Automated

自动化
  • 文章类型: Journal Article
    红细胞沉降率(ESR)是临床实践中广泛使用的筛查测试,作为炎性和退行性恶性疾病的指标。韦斯特格伦方法,被誉为黄金标准,因其准确性和成本效益而受到重视,但需要相当长的时间和血量。新兴的自动化方法提供了更快、更方便的替代方案,旨在取代手动技术。尽管如此,根据参考韦斯特格伦方法验证这些自动化方法对于确保可靠性至关重要。因此,这项研究旨在评估从参考韦斯特格伦方法和自动(SFRIESR3000)方法获得的ESR测量结果。
    于2023年7月15日至9月16日在Jigjiga大学SheikHassenYabare转诊医院进行了基于医院的比较横断面研究。在获得知情同意书后,从158名参与者中获得了血液样本,每个参与者的五毫升血液。然后使用Westergren(参考)方法和自动(SFRIESR3000)方法对这些样品进行ESR估算。随后,使用SPSS20版和MedCalc12.3.0.0版统计软件对收集的数据进行分析.统计分析,如配对t检验,皮尔逊相关性,线性回归,布兰德和奥特曼的阴谋也被利用了.P值<0.05被认为是统计学上显著的。
    配对样本t检验分析显示,使用参考韦斯特格伦方法与ESR测定的自动化方法之间没有显着差异,平均差(MD)为0.7±9.2mm/h(P=0.36)。此外,在两种方法之间观察到显著的相关性,相关系数显著(r=0.94,p<0.001)。Bland-Altman数据分析表明没有系统偏差的证据,并且证明了两种方法之间ESR值的良好一致性。协议限制为-17.3至+18.7。此外,在一系列ESR值的自动方法的运行中不精确分析显示,低的变异系数为27.08,12.65和10.32%,中等,和高ESR水平,分别。
    SFRIESR300自动化方法证明了与Westergren方法可互换使用以确定ESR的潜力,考虑到强相关性和良好的一致性。此外,在解释过程中可以应用相同的参考范围。
    UNASSIGNED: Erythrocyte sedimentation rate (ESR) is a widely used screening test in clinical practice as an indicator of inflammatory and degenerative malignant diseases. The Westergren method, renowned as the gold standard, is valued for its accuracy and cost-effectiveness but demands considerable time and blood volume. Emerging automated methods offer quicker and more convenient alternatives, aiming to replace manual techniques. Nonetheless, validating these automated methods against the reference Westergren method is essential to ensure reliability. Therefore, this study aimed to evaluate ESR measurement results obtained from both the reference Westergren method and the automated (SFRI ESR 3000) method.
    UNASSIGNED: A Hospital-based comparative cross-sectional study was conducted at Jigjiga University Sheik Hassen Yabare Referral Hospital from July 15 to September 16, 2023. Following the acquisition of informed consent, blood samples were obtained from 158 participants, five milliliters of blood from each participant. These samples were then subjected to ESR estimation using both the Westergren (reference) method and the automated (SFRI ESR 3000) method. Subsequently, the collected data were analyzed using SPSS version 20 and MedCalc version 12.3.0.0 statistical Softwares. Statistical analyses such as Paired t-tests, Pearson correlation, linear regression, and the Bland and Altman plot were employed. A p-value of < 0.05 was considered statistically significant.
    UNASSIGNED: The paired sample t-test analysis revealed no significant difference between the use of the reference Westergren method and the automated method for ESR determination, with a mean difference (MD) of 0.7 ± 9.2 mm/h (P = 0.36). Additionally, a significant correlation was observed between the two methods, with a remarkable correlation coefficient (r = 0.94, p < 0.001). The Bland-Altman data analysis indicated no evidence of systematic bias and demonstrated good agreement of ESR values between the two methods, with a limit of agreement of -17.3 to +18.7. Moreover, within-run imprecision analysis for the automated method across a range of ESR values showed coefficient of variation of 27.08, 12.65, and 10.32% for low, medium, and high ESR levels, respectively.
