Colorectal cancer remains a leading cause of cancer-related deaths worldwide, with early detection and removal of polyps being critical in preventing disease progression. Automated polyp segmentation, particularly in colonoscopy images, is a challenging task due to the variability in polyp appearance and the low contrast between polyps and surrounding tissues. In this work, we propose an edge-enhanced network (EENet) designed to address these challenges by integrating two novel modules: the covariance edge-enhanced attention (CEEA) and cross-scale edge enhancement (CSEE) modules. The CEEA module leverages covariance-based attention to enhance boundary detection, while the CSEE module bridges multi-scale features to preserve fine-grained edge details. To further improve the accuracy of polyp segmentation, we introduce a hybrid loss function that combines cross-entropy loss with edge-aware loss. Extensive experiments show that the EENet achieves a Dice score of 0.9208 and an IoU of 0.8664 on the Kvasir-SEG dataset, surpassing state-of-the-art models such as Polyp-PVT and PraNet. Furthermore, it records a Dice score of 0.9316 and an IoU of 0.8817 on the CVC-ClinicDB dataset, demonstrating its strong potential for clinical application in polyp segmentation. Ablation studies further validate the contribution of the CEEA and CSEE modules.
Background: This scoping review aims to examine the extant literature and summarize findings related to barriers to accessing health care faced by older Chinese immigrants in Canada.Methods: We conducted a search of electronic databases for peer-reviewed articles using a comprehensive set of keywords without limiting the search to a specific time period. To be included in our review, articles had to meet the following criteria: (a) published in a peer-reviewed journal, (b) written in English, (c) provide a clear description of the methods used, and (d) respond to our research question, which focuses on identifying barriers to accessing healthcare for older Chinese immigrants living in Canada.Results: Fifteen papers were selected based on the criteria, and five main barriers were identified, which are ranked in descending order according to the number of times they were mentioned: culture and health beliefs (N = 13), language and communication (N = 7), structural and circumstances (N = 2), health literacy and information (N = 2), and demographic, social, and economic factors (N = 2).Conclusions: The issue of accessing healthcare for older Chinese immigrants in Canada is complex, as it involves multiple aspects that are relevant to both patients and healthcare providers. Our research findings suggest that the culturally and linguistically sensitive education programs, inter-sectoral coordination, and social support should be improved for older Chinese immigrants and those of other ethnic backgrounds.
Polyp segmentation is crucial for early colorectal cancer detection, but accurately delineating polyps is challenging due to their variations in size, shape, and texture and low contrast with surrounding tissues. Existing methods often rely solely on spatial-domain processing, which struggles to separate high-frequency features (edges, textures) from low-frequency ones (global structures), leading to suboptimal segmentation performance. We propose the Dynamic Frequency-Decoupled Refinement Network (DFDRNet), a novel segmentation framework that integrates frequency-domain and spatial-domain processing. DFDRNet introduces the Frequency Adaptive Decoupling (FAD) module, which dynamically separates high- and low-frequency components, and the Frequency Adaptive Refinement (FAR) module, which refines these components before fusing them with spatial features to enhance segmentation accuracy. Embedded within a U-shaped encoder–decoder framework, DFDRNet achieves state-of-the-art performance across three benchmark datasets, demonstrating superior robustness and efficiency. Our extensive evaluations and ablation studies confirm the effectiveness of DFDRNet in balancing segmentation accuracy with computational efficiency.
Background: Poor sleep quality is common in older adults and closely tied to emotional well-being. While life satisfaction has been linked to sleep outcomes, the psychological pathways remain underexplored. Purpose: This study examines whether psychological resilience and anxiety symptoms mediate the relationship between life satisfaction and sleep quality among older adults, and whether chronic disease moderates these pathways. Methods: Data were drawn from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, including 3089 community-dwelling adults aged 65 years and older. Sleep quality and life satisfaction were measured using validated single-item indicators. Psychological resilience was assessed using five self-reported items capturing adaptive functioning, and anxiety symptoms were measured using the 7-item Generalized Anxiety Disorder Scale. A parallel mediation model and a moderated mediation model were tested using SPSS with bootstrapping procedures (5000 samples). Results: Life satisfaction was significantly associated with sleep quality among older adults. This association was partially mediated by both psychological resilience (indirect association = −0.0100, 95% CI [−0.0163, −0.0045]) and anxiety symptoms (indirect association = −0.0356, 95% CI [−0.0483, −0.0238]). The direct association remained significant (β = −0.2399, p < 0.001), indicating a partial mediation pattern. Furthermore, in the moderated mediation model, chronic disease moderated the association between anxiety symptoms and sleep quality, whereas the indices of moderated mediation were not significant. Conclusions: Life satisfaction was associated with sleep quality, with psychological resilience and anxiety symptoms accounting for part of this association. Although chronic disease strengthened the association between anxiety symptoms and poorer sleep quality, the overall moderated mediation effect was not significant.
Introduction: With the rapid industrialization in China, the issue of labor rights protection in emerging business sectors has become a hot topic within academic research and market practice. However, there were still few studies on the assessment of policy instruments in China. Accordingly, this study attempted to construct a three-dimensional framework regarding “policy instruments, policy intensity, and policy stakeholders,” to explore the policy adaptability of occupational injury insurance for employees of emerging business sectors in China.Methods: Followed by compiling 60 policies pertaining to occupational injury insurance for employees of emerging business sectors in China, this study conducted Nvivo 12 to summarize the specific provisions of these policies. Subsequently, we employed the rule code of “policy serial number, chapter serial number, and clause serial number” to investigate the adaptability of these occupational injury insurance policies.Results: It suggested that the development of occupational injury insurance policies for employees of emerging business sectors in China was still in its early stages, with characteristics of uneven utilization of policy instruments and limited adaptability to specific targets. While there was an upward trend in policy intensity, improvements in efficiency and capacity were necessary. Moreover, the presence of competing policy interests and inadequate governance capacity remained significant challenges.Discussion: Based on the central theme of “content adaptation, effective instruments, and inclusive development,” this study attempted to provide several managerial implications. First, it should enhance the publicity of policies to increase policy satisfaction. Second, it was necessary to refine planning to improve the efficiency of public policies. Third, there was a need to optimize the application structure of policy tools to enhance the alignment with policy goals. Finally, it needed to give priority to the needs of emerging business sectors to ensure a balance between policy supply and demand.