A Deep Learning Model for Classification of Endoscopic Gastroesophageal Reflux Disease.

Gastroesophageal reflux disease (GERD) is a common disease with high prevalence, and its endoscopic severity can be evaluated using the Los Angeles classification (LA grade). This paper proposes a deep learning model (i.e., GERD-VGGNet) that employs convolutional neural networks for automatic classification and interpretation of routine GERD LA grade. The proposed model employs a data augmentation technique, a two-stage no-freezing fine-tuning policy, and an early stopping criterion. As a result, the proposed model exhibits high generalizability. A dataset of images from 464 patients was used for model training and validation. An additional 32 patients served as a test set to evaluate the accuracy of both the model and our trainees. Experimental results demonstrate that the best model for the development set exhibited an overall accuracy of 99.2% (grade A-B), 100% (grade C-D), and 100% (normal group) using narrow-band image (NBI) endoscopy. On the test set, the proposed model resulted in an accuracy of 87.9%, which was significantly higher than the results of the trainees (75.0% and 65.6%). The proposed GERD-VGGNet model can assist automatic classification of GERD in conventional and NBI environments and thereby increase the accuracy of interpretation of the results by inexperienced endoscopists.

Correlation of impulsivity with self-harm and suicidal attempt: a community study of adolescents in Taiwan.

OBJECTIVES: The aim of this study was to investigate differences and similarities in risk factors for deliberate self-harm (DSH) and suicidal attempt (SA), and the role of impulsivity among a group of community adolescents. SETTING: This is a cross-sectional study conducted at high schools in Northern Taiwan. DATA AND PARTICIPANTS: We recruited grade 1 students from 14 high schools. A total of 5879 participants (mean age 16.02 years, female adolescents: 57.7%) completed the online assessment. OUTCOME MEASURES: Participants completed online questionnaires about sociodemographic data, suicidality, history of DSH and SA, depressed mood, self-esteem, social support, family discord, impulsivity (Barratt Impulsiveness Scale Version 11 (BIS-11)) and the use of alcohol, tobacco and illicit drugs. A subsample was interviewed about lifetime SA, and the results were compared with those from the online questionnaires. RESULTS: In our sample, 25% of the students had lifetime DSH and 3.5% had lifetime SA. Two hundred and seventy-two students received face-to-face interviews. The concordance between the online questionnaires and interviews in terms of ascertaining cases of SA was moderate (concordance rate 82.76%; kappa value 0.59). Similar risk factors for DSH/SA among the whole sample included female gender, lower academic performance, depression, substance use (tobacco and alcohol) and low self-esteem. The BIS-11 score was correlated with DSH. Factor 3 score of the BIS-11 (novelty seeking) was correlated with DSH in both boys and girls, whereas factor 2 score (lack of self-control) was correlated with SA in boys. Social support was a protective factor against SA among the female adolescents. Gender modulated the association of impulsivity and DSH/SA. Associations between impulsivity and DSH and SA were particularly strong among boys. CONCLUSIONS: Risk factors for DSH and SA were similar, but not identical. Early identification of those at risk and appropriate interventions may be helpful.

Gender differences and stage-specific influence of parent-adolescent conflicts on adolescent suicidal ideation.

This study examined familial and peer related factors as predictors of suicidal ideation in school students. Total 2896 participants were included from Taiwan Youth Project released data, a longitudinal survey of adolescent suicidal ideation at ages 15, 18, and 20. Logistic regression analysis risk factors associated with adolescent suicidal ideation reveled differences during the developmental stages. After adjusted for psychological symptoms, effect of quarrels with parents on suicidal ideation lasts in early and middle stages; in the late adolescent stage, only cigarette or alcohol use remained significant. Girls who reported quarrels with parents had the highest level of suicidal ideation before age 18. Stage- and gender-specific differences may provide appropriate intervention strategies for parents and teachers preventing adolescent suicidal ideation.