Camina plácido entre el ruido y la prisa...
… y piensa en la paz que se puede encontrar en el silencio.
Desde que nacemos comienza nuestro aprendizaje del mundo que nos rodea y empezamos a desarrollar nuestros cuerpos y nuestro intelecto, pero en algunas ocasiones olvidamos que también somos alma y espíritu.
Este olvido causa un desequilibrio en nosotros y nos concentramos en lo inmediato y lo material y olvidamos la esencia real de todo ser humano y rompemos esa conexión intrínseca que debe existir siempre con el universo.
Al ocurrir esto nos desalineamos y dejamos de fluir con el rio de la vida que nace y desemboca en la esencia del universo, que es conocida coloquialmente por nosotros como Dios.
Y cuando digo “Dios” lo digo en forma genérica sin importar los diferentes credos que existen en el mundo y que le han dado diferentes nombres a lo largo de los años.
Lo primero que debemos aceptar es que vinimos a este mundo a ser felices y a hacer felices a los demás, por lo que cada paso que demos, cada palabra que digamos, cada plegaria que elevemos y cada acto que ejecutemos deben estar orientados a encontrar nuestra felicidad.
No importa si a nuestro alrededor reina el caos y la desesperanza, nosotros debemos mantener nuestra paz interior y aceptar lo que la vida nos brinde sin importar si es bueno o malo, ya que con el tiempo y si mantenemos una actitud positiva y optimista, no perdemos el norte de la felicidad, lograremos cambiar poco a poco nuestra realidad hasta lograr hacer realidad nuestros sueños más sublimes.
¿Pero cómo mantener todo esto sin flaquear?
Pues allí es donde debemos alimentar nuestra alma y espíritu y sin importar nuestro credo debemos cultivar la fuerza más poderosa del universo después del amor…La Fe.
¿Has escuchado que “La fe mueve montañas”?
Pues es verdad, lo primero que debes hacer es cultivar la fe, no importa en qué o en quien la pongas, pero fortalécela a través de la oración y la meditación.
Estas dos herramientas tan sencillas, pero tan poderosas son la base para que empieces tu alineación con el universo.
La oración es la forma más antigua de hablar con ese ser supremo que todo lo ve y todo lo sabe. Pero hay que hacerlo en voz alta y no mentalmente, hay que hacerlo con toda la fe puesta en que tus palabras van a ser escuchadas y que la respuesta a tus preguntas si las hay, llegará de la forma más inesperada e incluso en tus sueños.
Tienes que aprender a escuchar esa voz interior que a veces nos habla y que por prejuicios o simplemente por inseguridad, no la escuchamos y terminamos ignorando lo que nos decía.
La oración debe ser sincera y jamás debe contener la más mínima intención de hacer daño a otra persona o peticiones de “Que todo me salga bien”, sabiendo que los actos por los que pedimos están orientados al mal, esto realmente no solo nos desalínea con el universo sino que nuestro balance universal quedará en negativo y esa deuda Kármica[1] tendrá que ser saldada tarde o temprano, en esta vida o la otra, ya que el universo está compuesto de opuestos siempre en movimiento (día y noche, bien y mal, vida y muerte, etc.).
La meditación es la forma más simple para comenzar a alinearnos con el universo y contrario a lo que se piensa es muy sencillo meditar:
Busca un momento del día en que estés a solas (duchándote, acostado antes de dormir, en tu auto antes de bajarte, etc.) cierra tus ojos, relaja tu cuerpo, respira profundamente y elije una sola cosa en la que quieras concentrar toda tu energía, para poder observarla desde todas sus aristas y de esta forma hacer que la energía del universo fluya a través tuyo y puedas recargarte cada vez que lo necesites.
Este tipo de meditación si la practicas todos los días te irá llevando a otro nivel de tranquilidad y claridad de pensamiento, entonces buscarás un espacio en tu día un poco más prolongado para entrar en meditación y esto paulatinamente te permitirá no solo que te relajes y recargues energía, sino que la conviertas en una herramienta para tomar decisiones, controlar tu temperamento y encontrar tu punto de equilibrio.
Cuando una persona aplica la oración y la meditación en su vida, esto se manifiesta inmediatamente en su semblante y los demás lo comienzan a ver diferente sin saber por qué, el futuro se ve mucho más claro y es más fácil tomar buenas decisiones y aceptar las pruebas que nos trae el día a día, porque con estas dos piedras estamos construyendo el templo en que todos debemos convertirnos para que la energía del universo fluya a través nuestro, la esencia divina habite en nosotros y podamos empezar a vivir nuestra felicidad.
Hermano lector, si estás leyendo este libro no es coincidencia, es el universo que te está poniendo una herramienta que te ayudará a alinearte con él y a adentrarte en el maravilloso mundo de la voluntad humana.
A lo largo de la vida todos hemos visto pasar oportunidades ante nuestros ojos, pero a veces no somos capaces de tomar acción y dejamos que se nos escapen, otras veces tomamos decisiones equivocadas y otras tantas no somos capaces de admitir que lo bueno o lo malo que pasa en nuestras vidas depende en gran parte de nosotros mismos.
Cuantas veces decimos que hay que cambiar algo para que el mundo sea mejor, pero nunca comenzamos por cambiar nosotros mismos para producir esa chispa que desate una reacción en cadena que no solo me cambiará y a los que me rodean, sino que con el tiempo puede llegar a hacer un cambio significativo en nuestra sociedad.
