precision healthcare

  • 文章类型: Journal Article
    老年人从地板上捡起物体的能力会随着时间的推移而退化,导致生活质量下降和跌倒风险增加。医疗保健专业人员表示有兴趣在长时间内监测受试者的拾取能力的下降,并在其对受试者的健康有害时进行干预。当前评估涉及临床患者就诊的接送能力的方法既时间又经济上昂贵。显然需要一种具有成本效益的,远程接送评估手段,以减轻患者和医生的负担。为了应对这些挑战,我们介绍了一种取货时间(ToP)解决方案,叫做ToPick,设计用于自动评估拾取能力。ToPick的实际性能是显而易见的,在评估10位老年人的20次接载事件时,中位误差约为100毫秒。此外,ToPick具有很高的可靠性,实现完美的精度,精度,以及用于拾取事件检测的召回分数。我们通过设计旨在由医疗保健从业人员和老年人采用的应用程序来实现我们的研究结果。该应用程序旨在减少时间和财务成本,同时为用户提供移动治疗。
    The ability to pick up objects off the floor can degrade over time with elderly individuals, leading to a reduced quality of life and an increase in the risk of falling. Healthcare professionals have expressed an interest in monitoring the decline in pickup ability of a subject over extended periods of time and intervening when it becomes hazardous to the subject\'s health. The current means of evaluating pickup ability involving in-clinic patient visits is both time and financially expensive. There is a clear need for a cost-effective, remote means of pickup evaluation to ease the burden on both patients and physicians. To address these challenges, we introduce a Time-of-Pickup (ToP) solution, called ToPick, designed for the automatic assessment of pickup ability over time. The practical performance of ToPick is evident, demonstrated by a minimal median error of approximately 100 milliseconds in evaluating 20 pickup events among 10 elderly individuals. Furthermore, ToPick exhibits a high level of reliability, achieving perfect accuracy, precision, and recall scores for pickup event detection. We actualize our research findings by designing an application intended for adoption by both healthcare practitioners and elderly individuals. The app aims to reduce both time and financial costs while enabling mobile treatment for users.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    高尿酸血症和痛风是肾结石的危险因素。然而,目前尚不清楚ABCG2基因是否有助于肾结石的发展。我们旨在调查台湾人群中ABCG2rs2231142变体与偶发肾结石之间的相互作用。
    在这项回顾性病例对照研究中,从台湾生物库数据库中招募了120,267名30-70岁的成年人,并对rs2231142进行了基因分型。主要结果是自我报告的肾结石的患病率。通过多变量逻辑回归模型分析了肾结石的比值比(OR),并调整了多因素混杂因素。ABCG2rs2231142变体与血清尿酸水平的关联,并探讨了肾结石的事件。
    rs2231142T等位基因频率为53%,8,410名参与者患有肾结石。TT和GT基因型肾结石的多变量校正OR(95%置信区间)为1.18(1.09-1.28)和1.12(1.06-1.18),分别,与GG基因型相比(p<0.001),特别是在高尿酸血症的男性人群中。年龄较高,男性,高脂血症,高血压,糖尿病,高尿酸血症,吸烟和超重是肾结石的独立危险因素。相比之下,定期体育锻炼是预防肾结石的保护因素。
    ABCG2遗传变异是肾结石的重要风险,与血清尿酸水平无关。对于rs2231142T等位基因携带者,我们的结果为精准医疗解决高尿酸血症提供了证据,合并症,吸烟,超重,并建议定期进行体育锻炼以预防肾结石。
    Hyperuricemia and gout are risk factors of nephrolithiasis. However, it is unclear whether the ABCG2 gene contributes to the development of nephrolithiasis. We aimed to investigate the interaction between the ABCG2 rs2231142 variant and incident nephrolithiasis in the Taiwanese population.
