The Berkeley Transcription System (BTS) has been designed for the transcription of sign language videotapes at the level of meaning components. The system is based on efforts to transcribe adult-child interactions in American Sign Language (ASL) and Sign Language of the Netherlands (SLN). The goal of BTS is to provide a standard means of transcribing signed utterances, meeting the following objectives: –compatibility with CHAT format and CLAN programs (CHILDES) –linear representation on a continuous typed line, using only ASCII characters –representation at the level of meaning components –full representation of elements of polycomponential verbs –representation of manual and nonmanual elements –representation of gaze direction, role shift, visual attention –representation of gestures and other communicative acts –notation of characteristics of adult-child interaction (child-directed signing, errors, overlap, self-correction).
Vitiligo is a multifaceted autoimmune depigmenting disorder affecting around 0.5 to 2.0% of individuals globally. Standardizing diagnosis and therapy tracking can be arduous, as numerous clinical evaluation methods are subject to interobserver variability and may not be validated. Therefore, there is a need for diagnostic tools that are objective, dependable, and preferably non-invasive.AimsThis systematic review provides a comprehensive overview of the non-invasive objective skin measurement methods that are currently used to evaluate the diagnosis, severity, and progression of vitiligo, as well as the advantages and limitations of each technique.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for the systematic review. Scopus, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for non-invasive imaging and biophysical skin measuring methods to diagnose, evaluate the severity of, or monitor the effects of vitiligo treatment. The risk of bias in included articles was assessed using the QUADAS-2 quality assessment scale.ResultsAn extensive literature search resulted in 64 studies for analysis, describing eight imaging techniques (reflectance confocal microscopy, computer-aided imaging analysis, optical coherence tomography, infrared photography, third-harmonic generation microscopy, multiphoton microscopy, ultraviolet light photography, and visible light/digital photograph), and three biophysical approaches (dermoscopy, colorimetry, spectrometry) used in diagnosing and assessing vitiligo. Pertinent information about functionality, mechanisms of action, sensitivity, and specificity was obtained for all studies, and insights into the strengths and limitations of each diagnostic technique were addressed. Methodological study quality was adequate; however, statistical analysis was not achievable because of the variety of methods evaluated and the non-standardized reporting of diagnostic accuracy results.ConclusionsThe results of this systematic review can enhance clinical practice and research by providing a comprehensive overview of the spectrum of non-invasive imaging and biophysical techniques in vitiligo assessment. Studies with larger sample sizes and sound methodology are required to develop verified methods for use in future practice and research.Systematic review registration(PROSPERO) database, (CRD42023395996).
Gastric cancer is a prevalent cancer with a predilection for Asian ethnicity and male patients. In early and locally advanced gastric cancer, without significant comorbidities, surgery is a part of the treatment management of this cancer. However, with concurrent comorbidities, surgery may not be recommended and alternative treatment options such as palliative chemotherapy and/or radiation and definitive chemoradiation can be considered to reduce morbidity. We present three cases of gastric cancer where definitive chemoradiation with dose escalation was utilized due to underlying comorbidities and poor performance status. The treatment was generally well tolerated by patients and resulted in substantial reduction in gastric mass size in two patients with median overall survival of 10 months.
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