Pues bien, hermano lector este libro fue inspirado en un precepto sencillo e innegable: “Todos somos hijos del mismo universo” y por lo tanto cada una de nuestras acciones por simple que sea, afectará su delicado equilibrio y desatará una serie de eventos que repercutirán en muchas vidas de personas que ni siquiera conocemos.
Por eso debemos aprender a hacer siempre lo correcto, a ser agradecidos y sobre todo a convertirnos en templos donde esa energía que regula el universo no importa el nombre que le des (Dios, Yahveh, Allah, Buda, Vishnú, Krisna, etc.) pueda vivir en nosotros y de esta forma su espíritu hable a través nuestro, su esencia nos proteja y su luz nos guie a lo largo de nuestra vida.
Todos somos Mente, Cuerpo y Espíritu y así como alimentamos y cuidamos nuestros cuerpos, debemos aprender a alimentar y cuidar nuestra mente y nuestro espíritu.
Este libro fue escrito sin ninguna pretensión y con el único objetivo de ser un referente para que puedas vivir tu fe en forma integral, sin importar tu credo o la idea que tengas de esa fuerza que regula el universo y que día a día trabajes para convertirte en una mejor versión de ti mismo, que con tus actos, no solo des testimonio de que hacer el bien conduce a la felicidad, sino que seas promotor de un cambio positivo que impactará primero tu núcleo familiar, luego a tus amigos y por último a una parte de la sociedad.
Si nos alineamos con el universo, aprendemos a fluir con él, aceptamos que lo que pedimos nos llega cuando lo necesitamos realmente y no cuando creemos necesitarlo, hacemos siempre lo correcto, aceptamos que nuestra libertad termina donde comienza la de nuestro hermano, agradecemos de forma sincera y de corazón; créeme, hermano lector, que nuestras vidas cambiarán para siempre y por toda la eternidad.
Lymphedema (also known as lymphatic obstruction) is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system.
Fontanels are soft spots on a baby's head which, during birth, enable the bony plates of the skull to flex, allowing the child's head to pass through the birth canal.
Gastric outlet obstruction (often abbreviated as GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach.
Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles).
Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive build-up of fluid, or to drain pus.
Colonoscopy is the endoscopic examination of the colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus.
Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye(s) and progressing to complete blindness if untreated.
Herpes zoster (or simply zoster), commonly known as shingles, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body (often in a stripe).
Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction.
Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed.
Edema, formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling.
A corneal ulcer, or ulcerative keratitis, or eyesore is an inflammatory or more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma.
A bruise, also called a contusion, is a type of relatively minor hematoma of tissue in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep into the surrounding interstitial tissues.
Magnetic resonance imaging (MRI), nuclear magnetic resonance imaging (NMRI), or magnetic resonance tomography (MRT) is a medical imaging technique used in radiology to visualize detailed internal structures.
Angina pectoris, commonly known as angina, is severe chest pain due to ischemia (a lack of blood, thus a lack of oxygen supply) of the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels).
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.
A Caesarean section, (also C-section, Caesarian section, Cesarean section, Caesar, etc.) is a surgical procedure in which one or more incisions are made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies.
Lithotomy is a surgical method for removal of calculi, stones formed inside certain hollow organs, such as the kidneys (kidney stones), bladder (bladder stones), and gallbladder (gallstones), that cannot exit naturally through the urinary system or biliary tract.
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An arthroscope, a type of endoscope, is inserted into the joint through a small incision during arthroscopy.
A craniotomy is a surgical operation in which a bone flap is temporarily removed from the skull to access the brain.
Chickenpox or chicken pox is a highly contagious illness caused by primary infection with varicella zoster virus.
A hematoma is a localized collection of blood outside the blood vessels.
Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes.
The uterus or womb is a major female hormone-responsive reproductive sex organ of most mammals, including humans.
X-ray computed tomography (CT) is a medical imaging method employing tomography created by computer processing.
Pus is a whitish-yellow, yellow, or yellow-brown exudate produced by vertebrates during inflammatory pyogenic bacterial infections.
The removal of an ovary together with the fallopian tube is called
salpingo-oophorectomy or unilateral salpingo-oophorectomy.
Septoplasty is a corrective surgical procedure done to straighten the nasal septum, the partition between the two nasal cavities.
Tinnitus is the perception of sound (possibly a ‘ringing’ sound) within the human ear (in the absence of corresponding external sound).
The clouding of the eye caused by a cataract can vary in degree from slight to complete opacity and obstructing the passage of light.
Laparoscopy is an operation performed in the abdomen or pelvis through small incisions (usually 0.5–1.5 cm) with the aid of a camera.
A laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity.
Mammography is the process of using low-energy x-rays to examine the human breast and is used as a diagnostic and a screening tool.
Fibromyalgia is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure.
Colonoscopy is similar to, but not the same as, sigmoidoscopy. The difference being related to which parts of the colon are examined.
Rhinitis, commonly known as a stuffy nose, is the medical term describing irritation and inflammation of some internal areas of the nose.
Malignancy is the tendency of a medical condition, such as a tumour, to become progressively worse and to potentially result in death.
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants.
A sigmoidoscopy is often used as a screening procedure for a full colonoscopy, often done in conjunction with a fecal occult blood test (FOBT).
In anatomy, pronation is a rotational movement of the forearm at the radioulnar joint, or of the foot at the subtalar and talocalcaneonavicular joints.
