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Automated Multi-Class Facial Syndrome Classification Using Transfer Learning Techniques. 利用迁移学习技术自动进行多类面部综合征分类。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-13 DOI: 10.3390/bioengineering11080827
Fayroz F Sherif, Nahed Tawfik, Doaa Mousa, Mohamed S Abdallah, Young-Im Cho

Genetic disorders affect over 6% of the global population and pose substantial obstacles to healthcare systems. Early identification of these rare facial genetic disorders is essential for managing related medical complexities and health issues. Many people consider the existing screening techniques inadequate, often leading to a diagnosis several years after birth. This study evaluated the efficacy of deep learning-based classifier models for accurately recognizing dysmorphic characteristics using facial photos. This study proposes a multi-class facial syndrome classification framework that encompasses a unique combination of diseases not previously examined together. The study focused on distinguishing between individuals with four specific genetic disorders (Down syndrome, Noonan syndrome, Turner syndrome, and Williams syndrome) and healthy controls. We investigated how well fine-tuning a few well-known convolutional neural network (CNN)-based pre-trained models-including VGG16, ResNet-50, ResNet152, and VGG-Face-worked for the multi-class facial syndrome classification task. We obtained the most encouraging results by adjusting the VGG-Face model. The proposed fine-tuned VGG-Face model not only demonstrated the best performance in this study, but it also performed better than other state-of-the-art pre-trained CNN models for the multi-class facial syndrome classification task. The fine-tuned model achieved both accuracy and an F1-Score of 90%, indicating significant progress in accurately detecting the specified genetic disorders.

遗传疾病影响着全球 6% 以上的人口,给医疗保健系统带来了巨大障碍。及早发现这些罕见的面部遗传疾病对于处理相关的复杂医疗问题和健康问题至关重要。许多人认为现有的筛查技术不够完善,往往导致出生后数年才能确诊。本研究评估了基于深度学习的分类器模型在使用面部照片准确识别畸形特征方面的功效。本研究提出了一种多类面部综合征分类框架,它包含了以前未一起研究过的疾病的独特组合。研究重点是区分四种特定遗传疾病(唐氏综合征、努南综合征、特纳综合征和威廉姆斯综合征)患者和健康对照组。我们研究了微调几个著名的基于卷积神经网络(CNN)的预训练模型(包括 VGG16、ResNet-50、ResNet152 和 VGG-Face)在多类面部综合征分类任务中的效果。我们通过调整 VGG-Face 模型获得了最令人鼓舞的结果。经过微调的 VGG-Face 模型不仅在本研究中表现最佳,而且在多类面部综合征分类任务中的表现也优于其他最先进的预训练 CNN 模型。微调模型的准确率和 F1 分数均达到了 90%,这表明它在准确检测特定遗传疾病方面取得了重大进展。
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引用次数: 0
Bioengineering Human Upper Respiratory Mucosa: A Systematic Review of the State of the Art of Cell Culture Techniques. 人体上呼吸道黏膜生物工程:细胞培养技术现状的系统回顾》。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-13 DOI: 10.3390/bioengineering11080826
Davaine Joel Ndongo Sonfack, Clémence Tanguay Boivin, Lydia Touzel Deschênes, Thibault Maurand, Célina Maguemoun, François Berthod, François Gros-Louis, Pierre-Olivier Champagne

Background: The upper respiratory mucosa plays a crucial role in both the physical integrity and immunological function of the respiratory tract. However, in certain situations such as infections, trauma, or surgery, it might sustain damage. Tissue engineering, a field of regenerative medicine, has found applications in various medical fields including but not limited to plastic surgery, ophthalmology, and urology. However, its application to the respiratory system remains somewhat difficult due to the complex morphology and histology of the upper respiratory tract. To date, a culture protocol for producing a handleable, well-differentiated nasal mucosa has yet to be developed. The objective of this review is to describe the current state of research pertaining to cell culture techniques used for producing autologous healthy human upper respiratory cells and mucosal tissues, as well as describe its clinical applications.

Methods: A search of the relevant literature was carried out with no time restriction across Embase, Cochrane, PubMed, and Medline Ovid databases. Keywords related to "respiratory mucosa" and "culture techniques of the human airway" were the focus of the search strategy for this review. The risk of bias in retained studies was assessed using the Joanna Briggs Institute's (JBI) critical appraisal tools for qualitative research. A narrative synthesis of our results was then conducted.

