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T
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p
lear
n
in
g
i
s
th
e
m
o
s
t
co
m
m
o
n
f
o
r
m
o
f
m
ac
h
in
e
lear
n
i
n
g
f
o
r
an
al
y
s
in
g
o
b
j
ec
ts
b
y
o
m
itti
n
g
n
o
n
-
e
v
id
en
t
co
m
p
o
n
e
n
t
s
f
r
o
m
th
e
i
m
a
g
es
,
an
d
m
i
n
o
r
m
atter
s
ar
e
d
eb
ated
at
a
r
ap
id
tem
p
o
.
Sev
er
al
in
d
iv
id
u
als
h
a
v
e
ex
p
r
ess
ed
i
n
ter
est
i
n
A
I
b
ec
au
s
e
o
f
i
ts
p
o
ten
tial
to
tr
a
n
s
f
o
r
m
th
e
m
et
h
o
d
s
o
f
d
i
s
ea
s
e
d
etec
t
io
n
an
d
tr
ea
t
m
e
n
t,
p
ar
ticu
lar
l
y
i
n
t
h
e
d
i
s
cip
lin
e
s
o
f
g
as
tr
o
en
ter
o
lo
g
y
a
n
d
liv
er
d
is
ea
s
e,
w
h
ic
h
f
r
eq
u
en
tl
y
e
m
p
lo
y
v
i
s
u
al
aid
e
s
[
2
]
.
A
I
is
n
o
w
ca
p
ab
le
o
f
id
en
ti
f
y
i
n
g
m
i
n
u
te
m
o
d
i
f
icatio
n
s
i
n
th
e
m
u
co
s
a,
s
u
c
h
as
p
o
l
y
p
s
o
r
e
ar
l
y
s
i
g
n
s
o
f
ca
n
ce
r
.
P
h
y
s
icia
n
s
w
er
e
o
b
lig
ated
to
r
ev
ie
w
a
p
leth
o
r
a
o
f
r
ec
o
r
d
s
an
d
p
h
o
to
g
r
ap
h
s
ca
p
tu
r
ed
w
it
h
a
s
p
ec
if
ic
ca
m
er
a
i
n
o
r
d
er
t
o
ascer
tain
th
e
m
o
s
t
s
u
itab
le
co
u
r
s
e
o
f
tr
ea
t
m
e
n
t.
F
u
r
th
er
m
o
r
e,
AI
i
s
ca
p
ab
le
o
f
o
b
s
er
v
in
g
i
m
ag
e
s
i
n
p
r
o
g
r
ess
b
y
g
az
i
n
g
th
r
o
u
g
h
a
len
s
.
T
h
e
p
h
y
s
icia
n
w
i
ll b
e
ab
le
to
m
ak
e
a
m
o
r
e
p
r
ec
is
e
d
ec
i
s
io
n
in
a
b
r
ief
a
m
o
u
n
t o
f
ti
m
e,
a
n
d
th
e
p
atie
n
t
w
il
l
r
e
ce
iv
e
th
e
n
ec
e
s
s
ar
y
m
e
d
icatio
n
s
f
o
r
r
ec
o
v
er
y
.
A
I
ca
n
h
elp
d
etec
t
g
astric
ca
n
ce
r
(
G
C
)
at
an
ea
r
ly
s
ta
g
e,
w
h
ic
h
ca
n
f
ac
ili
tate
th
e
r
ec
o
v
er
y
o
f
t
h
e
illn
es
s
an
d
r
ed
u
ce
its
r
ap
id
d
is
s
e
m
in
a
tio
n
.
P
er
s
is
ten
t
g
astritis
is
o
n
e
o
f
th
e
p
r
i
m
ar
y
s
y
m
p
to
m
s
.
C
h
r
o
n
ic
g
astri
tis
th
at
d
eter
io
r
ates
o
v
er
tim
e
m
a
y
lead
to
g
r
o
w
t
h
s
t
h
at
h
a
v
e
th
e
p
o
ten
tial
to
d
ev
elo
p
in
to
ca
n
ce
r
.
Div
er
s
e
ter
m
s
,
in
cl
u
d
in
g
d
y
s
p
las
ia,
m
etap
lasi
a,
an
d
atr
o
p
h
ic
g
astriti
s
(
AG)
,
m
a
y
b
e
e
m
p
lo
y
ed
to
id
en
ti
f
y
t
h
ese
c
h
r
o
n
ic
d
i
s
ea
s
es.
T
h
e
ter
m
“
g
a
s
tr
ic
ad
e
n
o
ca
r
ci
n
o
m
a
”
i
s
t
y
p
icall
y
e
m
p
lo
y
ed
to
d
en
o
te
th
e
s
p
ec
if
ic
f
o
r
m
o
f
s
to
m
ac
h
ca
n
ce
r
th
at
t
h
ese
le
s
io
n
s
w
ill
d
ev
e
l
o
p
o
v
er
tim
e.
T
h
e
r
esear
ch
is
m
etic
u
lo
u
s
l
y
d
esi
g
n
ed
to
ex
h
ib
it
t
h
e
f
u
n
ctio
n
al
it
y
o
f
A
I
a
n
d
its
ca
p
ac
it
y
to
i
d
en
tify
i
n
d
iv
id
u
als
w
h
o
f
r
eq
u
e
n
tl
y
v
o
m
i
t
w
it
h
o
u
t
u
n
d
er
s
ta
n
d
in
g
t
h
e
r
ep
er
cu
s
s
io
n
s
[
3
]
.
A
d
d
itio
n
a
ll
y
,
n
u
m
er
o
u
s
s
t
u
d
ies
h
av
e
b
ee
n
co
n
d
u
cted
to
d
iag
n
o
s
e
g
a
s
tr
it
is
u
s
i
n
g
A
I
to
o
ls
.
T
h
e
ad
v
a
n
t
ag
es
a
n
d
d
is
ad
v
a
n
ta
g
es
o
f
th
ese
m
et
h
o
d
o
lo
g
ies,
w
h
ic
h
ar
e
em
p
lo
y
ed
to
id
en
tify
GC
,
w
er
e
th
o
r
o
u
g
h
l
y
e
x
a
m
i
n
ed
.
A
I
h
as
th
e
p
o
ten
tial
t
o
r
ev
o
lu
tio
n
is
e
th
e
p
r
o
ce
s
s
o
f
d
etec
tin
g
ac
cu
r
ate
p
o
s
s
ib
ilit
ies
o
f
m
alad
ies
an
d
ass
is
tin
g
w
it
h
a
v
ar
iet
y
o
f
an
al
y
tical
tec
h
n
iq
u
es.
T
h
e
co
m
p
r
eh
e
n
s
i
v
e
i
n
v
e
s
ti
g
at
io
n
co
n
d
u
cted
w
it
h
A
I
h
a
s
ev
o
lv
ed
as
a
r
esu
l
t
o
f
o
n
g
o
in
g
r
esear
ch
i
n
a
v
ar
iet
y
o
f
ap
p
licatio
n
s
.
I
n
d
iv
id
u
a
ls
w
h
o
s
u
f
f
er
f
r
o
m
s
to
m
ac
h
u
lcer
s
ar
e
at
an
i
n
cr
ea
s
ed
r
is
k
o
f
d
e
v
elo
p
in
g
m
u
co
s
a
-
ass
o
ciate
d
l
y
m
p
h
o
id
ti
s
s
u
e
ca
n
ce
r
,
s
to
m
ac
h
ad
en
o
ca
r
cin
o
m
a,
o
r
im
m
u
n
e
t
h
r
o
m
b
o
c
y
to
p
e
n
ic
p
u
r
p
u
r
a.
T
h
ese
m
icr
o
o
r
g
an
i
s
m
s
ar
e
t
y
p
icall
y
o
b
s
er
v
ed
in
m
o
r
e
th
a
n
5
0
%
o
f
th
e
g
lo
b
al
p
o
p
u
latio
n
.
Star
tin
g
w
it
h
a
g
e
n
er
al
ail
m
e
n
t,
it p
r
o
g
r
es
s
es
to
in
te
s
ti
n
e
m
etap
lasi
a
(
I
M)
,
ch
r
o
n
ic
AG
,
an
d
,
in
th
e
en
d
,
s
to
m
ac
h
ca
n
ce
r
.
A
cc
o
r
d
in
g
to
th
e
I
n
ter
n
atio
n
al
Ag
e
n
c
y
f
o
r
R
esear
ch
o
n
C
a
n
ce
r
(
I
A
R
C
)
,
in
d
iv
id
u
als
w
h
o
ar
e
in
itia
ll
y
a
f
f
licted
w
it
h
HP
do
n
o
t
s
u
f
f
er
f
r
o
m
an
y
s
y
m
p
to
m
s
;
h
o
w
e
v
er
,
th
e
y
f
r
eq
u
en
tl
y
d
ev
elo
p
g
astritis
.
