An efficient framework for lesion segmentation in ultrasound images using global adversarial learning and region-invariant loss.

Lesion segmentation in ultrasound images is an essential yet challenging step for early evaluation and diagnosis of cancers. In recent years, many automatic CNN-based methods have been proposed to assist this task. However, most modern approaches often lack capturing long-range dependencies and prior information making it difficult to identify the lesions with unfixed shapes, sizes, locations, and textures. To address this, we present a novel lesion segmentation framework that guides the model to learn the global information about lesion characteristics and invariant features (e.g., morphological features) of lesions to improve the segmentation in ultrasound images. Specifically, the segmentation model is guided to learn the characteristics of lesions from the global maps using an adversarial learning scheme with a self-attention-based discriminator. We argue that under such a lesion characteristics-based guidance mechanism, the segmentation model gets more clues about the boundaries, shapes, sizes, and positions of lesions and can produce reliable predictions. In addition, as ultrasound lesions have different textures, we embed this prior knowledge into a novel region-invariant loss to constrain the model to focus on invariant features for robust segmentation. We demonstrate our method on one in-house breast ultrasound (BUS) dataset and two public datasets (i.e., breast lesion (BUS B) and thyroid nodule from TNSCUI2020). Experimental results show that our method is specifically suitable for lesion segmentation in ultrasound images and can outperform the state-of-the-art approaches with Dice of 0.931, 0.906, and 0.876, respectively. The proposed method demonstrates that it can provide more important information about the characteristics of lesions for lesion segmentation in ultrasound images, especially for lesions with irregular shapes and small sizes. It can assist the current lesion segmentation models to better suit clinical needs.

A new snake of the genus Dendrelaphis Boulenger, 1890 (Squamata: Colubridae) from the coastal area of southern Vietnam.

We describe a new species of Dendrelaphis from the coastal area in southern Vietnam based on morphological data and nucleotide sequences from one partial mitochondrial gene (Cytb). Dendrelaphis binhi sp. nov. is diagnosed by the following morphological characters: body scale rows 13 at neck and midbody, 9-11 before vent; vertebral scale row feebly enlarged; ventrals 154-158 in males and 161-170 in females; subcaudals 95-106 in males and 95-102 in females; one supralabial touching the eye; 18 or 19 maxillary teeth; hemipenis spinose, reaching 10th or 11th SC, with a slender papilla; cloacal plate divided; dorsum dark brown; and a white stripe along the lower flank. The new species differs from its congeners by an uncorrected p-distance in Cytb sequences of at least 8.1%.

A new species of Vietnamophryne (Anura: Microhylidae) from Northeastern Vietnam.

A new species of the genus Vietnamophryne is described from Vietnam on the basis of two specimens collected from Tuyen Quang Province, Northeastern Vietnam. The new species is morphologically most similar to Vietnamophryne occidentalis from Thailand, however, it differs from the latter by having large black blotches in the lower jaw region, and a yellow-orange chest and belly. The genetic distance between the new species and other Vietnamophryne taxa is > 2.13% (16S mtDNA gene fragment). Vietnamophryne aurantifusca sp. nov. can be distinguished from all other species of Vietnamophryne by a combination of the following morphological characteristics: Size medium (SVL 17.618.2 mm in males); head wider than long; tympanum medium; finger I longer than half of finger II; dorsal skin relatively smooth with some round nodules, concentrated in the middle of the back, arranged along the length of the back, with a prominent ridge along the spine; Dorsum orangish-brown entirely and paler on margin of back with a small brownish ridge along the spine; sides brownish with creamy patches and orange spots; ventral surface orange, with grey marbling, most intense on the throat, ventral side of arms and thighs, and ventral surfaces of limbs dark grey with some orange spots.

Changes in excitability and GABAergic neuronal activity of the primary somatosensory cortex after motor learning.