    UNASSIGNED: The SFRI ESR 300 automated method demonstrates the potential for interchangeable use with the Westergren method for determining ESR, given the strong correlation and good agreement. Additionally, the same reference range could be applied during interpretation.
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  • 文章类型: Journal Article
    这里提出的工作是集成到PanAir的自动化前后处理器,这是一种基于高阶空气动力学面板方法的软件,用于70年代开发的流量分析,但仍在积极使用,尤其是用于飞机的初步设计。在这项工作中提出的集成环境,操作输入和输出数据和从PanAir成功绕过,否则需要手动操作和使用第三方软件。在具有改进的NLF(1)-0414机翼的塞斯纳210飞机上验证了集成环境。使用PanAir与集成环境一起分析了飞机周围的流量,结果表明,预处理和后处理时间减少,PanAir使用的便利性显着增加。
    The work proposed here is an automated pre and post-processor integrated to PanAir that is is a high-order aerodynamic panel method-based software for flow analysis developed in 70s but still in active use especially for preliminary aircraft design. With the integrated environment proposed in this work, manipulation of input and output data to and from PanAir is bypassed successfully that is otherwise requires manual manipulations and use of third party software. The integrated environment is validated over a Cessna 210 aircraft with a modified NLF (1)-0414 airfoil. The flow around the aircraft is analyzed using PanAir together with the integrated environment and results show that pre and post processing times reduced and ease in PanAir use is increased significantly.
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  • 文章类型: Journal Article
    人类的观察只能捕获正在进行的课堂社交活动的一部分,并且对于理解儿童的互动是如何空间结构并不理想。在这里,我们演示了如何通过使用基于射频识别的商业系统对儿童位置和运动的自动连续测量进行建模来研究社交互动。在三个1小时的教室免费游戏观察中,从16名五岁儿童中获得了连续的位置数据。说明性坐标图表明,男孩和女孩倾向于聚集在教室的不同物理位置,但没有暗示儿童速度的性别差异(即,运动速度)。为了检测社交互动,我们给出了径向分布函数,儿童在社交中的接触时间高于机会水平的指数。等级图表明,儿童与某些同龄人的社交联系比其他人多数十到数百倍。我们说明了使用社会关系(高于平均水平的社会联系)来可视化教室网络。对网络的分析表明,传递性是一种潜在的透镜,通过它来检查男性,女性,和混血儿.通过从新的角度重新审查既定的性别隔离发现,说明性发现表明了新测量方法的有效性。
    Human observations can only capture a portion of ongoing classroom social activity, and are not ideal for understanding how children\'s interactions are spatially structured. Here we demonstrate how social interaction can be investigated by modeling automated continuous measurements of children\'s location and movement using a commercial system based on radio frequency identification. Continuous location data were obtained from 16 five-year-olds observed during three 1-h classroom free play observations. Illustrative coordinate mapping indicated that boys and girls tended to cluster in different physical locations in the classroom, but there was no suggestion of gender differences in children\'s velocity (i.e., speed of movement). To detect social interaction, we present the radial distribution function, an index of when children were in social contact at greater than chance levels. Rank-order plots indicated that children were in social contact tens to hundreds of times more with some peers than others. We illustrate the use of social ties (higher than average levels of social contact) to visualize the classroom network. Analysis of the network suggests that transitivity is a potential lens through which to examine male, female, and mixed-sex cliques. The illustrative findings suggest the validity of the new measurement approach by re-examining well-established gender segregation findings from a new perspective.