I
n
g
en
er
al,
a
s
ig
n
i
f
ican
t
n
u
m
b
er
o
f
in
d
iv
id
u
als
ar
e
o
f
th
e
o
p
in
io
n
th
at
th
e
m
o
s
t
e
f
f
ec
t
iv
e
m
eth
o
d
o
f
p
r
ev
en
tin
g
GC
is
to
er
ad
i
ca
te
th
is
in
f
ec
tio
n
.
I
n
th
e
i
n
ter
i
m
,
t
h
e
s
e
v
er
it
y
o
f
d
is
ea
s
es
is
u
n
d
er
s
co
r
ed
b
y
th
e
ex
a
m
i
n
atio
n
o
f
t
h
e
m
u
s
c
u
la
tu
r
e
in
t
h
e
s
to
m
ac
h
th
r
o
u
g
h
e
n
d
o
s
co
p
y
.
T
h
is
te
s
t
ca
n
ascer
tai
n
w
h
et
h
er
HP
is
c
ap
ab
le
o
f
ca
u
s
in
g
g
astrit
is
.
C
er
tain
p
atie
n
ts
m
a
y
u
n
d
er
g
o
th
i
s
m
et
h
o
d
to
id
en
ti
f
y
t
h
o
s
e
w
h
o
ar
e
m
o
s
t
s
u
s
ce
p
tib
le
to
d
ev
elo
p
in
g
GC
.
T
h
e
v
ar
io
u
s
asp
ec
t
s
o
f
g
astriti
s
c
au
s
ed
b
y
HP
h
av
e
b
ee
n
th
e
s
u
b
j
ec
t
o
f
n
u
m
er
o
u
s
s
tu
d
ies
an
d
p
u
b
licatio
n
s
.
Oed
em
a
m
a
y
b
e
p
r
esen
t
in
th
e
p
o
s
ter
io
r
r
eg
io
n
o
f
th
e
p
h
ar
y
n
x
,
a
n
d
th
e
lip
s
m
a
y
co
n
tr
ac
t o
r
ex
p
an
d
.
I
n
ce
r
tain
i
n
d
iv
id
u
als,
s
y
m
p
to
m
s
m
a
y
b
e
ab
le
to
id
en
ti
f
y
t
h
e
r
eg
io
n
o
f
t
h
e
i
n
te
s
ti
n
es
w
h
e
r
e
HP
d
o
n
o
t
r
esid
e
d
u
e
to
th
e
p
r
o
lif
er
at
io
n
o
f
f
u
n
d
ic
g
la
n
d
s
an
d
v
e
n
u
les.
B
lu
e
laser
i
m
a
g
in
g
(
B
L
I
)
en
d
o
s
co
p
y
m
a
y
b
e
i
m
p
le
m
en
ted
to
i
n
v
e
s
ti
g
ate
t
h
e
g
astro
in
test
i
n
al
tr
ac
t
’
s
i
n
ter
io
r
th
r
o
u
g
h
w
h
ite
-
li
g
h
t
e
n
d
o
s
co
p
y
(
W
L
E
)
.
T
h
ese
t
w
o
m
et
h
o
d
s
p
r
o
v
id
e
a
co
m
p
r
eh
en
s
i
v
e
u
n
d
er
s
ta
n
d
in
g
o
f
t
h
e
ea
r
ly
s
y
m
p
to
m
s
o
f
GC
.
T
o
b
e
m
o
r
e
s
p
ec
if
ic,
it
ass
is
ts
i
n
t
h
e
id
en
ti
f
icatio
n
o
f
lesi
o
n
s
,
p
ar
ticu
lar
l
y
in
r
eg
io
n
s
th
at
ar
e
c
h
alle
n
g
i
n
g
to
d
etec
t.
So
m
e
i
n
d
iv
id
u
als
h
av
e
co
n
cl
u
d
ed
th
at
th
e
li
n
in
g
o
f
t
h
e
s
to
m
ac
h
a
n
d
th
e
w
all
o
f
t
h
e
co
lo
n
ar
e
in
ter
co
n
n
ec
ted
as
a
r
es
u
lt
o
f
t
h
es
e
f
ac
ts
.
T
h
e
in
f
ec
ted
r
eg
io
n
s
m
a
y
n
o
t
b
e
ac
ce
s
s
ib
le
to
in
d
iv
i
d
u
als
w
h
o
ar
e
in
f
ec
ted
w
i
th
HP
.
HP
in
f
ec
tio
n
ca
n
b
e
id
en
tif
ied
b
y
t
h
o
r
o
u
g
h
l
y
an
al
y
s
i
n
g
th
e
t
is
s
u
e
b
y
s
p
ec
if
ic
en
d
o
s
co
p
is
ts
.
Nev
er
t
h
ele
s
s
,
t
h
e
clin
icia
n
s
m
a
y
b
e
r
eq
u
ir
ed
to
tak
e
a
s
u
b
s
ta
n
tial
a
m
o
u
n
t
o
f
ti
m
e
to
co
m
p
lete
th
is
tas
k
ac
c
u
r
atel
y
.
I
m
a
g
e
-
en
h
an
ce
d
e
n
d
o
s
co
p
y
(
IEE
)
,
is
a
n
o
v
el
tec
h
n
iq
u
e
t
h
at
in
cl
u
d
es
n
ar
r
o
w
-
b
an
d
i
m
ag
i
n
g
(
NB
I
)
,
b
r
o
ad
-
b
an
d
i
m
a
g
in
g
(
B
B
I
)
,
an
d
lin
k
ed
co
lo
u
r
i
m
a
g
in
g
(
L
C
I
)
.
T
h
e
id
en
ti
f
icatio
n
o
f
g
astric
m
ali
g
n
an
cies
b
y
p
h
y
s
icia
n
s
h
as
b
ee
n
f
ac
ilit
ated
b
y
t
h
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n
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en
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r
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et
h
er
an
in
d
iv
id
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a
s
an
HP
in
f
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n
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I
n
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eter
m
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e
p
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e
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p
h
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ic
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also
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th
er
f
o
r
m
o
f
i
n
ter
n
al
ex
a
m
i
n
atio
n
[
4
]
.
A
I
is
ess
e
n
tial
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n
n
ea
r
l
y
all
in
d
u
s
tr
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I
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s
p
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cr
ea
s
in
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in
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A
d
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s
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u
m
er
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icie
n
cie
s
Evaluation Warning : The document was created with Spire.PDF for Python.
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23
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Dec
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er
20
25
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th
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y
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Neg
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d
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t
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t
i
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m
o
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th
a
n
5
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al
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W
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p
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2
3
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m
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m
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p
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a
[
5
]
.
It
w
i
ll
b
e
c
h
allen
g
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g
f
o
r
all
in
d
iv
id
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als
w
h
o
h
a
v
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co
n
tr
ac
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HP
.
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HP
at
an
ea
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lier
s
tag
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h
e
m
o
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in
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e
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o
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h
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its
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s
et
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d
d
r
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m
er
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es
s
m
en
t
s
ar
e
eith
er
d
ir
ec
t
o
r
in
d
ir
ec
t.
T
h
e
u
r
ea
b
r
ea
th
test
(
UB
T
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s
to
o
l
an
ti
g
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t
(
SA
T
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,
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d
HP
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m
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G
(
I
g
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th
e
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ar
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g
t
h
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at
w
ill
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o
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ts
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S
AT
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h
e
UB
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n
b
e
em
p
lo
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ed
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ascer
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w
h
et
h
er
an
in
d
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id
u
al
h
as
an
HP
in
f
ec
tio
n
.
UB
T
is
less
ef
f
e
ctiv
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f
o
r
in
d
iv
id
u
als
w
h
o
h
av
e
u
n
d
er
g
o
n
e
s
to
m
ac
h
s
u
r
g
er
y
o
r
w
h
o
tak
e
m
ed
icatio
n
s
t
h
at
alter
t
h
e
p
H
v
al
u
e
o
f
t
h
e
s
to
m
ac
h
w
al
ls
.
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h
is
m
et
h
o
d
is
u
n
co
m
p
licate
d
,
in
ex
p
en
s
i
v
e,
an
d
u
n
ab
le
to
d
if
f
er
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n
tiate
b
et
w
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en
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n
t
an
d
n
e
w
d
is
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s
e
s
.
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n
alter
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ati
v
e
an
d
m
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in
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v
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et
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o
f
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eter
m
in
i
n
g
w
h
et
h
er
an
in
d
i
v
id
u
al
h
a
s
an
HP
in
f
ec
tio
n
is
an
en
d
o
s
co
p
y
.