Fever (also known as pyrexia or controlled hyperthermia) is a common medical sign characterized by an elevation of temperature above the normal.
A kidney stone, also known as a renal calculus is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine.
An episiotomy, also known as perineotomy, is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour.
Supination is a position of either the forearm or foot; in the forearm when the palm faces anteriorly, or faces up (when the arms are unbent and at the sides).
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system.
Bleeding, technically known as hemorrhaging is the loss of blood or blood escape from the circulatory system.
In anatomy, the prone position is a position of the body lying face down.
Augmentation mammoplasty is the enlarging of the breasts via implants.
‘Benign’ is a medical term used to describe a condition that is harmless.
An otoscope or auriscope is a medical device, which is used to look into the ears.
A biopsy is a medical test involving the removal of cells or tissues for
examination.
The vas deferens transport sperm from the epididymis in anticipation of
ejaculation.
A cataract is a clouding that develops in the crystalline lens of the eye or in its
envelope.
Cushing syndrome is a hormone disorder caused by high levels of cortisol in the
blood.
Measles, also known as rubeola, is an infection of the respiratory system caused
by a virus.
Cholangiography is the imaging of the bile duct (also known as the biliary tree) by
x-rays.
Carcinoma is the medical term for the most common type of cancer occurring in
humans.
Laparoscopy can either be used to inspect and diagnose a condition or to
perform surgery.
The vas deferens, also called ductus deferens, is part of the male anatomy of
many vertebrates.
Adduction is a movement which brings a part of the anatomy closer to the sagittal
plane of the body.
Inflammation is not a synonym for infection, even in cases where inflammation is
caused by infection.
Excision means ‘removal by cutting’.
The opposite of benign is malignant.
Swelling is the enlargement of tissue.
Cystitis is a term that refers to inflammation of the bladder.
Laparotomy is also known as coeliotomy.
Cholecystitis is inflammation of the gallbladder.
Oophorectomy surgery is also called ovariectomy.
Alopecia means loss of hair from the head or body.
The epididymis is part of the male reproductive system.
Polypectomy is the medical term for the removal of a polyp.
Oophorectomy is the surgical removal of an ovary or ovaries.
Menstruation is the shedding of the uterine lining (endometrium).
Colonoscopy can remove polyps as small as one millimetre or less.
Otitis media is inflammation of the middle ear, or a middle ear infection.
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abdominal adduction allodynia alopecia
angina anus arthroscope arthroscopy
auriscope bacterial benign biliary
biological biopsy bronchoscopy Caesarean
calculus capillaries carcinoma cataract
cholangiography cholecystitis coeliotomy colon
colonoscopy contagious contusion cornea
corneal coronary cortisol craniotomy
crystalline Cushing cystitis diabetes mellitus
diagnostic dropsy ductus edema
ejaculation endometrium endoscope endoscopic
epididymis episiotomy epithelial excision
exudate fecal fibromyalgia fontanels (fontanelles)
gallbladder gastric glaucoma hematoma
hemorrhage herpes hydropsy hysterotomy
infection inflammation inflammatory insulin
interstitial ischemia keratitis laparoscopy
laparotomy lymphatic lymphedema malignant
mammography mammoplasty measles menstruation
metabolic musculoskeletal myringotomy oophorectomy
opacity optic orthopedic ossicles
otitis media otoscope ovariectomy pathogens
pectoris perineotomy perineum polypectomy
polyps pronation pylorus pyogenic
radiology radioulnar renal reproductive
retention rhinitis rubeola sagittal salpingo-oophorectomy septoplasty sigmoidoscopy stimuli stroma subtalar supination talocalcaneonavicular
therapeutic tinnitus tomography trauma
tympanic tympanostomy ulcerative urinary
uterus vaginal varicella vas deferens
vascular venules vertebrates vertebrates
viral virus zoster
Know yourself and seek self improvement. Know your Marines and look out for their welfare. Keep your Marines informed. Be technically and tactically proficient. Ensure that the task is understood, supervised, and accomplished. Set the example. Train your Marines and Sailors as a team. Make sound and timely decisions. Employ your command in accordance with its capabilities. Develop a sense of responsibility among your subordinates. Seek responsibility and take responsibility.
Development of AI-tool for breast cancer diagnostics
Introduction
Breast cancer is a prevalent and significant health concern globally, impacting morbidity and
mortality rates. It stands as the most common cancer among women, and its incidence
continues to rise, posing a substantial health burden. According to recent statistics, breast
cancer is the leading cause of cancer-related deaths in women worldwide (1). In 2020, over 2.2
million new cases were diagnosed globally, resulting in approximately 0.68 million deaths (2).
The prevalence of breast cancer remains high, with an estimated 6.9 million survivors living with
this disease (2). Projections suggest a concerning escalation, with an expected increase in new
cases up to 3.4 million per year by 2040 (2).
Early detection significantly influences the prognosis of breast cancer. The five-year survival
rate is notably higher at 90% when diagnosed at an early stage, whereas late-stage diagnosis
leads to a substantially reduced survival rate of around 13% (2). Detecting precancerous
lesions, such as ductal carcinoma in situ (DCIS) or certain benign breast conditions, can
contribute significantly to early intervention and improved outcomes.
