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Predicting Heart Rejection Using Histopathological Whole-Slide Imaging and Deep Neural Network with Dropout. 利用组织病理学全切片成像和带Dropout的深度神经网络预测心脏排斥反应。
Li Tong, Ryan Hoffman, Shriprasad R Deshpande, May D Wang

Cardiac allograft rejection is one major limitation for long-term survival for patients with heart transplants. The endomyocardial biopsy is one gold standard to screen heart rejection for patients that have heart transplantation. However, manual identification of heart rejection is expensive and time-consuming. With the development of imaging processing techniques and machine learning tools, automatic prediction of heart rejection using whole-slide images is one promising approach to improve the care of patients with heart transplants. In this paper, we first develop a histopathological whole-slide image processing pipeline to extract features automatically. Then, we construct deep neural networks with and without regularization and dropout to classify the patients into nonrejection and rejection respectively. Our results show that neural networks with regularization and dropout can significantly reduce overfitting and achieve more stable accuracies.

异体心脏移植排斥反应是影响心脏移植患者长期生存的主要因素之一。心内膜肌活检是筛选心脏移植患者心脏排斥反应的金标准。然而,人工鉴定心脏排斥反应既昂贵又耗时。随着图像处理技术和机器学习工具的发展,利用全幻灯片图像自动预测心脏排斥反应是改善心脏移植患者护理的一种有前途的方法。在本文中,我们首先开发了一种组织病理学全幻灯片图像处理流水线来自动提取特征。然后,我们构建了带正则化和不带dropout的深度神经网络,将患者分别分类为非排斥和排斥。我们的研究结果表明,正则化和dropout的神经网络可以显著减少过拟合,并获得更稳定的精度。
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引用次数: 15
Multimodal Ambulatory Sleep Detection. 多模式动态睡眠检测
Weixuan Chen, Akane Sano, Daniel Lopez Martinez, Sara Taylor, Andrew W McHill, Andrew J K Phillips, Laura Barger, Elizabeth B Klerman, Rosalind W Picard

Inadequate sleep affects health in multiple ways. Unobtrusive ambulatory methods to monitor long-term sleep patterns in large populations could be useful for health and policy decisions. This paper presents an algorithm that uses multimodal data from smartphones and wearable technologies to detect sleep/wake state and sleep episode on/offset. We collected 5580 days of multimodal data and applied recurrent neural networks for sleep/wake classification, followed by cross-correlation-based template matching for sleep episode on/offset detection. The method achieved a sleep/wake classification accuracy of 96.5%, and sleep episode on/offset detection F1 scores of 0.85 and 0.82, respectively, with mean errors of 5.3 and 5.5 min, respectively, when compared with sleep/wake state and sleep episode on/offset assessed using actigraphy and sleep diaries.

睡眠不足会在多个方面影响健康。用不显眼的流动方法监测大量人群的长期睡眠模式对健康和政策决策很有帮助。本文介绍了一种利用智能手机和可穿戴技术提供的多模态数据来检测睡眠/觉醒状态和睡眠发作开/关的算法。我们收集了 5580 天的多模态数据,并应用递归神经网络进行睡眠/觉醒分类,然后使用基于交叉相关性的模板匹配进行睡眠发作开/关检测。该方法的睡眠/觉醒分类准确率为96.5%,睡眠发作开始/结束检测F1得分分别为0.85和0.82,与使用动图和睡眠日记评估的睡眠/觉醒状态和睡眠发作开始/结束相比,平均误差分别为5.3和5.5分钟。
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引用次数: 0
Causes of death in the United States, 1999 to 2014. 1999年至2014年美国的死亡原因。
Hanyu Jiang, Hang Wu, May Dongmei Wang

Statistical methods have been widely used in studies of public health. Although useful in clinical research and public health policy making, these methods could not find correlation among health conditions automatically, or capture the temporal evolution of causes of death correctly. To cope with two challenges above, we implement an unsupervised machine learning model, termed topic models, to investigate the mortality data of the United States. Our model successfully groups morbidities based on their correlation, and reveals the temporal evolution of these groups from 1999 to 2014, which are also validated by existing literature. This work could provide a novel view for clinical practitioners to provide more accurate healthcare service, and for public health policymakers to make better policy.

