• 文章类型: English Abstract
    The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model\'s lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology.
    Desde o início, a evolução da saúde pública na América Latina ao longo do século XX combinou o marco teórico da medicina social sobre as origens sociais, políticas e ambientais das doenças com as contribuições derivadas do trabalho de campo da antropologia médica. Apesar da hegemonia do modelo médico, o surgimento do modelo de medicina preventiva legitimou ainda mais a participação dos cientistas sociais no estudo da multicausalidade das doenças. Entretanto, as limitações causadas pela falta de contextualização histórica e política do modelo de medicina preventiva abriram espaço para o movimento latino-americano de medicina social, fundamentado no materialismo histórico, e para o desenvolvimento da epidemiologia crítica e da antropologia médica crítica.
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  • 文章类型: Journal Article
    淋巴丝虫病是一种被忽视的热带病,影响人类的淋巴系统。主要的病原体是一种名为Wucherriabancrofti的线虫,但是有时会遇到BrugiaMalayi和BrugiaTimoriois作为病原体。蚊子是媒介,而人类是最终的宿主。尼日利亚的疾病负担比非洲其他流行国家更重。这种情况随着国内不同地点的发病率和死亡率的增加而发生,世界卫生组织推荐的淋巴丝虫病治疗方法包括在与loaloa共同流行的地区每年使用阿苯达唑(400mg)两次,伊维菌素(200mcg/kg)与阿苯达唑(400mg)在与盘尾丝虫病共同流行的地区联合使用,在没有盘尾丝虫病的地区,伊维菌素(200mcg/kg)与柠檬酸二乙基卡巴嗪(DEC)(6mg/kg)和阿苯达唑(400mg)。本文进行了系统的回顾,荟萃分析,以及对该国各自地缘政治地区的淋巴丝虫病进行范围审查。使用的文献是通过包括PubMed和GoogleScholar在内的在线搜索引擎获得的,标题为“以国家名义的淋巴丝虫病”,尼日利亚。这篇综述显示,西北地区的总体患病率为11.18%(1.59%),中北部和东北部,(4.52%),西南(1.26%),和南南与东南(3.81%)患病率。该疾病已在Kebbi州的Argungu地方政府地区(LGA)成功消除,高原,分别是纳萨拉瓦州。大多数临床表现(31.12%)包括鞘膜积液,淋巴水肿,象皮病,疝气,和皮炎。夜间血液样本适用于微丝菌调查。持续的MDAs,正确的测试方法,感染病例的早期治疗,和病媒控制有助于消除淋巴丝虫病,用于该国的发病率管理和残疾预防。区域控制策略,提高对调查和干预计划的质量监测,并记录需要干预的发病率和残疾,是及时消除尼日利亚疾病的重要方法。
    Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. The burden of the disease is heavier in Nigeria than in other endemic countries in Africa. This occurs with increasing morbidity and mortality at different locations within the country, the World Health Organization recommended treatments for lymphatic filariasis include the use of Albendazole (400mg) twice per year in co-endemic areas with loa loa, Ivermectin (200mcg/kg) in combination with Albendazole (400mg) in areas that are co-endemic with onchocerciasis, ivermectin (200mcg/kg) with diethylcarbamazine citrate (DEC) (6mg/kg) and albendazole (400mg) in areas without onchocerciasis. This paper covered a systematic review, meta-analysis, and scoping review on lymphatic filariasis in the respective geopolitical zones within the country. The literature used was obtained through online search engines including PubMed and Google Scholar with the heading \"lymphatic filariasis in the name of the state\", Nigeria. This review revealed an overall prevalence of 11.18% with regional spread of Northwest (1.59%), North Central and North East, (4.52%), South West (1.26%), and South-South with South East (3.81%) prevalence. The disease has been successfully eliminated in Argungu local government areas (LGAs) of Kebbi State, Plateau, and Nasarawa States respectively. Most clinical manifestations (31.12%) include hydrocele, lymphedema, elephantiasis, hernia, and dermatitis. Night blood samples are appropriate for microfilaria investigation. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.