    A total of 120,267 adults aged 30-70 years were enrolled from the Taiwan Biobank data-base in this retrospective case-control study and genotyped for rs2231142. The primary outcome was the prevalence of self-reported nephrolithiasis. The odds ratio (OR) of incident nephrolithiasis was analyzed by multivariable logistic regression models with adjustment for multifactorial confounding factors. Associations of the ABCG2 rs2231142 variant with serum uric acid levels, and the incident nephrolithiasis were explored.
    The frequency of rs2231142 T allele was 53%, and 8,410 participants had nephrolithiasis. The multivariable-adjusted OR (95% confidence interval) of nephrolithiasis was 1.18 (1.09-1.28) and 1.12 (1.06-1.18) for TT and GT genotypes, respectively, compared with the GG genotype (p<0.001), specifically in the male population with hyperuricemia. Higher age, male sex, hyperlipidemia, hypertension, diabetes mellitus, hyperuricemia, smoking and overweight were independent risk factors for nephrolithiasis. In contrast, regular physical exercise is a protective factor against nephrolithiasis.
    ABCG2 genetic variation is a significant risk of nephrolithiasis, independent of serum uric acid levels. For rs2231142 T allele carriers, our result provides evidence for precision healthcare to tackle hyperuricemia, comorbidities, smoking, and overweight, and recommend regular physical exercise for the prevention of nephrolithiasis.
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  • 文章类型: Journal Article
    人类经常对饮食表现出不同的反应,益生元,和益生菌干预措施。新出现的证据表明,肠道微生物群是这种群体异质性的关键决定因素。这里,我们概述了一些主要的计算和实验工具,这些工具被应用于微生物群介导的个性化营养和健康的关键问题。首先,我们讨论了微生物群-营养-健康轴的计算机建模的最新进展,包括统计的应用,机械学,和混合人工智能模型。第二,我们致力于评估个体间异质性的高通量体外技术,来自粪便的离体分批培养和厌氧生物反应器中的连续培养,整合宿主和微生物区室的更复杂的芯片上器官模型。第三,我们探索体内的方法,以更好地理解个性化,微生物群介导的对饮食的反应,益生元,和益生菌,来自非人类动物模型和人类观察研究,人类喂养试验和交叉干预。我们强调现有的例子,面向消费者的精准营养平台,目前正在利用肠道微生物群。此外,我们将讨论如何整合本文中描述的更广泛的工具和技术可以生成必要的数据,以支持更多的精确营养策略。最后,我们提出了精准营养和医疗保健未来的愿景,利用肠道微生物区来设计有效的,针对个人的干预措施。
    Humans often show variable responses to dietary, prebiotic, and probiotic interventions. Emerging evidence indicates that the gut microbiota is a key determinant for this population heterogeneity. Here, we provide an overview of some of the major computational and experimental tools being applied to critical questions of microbiota-mediated personalized nutrition and health. First, we discuss the latest advances in in silico modeling of the microbiota-nutrition-health axis, including the application of statistical, mechanistic, and hybrid artificial intelligence models. Second, we address high-throughput in vitro techniques for assessing interindividual heterogeneity, from ex vivo batch culturing of stool and continuous culturing in anaerobic bioreactors, to more sophisticated organ-on-a-chip models that integrate both host and microbial compartments. Third, we explore in vivo approaches for better understanding of personalized, microbiota-mediated responses to diet, prebiotics, and probiotics, from nonhuman animal models and human observational studies, to human feeding trials and crossover interventions. We highlight examples of existing, consumer-facing precision nutrition platforms that are currently leveraging the gut microbiota. Furthermore, we discuss how the integration of a broader set of the tools and techniques described in this piece can generate the data necessary to support a greater diversity of precision nutrition strategies. Finally, we present a vision of a precision nutrition and healthcare future, which leverages the gut microbiota to design effective, individual-specific interventions.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    人类经常对饮食表现出不同的反应,益生元,和益生菌干预措施。新出现的证据表明,肠道微生物群是这种群体异质性的关键决定因素。这里,我们概述了一些主要的计算和实验工具,这些工具被应用于微生物群介导的个性化营养和健康的关键问题。首先,我们讨论了微生物群-营养-健康轴的计算机建模的最新进展,包括统计的应用,机械学,和混合人工智能模型。第二,我们致力于评估个体间异质性的高通量体外技术,来自粪便的离体分批培养和厌氧生物反应器中的连续培养,整合宿主和微生物区室的更复杂的芯片上器官模型。第三,我们探索体内的方法,以更好地理解个性化,微生物群介导的对饮食的反应,益生元,和益生菌,来自非人类动物模型和人类观察研究,人类喂养试验和交叉干预。我们强调现有的例子,面向消费者的精准营养平台,目前正在利用肠道微生物群。此外,我们将讨论如何整合本文中描述的更广泛的工具和技术可以生成必要的数据,以支持更多的精确营养策略。最后,我们提出了精准营养和医疗保健未来的愿景,利用肠道微生物区来设计有效的,针对个人的干预措施。