T
h
e
f
o
llo
w
i
n
g
ar
e
s
o
m
e
o
f
th
e
in
d
icato
r
s
o
f
g
a
s
tr
iti
s
ca
u
s
ed
b
y
s
p
ec
if
i
c
s
tr
ai
n
s
o
f
HP
:
-
A
tr
o
p
h
y
is
a
co
n
d
itio
n
in
w
h
ic
h
th
e
s
ize
o
f
an
o
r
g
a
n
o
r
tis
s
u
e
d
ec
r
ea
s
es.
-
Dif
f
u
s
e
er
y
t
h
e
m
a
is
a
co
n
d
iti
o
n
ch
ar
ac
ter
is
ed
b
y
p
atch
es
o
f
r
ed
n
ess
a
n
d
in
f
la
m
m
atio
n
i
n
th
e
d
ig
esti
v
e
tr
ac
t.
-
Mu
co
s
al
o
ed
e
m
a
is
ch
ar
ac
te
r
is
ed
b
y
th
e
ac
cu
m
u
latio
n
o
f
f
l
u
id
in
th
e
n
o
s
e,
m
o
u
t
h
,
p
h
ar
y
n
x
,
an
d
p
h
y
r
an
x
.
-
Dis
te
n
d
ed
p
leats
-
a
d
is
ten
d
ed
lin
i
n
g
o
f
th
e
i
n
te
s
ti
n
es.
-
No
d
u
lar
it
y
is
t
h
e
d
ev
elo
p
m
en
t
o
f
a
m
as
s
b
en
ea
t
h
th
e
air
w
a
y
s
.
T
h
e
ac
cu
m
u
lati
n
g
v
en
u
les
an
d
s
to
m
ac
h
f
o
v
eo
lar
lesi
o
n
s
ar
e
co
n
f
i
g
u
r
ed
d
if
f
er
en
tl
y
i
n
i
n
d
iv
id
u
al
s
w
h
o
d
o
n
o
t
h
av
e
HP
in
t
h
eir
i
n
test
i
n
e
s
.
A
s
u
b
s
ta
n
tial
q
u
a
n
tit
y
o
f
ti
m
e
an
d
s
p
ec
ialis
ed
s
k
ill
s
ar
e
r
eq
u
ir
ed
to
m
a
k
e
a
d
ec
is
io
n
b
ased
o
n
in
v
e
s
ti
g
atio
n
.
E
ac
h
i
n
d
iv
id
u
al
u
n
d
er
g
o
es
a
u
n
iq
u
e
ex
p
er
ie
n
c
e.
I
f
th
e
e
n
d
o
s
co
p
is
t
i
s
i
n
ad
eq
u
atel
y
tr
ain
ed
,
t
h
is
ex
a
m
in
at
io
n
m
a
y
g
e
n
er
ate
f
al
s
e
p
o
s
itiv
es
a
n
d
n
eg
a
tiv
e
s
.
A
n
o
v
el
p
er
s
p
ec
tiv
e
is
r
eq
u
ir
ed
to
in
v
esti
g
ate
t
h
e
in
ter
io
r
o
f
th
e
s
to
m
ac
h
.
T
h
is
i
s
th
e
“
g
o
ld
s
ta
n
d
ar
d
”
m
eth
o
d
f
o
r
id
en
tify
i
n
g
tu
m
o
u
r
s
an
d
d
eter
m
i
n
i
n
g
t
h
e
m
o
s
t
ef
f
ec
tiv
e
tr
ea
t
m
e
n
t.
T
h
e
p
r
o
lif
er
atio
n
o
f
HP
is
ev
al
u
ated
i
n
all
g
as
tr
o
in
tes
tin
al
s
a
m
p
les
t
h
at
ar
e
co
llected
in
th
e
h
is
to
lo
g
y
lab
o
r
ato
r
ies.
I
t
is
i
m
p
er
ati
v
e
to
h
a
v
e
a
le
n
s
th
at
is
ca
p
ab
le
o
f
o
b
s
er
v
i
n
g
a
t
l
ea
s
t
o
n
e
o
f
t
h
e
b
u
g
s
in
o
r
d
er
to
id
en
ti
f
y
it
s
s
p
ec
ie
s
.
I
n
n
u
m
er
o
u
s
i
n
s
tan
ce
s
,
th
e
o
u
tco
m
es
w
er
e
d
is
r
eg
ar
d
ed
.
Desp
ite
t
h
e
f
ac
t
th
a
t
He
m
ato
x
y
li
n
a
n
d
E
o
s
in
(
H
&
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)
s
p
o
ttin
g
i
s
h
ig
h
l
y
e
f
f
ec
tiv
e
i
n
id
en
ti
f
y
i
n
g
HP
in
t
h
e
p
r
esen
ce
o
f
a
h
i
g
h
v
o
l
u
m
e
o
f
b
ac
ter
ia,
th
is
r
e
m
ai
n
s
ac
c
u
r
ate.
T
h
er
e
ar
e
n
u
m
er
o
u
s
t
ec
h
n
iq
u
e
s
th
a
t
ca
n
b
e
e
m
p
lo
y
ed
;
h
o
w
ev
er
,
t
h
e
y
ar
e
m
o
r
e
co
s
tl
y
a
n
d
n
ec
es
s
itate
a
l
o
n
g
er
d
u
r
atio
n
to
co
m
p
lete
t
h
e
b
ac
ter
ial
id
en
tif
icat
io
n
p
r
o
ce
s
s
.
T
h
e
ex
am
in
at
io
n
o
f
m
ed
ical
i
m
ag
e
s
h
as
r
ea
ch
ed
a
m
iles
to
n
e
th
at
h
a
s
n
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b
ee
n
ac
h
ie
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b
ef
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r
e
,
th
an
k
s
to
A
I
a
n
d
d
ee
p
lear
n
i
n
g
.
I
n
t
h
e
p
ast,
it
w
a
s
n
ec
es
s
ar
y
f
o
r
in
d
i
v
id
u
al
s
to
e
x
a
m
i
n
e
a
ti
s
s
u
e
s
a
m
p
le
th
r
o
u
g
h
a
m
icr
o
s
co
p
e
af
ter
ex
tr
ac
tin
g
it
f
r
o
m
a
b
o
d
y
p
ar
t
in
o
r
d
e
r
to
d
etec
t
HP
.
Nev
er
th
eless
,
th
ese
m
et
h
o
d
s
ar
e
n
o
t
al
w
a
y
s
ef
f
ec
ti
v
e
an
d
ar
e
o
n
l
y
ef
f
ec
ti
v
e
in
s
p
ec
if
ic
lo
ca
tio
n
s
.
A
I
ca
n
n
o
w
b
e
im
p
le
m
e
n
ted
in
in
n
o
v
ati
v
e
w
a
y
s
to
f
ac
i
litate
th
e
d
etec
tio
n
o
f
HP
th
r
o
u
g
h
th
e
u
s
e
o
f
t
h
ese
n
e
w
ca
m
er
a
im
ag
e
s
.
A
I
h
a
s
th
e
ca
p
ac
it
y
to
co
m
p
lete
s
o
m
e
ad
v
an
ta
g
eo
u
s
d
u
ties
;
h
o
w
e
v
er
,
th
eir
ef
f
icac
y
i
s
co
n
t
in
g
e
n
t
u
p
o
n
s
p
ec
if
ic
f
ac
to
r
s
,
s
u
c
h
as
th
e
q
u
alit
y
o
f
th
e
i
m
a
g
es,
th
e
q
u
a
n
tit
y
o
f
d
ata
th
e
y
co
n
tain
,
an
d
th
e
w
a
y
i
n
w
h
ic
h
th
e
y
ar
e
co
n
f
i
g
u
r
ed
[
6
]
.
T
h
e
p
r
im
ar
y
g
o
al
o
f
t
h
e
r
esear
ch
is
to
as
s
es
s
th
e
ca
p
ac
i
t
y
o
f
A
I
to
d
is
ti
n
g
u
i
s
h
b
et
w
ee
n
i
m
ag
e
s
o
f
a
n
HP
in
f
ec
tio
n
a
n
d
o
th
er
h
ea
lt
h
is
s
u
es.
2.
DIA
G
NO
SI
S SYS
T
E
M
F
O
R
G
AS
T
R
I
T
I
S D
E
T
E
C
T
I
O
N
T
h
is
s
ec
tio
n
h
as
e
x
ten
s
i
v
el
y
e
x
a
m
in
ed
t
h
e
p
o
ten
tial
o
f
d
ee
p
lear
n
in
g
to
id
en
ti
f
y
i
m
ag
e
s
o
f
m
ed
ica
l
o
b
j
ec
ts
.
