Publications by authors named "Gang Luo"

379 Publications

Home-Use Evaluation of a Wearable Collision Warning Device for Individuals With Severe Vision Impairments: A Randomized Clinical Trial.

JAMA Ophthalmol 2021 Jul 22. Epub 2021 Jul 22.

Schepens Eye Research Institute of Mass Eye and Ear, Boston, Massachusetts.

Importance: There is scant rigorous evidence about the real-world mobility benefit of electronic mobility aids.

Objective: To evaluate the effect of a collision warning device on the number of contacts experienced by blind and visually impaired people in their daily mobility.

Design, Setting, And Participants: In this double-masked randomized clinical trial, participants used a collision warning device during their daily mobility over a period of 4 weeks. A volunteer sample of 31 independently mobile individuals with severe visual impairments, including total blindness and peripheral visual field restrictions, who used a long cane or guide dog as their habitual mobility aid completed the study. The study was conducted from January 2018 to December 2019.

Interventions: The device automatically detected collision hazards using a chest-mounted video camera. It randomly switched between 2 modes: active mode (intervention condition), where it provided alerts for detected collision threats via 2 vibrotactile wristbands, and silent mode (control condition), where the device still detected collisions but did not provide any warnings to the user. Scene videos along with the collision warning information were recorded by the device. Potential collisions detected by the device were reviewed and scored, including contacts with the hazards, by 2 independent reviewers. Participants and reviewers were masked to the device operation mode.

Main Outcomes And Measures: Rate of contacts per 100 hazards per hour, compared between the 2 device modes within each participant. Modified intention-to-treat analysis was used.

Results: Of the 31 included participants, 18 (58%) were male, and the median (range) age was 61 (25-73) years. A total of 19 participants (61%) had a visual acuity (VA) of light perception or worse, and 28 (90%) reported a long cane as their habitual mobility aid. The median (interquartile range) number of contacts was lower in the active mode compared with silent mode (9.3 [6.6-14.9] vs 13.8 [6.9-24.3]; difference, 4.5; 95% CI, 1.5-10.7; P < .001). Controlling for demographic characteristics, presence of VA better than light perception, and fall history, the rate of contacts significantly reduced in the active mode compared with the silent mode (β = 0.63; 95% CI, 0.54-0.73; P < .001).

Conclusions And Relevance: In this study involving 31 visually impaired participants, the collision warnings were associated with a reduced rate of contacts with obstacles in daily mobility, indicating the potential of the device to augment habitual mobility aids.

Trial Registration: ClinicalTrials.gov Identifier: NCT03057496.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaophthalmol.2021.2624DOI Listing
July 2021

Towards Wide Range Tracking of Head Scanning Movement in Driving.

Intern J Pattern Recognit Artif Intell 2020 Dec 20;34(13). Epub 2020 Apr 20.

Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, MA, USA, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

Gaining environmental awareness through lateral head scanning (yaw rotations) is important for driving safety, especially when approaching intersections. Therefore, head scanning movements could be an important behavioral metric for driving safety research and driving risk mitigation systems. Tracking head scanning movements with a single in-car camera is preferred hardware-wise, but it is very challenging to track the head over almost a 180° range. In this paper we investigate two state-of-the-art methods, a multi-loss deep residual learning method with 50 layers (multi-loss ResNet-50) and an ORB feature-based simultaneous localization and mapping method (ORB-SLAM). While deep learning methods have been extensively studied for head pose detection, this is the first study in which SLAM has been employed to innovatively track head scanning over a very wide range. Our laboratory experimental results showed that ORB-SLAM was more accurate than multi-loss ResNet-50, which often failed when many facial features were not in the view. On the contrary, ORB-SLAM was able to continue tracking as it doesn't rely on particular facial features. Testing with real driving videos demonstrated the feasibility of using ORB-SLAM for tracking large lateral head scans in naturalistic video data.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1142/s0218001420500330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276872PMC
December 2020

Dietary iron overload mitigates atherosclerosis in high-fat diet-fed apolipoprotein E knockout mice: Role of dysregulated hepatic fatty acid metabolism.

Biochim Biophys Acta Mol Cell Biol Lipids 2021 Jul 7;1866(10):159004. Epub 2021 Jul 7.

Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; Ministry of Education Key Laboratory of Environment, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. Electronic address:

The atherosclerosis "iron hypothesis" generates a fair amount of debate since it has been proposed. Here, we revisited the "iron hypothesis" by examining whether dietary iron overload would intensify iron deposition in plaques and thus lead to further exacerbation of atherosclerosis in apolipoprotein E knockout (ApoE KO) mice. ApoE KO mice were fed either a normal chow diet (ND) or a high fat diet (HFD) supplemented with or without 2% carbonyl iron (Fe) for 16 weeks. However, contrary to our assumption, dietary iron overloading did not intensify, but rather diminished the atherosclerotic lesion area by 65.3%, which was accompanied by significantly decreased serum total cholesterol, triglyceride and low-density lipoprotein cholesterol contents, together with hepatic lipid accumulation decline, despite the evident existence of aortic iron accumulation and the typical signs of iron overload in ApoE KO mice. Using isobaric tag for absolute quantification (iTRAQ) proteomics approach, hepatic CD36 and fatty acid binding proteins-mediated fatty acid (FA) uptake and trafficking impairment were identified as the key potential pathomechanisms by which iron overload diminishes atherosclerotic lesions. Furthermore, downstream hepatic FA de novo biosynthesis was enhanced and FA oxidation was inhibited to compensate for the FA deficiency triggered by iron overload-impaired fatty acid uptake and trafficking. Our findings suggested that dietary iron overload is not atherogenic in ApoE KO mice, and more research efforts are warranted to revisit the "iron hypothesis" of atherosclerosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbalip.2021.159004DOI Listing
July 2021

Barrett's Esophagus and Intestinal Metaplasia.

Front Oncol 2021 17;11:630837. Epub 2021 Jun 17.

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou City, China.

