Differential diagnosis of Crohn's disease and intestinal tuberculosis based on ATR-FTIR spectroscopy combined with machine learning.

BACKGROUND: Crohn's disease (CD) is often misdiagnosed as intestinal tuberculosis (ITB). However, the treatment and prognosis of these two diseases are dramatically different. Therefore, it is important to develop a method to identify CD and ITB with high accuracy, specificity, and speed. AIM: To develop a method to identify CD and ITB with high accuracy, specificity, and speed. METHODS: A total of 72 paraffin wax-embedded tissue sections were pathologically and clinically diagnosed as CD or ITB. Paraffin wax-embedded tissue sections were attached to a metal coating and measured using attenuated total reflectance fourier transform infrared spectroscopy at mid-infrared wavelengths combined with XGBoost for differential diagnosis. RESULTS: The results showed that the paraffin wax-embedded specimens of CD and ITB were significantly different in their spectral signals at 1074 cm-1 and 1234 cm-1 bands, and the differential diagnosis model based on spectral characteristics combined with machine learning showed accuracy, specificity, and sensitivity of 91.84%, 92.59%, and 90.90%, respectively, for the differential diagnosis of CD and ITB. CONCLUSION: Information on the mid-infrared region can reveal the different histological components of CD and ITB at the molecular level, and spectral analysis combined with machine learning to establish a diagnostic model is expected to become a new method for the differential diagnosis of CD and ITB.

Incidence and risk factors for pulmonary hemorrhage after percutaneous CT-guided pulmonary nodule biopsy: an observational study.

To evaluate the current incidence of pulmonary hemorrhage and the potential factors contributing to its increased risk after percutaneous CT-guided pulmonary nodule biopsy and to summarize the technical recommendations for its treatment. In this observational study, patient data were collected from ten medical centers from April 2021 to April 2022. The incidence of pulmonary hemorrhage was as follows: grade 0, 36.1% (214/593); grade 1, 36.8% (218/593); grade 2, 18.9% (112/593); grade 3, 3.5% (21/593); and grade 4, 4.7% (28/593). High-grade hemorrhage (HGH) occurred in 27.2% (161/593) of the patients. The use of preoperative breathing exercises (PBE, p =0.000), semiautomatic cutting needles (SCN, p = 0.004), immediate contrast enhancement (ICE, p =0.021), and the coaxial technique (CoT, p = 0.000) were found to be protective factors for HGH. A greater length of puncture (p =0.021), the presence of hilar nodules (p = 0.001), the presence of intermediate nodules (p = 0.026), a main pulmonary artery diameter (mPAD) larger than 29 mm (p = 0.015), and a small nodule size (p = 0.014) were risk factors for high-grade hemorrhage. The area under the curve (AUC) was 0.783. These findings contribute to a deeper understanding of the risks associated with percutaneous CT-guided pulmonary nodule biopsy and provide valuable insights for developing strategies to minimize pulmonary hemorrhage.

Pneumothorax after percutaneous CT-guided lung nodule biopsy: a prospective, multicenter study.

Background: Pneumothorax is a common complication induced by computed tomography (CT)-guided percutaneous needle biopsy, with a frequency of 17-40.4%. It remains debatable how to predict and prevent the occurrence of post-biopsy pneumothorax. In a real-world setting, we investigated the characteristics associated with pneumothorax in primary lung nodule biopsy. Methods: This clinical registry cohort study recorded patients with newly diagnosed pulmonary nodules from 10 medical centers from April 2021 to April 2022, and the data were input into the electronic data capture (EDC) system. The eligibility criteria for participants included being within the age range of 18 to 80 years and expressing a willingness to undergo percutaneous puncture biopsy, among other requirements. Conversely, the exclusion criteria included an inability to cooperate throughout the biopsy process and the emergence of new health issues during the study duration resulting in attendance delays, among other factors. This study collected data from 924 patients, out of which 593 were included after exclusion. The essential characteristics, imaging features of pulmonary nodules, and technical factors associated with percutaneous biopsy were recorded. T-tests or one-way analysis of variance (ANOVA) were performed for continuous variables and Pearson's χ2 test, likelihood ratio, or Fisher's exact test were applied for categorical variables for comparison as appropriate, followed by multivariate logistic regression. Results: The overall incidence of pneumothorax was 13.0% (77/593), among which timely pneumothorax was 10.3% (61/593), delayed pneumothorax was 2.7% (16/593), and the rate of chest tube placement was 3.4% (20/593). There was no significant difference in the incidence of pneumothorax in a needle size range of 16-19 G (P=0.129), but the incidence of pneumothorax was lower with 17 G needles than with 18 G. An increased morbidity of pneumothorax was correlated with age (P=0.003), emphysema (P=0.006), and operation time (P=0.002). There was no significant increase in the incidence of pneumothorax between 1 or 2 passes through the pleura (P=0.062). However, multiple pleural passes (3 times) increased the chances of pneumothorax significantly (P=0.022). These risk factors have a certain clinical value in predicting the incidence of post-biopsy pneumothorax, and the area under the curve (AUC) was 0.749. Conclusions: The most common post-biopsy complication, pneumothorax, was managed conservatively in most cases. A maximum of two pleural passes does not increase the incidence of pneumothorax, and the 17 G needle is more suitable for percutaneous biopsy of pulmonary nodules in the real world.