I
t a
ls
o
clar
if
ies t
h
e
t
y
p
ical
o
cc
u
r
r
en
ce
o
f
g
a
s
tr
o
in
te
s
t
in
al
is
s
u
e
s
.
2
.
1
.
O
v
er
v
ie
w
a
nd
s
t
a
t
us
o
f
g
a
s
t
ro
inte
s
t
ina
l dis
ea
s
es
T
h
e
in
itiati
v
e
ai
m
s
to
en
h
a
n
c
e
th
e
e
f
f
icie
n
c
y
o
f
id
e
n
ti
f
y
i
n
g
ail
m
e
n
t
s
b
y
u
til
is
i
n
g
A
I
.
T
h
e
q
u
al
it
y
o
f
h
ea
lt
h
ca
r
e
f
o
r
in
d
iv
id
u
al
s
w
o
r
ld
w
id
e
h
as
t
h
e
p
o
ten
tial
to
b
e
im
p
r
o
v
ed
b
y
th
i
s
in
v
esti
g
atio
n
.
T
h
e
in
itial
th
r
ee
s
ec
tio
n
s
ar
e
co
n
ce
r
n
ed
w
it
h
t
h
e
o
p
er
atio
n
o
f
o
b
j
ec
ts
,
w
h
i
le
th
e
s
u
b
s
eq
u
e
n
t
t
h
r
ee
s
ec
tio
n
s
ar
e
co
n
ce
r
n
ed
w
it
h
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p
h
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s
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u
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in
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a
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astro
s
co
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all
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ates
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[
7
]
.
Hig
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t
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e
ca
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ep
icted
in
Fig
u
r
e
1
,
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ig
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r
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u
r
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1
.
P
R
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2
.
2
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Art
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et
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o
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NN)
a
n
d
o
th
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et
w
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s
.
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t
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er
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s
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elate
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o
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n
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ed
o
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th
e
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m
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at
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-
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co
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y
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n
f
o
r
m
atio
n
.
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e
n
tl
y
,
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h
av
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m
e
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l
y
p
r
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t
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astrit
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u
e
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eir
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n
tio
n
ed
.
T
ab
le
2
.
P
r
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ts
th
e
p
er
f
o
r
m
a
n
ce
m
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ic
s
o
f
d
if
f
er
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n
t d
ee
p
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ch
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tu
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f
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tr
itis
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o
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r
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(
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m
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T
h
is
w
as
f
i
n
alis
ed
u
p
o
n
t
h
e
p
er
m
a
n
en
t
er
ad
icatio
n
o
f
HP
.
I
t
h
as
b
ee
n
g
en
er
all
y
o
b
s
er
v
ed
th
at
in
d
iv
id
u
als
r
e
s
id
in
g
i
n
E
ast
Asi
a
w
h
o
p
o
s
s
e
s
s
t
h
e
C
AG
g
e
n
e
h
av
e
a
h
i
g
h
er
li
k
eli
h
o
o
d
o
f
r
ec
eiv
in
g
G
C
.
T
h
is
r
ep
r
esen
ts
a
u
n
iq
u
e
co
n
ce
p
t.
A
cc
o
r
d
in
g
to
a
s
tu
d
y
co
n
d
u
ct
ed
in
Ko
r
ea
,
1
8
.
4
%
o
f
in
d
iv
id
u
als
w
it
h
an
av
er
ag
e
GC
also
h
ad
C
AG.
GC
w
a
s
d
etec
ted
o
n
th
e
b
o
d
ies
o
f
m
o
r
e
th
an
5
2
.
5
%
o
f
in
d
iv
id
u
als.
I
f
o
n
e
is
co
g
n
is
a
n
t
o
f
C
A
G
f
r
o
m
t
h
e
I
n
ce
p
tio
n
,
it
is
p
o
s
s
ib
le
to
p
r
ev
en
t
GC
.
T
h
is
is
ac
cu
r
ate
b
ec
au
s
e
GC
h
as
th
e
p
o
ten
tial
to
ca
u
s
e
m
ali
g
n
a
n
c
y
.
Gastro
s
co
p
y
en
tails
th
e
ex
ci
s
io
n
o
f
a
p
o
r
tio
n
o
f
f
lex
ib
le
g
astro
in
test
i
n
al
tis
s
u
e
an
d
its
ex
a
m
in
at
io
n
th
r
o
u
g
h
a
s
m
all
l
en
s
.
T
h
is
tech
n
iq
u
e
is
co
n
s
id
e
r
ed
th
e
“
g
o
ld
s
tan
d
ar
d
”
f
o
r
d
e
ter
m
i
n
in
g
C
A
G.
A
w
h
ite
li
g
h
t
-
e
m
itti
n
g
ca
m
er
a
is
th
e
p
r
i
m
ar
y
ele
m
e
n
t
o
f
t
h
er
ap
eu
tic
e
n
d
o
s
co
p
y
.
T
h
ese
f
ac
ilit
a
te
th
e
v
is
u
ali
s
atio
n
o
f
t
h
e
la
y
er
s
o
f
g
astro
in
test
i
n
al
m
u
co
u
s
.
T
h
e
p
h
y
s
ician
w
ill
d
eter
m
in
e
w
h
e
t
h
er
o
r
n
o
t
a
p
atien
t
r
eq
u
ir
es
th
e
test
b
ased
o
n
t
h
e
ir
ab
ilit
ies.
W
L
E
is
o
n
l
y
ca
p
a
b
le
o
f
d
etec
tin
g
ca
r
d
iac
d
is
ea
s
e
C
AG
i
n
4
2
%
o
f
ca
s
es.
I
n
6
5
%
o
f
ca
s
es,
s
ta
n
d
ar
d
W
L
E
w
a
s
ca
p
ab
le
o
f
d
is
tin
g
u
i
s
h
in
g
b
et
w
ee
n
t
w
o
o
b
j
ec
ts
in
th
e
g
astric
s
i
n
u
s
.
I
t
h
as
th
e
p
o
ten
tial
to
d
is
tin
g
u
i
s
h
b
et
w
ee
n
th
e
ab
d
o
m
in
al
b
o
d
y
a
n
d
s
o
m
eth
in
g
else
in
7
6
.
4
%
o
f
ca
s
es.
T
h
er
e
is
a
g
r
o
w
i
n
g
tr
en
d
a
m
o
n
g
i
n
d
iv
i
d
u
als to
id
en
ti
f
y
C
A
G
o
n
a
co
m
p
u
ter
o
r
a
v
ir
tu
a
l c
o
lo
u
r
ca
m
er
a.
T
h
e
p
h
y
s
ician
s
p
ar
ticip
ate
in
th
is
ac
ti
v
it
y
b
ec
au
s
e
it
f
o
s
ter
s
t
h
eir
p
r
o
f
ess
io
n
al
g
r
o
w
t
h
.
W
h
en
C
A
G
is
s
u
s
p
ec
ted
as
th
e
u
n
d
er
l
y
i
n
g
c
au
s
e,
t
h
e
p
h
y
s
icia
n
d
ec
id
es
to
i
m
p
le
m
en
t
W
L
E
.
I
n
o
r
d
er
to
m
ak
e
a
n
i
n
f
o
r
m
ed
d
ec
is
io
n
r
eg
ar
d
in
g
t
h
e
co
u
r
s
e
o
f
tr
ea
t
m
e
n
t,
t
h
e
en
d
o
s
co
p
is
t
m
u
s
t p
o
s
s
e
s
s
t
h
e
r
eq
u
is
i
te
s
k
il
ls
.
I
t c
an
b
e
d
if
f
icu
l
t
to
ad
m
i
n
is
ter
t
h
e
tr
ea
t
m
e
n
t
ef
f
ec
ti
v
el
y
w
h
e
n
en
d
o
s
co
p
is
ts
a
r
e
f
atig
u
ed
o
r
in
ex
p
er
ien
ce
d
.
T
h
e
tr
ea
tm
e
n
t
m
a
y
b
e
co
s
tly
an
d
ti
m
e
-
co
n
s
u
m
i
n
g
.
Fu
r
th
er
m
o
r
e,
th
e
y
m
a
y
r
e
s
u
lt
i
n
an
elev
ated
in
cid
en
ce
o
f
g
a
s
tr
o
in
test
in
a
l
h
ae
m
o
r
r
h
a
g
e.
T
h
e
tr
ea
t
m
e
n
t
s
h
o
u
ld
b
e
b
o
th
eq
u
itab
le
a
n
d
co
n
v
e
n
ien
t
f
o
r
t
h
e
p
u
r
p
o
s
e
o
f
lo
ca
tin
g
C
AG.