统计方法已广泛应用于公共卫生研究。尽管这些方法在临床研究和公共卫生政策制定中很有用,但它们不能自动发现健康状况之间的相关性,也不能正确捕捉死亡原因的时间演变。为了应对上述两个挑战,我们实施了一种称为主题模型的无监督机器学习模型来调查美国的死亡率数据。我们的模型成功地根据发病率的相关性进行了分组,并揭示了这些分组从1999年到2014年的时间演变,这也得到了现有文献的验证。本研究可为临床医生提供更精准的医疗服务,为公共卫生决策者制定更好的政策提供新的视角。
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引用次数: 2
Agile Model Driven Development of Electronic Health Record-Based Specialty Population Registries. 敏捷模型驱动的基于电子健康记录的专科人口登记的开发。
Vaishnavi Kannan, Jason C Fish, DuWayne L Willett

The transformation of the American healthcare payment system from fee-for-service to value-based care increasingly makes it valuable to develop patient registries for specialized populations, to better assess healthcare quality and costs. Recent widespread adoption of Electronic Health Records (EHRs) in the U.S. now makes possible construction of EHR-based specialty registry data collection tools and reports, previously unfeasible using manual chart abstraction. But the complexities of specialty registry EHR tools and measures, along with the variety of stakeholders involved, can result in misunderstood requirements and frequent product change requests, as users first experience the tools in their actual clinical workflows. Such requirements churn could easily stall progress in specialty registry rollout. Modeling a system's requirements and solution design can be a powerful way to remove ambiguities, facilitate shared understanding, and help evolve a design to meet newly-discovered needs. "Agile Modeling" retains these values while avoiding excessive unused up-front modeling in favor of iterative incremental modeling. Using Agile Modeling principles and practices, in calendar year 2015 one institution developed 58 EHR-based specialty registries, with 111 new data collection tools, supporting 134 clinical process and outcome measures, and enrolling over 16,000 patients. The subset of UML and non-UML models found most consistently useful in designing, building, and iteratively evolving EHR-based specialty registries included User Stories, Domain Models, Use Case Diagrams, Decision Trees, Graphical User Interface Storyboards, Use Case text descriptions, and Solution Class Diagrams.

美国医疗保健支付系统从按服务收费向以价值为基础的医疗服务转变,这使得为专业人群开发患者登记系统变得越来越有价值,从而更好地评估医疗保健质量和成本。最近电子健康记录(EHRs)在美国的广泛采用使得构建基于ehr的专业注册数据收集工具和报告成为可能,而以前使用手动图表抽象是不可行的。但是,专业注册EHR工具和度量的复杂性,以及涉及的利益相关者的多样性,可能导致误解需求和频繁的产品更改请求,因为用户在实际临床工作流程中首次体验这些工具。这样的需求波动很容易阻碍专业注册表的推出。对系统需求和解决方案设计进行建模是一种强大的方法,可以消除歧义,促进共享理解,并帮助改进设计以满足新发现的需求。“敏捷建模”保留了这些值,同时避免了过多的未使用的前期建模,以支持迭代增量建模。利用敏捷建模原则和实践,在2015日历年,一家机构开发了58个基于电子病历的专业登记处,使用111个新的数据收集工具,支持134个临床过程和结果测量,并招募了16,000多名患者。UML和非UML模型的子集在设计、构建和迭代地发展基于ehr的专业注册表中发现了最一致的用途,包括用户故事、领域模型、用例图、决策树、图形用户界面故事板、用例文本描述和解决方案类图。
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引用次数: 9
Integration of Multi-Modal Biomedical Data to Predict Cancer Grade and Patient Survival. 整合多模式生物医学数据预测癌症分级和患者生存。
John H Phan, Ryan Hoffman, Sonal Kothari, Po-Yen Wu, May D Wang

The Big Data era in Biomedical research has resulted in large-cohort data repositories such as The Cancer Genome Atlas (TCGA). These repositories routinely contain hundreds of matched patient samples for genomic, proteomic, imaging, and clinical data modalities, enabling holistic and multi-modal integrative analysis of human disease. Using TCGA renal and ovarian cancer data, we conducted a novel investigation of multi-modal data integration by combining histopathological image and RNA-seq data. We compared the performances of two integrative prediction methods: majority vote and stacked generalization. Results indicate that integration of multiple data modalities improves prediction of cancer grade and outcome. Specifically, stacked generalization, a method that integrates multiple data modalities to produce a single prediction result, outperforms both single-data-modality prediction and majority vote. Moreover, stacked generalization reveals the contribution of each data modality (and specific features within each data modality) to the final prediction result and may provide biological insights to explain prediction performance.