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  • 文章类型: Journal Article
    UNASSIGNED: Desmoid Tumors (DT) are rare neoplasms with higher incidence in younger women.
    UNASSIGNED: Retrospective, single-center analysis of patients with DT. Variables were age, sex, biopsy, treatment and recurrence. The disease-free survival (DFS) was calculated with the Kaplan-Meier method.
    UNASSIGNED: 242 patients were evaluated, mean age was 34 years, 70.7% women, 44.4% originated in the trunk/abdomen and 54.5% had size > 5cm. Surgery was performed in 70.2%, 31% with negative margin and only 57% with previous biopsy. Recurrence rate was 38% and 1,2,5-year DFS was 75.3%, 64.2%, 57.8%, respectively. Size (p = 0.018) and tumor location in the dorsum (p = 0.001), extremities (p = 0.003) and pelvis (p = 0.003) were related to higher relapse rate.
    UNASSIGNED: our data reinforces the need to gather data from real world practice and the importance of awareness of DT and medical education about DT behavior and best approach due to the high rates of surgery and elevated number of patients treated without biopsy. Level of Evidence III; Retrospective Comparative Study.
    UNASSIGNED: Os tumores desmóides (TD) são neoplasias raras com maior incidência em mulheres jovens.
    UNASSIGNED: Trata-se de uma análise retrospectiva, em um único centro, de pacientes com TD. As variáveis foram idade, sexo, biópsia, tratamento e recorrência. A sobrevida livre de doença (SLD) foi calculada pelo método de Kaplan-Meier.
    UNASSIGNED: Foram avaliados 242 pacientes, com idade média de 34 anos, 70,7% mulheres, 44,4% com origem no tronco/abdômen e 54,5% com tamanho > 5 cm. A cirurgia foi realizada em 70,2%, 31% com margem negativa e apenas 57% com biópsia prévia. A taxa de recorrência foi de 38% e a SLD de 1, 2 e 5 anos foi de 75,3%, 64,2% e 57,8%, respectivamente. O tamanho (p = 0,018) e a localização do tumor no dorso (p = 0,001), nas extremidades (p = 0,003) e na pelve (p = 0,003) foram relacionados a uma maior taxa de recidiva.
    UNASSIGNED: Nossos dados reforçam a necessidade de coletar dados da prática do cenário real e a importância da conscientização da TD e da educação médica sobre o comportamento da TD e a melhor abordagem, devido às altas taxas de cirurgia e ao elevado número de pacientes tratados sem biópsia. Nível de Evidência III; Estudo Comparativo Retrospectivo.
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  • 文章类型: Journal Article
    肥胖是一个全球性的健康挑战,因为它的高患病率和增加相关的发病率和死亡率。因此,创建一个平台来输入肥胖患者的数据,治疗过程和结果是强制性的。此注册的目的是提供有关伊朗肥胖成年人的数据库,以促进未来的研究设计和有效的决策来控制这种情况。
    在获得符合条件的个人的知情同意后,实用问卷将用于收集有关基本特征的信息,家族史,既往病史,常规药物,肥胖成人的饮食摄入量和其他相关信息。这些数据以及实验室测试的结果,体检,人体测量将由训练有素的小组成员在亲自访问期间登记到登记系统中。患者将根据多学科医疗团队的决定接受特定的治疗方案。然后,可变变量及其治疗过程的结果将在后续会议中进行记录.
    该注册表旨在提供有关流行病学的全面数据集,肥胖的结果和管理过程,作为以后研究项目的基础,并改进针对这种情况的医学方法。
    UNASSIGNED: Obesity is a global health challenge due to its high prevalence and increased related morbidity and mortality. Accordingly, creating a platform to enter data on patients with obesity, treatment process and outcome is mandatory. The objective of this registry is to provide such a database regarding Iranian adults with obesity in order to facilitate future research designs and effective decision making to control this condition.