Introduction: It is widely known that motor learning changes the excitability of the primary motor cortex. More recently, it has been shown that the primary somatosensory cortex (S1) also plays an important role in motor learning, but the details have not been fully examined. Therefore, we investigated how motor skill training affects somatosensory evoked potential (SEP) in 30 neurologically healthy subjects. Methods: SEP N20/P25_component and N20/P25 SEP paired-pulse depression (SEP-PPD) were assessed before and immediately after complex or simple visuomotor tasks. Results: Motor learning was induced more efficiently by the complex visuomotor task than by the simple visuomotor task. Both the N20/P25 SEP amplitude and N20/P25 SEP-PPD increased significantly immediately after the complex visuomotor task, but not after the simple visuomotor task. Furthermore, the altered N20/P25 SEP amplitude was associated with an increase in motor learning efficiency. Conclusion: These results suggest that motor learning modulated primary somatosensory cortex excitability.

Multi-Attribute Attention Network for Interpretable Diagnosis of Thyroid Nodules in Ultrasound Images.

Ultrasound (US) is the primary imaging technique for the diagnosis of thyroid cancer. However, accurate identification of nodule malignancy is a challenging task that can elude less-experienced clinicians. Recently, many computer-aided diagnosis (CAD) systems have been proposed to assist this process. However, most of them do not provide the reasoning of their classification process, which may jeopardize their credibility in practical use. To overcome this, we propose a novel deep learning (DL) framework called multi-attribute attention network (MAA-Net) that is designed to mimic the clinical diagnosis process. The proposed model learns to predict nodular attributes and infer their malignancy based on these clinically-relevant features. A multi-attention scheme is adopted to generate customized attention to improve each task and malignancy diagnosis. Furthermore, MAA-Net utilizes nodule delineations as nodules spatial prior guidance for the training rather than cropping the nodules with additional models or human interventions to prevent losing the context information. Validation experiments were performed on a large and challenging dataset containing 4554 patients. Results show that the proposed method outperformed other state-of-the-art methods and provides interpretable predictions that may better suit clinical needs.

Histopathological Alterations in the Livers of Chronic Hepatitis Patients Exposed to Agent Orange/Dioxin in Vietnam.

We investigated changes in some laboratory indices and the liver histology of chronic hepatitis patients who were exposed to dioxin. In 2014, we collected liver biopsy samples for histopathological examination from 33 chronic hepatitis patients living around the Da Nang Airbase, which is a dioxin-contaminated area due to the herbicide spraying in Vietnam. Dioxin exposure was measured by its levels in the blood. METAVIR classification was used to clarify the liver fibrosis stage. Laboratory tests included ten biochemical and six hematological indices that were measured in the blood. A regression linear model and binary logistic regression were used for data analysis. The observed alterations in the liver at the histological level mainly comprised hydropic degenerative hepatocytes, lymphocytes and polynuclear leukocytes surrounding the liver cells and granular and lipoic degeneration. In addition, increased TCDD levels were associated with increasing aminotransferase (AST), alanine aminotransferase, protein and total bilirubin levels and liver fibrosis stage. Similarly, increased TEQ-PCDD/Fs levels were associated with higher levels of AST and protein and liver fibrosis stage. In conclusion, dioxin exposure altered the liver histology and increased some biochemical marker indices and the liver fibrosis stage of chronic hepatitis patients living in dioxin-contaminated areas in Da Nang, Vietnam.

A new species of the genus Oligodon Fitzinger, 1826 (Squamata: Colubridae) from Langbian Plateau, Vietnam.

We describe a new species of kukri snake from Da Lat City and its vicinity in Lam Dong Province, southern Vietnam on the basis of morphological characters of four specimens, including two males and two females. Oligodon tuani sp. nov. differs from other congeners by a combination of the following characters: large size in adults (TL ≤ 888 mm); 19 dorsal scale rows at midbody; ventrals 173-179 in males and 187-193 in females; subcaudals 58 or 59 in males and 44 or 45 in females; presubocular present; 8 supralabials, fourth and fifth entering orbit; cloacal plate undivided; 10 maxillary teeth, posterior three enlarged; vertebral stripe present; temporal streak present but faint and interrupted; long and deeply forked hemipenes, extending to 25th subcaudal, without spines and papillae; and 13-15+3-4 dorsal blotches.

A new skink of the genus emSubdoluseps/em Freitas, Datta-Roy, Karanth, Grismer amp; Siler, 2019 (Squamata: Scincidae) from southern Vietnam.