Intestinal metaplasia refers to the replacement of the differentiated and mature normal mucosal epithelium outside the intestinal tract by the intestinal epithelium. This paper briefly describes the etiology and clinical significance of intestinal metaplasia in Barrett's esophagus. This article summarizes the impact of intestinal metaplasia on the diagnosis, monitoring, and treatment of Barrett's esophagus according to different guidelines. We also briefly explore the basis for the endoscopic diagnosis of intestinal metaplasia in Barrett's esophagus. The identification techniques of goblet cells in Barrett's esophagus are also elucidated by some scholars. Additionally, we further elaborate on the current treatment methods related to Barrett's esophagus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fonc.2021.630837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8252963PMC
June 2021

Identification of a novel heterozygous SPTB mutation by whole genome sequencing in a Chinese patient with hereditary spherocytosis and atrial septal defect: a case report.

BMC Pediatr 2021 06 28;21(1):291. Epub 2021 Jun 28.

Heart center, Qingdao Women and Children's Hospital, Qingdao University, 217 Liaoyangxi Road, Qingdao, 266034, China.

Background: Hereditary spherocytosis (HS) is a common inherited red blood cell membrane disorder characterized by an abnormal increase of spherocytes in peripheral blood. SPTB gene mutation is one of the most common causes of HS; however, few cases of HS resulting from SPTB mutation in the Chinese population have been reported so far.

Case Presentation: A 3-year-old Chinese girl presented to Qingdao Women and Children's Hospital, Qingdao University, with atrial septal defect (ASD). Meanwhile, she was clinically diagnosed with HS. Whole genome sequencing (WGS) was performed for the proband and her parents for genetic molecular analysis. A novel SPTB mutation (c.1756delG) was detected by WGS and confirmed by Sanger sequencing in the proband. This mutation results in a frameshift with a premature termination codon in exon 12, leading to a nonsense mutation (p.Ala586Profs*7). Her parents had no similar symptoms, and blood routine and serum biochemical tests showed no significant abnormalities. The patient's mother did not know of any relatives with HS-like symptoms. Percutaneous transcatheter closure was successfully performed for treating the ASD.

Conclusion: In this study, we identified a novel SPTB frameshift mutation in a Chinese girl with HS. This finding would expand the spectrum of SPTB mutations, provide a valuable insight into the genotyping of HS in the Chinese population, and contribute to the clinical management and genetic counseling in HS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12887-021-02771-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237424PMC
June 2021

Safety and Efficacy of Low-Dose Tirofiban Combined With Intravenous Thrombolysis and Mechanical Thrombectomy in Acute Ischemic Stroke: A Matched-Control Analysis From a Nationwide Registry.

Front Neurol 2021 10;12:666919. Epub 2021 Jun 10.

Interventional Neuroradiology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Tirofiban administration to acute ischemic stroke patients undergoing mechanical thrombectomy with preceding intravenous thrombolysis remains controversial. The aim of the current study was to evaluate the safety and efficacy of low-dose tirofiban during mechanical thrombectomy in patients with preceding intravenous thrombolysis. Patients with acute ischemic stroke undergoing mechanical thrombectomy and preceding intravenous thrombolysis were derived from "ANGEL-ACT," a multicenter, prospective registry study. The patients were dichotomized into tirofiban and non-tirofiban groups based on whether tirofiban was administered. Propensity score matching was used to minimize case bias. The primary safety endpoint was symptomatic intracerebral hemorrhage (sICH), defined as an intracerebral hemorrhage (ICH) associated with clinical deterioration as determined by the Heidelberg Bleeding Classification. All ICHs and hemorrhage types were recorded. Clinical outcomes included successful recanalization, dramatic clinical improvement, functional independence, and mortality at the 3-month follow-up timepoint. Successful recanalization was defined as a modified Thrombolysis in Cerebral Ischemia score of 2b or 3. Dramatic clinical improvement at 24 h was defined as a reduction in NIH stroke score of ≥10 points compared with admission, or a score ≤1. Functional independence was defined as a Modified Rankin Scale (mRS) score of 0-2 at 3-months. The study included 201 patients, 81 in the tirofiban group and 120 in the non-tirofiban group, and each group included 68 patients after propensity score matching. Of the 201 patients, 52 (25.9%) suffered ICH, 15 (7.5%) suffered sICH, and 18 (9.0%) died within 3-months. The median mRS was 3 (0-4), 99 (49.3%) achieved functional independence. There were no statistically significant differences in safety outcomes, efficacy outcomes on successful recanalization, dramatic clinical improvement, or 3-month mRS between the tirofiban and non-tirofiban groups (all > 0.05). Similar results were obtained after propensity score matching. In acute ischemic stroke patients who underwent mechanical thrombectomy and preceding intravenous thrombolysis, low-dose tirofiban was not associated with increased risk of sICH or ICH. Further randomized clinical trials are needed to confirm the effects of tirofiban in patients undergoing bridging therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2021.666919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225265PMC
June 2021

Treatment of Unruptured Vertebral Artery Aneurysm Involving Posterior Inferior Cerebellar Artery With Pipeline Embolization Device.

Front Neurol 2021 10;12:622457. Epub 2021 Jun 10.

Department of Interventional Neuroradiology, Bejing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Treatment of unruptured vertebral artery aneurysm involving posterior inferior cerebellar artery (PICA) is challenging. The experience of pipeline embolization device (PED) therapy for these lesions is still limited. To evaluate the safety and efficacy of the PED for unruptured vertebral artery aneurysm involving PICA. Thirty-two patients with unruptured vertebral artery aneurysm involving PICA underwent treatment with PED were retrospectively identified. Procedure-related complications, PICA patency, clinical, and angiographic outcomes were analyzed. Thirty-two aneurysms were successfully treated without any procedure-related complications. Images were available in 30 patients (93.8%) during a period of 3-26 months follow-up (average 8.4 months), which confirmed complete occlusion in 17 patients (56.5%), near-complete occlusion in 9 patients (30%), and incomplete occlusion in one patient (3.3%). Parent artery occlusion (PAO) was occurred in 3 patients (10%). Twenty-eight of 30 PICA remained patent. The two occlusions of PICA were secondary to PAO. At a mean of 20.7 months (range 7-50 months) clinical follow-up, all the patients achieved a favorable outcome without any new neurological deficit. PED seems to be a safe and effective alternative endovascular option for patients with unruptured vertebral artery aneurysm involving PICA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2021.622457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222993PMC
June 2021

FLDS: An Intelligent Feature Learning Detection System for Visualizing Medical Images Supporting Fetal Four-chamber Views.