Qualitative Study of a Solution-Focused Training Program for Taiwanese Military Instructors.

This study explored Taiwanese military instructors' perceptions of a training program using a solution-focused approach and its initial application to students with behavior problems. A total of 25 military instructors (16 men, 9 women; M age = 38.6 years, SD = 5.8) and 10 students (three men, seven women; M age = 17.5 years, SD = 0.9) participated in the study through convenience sampling. Grounded theory method was adopted for data analysis. Six prominent categories emerged from the focus group interview, weekly training notes, and the researcher's field notes, including reactions to learning solution-focused approach, strengths and weaknesses of using the solution-focused approach, identification of military instructors role function, initial responses to the techniques of the solution-focused approach, a positive attitude to deal with students' problems, and from assimilation to transformation. In addition, feedback collected from students was grouped into a seventh category. Finally, a modified pattern was developed for military instructors to use when working with students.

Perspectives of Taiwanese pastoral counselors on the use of scripture and prayer in the counseling process.

Interviews were carried out with 10 Christian pastoral counselors to explore their perspectives on the use of Scripture and prayer in the counseling process. Grounded Theory was utilized. Five main categories including a theological framework of pastoral counseling, counselors' considerations of using Scripture and prayer, preparation for Christian spiritual intervention, implications of spiritual resources, and ethical issues in the pastoral counseling process were generated. The results suggest the theological framework of pastoral counseling is crucial to the use of Scripture and prayer, and the issue of a neutral response should first be clarified for clients. Basic guidelines for ethically using Scripture and prayer for working with Christian clients are proposed for further pastoral counselor training, practice, and research.

Effectiveness of an enhancement program on Taiwanese university students' self-concept'.

This study examined the effectiveness of a Self-Concept Enhancement Program (SCEP) on Taiwanese university students. Participants were randomly assigned to an experimental group (n = 30) and a waiting-list control group (n = 30). The experimental group received SCEP psycho-educational treatment for 8 weeks, whereas the control group did not. Results indicated significant improvements on physical, personal, self-identity, and total self-concept in the experimental group, but not in the control group. Participants evaluated the SCEP as useful, beneficial, and powerful in promoting their self-concept. Cultural issues were highlighted and discussed. Implications for research and counseling practice are suggested.

Verbal interactions in Taiwanese group counseling process: a cross-cultural perspective.

Although group verbal behaviors have been extensively studied, little research has examined how the types and frequencies of interactions vary across cultures. The purpose of this study was to examine verbal interactions in the Taiwanese group counseling process from a cultural perspective. 58 students were recruited from seven colleges of a comprehensive university in Taiwan. They were randomly assigned to one of the following: the Family Reconstruction group, Transactional Analysis group, or Growth group, as well as three Counseling groups. By using the Hill Interaction Matrix-SS (HIM-SS), participants' verbal interactions in the three groups were coded. Personal and Relationship Content verbal interactions were frequently used and the Confrontative and Assertive Work verbal interactions were least used in the group process. Personal, Relationship, Conventional, and Speculative verbal interactions were ranked high, but those of Group, Topics, Confrontative, and Assertive were much less used by both leaders and members. The differences of the verbal interactions and Silence responses between leaders and members in counseling groups were examined; there were no significant differences between the leaders' and members' verbal interactions and Silence. Specific types of verbal interactions influenced by cultural issues were discussed.

Taiwanese members' report of verbal interactions and their relations to demographic variables in the group counseling process.

