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Ben shu yi Ben, Jing yu An san ge he shang wei xu shu xian suo, jiang shu liao yi ge you guan da zi ran gui lü de yu yan gu shi.

Upper gastrointestinal cancers (including oesophageal cancer and gastric cancer) are the most common cancers worldwide. Artificial intelligence platforms using deep learning algorithms have made remarkable progress in medical imaging but their application in upper gastrointestinal cancers has been limited. We aimed to develop and validate the Gastrointestinal Artificial Intelligence Diagnostic System (GRAIDS) for the diagnosis of upper gastrointestinal cancers through analysis of imaging data from clinical endoscopies. This multicentre, case-control, diagnostic study was done in six hospitals of different tiers (ie, municipal, provincial, and national) in China. The images of consecutive participants, aged 18 years or older, who had not had a previous endoscopy were retrieved from all participating hospitals. All patients with upper gastrointestinal cancer lesions (including oesophageal cancer and gastric cancer) that were histologically proven malignancies were eligible for this study. Only images with standard white light were deemed eligible. The images from Sun Yat-sen University Cancer Center were randomly assigned (8:1:1) to the training and intrinsic verification datasets for developing GRAIDS, and the internal validation dataset for evaluating the performance of GRAIDS. Its diagnostic performance was evaluated using an internal and prospective validation set from Sun Yat-sen University Cancer Center (a national hospital) and additional external validation sets from five primary care hospitals. The performance of GRAIDS was also compared with endoscopists with three degrees of expertise: expert, competent, and trainee. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of GRAIDS and endoscopists for the identification of cancerous lesions were evaluated by calculating the 95% CIs using the Clopper-Pearson method. 1 036 496 endoscopy images from 84 424 individuals were used to develop and test GRAIDS. The diagnostic accuracy in identifying upper gastrointestinal cancers was 0·955 (95% CI 0·952–0·957) in the internal validation set, 0·927 (0·925–0·929) in the prospective set, and ranged from 0·915 (0·913–0·917) to 0·977 (0·977–0·978) in the five external validation sets. GRAIDS achieved diagnostic sensitivity similar to that of the expert endoscopist (0·942 [95% CI 0·924–0·957] vs 0·945 [0·927–0·959]; p=0·692) and superior sensitivity compared with competent (0·858 [0·832–0·880], p<0·0001) and trainee (0·722 [0·691–0·752], p<0·0001) endoscopists. The positive predictive value was 0·814 (95% CI 0·788–0·838) for GRAIDS, 0·932 (0·913–0·948) for the expert endoscopist, 0·974 (0·960–0·984) for the competent endoscopist, and 0·824 (0·795–0·850) for the trainee endoscopist. The negative predictive value was 0·978 (95% CI 0·971–0·984) for GRAIDS, 0·980 (0·974–0·985) for the expert endoscopist, 0·951 (0·942–0·959) for the competent endoscopist, and 0·904 (0·893–0·916) for the trainee endoscopist. GRAIDS achieved high diagnostic accuracy in detecting upper gastrointestinal cancers, with sensitivity similar to that of expert endoscopists and was superior to that of non-expert endoscopists. This system could assist community-based hospitals in improving their effectiveness in upper gastrointestinal cancer diagnoses. The National Key R&D Program of China, the Natural Science Foundation of Guangdong Province, the Science and Technology Program of Guangdong, the Science and Technology Program of Guangzhou, and the Fundamental Research Funds for the Central Universities.

Cultivating intercultural competence is a long-term and staged process requiring the efforts of all counterparts in the education field from primary school up to university. Currently, most research on intercultural education in China focuses on the tertiary education context, and little attention has been paid to elementary education as well as primary school EFL teachers. Against this background, this study intends to investigate Chinese primary school EFL teachers’ preparedness for intercultural foreign language teaching (IFLT), its influencing factors, and the support teachers need to implement IFLT. A convergent mixed method was used in this study. Data was collected through questionnaires and interviews, SPSS and the thematic analysis method were used to analyze the data. Via both quantitative and qualitative methods, this empirical study found that: 1. Primary school EFL teachers are not well prepared for IFLT; 2. Textbooks, the current evaluation system, teachers’ lack of literacy in intercultural competence, insufficient teacher training on intercultural competence, and teachers’ lack of time and energy are five major factors that constrain the implementation of IFLT; 3. Support from school administration, the construction of intercultural-related materials and resources, and practice-oriented teacher training are the three main support teachers need. Based on these findings, the role of textbooks, experience abroad and general materials on culture in promoting IFLT were discussed. At last, implications and future research directions were proposed.

