This paper proposes a novel classification framework and a novel data reduction method to distinguish multiclass motor imagery (MI) electroencephalography (EEG) for brain computer interface (BCI) based on the manifold of covariance matrices in a Riemannian perspective. For method 1, a subject-specific decision tree (SSDT) framework with filter geodesic minimum distance to Riemannian mean (FGMDRM) is designed to identify MI tasks and reduce the classification error in the nonseparable region of FGMDRM. Method 2 includes a feature extraction algorithm and a classification algorithm. The feature extraction algorithm combines semisupervised joint mutual information (semi-JMI) with general discriminate analysis (GDA), namely, SJGDA, to reduce the dimension of vectors in the Riemannian tangent plane. And the classification algorithm replaces the FGMDRM in method 1 with k-nearest neighbor (KNN), named SSDT-KNN. By applying method 2 on BCI competition IV dataset 2a, the kappa value has been improved from 0.57 to 0.607 compared to the winner of dataset 2a. And method 2 also obtains high recognition rate on the other two datasets.

ObjectivePituitary adenomas are benign neoplasms that display invasive behavior—a characteristic traditionally associated with malignancy—through an ill-defined mechanism. The role of angiogenesis-related molecules in this pathological condition remains perplexing. Our purpose is to assess the impact of endocan (endothelial cell specific molecule-1, ESM-1), CD34 and CD105 on pituitary adenoma invasion.MethodsIn this study, immunohistochemical analyses for endocan, CD34 and CD105 were performed on paraffin-embedded samples of 66 pituitary adenomas, five normal pituitaries, and five primary hepatic carcinomas. Knosp tumor grades based on magnetic resonance imaging coronal scanning were used to assess the invasiveness of each sample. The associations between endocan expression, CD34/CD105-positive microvessel densities (MVDs), and Knosp tumor invasion grades were evaluated.ResultsThese results showed that endocan protein expression in tumor cells (TCs) was higher than that in endothelial cells (ECs) and strongly correlated with Knosp grades (P < 0.001, Spearman’s r = 0.616). Moreover, while endocan-positive TCs localized around the blood vessels in adenomas with higher Knosp grades, no significant association was found between CD34/CD105-MVDs and Knosp grades (CD34: P = 0.256, r = 0.142; CD105: P = 0.183, r = 0.166). Normal pituitary seemed to exhibit lower endocan expression and contained more CD34/CD105-MVDs than pituitary adenomas.ConclusionEndocan expresses in both TCs and ECs of pituitary adenoma. Endocan overexpression in TCs more accurately reflects invasiveness compared to that of CD34/CD105-MVDs and that angiogenesis may not be the primary driver of endocan-medicated pituitary adenoma invasion.

Background and Objectives: There is a lack of multicenter immediate breast reconstruction data comparing the surgical complication of implant and autologous breast reconstruction, especially in China. In this study, we used the data from eight centers to study the complications and their risk factors in this population. Methods: Sociodemographic and clinicopathological data were obtained and compared for patients who received immediate implant and autologous breast reconstruction after breast cancer surgery in the eight hospitals between 2012 and 2016. Logistic regression analysis was used to identify risk factors associated with the complication of breast reconstruction. Results: Immediate autologous reconstruction (IAR) was associated with significantly higher rates of overall complications (P = 0.036), fat liquefaction (P < 0.001), and reconstructive failure (P = 0.019), but lower rates of wound complications (P = 0.01) compared with the immediate implant reconstruction (IIR) at the median follow‐up time of 13.6 months. With the logistic regression analysis, older patient (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.15‐4.28; P = 0.017), and obesity (OR, 2.17; 95% CI, 1.08‐4.37; P = 0.030) were significant predictors of increased complications. Conclusion: Our multicenter results demonstrated that the rates of overall complications and reconstruction failure were higher after IAR than IIR. These findings can be used to better help surgeons and their patients with objective and reliable information to assist in selecting the modality of reconstruction.

Background and Objectives:Nipple-sparing mastectomy (NSM) is a widely accepted surgical technique for patients with early breast cancer. The technique improves cosmetic outcomes, but a decrease in nipple sensitivity has been observed with NSM because of the incision into the nipple–areola complex (NAC). Endoscopic nipple-sparing mastectomy with skin lifting system (ENSMSLS) removes all breast tissue through the axillary incision used for the sentinel lymph node biopsy, to avoid incision around the NAC area. With only one incision, NAC sensitivity is less likely to be affected by this technique. We sought to investigate the effect of ENSMSLS on sensation in the NAC, compared with NSM.Methods:A single-institution retrospective review was performed from August 2014 through August 2015. Thirty patients who underwent NSM in the past 6 years were frequency matched for age and cancer stage with those who underwent ENSMSLS between 2014 and 2015. All patients were recalled and re-examined for the study. Patients from the ENSMSLS group were recalled twice at both 3 and 6 months after surgery. Matched control subjects who underwent NSM were examined when they were recalled. The sensations of pressure, temperature, and vibration were measured.Results:Patients who underwent ENSMSLS were significantly less likely to have decreased or impaired sensations of pressure, temperature, and vibration compared those who had NSM. The improvement in preservation of sensations by the use of ENSMSLS was very impressive.Conclusions:ENSMSLS, which avoids incision around the NAC, significantly decreases the possibility of decline in NAC sensation.