    UNASSIGNED: After obtaining informed consent from eligible individuals, a practical questionnaire will be used to gather information about basic characteristics, family history, past medical history, regular medications, dietary intakes and other relevant information of adults with obesity. This data along with the results of laboratory tests, physical examination, and anthropometric measurements will be registered into the registry system by trained members of the team during an in-person visit. Patients will undergo a specific treatment plan based on the multidisciplinary medical team\'s decision. Then, changeable variables and the outcomes of their treatment process will be registered later in the follow-up sessions.
    UNASSIGNED: This registry aims to provide a comprehensive dataset on the epidemiology, outcomes and management process of obesity to serve as a foundation for later research projects and improve medical approaches toward this condition.
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  • 文章类型: Journal Article
    在个人中,非传染性疾病(NCDs)的发展和严重程度取决于其中是否存在聚集的NCDs危险因素。我们旨在确定印度Puducherry地区非传染性疾病的患病率和与风险因素聚集相关的因素。
    我们在2019年2月至2020年2月期间对Puducherry区(N=1114)的成年人口(18-69岁)进行了基于社区的横断面调查。非传染性疾病的十个危险因素(行为,物理测量和生化)进行评估。具有≥3个危险因素的个体被认为具有危险因素的聚类。分类变量使用比例(95%CI)进行汇总。使用加权前向逐步广义线性模型估计调整后的患病率。
    大多数存在非传染性疾病危险因素的聚类(95.2%,95%CI:93.8-96.3)。聚集的存在在女性中明显更高(97.1%,95%CI:95.9-98.3)和城市人口(97.2%,95%CI:96.1-98.3)。主要导致聚集患病率高的风险因素是该地区十分之九的人盐摄入量增加和水果和蔬菜摄入量不足。近十分之一(13.3%,95%CI:11.3-15.3),五分之一(21.5%,95%CI:19.1-23.8)和1/4(26.8%,95%CI:24.1-29.4)参与者有三个,四个和五个危险因素,分别。
    我们强调迫切需要在Puducherry地区以人群为基础的健康促进干预措施,以高度流行的非传染性疾病危险因素为目标,特别是在妇女和城市人口中。
    UNASSIGNED: In an individual, the development and severity of Non-Communicable Diseases (NCDs) are determined by the presence or absence of clustering of NCD risk factors in them. We aimed to determine the prevalence and the factors associated with clustering of risk factors of NCDs in the district of Puducherry in India.
    UNASSIGNED: We conducted a community-based cross-sectional survey among the adult population (18-69 years) of Puducherry district (N = 1114) between February 2019 and February 2020. Ten risk factors of NCDs (behavioral, physical measurements and biochemical) were assessed. Individuals having ≥ 3 risk factors were regarded as having clustering of risk factors. Categorical variables are summarized using proportions (95% CI). Adjusted prevalence ratio was estimated using weighted forward stepwise generalized linear modelling.
    UNASSIGNED: Clustering of NCD risk factors was present in majority (95.2%, 95% CI: 93.8-96.3) of the population. The presence of clustering was significantly higher among women (97.1%, 95% CI: 95.9-98.3) and the urban population (97.2%, 95% CI: 96.1-98.3). The risk factors that primarily drove the high prevalence of clustering were raised salt intake and inadequate intake for fruits and vegetables in nine out of 10 people in the district. Nearly 1 in 10 (13.3%, 95% CI: 11.3-15.3), 1 in 5 (21.5%, 95% CI: 19.1-23.8) and 1 in 4 (26.8%, 95% CI: 24.1-29.4) participants had three, four and five risk factors, respectively.
    UNASSIGNED: We highlight the urgent need for population-based health promotion interventions in the district of Puducherry targeting the highly prevalent NCD risk factors, especially among the women and urban populations.
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  • 文章类型: Journal Article
    肥胖是一种慢性低度炎症,全球患病率不断增加,与心血管疾病相关。在这项研究中,我们旨在调查德黑兰队列研究(TeCS)人群中肥胖的患病率.
