Scoring Scheme Research Articles

Fast unsupervised nuclear segmentation and classification scheme for automatic allred cancer scoring in immunohistochemical breast tissue images

Background and objectiveThis paper presents an improved scheme able to perform accurate segmentation and classification of cancer nuclei in immunohistochemical (IHC) breast tissue images in order to provide quantitative evaluation of estrogen or progesterone (ER/PR) receptor status that will assist pathologists in cancer diagnostic process. MethodsThe proposed segmentation method is based on adaptive local thresholding and an enhanced morphological procedure, which are applied to extract all stained nuclei regions and to split overlapping nuclei. In fact, a new segmentation approach is presented here for cell nuclei detection from the IHC image using a modified Laplacian filter and an improved watershed algorithm. Stromal cells are then removed from the segmented image using an adaptive criterion in order to get fast tumor nuclei recognition. Finally, unsupervised classification of cancer nuclei is obtained by the combination of four common color separation techniques for a subsequent Allred cancer scoring. ResultsExperimental results on various IHC tissue images of different cancer affected patients, demonstrate the effectiveness of the proposed scheme when compared to the manual scoring of pathological experts. A statistical analysis is performed on the whole image database between immuno-score of manual and automatic method, and compared with the scores that have reached using other state-of-art segmentation and classification strategies. According to the performance evaluation, we recorded more than 98% for both accuracy of detected nuclei and image cancer scoring over the truths provided by experienced pathologists which shows the best correlation with the expert's score (Pearson's correlation coefficient = 0.993, p-value < 0.005) and the lowest computational total time of 72.3 s/image (±1.9) compared to recent studied methods. ConclusionsThe proposed scheme can be easily applied for any histopathological diagnostic process that needs stained nuclear quantification and cancer grading. Moreover, the reduced processing time and manual interactions of our procedure can facilitate its implementation in a real-time device to construct a fully online evaluation system of IHC tissue images.

Relationship between extralaryngeal endoscopic findings, proton pump inhibitor (PPI) response, and pH measures in suspected laryngopharyngeal reflux.

Laryngopharyngeal reflux (LPR) is a clinical entity diagnosed by history laryngoscopic findings that has a variable response to empiric proton-pump inhibitor (PPI) therapy. While the reflux finding score (RFS), an endoscopic scoring scheme, has been advanced as a measure of LPR, it has not been externally validated against symptom severity in practice. Extralaryngeal pharyngeal endoscopic findings may have diagnostic utility but remain underexplored. This study assesses the correlation between extralaryngeal findings and (1) 24-hour oropharyngeal pH & (2) PPI response in patients with suspected LPR. Subjects presented to a tertiary care center with laryngeal symptoms ≥1 month and reflux symptom index (RSI) ≥13. Following baseline questionnaires, laryngoscopy, and a 24-hour oropharyngeal pH probe study, subjects were prescribed 8-12 week omeprazole trials. Baseline endoscopic findings were scored in a blinded fashion using the RFS and extralaryngeal score criteria, summatively the 'ELS.' PPI response was defined as ≥50% improvement in RSI. Thirty-three subjects with flexible endoscopic recordings completed baseline and follow-up questionnaires. The cohort's baseline mean RSI was 23.0±7.2 with a ΔRSI=9.8 after PPI therapy. The baseline RFS score averaged 5.3±2.7. 45% of our subjects was found to be PPI responsive. The Cohen's kappa for the ELS but not the RFS was significant. There were no significant differences between the RFS (P=0.10) or ELS (P=0.07) for PPI responders & nonresponders. Oropharyngeal pH measures did not correlate with the RFS or ELS. In conclusion, endoscopic scores of laryngeal and extralaryngeal findings did not predict PPI response or oropharyngeal acid exposure in suspected LPR.

Validation of renal-risk models for the prediction of non-renal replacement therapy cardiac surgery-associated acute kidney injury

