labeling

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  • 文章类型: Journal Article
    基于视频的应用程序在各个领域的广泛采用突出了它们在现代软件系统中的重要性。然而,与图像或文本相比,为了评估系统准确性而标记视频测试用例可能会由于其时间结构和更大的体积而导致费用增加。测试优先级已成为降低标签成本的一种有前途的方法,对可能错误分类的测试输入进行优先级排序,以便可以在有限的时间和手动标记工作下更早地识别这些输入。然而,将现有的优先化技术应用于视频测试用例面临某些限制:它们不考虑视频数据中存在的唯一时间信息。与仅包含空间信息的静态图像数据集不同,视频输入由多个帧组成,这些帧捕获对象随时间的动态变化。在本文中,我们提议VRank,第一种专门为视频测试输入设计的测试优先级排序方法。VRank背后的基本思想是,被评估的DNN分类器错误分类的可能性较高的视频类型测试被认为更有可能揭示故障,并且将被优先排序。为此,我们训练一个排名模型,目的是预测给定测试输入被DNN分类器错误分类的概率。这种预测依赖于四种类型的生成特征:时间特征(TF),视频嵌入功能(EF),预测特征(PF),和不确定性特征(UF)。我们根据目标测试集中的所有测试输入的错误分类概率对它们进行排名。错误分类可能性较高的视频将被优先排序。我们进行了实证评估,以评估VRank的绩效,涉及120名具有自然和嘈杂数据集的受试者。实验结果表明,VRank优于所有比较的测试优先级方法,在自然数据集上平均提高5.76%~46.51%,在嘈杂数据集上平均提高4.26%~53.56%。
    The widespread adoption of video-based applications across various fields highlights their importance in modern software systems. However, in comparison to images or text, labelling video test cases for the purpose of assessing system accuracy can lead to increased expenses due to their temporal structure and larger volume. Test prioritization has emerged as a promising approach to mitigate the labeling cost, which prioritizes potentially misclassified test inputs so that such inputs can be identified earlier with limited time and manual labeling efforts. However, applying existing prioritization techniques to video test cases faces certain limitations: they do not account for the unique temporal information present in video data. Unlike static image datasets that only contain spatial information, video inputs consist of multiple frames that capture the dynamic changes of objects over time. In this paper, we propose VRank, the first test prioritization approach designed specifically for video test inputs. The fundamental idea behind VRank is that video-type tests with a higher probability of being misclassified by the evaluated DNN classifier are considered more likely to reveal faults and will be prioritized higher. To this end, we train a ranking model with the aim of predicting the probability of a given test input being misclassified by a DNN classifier. This prediction relies on four types of generated features: temporal features (TF), video embedding features (EF), prediction features (PF), and uncertainty features (UF). We rank all test inputs in the target test set based on their misclassification probabilities. Videos with a higher likelihood of being misclassified will be prioritized higher. We conducted an empirical evaluation to assess the performance of VRank, involving 120 subjects with both natural and noisy datasets. The experimental results reveal VRank outperforms all compared test prioritization methods, with an average improvement of 5.76% ∼ 46.51% on natural datasets and 4.26% ∼ 53.56% on noisy datasets.