    我们在TeCS的招募阶段使用了通过系统随机抽样收集的数据。数据包括来自德黑兰大都市所有地区的4215户家庭,2016年5月至2019年2月,8296名≥35岁的成年人参加了该研究。社会人口统计数据,病史,实验室测试,并收集参与者的人体测量结果。数据缺失的参与者被排除在最终分析之外。最后,数据使用SPSS版本23进行分析,分布图由Stata14.2制作.
    共研究了8211名参与者(53.9%为女性),平均年龄为53.7±12.6岁。与男性相比,女性超重和肥胖的年龄加权患病率为(37.5%[95%置信区间(CI):34.5,40.6]和35.5%[95%CI:32.6-38.6])(47%[95%CI:43.6,50.3]和22.9%[95%CI:20.1-25.8])。基于腰围(WC)和腰臀比(WHR)的代谢并发症(SIRMC)风险显著增加的患病率分别为49.2%(95%CI:46.3-52.2)和75.5%(95%CI:72.7-78.1)。
    德黑兰的肥胖率(29.3%)远高于以前的报告,尤其是老年人,女人,和社会经济欠发达地区。55岁以后,超过80%的女性患有SIRMC,而男性为30%。
    在线版本包含补充材料,可在10.1007/s40200-023-01365-4获得。
    UNASSIGNED: Obesity is a chronic low-grade inflammatory condition with increasing global prevalence and is associated with cardiovascular diseases. In this study, we aimed to investigate the prevalence of obesity in the Tehran cohort study (TeCS) population.
    UNASSIGNED: We used the data collected by systematic random sampling during the recruitment phase of TeCS. The data comprised 4215 households from all districts of the Tehran metropolis, from which 8296 adults aged ≥ 35 years participated between May 2016 and February 2019. Sociodemographic data, medical history, laboratory tests, and anthropometric measurements were gathered from the participants. Participants with missing data were excluded from the final analysis. Finally, the data was analyzed using SPSS version 23, and distribution maps were created by Stata 14.2.
    UNASSIGNED: A total of 8211 participants (53.9% women) with an average age of 53.7 ± 12.6 years were studied. The age-weighted prevalence of overweight and obese among women was (37.5% [95% confidence interval (CI): 34.5, 40.6] and 35.5% [95% CI: 32.6 -38.6]) compared to men (47% [95% CI: 43.6, 50.3] and 22.9% [95% CI: 20.1 -25.8]). The prevalence of substantially increased risk of metabolic complications (SIRMC) based on waist circumference (WC) and waist-to-hip ratio (WHR) was 49.2% (95% CI: 46.3 -52.2) and 75.5% (95% CI: 72.7 -78.1) respectively.
    UNASSIGNED: The prevalence of obesity in Tehran (29.3%) was much higher than in previous reports, particularly among older people, women, and socioeconomically underdeveloped districts. After age 55, more than 80% of women had SIRMC compared to 30% of men.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s40200-023-01365-4.