BackgroundCardiac surgery-associated acute kidney injury (AKI) is a serious complication of cardiac surgery, even when renal replacement therapy (RRT) is not required. The existing risk models for cardiac surgery associated AKI are designed to predict AKI requiring RRT (RRT-AKI). The aim of this study is to validate three risk models for the prediction of RRT-dependent and non-RRT AKI after cardiac surgery. MethodsRetrospective analysis on 7675 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for stage 1 and 2. RRT AKI and non-RRT AKI were defined according to the need for RRT. Three risk models were validated separately for RRT and non-RRT AKI: the Cleveland Risk Score, the Bedside Risk Score, and the Simplified Renal Index Scoring Scheme. Discrimination power was assessed with Receiver Operating Characteristics analysis and c-statistics. ResultsThere were 502 (6.5%) non-RRT AKI events, 128 (1.7%) RRT-AKI events, and 7045 (91.8%) no-events. The three models performed well for predicting RRT-AKI (c-statistics 0.75–0.79) and poorly for predicting non-RRT AKI (c-statistics 0.54–0.59). The models had an excellent calibration for RRT-AKI but not for non-RRT AKI. Preoperative serum creatinine and estimated glomerular filtration rate were associated with RRT AKI but not with non-RRT AKI. Mortality was 12.2% in non-RRT AKI and 46.9% in RRT-AKI, significantly (P = 0.001) higher than in patients without AKI (1.3%). ConclusionsThe existing risk models are inadequate for predicting non-RRT AKI following cardiac surgery, both in terms of discrimination and calibration.

The Development of Bilingual Narrative Retelling Among Spanish-English Dual Language Learners Over Two Years.

This exploratory study investigates the development of oral narrative retell proficiency among Spanish-English emergent bilingual children longitudinally from kindergarten to second grade in Spanish and English as they learned literacy in the 2 languages concurrently. Oral narrative retell assessments were conducted with children who spoke Spanish at home and were enrolled in a dual language immersion program (N = 12) in the spring of kindergarten and second grade. Retells were transcribed and coded for vocabulary and grammar at the microlevel (Miller, Andriacchi, & Nockerts, 2015, 2016) and story structure at the macrolevel (Heilmann, Miller, Nockerts, & Dunaway, 2010). In microstructure paired-sample t tests, children showed significant improvements in vocabulary in both languages (Spanish total number of words η2 = .43, Spanish number of different words η2 = .44, English total number of words η2 = .61, English number of different words η2 = .62) but not grammar by second grade. At the macrostructure level, children showed significantly higher performance in English only (English narrative scoring scheme η2 = .47). The finding that children significantly improved in vocabulary in both languages but in overall story structure only in English suggests that discourse skills were being facilitated in English whereas Spanish discourse development may have stagnated even within a dual language immersion program. Results contribute to what is currently known about bilingual oral narrative development among young Spanish speakers enrolled in such programs and can inform assessment and instructional decisions.

Interactive Sleep Stage Labelling Tool For Diagnosing Sleep Disorder Using Deep Learning.

Traditional manual scoring of the entire sleep for diagnosis of sleep disorders is highly time-consuming and dependent to experts experience. Thus, automatic methods based on electrooculography (EOG) analysis have been increasingly attracted attentions to lower the cost of scoring. Such computeraided diagnosis of sleep disorders are usually based on the 6 scores, wake (W), sleep status (S1-S4) and REM by labelling every 30-second long EOG records. This paper presents an automatic scoring method of sleep stages by using the recent advancements in deep learning. We also suggest an interactive scoring scheme to enable the doctors of practitioners to give feedback by correcting errors and improve the accuracy of scoring as well as diagnosis of sleep disorders.

Benign Neglect or Malign Select?: Entry Cost to GATS/WTO

WTO was established in 1995 and as many as 36 new members joined WTO until December 2017. Thus it would be interesting to see if new members have committed higher or lower levels of market opening compared to the original members. In this regard, a sophisticated scoring scheme is needed to quantify market opening commitments. After proper econometric model is established for the original members, same model can be applied to the new members for comparison. It was found that new members committed a much higher level of commitment than the original members. In addition, it was also found that transition economies committed higher levels than the non-transition economies. More interesting finding is that among the new members, the larger the economies or the larger the trading volume are, the closer was the level of commitment to the predicted level. Then the question is whether this difference was due to benign neglect by the new members or due to malign select by the original members.

Benign Neglect or Malign Select?: Entry Cost to GATS/WTO

WTO was established in 1995 and as many as 36 new members joined WTO until December 2017. Thus it would be interesting to see if new members have committed higher or lower levels of market opening compared to the original members. In this regard, a sophisticated scoring scheme is needed to quantify market opening commitments. After proper econometric model is established for the original members, same model can be applied to the new members for comparison. It was found that new members committed a much higher level of commitment than the original members. In addition, it was also found that transition economies committed higher levels than the non-transition economies. More interesting finding is that among the new members, the larger the economies or the larger the trading volume are, the closer was the level of commitment to the predicted level. Then the question is whether this difference was due to benign neglect by the new members or due to malign select by the original members.