    Humans often show variable responses to dietary, prebiotic, and probiotic interventions. Emerging evidence indicates that the gut microbiota is a key determinant for this population heterogeneity. Here, we provide an overview of some of the major computational and experimental tools being applied to critical questions of microbiota-mediated personalized nutrition and health. First, we discuss the latest advances in in silico modeling of the microbiota-nutrition-health axis, including the application of statistical, mechanistic, and hybrid artificial intelligence models. Second, we address high-throughput in vitro techniques for assessing interindividual heterogeneity, from ex vivo batch culturing of stool and continuous culturing in anaerobic bioreactors, to more sophisticated organ-on-a-chip models that integrate both host and microbial compartments. Third, we explore in vivo approaches for better understanding of personalized, microbiota-mediated responses to diet, prebiotics, and probiotics, from nonhuman animal models and human observational studies, to human feeding trials and crossover interventions. We highlight examples of existing, consumer-facing precision nutrition platforms that are currently leveraging the gut microbiota. Furthermore, we discuss how the integration of a broader set of the tools and techniques described in this piece can generate the data necessary to support a greater diversity of precision nutrition strategies. Finally, we present a vision of a precision nutrition and healthcare future, which leverages the gut microbiota to design effective, individual-specific interventions.
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  • 文章类型: Journal Article
    The explosion of data throughout the biomedical sciences provides unprecedented opportunities to learn about the dynamics of evolution and disease progression, but harnessing these large and diverse datasets remains challenging. Here, we describe a highly generalizable statistical platform to infer the dynamic pathways by which many, potentially interacting, traits are acquired or lost over time. We use HyperTraPS (hypercubic transition path sampling) to efficiently learn progression pathways from cross-sectional, longitudinal, or phylogenetically linked data, readily distinguishing multiple competing pathways, and identifying the most parsimonious mechanisms underlying given observations. This Bayesian approach allows inclusion of prior knowledge, quantifies uncertainty in pathway structure, and allows predictions, such as which symptom a patient will acquire next. We provide visualization tools for intuitive assessment of multiple, variable pathways. We apply the method to ovarian cancer progression and the evolution of multidrug resistance in tuberculosis, demonstrating its power to reveal previously undetected dynamic pathways.
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  • 文章类型: Journal Article
    It is well-recognized that there is a need for medicine to migrate to a platform of delivering preventative care based on an individual\'s genetic make-up. The US National Research Council, the National Institute of Health and the American Heart Association all support the concept of utilizing genomic information to enhance the clinical management of patients. It is believed this type of precision healthcare will revolutionize health management. This current attitude of some of the most respected institutes in healthcare sets the stage for the utilization of the haptoglobin (Hp) genotype to guide precision management in type 2 diabetics (DM). There are three main Hp genotypes: 1-1, 2-1, 2-2. The Hp genotype has been studied extensively in (DM) and from the accumulated data it is clear that Hp should be considered in all DM patients as an additional independent cardiovascular disease (CVD) risk factor. In DM patients Hp2-2 generates five times increased risk of CVD compared to Hp1-1 and three times increased risk compared to Hp2-1. Data has also shown that carrying the Hp2-2 gene in DM compared to carrying an Hp1-1 genotype can increase the risk the microvascular complications of nephropathy and retinopathy. In addition, the Hp2-2 gene enhances post percutaneous coronary intervention (PCI) complications such as, in stent restenosis and need for additional revascularization during the first-year post PCI. Studies have demonstrated significant mitigation of CVD risk in Hp2-2 DM patients with administration of vitamin E and maintaining tight glycemic control. CVD is the leading cause of death and disability in DM as well-representing a huge financial burden. As such, evaluating the Hp genotype in DM patients can enhance the predictability and management of CVD risk.