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  • 文章类型: Journal Article
    钩端螺旋体病是一种影响全世界人类和动物的细菌性疾病。目前,乌克兰正在进行一场阵地战争,军方在战壕和防空洞中遇到了大量的啮齿动物,这是已知的钩端螺旋体的水库,钩端螺旋体病的病原体-一种潜在危险的传染病,死亡率很高。平民也面临钩端螺旋体病的潜在风险。2023年6月6日Kakhovka大坝的破坏导致了广泛的破坏和人类的痛苦。在短期内,如钩端螺旋体病等啮齿动物传播疾病的风险很大。我们利用乌克兰疾病预防控制中心的数据,观察到2023年患病率大幅增加。2023年乌克兰的通报率为每10万人1.06,高于欧盟其他国家。特别关注扎卡帕蒂亚州,位于乌克兰西部边界,与罗马尼亚有共同的边界,匈牙利,波兰,斯洛伐克,发病率极高,为每100,000人中12.08人。基于这些发现,我们建议开展教育和宣传活动,疫苗接种,个人保护措施,并改善监测,以解决乌克兰钩端螺旋体病发病率上升的问题。
    Leptospirosis is a bacterial disease that affects both humans and animals worldwide. Currently, a positional war is ongoing in Ukraine, and the military is encountering a significant number of rodents in trenches and dugouts, which are known reservoirs for Leptospira, the causative agent of leptospirosis-a potentially dangerous infectious disease with a high mortality rate. The civilian population is also at potential risk of leptospirosis. The destruction of the Kakhovka Dam on June 6, 2023, has led to widespread devastation and human suffering. In the short term, there is a significant risk of rodent-borne diseases such as leptospirosis. We utilized data from the Ukrainian Centre for Disease Prevention Control and observed a substantial increase in prevalence in 2023. The notification rate in Ukraine in 2023 was 1.06 per 100,000 persons, which is higher than that of other countries in the European Union. Particular attention is being given to Zakarpattia Oblast, located on the western border of Ukraine, which shares boundaries with Romania, Hungary, Poland, and Slovakia, with an extremely high incidence rate of 12.08 per 100,000 persons. Based on these findings, we recommend education and awareness campaigns, vaccination, personal protective measures, and improved surveillance to address the increasing incidence of leptospirosis in Ukraine.
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  • 文章类型: Journal Article
    我们调查了时间趋势并检查了年龄-,周期-,以及江苏省居民伤害相关死亡的队列特异性影响,为今后的伤害预防提供证据。
    这项研究包括江苏省人口死亡登记系统的406,936例伤害死亡。使用连接点回归分析年龄标准化死亡率(ASMR)的平均年变化百分比(AAPC)。生成了年龄-时期-队列模型来探索年龄的影响,period,和出生队列对死亡风险的影响。
    所有伤害的ASMR(AAPC=-2.3%),道路交通事故(AAPC=-5.3%),自杀(AAPC=-3.8%),2012-2021年溺水(AAPC=-3.9%)呈下降趋势(所有p<0.05),而意外下跌呈上升趋势(AAPC=5.1%,p<0.05)。从2012年到2021年,四种主要类型伤害的年龄标准化死亡率(ASMR)在男性中始终高于女性。农村地区的ASMR高于城市地区。道路交通事故的ASMR趋势,溺水,按性别和城市/农村地区分列的意外跌倒与总体趋势一致。重要的年龄,队列,在江苏省男女伤害相关死亡趋势中确定了时期效应。年龄效应显示伤害相关死亡的年龄效应最高的是85岁及以上,除了自杀,年龄在80-84岁之间。在2012年至2021年之间,对道路交通事故的时期影响有所下降,而意外跌倒的情况增加了。最初,对自杀的周期效应下降,但随后上升,2012年达到峰值,相对风险(RR)为1.11(95%CI:1.04-1.19)。同样,对溺水的时期影响最初在上升之前下降,2013年观察到的效果最高,RR为1.12(95%CI:1.07-1.19)。在1957-1961年组中观察到道路交通事故的最高队列效应,1952-1956年小组的意外跌倒,以及1927-1931年的溺水和自杀。
    意外跌倒的死亡率一直在增加。老年人有四种主要伤害的高风险。死亡率的提高可以归因于教育的进步,城市化,以及法律和政策的颁布和实施。
    UNASSIGNED: We investigated the temporal trends and examined age-, period-, and cohort-specific effects of injury-related deaths among residents in Jiangsu to provide evidence for future injury prevention.
    UNASSIGNED: This study included 406,936 injury deaths from the Jiangsu provincial population death registration system. The average annual percent change (AAPC) in age-standardized mortality rates (ASMRs) was analyzed using joinpoint regression. Age-period-cohort models were generated to explore the effects of age, period, and birth cohort effects on mortality risk.