Results: A total of 33 studies were included in this review, and thirteen of these focused solely on developing a cell culture protocol without further use. The rest of the studies used their own developed protocol for various applications such as cystic fibrosis, pharmacological, and viral research. One study was able to develop a promising model for nasal mucosa that could be employed as a replacement in nasotracheal reconstructive surgery.

Conclusions: This systematic review extensively explored the current state of research regarding cell culture techniques for producing tissue-engineered nasal mucosa. Bioengineering the nasal mucosa holds great potential for clinical use. However, further research on mechanical properties is essential, as the comparison of engineered tissues is currently focused on morphology rather than comprehensive mechanical assessments.

背景:上呼吸道粘膜对呼吸道的物理完整性和免疫功能起着至关重要的作用。然而,在某些情况下,如感染、创伤或手术,上呼吸道粘膜可能会受到损伤。组织工程是再生医学的一个领域,已被应用于多个医学领域,包括但不限于整形外科、眼科和泌尿科。然而,由于上呼吸道的形态和组织结构复杂,将其应用于呼吸系统仍有一定难度。迄今为止,还没有开发出一种可处理的、分化良好的鼻粘膜培养方案。本综述旨在描述用于生产自体健康人上呼吸道细胞和粘膜组织的细胞培养技术的研究现状,并介绍其临床应用:方法:在 Embase、Cochrane、PubMed 和 Medline Ovid 数据库中对相关文献进行了无时间限制的检索。与 "呼吸道粘膜 "和 "人体气道培养技术 "相关的关键词是本综述检索策略的重点。采用乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的定性研究批判性评估工具对保留研究的偏倚风险进行了评估。然后对结果进行了叙述性综合:本综述共纳入 33 项研究,其中 13 项研究仅关注细胞培养方案的制定,而没有进一步的使用。其余的研究则将自己开发的方案用于囊性纤维化、药理学和病毒研究等不同应用领域。有一项研究开发出了一种很有前景的鼻黏膜模型,可在鼻气管重建手术中用作替代物:本系统综述广泛探讨了细胞培养技术用于生产组织工程鼻黏膜的研究现状。鼻黏膜生物工程在临床应用方面潜力巨大。然而,由于目前对工程组织的比较主要集中在形态学上,而非全面的机械评估,因此进一步研究机械性能至关重要。
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引用次数: 0
Perlecan: An Islet Basement Membrane Protein with Protective Anti-Inflammatory Characteristics. Perlecan:具有保护性抗炎特性的胰岛基底膜蛋白
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-13 DOI: 10.3390/bioengineering11080828
Daniel Brandhorst, Heide Brandhorst, Samuel Acreman, Paul R V Johnson

Throughout the isolation process, human islets are subjected to destruction of the islet basement membrane (BM) and reduced oxygen supply. Reconstruction of the BM represents an option to improve islet function and survival post-transplant and may particularly be relevant for islet encapsulation devices and scaffolds. In the present study, we assessed whether Perlecan, used alone or combined with the BM proteins (BMPs) Collagen-IV and Laminin-521, has the ability to protect isolated human islets from hypoxia-induced damage. Islets isolated from the pancreas of seven different organ donors were cultured for 4-5 days at 2% oxygen in plain CMRL (sham-treated controls) or in CMRL supplemented with BMPs used either alone or in combination. Postculture, islets were characterized regarding survival, in vitro function and production of chemokines and reactive oxygen species (ROS). Individually added BMPs significantly doubled islet survival and increased in vitro function. Combining BMPs did not provide a synergistic effect. Among the tested BMPs, Perlecan demonstrated the significantly strongest inhibitory effect on chemokine and ROS production when compared with sham-treatment (p < 0.001). Perlecan may be useful to improve islet survival prior to and after transplantation. Its anti-inflammatory potency should be considered to optimise encapsulation and scaffolds to protect isolated human islets post-transplant.