Роль структурных изменений внеклеточного матрикса мочевого пузыря в возникновении побочных эффектов лучевой терапии разной степени тяжести

To investigate the role of structural changes of the urinary bladder extracellular matrix in the occurrence of different grades of adverse events after radiation therapy. The connective tissue matrix was studied using 126 images obtained from the histological sections of the bladder biopsy specimens of 12 patients classified according to the clinical presentation and the grades of late bladder toxicity according to RTOG/EORTC Late Radiation Morbidity Scoring Scheme. Control images of the normal bladder (n=23) were collected from the autopsy samples. We used nonlinear microscopy imaging method capturing the second harmonic generation (SHG) signal and two-photon excitation auto-fluorescence (TPEA). The findings of nonlinear microscopy of urinary bladder histological sections showed that the structural changes in the connective tissue differed depending on the grade of adverse events: grade II adverse events were associated with the preservation of the structure of collagen fibers and their compression, grade III adverse events caused pronounced disorganization of collagen fibers, blurring without a definite fiber direction. At the same time, in a normal bladder, the structure of collagen fibers was visualized; they had a spiral shape and in some areas were collected in bundles. Collagen fibers and bundles were loosely arranged and accompanied by elastic fibers. The findings suggest that the grade of urinary bladder radiation injury correlates with the data detected by nonlinear microscopy. The mosaic structure of radiation-induced alterations of the bladder tissue, even in the areas most affected by radiation (posterior bladder wall, bladder trigone, and bladder neck) indicates that patients with radiation-induced high-grade toxicity need comprehensive care designed to preserve the bladder functional reserves and capacity. The prevention of radiation-related adverse events before radiation therapy should be based on urologic care aimed to detect and treat chronic inflammatory diseases of the bladder and preserve its functional reserves. Another way to improve outcomes is to optimize the management of adverse events. The examination of bladder tissue specimens taken from different parts of the bladder carried out using nonlinear microscopy in the SHG and TPEA modes revealed that the degree of structural changes in the connective tissue matrix in the post-radiation period varies and correlates with the grades of the radiation bladder toxicity. The results of this study can be used to substantiate measures to prevent the onset of high-grade toxicity after radiation therapy of pelvic malignancies.

Educating undergraduate students on malaria: results from a pragmatic pre-test post-test intervention study

Background: To tackle the major public health problem of malaria, India has launched the National Vector borne Diseases Programme. Various strategies of this programme strongly depend on community’s knowledge and participation. However, there is a deficiency in evidence on the same from India.Methods: A single-group pre-test post-test study was carried out among consenting adult students of hotel management in Mangalore, India using a self-administered pre-tested questionnaire with an innovative scoring scheme. Following pre-test, an interactive audio-visual health education session was delivered. The intervention, which was prepared after reviewing the latest guidelines, incorporated many pictures and diagrams. The session covered aetiology, transmission, diagnosis and treatment aspects as well as personal, household and community level measures for prevention and control. Thereafter, post-test was administered.Results: 91 out of 120 students approached agreed to participate in the study. 4 out of these were lost at post-test yielding an overall response rate of 72.5%. The final participants’ mean age was 20.43 years (SD 1.12 years); 69% were male and all had completed 10+2 education. The median pre-test score was 8.4 points with inter-quartile range from 6.5-9.75; the median post-test score was 9.68 points with inter-quartile range from 7.76–11.1. Wilcoxon signed-ranks test yielded a p value of 0.001365 which was highly significant.Conclusions: Pending the conduct of better-designed intervention evaluation studies, this study provides a good starting point for designing pragmatic and scalable health education interventions against malaria.

Genomics driven approach for identification of novel therapeutic targets in Salmonella enterica

Salmonella enterica is a causative agent of enteric and systemic salmonellosis that affects human and many other animal species. Due to the emergence of drug-resistant strains, available drugs against S. enterica infection are no more effective as before. Thus, there is an urgent need to develop new therapeutic strategies. The current study aims at prioritizing therapeutic targets by an in-silico genomics driven method. The method involves searching proteins of each Salmonella strain for essentiality, virulence and antibiotic-resistance and host-pathogen protein-protein interactions. Using subtractive genomics approach, we further confirmed that none of the selected protein shares sequence homology with any human (host) protein and also with proteins from human symbiotic gut flora. Pathway analysis of these screened proteins revealed associated biological processes. Presence of proteins in pathogen-specific pathways was used as one of the assessment property in the subsequent scoring scheme. Simultaneously proteins are screened based on parameters like druggability (sequence similarity with existing drug targets), sub-cellular localization and presence of transmembrane domain. The implemented scoring scheme depicted a final list of 14 potential therapeutic targets out of which 6 could be identified as ‘high-confidence’ targets based on extensive literature curation. Identified therapeutic targets can aid in the design and development of effective antibacterial agents against S. enterica. The genomics driven strategy adopted in this study can also be applied to screen therapeutic targets for other pathogens.