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  • 文章类型: Journal Article
    最近在更多儿童中观察到的主要公共卫生问题之一是超重。原因当然在于儿童身体活动的减少,但主要是他们的饮食习惯。由于含糖量高,软饮料被认为是导致身体超重的最重要因素;因此,作为众多运动的结果,部分糖被人造甜味剂(AS)代替。尽管由于其低热量值而具有优势,世卫组织建议不应将其用于实现体重控制或作为降低非传染性疾病风险的预防措施,因为没有证据表明它们的有效性。除了饮料,人造甜味剂组合也被添加到各种“低脂肪”和“高蛋白”食品中,这在年轻人群中尤其受到青睐。因此,有必要照顾累积摄入量。这项研究包括对323名1-14岁儿童父母的调查,以及对受访者最常消费的产品中AS含量的分析。调查结果显示,很大一部分3-14岁的儿童(40%)经常饮用软饮料。不同的产品(软饮料,果汁/花盆,糖浆)根据受访者的回答进行抽样,一项分析表明,其中54%含有一个或多个AS。此外,调查表明,父母缺乏关于产品中存在AS的信息,51%的父母宣称他们没有阅读他们购买的产品的声明。必须坚持消费者教育,改变饮食偏好和习惯,尤其是在儿童中。
    One of the main public health issues that has recently been observed in a greater number of children is being overweight. The cause certainly lies in the decreasing physical activity of children, but mostly in their eating habits. Soft drinks are recognized as the most significant contributor to body overweight due to high sugar content; thus, as a result of numerous campaigns, part of the sugar is replaced by artificial sweeteners (ASs). Despite their advantage due to their low caloric value, WHO recommends that they should not be used to achieve weight control or as prevention for reducing the risk of non-communicable diseases, as there is no evidence of their effectiveness. Apart from beverages, artificial sweetener combinations are also added to a variety of \"low fat\" and \"high protein\" food products, which are highly favored especially among the young population. Therefore, it is necessary to take care of the cumulative intake. The conducted study included a survey of 323 parents of children aged 1-14 years, as well as an analysis of the AS content in the products most often consumed by the respondents. The results of the survey show that a large part of children (40%) aged 3-14 often consume soft drinks. Different products (soft drinks, juices/nectars, syrups) were sampled based on the respondents\' responses, and an analysis showed that 54% of them contained one or more ASs. In addition, the survey indicated parents\' lack of information about the presence of AS in products, as 51% of parents declared that they do not read the declarations of the products they buy. It is necessary to persist in consumer education and changes in dietary preferences and habits, especially among children.
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  • 文章类型: Journal Article
    背景:国家食品环境政策有助于减少与饮食相关的非传染性疾病。然而,它们在荷兰的执行仍然很低。据推测,媒体可以在引发政策关注度激增方面发挥关键作用,从而塑造政治行动。这项研究的目的是通过分析各种行为者使用的论点,研究2000-2022年间荷兰报纸文章中关于食品政策的论述。
    方法:在NexisUni中进行了系统搜索,以识别2000-2022年间在七家荷兰国家报纸上发表的涵盖国家级荷兰食品环境政策的报纸文章。承保政策分为六个领域,包括食品成分,标签,促销,价格,提供和零售,并进入政策周期的四个阶段;政策制定,决策,实施,和评价。灰色文献检索用于确定2000-2022年期间实施的食品政策。描述性统计数据被用来总结政策随着时间的推移,政策类型和政策阶段。对报纸文章的随机子样本进行了解释性内容分析,以确定演员,粮食政策的观点和论点。
    结果:我们确定了896篇相关报纸文章。报纸对食品政策的报道最初很低,但在2018/2021/2022年达到顶峰。通过灰色文献检索,我们确定了6项2000-2022年实施或调整的食品政策。大多数报纸文章都报道了食品定价政策,并在政策制定阶段进行了讨论。学者(主要是支持)是最多的,食品行业(主要是反对)是引用最少的参与者。支持性论点强调了健康后果,健康不平等和集体责任,而相反的论点集中在不必要的政府干预和政策无效上。
    结论:涉及食品政策的荷兰报纸文章代表了各种参与者和论点,个人对食物选择的责任和集体责任在争论中起着核心作用。这些见解可以作为进一步研究为什么使用某些论点及其对政策关注和执行的影响的基础。
    BACKGROUND: National food environment policies can contribute to the reduction of diet-related non-communicable diseases. Yet, their implementation in the Netherlands remains low. It has been hypothesized that the media can play a pivotal role in inducing spikes in policy attention, thereby shaping political action. The aim of this study was to examine the discourse on food policies in Dutch newspaper articles between 2000-2022, by analyzing arguments used by various actors.
