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Lymphatic spread determines treatment decisions in prostate cancer (PCa) patients. 68Ga-PSMA-PET/CT can be performed, although cost remains high and availability is limited. Therefore, computed tomography (CT) continues to be the most used modality for PCa staging. We assessed if convolutional neural networks (CNNs) can be trained to determine 68Ga-PSMA-PET/CT-lymph node status from CT alone. In 549 patients with 68Ga-PSMA PET/CT imaging, 2616 lymph nodes were segmented. Using PET as a reference standard, three CNNs were trained. Training sets balanced for infiltration status, lymph node location and additionally, masked images, were used for training. CNNs were evaluated using a separate test set and performance was compared to radiologists’ assessments and random forest classifiers. Heatmaps maps were used to identify the performance determining image regions. The CNNs performed with an Area-Under-the-Curve of 0.95 (status balanced) and 0.86 (location balanced, masked), compared to an AUC of 0.81 of experienced radiologists. Interestingly, CNNs used anatomical surroundings to increase their performance, “learning” the infiltration probabilities of anatomical locations. In conclusion, CNNs have the potential to build a well performing CT-based biomarker for lymph node metastases in PCa, with different types of class balancing strongly affecting CNN performance.

In this paper we describe the embryonic development of the polyclad flatworm Imogine mcgrathi. Imogine is an indirect developer that hatches as a planctonic Goette’s larva after an embryonic period of approximately 7 days. Light and electron microscopic analyses of sections of staged embryos were combined with antibody stainings of wholemounted embryos to reconstruct the origin and movement of the primordia of the various organ systems, with particular emphasis on the nervous system. We introduce a system of morphologically defined stages aimed at facilitating future studies and cross-species comparisons among flatworm embryos. Imogine embryos undergo typical spiral cleavage. Micromere quartets 1–3 form an irregular double layer of mesenchymal cells that during gastrulation expands over micromere quartet 4. Micromere 4d divides into several large mesendodermal precursors whose position defines the ventral pole of the embryo. These cells, along with the animal micromeres that obtained a sub-surface position during cleavage, form a deep layer of cells that gives rise to all internal structures, including the nervous system, musculature, nephridia, and gut. Micromeres 4a–c are large yolky cells that are incorporated into the lumen of the gut, but do not themselves contribute to the gut epithelium. Shortly after gastrulation, cell differentiation sets in. Cells located at the surface adopt epithelial characteristics and form cilia that result in continuous movement of the post-gastrula stage embryo. Deep cells at the lateral margins of the embryo become organized into a protonephridial tube. A cluster of approximately 50 deep cells at the anterior pole forms the brain, in which we have identified sets of founder neurons of the brain commissure and the dorsal and ventral connectives. The early differentiating neurons, along with other cells forming stabilized microtubules (ciliated cells of the epidermis, gut and protonephridia; apical gland cells) could be analyzed in detail because of their labeling with an antibody against acetylated α-tubulin. Our findings indicate that, despite significant differences in the cleavage pattern and arrangement of blastomeres in the early embryo, morphogenesis and organ formation of a polyclad embryo follows a pattern that is very similar to the pattern observed by us and others in phylogenetically more evolved rhabdocoel flatworms.

Lymphatic spread determines treatment decisions in prostate cancer (PCa) patients. 68Ga-PSMA-PET/CT can be performed, although cost remains high and availability is limited. Therefore, computed tomography (CT) continues to be the most used modality for PCa staging. We assessed if convolutional neural networks (CNNs) can be trained to determine 68Ga-PSMA-PET/CT-lymph node status from CT alone. In 549 patients with 68Ga-PSMA PET/CT imaging, 2616 lymph nodes were segmented. Using PET as a reference standard, three CNNs were trained. Training sets balanced for infiltration status, lymph node location and additionally, masked images, were used for training. CNNs were evaluated using a separate test set and performance was compared to radiologists' assessments and random forest classifiers. Heatmaps maps were used to identify the performance determining image regions. The CNNs performed with an Area-Under-the-Curve of 0.95 (status balanced) and 0.86 (location balanced, masked), compared to an AUC of 0.81 of experienced radiologists. Interestingly, CNNs used anatomical surroundings to increase their performance, \"learning\" the infiltration probabilities of anatomical locations. In conclusion, CNNs have the potential to build a well performing CT-based biomarker for lymph node metastases in PCa, with different types of class balancing strongly affecting CNN performance.

We have analyzed the embryonic development of the temnocephalid flatworms Craspedella pedum and Diceratocephala boschmai, using a combination of fuchsin-labeled whole-mount preparation, histology, and transmission electron microscopy. Following the staging system recently introduced for another flatworm species (Mesostoma lingua), we can distinguish eight morphologically defined stages. Temnocephalids produce eggs of the neoophoran type in which a small oocyte is surrounded by a layer of yolk cells. Cleavage takes place in the center of the yolk mass (stages 1-2) and results in an irregular, multilayered disc of mesenchymal cells that moves to the future ventral egg pole (stage 3). Organ primordia, including those of the brain, pharynx, male genital apparatus, sucker, and epidermis \"crystallize\" within this disc without undergoing gastrulation movements (stage 4). An invagination of the epidermal primordium pushes the embryo back into the center of the yolk (\"embryonic invagination\"). As a result, organogenesis begins while the embryo is invaginated (stage 5). The brain differentiates into an outer cortex of cell bodies that surround a central neuropile. Precursor cells of the epidermis, pharynx, and protonephridia become organized into epithelia. During stage 6, the embryonic primordium everts back to the surface, where organogenesis and cell differentiation continues. Epidermal cells fuse into a syncytium that expands around the yolk. Myoblasts initially do not spread out in the way epidermal cells do; they remain concentrated in two narrow, longitudinal bands that extend along the sides of the embryo. Three pairs of axon tracts extending posteriorly from the brain follow the bands of myoblasts. Stages 7 and 8 are characterized by the appearance of eye pigmentation, brain condensation, and the formation of tentacles and a sucker that bud out from the epidermis of the anterior and posterior end, respectively. Comparison of morphogenesis in temnocephalids with observations in other flatworm taxa suggests a phylotypic stage for this phylum of invertebrates.

Federal government organizations face both internal and external pressures to increase productivity and alter managerial practices. Reoccurring resource constraints, changing work-force and organizational roles, and rapid technological advances are forcing federal managers to rethink how they foster productivity and accomplish their organizational missions. Today's younger employees are better educated and...