited. OBJECTIVE: The aim of this study was to examine Taiwanese mothers' experiences of and cultural practices embedded in parenting young children while in treatment for breast cancer. METHODS: Sixteen mothers with at least 1 child younger than 12 years were recruited from a breast cancer organization in Taiwan. Data were collected from November 2016 to June 2017 via a semistructured individual interview and analyzed using a content analysis technique. RESULTS: Five themes, namely, "maternal limited disclosure, complementary with children's tacit knowledge," "the scar is no longer a scar but a symbol for intimate bonding," "issues of maternal absence for young children and school-aged children," "the power of 'We are a family'," and "to live a simple life and to live for one's self," elucidate how cultural beliefs and practices shape maternal parenting experiences during treatment of breast cancer. CONCLUSIONS: The findings illustrate how Taiwanese mothers interpret their illness, contextualize illness-related messages in daily life, and maintain family ties while coping with breast cancer. The will to maintain the family's integrity, including the extended family, can empower mothers throughout the trajectory. IMPLICATIONS FOR PRACTICE: Ill mothers may benefit from nurses' guidance on daily routines and cultural practices that they can exploit to frame illness messages for their children. Maternal efforts to change their outlook on life, vocalize their needs, and become more assertive should be acknowledged and supported.

Magnolol reduces glutamate-induced neuronal excitotoxicity and protects against permanent focal cerebral ischemia up to 4 hours.

Neuroprotective efficacy of magnolol, 5,5'-dially-2,2'-dihydroxydiphenyl, was investigated in a model of stroke and cultured neurons exposed to glutamate-induced excitotoxicity. Rats were subjected to permanent middle cerebral artery occlusion (pMCAO). Magnolol or vehicle was administered intraperitoneally, at 1 hr pre-insult or 1-6 hrs post-insult. Brain infarction was measured upon sacrifice. Relative to controls, animals pre-treated with magnolol (50-200 mg/kg) had significant infarct volume reductions by 30.9-37.8% and improved neurobehavioral outcomes (P<0.05, respectively). Delayed treatment with magnolol (100 mg/kg) also protected against ischemic brain damage and improved neurobehavioral scores, even when administered up to 4 hrs post-insult (P<0.05, respectively). Additionally, magnolol (0.1 µM) effectively attenuated the rises of intracellular Ca(2+) levels, [Ca(2+)](i), in cultured neurons exposed to glutamate. Consequently, magnolol (0.1-1 µM) significantly attenuated glutamate-induced cytotoxicity and cell swelling (P<0.05). Thus, magnolol offers neuroprotection against permanent focal cerebral ischemia with a therapeutic window of 4 hrs. This neuroprotection may be, partly, mediated by its ability to limit the glutamate-induced excitotoxicity.

Nicotinamide inhibits nuclear factor-kappa B translocation after transient focal cerebral ischemia.

OBJECTIVE: We explored the putative anti-inflammatory effects of nicotinamide against experimental stroke. DESIGN: Prospective laboratory study. SETTING: Research laboratory in a university teaching hospital. SUBJECTS: Adult male Sprague-Dawley rats (250-300 g). INTERVENTIONS: The antioxidant, radical scavenging, and anti-inflammatory actions of nicotinamide were evaluated using a panel of acellular assays and lipopolysaccharide-stimulated RAW 264.7 and BV2 cells. Animals were subjected to transient middle cerebral artery occlusion for 90 mins. Nicotinamide (500 mg/kg) or vehicle was given intravenously at reperfusion onset. MEASUREMENTS AND MAIN RESULTS: Nicotinamide effectively inhibited nuclear factor-κB translocation and binding activity as well as the production of tumor necrosis factor-α, nitrite/nitrate, and interleukin-6 in the lipopolysaccharide-stimulated RAW 264.7 and BV2 cells (p < .05, respectively) but exhibited weak antioxidant and radical-scavenging actions. Relative to controls, nicotinamide-treated animals had significant reductions in neutrophil and macrophage/activated microglial infiltration in the ischemic brain by 53% and 77% (p < .05, respectively). Additionally, nicotinamide significantly attenuated phosphorylation of nuclear factor-κB's inhibitory protein, nuclear factor-κB translocation and binding activity, and the synthesis of inducible nitric oxide in the ischemic brain (p < .05, respectively). Consequently, nicotinamide effectively reduced brain infarction and improved neurobehavioral outcome by 43% and 50% (p < .05, respectively). CONCLUSIONS: Nicotinamide effectively attenuated postischemic nuclear factor-kappa]B activation and exhibited robust anti-inflammatory actions against ischemic stroke.