diagnostic modeling

  • 文章类型: Journal Article
    人工智能(AI)越来越多地应用于医学的所有学科,包括牙科。口腔健康研究正在经历机器学习(ML)的快速使用,人工智能的一个分支,它识别数据中的固有模式,类似于人类的学习方式。在当代临床牙科中,ML支持计算机辅助诊断,风险分层,个体风险预测,和决策支持,最终提高临床口腔保健效率,结果,减少差距。Further,ML逐渐用于牙科和口腔健康研究,从基础科学和转化科学到临床研究。在ML视角下,这篇综述全面概述了牙科医学如何利用人工智能进行诊断,预后,和生成任务。介绍了牙科中可用数据模式的范围及其与各种应用AI方法的兼容性。最后,总结了当前的挑战和局限性,以及AI在牙科医学中应用的未来可能性和注意事项。
    Artificial intelligence (AI) is increasingly applied across all disciplines of medicine, including dentistry. Oral health research is experiencing a rapidly increasing use of machine learning (ML), the branch of AI that identifies inherent patterns in data similarly to how humans learn. In contemporary clinical dentistry, ML supports computer-aided diagnostics, risk stratification, individual risk prediction, and decision support to ultimately improve clinical oral health care efficiency, outcomes, and reduce disparities. Further, ML is progressively used in dental and oral health research, from basic and translational science to clinical investigations. With an ML perspective, this review provides a comprehensive overview of how dental medicine leverages AI for diagnostic, prognostic, and generative tasks. The spectrum of available data modalities in dentistry and their compatibility with various methods of applied AI are presented. Finally, current challenges and limitations as well as future possibilities and considerations for AI application in dental medicine are summarized.
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  • 文章类型: Journal Article
    脓毒症或脓毒性休克患者的延迟诊断与死亡率和发病率增加相关。UPLC-MS和NMR光谱用于测量脂蛋白组,脂质,生物胺,氨基酸,和色氨酸途径代谢物的血浆样本收集的152名患者在48小时内进入重症监护病房(ICU),其中62名患者没有败血症,71例患者有败血症,19例患者出现感染性休克。与非脓毒症患者相比,脓毒症或脓毒性休克患者的新蝶呤浓度较高,HDL胆固醇和磷脂颗粒水平较低。根据10种不同的脂质浓度,可以将败血症性休克与败血症患者区分开来,包括五种磷脂酰胆碱的浓度明显降低,三种胆固醇酯,一个二氢神经酰胺,和一种磷脂酰乙醇胺.所有ICU患者的超分子磷脂复合物(SPC)均减少,而脓毒症和脓毒性休克患者在入住ICU48小时内急性期糖蛋白的复合标志物升高。我们表明,在ICU入院48小时内获得的血浆代谢表型可诊断败血症的存在,并且可以根据血脂谱将败血症休克与败血症区分开。
    Delayed diagnosis of patients with sepsis or septic shock is associated with increased mortality and morbidity. UPLC-MS and NMR spectroscopy were used to measure panels of lipoproteins, lipids, biogenic amines, amino acids, and tryptophan pathway metabolites in blood plasma samples collected from 152 patients within 48 h of admission into the Intensive Care Unit (ICU) where 62 patients had no sepsis, 71 patients had sepsis, and 19 patients had septic shock. Patients with sepsis or septic shock had higher concentrations of neopterin and lower levels of HDL cholesterol and phospholipid particles in comparison to nonsepsis patients. Septic shock could be differentiated from sepsis patients based on different concentrations of 10 lipids, including significantly lower concentrations of five phosphatidylcholine species, three cholesterol esters, one dihydroceramide, and one phosphatidylethanolamine. The Supramolecular Phospholipid Composite (SPC) was reduced in all ICU patients, while the composite markers of acute phase glycoproteins were increased in the sepsis and septic shock patients within 48 h admission into ICU. We show that the plasma metabolic phenotype obtained within 48 h of ICU admission is diagnostic for the presence of sepsis and that septic shock can be differentiated from sepsis based on the lipid profile.