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  • 文章类型: Journal Article
    背景:在人道主义环境中采用3D成像系统需要与手动测量相当的精度,尽管存在与严格设置相关的额外限制。
    目的:这项研究旨在评估由BodySurfaceTranslationsInc.开发的AutoAnthro3D成像系统(第三代)产生的儿童身高和上臂中围(MUAC)测量的准确性。
    方法:在2021年9月至10月在南苏丹马拉卡勒平民保护站点进行的2阶段集群调查中,对设备准确性进行了研究。选定家庭中所有6至59个月的儿童都有资格。对于每个孩子,根据2006年世界卫生组织儿童生长标准研究中使用的方案,由2名人体肌层进行手动测量.然后,使用装有自定义软件的三星Galaxy8手机,由不同的枚举器捕获扫描结果,AutoAnthro,和英特尔实感3D扫描仪。使用全自动算法处理扫描。拟合多变量逻辑回归模型以评估实现成功扫描的调整几率。使用Bland-Altman图直观评估测量的准确性,并使用平均偏差进行量化,协议限制(LoAs),以及个体差异的95%精度区间。主要的线人访谈是与调查列举员和BodySurfaceTranslationsInc开发人员进行的远程访谈,以了解beta测试中的挑战,培训,数据采集和传输。
    结果:对539名符合条件的儿童进行了手动测量,并且扫描衍生的测量结果已成功处理了234例(43.4%)。至少10.4%(56/539)的儿童看护者拒绝同意扫描捕获;其他扫描未成功传输到服务器。儿童的人口统计学特征(年龄和性别)身材,MUAC也不与扫描衍生测量的可用性相关;团队显著相关(P<.001)。以cm为单位的扫描衍生测量的平均偏差对于身高为-0.5(95%CI-2.0至1.0),对于MUAC为0.7(95%CI0.4-1.0)。为了身材,95%LoA为-23.9cm至22.9cm。对于MUAC,95%LoA为-4.0cm至5.4cm。所有准确性指标因团队而异。与COVID-19大流行相关的物理距离和旅行政策限制了验证设备算法的测试,并阻止了开发人员进行亲自培训和现场监督,负面影响扫描捕获的质量,processing,和传输。
    结论:扫描衍生的测量对于当前技术的广泛采用来说不够准确。尽管该软件显示出希望,需要对软件算法进行进一步的投资,以解决扫描传输和极端现场环境的问题,以及改进现场监督。团队准确性的差异提供了证据,表明对培训的投资也可以提高绩效。
    BACKGROUND: Adoption of 3D imaging systems in humanitarian settings requires accuracy comparable with manual measurement notwithstanding additional constraints associated with austere settings.
    OBJECTIVE: This study aimed to evaluate the accuracy of child stature and mid-upper arm circumference (MUAC) measurements produced by the AutoAnthro 3D imaging system (third generation) developed by Body Surface Translations Inc.
    METHODS: A study of device accuracy was embedded within a 2-stage cluster survey at the Malakal Protection of Civilians site in South Sudan conducted between September 2021 and October 2021. All children aged 6 to 59 months within selected households were eligible. For each child, manual measurements were obtained by 2 anthropometrists following the protocol used in the 2006 World Health Organization Child Growth Standards study. Scans were then captured by a different enumerator using a Samsung Galaxy 8 phone loaded with a custom software, AutoAnthro, and an Intel RealSense 3D scanner. The scans were processed using a fully automated algorithm. A multivariate logistic regression model was fit to evaluate the adjusted odds of achieving a successful scan. The accuracy of the measurements was visually assessed using Bland-Altman plots and quantified using average bias, limits of agreement (LoAs), and the 95% precision interval for individual differences. Key informant interviews were conducted remotely with survey enumerators and Body Surface Translations Inc developers to understand challenges in beta testing, training, data acquisition and transmission.
    RESULTS: Manual measurements were obtained for 539 eligible children, and scan-derived measurements were successfully processed for 234 (43.4%) of them. Caregivers of at least 10.4% (56/539) of the children refused consent for scan capture; additional scans were unsuccessfully transmitted to the server. Neither the demographic characteristics of the children (age and sex), stature, nor MUAC were associated with availability of scan-derived measurements; team was significantly associated (P<.001). The average bias of scan-derived measurements in cm was -0.5 (95% CI -2.0 to 1.0) for stature and 0.7 (95% CI 0.4-1.0) for MUAC. For stature, the 95% LoA was -23.9 cm to 22.9 cm. For MUAC, the 95% LoA was -4.0 cm to 5.4 cm. All accuracy metrics varied considerably by team. The COVID-19 pandemic-related physical distancing and travel policies limited testing to validate the device algorithm and prevented developers from conducting in-person training and field oversight, negatively affecting the quality of scan capture, processing, and transmission.