We describe a new species of the genus Subdoluseps Freitas, Datta-Roy, Karanth, Grismer Siler from a coastal area in southern Vietnam. Subdoluseps vietnamensis sp. nov. is characterized by the following morphological characters: medium size in adults (snout-vent length up to 48.7 mm); tail length/snout-vent length ratio 1.04; toes not reaching finger when limbs adpressed; 27-30 midbody scale rows, smooth; 55-57 paravertebral scales; 55-62 ventral scale rows; 64-74 subcaudal scales; frontoparietal scale single; four supraoculars; prefrontals not in contact with one another; two loreal scales; seven supralabials; ear-opening with two lobules on the anterior border; smooth lamellae beneath finger III 9 or 10 and toe IV 12-15; six enlarged precloacal scales; and four distinct black stripes on dorsum. The new species differs genetically from its closest congeners, S. bowringii (Günther) and S. frontoparietale (Taylor), by uncorrected p-distances of 10.0% and 9.5%, respectively in ND1 sequences, and clusters into the same matriline with these two congeners on the phylogenetic trees.

Effect of Repetitive Passive Movement Before Motor Skill Training on Corticospinal Excitability and Motor Learning Depend on BDNF Polymorphisms.

A decrease in cortical excitability tends to be easily followed by an increase induced by external stimuli via a mechanism aimed at restoring it; this phenomenon is called "homeostatic plasticity." In recent years, although intervention methods aimed at promoting motor learning using this phenomenon have been studied, an optimal intervention method has not been established. In the present study, we examined whether subsequent motor learning can be promoted further by a repetitive passive movement, which reduces the excitability of the primary motor cortex (M1) before motor learning tasks. We also examined the relationship between motor learning and the brain-derived neurotrophic factor. Forty healthy subjects (Val/Val genotype, 17 subjects; Met carrier genotype, 23 subjects) participated. Subjects were divided into two groups of 20 individuals each. The first group was assigned to perform the motor learning task after an intervention consisting in the passive adduction-abduction movement of the right index finger at 5 Hz for 10 min (RPM condition), while the second group was assigned to perform the task without the passive movement (control condition). The motor learning task consisted in the visual tracking of the right index finger. The results showed that the corticospinal excitability was transiently reduced after the passive movement in the RPM condition, whereas it was increased to the level detected in the control condition after the motor learning task. Furthermore, the motor learning ability was decreased immediately after the passive movement; however, the motor performance finally improved to the level observed in the control condition. In individuals carrying the Val/Val genotype, higher motor learning was also found to be related to the more remarkable changes in corticospinal excitability caused by the RPM condition. This study revealed that the implementation of a passive movement before a motor learning tasks did not affect M1 excitatory changes and motor learning efficiency; in contrast, in subjects carrying the Val/Val polymorphism, the more significant excitatory changes in the M1 induced by the passive movement and motor learning task led to the improvement of motor learning efficiency. Our results also suggest that homeostatic plasticity occurring in the M1 is involved in this improvement.

Repetitive Passive Movement Modulates Corticospinal Excitability: Effect of Movement and Rest Cycles and Subject Attention.

Repetitive passive movement (PM) affects corticospinal excitability; however, it is unknown whether a duty cycle which repeats movement and rest, or subjects' conscious attention to movements, affects corticospinal excitability. We aimed to clarify the effect of the presence or absence of a duty cycle and subjects' attention on corticospinal excitability. Three experiments were conducted. In Experiment 1, PM of the right index finger was performed for 10 min. Three conditions were used: (1) continuous PM (cPM) at a rate of 40°/s; (2) intermittent PM (iPM) with a duty cycle at 40°/s; and (3) iPM at 100°/s. In conditions 1 and 3, motor evoked potential (MEP) amplitude was significantly reduced. In Experiment 2, PM was performed for 30 min: condition 1 comprised cPM at a rate of 40°/s and Condition 2 comprised iPM at 40°/s. MEP amplitude significantly decreased in both conditions. In Experiment 3, PM was performed for 10 min: condition 1 comprised paying attention to the moving finger during iPM and Condition 2 was similar to Condition 1 but while counting images on a monitor without looking at the movement finger, and Condition 3 comprised counting images on a monitor without performing PM. MEP amplitude significantly increased only under Condition 1. Thus, afferent input from movements above a certain threshold may affect corticospinal excitability reduction. Furthermore, corticospinal excitability increases when paying attention to passive finger movement.