在整个分离过程中,人体胰岛都会受到胰岛基底膜(BM)的破坏和氧气供应的减少。重建基底膜是改善胰岛功能和移植后存活率的一种选择,尤其适用于胰岛封装装置和支架。在本研究中,我们评估了单独使用或与基质蛋白(BMP)胶原蛋白-IV 和层粘连蛋白-521 结合使用的 Perlecan 是否有能力保护离体人胰岛免受缺氧引起的损伤。从七名不同器官捐献者的胰腺中分离出的小胰岛在2%的氧气条件下在普通CMRL(假处理对照组)或单独或混合使用BMPs的CMRL中培养4-5天。培养后,对胰岛的存活率、体外功能以及趋化因子和活性氧(ROS)的产生情况进行鉴定。单独添加的 BMPs 能明显提高胰岛存活率一倍,并增强体外功能。联合使用 BMPs 并不能产生协同效应。在测试的 BMPs 中,与假处理相比,Perlecan 对趋化因子和 ROS 生成的抑制作用明显最强(p < 0.001)。Perlecan可能有助于提高胰岛移植前后的存活率。在优化封装和支架以保护移植后的离体人胰岛时,应考虑其抗炎性能。
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引用次数: 0
Evolution of Retinal Neuron Fractality When Interfacing with Carbon Nanotube Electrodes. 与碳纳米管电极连接时视网膜神经元断裂的演变
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080823
Aiden P Dillon, Saba Moslehi, Bret Brouse, Saumya Keremane, Sam Philliber, Willem Griffiths, Conor Rowland, Julian H Smith, Richard P Taylor

Exploring how neurons in the mammalian body interact with the artificial interface of implants can be used to learn about fundamental cell behavior and to refine medical applications. For fundamental and applied research, it is crucial to determine the conditions that encourage neurons to maintain their natural behavior during interactions with non-natural interfaces. Our previous investigations quantified the deterioration of neuronal connectivity when their dendrites deviate from their natural fractal geometry. Fractal resonance proposes that neurons will exhibit enhanced connectivity if an implant's electrode geometry is matched to the fractal geometry of the neurons. Here, we use in vitro imaging to quantify the fractal geometry of mouse retinal neurons and show that they change during interaction with the electrode. Our results demonstrate that it is crucial to understand these changes in the fractal properties of neurons for fractal resonance to be effective in the in vivo mammalian system.

探索哺乳动物体内的神经元如何与人工植入界面相互作用,可用于了解细胞的基本行为并完善医疗应用。对于基础研究和应用研究来说,确定促使神经元在与非自然界面相互作用时保持其自然行为的条件至关重要。我们之前的研究量化了神经元树突偏离其自然分形几何形状时神经元连接性的恶化情况。分形共振认为,如果植入物的电极几何形状与神经元的分形几何形状相匹配,神经元将表现出更强的连接性。在这里,我们利用体外成像技术量化了小鼠视网膜神经元的分形几何,并证明它们在与电极相互作用的过程中会发生变化。我们的研究结果表明,要使分形共振在体内哺乳动物系统中有效,了解神经元分形特性的这些变化至关重要。
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引用次数: 0
Advancements in Biomedical and Bioengineering Technologies in Sports Monitoring and Healthcare. 生物医学和生物工程技术在运动监测和医疗保健中的应用进展。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080816
Yaodong Gu, Justin Fernandez

The intersection of biomedical and bioengineering technologies with sports monitoring and healthcare has recently emerged as a key area of innovation and research [...].

最近,生物医学和生物工程技术与运动监测和医疗保健的交叉已成为创新和研究的一个关键领域 [...] 。
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引用次数: 0
Toward Fully Automated Personalized Orthopedic Treatments: Innovations and Interdisciplinary Gaps. 迈向全自动个性化矫形治疗:创新与跨学科差距。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080817
Yunhua Luo

Personalized orthopedic devices are increasingly favored for their potential to enhance long-term treatment success. Despite significant advancements across various disciplines, the seamless integration and full automation of personalized orthopedic treatments remain elusive. This paper identifies key interdisciplinary gaps in integrating and automating advanced technologies for personalized orthopedic treatment. It begins by outlining the standard clinical practices in orthopedic treatments and the extent of personalization achievable. The paper then explores recent innovations in artificial intelligence, biomaterials, genomic and proteomic analyses, lab-on-a-chip, medical imaging, image-based biomechanical finite element modeling, biomimicry, 3D printing and bioprinting, and implantable sensors, emphasizing their contributions to personalized treatments. Tentative strategies or solutions are proposed to address the interdisciplinary gaps by utilizing innovative technologies. The key findings highlight the need for the non-invasive quantitative assessment of bone quality, patient-specific biocompatibility, and device designs that address individual biological and mechanical conditions. This comprehensive review underscores the transformative potential of these technologies and the importance of multidisciplinary collaboration to integrate and automate them into a cohesive, intelligent system for personalized orthopedic treatments.