    CONCLUSIONS: Scan-derived measurements were not sufficiently accurate for the widespread adoption of the current technology. Although the software shows promise, further investments in the software algorithms are needed to address issues with scan transmission and extreme field contexts as well as to enable improved field supervision. Differences in accuracy by team provide evidence that investment in training may also improve performance.
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  • 文章类型: Journal Article
    背景:青春期是预防和治疗心理健康问题出现的关键时期。基于智能手机的对话代理可以提供心理驱动的干预和支持,从而随着时间的推移增加心理健康。
    目的:本研究的目的是测试一个名为Kai的自动会话代理的潜力。AI为青少年提供基于接受承诺治疗工具的自助计划,旨在增加他们的福祉。
    方法:参与者为10387名青少年,14-18岁,谁用了Kai.AI在其中一个顶级消息应用程序上(例如,iMessage和WhatsApp)。使用5项世界卫生组织福祉指数问卷,对用户的福祉水平进行了2到5次评估,以评估他们对服务的参与度。
    结果:用户与对话代理的平均时间为45.39(SD46.77)天。时间点1的平均幸福感评分为39.28(SD18.17),表明,平均而言,用户体验到的幸福感降低。潜在生长曲线模型表明,参与者的幸福感随着时间的推移显着增加(β=2.49;P<.001),并达到临床可接受的幸福感平均得分(高于50)。
    结论:基于移动的对话代理有潜力提供有吸引力和有效的接受承诺治疗干预措施。
    BACKGROUND: Adolescence is a critical developmental period to prevent and treat the emergence of mental health problems. Smartphone-based conversational agents can deliver psychologically driven intervention and support, thus increasing psychological well-being over time.
    OBJECTIVE: The objective of the study was to test the potential of an automated conversational agent named Kai.ai to deliver a self-help program based on Acceptance Commitment Therapy tools for adolescents, aimed to increase their well-being.
    METHODS: Participants were 10,387 adolescents, aged 14-18 years, who used Kai.ai on one of the top messaging apps (eg, iMessage and WhatsApp). Users\' well-being levels were assessed between 2 and 5 times using the 5-item World Health Organization Well-being Index questionnaire over their engagement with the service.
    RESULTS: Users engaged with the conversational agent an average of 45.39 (SD 46.77) days. The average well-being score at time point 1 was 39.28 (SD 18.17), indicating that, on average, users experienced reduced well-being. Latent growth curve modeling indicated that participants\' well-being significantly increased over time (β=2.49; P<.001) and reached a clinically acceptable well-being average score (above 50).
    CONCLUSIONS: Mobile-based conversational agents have the potential to deliver engaging and effective Acceptance Commitment Therapy interventions.
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  • 文章类型: Journal Article
    描述选择用于创建临床ML模型的自动机器学习(AutoML)平台的标准清单的开发和应用。
    选择适合当地卫生区ML需求的AutoML平台的评估标准分为3个步骤:(1)确定关键要求,(2)市场扫描,和(3)具有预期结果的评估过程。
    在选择创建ML肝素给药模型的平台作为用例时,将包含21项功能和6项非功能标准的最终清单应用于供应商提交。
    一组临床医生,数据科学家,和关键利益相关者制定了一份清单,可以适应医疗机构的机器学习需求,提供相关示例的用例。
    开发了一个评估清单,用于选择需要在大型多站点研究中进行验证的AutoML平台。
    UNASSIGNED: To describe development and application of a checklist of criteria for selecting an automated machine learning (Auto ML) platform for use in creating clinical ML models.
    UNASSIGNED: Evaluation criteria for selecting an Auto ML platform suited to ML needs of a local health district were developed in 3 steps: (1) identification of key requirements, (2) a market scan, and (3) an assessment process with desired outcomes.
    UNASSIGNED: The final checklist comprising 21 functional and 6 non-functional criteria was applied to vendor submissions in selecting a platform for creating a ML heparin dosing model as a use case.
    UNASSIGNED: A team of clinicians, data scientists, and key stakeholders developed a checklist which can be adapted to ML needs of healthcare organizations, the use case providing a relevant example.