A
I
tech
n
iq
u
es
ar
e
e
m
p
lo
y
ed
b
y
en
d
o
s
co
p
is
ts
to
a
n
al
y
s
e
i
m
a
g
es.
A
I
p
r
i
m
ar
il
y
e
m
p
lo
y
ed
c
o
m
p
u
ter
v
is
io
n
to
id
en
ti
f
y
les
io
n
s
,
o
r
g
a
n
is
e
t
h
e
m
ac
co
r
d
in
g
to
th
eir
s
e
m
a
n
tic
co
n
te
n
t,
an
d
clas
s
if
y
i
m
ag
e
s
in
to
d
is
tin
ct
ca
teg
o
r
ies.
3.
G
AS
T
R
I
C
DI
SE
A
SE
AN
D
DE
E
P
L
E
A
RNIN
G
VGGN
et,
R
es
Net,
T
R
esNet,
an
d
SE
-
R
esNet
ar
e
ap
p
lied
b
y
p
h
y
s
ician
s
to
d
ev
is
e
m
ed
ical
im
ag
e
s
.
I
t
is
p
o
s
s
ib
le
to
d
eter
m
i
n
e
t
h
e
t
y
p
e
o
f
i
m
a
g
e
b
y
u
s
in
g
al
g
o
r
ith
m
s
lik
e,
R
-
C
N
N,
YO
L
O,
a
n
d
s
in
g
le
s
h
o
t
m
u
ltib
o
x
d
etec
to
r
(
SSD
)
w
h
ic
h
ar
e
a
m
o
n
g
t
h
e
o
p
tical
ch
ar
ac
ter
r
ec
o
g
n
itio
n
(
OC
R
)
to
o
ls
th
at
ca
n
b
e
e
m
p
l
o
y
ed
to
id
en
ti
f
y
an
d
d
esig
n
ate
s
p
ec
if
ic
elem
e
n
t
s
in
an
i
m
a
g
e.
Sq
u
ar
es
ca
n
also
b
e
em
p
lo
y
ed
to
en
clo
s
e
th
o
s
e
ite
m
s
.
I
t
is
also
b
en
e
f
icial
to
d
r
a
w
b
o
u
n
d
ar
ies
ar
o
u
n
d
t
h
o
s
e
ite
m
s
.
Se
m
an
tic
s
e
g
m
en
ta
tio
n
i
s
th
e
ter
m
t
h
at
r
ef
er
s
to
t
h
i
s
ap
p
r
o
ac
h
[1
2
]
.
A
lg
o
r
ith
m
s
i
n
c
lu
d
e
Dee
p
lab
V3
,
UNe
t++
,
an
d
U
-
Net.
Fig
u
r
e
5
ill
u
s
tr
ates
th
e
th
r
ee
m
et
h
o
d
s
,
th
eir
s
i
m
ilar
itie
s
an
d
d
if
f
er
en
ce
s
.
T
o
f
u
r
th
er
clar
if
y
th
e
d
is
tin
ct
io
n
s
a
m
o
n
g
t
h
ese
ap
p
r
o
ac
h
es,
Fi
g
u
r
e
5
(
a)
r
ep
r
esen
ts
i
m
a
g
e
clas
s
i
f
icatio
n
,
w
h
er
e
t
h
e
m
o
d
el
as
s
i
g
n
s
a
s
in
g
le
d
ia
g
n
o
s
tic
lab
el
to
t
h
e
en
tire
e
n
d
o
s
co
p
ic
i
m
a
g
e.
Fi
g
u
r
e
5
(
b
)
s
h
o
w
s
o
b
j
ec
t
d
etec
tio
n
,
w
h
ic
h
id
e
n
ti
f
ies
r
elev
an
t
ab
n
o
r
m
alitie
s
an
d
m
ar
k
s
th
eir
lo
ca
tio
n
s
w
it
h
b
o
u
n
d
i
n
g
b
o
x
es.
Me
a
n
w
h
ile,
Fig
u
r
e
5
(
c)
d
ep
icts
s
e
m
a
n
tic
s
e
g
m
en
tatio
n
,
a
m
o
r
e
d
etailed
tech
n
iq
u
e
th
at
as
s
ig
n
s
p
ix
e
l
-
lev
el
lab
els
to
p
r
ec
is
el
y
o
u
tlin
e
t
h
e
b
o
u
n
d
ar
ies
o
f
g
astr
it
is
-
r
elat
ed
lesi
o
n
s
.
T
h
ese
co
llecti
v
el
y
d
e
m
o
n
s
tr
ate
h
o
w
d
if
f
er
en
t
d
ee
p
lear
n
i
n
g
f
r
a
m
e
w
o
r
k
s
o
p
er
ate
w
h
en
a
n
al
y
s
i
n
g
g
astro
i
n
test
in
al
e
n
d
o
s
co
p
ic
im
a
g
es.
I
f
A
I
is
ca
p
ab
le
o
f
ac
cu
r
atel
y
id
en
ti
f
y
i
n
g
C
A
G
o
n
th
e
v
id
eo
ca
s
t,
th
en
it
s
er
v
es
as
a
g
r
ea
ter
aid
in
tr
ea
t
m
en
t.
C
A
G
is
n
e
ce
s
s
ar
y
to
ex
a
m
in
e
th
e
r
esu
lts
o
f
a
v
ar
iet
y
o
f
ex
p
e
r
i
m
en
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
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R
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.
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1535
(
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(
b
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Fig
u
r
e
5
.
Dif
f
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a
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ates t
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m
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g
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e
s
t
th
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leted
[1
3
]
.
A
I
h
a
s
m
ad
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ess
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et
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m
p
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m
p
le
m
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th
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p
r
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b
ab
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f
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t.
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s
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ter
co
n
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ted
p
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s
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I
t
h
a
s
n
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w
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g
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is
ed
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is
ti
n
ct
te
n
d
en
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th
at
w
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p
r
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s
l
y
u
n
d
etec
tab
le.
I
t
is
ad
v
an
ta
g
eo
u
s
f
o
r
v
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s
p
u
r
p
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in
clu
d
i
n
g
co
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p
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d
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d
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d
s
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d
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m
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g
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T
h
e
in
ter
n
et
[1
4
]
,
en
h
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ce
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p
r
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s
s
o
r
s
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d
th
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ata
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v
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u
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s
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n
tial a
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v
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m
en
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n
th
is
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ield
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n
th
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p
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t
d
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I
to
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l
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ar
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ap
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to
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s
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u
to
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d
u
s
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b
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k
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a
n
d
h
o
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u
m
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ca
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ls
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Flo
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P
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ch
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s
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lt,
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a
v
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m
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t
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r
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ated
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cr
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d
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ess
s
ec
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s
ar
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tili
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n
g
th
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ev
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ter
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ten
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NNs,
ar
e
a
d
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lea
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m
o
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el
th
a
t
is
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m
p
lo
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e
d
in
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v
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s
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t
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ir
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k
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ltit
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s
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m
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g
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t
h
at
in
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d
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an
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s
.
I
n
o
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d
er
to
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is
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T
h
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th
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t
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t
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m
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q
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ir
e
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m
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f
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ter
n
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Su
b
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ll
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ticip
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ar
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h
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en
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ch
m
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ar
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s
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m
m
ar
is
ed
in
T
a
b
le
3
,
w
h
ic
h
co
n
tr
as
ts
th
e
p
er
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ce
o
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m
u
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d
ee
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lear
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ch
itect
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r
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m
p
lo
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o
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s
tr
itis
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n
o
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C
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ter
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d
en
o
ted
b
y
v
al
u
es
in
p
ar
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th
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is
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
1
6
9
3
-
6930
T
E
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KOM
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K
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elec
o
m
m
u
n
C
o
m
p
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t E
l
C
o
n
tr
o
l
,
Vo
l.
23
,
No
.
6
,
Dec
em
b
er
20
25
:
1
5
2
8
-
1
542
1536
T
ab
le
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.
I
llu
s
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ates th
e
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o
r
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ce
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ic
s
o
f
d
if
f
er
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t d
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p
lear
n
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ar
ch
itect
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r
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o
r
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a
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tr
itis
d
ia
g
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o
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i
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u
s
i
n
g
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ath
o
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i
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B
u
i
l
d
i
n
g
p
l
a
n
s
H
o
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a
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c
u
r
a
t
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(
%)
H
o
w
se
n
si
t
i
v
e
(
%)
L
e
v
e
l
o
f
d
e
t
a
i
l
(
%)
A
U
C
T
h
e
n
u
m
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r
o
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r
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h
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sN
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t
-
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u
s
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C
u
r
r
en
tl
y
,
it
is
u
n
co
m
p
licate
d
to
id
en
tify
a
n
d
r
eso
lv
e
is
s
u
es
in
an
y
s
ec
to
r
.