个性化矫形设备因其提高长期治疗成功率的潜力而日益受到青睐。尽管各学科都取得了重大进展,但个性化矫形治疗的无缝集成和完全自动化仍然遥遥无期。本文指出了在整合和自动化先进技术进行个性化矫形治疗方面存在的主要跨学科差距。本文首先概述了骨科治疗的标准临床实践和可实现的个性化程度。然后,论文探讨了人工智能、生物材料、基因组和蛋白质组分析、芯片实验室、医学成像、基于图像的生物力学有限元建模、仿生学、3D 打印和生物打印以及植入式传感器等方面的最新创新,强调了它们对个性化治疗的贡献。报告提出了利用创新技术解决跨学科差距的初步战略或解决方案。主要研究结果强调了对骨质无创定量评估、患者特定生物兼容性以及针对个体生物和机械条件的设备设计的需求。这篇全面的综述强调了这些技术的变革潜力,以及多学科合作将这些技术整合并自动化为一个具有凝聚力的智能系统以实现个性化矫形治疗的重要性。
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引用次数: 0
Biomechanical Study of Symmetric Bending and Lifting Behavior in Weightlifter with Lumbar L4-L5 Disc Herniation and Physiological Straightening Using Finite Element Simulation. 利用有限元模拟对腰椎 4-L5 椎间盘突出症和生理伸直的举重运动员的对称弯曲和举重行为进行生物力学研究。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080825
Caiting Zhang, Yang Song, Qiaolin Zhang, Ee-Chon Teo, Wei Liu

Background: Physiological curvature changes of the lumbar spine and disc herniation can cause abnormal biomechanical responses of the lumbar spine. Finite element (FE) studies on special weightlifter models are limited, yet understanding stress in damaged lumbar spines is crucial for preventing and rehabilitating lumbar diseases. This study analyzes the biomechanical responses of a weightlifter with lumbar straightening and L4-L5 disc herniation during symmetric bending and lifting to optimize training and rehabilitation.

Methods: Based on the weightlifter's computed tomography (CT) data, an FE lumbar spine model (L1-L5) was established. The model included normal intervertebral discs (IVDs), vertebral endplates, ligaments, and a degenerated L4-L5 disc. The bending angle was set to 45°, and weights of 15 kg, 20 kg, and 25 kg were used. The flexion moment for lifting these weights was theoretically calculated. The model was tilted at 45° in Abaqus 2021 (Dassault Systèmes Simulia Corp., Johnston, RI, USA), with L5 constrained in all six degrees of freedom. A vertical load equivalent to the weightlifter's body mass and the calculated flexion moments were applied to L1 to simulate the weightlifter's bending and lifting behavior. Biomechanical responses within the lumbar spine were then analyzed.

Results: The displacement and range of motion (ROM) of the lumbar spine were similar under all three loading conditions. The flexion degree increased with the load, while extension remained unchanged. Right-side movement and bending showed minimal change, with slightly more right rotation. Stress distribution trends were similar across loads, primarily concentrated in the vertebral body, increasing with load. Maximum stress occurred at the anterior inferior margin of L5, with significant stress at the posterior joints, ligaments, and spinous processes. The posterior L5 and margins of L1 and L5 experienced high stress. The degenerated L4-L5 IVD showed stress concentration on its edges, with significant stress also on L3-L4 IVD. Stress distribution in the lumbar spine was uneven.

Conclusions: Our findings highlight the impact on spinal biomechanics and suggest reducing anisotropic loading and being cautious of loaded flexion positions affecting posterior joints, IVDs, and vertebrae. This study offers valuable insights for the rehabilitation and treatment of similar patients.