    UNASSIGNED: An evaluative checklist was developed for selecting Auto ML platforms which requires validation in larger multi-site studies.
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  • 文章类型: Journal Article
    目的:认知障碍现在被认为是一种迫在眉睫的公共卫生危机。大约三分之一的成年人担心他们的认知,在神经系统疾病患者中,客观认知障碍的患病率要高得多。现有的筛查工具只专注于检测老年人的痴呆症,必须由临床医生管理并进行评分。使它们对许多神经病学实践不切实际。这项研究检查了一个简短的实用性,自我管理,计算机化的认知筛查工具,认知健康简要评估(BACH),在确定成年人的认知障碍。
    方法:912名成年人(18-84岁)完成了BACH和神经心理电池。开发了多变量模型以提供反映个体患者认知障碍概率的BACH指数评分。在记忆障碍诊所的160名老年人中,将预测准确性与蒙特利尔认知评估(MoCA)进行了比较。
    结果:最终的多变量模型在识别认知障碍个体方面显示出良好的准确性(c=0·77)。与MoCA相比,BACH在识别老年认知障碍患者方面具有较高的预测准确性(c=0.79vs.0·67)以及将MCI或痴呆症患者与无认知障碍患者区分开来(c=0·86与c=0·67)。
    结论:结果表明,可以使用简短的,自我管理,自动认知筛查工具,和BACH提供了优于现有筛查者的几个优点:自我管理;自动评分;健康记录的即时结果;易于解释的评分;在广泛的患者中的实用性;以及可能导致认知投诉的可治疗因素的标志(即,抑郁症,睡眠问题,和压力)。
    OBJECTIVE: Cognitive impairment is now recognized as an impending public health crisis. About one-third of adults are concerned about their cognition, and the prevalence of objective cognitive impairment is much higher among those with neurological disorders. Existing screening tools are narrowly focused on detecting dementia in older adults and must be clinician-administered and scored, making them impractical for many neurology practices. This study examined the utility of a brief, self-administered, computerized cognitive screening tool, the Brief Assessment of Cognitive Health (BACH), in identifying cognitive impairment in adults.
    METHODS: 912 adults (ages 18-84) completed BACH and a neuropsychological battery. Multivariable models were developed to provide a BACH index score reflecting the probability of cognitive impairment for individual patients. Predictive accuracy was compared to that of the Montreal Cognitive Assessment (MoCA) in a subset of 160 older adults from a Memory Disorders clinic.
    RESULTS: The final multivariable model showed good accuracy in identifying cognitively impaired individuals (c = 0·77). Compared to MoCA, BACH had superior predictive accuracy in identifying older patients with cognitive impairment (c = 0·79 vs. 0·67) as well as differentiating those with MCI or dementia from those without cognitive impairment (c = 0·86 vs. c = 0·67).
    CONCLUSIONS: Results suggest that cognitive impairment can be identified in adults using a brief, self-administered, automated cognitive screening tool, and BACH provides several advantages over existing screeners: self-administered; automatic scoring; immediate results in health record; easily interpretable score; utility in wide range of patients; and flags for treatable factors that may contribute to cognitive complaints (i.e., depression, sleep problems, and stress).