B
y
ex
a
m
i
n
in
g
n
e
w
i
m
a
g
es,
in
d
i
v
id
u
al
s
w
h
o
h
av
e
ac
q
u
ir
ed
k
n
o
w
led
g
e
o
n
A
I
ca
n
r
ea
d
ily
id
en
t
if
y
g
as
tr
ic
n
eo
p
lasi
a(
s
)
(
C
A
De)
o
r
d
etec
t
th
e
m
(
C
A
D
x
)
.
T
h
e
m
o
s
t
ef
f
ec
ti
v
e
m
e
th
o
d
s
f
o
r
th
e
d
etec
tio
n
o
f
g
a
s
tr
o
in
te
s
ti
n
a
l
ca
n
ce
r
an
d
o
th
er
tu
m
o
u
r
s
i
n
t
h
e
UGI
tr
ac
t
ar
e
a
co
m
p
u
ted
to
m
o
g
r
ap
h
y
(
CT
)
s
ca
n
an
d
a
co
lo
n
o
s
co
p
y
.
A
I
ca
n
o
cc
as
io
n
all
y
f
o
r
ec
ast
t
h
e
p
r
o
f
u
n
d
it
y
o
f
G
C
,
w
h
ic
h
i
s
ad
v
a
n
ta
g
eo
u
s
f
o
r
t
h
e
d
eter
m
i
n
atio
n
o
f
tr
ea
t
m
en
t
at
an
ea
r
lier
s
ta
g
e.
T
h
is
A
I
is
f
r
eq
u
e
n
tl
y
ca
p
ab
l
e
o
f
id
e
n
ti
f
y
i
n
g
t
h
e
i
s
s
u
e
with
t
h
e
s
a
m
e
p
r
ec
is
io
n
as
s
k
illed
en
d
o
s
co
p
is
ts
.
Fu
r
t
h
er
m
o
r
e,
th
is
m
et
h
o
d
m
a
y
b
e
i
m
p
le
m
e
n
ted
to
d
i
s
tin
g
u
is
h
b
et
w
ee
n
g
a
s
tr
ic
i
n
test
in
al
m
etap
las
ia
(
GI
M
)
an
d
h
ea
lt
h
y
g
a
s
tr
o
in
te
s
ti
n
al
ti
s
s
u
e.
T
h
e
p
r
o
ce
d
u
r
e
o
f
g
astro
in
tes
tin
a
l
en
d
o
s
co
p
y
ca
n
b
e
tr
an
s
f
o
r
m
ed
b
y
A
I
.
Nev
er
th
e
less
,
t
h
e
i
n
te
g
r
atio
n
o
f
C
A
De
an
d
C
AD
x
in
s
tr
u
m
en
ts
i
s
n
o
t
al
w
a
y
s
ev
id
en
t.
T
h
e
r
eso
lu
tio
n
o
f
n
u
m
er
o
u
s
is
s
u
e
s
is
r
eq
u
ir
ed
b
y
A
I
’
s
f
u
n
c
tio
n
alit
y
.
A
I
an
d
in
d
iv
id
u
als
d
o
n
o
t
co
n
s
is
te
n
tl
y
ac
co
m
p
li
s
h
th
e
o
u
tco
m
es
t
h
e
y
an
ticip
ate.
Dee
p
lear
n
in
g
is
ca
p
ab
le
o
f
a
w
i
d
e
r
an
g
e
o
f
task
s
,
in
cl
u
d
in
g
t
h
e
id
en
ti
f
icatio
n
o
f
b
r
ain
ca
n
ce
r
th
r
o
u
g
h
s
p
ee
ch
an
d
i
m
ag
e
r
ec
o
g
n
itio
n
.
T
h
e
r
esear
ch
p
ap
er
ex
a
m
i
n
es
th
e
b
en
ef
its
a
n
d
d
r
aw
b
ac
k
s
o
f
e
m
p
lo
y
in
g
a
m
icr
o
s
co
p
e
i
n
a
C
NN
-
s
t
y
le
ap
p
r
o
ac
h
to
id
en
tify
t
h
e
d
ev
elo
p
m
en
t
o
f
g
astrit
is
i
n
t
h
e
i
n
test
i
n
e
s
.
I
n
2
0
2
0
,
a
r
ep
o
r
t
w
a
s
r
elea
s
ed
b
y
a
n
I
A
R
C
t
h
at
p
r
ed
icted
t
h
at
1
,
1
0
9
,
1
0
3
in
d
iv
id
u
als
w
o
u
l
d
d
ev
elo
p
GC
,
a
n
d
7
6
8
,
7
9
3
w
o
u
ld
d
ie
f
r
o
m
t
h
e
d
is
ea
s
e.
T
h
is
s
p
ec
i
f
ic
r
e
g
io
n
o
f
th
e
b
o
d
y
is
r
esp
o
n
s
ib
le
f
o
r
5
.
6
%
o
f
n
e
w
ca
s
e
s
an
d
7
.
7
% o
f
d
ea
th
s
,
r
an
k
in
g
f
o
u
r
th
i
n
ter
m
s
o
f
ca
s
es a
n
d
f
i
f
t
h
in
ter
m
s
o
f
f
atal
ities
.
Gastric
ad
en
o
ca
r
cin
o
m
a
is
t
h
e
ter
m
u
s
ed
to
d
escr
ib
e
th
i
s
f
o
r
m
o
f
s
to
m
ac
h
ca
n
ce
r
.
B
ef
o
r
e
GC
d
ev
elo
p
s
,
g
r
o
w
t
h
ca
n
e
n
d
u
r
e
a
v
ar
iet
y
o
f
s
tag
e
s
.
GC
i
s
1
.
9
%
m
o
r
e
lik
el
y
to
d
ev
elo
p
in
i
n
d
iv
id
u
als
w
i
th
C
A
G
w
it
h
i
n
t
h
e
n
e
x
t
f
i
v
e
y
ea
r
s
.
C
AG
is
p
r
ese
n
t
in
o
v
er
5
0
%
o
f
t
h
e
p
o
p
u
latio
n
i
n
C
h
i
n
a
a
n
d
J
ap
an
,
ac
co
r
d
in
g
to
a
r
estricte
d
n
u
m
b
er
o
f
as
s
a
y
s
.
A
g
as
tr
o
s
co
p
y
w
it
h
s
a
m
p
le
s
i
s
t
h
e
“
g
o
ld
s
ta
n
d
ar
d
”
m
et
h
o
d
f
o
r
d
etec
tin
g
C
A
G.
I
t
is
r
e
m
ar
k
ab
le
to
d
eter
m
i
n
e
th
e
ex
ten
t
to
w
h
ic
h
th
e
e
n
d
o
s
co
p
is
t
is
ca
p
ab
le
o
f
co
n
d
u
cti
n
g
b
io
p
s
ies.
C
A
G
ca
n
b
e
d
etec
ted
b
y
a
W
L
E
;
h
o
w
e
v
er
,
it
is
n
o
t
p
ar
tic
u
lar
l
y
e
f
f
ec
tiv
e
i
n
t
h
is
m
a
n
n
er
.
W
h
en
a
c
a
m
er
a
is
e
m
p
lo
y
ed
,
AG
i
s
m
o
s
t
f
r
eq
u
e
n
tl
y
id
en
t
i
f
ied
in
t
h
e
an
tr
u
m
(
6
1
.
5
%)
a
n
d
th
e
s
to
m
ac
h
b
o
d
y
(
4
6
.
7
%)
[1
5
]
.
E
r
a
d
icatin
g
ail
m
e
n
ts
t
h
at
w
er
e
o
v
er
lo
o
k
ed
b
y
t
h
e
p
h
y
s
ician
as
a
r
es
u
lt
o
f
h
u
m
a
n
er
r
o
r
is
a
d
if
f
ic
u
lt
tas
k
.
T
h
e
p
h
y
s
icia
n
is
o
b
lig
ated
to
ex
ec
u
te
th
is
task
m
an
u
all
y
,
as
o
p
p
o
s
ed
to
em
p
l
o
y
i
n
g
a
m
ac
h
i
n
e.
E
n
d
o
s
co
p
is
ts
ar
e
n
o
t
o
b
lig
ated
to
co
n
d
u
ct
an
y
ad
d
itio
n
a
l
tes
ts
i
f
th
e
y
ar
e
ab
le
to
lo
ca
te
C
A
G
w
i
th
ea
s
e
an
d
clar
it
y
.