This paper investigates music education, where an efficient and accurate performance evaluation system in the piano teaching and performance ecosystem is increasingly becoming an essential tool for improving teaching quality and performance level. The objective evaluation of students’ performance skills can be achieved by carefully analyzing piano performances using the network flow optimization technique. This technique optimizes the performance evaluation system’s audio recognition ability by analyzing the piano audio signal and solving the multi-constraint nonlinear optimization problem in a limited time domain. This paper establishes a network flow optimization model, applies the multi-constraint nonlinear optimization technique, and combines the non-negative matrix decomposition and dynamic time regularization algorithm to analyze the piano performance for experiments. After optimization processing, hundreds of piano audio samples were collected, and the audio recognition accuracy was improved by 20%. By optimizing and processing the audio signals from the network stream, the evaluation system could detect polyphony more accurately and track the musical score effectively, improving accuracy and efficiency. Using the non-negative matrix decomposition algorithm, the accuracy of detecting polyphony can reach 85%, while the dynamic temporal regularization algorithm can match the position of the musical score with 95% accuracy. The accuracy of piano performance evaluation is optimized by this network flow optimization method, providing new technical means for music education, and promoting the quality of teaching and performance.

Deep brain regions such as hippocampus, insula, and amygdala are involved in neuropsychiatric disorders, including chronic insomnia and depression. Our recent reports showed that transcranial alternating current stimulation (tACS) with a current of 15 mA and a frequency of 77.5 Hz, delivered through a montage of the forehead and both mastoids was safe and effective in intervening chronic insomnia and depression over 8 weeks. However, there is no physical evidence to support whether a large alternating current of 15 mA in tACS can send electrical currents to deep brain tissue in awake humans. Here, we directly recorded local field potentials (LFPs) in the hippocampus, insula and amygdala at different current strengths (1 to 15 mA) in 11 adult patients with drug-resistant epilepsy implanted with stereoelectroencephalography (SEEG) electrodes who received tACS at 77.5 Hz from 1 mA to 15 mA at 77.5 Hz for five minutes at each current for a total of 40 min. For the current of 15 mA at 77.5 Hz, additional 55 min were applied to add up a total of 60 min. Linear regression analysis revealed that the average LFPs for the remaining contacts on both sides of the hippocampus, insula, and amygdala of each patient were statistically associated with the given currents in each patient ( p  < 0.05–0.01), except for the left insula of one subject ( p  = 0.053). Alternating currents greater than 7 mA were required to produce significant differences in LFPs in the three brain regions compared to LFPs at 0 mA ( p  < 0.05). The differences remained significant after adjusting for multiple comparisons ( p  < 0.05). Our study provides direct evidence that the specific tACS procedures are capable of delivering electrical currents to deep brain tissues, opening a realistic avenue for modulating or treating neuropsychiatric disorders associated with hippocampus, insula, and amygdala.

Postoperative ileus is a major problem following gastrointestinal cancers surgery, several randomized controlled trials have been conducted investigating the use of probiotics or synbiotics to reduce postoperative ileus, but their findings are controversial. We conducted a meta-analysis to determine the effect of probiotics or synbiotics on early postoperative recovery of gastrointestinal function in patients with gastrointestinal cancer. The Embase, Cochrane Library, PubMed, and Web of Science databases were comprehensively searched for randomized controlled trials (RCTs) that evaluated the effects of probiotics or synbiotics on postoperative recovery of gastrointestinal function as of April 27, 2021. Outcomes included the time to first flatus, time to first defecation, days to first solid diet, days to first fluid diet, length of postoperative hospital stay, incidence of abdominal distension and incidence of postoperative ileus. The results were reported as the mean difference (MD) and relative risk (RR) with 95% confidence intervals (CI). A total of 21 RCTs, involving 1776 participants, were included. Compared with the control group, probiotic and synbiotic supplementation resulted in a shorter first flatus (MD, -0.53 days), first defecation (MD, -0.78 days), first solid diet (MD, -0.25 days), first fluid diet (MD, -0.29 days) and postoperative hospital stay (MD, -1.43 days). Furthermore, Probiotic and synbiotic supplementation reduced the incidence of abdominal distension (RR, 0.62) and incidence of postoperative ileus (RR, 0.47). Perioperative supplementation of probiotics or synbiotics can effectively promote the recovery of gastrointestinal function after gastrointestinal cancer surgery.

Two new species of the genus Narynia Martynova from China are described: Narynia alxaica sp. nov. from the western Inner Mongolia Autonomous Region, northern China and Narynia ritongensis sp. nov. from Xizang Province, southwestern China. The two new species can be separated from known species by the length ratio (lateral vs. medial) and location of sensilla on abdominal segment V. An identification key to the species of the genus Narynia is given.