IEEE J Biomed Health Inform 2021 Jun 22;PP. Epub 2021 Jun 22.

Fetal congenital heart disease (CHD) is the most common type of fatal congenital malformation. Fetal four-chamber (FC) view is a significant and easily accessible ultrasound (US) image among fetal echocardiography images. Automatic detection of four fetal heart chambers considerably contributes to the early diagnosis of fetal CHD. Furthermore, robust and discriminative features are essential for detecting crucial visualizing medical images, especially fetal FC views. However, it is an incredibly challenging task due to several key factors, such as numerous speckles in US images, the fetal four chambers with small size and unfixed positions, and category confusion caused by the similarity of cardiac chambers. These factors hinder the process of capturing robust and discriminative features, hence destroying the fetal four chambers' precise detection. Therefore, we propose an intelligent feature learning detection system (FLDS) for FC views to detect the four chambers. A multistage residual hybrid attention module (MRHAM) presented in this paper is incorporated in the FLDS for learning powerful and robust features, helping FLDS accurately locate the four chambers in the fetal FC views. Extensive experiments demonstrate that our proposed FLDS outperforms the current state-of-the-art, including the precision of 0.919, the recall of 0.971, the F1 score of 0.944, the mAP of 0.953, and the frames per second (FPS) of 43. In addition, our proposed FLDS is also validated on other visualizing nature images such as the PASCAL VOC dataset, achieving a higher mAP of 0.878 while input size is 608 * 608.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1109/JBHI.2021.3091579DOI Listing
June 2021

Prediction of arrhythmia after intervention in children with atrial septal defect based on random forest.

BMC Pediatr 2021 06 16;21(1):280. Epub 2021 Jun 16.

Qingdao Women and Children's Hospital, Qingdao University, 266034, Qingdao, China.

Background: Using random forest to predict arrhythmia after intervention in children with atrial septal defect.

Methods: We constructed a prediction model of complications after interventional closure for children with atrial septal defect. The model was based on random forest, and it solved the need for postoperative arrhythmia risk prediction and assisted clinicians and patients' families to make preoperative decisions.

Results: Available risk prediction models provided patients with specific risk factor assessments, we used Synthetic Minority Oversampling Technique algorithm and random forest machine learning to propose a prediction model, and got a prediction accuracy of 94.65 % and an Area Under Curve value of 0.8956.

Conclusions: Our study was based on the model constructed by random forest, which can effectively predict the complications of arrhythmia after interventional closure in children with atrial septal defect.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12887-021-02744-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207618PMC
June 2021

The Neutrophil-to-Monocyte Ratio and Platelet-to-White Blood Cell Ratio Represent Novel Prognostic Markers in Patients with Pancreatic Cancer.

Gastroenterol Res Pract 2021 24;2021:6693028. Epub 2021 May 24.

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China.

Background: Inflammation plays an important role in the development of tumors. Several serum based-markers and ratios have been investigated for their prognostic value in pancreatic cancer. However, the prognostic value of the neutrophil-to-monocyte ratio (NMR) and platelet-to-white blood cell ratio (PWR) for patients with pancreatic cancer has scarcely been investigated.

Methods: From October 2013 to November 2018, a retrospective cohort study was performed on 269 pancreatic cancer patients without treatment. Receiver operating characteristic curves were generated, and areas under the curve were compared for the evaluation of the discriminatory ability of inflammation-based prognostic scoring systems. Kaplan-Meier curves and the Cox proportional hazard model were employed to analyze the relationships among NMR, PWR, and overall survival (OS).

Results: The optimal cutoff values of NMR and PWR were 48 and 6, respectively. In univariate analysis, the survival time of NMR > 48 and PWR ≤ 6 was shorter than that of NMR ≤ 48 and PWR > 6 in patients with pancreatic cancer ( < 0.001). In Cox univariate and multivariate analyses, NMR (hazard ratio (HR), 9.095; 95% confidence interval (CI), 3.64-22.72; < 0.001) and PWR (HR, 8.230; 95% CI, 3.32-20.43; < 0.001) were significantly correlated with OS.

Conclusions: The current study demonstrated that NMR and PWR may serve as novel and promising inflammatory prognostic scores for patients with pancreatic cancer. Elevated NMR (>48) and depressed PWR (<6) were independently associated with poor prognosis in patients with pancreatic cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2021/6693028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169265PMC
May 2021

Quercetin Attenuates Trauma-Induced Heterotopic Ossification by Tuning Immune Cell Infiltration and Related Inflammatory Insult.

Front Immunol 2021 20;12:649285. Epub 2021 May 20.

Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Heterotopic ossification (HO) is one of the most intractable disorders following musculoskeletal injury and is characterized by the ectopic presence of bone tissue in the soft tissue leading to severe loss of function in the extremities. Recent studies have indicated that immune cell infiltration and inflammation are involved in aberrant bone formation. In this study, we found increased monocyte/macrophage and mast cell accumulation during early HO progression. Macrophage depletion by clodronate liposomes and mast cell stabilization by cromolyn sodium significantly impeded HO formation. Therefore, we proposed that the dietary phytochemical quercetin could also suppress immune cell recruitment and related inflammatory responses to prevent HO. As expected, quercetin inhibited the monocyte-to-macrophage transition, macrophage polarization, and mast cell activation in a dose-dependent manner. Using a murine burn/tenotomy model, we also demonstrated that quercetin attenuated inflammatory responses and HO . Furthermore, elevated SIRT1 and decreased acetylated NFκB p65 expression were responsible for the mechanism of quercetin, and the beneficial effects of quercetin were reversed by the SIRT1 antagonist EX527 and mimicked by the SIRT agonist SRT1720. The findings in this study suggest that targeting monocyte/macrophage and mast cell activities may represent an attractive approach for therapeutic intervention of HO and that quercetin may serve as a promising therapeutic candidate for the treatment of trauma-induced HO by modulating SIRT1/NFκB signaling.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fimmu.2021.649285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173182PMC
May 2021

Unilateral lumbopelvic fixation for AO/OTA Type C1 and C2 pelvic fractures: Clinical efficacy and preliminary experiences in 23 patients.

Injury 2021 May 17. Epub 2021 May 17.

Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China. Electronic address:

Purpose: To report the clinical outcomes and preliminary experiences of unilateral lumbopelvic fixation for patients with AO/OTA Type C1 and C2 pelvic fractures.

Materials And Methods: Between May 2014 and Dec 2017, 23 consecutive patients with AO/OTA Type C1 and C2 pelvic factures were treated by unilateral lumbopelvic fixation. Estimated blood loss, operation duration, reduction quality, functional outcomes using Majeed scores and complications were evaluated. Subgroup analysis was used to assess the influence of unilateral lumbopelvic fixation on different type of pelvic fractures.

Results: Fifteen patients with Type C1 pelvic fractures and eight patients with Type C2 fractures underwent unilateral lumbopelvic fixation respectively. The mean follow-up time till May 2019 was 34.3 ± 9.9 months (range 17-60 months). Mean estimated blood loss was 473 ml and mean operation duration was 156 min during unilateral lumbopelvic fixation. The mean vertical displacement of pelvis decreased from 10.1 ± 4.9 mm to 3.1 ± 1.9 mm after unilateral lumbopelvic fixation. Majeed score assessments were available for 22 patients. Of these, 13 patients were graded as excellent, 8 were good and one was fair. The results of subgroup analysis showed that there was no difference of estimated blood loss, operation duration, postoperative displacements of pelvis and Majeed scores between the patients with Type C1 and C2 fractures.

Conclusion: Unilateral lumbopelvic fixation could provide a well reduction quality and was an effective treatment for AO/OTA Type C1 and C2 pelvic fractures.

Study Design: Retrospective evaluation of 23 consecutive patients with AO/OTA Type C1 and C2 pelvic fractures treated by unilateral lumbopelvic fixation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.injury.2021.05.018DOI Listing
May 2021

A Roadmap for Automating Lineage Tracing to Aid Automatically Explaining Machine Learning Predictions for Clinical Decision Support.

Authors:
Gang Luo

JMIR Med Inform 2021 May 27;9(5):e27778. Epub 2021 May 27.

Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.

Using machine learning predictive models for clinical decision support has great potential in improving patient outcomes and reducing health care costs. However, most machine learning models are black boxes that do not explain their predictions, thereby forming a barrier to clinical adoption. To overcome this barrier, an automated method was recently developed to provide rule-style explanations of any machine learning model's predictions on tabular data and to suggest customized interventions. Each explanation delineates the association between a feature value pattern and an outcome value. Although the association and intervention information is useful, the user of the automated explaining function often requires more detailed information to better understand the patient's situation and to aid in decision making. More specifically, consider a feature value in the explanation that is computed by an aggregation function on the raw data, such as the number of emergency department visits related to asthma that the patient had in the prior 12 months. The user often wants to rapidly drill through to see certain parts of the related raw data that produce the feature value. This task is frequently difficult and time-consuming because the few pieces of related raw data are submerged by many pieces of raw data of the patient that are unrelated to the feature value. To address this issue, this paper outlines an automated lineage tracing approach, which adds automated drill-through capability to the automated explaining function, and provides a roadmap for future research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/27778DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193496PMC
May 2021

Spatially explicit analysis identifies significant potential for bioenergy with carbon capture and storage in China.

Nat Commun 2021 05 26;12(1):3159. Epub 2021 May 26.

Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention, Department of Environmental Science and Engineering, Fudan University, Shanghai, China.

As China ramped-up coal power capacities rapidly while CO emissions need to decline, these capacities would turn into stranded assets. To deal with this risk, a promising option is to retrofit these capacities to co-fire with biomass and eventually upgrade to CCS operation (BECCS), but the feasibility is debated with respect to negative impacts on broader sustainability issues. Here we present a data-rich spatially explicit approach to estimate the marginal cost curve for decarbonizing the power sector in China with BECCS. We identify a potential of 222 GW of power capacities in 2836 counties generated by co-firing 0.9 Gt of biomass from the same county, with half being agricultural residues. Our spatially explicit method helps to reduce uncertainty in the economic costs and emissions of BECCS, identify the best opportunities for bioenergy and show the limitations by logistical challenges to achieve carbon neutrality in the power sector with large-scale BECCS in China.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41467-021-23282-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154910PMC
May 2021

Genome-Centric Metatranscriptomics Analysis Reveals the Role of Hydrochar in Anaerobic Digestion of Waste Activated Sludge.

Environ Sci Technol 2021 06 24;55(12):8351-8361. Epub 2021 May 24.

Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China.

Anaerobic digestion (AD) of waste activated sludge (WAS) has been widely used, while it poses problems including low methane yield and production rate. Hydrochar is produced by hydrothermal liquefaction of biomass; however, little is known about the role of hydrochar in promoting AD of WAS. The present study showed that hydrochar increased the methane production rate by 30.8% and yield by 31.4% of hydrothermal pretreated dewatered WAS. Hydrochar increased the methane production rate and yield by enhancing the acidification and methanogenesis processes. Genomic-centric metatranscriptomics were used to identify the metabolic activities and transcriptomic response of individual metagenome-assembled genomes that were enriched by hydrochar. Although sp. FDU0106 had been shown unable to used H, it had the complete pathway for the reduction of CO to methane. sp. FDU0164 expressed genes for extracellular electron transfer via electrically pili, suggesting that sp. FDU0164 and sp. FDU0106 were exchanging electrons via direct interspecies electron transfer. The expression of pili was decreased, indicating that hydrochar could replace its roles. Additionally, sp. FDU0048, sp. FDU0082, and FDU0089 were related to the degradation of organics, which could be related to the enhanced methane yield.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.est.1c01995DOI Listing
June 2021

Candida albicans requires iron to sustain hyphal growth.

Biochem Biophys Res Commun 2021 Jul 19;561:106-112. Epub 2021 May 19.

Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, Wuhan University, Wuhan, 430072, China. Electronic address:

Candida albicans is an important opportunistic fungal pathogen of immunocompromised individuals. The ability to switch between yeast and hyphal growth forms is critical for its pathogenesis. Hyphal development in C. albicans requires two temporally linked regulations for initiation and maintenance. Here, we performed transcriptome sequencing (RNA-Seq) to analyze the transcriptional consequences for the two different phases of hyphal development. Genome-wide transcription profiling reveals that the sets associated with hyphal initiation were significantly enriched in genes for hyphal cell wall, biofilm matrix and actin polarization. In addition to hypha-specific genes, numerous genes involved in iron acquisition, such as FTR1 and SEF1, are highly induced specifically during sustained hyphal development even when additional free iron is supplied in the medium. Therefore, iron uptake genes are induced by signals that can support prolonged hyphal development in an iron-independent manner. The induction of iron acquisition genes during hyphal elongation was further confirmed by quantitative reverse transcription-PCR under various hypha-inducing conditions. Remarkably, preventing C. albicans from acquiring iron blocks BRG1 activation, leading to impaired hyphal maintenance, and ectopically expressed BRG1 can sustain hyphal development bypassing the requirement of iron. Our study elucidates an underlying mechanism of how multiple virulence factors are interconnected and are induced simultaneously during infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbrc.2021.05.039DOI Listing
July 2021

Safety and Efficacy of Anticoagulation in Patients with Cirrhosis: A Meta-Analysis.

Can J Gastroenterol Hepatol 2021 21;2021:8859602. Epub 2021 Apr 21.

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.

Background And Aims: Portal vein thrombosis is a serious adverse event that occurs during liver cirrhosis. We performed a meta-analysis to evaluate the safety and efficacy of anticoagulant therapy and prophylactic anticoagulant therapy in cirrhosis patients with (/without) portal vein thrombosis.

Methods: Eligible comparative studies were identified by searching the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and CNKI. A meta-analysis was performed to calculate odds ratios and 95% confidence intervals using fixed-effects models. Recanalization and thrombus progression were defined as the primary outcomes. Secondary outcomes included adverse events and death mortality.

Results: A total of 3479 patients were included in this analysis. Compared with the control group, the recanalization rate in the anticoagulant therapy group was increased ( < 0.00001) in patients with cirrhosis and portal vein thrombosis without increasing adverse events. Multiple use of enoxaparin in small doses is safer than single large doses (=0.004). Direct oral anticoagulants are more effective ( < 0.00001) and safer than traditional anticoagulants. Prophylactic anticoagulant therapy can effectively prevent portal vein thrombosis formation ( < 0.00001).

Conclusions: Anticoagulation therapy can treat or prevent portal vein thrombosis in patients with liver cirrhosis and is a relatively safe treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2021/8859602DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102101PMC
April 2021

What Visual Targets Are Viewed by Users With a Handheld Mobile Magnifier App.

Authors:
Gang Luo

Transl Vis Sci Technol 2021 03;10(3):16

Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

Purpose: Mobile video magnifier apps are used by many visually impaired people for seeing details that are beyond their visual capacity. Understanding the common types of visual targets will be importantly informative for low-vision research and assistive technology development. This study addressed this question through analysis of images captured by magnifier app users pursuing their daily activities.

Methods: An iOS magnifier app, free to the public, was used to capture and upload images to the Azure Computer Vision cloud service for object recognition. Returned object tag results for each image were uploaded to the Umeng analytics server for aggregated tallies. Consolidated data from 24,295 users across 1 month were analyzed. More than 1300 types of object tags found in 152,819 images were grouped into 11 categories. The data collection and analyses were conducted separately for users who toggled on or off iOS vision-accessibility features.

Results: For accessibility and nonaccessibility user groups, 60% to 70% of objects were nontextual, such as an indoor scene, human, or art. More than 40% of the images contained more than one object category. Accessibility users viewed textual objects more frequently than nonaccessibility users (41.1% vs. 29.8%), but overall, the probability ranking of categories was not significantly different between the two groups.

Conclusions: Nontextual objects make up a major portion of visual needs of magnifier users across a wide range of vision loss.

Translational Relevance: Low-vision research and vision assistance technology development should address the need for nontextual object viewing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1167/tvst.10.3.16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980048PMC
March 2021

Using Computational Methods to Improve Integrated Disease Management for Asthma and Chronic Obstructive Pulmonary Disease: Protocol for a Secondary Analysis.

JMIR Res Protoc 2021 May 18;10(5):e27065. Epub 2021 May 18.

Department of Pediatrics, University of Utah, Salt Lake City, UT, United States.

Background: Asthma and chronic obstructive pulmonary disease (COPD) impose a heavy burden on health care. Approximately one-fourth of patients with asthma and patients with COPD are prone to exacerbations, which can be greatly reduced by preventive care via integrated disease management that has a limited service capacity. To do this well, a predictive model for proneness to exacerbation is required, but no such model exists. It would be suboptimal to build such models using the current model building approach for asthma and COPD, which has 2 gaps due to rarely factoring in temporal features showing early health changes and general directions. First, existing models for other asthma and COPD outcomes rarely use more advanced temporal features, such as the slope of the number of days to albuterol refill, and are inaccurate. Second, existing models seldom show the reason a patient is deemed high risk and the potential interventions to reduce the risk, making already occupied clinicians expend more time on chart review and overlook suitable interventions. Regular automatic explanation methods cannot deal with temporal data and address this issue well.

Objective: To enable more patients with asthma and patients with COPD to obtain suitable and timely care to avoid exacerbations, we aim to implement comprehensible computational methods to accurately predict proneness to exacerbation and recommend customized interventions.

Methods: We will use temporal features to accurately predict proneness to exacerbation, automatically find modifiable temporal risk factors for every high-risk patient, and assess the impact of actionable warnings on clinicians' decisions to use integrated disease management to prevent proneness to exacerbation.

Results: We have obtained most of the clinical and administrative data of patients with asthma from 3 prominent American health care systems. We are retrieving other clinical and administrative data, mostly of patients with COPD, needed for the study. We intend to complete the study in 6 years.

Conclusions: Our results will help make asthma and COPD care more proactive, effective, and efficient, improving outcomes and saving resources.

International Registered Report Identifier (irrid): PRR1-10.2196/27065.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/27065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170556PMC
May 2021

Untargeted and targeted gingival metabolome in rodents reveal metabolic links between high-fat diet-induced obesity and periodontitis.

J Clin Periodontol 2021 Aug 27;48(8):1137-1148. Epub 2021 May 27.

Department of Periodontics, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

Aim: To characterize gingival metabolome in high-fat diet (HFD)-induced obesity in mice with/without periodontitis.