T
h
e
r
ate
o
f
s
to
m
ac
h
ca
n
ce
r
d
ev
elo
p
m
e
n
t
w
ill
eit
h
e
r
b
e
r
ed
u
ce
d
o
r
elim
i
n
ated
en
tire
l
y
if
th
is
is
co
m
b
in
ed
w
it
h
d
ee
p
lear
n
in
g
an
d
o
th
er
f
o
r
m
s
o
f
A
I
.
Ov
er
th
e
p
ast
f
e
w
y
ea
r
s
,
t
h
e
y
h
a
v
e
b
ee
n
ex
te
n
s
iv
el
y
u
tili
s
ed
in
a
v
ar
iet
y
o
f
m
ed
ica
l
i
m
a
g
in
g
ap
p
licatio
n
s
.
A
d
d
itio
n
all
y
,
in
d
i
v
id
u
al
s
w
h
o
h
a
v
e
e
x
p
er
ien
ce
d
g
a
s
tr
itis
m
a
y
e
x
p
er
ien
ce
n
a
u
s
ea
a
s
a
r
esu
lt o
f
A
I
-
b
ased
m
et
h
o
d
o
lo
g
ies.
I
n
9
8
%
o
f
ca
s
es,
th
e
d
ee
p
lear
n
in
g
m
et
h
o
d
w
i
t
h
a
co
m
p
u
ter
is
ef
f
ec
ti
v
e
in
d
etec
ti
n
g
ea
r
l
y
GC
.
I
t
w
a
s
p
r
ec
is
e
9
8
.
7
%
o
f
th
e
ti
m
e.
A
s
m
al
l
en
s
e
m
b
le
w
a
s
e
m
p
lo
y
e
d
to
ca
p
tu
r
e
th
e
i
m
ag
e
s
.
A
C
NN
w
a
s
e
m
p
lo
y
ed
in
a
s
er
ies
o
f
ex
p
er
i
m
e
n
ts
to
a
s
c
er
tain
it
s
ca
p
ac
it
y
to
id
en
t
if
y
HP
ca
s
es.
W
ith
a
p
er
f
o
r
m
a
n
c
e
o
f
8
7
.
7
%,
it
w
as
in
telli
g
e
n
t
at
8
8
.
9
%.
R
esear
ch
er
s
e
m
p
lo
y
ed
d
ee
p
lear
n
in
g
to
c
r
ea
te
an
alg
o
r
ith
m
th
at
co
u
ld
aid
in
th
e
d
etec
tio
n
o
f
co
lo
n
ca
n
ce
r
.
T
h
e
s
y
s
te
m
w
a
s
s
u
b
s
eq
u
en
tl
y
d
em
o
n
s
tr
ated
to
b
e
9
8
.
4
%
ac
cu
r
ate
in
d
etec
tin
g
th
e
m
ali
g
n
a
n
c
y
.
T
h
e
A
I
’
s
d
is
co
v
er
y
o
f
C
A
G
is
co
m
m
en
d
ab
le,
w
ith
a
9
3
%
s
u
cc
es
s
r
ate.
C
o
n
v
er
s
el
y
,
th
e
d
ee
p
lear
n
in
g
tech
n
iq
u
e
o
f
a
u
to
n
o
m
o
u
s
l
y
ex
tr
ac
tin
g
f
ea
t
u
r
es
f
r
o
m
e
n
d
o
s
co
p
y
i
m
a
g
es
ac
h
ie
v
ed
a
9
5
%
s
u
cc
es
s
r
ate.
I
n
th
e
p
h
ar
y
n
x
,
l
u
m
p
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I
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s
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d
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es d
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g
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s
tr
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co
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.
Evaluation Warning : The document was created with Spire.PDF for Python.
T
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)
1537
3
.
1
.
I
m
pa
ct
o
f
da
t
a
s
et
s
ize
o
n
perf
o
r
m
a
nce
T
h
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ad
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t
ac
c
u
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(
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tNet
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t
w
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w
as
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ev
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p
ed
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I
n
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AM
,
it
is
f
ea
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to
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m
p
le
m
en
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in
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th
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co
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a
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th
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av
ailab
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s
p
ac
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T
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e
m
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t
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b
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w
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th
e
m
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cr
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co
m
p
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n
e
n
t
s
.
T
h
eir
o
u
tp
u
ts
w
er
e
p
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is
e
w
it
h
9
4
%,
d
elica
te
w
i
th
9
3
%,
an
d
ac
cu
r
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w
it
h
9
3
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5
%.
I
n
d
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id
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s
w
it
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C
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ca
p
ab
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m
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th
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ter
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tes
t
s
et
[1
6
]
.
T
h
e
d
is
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s
e
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lo
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ted
w
it
h
r
e
m
ar
k
ab
le
p
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b
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th
e
m
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er
,
it
m
a
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cc
asio
n
all
y
b
e
in
ac
c
u
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ate.
T
ab
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4
d
is
p
lay
s
t
h
e
m
o
s
t
p
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e
d
ee
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lear
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a
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ted
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ataset
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ize.
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f
9
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s
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t
h
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s
is
.
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ab
le
4
.
I
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s
tr
ates th
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s
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ip
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atase
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M
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(
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3
T
h
ey
g
e
n
er
ate
a
g
r
id
t
h
at
ill
u
s
tr
ates
th
e
p
r
i
n
cip
al
lo
ca
tio
n
s
w
h
er
e
th
e
G
A
M
-
E
f
f
icie
n
tNe
t
estab
lis
h
es
co
n
n
ec
tio
n
s
,
t
h
er
eb
y
allo
w
i
n
g
th
e
en
d
o
s
co
p
is
t
to
u
n
d
er
s
ta
n
d
th
e
i
m
a
g
es
th
e
y
ar
e
v
ie
w
in
g
.
A
v
id
eo
tes
t
s
e
t
w
o
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ld
b
e
im
p
le
m
e
n
ted
to
ass
ess
th
e
m
o
d
el
’
s
ac
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u
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ac
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.
C
o
n
s
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e
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tl
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o
b
tain
ed
an
AUC
s
co
r
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o
f
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2
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3
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d
an
F1
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r
e
o
f
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1
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8
9
%.
T
h
is
v
al
u
e
is
b
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w
ee
n
1
.
5
8
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d
6
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7
3
p
er
ce
n
tag
e
p
o
in
ts
lo
w
er
th
an
t
h
e
v
alu
e
t
h
at
w
a
s
o
b
s
er
v
ed
i
n
t
h
e
o
u
td
o
o
r
test
s
et.
Desp
ite
t
h
e
f
ac
t
th
at
all
th
r
ee
n
et
w
o
r
k
s
d
e
m
o
n
s
tr
ated
s
u
p
er
io
r
p
er
f
o
r
m
a
n
ce
o
n
th
e
v
id
eo
test
s
et,
th
e
y
w
er
e
u
l
ti
m
atel
y
u
n
ab
le
to
s
u
r
p
ass
G
A
M
-
E
f
f
ic
ie
n
tN
et.
W
h
ile
th
er
e
ar
e
ce
r
tain
asp
ec
ts
th
at
ar
e
i
n
ac
c
u
r
ate,
th
e
y
ar
e
s
u
b
j
ec
t
to
i
m
p
r
o
v
e
m
en
t
a
s
ti
m
e
p
r
o
g
r
ess
e
s
.
T
h
e
y
r
ev
ie
w
ed
a
v
ar
iet
y
o
f
cr
itical
i
m
a
g
es
o
f
i
n
d
iv
id
u
al
s
in
f
ec
ted
w
it
h
g
astrit
i
s
f
r
o
m
a
s
i
n
g
le
h
o
s
p
ital.
T
h
is
i
s
th
e
s
o
u
r
ce
o
f
t
h
e
p
r
ac
tice
s
et
th
at
w
as
e
m
p
lo
y
e
d
in
th
i
s
s
t
u
d
y
.
T
h
e
o
b
j
ec
ts
th
at
ar
e
em
p
lo
y
ed
ca
n
alter
th
e
ca
m
er
a
’
s
i
m
ag
e
s
i
n
r
ea
l
lif
e.
I
n
ad
d
itio
n
,
th
e
m
o
d
el
’
s
s
co
r
e
m
a
y
f
l
u
ct
u
ate
in
r
esp
o
n
s
e
to
f
ac
to
r
s
s
u
c
h
as
th
e
lo
c
atio
n
o
f
its
s
to
r
ag
e,
th
e
a
m
o
u
n
t o
f
li
g
h
t it
r
ec
eiv
es,
m
ea
l r
e
m
ai
n
s
,
a
n
d
g
as
tr
o
in
tes
tin
al
f
l
u
id
.