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  • 文章类型: Journal Article
    在听力学领域,实现听觉障碍的准确辨别仍然是一个巨大的挑战。耳聋和耳鸣等情况对患者的整体生活质量产生重大影响,强调迫切需要精确有效的分类方法。这项研究引入了一种创新的方法,利用从三个不同队列获得的多视图脑网络数据:51名聋哑患者,54伴有耳鸣,和42个正常对照。精心收集脑电图(EEG)记录数据,聚焦于连接到具有10个感兴趣区域(ROI)的端到端密钥的70个电极。这些数据与机器学习算法协同集成。为了解决大脑连接数据固有的高维性质,主成分分析(PCA)用于特征约简,增强可解释性。所提出的方法使用集成学习技术进行评估,包括随机森林,额外的树木,梯度提升,和CatBoost。建议的模型的性能经过了一系列全面的指标审查,包括交叉验证准确性(CVA),精度,召回,F1分数,Kappa,和马修斯相关系数(MCC)。所提出的模型显示出统计意义,并有效地诊断听觉障碍,有助于早期发现和个性化治疗,从而提高患者的治疗效果和生活质量。值得注意的是,它们表现出可靠性和鲁棒性,具有高Kappa和MCC值。这项研究代表了听力学交叉的重大进展,神经影像学,和机器学习,对临床实践和护理具有变革性意义。
    In the field of audiology, achieving accurate discrimination of auditory impairments remains a formidable challenge. Conditions such as deafness and tinnitus exert a substantial impact on patients\' overall quality of life, emphasizing the urgent need for precise and efficient classification methods. This study introduces an innovative approach, utilizing Multi-View Brain Network data acquired from three distinct cohorts: 51 deaf patients, 54 with tinnitus, and 42 normal controls. Electroencephalogram (EEG) recording data were meticulously collected, focusing on 70 electrodes attached to an end-to-end key with 10 regions of interest (ROI). This data is synergistically integrated with machine learning algorithms. To tackle the inherently high-dimensional nature of brain connectivity data, principal component analysis (PCA) is employed for feature reduction, enhancing interpretability. The proposed approach undergoes evaluation using ensemble learning techniques, including Random Forest, Extra Trees, Gradient Boosting, and CatBoost. The performance of the proposed models is scrutinized across a comprehensive set of metrics, encompassing cross-validation accuracy (CVA), precision, recall, F1-score, Kappa, and Matthews correlation coefficient (MCC). The proposed models demonstrate statistical significance and effectively diagnose auditory disorders, contributing to early detection and personalized treatment, thereby enhancing patient outcomes and quality of life. Notably, they exhibit reliability and robustness, characterized by high Kappa and MCC values. This research represents a significant advancement in the intersection of audiology, neuroimaging, and machine learning, with transformative implications for clinical practice and care.
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  • 文章类型: Journal Article
    探讨SARS-CoV-2感染的全身代谢效应,我们分析了人血浆的1HNMR光谱数据,并与多种血浆细胞因子和趋化因子共同建模(平行测量).因此,600MHz1H溶剂抑制单脉冲,自旋回波,收集SARS-CoV-2rRT-PCR阳性患者(n=15,多个采样时间点)和年龄匹配的健康对照(n=34,确认rRT-PCR阴性)的血浆的2DJ分辨光谱,以及SARS-CoV-2检测阴性的COVID-19/流感样临床症状患者(n=35)。我们将单脉冲NMR光谱数据与从原始1DNMR数据中提取的定量脂蛋白谱(112个参数)的体外诊断研究(IVDr)信息进行了比较。所有NMR方法均可对SARS-CoV-2阳性患者与对照组和SARS-CoV-2阴性患者进行高度区分。对疾病诱导的表型转化提供不同的诊断信息窗口。选定患者的纵向轨迹分析表明,在恢复期没有检测到病毒的个体中,代谢恢复不完全。我们观察到四个血浆细胞因子簇,它们与多种脂蛋白和代谢物表达了复杂的差异统计关系。这些包括以下内容:簇1,包括MIP-1β,SDF-1α,IL-22和IL-1α,与多个LDL和VLDL亚组分增加相关;第2组,包括IL-10和IL-17A,仅与脂蛋白谱弱相关;簇3,包括IL-8和MCP-1,与多种脂蛋白成反比。IL-18,IL-6和IFN-γ与IP-10和RANTES一起与LDL1-4亚组分呈强正相关,与多个HDL亚组分呈负相关。总的来说,这些数据显示了一种独特的模式,表明对SARSCoV-2感染的多水平细胞免疫应答与血浆脂蛋白组相互作用,从而为该疾病提供了强烈和特征性的免疫代谢表型。我们观察到一些处于呼吸恢复期和检测无病毒的患者在代谢上仍然高度异常,这表明这些技术在评估全面系统恢复方面的新作用。
    To investigate the systemic metabolic effects of SARS-CoV-2 infection, we analyzed 1H NMR spectroscopic data on human blood plasma and co-modeled with multiple plasma cytokines and chemokines (measured in parallel). Thus, 600 MHz 1H solvent-suppressed single-pulse, spin-echo, and 2D J-resolved spectra were collected on plasma recorded from SARS-CoV-2 rRT-PCR-positive patients (n = 15, with multiple sampling timepoints) and age-matched healthy controls (n = 34, confirmed rRT-PCR negative), together with patients with COVID-19/influenza-like clinical symptoms who tested SARS-CoV-2 negative (n = 35). We compared the single-pulse NMR spectral data with in vitro diagnostic research (IVDr) information on quantitative lipoprotein profiles (112 parameters) extracted from the raw 1D NMR data. All