Various risk factors contribute to the development of breast cancer. General risk factors
encompass genetic predisposition, lifestyle choices (such as obesity, lack of physical activity,
and dietary habits), as well as uncontrollable factors like age, gender, and socio-economic
status (Colditz et al., 2020). Additionally, specific risk factors related to breast cancer include a
family history of the disease, presence of certain genetic mutations like BRCA1 and BRCA2,
exposure to radiation, and hormonal influences (3).
The hereditary nature of breast cancer is evident in cases associated with mutations in specific
genes like BRCA1 and BRCA2, which significantly increase the risk of developing breast cancer
(4). Individuals with BRCA1 mutations have a lifetime risk of approximately 70-80% for
developing breast cancer, while those with BRCA2 mutations face a risk of about 60-70% (4).
Early detection and genetic counseling play a crucial role in managing the risk and exploring
preventive measures for individuals with these genetic predispositions.
Digital pathology emerged as a technology-driven transformation aiming to digitize traditional
histopathology practices. Initially, its adoption was sluggish due to challenges in infrastructure,
high costs, and the need for standardization. Pathologists relied on conventional microscopes
and glass slides, hindering rapid information exchange and collaborative analysis [5].
However, in recent years, digital pathology has gained momentum, assuming an increasingly
central role in diagnostics. Advancements in imaging technology, coupled with improved
software for slide scanning and image analysis, have revolutionized the field. The transition to
digital formats allows for remote access, facilitating collaboration among pathologists and
enabling faster consultations [6].
Artificial intelligence has significantly enhanced digital pathology, particularly through image
segmentation technologies. AI algorithms, particularly deep learning models, aid in the
automated identification and segmentation of regions of interest in tissue samples [7]. In breast
cancer diagnosis, AI assists in detecting subtle features, improving accuracy in tumor
identification, classification, and prediction of prognosis [8].
The utilization of digital pathology and AI is poised to revolutionize diagnostic processes. AI
algorithms can rapidly analyze vast amounts of pathology data, leading to more accurate and
efficient diagnoses. Furthermore, these technologies have the potential to redefine current
grading criteria for tumors by considering a broader spectrum of features and patterns [9].
The integration of digital pathology and AI promises a paradigm shift in the diagnostic
landscape, offering more precise and personalized approaches. It is expected to improve
patient outcomes through earlier detection, accurate classification, and tailored treatment
strategies.
Aim of the study
The aim of this study is to develop a clinically valuable AI-based diagnostic tool tailored for the
analysis of pathological breast specimens and to validate it in the clinical context.
Materials and Methods
The first phase of this study involves compiling the training set using histological whole-slide
images (WSI) obtained from the Breast Cancer cohort within The Cancer Genome Atlas
(TCGA). Established in 2005 through collaboration between the National Cancer Institute (NCI)
and the National Human Genome Research Institute, The Cancer Genome Atlas initiative
involved next-generation sequencing and comprehensive molecular genetic profiling of 33
malignant tumor types, encompassing approximately 20,000 patients with primary tumors
(National Cancer Institute, 2020). The data and images associated with this project were made
publicly accessible on the TCGA website in 2018, serving as a resource for research and
information dissemination in the medical community (National Cancer Institute, 2020).
The Breast carcinoma cohort within TCGA provides whole-slide images of tumors along with
associated molecular genetic and clinical data for all patient cases. Clinical information includes
demographic details such as age, gender, and pertinent risk factors like alcohol and smoking
habits, along with relevant medical history and survival endpoints. Additionally, the dataset
includes critical pathological information encompassing tumor staging, grading, primary
diagnosis, and site of resection.
To develop the diagnostic tool, a subset of whole-slide images from the TCGA cohort will be
selected. The software QuPath version (Version: 0.3.2), renowned for its utility in digital
pathology and annotation, will be utilized for annotating the WSIs (Bankhead et al., 2017;
Humphries, Maxwell, & Salto-Tellez, 2021). This process aims to construct a training dataset by
delineating smaller regions within the images and assigning labels corresponding to distinct
tissue classes. QuPath, or Quantitative Pathology, offers a robust framework for precise
annotation across different tissue classes. These classes will include benign epithelial tissues to
various pathological entities such as ductal carcinoma in situ, invasive ductal carcinoma, and
necrosis. Annotations will deliberately exclude artifacts like unfocused areas or tissue foldings.
The meticulous manual annotation conducted via QuPath is integral to establishing a
comprehensive and meticulously labeled training dataset crucial for the advancement of the AI-
based diagnostic tool.
The second phase of this investigation focuses on assembling the test dataset, accompanied
by the corresponding clinical data. This phase involves the inclusion of several distinct and
independent test cohorts comprising breast biopsy specimens and resection specimens. These
specimens originate from two pathology departments: University Hospital Cologne (UKK), and
Bethesda Hospital Duisburg (BHD); and one large open-source cohort (Prostate, Lung,
Colorectal, and Ovarian Cancer Screening Trial – access was already granted). This material
represents heterogeneous laboratory practices concerning tissue processing, sectioning, and
staining techniques. All biopsy slides encompassed within these cohorts underwent meticulous
examination and evaluation by an experienced pathologist.