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  • 文章类型: Journal Article
    背景:泰国的艾滋病毒流行主要集中在男男性行为者(MSM)中,监测工作主要基于病例监测和当地生物行为调查。
    目标:我们驾驶了KaiNoi,MSM中基于网络的受访者驱动抽样(RDS)调查。
    方法:我们开发了一个用PHP编码的应用程序,该应用程序简化了RDS办公室中通常使用的所有程序和事件,以便在Web上使用。包括电子优惠券验证,资格筛选,同意,采访,同行招聘,电子优惠券发行,和补偿。所有程序都是自动化的,电子优惠券ID号是随机生成的。参与者的电话号码是检测和防止重复登记的主要手段。泰国各地进行了采样;曼谷居民还被邀请参加10个诊所中的1个,进行与艾滋病毒有关的抽血,并获得额外补偿。
    结果:从2022年2月至6月进行采样;种子(开始时21,14后来添加)是通过横幅广告识别的,微消息,和在线聊天室。抽样遍及所有6个地区和几乎所有省份。识别出使用“借用”电话号码的欺诈性(重复)注册,并导致318个调查记录的检测和失效。另有106名参与者没有通过注意力过滤问题(要求新兵选择特定的分类回答),并被排除在数据分析之外。导致1643名有效参与者的最终数据集。只有一个记录显示出直线的迹象(相同的相邻响应)。曼谷受访者均未提出抽血。
    结论:我们成功开发了一个应用程序,在泰国的MSM中实施基于Web的RDS。尽量减少措施,检测,在提供补偿的基于网络的调查中,消除欺诈性的调查登记势在必行。需要努力改善生物标志物的吸收,以充分挖掘基于网络的采样和数据收集的潜力。
    BACKGROUND: Thailand\'s HIV epidemic is heavily concentrated among men who have sex with men (MSM), and surveillance efforts are mostly based on case surveillance and local biobehavioral surveys.
    OBJECTIVE: We piloted Kai Noi, a web-based respondent-driven sampling (RDS) survey among MSM.
    METHODS: We developed an application coded in PHP that facilitated all procedures and events typically used in an RDS office for use on the web, including e-coupon validation, eligibility screening, consent, interview, peer recruitment, e-coupon issuance, and compensation. All procedures were automated and e-coupon ID numbers were randomly generated. Participants\' phone numbers were the principal means to detect and prevent duplicate enrollment. Sampling took place across Thailand; residents of Bangkok were also invited to attend 1 of 10 clinics for an HIV-related blood draw with additional compensation.
    RESULTS: Sampling took place from February to June 2022; seeds (21 at the start, 14 added later) were identified through banner ads, micromessaging, and in online chat rooms. Sampling reached all 6 regions and almost all provinces. Fraudulent (duplicate) enrollment using \"borrowed\" phone numbers was identified and led to the detection and invalidation of 318 survey records. A further 106 participants did not pass an attention filter question (asking recruits to select a specific categorical response) and were excluded from data analysis, leading to a final data set of 1643 valid participants. Only one record showed signs of straightlining (identical adjacent responses). None of the Bangkok respondents presented for a blood draw.
    CONCLUSIONS: We successfully developed an application to implement web-based RDS among MSM across Thailand. Measures to minimize, detect, and eliminate fraudulent survey enrollment are imperative in web-based surveys offering compensation. Efforts to improve biomarker uptake are needed to fully tap the potential of web-based sampling and data collection.
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  • 文章类型: Journal Article
    脑磁图(MEG)是一种非侵入性神经成像技术,可广泛用于癫痫和肿瘤定位。MEG临床报告需要多学科团队,包括关于每个偶极子的解剖定位的专家输入。这里,我们介绍一种新颖的工具,“脑磁图查看器”(MAV),简化了解剖分析。MAV将患者的磁共振成像(MRI)标准化到蒙特利尔神经病学研究所(MNI)空间,将MNI图谱反向归一化为天然MRI,识别MEG偶极文件,并将偶极子\'坐标与它们在阿特拉斯文件中的空间位置相匹配。它提供了一个用户友好和交互式图形用户界面(GUI),用于显示单个偶极子,groups,坐标,解剖标签,和具有偶极覆盖层的患者的三平面MRI视图。它评估了在临床癫痫受试者中获得的273个偶极子。基于共识的基本事实是由三位神经放射学家建立的,最低协议门槛为2。真相和MAV标签之间的一致性从79%到84%,取决于归一化方法。在MRI上具有最小或没有结构异常的受试者中观察到更高的一致率,从80%到90%不等。MAV提供了一种简单的MEG偶极解剖定位方法,允许非专业人员预先填充一份报告,从而促进和减少临床报告的时间。
    Magnetoencephalography (MEG) is a noninvasive neuroimaging technique widely recognized for epilepsy and tumor mapping. MEG clinical reporting requires a multidisciplinary team, including expert input regarding each dipole\'s anatomic localization. Here, we introduce a novel tool, the \"Magnetoencephalography Atlas Viewer\" (MAV), which streamlines this anatomical analysis. The MAV normalizes the patient\'s Magnetic Resonance Imaging (MRI) to the Montreal Neurological Institute (MNI) space, reverse-normalizes MNI atlases to the native MRI, identifies MEG dipole files, and matches dipoles\' coordinates to their spatial location in atlas files. It offers a user-friendly and interactive graphical user interface (GUI) for displaying individual dipoles, groups, coordinates, anatomical labels, and a tri-planar MRI view of the patient with dipole overlays. It evaluated over 273 dipoles obtained in clinical epilepsy subjects. Consensus-based ground truth was established by three neuroradiologists, with a minimum agreement threshold of two. The concordance between the ground truth and MAV labeling ranged from 79% to 84%, depending on the normalization method. Higher concordance rates were observed in subjects with minimal or no structural abnormalities on the MRI, ranging from 80% to 90%. The MAV provides a straightforward MEG dipole anatomic localization method, allowing a nonspecialist to prepopulate a report, thereby facilitating and reducing the time of clinical reporting.