Adaptive landscape flattening in amino acid sequence space for the computational design of protein:peptide binding.

For the high throughput design of protein:peptide binding, one must explore a vast space of amino acid sequences in search of low binding free energies. This complex problem is usually addressed with either simple heuristic scoring or expensive sequence enumeration schemes. Far more efficient than enumeration is a recent Monte Carlo approach that adaptively flattens the energy landscape in sequence space of the unbound peptide and provides formally exact binding free energy differences. The method allows the binding free energy to be used directly as the design criterion. We propose several improvements that allow still more efficient sampling and can address larger design problems. They include the use of Replica Exchange Monte Carlo and landscape flattening for both the unbound and bound peptides. We used the method to design peptides that bind to the PDZ domain of the Tiam1 signaling protein and could serve as inhibitors of its activity. Four peptide positions were allowed to mutate freely. Almost 75 000 peptide variants were processed in two simulations of 109 steps each that used 1 CPU hour on a desktop machine. 96% of the theoretical sequence space was sampled. The relative binding free energies agreed qualitatively with values from experiment. The sampled sequences agreed qualitatively with an experimental library of Tiam1-binding peptides. The main assumption limiting accuracy is the fixed backbone approximation, which could be alleviated in future work by using increased computational resources and multi-backbone designs.

A diagnostic tree model for polytomous responses with multiple strategies.

Constructed-response items have been shown to be appropriate for cognitively diagnostic assessments because students' problem-solving procedures can be observed, providing direct evidence for making inferences about their proficiency. However, multiple strategies used by students make item scoring and psychometric analyses challenging. This study introduces the so-called two-digit scoring scheme into diagnostic assessments to record both students' partial credits and their strategies. This study also proposes a diagnostic tree model (DTM) by integrating the cognitive diagnosis models with the tree model to analyse the items scored using the two-digit rubrics. Both convergent and divergent tree structures are considered to accommodate various scoring rules. The MMLE/EM algorithm is used for item parameter estimation of the DTM, and has been shown to provide good parameter recovery under varied conditions in a simulation study. A set of data from TIMSS 2007 mathematics assessment is analysed to illustrate the use of the two-digit scoring scheme and the DTM.

Late toxicity in long-term survivors from a phase 2 study of concurrent radiation therapy, temozolomide and valproic acid for newly diagnosed glioblastoma.

Valproic acid (VPA) is an antiepileptic agent with histone deacetylase inhibitor activity shown to enhance overall survival and progression free survival in patients with newly diagnosed glioblastoma (GBM). This reports on the late toxicity of the VPA/radiotherapy (RT)/temozolomide (TMZ) combination in the long-term survivors of a phase 2 study evaluating this regimen. 37 patients with newly diagnosed GBM were initially enrolled on this trial and received combination therapy. VPA/RT/TMZ related late toxicities were evaluated in the 6 patients that lived greater than 3 years using the Cancer Therapy and Evaluation Program Common Toxicity Criteria (CTC) Version 4.0 for toxicity and adverse event reporting as well as the RTOG/EORTC Radiation Morbidity Scoring Scheme. The median duration of follow-up for these 6 patients was 69.5m. In this cohort, the median OS was 73.8m (60.8-103.8m) and median PFS was 53.1m (37.3 - 103.8m). The most common late toxicity of VPA in conjunction with RT/TMZ were the CTC classifications of neurological, pain, and blood/ bone marrow toxicity and most were grade 1/2. There were only two grade 3/4 toxicities. The addition of VPA to concurrent RT/TMZ in patients with newly diagnosed GBM was well tolerated with little late toxicity. Additionally, VPA may result in improved outcomes as compared to historical data and merits further study.

On Fair Person Classification Based on Efficient Factor Score Estimates in the Multidimensional Factor Analysis Model.

Since Hooker, Finkelman and Schwartzman (Psychometrika 74(3): 419-442, 2009) it is known that person parameter estimates from multidimensional latent variable models can induce unfair classifications via paradoxical scoring effects. The open question as to whether there is a fair and at the same time multidimensional scoring scheme with adequate statistical properties is addressed in this paper. We develop a theorem on the existence of a fair, multidimensional classification scheme in the context of the classical linear factor analysis model and show how the computation of the scoring scheme can be embedded in the context of linear programming. The procedure is illustrated in the framework of scoring the Wechsler Adult Intelligence Scale (WAIS-IV).