In the third, algorithm development phase, the process involves training deep learning
models using a specific dataset composed of manually annotated Whole Slide Images (WSIs),
as previously mentioned. Deep learning models, initially pre-trained on the extensive ImageNet
dataset, will undergo transfer learning to adapt to the breast cancer domain. This adaptation will
be achieved by utilizing annotated training images, which will be tiles into smaller patches
labeled according to their respective classes. The semantic segmentation principle will be
utilized for pixel-precise detection and classification of objects. Such deep learning models
normally contain two components – encoder (feature extraction, e.g. ResNet50 or EfficientNetB-
family of networks) and decoder (such as Unet or Unet++).
The primary objectives of this training process include the detection of tumor tissue,
identification of tumoral stroma for prognostic evaluation, recognition of benign structures, and
the detection of atypical epithelial structures within the breast tissue, - in total > 10 different
tissue classes. The training procedure will be conducted leveraging the technical infrastructure
available at the Institute of Pathology and Computational Center of the University of Cologne,
utilizing an established software pipeline for this purpose.
The fourth phase (data analysis and statistics) involves rigorous analytical testing of the
model versions (so called checkpoints) that demonstrate the highest performance during the
training phase. This testing will utilize independent test datasets to evaluate the model's
accuracy, specificity, and sensitivity specifically in tumor detection, stromal identification, and
distinguishing between benign and malignant structures. This will be performed at pixel level (so
called formal validation with statistical metrics) and at slide level (concrete clinical tasks, such as
tumor detection in the biopsy specimens). Statistical analysis of the model's performance
(metrics) will be conducted using SPSS and R software.
The concluding step will involve synthesizing the project's outcomes and discoveries into a
manuscript suitable for publication in scientific journals or relevant academic forums.
Alternative strategies
We don’t await significant difficulties in course of the project. One of the potential problems
during the model development is low performance. This will be addressed from the beginning
through using a very heterogeneous dataset with high-quality manual annotations. Another
potential problem is bad generalization of the model to unseen data (e.g. data from other
departments that should be used for independent validation in this project). This is a common
issue. However, necessary steps to mitigate the risks will be performed during training such as
state-of-the-art data augmentation and, again, including heterogeneous data representative of
different staining and lab practices. E.g., TCGA dataset used for training purposes is a
compilation of whole slide images from 36 different departments – a very representative
dataset, ideal for training purposes. From development perspective necessary hardware and
software is readily available (AG Tolkach) and was used for similar projects many times.
Perspectives
The findings of this study and the release of the datasets prepared in course of the project
possess the potential not only to enhance the accuracy and efficiency of breast cancer
diagnosis but also to drive progress in computational pathology. One of the potential steps for
further application, should the algorithm show awaited high accuracy in the validation phase, is
prospective evaluation of performance and benefits during the routine diagnostics (long-term
perspective outside of the scope of this dissertation).
Ethical considerations
The ethic votum for this project is available from the ethical committee of the University of
Cologne (20-1583).
References:
1. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global
cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36
cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), 394-424.
2. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F.
(2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality
worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 71(3), 209-249.
3. Colditz, G. A., Bohlke, K., & Berkey, C. S. (2020). Breast cancer risk accumulation starts
early: prevention must also. Breast Cancer Research and Treatment, 180(1), 3-4.
4. Mavaddat, N., Michailidou, K., Dennis, J., Lush, M., Fachal, L., Lee, A., ... & Manoochehri,
M. (2019). Polygenic risk scores for prediction of breast cancer and breast cancer subtypes.
The American Journal of Human Genetics, 104(1), 21-34.
5. Pantanowitz L, et al. "Review of the current state of whole slide imaging in pathology."
Journal of Pathology Informatics, 2011.
6. Crowley RS, et al. "Whole Slide Imaging: Technology and Applications." Advances in
Anatomic Pathology, 2017.
7. Litjens G, et al. "A survey on deep learning in medical image analysis." Medical Image
Analysis, 2017.
8. Cruz-Roa A, et al. "Automatic detection of invasive ductal carcinoma in whole slide images
with convolutional neural networks." Medical Image Analysis, 2014.
9. Nagpal K, et al. "Development and Validation of a Deep Learning Algorithm for Improving
Gleason Scoring of Prostate Cancer." npj Digital Medicine, 2019.
Financial literacy plays a pivotal role in supporting the developmental objective of inclusive growth by empowering individuals and communities to make informed financial decisions, access financial services, and participate effectively in the economy. However, despite its importance, there are several challenges and gaps that need to be addressed to enhance financial literacy and promote inclusive growth.
One of the primary challenges is the lack of awareness and understanding of basic financial concepts and products among large segments of the population, particularly in low-income and marginalized communities. Many individuals lack knowledge about topics such as budgeting, saving, investing, and managing debt, which can hinder their ability to build assets, plan for the future, and mitigate financial risks. Addressing this challenge requires comprehensive and targeted financial education programs that are accessible, relevant, and culturally appropriate.
Additionally, there is a need to bridge the digital divide and promote digital financial literacy, especially in rural and underserved areas where access to technology and internet connectivity may be limited. While digital financial services offer opportunities to expand financial inclusion and reach underserved populations, many people lack the necessary skills and confidence to use digital platforms and navigate online transactions safely and securely. Efforts to improve digital literacy should focus on providing training, support, and awareness campaigns to empower individuals to leverage digital tools for financial management and access to financial services.
Furthermore, there are disparities in financial literacy levels across different demographic groups, including gender, age, education, and socio-economic status. Women, youth, seniors, and individuals with lower levels of education or income are often disproportionately affected by limited financial literacy, exacerbating existing inequalities and barriers to economic participation. Tailored interventions and targeted outreach programs are needed to address the specific needs and challenges faced by these vulnerable groups and promote inclusive access to financial education and services.