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  • 文章类型: Journal Article
    原理:中重度阻塞性睡眠呼吸暂停(OSA)(呼吸暂停低通气指数[AHI],>15个事件/小时)通过频繁的呼吸暂停来干扰睡眠,并与白天嗜睡有关。然而,许多没有中度-重度OSA的人(即,AHI<15个事件/h)也报告嗜睡。目标:检验以下假设:AHI<15事件/h组中的嗜睡是在没有明显减少气流的情况下流量限制的结果(即,呼吸暂停/呼吸不足)。方法:对来自MESA睡眠队列的1,886名参与者进行了多导睡眠图记录的鼻气流信号的流量受限频率分析。白天过度嗜睡(EDS)由Epworth嗜睡量表评分11定义。协变量调整逻辑回归评估了AHI<15事件/h的个体中EDS(二元因变量)与流量限制频率(连续)之间的关联。结果:共有772名AHI<15事件/h的个体被纳入主要分析。流量限制与EDS相关(比值比,2.04;95%置信区间,1.17-3.54;流量限制频率每增加2个标准偏差)调整年龄后,性别,身体质量指数,种族/民族,和睡眠时间。在也针对AHI进行调整之后,该效应大小没有明显变化。结论:在AHI<15事件/h的个体中,流量限制频率增加2个标准差与EDS风险增加两倍相关。未来的研究应该研究解决低AHI个体的流量限制作为改善嗜睡的潜在机制。
    Rationale: Moderate-severe obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI], >15 events/h) disturbs sleep through frequent bouts of apnea and is associated with daytime sleepiness. However, many individuals without moderate-severe OSA (i.e., AHI <15 events/h) also report sleepiness. Objectives: To test the hypothesis that sleepiness in the AHI <15 events/h group is a consequence of substantial flow limitation in the absence of overt reductions in airflow (i.e., apnea/hypopnea). Methods: A total of 1,886 participants from the MESA sleep cohort were analyzed for frequency of flow limitation from polysomnogram-recorded nasal airflow signal. Excessive daytime sleepiness (EDS) was defined by an Epworth Sleepiness Scale score ⩾11. Covariate-adjusted logistic regression assessed the association between EDS (binary dependent variable) and frequency of flow limitation (continuous) in individuals with an AHI <15 events/h. Results: A total of 772 individuals with an AHI <15 events/h were included in the primary analysis. Flow limitation was associated with EDS (odds ratio, 2.04; 95% confidence interval, 1.17-3.54; per 2-standard deviation increase in flow limitation frequency) after adjusting for age, sex, body mass index, race/ethnicity, and sleep duration. This effect size did not appreciably change after also adjusting for AHI. Conclusions: In individuals with an AHI <15 events/h, increasing flow limitation frequency by 2 standard deviations is associated with a twofold increase in the risk of EDS. Future studies should investigate addressing flow limitation in low-AHI individuals as a potential mechanism for ameliorating sleepiness.
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