    METHODS: A systematic search in Nexis Uni was used to identify newspaper articles that covered national-level Dutch food environment policies published in seven Dutch national newspapers between 2000-2022. Covered policies were classified into six domains including food composition, labeling, promotion, prices, provision and retail and into the four stages of the policy cycle; policy formulation, decision-making, implementation, and evaluation. A grey literature search was used to identify food policies implemented during 2000-2022. Descriptive statistics were used to summarize coverage of policies over time, policy type and policy stage. An interpretive content analysis was performed on a random subsample of the newspaper articles to determine the actors, viewpoints and arguments of the food policies.
    RESULTS: We identified 896 relevant newspaper articles. The coverage of food policies in newspapers was initially low but peaked in 2018/2021/2022. Through grey literature search we identified 6 food policies which were implemented or adjusted between 2000-2022. The majority of the newspaper articles reported on food pricing policies and were discussed in the policy formulation stage. Academics (mainly supportive) were the most and food industry (mostly opposing) the least cited actors. Supportive arguments highlighted health consequences, health inequalities and collective responsibility, whereas opposing arguments focused on unwanted governmental interference and ineffectiveness of policies.
    CONCLUSIONS: Dutch newspaper articles covering food policies represented a variety of actors and arguments, with individual versus collective responsibility for food choices playing a central role in the arguments. These insights may serve as a basis for further research into why certain arguments are used and their effect on policy attention and implementation.
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  • 文章类型: Journal Article
    为了评估在日本食品标签制度下加工的食品中食物过敏的风险,估计暴露于隐藏的过敏原是必要的。我们根据日本食品标签系统评估了加工食品中鸡蛋蛋白的暴露情况。首先,我们使用文献中的数据和在标签边缘有预防性声明的食品测量数据,通过贝叶斯方法估计了鸡蛋蛋白的浓度分布。然后,我们估计了两种情况下的食物摄入部分大小分布:软饮料消费作为单一的例子,高摄入消耗,和甜点,儿童经常食用,作为低摄入量消费的一个现实例子。最后,我们估计了以单次消费形式意外摄入的卵蛋白的分布。在高摄入量的情况下,1-15岁儿童对鸡蛋蛋白的平均暴露量估计为0.0164mg,0.0171毫克,4-15岁,0.0181毫克,7-15岁,16岁儿童≥0.0188mg。在低摄入量的情况下,1-15岁儿童对鸡蛋蛋白的平均暴露量估计为0.0018mg,0.0019毫克,4-15岁,0.0020毫克,7-15岁,16岁儿童≥0.0022mg。与粮食及农业组织(粮农组织)/世界卫生组织(世卫组织)联合专家委员会提出的2.0mg参考剂量相比,在目前的日本食品标签制度下,由于没有鸡蛋标签的食物中鸡蛋蛋白污染而引起食物过敏的风险被认为是极低的。
    To assess the risk of food allergies in foods processed under the Japanese food labeling system, estimating exposure to hidden allergens is necessary. We assessed exposure to egg protein in foods processed according to the Japanese food labeling system. First, we estimated the concentration distribution of egg protein by Bayesian methods using data from the literature and the measurement of food products with precautional declarations in the labeling margin. We then estimated the food-intake portion-size distribution under two scenarios: soft drink consumption as an example of single, high-intake consumption, and confections, which are frequently consumed by children, as a realistic example of low-intake consumption. Finally, we estimated the distribution of unexpected intake of egg proteins in the form of single consumption. The mean exposure to egg protein under the high-intake scenario was estimated to be 0.0164 mg for 1-15-year-olds, 0.0171 mg for 4-15-year-olds, 0.0181 mg for 7-15-year-olds, and ≥0.0188 mg for 16-year-olds. The mean exposure to egg protein under the low-intake scenario was estimated to be 0.0018 mg for 1-15-year-olds, 0.0019 mg for 4-15-year-olds, 0.0020 mg for 7-15-year-olds, and ≥0.0022 mg for 16-year-olds. Compared to the reference dose of 2.0 mg proposed by the Joint the Food and Agriculture Organization (FAO)/World Health Organization (WHO) Expert Committee, the risk of onset of food allergies due to egg protein contamination from foods without egg labeling is considered to be extremely low under the current Japanese food labeling system.