3
.
2
.
Art
if
ici
a
l
i
nte
llig
ence
a
nd
helico
ba
ct
er
py
lo
ri
infe
ct
io
n
C
o
n
s
eq
u
en
tl
y
,
it
w
ill
o
p
er
ate
m
o
r
e
ef
f
ec
ti
v
el
y
i
n
a
v
ar
iety
o
f
s
itu
a
tio
n
s
.
I
n
o
r
d
er
to
i
m
p
r
o
v
e
th
e
o
r
d
er
,
th
e
r
ate
o
f
d
ec
lin
e
w
a
s
tak
en
i
n
to
ac
co
u
n
t.
T
h
e
s
o
le
p
u
r
p
o
s
e
o
f
th
is
i
n
v
e
s
ti
g
atio
n
is
to
r
ec
o
g
n
is
e
C
A
G
.
I
t
is
f
ea
s
ib
le
th
at
th
e
clin
ician
s
’
ev
al
u
atio
n
o
f
th
e
w
ei
g
h
t
lo
s
s
d
u
r
in
g
th
e
in
itial
p
h
ase
is
i
n
a
cc
u
r
ate.
Diag
n
o
s
tic
b
io
p
s
ies
w
er
e
ad
m
in
is
ter
ed
in
th
e
r
eg
io
n
s
,
an
d
ex
cl
u
s
i
v
e
i
m
ag
e
s
w
er
e
ca
p
tu
r
ed
.
T
h
e
r
e
s
ea
r
ch
w
o
u
ld
g
r
o
u
p
th
e
m
o
d
el
in
to
g
r
o
u
p
s
b
ased
o
n
th
e
at
y
p
ical
o
u
tco
m
es
b
ef
o
r
e
in
s
tr
u
c
tin
g
it,
th
er
eb
y
d
e
m
o
n
s
tr
ati
n
g
th
e
ex
te
n
t
to
w
h
ich
t
h
e
y
d
e
v
iate.
T
h
is
ca
n
b
e
e
m
p
lo
y
ed
to
i
m
p
r
o
v
e
th
e
m
ac
h
i
n
e
’
s
v
i
s
u
al
ca
p
ab
ilit
ies
in
id
e
n
ti
f
y
in
g
r
eg
io
n
s
w
h
er
e
co
n
d
itio
n
s
w
er
e
d
eter
io
r
atin
g
[1
7
]
.
T
h
e
atr
o
p
h
y
’
s
lo
ca
tio
n
w
o
u
ld
r
e
m
ai
n
u
n
k
n
o
w
n
;
it
s
er
v
e
s
a
s
a
d
escr
ip
tiv
e
to
o
l
f
o
r
th
e
s
itu
atio
n
.
Nev
er
th
e
less
,
t
h
e
m
atr
i
x
m
a
y
b
e
ab
le
to
h
elp
r
eso
lv
e
th
e
m
atter
.
I
f
all
o
p
er
atio
n
s
w
er
e
co
n
d
u
c
ted
in
ac
co
r
d
an
ce
w
i
th
t
h
e
esta
b
lis
h
ed
s
c
h
ed
u
le,
t
h
e
i
m
a
g
e
w
o
u
ld
aid
in
th
e
id
en
ti
f
icatio
n
o
f
t
h
e
d
escen
t.
E
n
d
o
s
co
p
is
ts
r
eq
u
ir
e
t
h
is
i
n
f
o
r
m
atio
n
to
i
m
p
r
o
v
e
t
h
eir
v
i
s
io
n
.
C
er
tai
n
l
y
,
b
u
t
t
h
is
is
a
d
i
f
f
ic
u
lt
ass
ig
n
m
en
t.
I
n
t
h
e
p
r
esen
t
d
a
y
,
th
er
e
ar
e
n
u
m
er
o
u
s
d
is
c
u
s
s
io
n
s
co
n
ce
r
n
in
g
t
h
e
ex
p
an
s
io
n
o
f
A
I
.
T
h
e
en
d
o
s
co
p
is
ts
m
a
y
h
a
v
e
s
elec
ted
all
o
f
t
h
e
d
etails
u
s
e
d
in
th
e
test
,
w
h
ic
h
i
m
p
lies
t
h
at
t
h
e
m
o
d
el
w
a
s
ex
ce
s
s
iv
el
y
ac
c
u
r
ate.
T
h
e
im
a
g
es
cr
ea
ted
th
e
illu
s
io
n
th
at
th
e
s
p
ec
i
f
ic
b
o
d
y
p
ar
t
w
a
s
g
r
av
el
y
a
f
f
ec
ted
,
d
esp
ite
th
e
ab
s
en
ce
o
f
g
e
n
u
in
e
le
s
io
n
s
.
I
t
is
i
m
p
er
ativ
e
to
tes
t
th
e
m
o
d
el
i
n
o
r
d
er
to
ascer
tain
it
s
ca
p
ac
it
y
to
d
e
tect
n
e
w
le
s
io
n
s
.
I
n
o
r
d
er
to
cr
ea
te
a
C
AG
clas
s
i
f
icatio
n
m
o
d
el
th
at
is
ca
p
ab
le
o
f
id
en
ti
f
y
i
n
g
o
b
j
ec
ts
w
ith
a
h
i
g
h
er
d
e
g
r
ee
o
f
ac
cu
r
ac
y
t
h
an
e
n
d
o
s
co
p
is
ts
a
n
d
is
b
ased
o
n
d
ee
p
lear
n
in
g
,
t
h
e
p
r
o
ce
d
u
r
e
is
r
ep
ea
ted
f
o
r
a
n
ex
te
n
d
ed
p
er
io
d
.
I
n
t
h
is
m
a
n
n
er
,
th
e
y
m
a
y
b
e
ab
le
to
ascer
tain
w
h
at
i
s
f
air
an
d
j
u
s
t.
T
h
e
i
n
co
r
p
o
r
atio
n
o
f
A
I
in
to
en
d
o
s
co
p
y
i
m
a
g
es
s
u
b
s
tan
t
iall
y
s
i
m
p
li
f
ie
s
th
e
p
r
o
c
ess
o
f
i
n
f
ec
tio
n
d
etec
tio
n
.
F
u
r
th
er
m
o
r
e,
t
h
e
o
u
tc
o
m
e
s
o
f
test
s
t
h
at
in
v
e
s
ti
g
ate
t
h
e
s
to
m
ac
h
’
s
i
n
ter
io
r
m
a
y
d
i
f
f
er
a
m
o
n
g
i
n
d
iv
id
u
als.
A
n
o
v
el
A
I
-
b
ased
m
et
h
o
d
h
as
s
i
m
p
li
f
ied
th
e
id
en
ti
f
icatio
n
a
n
d
d
esi
g
n
at
io
n
o
f
g
astro
i
n
test
in
al
is
s
u
es
[1
8
]
.
Fu
r
th
er
m
o
r
e,
en
d
o
s
co
p
is
ts
m
a
y
s
h
ar
e
t
h
eir
p
r
ef
er
ab
le
o
b
s
er
v
atio
n
s
.
As
a
r
esu
lt,
t
h
e
r
ate
o
f
p
r
o
g
r
ess
w
a
s
s
u
b
s
ta
n
tiall
y
ac
ce
ler
ated
.
I
t
i
s
h
i
g
h
l
y
li
k
el
y
t
h
at
clin
icia
n
s
w
i
ll
i
m
p
le
m
e
n
t
al
g
o
r
ith
m
s
to
m
a
n
a
g
e
an
d
i
n
ter
p
r
et
a
d
iv
er
s
e
ar
r
a
y
o
f
m
ed
ica
l
d
ata,
s
u
c
h
as
p
atie
n
t
r
ec
o
r
d
s
,
m
ed
ical
i
m
a
g
es,
D
N
A
d
ata,
a
n
d
b
io
m
ar
k
er
p
r
o
f
il
es.
T
h
ese
d
ata
f
ac
i
litate
t
h
e
i
d
en
tific
atio
n
o
f
G
C
ten
d
en
cie
s
b
y
A
I
to
o
ls
.
T
h
is
s
u
g
g
es
ts
t
h
at
th
e
y
m
a
y
id
en
ti
f
y
s
u
b
tle
clu
e
s
an
d
i
n
d
icato
r
s
th
at
o
th
er
s
w
o
u
ld
f
ai
l
to
n
o
tice.
Nu
m
er
o
u
s
e
x
p
er
i
m
e
n
ts
h
a
v
e
ill
u
s
tr
ated
th
at
A
I
is
c
ap
ab
le
o
f
lo
ca
tin
g
G
C
at
a
f
ast
er
p
ac
e.
Du
r
in
g
a
n
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