    UNASSIGNED: ASMRs for all injuries (AAPC = -2.3%), road traffic accidents (AAPC = -5.3%), suicide (AAPC = -3.8%), and drowning (AAPC = -3.9%) showed a downward trend during 2012-2021(all p < 0.05), while unintentional falls showed an upward trend (AAPC = 5.1%, p < 0.05). From 2012 to 2021, the age-standardized mortality rates (ASMRs) for four primary types of injuries consistently exhibited higher among males compared to females, with rural regions displaying higher ASMRs than urban areas. Trends in ASMRs for road traffic accidents, drowning, and unintentional falls by sex and urban/rural areas were consistent with overall trends. Significant age, cohort, and period effects were identified in the trends of injury-related deaths for both sexes in Jiangsu. The age effect showed that the highest age effect for injury-related deaths was for the ages of 85 years and above, except for suicide, which was for the ages 80-84 years. Between 2012 and 2021, the period effect on road traffic accidents declined, while that on accidental falls increased. Initially, the period effect on suicide decreased but then rose, peaking in 2012 with a Relative Risk (RR) of 1.11 (95% CI: 1.04-1.19). Similarly, the period effect on drowning initially declined before rising, with the highest effect observed in 2013, at an RR of 1.12 (95% CI: 1.07-1.19). The highest cohort effects for road traffic accidents were observed in the 1957-1961 group, for accidental falls in the 1952-1956 group, and for both drowning and suicide in the 1927-1931 group.
    UNASSIGNED: The mortality rate of unintentional falls has been increasing. Older adults are at high risk for the four leading injuries. The improvements in mortality rates can be attributed to advancements in education, urbanization, and the promulgation and implementation of laws and policies.
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  • 文章类型: Journal Article
    整个美国的COVID-19监测对于追踪和减轻大流行至关重要,但是代表病例和死亡的数据可能会受到属性的影响,空间,时间的不确定性。COVID-19病例和死亡数据对于理解大流行至关重要,并作为预测模型的关键输入,为决策提供信息;数据集之间的一致信息对于确保一致的发现至关重要。我们实施了一种探索性数据分析方法来表征,合成,并可视化病例和死亡指标常用数据集不确定性的时空维度(约翰·霍普金斯大学,纽约时报,美国空军,和1点3英亩)。我们会仔细检查数据一致性,以评估出现分歧的地点和时间。可能表明潜在的不确定性。我们观察累积病例和死亡率的差异,以突出差异并确定空间模式。使用成对协议(Cohen\'skappa)和所有数据集的协议(Fleiss\'kappa)来评估数据,以总结随时间的变化。研究结果表明CDC之间达成了最高的协议,JHU,和NYT数据集。我们发现COVID-19数据集的信息不确定性的九个离散类型成分反映了各种复杂的过程。了解COVID-19数据报告中的不确定性过程和指标尤其与公共卫生专业人员和决策者准确理解和传达有关大流行的信息有关。
    COVID-19 surveillance across the U.S. is essential to tracking and mitigating the pandemic, but data representing cases and deaths may be impacted by attribute, spatial, and temporal uncertainties. COVID-19 case and death data are essential to understanding the pandemic and serve as key inputs for prediction models that inform policy-decisions; consistent information across datasets is critical to ensuring coherent findings. We implement an exploratory data analytic approach to characterize, synthesize, and visualize spatial-temporal dimensions of uncertainty across commonly used datasets for case and death metrics (Johns Hopkins University, the New York Times, USAFacts, and 1Point3Acres). We scrutinize data consistency to assess where and when disagreements occur, potentially indicating underlying uncertainty. We observe differences in cumulative case and death rates to highlight discrepancies and identify spatial patterns. Data are assessed using pairwise agreement (Cohen\'s kappa) and agreement across all datasets (Fleiss\' kappa) to summarize changes over time. Findings suggest highest agreements between CDC, JHU, and NYT datasets. We find nine discrete type-components of information uncertainty for COVID-19 datasets reflecting various complex processes. Understanding processes and indicators of uncertainty in COVID-19 data reporting is especially relevant to public health professionals and policymakers to accurately understand and communicate information about the pandemic.