Methods: HFD-induced obesity mouse model was established by 16-week feeding, and a lean control group was fed with low-fat diet (n = 21/group). Both models were induced for periodontitis on the left sides by molar ligation for 10 days, whereas the right sides were used as controls. Gingival metabolome and arginine metabolism were analysed by non-targeted/targeted liquid chromatography-mass spectrometry.

Results: Of 2247 reference features, presence of periodontitis altered 165 in lean versus 885 in HFD mice; and HFD altered 525 in absence versus 1435 in presence of periodontitis. Compared with healthy condition, periodontitis and HFD had distinct effects on gingival metabolome. Metabolomic impacts of periodontitis were generally greater in HFD mice versus lean controls. K-medoids clustering showed that HFD amplified the impacts of periodontitis on gingival metabolome in both intensity and extensity. Ten metabolic pathways were enriched, including 2 specific to periodontitis, 5 specific to HFD and 3 shared ones. Targeted validation on arginine metabolism confirmed the additive effects between HFD and periodontitis.

Conclusion: The obese population consuming excessive HFD display amplified metabolic response to periodontitis, presenting a metabolic susceptibility to exacerbated periodontal destruction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jcpe.13486DOI Listing
August 2021

Delayed dark adaptation in central serous chorioretinopathy.

Am J Ophthalmol Case Rep 2021 Jun 21;22:101098. Epub 2021 Apr 21.

Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.

Purpose: To evaluate the effect of central serous chorioretinopathy (CSCR) on retinal function using dark adaptation in a human subject, and to follow it through resolution of the disease.

Patients: Single patient, 50 years old male patient, with acute CSCR in one eye and resolved old CSCR in the other eye.

Observations: Observational study in patient with CSCR followed through resolution of the subretinal fluid (52 days). Dark adaptation was assessed using the AdaptDx® (Maculogix Inc.) measured by Rod Intercept time (RIT) in minutes. A normal retinal locus of the same eye on the opposite side of the fovea was used as control. Retinal separation (microns) was measured using Spectralis Optical Coherence Tomography (Spectralis®, HRA + OCT, Heidelberg engineering). Change in time to dark adapt, were correlated with retinal separation measured in microns, during the course of CSCR.The Rod Intercept time was delayed in the area of detached retina compared to the normal region (control) on presentation with retinal separation (RS) of 104 μm. The Rod Intercept time returned to normal as the retinal separation from retinal pigment epithelium decreased and eventually resolved.

Conclusions: This case shows that delay in dark adaptation is proportional to the amount of separation of neurosensory retina from retinal pigment epithelium in CSCR, this may offer a potential of using DA to characterize visual function in CSCR. The association of dark adaptation response with the state of retinal pigment epithelial function and its ability to predict the recurrence of CSCR needs further evaluation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajoc.2021.101098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094908PMC
June 2021

Cardamonin inhibits the progression of oesophageal cancer by inhibiting the PI3K/AKT signalling pathway.

J Cancer 2021 24;12(12):3597-3610. Epub 2021 Apr 24.

Department of Gastroenterology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China.

Oesophageal cancer is the most common malignant tumour with a poor prognosis, and the current treatment methods are limited. Therefore, identifying effective treatment methods has become a research hotspot. Cardamonin (CAR) is a natural chalcone compound and has been reported to play an anticancer role in several cancers. However, its function in oesophageal cancer and the possible underlying mechanism are still unclear. The purpose of this study was to demonstrate the anticancer effect of CAR on oesophageal cancer and and to explore the underlying mechanism. MTT, crystal violet, and colony formation assays were used to detect oesophageal cancer cell proliferation. The effects of CAR on oesophageal cancer cell migration and invasion were detected by wound healing assay and Transwell assay. Hoechst 33258 staining and flow cytometry were used to detect cell apoptosis. Protein expression levels were detected by Western blot. A tumour xenograft model was established to further test the effect of CAR on the growth of oesophageal cancer . The results showed that CAR inhibited the proliferation, migration, and invasion of oesophageal cancer cells in a concentration-dependent manner and induced apoptosis. Furthermore, the Western blot assay showed that CAR could suppress metastasis by inhibiting epithelial-mesenchymal transition (EMT) as indicated by downregulated expression of the mesenchymal markers N-cadherin and vimentin, the EMT transcription factor Snail, and matrix metalloproteinases (MMPs) and upregulated expression of the epithelial marker E-cadherin. CAR was associated with upregulation of the pro-apoptotic proteins Bax and Bad and downregulation of the anti-apoptotic protein Bcl-2 and triggered the mitochondrial apoptosis pathway, which in turn promoted caspase-3 activation and subsequent cleavage of PARP; however, the mitochondria-related apoptotic effects induced by CAR were blocked by caspase inhibitor Z-VAD-FMK pretreatment, which prevented programmed cell death triggered by CAR. In addition, CAR reduced the phosphorylation level of downstream effector molecules of phosphatidylinositol 3 kinase (PI3K) in a dose-dependent manner, and treatment with the PI3K agonist 740Y-P could partially reverse the anticancer effect of CAR, demonstrating that CAR played an antitumour role by inhibiting the PI3K/AKT signalling pathway in oesophageal cancer cells. Moreover, the EC9706 xenograft model further confirmed that CAR can significantly inhibit tumour growth . In summary, CAR exhibited a strong anticancer effect on human oesophageal cancer cells and promoted apoptosis by inhibiting the PI3K/AKT signalling pathway, suggesting that CAR can be used as new strategy for oesophageal cancer treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7150/jca.55519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120183PMC
April 2021

Influence of COVID-19 Lockdowns on the Usage of a Vision Assistance App Among Global Users With Visual Impairment: Big Data Analytics Study.

J Med Internet Res 2021 05 12;23(5):e26283. Epub 2021 May 12.

Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, United States.

Background: Millions of individuals with visual impairment use vision assistance apps to help with their daily activities. The most widely used vision assistance apps are magnifier apps. It is still largely unknown what the apps are used for. Lack of insight into the visual needs of individuals with visual impairment is a hurdle for the development of more effective assistive technologies.

Objective: This study aimed to investigate how needs for visual aids may vary with social activities, by observing the changes in the usage of a smartphone magnifier app when many users take breaks from work.