Moreover, the complexity and opacity of financial products and services can pose significant barriers to financial literacy and consumer protection. Many financial products, such as loans, insurance policies, and investment products, involve complex terms, fees, and risks that may not be fully understood by consumers, leading to potential exploitation, mis-selling, and financial harm. Enhancing transparency, disclosure, and consumer rights protection through effective regulation, supervision, and enforcement mechanisms is essential to build trust and confidence in the financial system and empower consumers to make informed choices.
In conclusion, financial literacy is crucial for advancing the developmental objective of inclusive growth by equipping individuals and communities with the knowledge, skills, and confidence to manage their finances effectively, access financial services, and participate in economic opportunities. However, addressing the challenges and gaps in financial literacy requires a multi-faceted approach that combines education, technology, outreach, and consumer protection initiatives to ensure that everyone has the opportunity to achieve financial well-being and contribute to inclusive and sustainable development.
Did you really beam me up? In a cloud of sparkling dust, just to do experiments on, tell me I was the chosen one. Show me that this world was bigger than us, then sent me back where I came from.
For a moment, I knew cosmic love. Now I'm down bad crying at the gym, everything comes out teenage petulance. "Fuck it if I can't have him, I might just die, it would make no difference."
Down bad, waking up in blood. Staring at the sky, come back and pick me up. Fuck it if I can't have us. I might just not get up. I might stay down bad.
Lately things are only mind, good news is hard to find. And I work on the factory line, and all I do is stay behind. I call my momma like I should, she says daddy ain't doin' too good. Me and him should wet a line, just can't seem to find the time. But I love my life. But I love my life, man, it's something to see, it's the kids and the dogs and you and me. It's a way, it's alright, everything goes wrong. It's the sound of a slow simple song.
Hello everyone from the Research Partner Success (team). I am Tonya Harding! I hear you are going to be doing the office Olympics. Oh my god, I’m so excited for you! That is going to be awesome, and I hear there’s gonna be a couple different activities. Now, I want you all to be extra ready for this. I want you to – now, I wrote some stuff down so I am looking at my writing, okay? So, I’m sorry about that; but I want you to fill your stapler, get extra lots of paper, find five pens, five pencils that you know work and are not broken and are sharpened and ready to go, and make sure your desk is just, *kiss*, fabulous, okay? Because everything is about first impressions. So anyway, I know that you guys got this, and you’re gonna do great. Always remember who you are, and always be proud of yourself. Be proud of your partners. Be proud of everything that you do in life, because life is precious. I love you guys so much, and best of luck, and God bless. *kiss* bye!
567432 XYZ123 Smith (111) 112-1234 $123,679.70 $457,345.67 33.50% 123456 Tim Johny 14/08/2004 Marketing Johson 1234 Street, Citytown, State 44321 xyz123@gmail.com UK
987654 ABC456 Johnson (222) 222-2222 $345,678.90 $678,901.23 25.00% 654321 Mary Smith 25/12/1990 HR Smithson 5678 Avenue, Towndale, Province 98765 mary.smith@example.com Canada
246810 DEF789 Williams (333) 333-3333 $234,567.89 $789,012.34 20.50% 135790 John Doe 18/06/1985 Finance William 9876 Road, Villagetown, County 13579 john.doe@example.com USA
135792 GHI012 Brown (444) 444-4444 $456,789.01 $901,234.56 15.20% 246801 Emily Wong 3/4/1976 IT Browning 6543 Lane, Hamletville, District 24680 emily.wong@example.com Australia
314159 JKL345 Taylor (555) 555-5555 $567,890.12 $123,456.78 28.10% 987654 Jack Smith 9/11/2000 Sales Taylor 5432 Boulevard, Metropolis, Region 31415 jack.smith@example.com Franc
123456 MNO789 Miller (666) 666-6666 $678,901.23 $234,567.89 19.80% 369258 Lisa Brown 27/03/1995 Operations Miller 4321 Court, Townsville, District 12345 lisa.brown@example.com Australia