The four-domain structure model of a depression scale for medical students: A cross-sectional study in Haiphong, Vietnam.

Depression is a common mental health problem with a higher prevalence in medical students than in the general population. This study aims to investigate the association between depressive symptoms, particularly those in each domain of the Center for Epidemiological Studies Depression (CES-D) Scale, and related factors. A cross-sectional study was conducted with a random sample of 1319 medical students at Haiphong University of Medicine and Pharmacy in 2016. The CES-D scale and a self-reported questionnaire were used to identify the prevalence of depressive symptoms and related risk factors. Univariate and multivariate logistic regression were performed to assess the risk factors associated with depressive symptoms and the score for each structure factor. Depressive symptoms were observed in 514 (39%) students, including more males than females (44.2% vs 36.9%, p = 0.015). Students whose mothers' highest education level was primary school had a higher prevalence of depressive symptoms than students whose mothers had higher education levels (p = 0.038). There was a significant relationship between depressive symptoms and stressful life events, especially a decline in personal health. A higher correlation was found between the somatic complaints and depressive affect domains. The impacts of risk factors differed for each domain of the depression scale. Only the factor of achieving excellence showed no statistically significant associations with depressive symptoms and the scores on the four domains considered in this study. The high prevalence of depressive symptoms among medical students with risk factors and the impact of these risk factors on each domain of depression scale need further clarification to alleviate depression in students during their medical training.

Study on changes of T-lymphocyte subsets (CD3, CD4, CD8) in kidney transplant recipients

Background: Chronic renal failure patients with end-stage must be treated with renal replacement methods such as artificial kidneys, renal peritoneum purification or kidney transplant, in which kidney transplant is considered as the optimal method.\r\n', u'Objectives: To study changes of lymphocyte subsets (CD3, CD4, CD8) in kidney transplant recipients.\r\n', u'Subjects and methods: A prospective descriptive study was performed on 80 people including 45 healthy people and 35 patients with transplanted kidney over two years.\r\n', u'Results and conclusion: The average number of lymphocyte subsets in adult healthy people were determined in this study, as follows: TCD4: 540 \xb1 177 tb/\u03bcl, TCD8: 728 \xb1 208 tb/\u03bcl; TCD3: 1389 \xb1 372 tb/\u03bcl; TCD4/TCD8: 0.39 \xb1 0.08; TCD4/TCD3: 0.76 \xb1 0.23 and TCD8/TCD3: 0.76 \xb1 0.23. There was no significant difference in mean number of TCD4 between pre-transplant and 1 year and 2 years post transplantation (p >0.05) but TCD4/TCD8 ratio was significantly decreased at both 1 year and 2 years post-transplantation (p<0.001). TCD4/TCD8 ratio was not significantly different between 1 year and 2 years after transplantation (p >0.05)\r\n', u'\r\n', u'

Initial result of community-based nutritional intervention with sprout powder in 0 to 12-month children in a rural area of Thanh Hoa province

The incidence of malnutrition in 0 to 12-month children is high in Thanh Hãa province. Use of intestinal enzyme aplase as an augment, combining hamlet health workers and families to construct the structure of diet for children with available foods can reduce the malnutrition incidence to lower than 30%. Beside this, the interventional activities to provide the nutritional knowledge with mothers can change the nutritional practice rapidly and solidly.

Investigating the energy supplement for 0 to12-month children and some social factors that related to child-feeding knowledge of mothers at two communes of hoang hoa district, thanh hoa province

The energy allowance for under 6 month children is 34565Kcal, achieves 55.6% of level recommended by National Institute of Nutrition. The energy allowance for 6 to 12 month children is 59441Kcal, achieves 72% of recommended level. The dietary supplement form is multiple. The mean lipid content in allowances of under 6-month children and in 6 to 12 month children achieve only 30% and 43% of recommended level, respectively. More than 92% of mothers give their babies the first meal with sugar solution. The duration of exclusive breastfeeding is short. Early breastfeeding discontinuation is common here (80%).