背景:腰椎的生理弯曲变化和椎间盘突出会导致腰椎的生物力学反应异常。针对特殊举重运动员模型的有限元(FE)研究非常有限,但了解受损腰椎的应力对于预防和康复腰椎疾病至关重要。本研究分析了腰椎变直和 L4-L5 椎间盘突出的举重运动员在对称弯曲和举重过程中的生物力学反应,以优化训练和康复:方法:根据举重运动员的计算机断层扫描(CT)数据,建立了一个腰椎(L1-L5)FE模型。该模型包括正常的椎间盘(IVD)、椎体终板、韧带和退化的 L4-L5 椎间盘。弯曲角度设定为 45°,重量分别为 15 千克、20 千克和 25 千克。举起这些重物的屈曲力矩是通过理论计算得出的。模型在 Abaqus 2021(Dassault Systèmes Simulia Corp., Johnston, RI, USA)中倾斜 45°,L5 在所有六个自由度上都受到约束。在 L1 上施加了相当于举重运动员体重的垂直负载和计算得出的屈曲力矩,以模拟举重运动员的弯曲和举重行为。然后对腰椎的生物力学反应进行分析:结果:在三种负载条件下,腰椎的位移和运动范围(ROM)相似。屈曲度随着负荷的增加而增加,而伸展度保持不变。右侧移动和弯曲的变化极小,右旋略有增加。各种负荷下的应力分布趋势相似,主要集中在椎体,并随着负荷的增加而增加。最大应力出现在 L5 椎体的前下缘,后关节、韧带和棘突也有很大应力。L5 后部以及 L1 和 L5 的边缘承受着较大的应力。变性的 L4-L5 IVD 显示应力集中在其边缘,L3-L4 IVD 也有很大的应力。腰椎的应力分布不均匀:我们的研究结果凸显了对脊柱生物力学的影响,并建议减少各向异性负荷,谨慎对待影响后关节、IVD 和椎体的负荷屈曲位置。这项研究为类似患者的康复和治疗提供了宝贵的见解。
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引用次数: 0
Deciphering Factors Contributing to Cost-Effective Medicine Using Machine Learning. 利用机器学习破译提高医疗成本效益的因素。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080818
Bowen Long, Jinfeng Zhou, Fangya Tan, Srikar Bellur

This study uses machine learning to identify critical factors influencing the cost-effectiveness of over-the-counter (OTC) medications. By developing a novel cost-effectiveness rating (CER) based on user ratings and prices, we analyzed data from Amazon. The findings indicate that Flexible Spending Account (FSA)/Health Savings Account (HSA) eligibility, symptom treatment range, safety warnings, special effects, active ingredients, and packaging size significantly impact cost-effectiveness across cold, allergy, digestion, and pain relief medications. Medications eligible for FSA or HSA funds, treating a broader range of symptoms, and having smaller packaging are perceived as more cost-effective. Cold medicines with safety warnings were cost-effective due to their lower average price and effective ingredients like phenylephrine and acetaminophen. Allergy medications with kid-friendly features showed higher cost-effectiveness, and ingredients like calcium, famotidine, and magnesium boosted the cost-effectiveness of digestion medicines. These insights help consumers make informed purchasing decisions and assist manufacturers and retailers in enhancing product competitiveness. Overall, this research supports better decision-making in the pharmaceutical industry by highlighting factors that drive cost-effective medication purchases.

本研究利用机器学习识别影响非处方药(OTC)成本效益的关键因素。通过开发基于用户评分和价格的新型成本效益评级(CER),我们分析了亚马逊的数据。研究结果表明,灵活支出账户(FSA)/健康储蓄账户(HSA)资格、症状治疗范围、安全警告、特殊效果、活性成分和包装尺寸对感冒、过敏、消化和止痛药物的成本效益有显著影响。符合 FSA 或 HSA 资助条件、治疗症状范围更广、包装更小的药品被认为更具成本效益。有安全警示的感冒药由于平均价格较低,且含有苯肾上腺素和对乙酰氨基酚等有效成分,因此性价比较高。带有儿童友好功能的抗过敏药物具有更高的成本效益,而钙、法莫替丁和镁等成分则提高了消化药物的成本效益。这些见解有助于消费者做出明智的购买决策,并帮助制造商和零售商提高产品竞争力。总之,这项研究通过强调推动高性价比药品购买的因素,为制药行业做出更好的决策提供了支持。
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引用次数: 0
Initial Clinical Experience with Ahmed Valve in Romania: Five-Year Patient Follow-Up and Outcomes. 罗马尼亚使用艾哈迈德瓣膜的初步临床经验:五年患者随访及结果。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080820
Ramona Ileana Barac, Vasile Harghel, Nicoleta Anton, George Baltă, Ioana Teodora Tofolean, Christiana Dragosloveanu, Laurențiu Flavius Leuștean, Dan George Deleanu, Diana Andreea Barac

Background: Glaucoma is a leading cause of irreversible blindness worldwide and is particularly challenging to treat in its refractory forms. The Ahmed valve offers a potential solution for these difficult cases. This research aims to assess the initial clinical experience with Ahmed valve implantation in Romania, evaluating its effectiveness, associated complications, and overall patient outcomes over a five-year period.