Methods: The number of launches of the SuperVision Magnifier app was determined retrospectively from 2018 to 2020 from among active users worldwide. The fluctuation in app usage was examined by comparing weekday vs weekend periods, Christmas and new year vs nonholiday seasons, and COVID-19 lockdowns vs the easing of restriction during the pandemic.

Results: On average, the app was used 262,466 times by 38,237 users each month in 2020 worldwide. There were two major trough points on the timeline of weekly app usage, one aligned with the COVID-19 lockdowns in April 2020 and another aligned with the Christmas and new year week in 2018 and 2019. The app launches declined by 6947 (11% decline; P<.001) during the lockdown and by 5212 (9% decline; P=.001) during the holiday weeks. There was no significant decline during March to May 2019. App usage compensated for seasonal changes was 8.6% less during weekends than during weekdays (P<.001).

Conclusions: The need for vision assistance technology was slightly lower during breaks and lockdowns, probably because the activities at home were different and less visually demanding. Nevertheless, for the entire user population, the needs for visual aids are still substantial.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/26283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117957PMC
May 2021

Current status of aspiration thrombectomy for acute stroke patients in China: data from ANGEL-ACT Registry.

Ther Adv Neurol Disord 2021 12;14:17562864211007715. Epub 2021 Apr 12.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, 100070, China.

Background And Aims: Although noninferior to stent retriever (SR) as first-line approach for endovascular treatment (EVT) of acute large vessel occlusion (LVO) stroke, little is known about the current status of direct aspiration (DA) as first-line thrombectomy in China. This analysis of a prospective, nationwide registry (ANGEL-ACT) aimed to investigate the prevalence and comparative effectiveness of DA-first thrombectomy in a real-world practice in China.

Methods: All patients receiving thrombectomy were screened from a prospective cohort of LVO patients undergoing EVT at 111 hospitals in China between November 2017 and March 2019, and divided into two groups based upon which type of thrombectomy was attempted first ("DA-first" and "SR-first"). The following outcome measures were compared using logistic regression models with adjustment: successful recanalization after first-device alone and all procedures, use of rescue treatment, intracranial hemorrhage (ICH) within 24 h, and modified Rankin Scale (mRS) score at 90 days.

Results: A total of 1225 patients, 102 (8.3%) in DA-first group and 1123 (91.7%) in SR-first group, were included. Patients receiving DA-first had less often successful recanalization after first-device alone [30.4 66.4%; odds ratio (OR) = 0.23, 95% confidence interval (CI) = 0.15-0.37], more frequent rescue treatment (62.8 27.0%; OR = 4.55, 95% CI = 2.92-7.08) and ICH (35.4 22.1%; OR = 1.78, 95% CI = 1.12-2.83) than those receiving SR-first; however, no significant difference was found in successful recanalization after all procedures (84.3 90.3%;  = 0.18) and 90-day mRS (median: 3 3 points;  = 0.90) between both groups.

Conclusion: This real-world registry suggested that DA-first thrombectomy for acute stroke patients lagged behind in China during the study period. Far fewer DA-first than SR-first thrombectomies were performed, and DA-first was associated with lower first-device recanalization, more frequently requiring rescue treatment, and increased ICH risk.

Clinical Trial Registration: ClinicalTrials.gov, NCT03370939.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/17562864211007715DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047968PMC
April 2021

Area under the dark adaptation curve as a reliable alternate measure of dark adaptation response.

Br J Ophthalmol 2021 Apr 22. Epub 2021 Apr 22.

Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA.

Purpose: Quantification of dark adaptation (DA) response using the conventional rod intercept time (RIT) requires very long testing time and may not be measurable in the presence of impairments due to diseases such as age-related macular degeneration (AMD). The goal of this study was to investigate the advantages of using area under the DA curve (AUDAC) as an alternative to the conventional parameters to quantify DA response.

Methods: Data on 136 eyes (AMD: 98, normal controls: 38) from an ongoing longitudinal study on AMD were used. DA was measured using the AdaptDx 20 min protocol. AUDAC was computed from the raw DA characteristic curve at different time points, including 6.5 min and 20 min (default). The presence of AMD in the given eye was predicted using a logistic regression model within the leave-one-out cross-validation framework, with DA response as the predictor while adjusting for age and gender. The DA response variable was either the AUDAC values computed at 6.5 min (AUDAC6.5) or at 20 min (AUDAC20) cut-off, or the conventional RIT.

Results: AUDAC6.5 was strongly correlated with AUDAC20 (β=86, p<0.001, R=0.87). The accuracy of predicting the presence of AMD using AUDAC20 was 76%, compared with 79% when using RIT, the current gold standard. In addition, when limiting AUDAC calculation to 6.5 min cut-off, the predictive accuracy of AUDAC6.5 was 80%.

Conclusions: AUDAC can be a valuable measure to quantify the overall DA response and can potentially facilitate shorter testing duration while maintaining diagnostic accuracy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bjophthalmol-2021-318806DOI Listing
April 2021

Forecasting Future Asthma Hospital Encounters of Patients With Asthma in an Academic Health Care System: Predictive Model Development and Secondary Analysis Study.

J Med Internet Res 2021 Apr 16;23(4):e22796. Epub 2021 Apr 16.

Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States.

Background: Asthma affects a large proportion of the population and leads to many hospital encounters involving both hospitalizations and emergency department visits every year. To lower the number of such encounters, many health care systems and health plans deploy predictive models to prospectively identify patients at high risk and offer them care management services for preventive care. However, the previous models do not have sufficient accuracy for serving this purpose well. Embracing the modeling strategy of examining many candidate features, we built a new machine learning model to forecast future asthma hospital encounters of patients with asthma at Intermountain Healthcare, a nonacademic health care system. This model is more accurate than the previously published models. However, it is unclear how well our modeling strategy generalizes to academic health care systems, whose patient composition differs from that of Intermountain Healthcare.

Objective: This study aims to evaluate the generalizability of our modeling strategy to the University of Washington Medicine (UWM), an academic health care system.

Methods: All adult patients with asthma who visited UWM facilities between 2011 and 2018 served as the patient cohort. We considered 234 candidate features. Through a secondary analysis of 82,888 UWM data instances from 2011 to 2018, we built a machine learning model to forecast asthma hospital encounters of patients with asthma in the subsequent 12 months.