987654 PQR012 Wilson (777) 777-7777 $789,012.34 $345,678.90 22.30% 852963 Chris Lee 5/9/1980 R&D Wilson 8765 Drive, Countryside, County 67890 chris.lee@example.com USA
654321 STU345 Jones (888) 888-8888 $901,234.56 $456,789.01 17.60% 741852 Sarah White 11/2/1992 Finance Joneston 7890 Way, Villagetown, Province 23456 sarah.white@example.com Canada
147258 VWX678 Davis (999) 999-9999 $123,456.78 $567,890.12 30.40% 963852 Alex Green 19/07/1988 Marketing Davison 8901 Avenue, Hamletville, Region 78901 alex.green@example.com UK
369258 YZA901 Rodriguez (000) 000-0000 $234,567.89 $678,901.23 14.90% 258369 Emma Taylor 23/05/2001 Sales Rodriguez 9012 Street, Citytown, State 34567 emma.taylor@example.com France
159753 BCD234 Patel (123) 456-7890 $345,678.90 $789,012.34 27.60% 753159 Rachel Wang 8/6/1993 Marketing Patel 6789 Lane, Metropolis, Region 56789 rachel.wang@example.com USA
369147 EFG567 Nguyen (234) 567-8901 $456,789.01 $901,234.56 31.20% 951357 Daniel Liu 17/09/1997 Operations Nguyenton 7891 Road, Countryside, County 67890 daniel.liu@example.com Canada
789456 HIJ890 Khan (345) 678-9012 $567,890.12 $123,456.78 16.80% 357951 Sophia Chen 29/12/1986 R&D Khanson 8910 Drive, Townsville, District 78901 sophia.chen@example.com Australia
258369 KLM123 Gomez (456) 789-0123 $678,901.23 $234,567.89 22.50% 654987 Michael Wu 2/3/2002 Finance Gomez 9102 Court, Villagetown, Province 89012 michael.wu@example.com UK
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Dream Weddings Sarah Johnson Sarah.Johnson@DreamWeddings.com 987-654-3210 123 Main St, Suite 100, New York, NY 10001 Weddings $7,846.32 5/10/2000
Luxe Events Michael Brown Michael.Brown@LuxeEvents.com 777-888-9999 456 Elm St, Los Angeles, CA 90012 Corporate Events $8,372.99 8/25/2012
Perfect Parties Emily Chen Emily.Chen@PerfectParties.com 444-555-6666 789 Pine Ave, Chicago, IL 60611 Birthday Parties $4,892.34 3/15/2005
Gala Galore David Lee David.Lee@GalaGalore.com 111-222-3333 101 Oak St, Miami, FL 33130 Fundraising Events $2,407.63 11/2/2018
Divine Occasions Jessica Green Jessica.Green@DivineOccasions.com 222-333-4444 202 Maple Ave, Atlanta, GA 30303 Anniversaries $10,912.68 2/20/2010
Sparkle Shine Alex Wang Alex.Wang@SparkleShine.com 555-666-7777 303 Palm St, San Francisco, CA 94107 Holiday Parties $2,762.08 9/12/2015
Corporate Affairs Lisa Kim Lisa.Kim@CorporateAffairs.com 999-888-7777 404 Market St, Suite 200, Dallas, TX 75201 Conferences $11,024.13 7/30/2008
Timeless Celebrations Mark Thompson Mark.Thompson@TimelessCelebrations.com 333-444-5555 505 Oakwood Blvd, Suite 300, Seattle, WA 98101 Destination Weddings $2,584.50 4/18/2014
Elite Entertainments Rachel Lee Rachel.Lee@EliteEntertainments.com 888-999-0000 606 Broadway St, Suite 400, Boston, MA 02108 Galas $11,351.29 6/8/2011
Grand Events Tom Smith Tom.Smith@GrandEvents.com 111-222-3333 707 Main St, Suite 500, Denver, CO 80202 Product Launches $2,935.78 10/5/2006
Divine Events Amanda White Amanda.White@DivineEvents.com 123-456-7890 789 Oak St, Orlando, FL 32801 Corporate Events $3,527.89 5/15/2012
Serene Soirees Ethan Taylor Ethan.Taylor@SereneSoirees.com 456-789-0123 456 Pine Ave, Austin, TX 78701 Baby Showers $4,619.83 9/20/2007
Blissful Occasions Olivia Brown Olivia.Brown@BlissfulOccasions.com 789-012-3456 101 Elm St, Nashville, TN 37201 Destination Weddings $7,111.78 11/10/2015
Elegant Engagements William Miller William.Miller@ElegantEngagements.com 234-567-8901 234 Maple Ave, Charlotte, NC 28202 Graduations $8,954.22 3/25/2009
Opulent Events Sophia Garcia Sophia.Garcia@OpulentEvents.com 567-890-1234 345 Oakwood Blvd, Houston, TX 77002 Charity Events $7,441.36 7/5/2017
Royal Gatherings Daniel Martinez Daniel.Martinez@RoyalGatherings.com 890-123-4567 567 Pine St, Philadelphia, PA 19101 Halloween Parties $8,619.03 1/30/2013
Majestic Moments Chloe Wilson Chloe.Wilson@MajesticMoments.com 123-234-5678 678 Elm St, San Diego, CA 92101 Reunions $7,063.29 8/15/2010
Grandeur Affairs Lucas Anderson Lucas.Anderson@GrandeurAffairs.com 234-345-6789 789 Broadway St, Portland, OR 97201 Anniversaries $8,785.67 12/12/2014
Lavish Celebrations Harper Thompson Harper.Thompson@LavishCelebrations.com 345-456-7890 890 Cherry Ave, Denver, CO 80202 Product Launches $7,790.36 4/8/2011
Glorious Galas Isabella Lee Isabella.Lee@GloriousGalas.com 456-567-8901 901 Palm St, Boston, MA 02101 Auctions $8,201.16 6/20/2016