NMR methods gave highly significant discrimination of SARS-CoV-2 positive patients from controls and SARS-CoV-2 negative patients with individual NMR methods, giving different diagnostic information windows on disease-induced phenoconversion. Longitudinal trajectory analysis in selected patients indicated that metabolic recovery was incomplete in individuals without detectable virus in the recovery phase. We observed four plasma cytokine clusters that expressed complex differential statistical relationships with multiple lipoproteins and metabolites. These included the following: cluster 1, comprising MIP-1β, SDF-1α, IL-22, and IL-1α, which correlated with multiple increased LDL and VLDL subfractions; cluster 2, including IL-10 and IL-17A, which was only weakly linked to the lipoprotein profile; cluster 3, which included IL-8 and MCP-1 and were inversely correlated with multiple lipoproteins. IL-18, IL-6, and IFN-γ together with IP-10 and RANTES exhibited strong positive correlations with LDL1-4 subfractions and negative correlations with multiple HDL subfractions. Collectively, these data show a distinct pattern indicative of a multilevel cellular immune response to SARS CoV-2 infection interacting with the plasma lipoproteome giving a strong and characteristic immunometabolic phenotype of the disease. We observed that some patients in the respiratory recovery phase and testing virus-free were still metabolically highly abnormal, which indicates a new role for these technologies in assessing full systemic recovery.
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  • 文章类型: Journal Article
    尚未探索失眠,因为它与轻度创伤性脑损伤(mTBI)后的恢复有关。我们旨在评估安大略省mTBI延迟恢复的工人失眠的患病率,以及它与社会人口统计学的关系,TBI-与索赔相关,行为,和临床因素。
    这是一项在安大略省一家大型康复医院进行的为期24个月的横断面研究。评估失眠的患病率,我们使用了失眠严重程度指数(ISI)。数据来自标准化问卷,保险公司记录,和招募时的临床评估。使用Spearman相关系数或方差分析计算双变量关联。我们建立了失眠相关因素的逐步多元线性回归模型。其他分析,包括对ISI内部一致性的评估,被执行了。
    在94名被诊断为mTBI的参与者中,临床失眠报告为69.2%.平均年龄为45.20±9.94岁;61.2%为男性。在失眠的患病率或严重程度上没有观察到与性别相关的差异。失眠与某些社会人口统计学显著相关,索赔相关,行为,和临床变量。在多元回归分析中,几个决定因素解释了53%的失眠变异。ISI的内部一致性,用克朗巴赫的α来衡量,是0.86
    失眠常见于mTBI延迟恢复的患者,并且与潜在可修改的临床和非临床变量显著相关。在失眠和相关疾病的诊断和管理方面,对脑损伤患者的护理需要更多的关注。
    Insomnia has not been explored as it relates to recovery after mild traumatic brain injury (mTBI). We aimed to evaluate the prevalence of insomnia among Ontario workers with delayed recovery from mTBI, and its relationship with sociodemographic, TBI- and claim-related, behavioral, and clinical factors.
    This was a cross-sectional study carried out over a period of 24 months in a large rehabilitation hospital in Ontario. To assess the prevalence of insomnia, we used the Insomnia Severity Index (ISI). Data were collected from standardized questionnaires, insurer records, and clinical assessment at the time of recruitment. Bivariate associations were calculated using the Spearman\'s correlation coefficient or analysis of variance. We established stepwise multivariate linear regression models of factors associated with insomnia. Additional analyses, including the assessment of the internal consistency of the ISI, were performed.
    Of the 94 participants diagnosed with mTBI, clinical insomnia was reported by 69.2%. The mean age was 45.20 ± 9.94 years; 61.2% were men. No sex-related differences were observed in insomnia prevalence or severity. Insomnia was significantly associated with certain sociodemographic, claim-related, behavioral, and clinical variables. In the multivariable regression analysis, several determinants explained 53% of the insomnia variance. The internal consistency of the ISI, as measured by Cronbach\'s α, was 0.86.
    Insomnia is common in persons with delayed recovery from mTBI, and is significantly associated with potentially modifiable clinical and nonclinical variables. Care of persons with brain injury requires greater attention with regard to the diagnosis and management of insomnia and associated disorders.
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