Results: Our UWM model yielded an area under the receiver operating characteristic curve (AUC) of 0.902. When placing the cutoff point for making binary classification at the top 10% (1464/14,644) of patients with asthma with the largest forecasted risk, our UWM model yielded an accuracy of 90.6% (13,268/14,644), a sensitivity of 70.2% (153/218), and a specificity of 90.91% (13,115/14,426).

Conclusions: Our modeling strategy showed excellent generalizability to the UWM, leading to a model with an AUC that is higher than all of the AUCs previously reported in the literature for forecasting asthma hospital encounters. After further optimization, our model could be used to facilitate the efficient and effective allocation of asthma care management resources to improve outcomes.

International Registered Report Identifier (irrid): RR2-10.2196/resprot.5039.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/22796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087967PMC
April 2021

Corrigendum: Long-Term Risk Factors for Intracranial In-Stent Restenosis From a Multicenter Trial of Stenting for Symptomatic Intracranial Artery Stenosis Registry in China.

Front Neurol 2021 30;12:673264. Epub 2021 Mar 30.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

[This corrects the article DOI: 10.3389/fneur.2020.601199.].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2021.673264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042608PMC
March 2021

Generalizability of an Automatic Explanation Method for Machine Learning Prediction Results on Asthma-Related Hospital Visits in Patients With Asthma: Quantitative Analysis.

J Med Internet Res 2021 Apr 15;23(4):e24153. Epub 2021 Apr 15.

Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.

Background: Asthma exerts a substantial burden on patients and health care systems. To facilitate preventive care for asthma management and improve patient outcomes, we recently developed two machine learning models, one on Intermountain Healthcare data and the other on Kaiser Permanente Southern California (KPSC) data, to forecast asthma-related hospital visits, including emergency department visits and hospitalizations, in the succeeding 12 months among patients with asthma. As is typical for machine learning approaches, these two models do not explain their forecasting results. To address the interpretability issue of black-box models, we designed an automatic method to offer rule format explanations for the forecasting results of any machine learning model on imbalanced tabular data and to suggest customized interventions with no accuracy loss. Our method worked well for explaining the forecasting results of our Intermountain Healthcare model, but its generalizability to other health care systems remains unknown.

Objective: The objective of this study is to evaluate the generalizability of our automatic explanation method to KPSC for forecasting asthma-related hospital visits.

Methods: Through a secondary analysis of 987,506 data instances from 2012 to 2017 at KPSC, we used our method to explain the forecasting results of our KPSC model and to suggest customized interventions. The patient cohort covered a random sample of 70% of patients with asthma who had a KPSC health plan for any period between 2015 and 2018.

Results: Our method explained the forecasting results for 97.57% (2204/2259) of the patients with asthma who were correctly forecasted to undergo asthma-related hospital visits in the succeeding 12 months.

Conclusions: For forecasting asthma-related hospital visits, our automatic explanation method exhibited an acceptable generalizability to KPSC.

International Registered Report Identifier (irrid): RR2-10.2196/resprot.5039.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/24153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085752PMC
April 2021

Parameter Sensitivity Analysis for the Progressive Sampling-Based Bayesian Optimization Method for Automated Machine Learning Model Selection.

Heterog Data Manag Polystores Anal Healthc (2020) 2021 4;12633:213-227. Epub 2021 Mar 4.

University of Washington, Seattle, WA 98195, USA.

As a key component of automating the entire process of applying machine learning to solve real-world problems, automated machine learning model selection is in great need. Many automated methods have been proposed for machine learning model selection, but their inefficiency poses a major problem for handling large data sets. To expedite automated machine learning model selection and lower its resource requirements, we developed a progressive sampling-based Bayesian optimization (PSBO) method to efficiently automate the selection of machine learning algorithms and hyper-parameter values. Our PSBO method showed good performance in our previous tests and has 20 parameters. Each parameter has its own default value and impacts our PSBO method's performance. It is unclear for each of these parameters, how much room for improvement there is over its default value, how sensitive our PSBO method's performance is to it, and what its safe range is. In this paper, we perform a sensitivity analysis of these 20 parameters to answer these questions. Our results show that these parameters' default values work well. There is not much room for improvement over them. Also, each of these parameters has a reasonably large safe range, within which our PSBO method's performance is insensitive to parameter value changes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/978-3-030-71055-2_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990322PMC
March 2021

A smartphone ocular alignment measurement app in school screening for strabismus.

BMC Ophthalmol 2021 Mar 25;21(1):150. Epub 2021 Mar 25.

Schepens Eye Research Institute, Massachusetts Eye & Ear, Harvard Medical School, Boston, MA, USA.

Background: Strabismus is the leading risk factor for amblyopia, which should be early detected for minimized visual impairment. However, traditional school screening for strabismus can be challenged due to several factors, most notably training, mobility and cost. The purpose of our study is to evaluate the feasibility of using a smartphone application in school vision screening for detection of strabismus.

Methods: The beta smartphone application, EyeTurn, can measure ocular misalignment by computerized Hirschberg test. The application was used by a school nurse in a routine vision screening for 133 elementary school children. All app measurements were reviewed by an ophthalmologist to assess the rate of successful measurement and were flagged for in-person verification with prism alternating cover test (PACT) using a 2.4Δ threshold (root mean squared error of the app). A receiver operating characteristic (ROC) curve was used to determine the best sensitivity and specificity for an 8Δ threshold (recommended by AAPOS) with the PACT measurement as ground truth.

Results: The nurse obtained at least one successful app measurement for 93% of children (125/133). 40 were flagged for PACT, of which 6 were confirmed to have strabismus, including 4 exotropia (10△, 10△, 14△ and 18△), 1 constant esotropia (25△) and 1 accommodative esotropia (14△). Based on the ROC curve, the optimum threshold for the app to detect strabismus was determined to be 3.0△, with the best sensitivity (83.0%), specificity (76.5%). With this threshold the app would have missed one child with accommodative esotriopia, whereas conventional screening missed 3 cases of intermittent extropia.

Conclusions: Results support feasibility of use of the app by personnel without professional training in routine school screenings to improve detection of strabismus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12886-021-01902-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992982PMC
March 2021