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  • 文章类型: Journal Article
    放射性标记的肽是用于诊断或治疗的有价值的工具;它们通常使用基于F-18辅基的间接方法进行放射性氟化。在这里,我们正在报告使用基于点击反应的两种不同方法对三种肽进行F-18放射性标记的结果.第一个使用众所周知的CuAAC反应,第二个是基于我们最近报道的异Diels-Alder(HDA)使用二硫酯(thia-Diels-Alder)反应。这两种方法都是自动化的,并且18F-肽以相似的产率和合成时间获得(通过两种方法在120-140分钟内进行37-39%衰减校正产率)。然而,为了获得相似的产量,CuAAC需要大量的铜以及许多添加剂,而HDA是催化剂和不含金属的反应,仅需要适当比例的水/乙醇。因此,HDA可以被认为是一种极简主义方法,其提供了容易获得氟-18标记的肽,并使其成为用于肽或生物分子的间接和位点特异性标记的有价值的附加工具。
    Radiolabeled peptides are valuable tools for diagnosis or therapies; they are often radiofluorinated using an indirect approach based on an F-18 prosthetic group. Herein, we are reporting our results on the F-18 radiolabeling of three peptides using two different methods based on click reactions. The first one used the well-known CuAAC reaction, and the second one is based on our recently reported hetero-Diels-Alder (HDA) using a dithioesters (thia-Diels-Alder) reaction. Both methods have been automated, and the 18F-peptides were obtained in similar yields and synthesis time (37-39% decay corrected yields by both methods in 120-140 min). However, to obtain similar yields, the CuAAC needs a large amount of copper along with many additives, while the HDA is a catalyst and metal-free reaction necessitating only an appropriate ratio of water/ethanol. The HDA can therefore be considered as a minimalist method offering easy access to fluorine-18 labeled peptides and making it a valuable additional tool for the indirect and site-specific labeling of peptides or biomolecules.
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  • 文章类型: Journal Article
    背景:机器学习(ML)模型可以产生更快,更准确的医疗诊断;但是,开发ML模型受到缺乏高质量标记训练数据的限制。众包标签是一种潜在的解决方案,但可能会受到对标签质量的担忧的限制。
    目的:本研究旨在研究具有持续绩效评估的游戏化众包平台,用户反馈,基于绩效的激励措施可以在医学影像数据上产生专家质量标签。
    方法:在这项诊断比较研究中,回顾性收集了203例急诊科患者的2384例肺超声夹。共有6位肺部超声专家将这些夹子中的393个归类为没有B线,一条或多条离散的B线,或融合的B线创建2套参考标准数据集(195个训练剪辑和198个测试剪辑)。集合分别用于(1)在游戏化的众包平台上训练用户,以及(2)将所得人群标签的一致性与各个专家与参考标准的一致性进行比较。人群意见来自DiagnosUs(Centaur实验室)iOS应用程序用户超过8天,根据过去的性能进行过滤,使用多数规则聚合,并分析了与专家标记的夹子的固定测试集相比的标签一致性。主要结果是将经过整理的人群意见的标签一致性与训练有素的专家比较,以对肺部超声夹子上的B线进行分类。
    结果:我们的临床数据集包括平均年龄为60.0(SD19.0)岁的患者;105例(51.7%)患者为女性,114例(56.1%)患者为白人。在195个训练剪辑中,专家共识标签分布为114(58%)无B线,56(29%)离散B线,和25(13%)融合的B系。在198个测试夹上,专家共识标签分布为138(70%)无B线,36条(18%)离散B线,和24(12%)融合的B系。总的来说,收集了426个独特用户的99,238条意见。在198个夹子的测试集上,个别专家相对于参考标准的平均标签一致性为85.0%(SE2.0),与87.9%的众包标签一致性相比(P=0.15)。当个别专家的意见与参考标准标签进行比较时,多数投票创建的不包括他们自己的意见,人群一致性高于个别专家对参考标准的平均一致性(87.4%vs80.8%,SE1.6表示专家一致性;P<.001)。具有离散B线的剪辑在人群共识和专家共识中的分歧最大。使用随机抽样的人群意见子集,7种经过质量过滤的意见足以达到接近最大的人群一致性。
    结论:通过游戏化方法对肺部超声夹进行B线分类的众包标签达到了专家级的准确性。这表明游戏化众包在有效生成用于训练ML系统的标记图像数据集方面具有战略作用。
    BACKGROUND: Machine learning (ML) models can yield faster and more accurate medical diagnoses; however, developing ML models is limited by a lack of high-quality labeled training data. Crowdsourced labeling is a potential solution but can be constrained by concerns about label quality.