Same or different: Narrative retells in bilingual Latino kindergarten children

ABSTRACTThe present study examines the association of micro- and macrostructural components in narrative retells within and across languages in Spanish-English bilingual Latino kindergarten children. Using a within-subject research design, fourteen Spanish-English speaking Latino kindergarten children were individually read a scripted picture book, after which narrative retells were elicited separately in each language using the pictures of the book as an aid. Cross-sectional data of the children’s retell transcriptions were coded and analyzed for macrostructure using the narrative scoring scheme and for microstructure by computing the mean length of utterance in words, the number of different words, and the subordination index. Results of the study suggest that elements of macrostructure retells are associated across languages. Microstructure components do not seem to be related across languages but are strongly associated within the same language. Performance in microstructural measures in each language was observed to vary across languages, suggesting that children in the sample acquired the lexical and grammar skills associated with microstructure independently in each of their two languages. Findings from this study have clinical and educational implications for the assessment and instruction of Spanish-English bilingual kindergarten children.

GPS: Identification of disease genes by rank aggregation of multi-genomic scoring schemes

In solving the gene prioritization problem, ranking candidate genes from most to least promising is attempted before further experimental validation. Integrating the results of various data sources and methods tends to result in a better performance when solving the gene prioritization problem. Therefore, a wide range of datasets and algorithms was investigated; these included topological features of protein networks, physicochemical characteristics and blast similarity scores of protein sequences, gene ontology, biological pathways, and tissue-based data sources. The novelty of this study lies in how the best-performing methods and reliable multi-genomic data sources were applied in an efficient two-step approach. In the first step, various multi-genomic data sources and algorithms were evaluated and seven best-performing rankers were then applied to prioritize candidate genes in different ways. In the second step, global prioritization was obtained by aggregating several scoring schemes.The results showed that protein networks, functional linkage networks, gene ontology, and biological pathway data sources have a significant impact on the quality of the gene prioritization approach. The findings also demonstrated a direct relationship between the degree of genes and the ranking quality of the evaluated tools. This approach outperformed previously published algorithms (e.g., DIR, GPEC, GeneDistiller, and Endeavour) in all evaluation metrices and led to the development of GPS software. Its user-friendly interface and accuracy makes GPS a powerful tool for the identification of human disease genes. GPS is available at http://gpsranker.com and http://LBB.ut.ac.ir.

Analyzing the pathways enriched in genes associated with nicotine dependence in the context of human protein–protein interaction network

Nicotine dependence is the primary addictive stage of cigarette smoking. Although a lot of studies have been performed to explore the molecular mechanism underlying nicotine dependence, our understanding on this disorder is still far from complete. Over the past decades, an increasing number of candidate genes involved in nicotine dependence have been identified by different technical approaches, including the genetic association analysis. In this study, we performed a comprehensive collection of candidate genes reported to be genetically associated with nicotine dependence. Then, the biochemical pathways enriched in these genes were identified by considering the gene’s propensity to be related to nicotine dependence. One of the most widely used pathway enrichment analysis approach, over-representation analysis, ignores the function non-equivalence of genes in candidate gene set and may have low discriminative power in identifying some dysfunctional pathways. To overcome such drawbacks, we constructed a comprehensive human protein–protein interaction network, and then assigned a function weighting score to each candidate gene based on their network topological features. Evaluation indicated the function weighting score scheme was consistent with available evidence. Finally, the function weighting scores of the candidate genes were incorporated into pathway analysis to identify the dysfunctional pathways involved in nicotine dependence, and the interactions between pathways was detected by pathway crosstalk analysis. Compared to conventional over-representation-based pathway analysis tool, the modified method exhibited improved discriminative power and detected some novel pathways potentially underlying nicotine dependence. In summary, we conducted a comprehensive collection of genes associated with nicotine dependence and then detected the biochemical pathways enriched in these genes using a modified pathway enrichment analysis approach with function weighting score of candidate genes integrated. Our results may provide insight into the molecular mechanism underlying nicotine dependence.

Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer

Optimizing radiation therapy techniques for localized prostate cancer can affect patient outcomes. Dose escalation improves biochemical control, but no prior trials were powered to detect overall survival (OS) differences. To determine whether radiation dose escalation to 79.2 Gy compared with 70.2 Gy would improve OS and other outcomes in prostate cancer. The NRG Oncology/RTOG 0126 randomized clinical trial randomized 1532 patients from 104 North American Radiation Therapy Oncology Group institutions March 2002 through August 2008. Men with stage cT1b to T2b, Gleason score 2 to 6, and prostate-specific antigen (PSA) level of 10 or greater and less than 20 or Gleason score of 7 and PSA less than 15 received 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy to 79.2 Gy in 44 fractions or 70.2 Gy in 39 fractions. Time to OS measured from randomization to death due to any cause. American Society for Therapeutic Radiology and Oncology (ASTRO)/Phoenix definitions were used for biochemical failure. Acute (≤90 days of treatment start) and late radiation therapy toxic effects (>90 days) were graded using the National Cancer Institute Common Toxicity Criteria, version 2.0, and the RTOG/European Organisation for the Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme, respectively. With a median follow-up of 8.4 (range, 0.02-13.0) years in 1499 patients (median [range] age, 71 [33-87] years; 70% had PSA <10 ng/mL, 84% Gleason score of 7, 57% T1 disease), there was no difference in OS between the 751 men in the 79.2-Gy arm and the 748 men in the 70.2-Gy arm. The 8-year rates of OS were 76% with 79.2 Gy and 75% with 70.2 Gy (hazard ratio [HR], 1.00; 95% CI, 0.83-1.20; P = .98). The 8-year cumulative rates of distant metastases were 4% for the 79.2-Gy arm and 6% for the 70.2-Gy arm (HR, 0.65; 95% CI, 0.42-1.01; P = .05). The ASTRO and Phoenix biochemical failure rates at 5 and 8 years were 31% and 20% with 79.2 Gy and 47% and 35% with 70.2 Gy, respectively (both P < .001; ASTRO: HR, 0.59; 95% CI, 0.50-0.70; Phoenix: HR, 0.54; 95% CI, 0.44-0.65). The high-dose arm had a lower rate of salvage therapy use. The 5-year rates of late grade 2 or greater gastrointestinal and/or genitourinary toxic effects were 21% and 12% with 79.2 Gy and 15% and 7% with 70.2 Gy (P = .006 [HR, 1.39; 95% CI, 1.10-1.77] and P = .003 [HR, 1.59; 95% CI, 1.17-2.16], respectively). Despite improvements in biochemical failure and distant metastases, dose escalation did not improve OS. High doses caused more late toxic effects but lower rates of salvage therapy. clinicaltrials.gov Identifier: NCT00033631.

An approach for N-linked glycan identification from MS/MS spectra by target-decoy strategy

Glycan structure determination serves as an essential step for the thorough investigation of the structure and function of protein. Currently, appropriate sample preparation followed by tandem mass spectrometry has emerged as the dominant technique for the characterization of glycans and glycopeptides. Although extensive efforts have been made to the development of computational approaches for the automated interpretation of glycopeptide spectra, the previously appeared methods lack a reasonable quality control strategy for the statistical validation of reported results. In this manuscript, we introduced a novel method that constructed a decoy glycan database based on the glycan structures in the target database, and searched the experimental spectra against both the target and decoy databases to find the best matched glycans. Specifically, a two-layer scoring scheme for calculating a normalized matching score is applied in the search procedure which enables the unbiased ranking of the matched glycans. Experimental analysis showed that our proposed method can report more structures with high confidence compared with previous approaches.

Learning With E-books and Project-based Strategy in a Community Health Nursing Course.

With advances in information technology, "information-assisted instruction" has been gradually introduced to nursing education curricula. Specifically, the integration of an e-book system can effectively enhance nursing students' attention and interest. Most studies on nursing education that incorporated e-books have focused on the advantages of convenience and assistance provided by e-books. Few studies have addressed community health nursing and off-campus practice activities in relation to suitable teaching strategies for learning activities. This study involved designing and planning a multimedia e-book learning system with a project-based learning activity that conforms to the curriculum and practical requirements of a community health nursing course. The purpose was to reduce the gap between theory and practice and realize an effective learning process. For learning evaluations, a final examination analysis with an independent sample t test; a scoring scheme with intrateam, interteam, and expert ratings; and Bloom's taxonomy-based analysis were conducted. The evaluation results indicated that the comprehension and learning abilities of the experimental group using the e-book system with a mobile device were effectively improved. In addition, the exploratory process involved in project-based learning can develop multiple cognitive skills and problem-solving ability, thereby realizing effective learning.