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  • 文章类型: Journal Article
    本研究旨在开发和验证机器学习模型,以预测增殖性狼疮性肾炎(PLN)的发生,当肾活检不可行或不安全时,提供可靠的诊断选择。
    本研究回顾性分析了2011年至2021年在四川大学华西医院接受肾活检的SLE和肾脏受累患者的临床和实验室数据。我们将70%的患者随机分配到一个训练队列,其余30%随机分配到一个测试队列。在训练队列上构建了各种机器学习模型,包括广义线性模型(例如,逻辑回归,最小绝对收缩和选择运算符,岭回归,和弹性网),支持向量机(线性和径向基核函数),和决策树模型(例如,经典决策树,条件推理树,和随机森林)。使用ROC曲线评估诊断性能,校正曲线,和DCA为两个队列。此外,比较了不同的机器学习模型,以识别关键和共享特征,旨在筛选潜在的PLN诊断标志物。
    涉及1312名LN患者,对780例PLN/NPLN病例进行了分析。随机分为训练组(547例)和试验组(233例)。我们在训练组中开发了9种机器学习模型。七个模型在测试队列中表现出出色的辨别能力,随机森林模型的判别能力最高(AUC:0.880,95%置信区间(CI):0.835~0.926)。Logistic回归具有最佳的校准,而随机森林表现出最大的临床净效益。通过比较各种模型的特征,我们证实了传统指标如抗dsDNA抗体的功效,补码水平,血清肌酐,和尿红细胞和白细胞在预测和区分PLN中的作用。此外,我们发现了以前有争议或未充分利用的指标的潜在价值,如血清氯化物,中性粒细胞百分比,血清胱抑素C,血细胞比容,尿液pH值,血常规红细胞,和免疫球蛋白M在预测PLN中的作用。
    这项研究为纳入更广泛的生物标志物以诊断和预测PLN提供了全面的视角。此外,它为无法进行肾活检的SLE患者提供了理想的非侵入性诊断工具。
    UNASSIGNED: This study aims to develop and validate machine learning models to predict proliferative lupus nephritis (PLN) occurrence, offering a reliable diagnostic alternative when renal biopsy is not feasible or safe.
    UNASSIGNED: This study retrospectively analyzed clinical and laboratory data from patients diagnosed with SLE and renal involvement who underwent renal biopsy at West China Hospital of Sichuan University between 2011 and 2021. We randomly assigned 70% of the patients to a training cohort and the remaining 30% to a test cohort. Various machine learning models were constructed on the training cohort, including generalized linear models (e.g., logistic regression, least absolute shrinkage and selection operator, ridge regression, and elastic net), support vector machines (linear and radial basis kernel functions), and decision tree models (e.g., classical decision tree, conditional inference tree, and random forest). Diagnostic performance was evaluated using ROC curves, calibration curves, and DCA for both cohorts. Furthermore, different machine learning models were compared to identify key and shared features, aiming to screen for potential PLN diagnostic markers.
    UNASSIGNED: Involving 1312 LN patients, with 780 PLN/NPLN cases analyzed. They were randomly divided into a training group (547 cases) and a testing group (233 cases). we developed nine machine learning models in the training group. Seven models demonstrated excellent discriminatory abilities in the testing cohort, random forest model showed the highest discriminatory ability (AUC: 0.880, 95% confidence interval(CI): 0.835-0.926). Logistic regression had the best calibration, while random forest exhibited the greatest clinical net benefit. By comparing features across various models, we confirmed the efficacy of traditional indicators like anti-dsDNA antibodies, complement levels, serum creatinine, and urinary red and white blood cells in predicting and distinguishing PLN. Additionally, we uncovered the potential value of previously controversial or underutilized indicators such as serum chloride, neutrophil percentage, serum cystatin C, hematocrit, urinary pH, blood routine red blood cells, and immunoglobulin M in predicting PLN.
    UNASSIGNED: This study provides a comprehensive perspective on incorporating a broader range of biomarkers for diagnosing and predicting PLN. Additionally, it offers an ideal non-invasive diagnostic tool for SLE patients unable to undergo renal biopsy.
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