    OBJECTIVE: This study aims to examine whether a gamified crowdsourcing platform with continuous performance assessment, user feedback, and performance-based incentives could produce expert-quality labels on medical imaging data.
    METHODS: In this diagnostic comparison study, 2384 lung ultrasound clips were retrospectively collected from 203 emergency department patients. A total of 6 lung ultrasound experts classified 393 of these clips as having no B-lines, one or more discrete B-lines, or confluent B-lines to create 2 sets of reference standard data sets (195 training clips and 198 test clips). Sets were respectively used to (1) train users on a gamified crowdsourcing platform and (2) compare the concordance of the resulting crowd labels to the concordance of individual experts to reference standards. Crowd opinions were sourced from DiagnosUs (Centaur Labs) iOS app users over 8 days, filtered based on past performance, aggregated using majority rule, and analyzed for label concordance compared with a hold-out test set of expert-labeled clips. The primary outcome was comparing the labeling concordance of collated crowd opinions to trained experts in classifying B-lines on lung ultrasound clips.
    RESULTS: Our clinical data set included patients with a mean age of 60.0 (SD 19.0) years; 105 (51.7%) patients were female and 114 (56.1%) patients were White. Over the 195 training clips, the expert-consensus label distribution was 114 (58%) no B-lines, 56 (29%) discrete B-lines, and 25 (13%) confluent B-lines. Over the 198 test clips, expert-consensus label distribution was 138 (70%) no B-lines, 36 (18%) discrete B-lines, and 24 (12%) confluent B-lines. In total, 99,238 opinions were collected from 426 unique users. On a test set of 198 clips, the mean labeling concordance of individual experts relative to the reference standard was 85.0% (SE 2.0), compared with 87.9% crowdsourced label concordance (P=.15). When individual experts\' opinions were compared with reference standard labels created by majority vote excluding their own opinion, crowd concordance was higher than the mean concordance of individual experts to reference standards (87.4% vs 80.8%, SE 1.6 for expert concordance; P<.001). Clips with discrete B-lines had the most disagreement from both the crowd consensus and individual experts with the expert consensus. Using randomly sampled subsets of crowd opinions, 7 quality-filtered opinions were sufficient to achieve near the maximum crowd concordance.
    CONCLUSIONS: Crowdsourced labels for B-line classification on lung ultrasound clips via a gamified approach achieved expert-level accuracy. This suggests a strategic role for gamified crowdsourcing in efficiently generating labeled image data sets for training ML systems.