Majestic Occasions Benjamin Adams Benjamin.Adams@MajesticOccasions.com 567-678-7890 123 Oak St, San Francisco, CA 94101 Weddings $9,104.75 6/25/2013
Royal Events Emma Roberts Emma.Roberts@RoyalEvents.com 678-789-8901 456 Pine Ave, Seattle, WA 98101 Corporate Events $1,785.60 9/15/2010
Everlasting Events Ethan Wilson Ethan.Wilson@EverlastingEvents.com 789-890-9012 789 Elm St, Chicago, IL 60601 Birthday Parties $3,298.91 4/30/2015
Radiant Gatherings Isabella Smith Isabella.Smith@RadiantGatherings.com 890-901-0123 101 Maple Ave, New York, NY 10001 Fundraising Events $5,076.54 8/10/2018
Exquisite Events William Brown William.Brown@ExquisiteEvents.com 901-012-3456 345 Oakwood Blvd, Los Angeles, CA 90001 Anniversaries $3,174.81 1/20/2011
Timeless Memories Olivia Garcia Olivia.Garcia@TimelessMemories.com 123-234-5678 567 Broadway St, Boston, MA 02101 Holiday Parties $5,202.97 11/5/2016
Chic Celebrations Lucas Martin Lucas.Martin@ChicCelebrations.com 234-345-6789 890 Cherry Ave, Dallas, TX 75201 Conferences $3,044.76 2/15/2014
Grand Gala Chloe Rodriguez Chloe.Rodriguez@GrandGala.com 345-456-7890 678 Palm St, Miami, FL 33130 Destination Weddings $5,329.72 7/30/2009
Opulent Occasions Daniel Kim Daniel.Kim@OpulentOccasions.com 456-567-8901 901 Maple Ave, Atlanta, GA 30303 Galas $3,389.45 12/25/2012
Grandeur Galas Sophia Lee Sophia.Lee@GrandeurGalas.com 567-678-9012 234 Oak St, San Diego, CA 92101 Charity Events $5,550.88 5/10/2017
Digital Dynamos Sarah Johnson Sarah.Johnson@DigitalDynamos.com 987-654-3210 123 Main St, Suite 100, New York, NY 10001 E-commerce, B2B $6,218.46 3/20/2010
Click Marketing Michael Brown Michael.Brown@ClickMarketing.com 777-888-9999 456 Elm St, Los Angeles, CA 90012 Healthcare, SaaS $5,943.27 7/15/2012
Web Wizards Emily Chen Emily.Chen@WebWizards.com 444-555-6666 789 Pine Ave, Chicago, IL 60611 Retail, Hospitality $9,560.12 10/30/2008
Social Splash David Lee David.Lee@SocialSplash.com 111-222-3333 101 Oak St, Miami, FL 33130 Fashion, Lifestyle $1,630.99 2015-05
Web Wizards Emily Chen Emily.Chen@WebWizards.com 444-555-6666 789 Pine Ave, Chicago, IL 60611 Retail, Hospitality $9,783.20 10/30/2008
Social Splash David Lee David.Lee@SocialSplash.com 111-222-3333 101 Oak St, Miami, FL 33130 Fashion, Lifestyle $1,476.30 5/2/2015
Buzz Builders Jessica Green Jessica.Green@BuzzBuilders.com 222-333-4444 202 Maple Ave, Atlanta, GA 30303 Real Estate, Travel $9,372.01 12/12/2013
Data-Driven Digital Alex Wang Alex.Wang@Data-DrivenDigital.com 555-666-7777 303 Palm St, San Francisco, CA 94107 B2B, Tech $1,717.94 9/5/2016
Creative Catalysts Lisa Kim Lisa.Kim@CreativeCatalysts.com 999-888-7777 404 Market St, Suite 200, Dallas, TX 75201 Food & Beverage $9,948.82 8/28/2011
Tech Trends Mark Thompson Mark.Thompson@TechTrends.com 333-444-5555 505 Oakwood Blvd, Suite 300, Seattle, WA 98101 Software, Hardware $2,935.10 4/10/2014
Impactful Ideas Rachel Lee Rachel.Lee@ImpactfulIdeas.com 888-999-0000 606 Broadway St, Suite 400, Boston, MA 02108 Nonprofits $10,267.55 11/15/2017
Market Maven Tom Smith Tom.Smith@MarketMaven.com 111-222-3333 707 Main St, Suite 500, Denver, CO 80202 Finance, Education $6,735.40 12/3/2009
WiseWeb Solutions Alexander Wong Alexander.Wong@WiseWebSolutions.com 234-567-8901 678 Elm St, San Francisco, CA 94101 E-commerce, B2B $4,357.75 8/20/2013
Digital Dominion Madison White Madison.White@DigitalDominion.com 345-678-9012 890 Pine Ave, Seattle, WA 98101 Tech, Fashion $6,512.49 2/10/2016
Pixel Perfect Ethan Smith Ethan.Smith@PixelPerfect.com 456-789-0123 123 Oakwood Blvd, Los Angeles, CA 90001 Healthcare, SaaS $4,986.91 12/5/2011
Quantum Marketing Olivia Martinez Olivia.Martinez@QuantumMarketing.com 567-890-1234 456 Broadway St, Boston, MA 02101 Real Estate, Travel $6,119.88 9/15/2014
Digital Dynamics William Johnson William.Johnson@DigitalDynamics.com 678-901-2345 789 Maple Ave, Chicago, IL 60601 Food & Beverage, Fashion $4,430.10 11/20/2017
Brighter Digital Sophia Davis Sophia.Davis@BrighterDigital.com 789-012-3456 101 Cherry Ave, Dallas, TX 75201 Tech, E-commerce $6,947.63 6/30/2010
Magna Marketing Daniel Brown Daniel.Brown@MagnaMarketing.com 890-123-4567 234 Broadway St, Atlanta, GA 30303 Finance, Education $5,943.27 4/25/2015
Creative Catalysts Harper Thompson Harper.Thompson@CreativeCatalysts.com 901-234-5678 345 Palm St, Miami, FL 33130 Hospitality, Travel $9,560.12 3/10/2009