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  • 文章类型: Journal Article
    情绪饮食与卵巢激素功能有关,但是到目前为止,还没有研究考虑到大脑功能的作用。这种知识差距可能源于方法论上的挑战:数据是异构的,违反了主体间分析做出的同质性假设。本文的主要目的是描述一种创新的学科内分析,该分析对异质性进行建模,并有可能填补饮食失调研究中的知识空白。我们说明了它在飞行员神经成像应用中的实用性,激素,和整个月经周期的情绪饮食数据。
    组迭代多模型估计(GIMME)是一种用于估计样本的特定于人的网络方法-,子组-,和大脑区域之间的个体水平连接。为了说明它对饮食失调研究的潜力,我们将其应用于10对雌性双胞胎(N=5对)的飞行员数据,这些双胞胎因情绪饮食和/或焦虑而不一致,他提供了两个静息状态功能磁共振成像扫描和激素测定。然后,我们演示了如何在多级模型中链接多模式数据。
    GIMME生成了特定于个人的神经网络,其中包含了整个样本中常见的连接,在双胞胎之间分享,和独特的个人。说明性分析表明,对照双胞胎的激素与默认模式连接强度之间存在正相关关系,但没有关系的共同双胞胎谁从事情绪饮食或谁有焦虑。
    本文展示了人特异性神经影像学网络分析及其多模态关联在异质性生物心理社会现象研究中的价值,比如饮食行为。
    Emotional eating has been linked to ovarian hormone functioning, but no studies to-date have considered the role of brain function. This knowledge gap may stem from methodological challenges: Data are heterogeneous, violating assumptions of homogeneity made by between-subjects analyses. The primary aim of this paper is to describe an innovative within-subjects analysis that models heterogeneity and has potential for filling knowledge gaps in eating disorder research. We illustrate its utility in an application to pilot neuroimaging, hormone, and emotional eating data across the menstrual cycle.
    Group iterative multiple model estimation (GIMME) is a person-specific network approach for estimating sample-, subgroup-, and individual-level connections between brain regions. To illustrate its potential for eating disorder research, we apply it to pilot data from 10 female twins (N = 5 pairs) discordant for emotional eating and/or anxiety, who provided two resting state fMRI scans and hormone assays. We then demonstrate how the multimodal data can be linked in multilevel models.
    GIMME generated person-specific neural networks that contained connections common across the sample, shared between co-twins, and unique to individuals. Illustrative analyses revealed positive relations between hormones and default mode connectivity strength for control twins, but no relations for their co-twins who engage in emotional eating or who had anxiety.
    This paper showcases the value of person-specific neuroimaging network analysis and its multimodal associations in the study of heterogeneous biopsychosocial phenomena, such as eating behavior.
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  • 文章类型: Journal Article
    The occurrence and progression of diseases are strongly associated with a combination of genetic, lifestyle, and environmental factors. Understanding the interplay between genetic and nongenetic components provides deep insights into disease pathogenesis and promotes personalized strategies for people healthcare. Recently, the paradigm of systems medicine, which integrates biomedical data and knowledge at multidimensional levels, is considered to be an optimal way for disease management and clinical decision-making in the era of precision medicine. In this chapter, epigenetic-mediated genetics-lifestyle-environment interactions within specific diseases and different ethnic groups are systematically discussed, and data sources, computational models, and translational platforms for systems medicine research are sequentially presented. Moreover, feasible suggestions on precision healthcare and healthy longevity are kindly proposed based on the comprehensive review of current studies.
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