The purpose was to examine differences in verbal interactions during the group counseling process and the relationship between perceived verbal interactions and members' demographic variables. 42 participants were recruited and randomly assigned to one of four counseling groups. Based on the Hill Interaction Matrix, Quadrant 4 verbal interactions, consisting of Speculative and Confrontative verbal behaviors in Personal and Relationship levels, were perceived significantly more often at the closing stage than at the initial stage. Furthermore, the perceived verbal interactions were related to the demographic variables of sex, educational level, and group experience, but not acquaintanceship. The findings suggested that the higher ratings of perceived Speculative and Confrontative verbal behaviors and the lower ratings of Assertive and Silence verbal interactions must be interpreted cautiously from a cross-cultural perspective, especially in Asian cultures.

Correctional officers' perceptions of a solution-focused training program: potential implications for working with offenders.

The purpose of this exploratory study was to explore correctional officers' perceptions and experiences during a solution-focused training program and to initiate development of a modified pattern for correctional officers to use in jails. The study uses grounded theory procedures combined with a follow-up survey. The findings identified six emergent themes: obstacles to doing counseling work in prisons, offenders' amenability to change, correctional officers' self-image, advantages of a solution-focused approach (SFA), potential advantages of applying SFA to offenders, and the need for the consolidation of learning and transformation. Participants perceived the use of solution-focused techniques as appropriate, important, functional, and of only moderate difficulty in interacting with offenders. Finally, a modified pattern was developed for officers to use when working with offenders in jails. Suggestions and recommendations are made for correctional interventions and future studies.

Understanding Taiwanese children's perceptions of peace and strategies to make peace: a social and cultural perspective.

This exploratory study described Taiwanese children's perceptions of peace and what they think children can do to make peace. In-depth interviews were conducted with 60 Taiwanese children ages 4 to 18 years. The most predominant themes for the perceptions of peace were what peace is not, prosocial behaviors, positive emotions, and positive evaluations of peace. Approximately half of the children (48%) provided specific strategies for making peace. The suggested strategies generally were based on the child's immediate environment, such as "don't fight" "don't argue," and specific prosocial behaviors. 52% of children either said, "I don't know" when asked what children can do to make peace, or did not feel empowered to make peace. The initial findings were interpreted in terms of sociocultural issues, such as cultural heritage and upbringing, as well as within a political context.

Pyridostigmine bromide and the long-term subjective health status of a sample of over 700 male Reserve Component Gulf War era veterans.

Data from a 1996-1997 survey of approximately 700 Reserve Component male veterans indicate that the consumption of pyridostigmine bromide pills, used as a pretreatment for potential exposure to the nerve agent Soman, was a significant predictor of declines in reported subjective health status after the war, even after controlling for a number of other possible factors. Reported reactions to vaccines and other medications also predicted declines in subjective health. While higher military rank generally predicted better health during and after the war, educational attainment, minority status, number of days in theater, and age generally did not predict changes in subjective health. Although servicemembers were directed to take three pills a day, veterans reported a range of compliance--less than a fourth (24%) followed the medical instructions compared to 61% who took fewer than three pills daily and 6% who took six or more pills a day. Implications for use of pyridostigmine bromide are discussed.

Self-reported changes in subjective health and anthrax vaccination as reported by over 900 Persian Gulf War era veterans.

A 1999 study of United Kingdom servicemembers by Unwin, et al. recently found significant relationships between anthrax and other vaccinations, reactions to those vaccines, and later health problems for male current or former active military Gulf War veterans. Likewise, in 2000 Steele and in 1998 Gilroy found possible adverse effects of vaccinations on Gulf War veterans. However, the role of such vaccinations remains controversial; more recent government reports continue to dispute the existence of any data that might reflect adversely on the role of vaccinations on the health of Gulf War veterans. To address this controversy, the current study assessed similar relationships for over 900 Reserve Component Gulf War Era veterans from Ohio and nearby states. Gulf War veterans were more likely to report poorer health than non-Gulf veterans. Female veterans were more likely to report mild or severe reactions to vaccines than male veterans. Those veterans who received anthrax vaccine reported more reactions to vaccines than those who did not receive anthrax vaccine. Declines in long-term subjective health were associated with receipt of anthrax vaccine by Gulf War veterans but not for those who did not deploy to the Gulf, although few of the latter received anthrax vaccine. Regardless of deployment status, veterans who reported more severe reactions to vaccines were more likely to report declines in subjective health. Female veterans reported poorer health during the Gulf War than did male veterans, but sex was not related to veterans' reports of subjective health at subsequent times. It is recommended that servicemembers who experience severe reactions to anthrax vaccine be medically reevaluated before receiving further anthrax vaccine and that careful follow-ups be conducted of those receiving the vaccine currently, in accordance with Nass's 1999 recommendations. We also recommend that safer alternatives to thimerosal (a mercury sodium salt, 50% mercury) be used to preserve all vaccines.