生物医学研究的大数据时代催生了大型队列数据库,如癌症基因组图谱(TCGA)。这些数据库通常包含数百个匹配的患者样本,用于基因组学、蛋白质组学、成像和临床数据模式,从而实现对人类疾病的整体和多模式综合分析。利用TCGA肾癌和卵巢癌数据,我们通过结合组织病理学图像和RNA-seq数据进行了一项多模式数据整合的新研究。我们比较了多数投票和堆叠泛化两种综合预测方法的性能。结果表明,多种数据模式的整合提高了癌症分级和预后的预测。具体来说,堆叠泛化是一种集成多个数据模式以产生单一预测结果的方法,优于单数据模式预测和多数投票。此外,堆叠泛化揭示了每种数据模态(以及每种数据模态中的特定特征)对最终预测结果的贡献,并可能提供解释预测性能的生物学见解。
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引用次数: 13
Supporting novice clinicians cognitive strategies: System design perspective. 支持临床新手认知策略:系统设计视角。
Roosan Islam, Jeanmarie Mayer, Justin Clutter

Infections occur among all clinical domains. The changing nature of microbes, viruses and infections poses a great threat to the overall well-being in medicine. Clinicians in the infectious disease (ID) domain deal with diagnostic as well as treatment uncertainty in their everyday practice. Our current health information technology (HIT) systems do not consider the level of clinician expertise into the system design process. Thus, information is presented to both novice and expert ID clinicians in identical ways. The purpose of this study was to identify the cognitive strategies novice ID clinicians use in managing complex cases to make better recommendations for system design. In the process, we interviewed 14 ID experts and asked them to give us a detailed description of how novice clinicians would have dealt with complex cases. From the interview transcripts, we identified four major themes that expert clinicians suggested about novices' cognitive strategies including: A) dealing with uncertainty, B) lack of higher macrocognition, C) oversimplification of problems through heuristics and D) dealing with peer pressure. Current and future innovative decision support tools embedded in the electronic health record that can match these cognitive strategies may hold the key to cognitively supporting novice clinicians. The results of this study may open up avenues for future research and suggest design directions for better healthcare systems.

感染发生在所有临床领域。微生物、病毒和感染性质的变化对医学的整体福祉构成了巨大威胁。临床医生在传染病(ID)领域处理诊断以及治疗的不确定性在他们的日常实践。我们目前的卫生信息技术(HIT)系统在系统设计过程中没有考虑临床医生的专业知识水平。因此,信息以相同的方式呈现给新手和专家临床医生。本研究的目的是确定新手临床医生在处理复杂病例时使用的认知策略,以便为系统设计提供更好的建议。在此过程中,我们采访了14位ID专家,并请他们详细描述临床医生新手如何处理复杂病例。从访谈记录中,我们确定了专家临床医生对新手认知策略的四个主要主题,包括:A)处理不确定性;B)缺乏更高的宏观认知;C)通过启发式过度简化问题;D)处理同伴压力。当前和未来嵌入在电子健康记录中的创新决策支持工具可以匹配这些认知策略,可能是认知支持新手临床医生的关键。本研究结果可能为未来的研究开辟道路,并为更好的医疗保健系统提供设计方向。
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引用次数: 14
Automated Risk Prediction for Esophageal Optical Endomicroscopic Images. 食管光学内镜图像的自动风险预测。
Sonal Kothari, Hang Wu, Li Tong, Kevin E Woods, May D Wang

Biomedical in vivo imaging has been playing an essential role in diagnoses and treatment in modern medicine. However, compared with the fast development of medical imaging systems, the medical imaging informatics, especially automated prediction, has not been fully explored. In our paper, we compared different feature extraction and classification methods for prediction pipeline to analyze in vivo endomicroscopic images, obtained from patients who are at risks for the development of gastric disease, esophageal adenocarcionoma. Extensive experiment results show that the selected feature representation and prediction algorithms achieved high accuracy in both binary and multi-class prediction tasks.