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  • 文章类型: Journal Article
    美国(US)的处方信息(PI)和欧盟(EU)的产品特征摘要(SmPC)已获得美国食品和药物管理局(FDA)的批准。和欧洲药品管理局(EMA),分别。在这些文件中包含过量信息是两个地区的监管要求。这项研究评估了美国和欧盟标签过量部分的含量。分析了三个时间段在美国批准的药物标签的过量部分:2000-2001,2010-2011和2020-2021。如果通过集中程序注册,这些相同产品的欧盟标签也会受到审查。使用预定义的问卷进行数据收集和分析,专注于遵守监管要求,并确定额外监管指导可能有益的领域。研究结果表明,过量部分的含量在很大程度上符合各自地区的监管要求。不到一半的标签包括从临床研究中观察到的超治疗剂量信息,用药过量的危险因素或与用药过量相关的人群特异性数据。当人类数据可用时,在纳入动物数据方面注意到不一致,除了参考毒物中心。非特异性治疗建议的总体效用,除了洗胃还讨论了。虽然过量部分的内容通常与监管机构的预期一致,额外的监管指导可以增强这一部分标签如何呈现的一致性,并阐明期望,以提高其对医疗保健专业人员(HCP)的有用性.
    The Prescribing Information (PI) in the United States (US) and the Summary of Product Characteristics (SmPC) in the European Union (EU) are approved by the US Food & Drug Administration (FDA), and the European Medicines Agency (EMA), respectively. The inclusion of overdosage information in these documents is a regulatory requirement in both regions. This research evaluates the content of the overdosage section of US and EU labeling. The overdosage sections of labels for drugs approved in the US in three time periods were analyzed: 2000-2001, 2010-2011, and 2020-2021. EU labels for these same products were also reviewed if registered through the Centralized Procedure. Data collection and analyses were performed using a predefined questionnaire, focusing on adherence to regulatory requirements and identifying areas where additional regulatory guidance may be beneficial. The findings indicate that the content of the overdosage sections largely comply with the regulatory requirements of their respective regions. Fewer than half of the labels included information on supratherapeutic doses observed from clinical studies, risk factors for overdose or population specific data associated with overdose. Inconsistencies were noted concerning the incorporation of animal data when human data were available, in addition to the referencing of Poison Centers. The overall utility of non-specific treatment recommendations, in addition to gastric lavage is discussed. While the content of the overdosage section generally aligns with regulatory expectations, additional regulatory guidance could enhance consistency in how this section of labeling is presented and clarify expectations to improve its usefulness for health care professionals (HCPs).
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  • 文章类型: Journal Article
    迁移体是一种新型的细胞器,形成在迁移细胞后部的回缩纤维上。近年来,许多研究揭示了迁移体形成的机制,并强调了迁移体在生理和病理过程中的重要作用。基于已发表作品中概述的策略和我们自己的研究经验,我们已经编制了一套全面的方案来观察迁徙体.这些分步说明涵盖了各个方面,例如细胞培养,标签,成像,体外重建,和统计分析。我们认为,这些协议是研究人员探索偏头痛生物学的宝贵资源。
    Migrasomes are a novel type of cell organelle that form on the retraction fibers at the rear of migrating cells. In recent years, numerous studies have unveiled the mechanisms of migrasome formation and have highlighted significant roles of migrasomes in both physiological and pathological processes. Building upon the strategies outlined in published works and our own research experiences, we have compiled a comprehensive set of protocols for observing migrasomes. These step-by-step instructions encompass various aspects such as cell culture, labeling, imaging, in vitro reconstitution, and statistical analysis. We believe that these protocols serve as a valuable resource for researchers exploring migrasome biology.
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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
    具有进行预诊断的能力,消费者可穿戴设备有可能影响后续诊断和医疗保健服务的水平。尽管如此,由于电子健康记录(EHR)中缺乏编码术语来捕获可穿戴使用,因此阻碍了对消费者可穿戴设备的上市后监控。
    我们试图开发一种基于监督的弱方法,以证明基于EHR的上市后监测对导致房颤(AF)预诊断的消费者可穿戴设备的可行性和有效性。
    我们应用了数据编程,其中标记启发式表示为基于代码的标记函数,检测房颤预诊断事件。然后使用Snorkel框架从标记函数的预测中得出标记器模型。标签器模型被应用于临床笔记,以概率标记它们,然后将标记的注释用作训练集,以微调称为Clinical-Longformer的分类器。所得到的分类器识别出具有AF预诊断的患者。进行了一项回顾性队列研究,其中将分类器识别的患者的基线特征和后续护理模式与未接受预诊断的患者进行比较.