生物医学体内成像在现代医学诊断和治疗中发挥着重要作用。然而,与医学影像系统的快速发展相比,医学影像信息学特别是自动预测的研究尚未得到充分的探索。在我们的论文中,我们比较了不同的特征提取和分类方法用于预测管道,以分析来自胃疾病,食管腺癌发展风险患者的体内内镜图像。大量的实验结果表明,所选择的特征表示和预测算法在二值和多类预测任务中都取得了较高的精度。
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引用次数: 2
A Fully Implantable, NFC Enabled, Continuous Interstitial Glucose Monitor. 一种完全植入式、近场通信功能、连续间质血糖监测仪。
Nijad Anabtawi, Sabrina Freeman, Rony Ferzli

This work presents an integrated system-on-chip (SoC) that forms the core of a long-term, fully implantable, battery assisted, passive continuous glucose monitor. It integrates an amperometric glucose sensor interface, a near field communication (NFC) wireless front-end and a fully digital switched mode power management unit for supply regulation and on board battery charging. It uses 13.56 MHz (ISM) band to harvest energy and backscatter data to an NFC reader. System was implemented in 14nm CMOS technology and validated with post layout simulations.

这项工作提出了一个集成的片上系统(SoC),它构成了一个长期的、完全可植入的、电池辅助的、被动的连续血糖监测仪的核心。它集成了一个电流葡萄糖传感器接口,一个近场通信(NFC)无线前端和一个全数字开关模式电源管理单元,用于电源调节和车载电池充电。它使用13.56 MHz (ISM)频段来收集能量并将数据反向散射到NFC读取器。系统采用14nm CMOS技术实现,并进行了布局后仿真验证。
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引用次数: 0
Toward patient-tailored summarization of lung cancer literature. 针对患者的肺癌文献综述。
Jean I Garcia-Gathright, Nicholas J Matiasz, Edward B Garon, Denise R Aberle, Ricky K Taira, Alex A T Bui

As the volume of biomedical literature increases, it can be challenging for clinicians to stay up-to-date. Graphical summarization systems help by condensing knowledge into networks of entities and relations. However, existing systems present relations out of context, ignoring key details such as study population. To better support precision medicine, summarization systems should include such information to contextualize and tailor results to individual patients. This paper introduces "contextualized semantic maps" for patient-tailored graphical summarization of published literature. These efforts are demonstrated in the domain of driver mutations in non-small cell lung cancer (NSCLC). A representation for relations and study population context in NSCLC was developed. An annotated gold standard for this representation was created from a set of 135 abstracts; F1-score annotator agreement was 0.78 for context and 0.68 for relations. Visualizing the contextualized relations demonstrated that context facilitates the discovery of key findings that are relevant to patient-oriented queries.

随着生物医学文献数量的增加,对临床医生来说,保持最新是一项挑战。图形总结系统有助于将知识浓缩到实体和关系的网络中。然而,现有的系统呈现出脱离背景的关系,忽略了关键的细节,如研究人口。为了更好地支持精准医疗,摘要系统应该包括这样的信息,以便为个体患者提供背景和定制结果。本文介绍了“语境化语义图”,用于对已发表文献进行个性化的图形化摘要。这些努力在非小细胞肺癌(NSCLC)的驱动突变领域得到证实。建立了非小细胞肺癌关系和研究人群背景的表征。这种表示的注释金标准是从一组135个摘要中创建的;f1评分注解者对上下文的一致性为0.78,对关系的一致性为0.68。可视化上下文化关系表明,上下文有助于发现与面向患者的查询相关的关键发现。
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引用次数: 3
An Auditory Nerve Stimulation Chip with Integrated AFE, Sound Processing, and Power Management for Fully Implantable Cochlear Implants. 一种集成了AFE、声音处理和电源管理的听觉神经刺激芯片,用于完全植入式耳蜗植入。
Nijad Anabtawi, Sabrina Freeman, Rony Ferzli

This paper presents a system on chip for a fully implantable cochlear implant. It includes acoustic sensor front-end, 4-channel digital sound processing and auditory nerve stimulation circuitry. It also features a digital, switched mode, single inductor dual output power supply that generates two regulated voltages; 0.4 V used to supply on-chip digital blocks and 0.9 V to supply analog blocks and charge the battery when an external RF source is detected. All passives are integrated on-chip including the inductor. The system was implemented in 14nm CMOS and validated with post layout simulations.

本文介绍了一种全植入式人工耳蜗的芯片系统。它包括声传感器前端、4通道数字声音处理和听觉神经刺激电路。它还具有数字,开关模式,单电感双输出电源,产生两个稳压;0.4 V用于提供片上数字模块,0.9 V用于提供模拟模块,并在检测到外部射频源时为电池充电。所有的无源元件都集成在芯片上,包括电感器。该系统在14nm CMOS上实现,并通过布局后仿真进行了验证。
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引用次数: 0
期刊
... IEEE-EMBS International Conference on Biomedical and Health Informatics. IEEE-EMBS International Conference on Biomedical and Health Informatics
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