    从标记函数得出的贴标机模型在训练集上显示出很高的准确性(0.92;F1分数=0.77)。在概率标记的注释上训练的分类器准确地识别出具有AF预诊断的患者(0.95;F1得分=0.83)。使用构建的系统进行的队列研究具有足够的统计能力来验证AppleHeart研究的关键发现,注册了更多的参与者,接受预诊断的患者往往年龄较大,男性,和白色与更高的CHA2DS2-VASc(充血性心力衰竭,高血压,年龄≥75岁,糖尿病,中风,血管疾病,年龄65-74岁,性别类别)得分(P<.001)。我们还发现,预先诊断的患者更可能使用抗凝剂(525/1037,50.63%vs5936/16,560,35.85%),并且最终诊断为AF(305/1037,29.41%vs262/16,560,1.58%)。在索引诊断时,预诊断的存在并没有根据临床特征区分患者,但确实与抗凝剂处方相关(阿哌沙班P=.004,利伐沙班P=.01)。
    我们的工作确立了基于EHR的监测系统的可行性和有效性,该系统适用于可进行AF预诊断的消费者可穿戴设备。需要进一步的工作来将这些发现推广到其他地点的患者人群。
    UNASSIGNED: With the capability to render prediagnoses, consumer wearables have the potential to affect subsequent diagnoses and the level of care in the health care delivery setting. Despite this, postmarket surveillance of consumer wearables has been hindered by the lack of codified terms in electronic health records (EHRs) to capture wearable use.
    UNASSIGNED: We sought to develop a weak supervision-based approach to demonstrate the feasibility and efficacy of EHR-based postmarket surveillance on consumer wearables that render atrial fibrillation (AF) prediagnoses.
    UNASSIGNED: We applied data programming, where labeling heuristics are expressed as code-based labeling functions, to detect incidents of AF prediagnoses. A labeler model was then derived from the predictions of the labeling functions using the Snorkel framework. The labeler model was applied to clinical notes to probabilistically label them, and the labeled notes were then used as a training set to fine-tune a classifier called Clinical-Longformer. The resulting classifier identified patients with an AF prediagnosis. A retrospective cohort study was conducted, where the baseline characteristics and subsequent care patterns of patients identified by the classifier were compared against those who did not receive a prediagnosis.
    UNASSIGNED: The labeler model derived from the labeling functions showed high accuracy (0.92; F1-score=0.77) on the training set. The classifier trained on the probabilistically labeled notes accurately identified patients with an AF prediagnosis (0.95; F1-score=0.83). The cohort study conducted using the constructed system carried enough statistical power to verify the key findings of the Apple Heart Study, which enrolled a much larger number of participants, where patients who received a prediagnosis tended to be older, male, and White with higher CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke, vascular disease, age 65-74 years, sex category) scores (P<.001). We also made a novel discovery that patients with a prediagnosis were more likely to use anticoagulants (525/1037, 50.63% vs 5936/16,560, 35.85%) and have an eventual AF diagnosis (305/1037, 29.41% vs 262/16,560, 1.58%). At the index diagnosis, the existence of a prediagnosis did not distinguish patients based on clinical characteristics, but did correlate with anticoagulant prescription (P=.004 for apixaban and P=.01 for rivaroxaban).
    UNASSIGNED: Our work establishes the feasibility and efficacy of an EHR-based surveillance system for consumer wearables that render AF prediagnoses. Further work is necessary to generalize these findings for patient populations at other sites.
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