Methods: We conducted a prospective study on 50 patients who underwent Ahmed valve implantation due to various types of glaucoma. Patients were monitored at several intervals, up to five years post-surgery. Intraocular pressure and visual acuity were the primary measures of success.

Results: On average, patients maintained the intraocular pressure within the targeted range, with the mean intraocular pressure being 17 mmHg 5 years post-surgery. Success, defined as maintaining target intraocular pressure without additional surgery, was achieved in 82% at 1 year, 68% at 3 years, and 60% after 5 years postoperative.

Conclusion: Ahmed valve implantation is a viable treatment option for refractory glaucoma, demonstrating significant intraocular pressure reduction and manageable complication rates over a five-year follow-up period. Future research should focus on long-term outcomes and optimization of surgical techniques to further reduce complication rates and improve patient quality of life.

背景:青光眼是导致全球不可逆失明的主要原因之一,其难治性尤其具有挑战性。艾哈迈德瓣膜为这些疑难病例提供了潜在的解决方案。本研究旨在评估在罗马尼亚进行艾哈迈德瓣膜植入术的初步临床经验,评价其有效性、相关并发症以及五年内患者的总体疗效:我们对 50 名因各种类型的青光眼而接受艾哈迈德瓣膜植入术的患者进行了前瞻性研究。我们在手术后的五年内对患者进行了多次监测。眼压和视力是衡量手术成功与否的主要指标:结果:平均而言,患者的眼压保持在目标范围内,术后 5 年的平均眼压为 17 mmHg。术后 1 年成功率为 82%,3 年成功率为 68%,5 年后成功率为 60%:艾哈迈德瓣膜植入术是治疗难治性青光眼的一种可行方法,在五年的随访期间,眼压明显下降,并发症发生率也在可控范围内。未来的研究应侧重于长期疗效和手术技术的优化,以进一步降低并发症发生率,提高患者的生活质量。
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引用次数: 0
Assessing the Value of Imaging Data in Machine Learning Models to Predict Patient-Reported Outcome Measures in Knee Osteoarthritis Patients. 评估成像数据在机器学习模型中的价值,以预测膝关节骨性关节炎患者的患者报告结果指标。
IF 3.8 3区 医学 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-12 DOI: 10.3390/bioengineering11080824
Abhinav Nair, M Abdulhadi Alagha, Justin Cobb, Gareth Jones

Knee osteoarthritis (OA) affects over 650 million patients worldwide. Total knee replacement is aimed at end-stage OA to relieve symptoms of pain, stiffness and reduced mobility. However, the role of imaging modalities in monitoring symptomatic disease progression remains unclear. This study aimed to compare machine learning (ML) models, with and without imaging features, in predicting the two-year Western Ontario and McMaster Universities Arthritis Index (WOMAC) score for knee OA patients. We included 2408 patients from the Osteoarthritis Initiative (OAI) database, with 629 patients from the Multicenter Osteoarthritis Study (MOST) database. The clinical dataset included 18 clinical features, while the imaging dataset contained an additional 10 imaging features. Minimal Clinically Important Difference (MCID) was set to 24, reflecting meaningful physical impairment. Clinical and imaging dataset models produced similar area under curve (AUC) scores, highlighting low differences in performance AUC < 0.025). For both clinical and imaging datasets, Gradient Boosting Machine (GBM) models performed the best in the external validation, with a clinically acceptable AUC of 0.734 (95% CI 0.687-0.781) and 0.747 (95% CI 0.701-0.792), respectively. The five features identified included educational background, family history of osteoarthritis, co-morbidities, use of osteoporosis medications and previous knee procedures. This is the first study to demonstrate that ML models achieve comparable performance with and without imaging features.

膝关节骨关节炎(OA)影响着全球 6.5 亿多患者。全膝关节置换术主要针对终末期 OA,以缓解疼痛、僵硬和行动不便等症状。然而,成像模式在监测症状性疾病进展方面的作用仍不明确。本研究旨在比较有成像特征和无成像特征的机器学习(ML)模型在预测膝关节OA患者两年后的西安大略和麦克马斯特大学关节炎指数(WOMAC)评分方面的作用。我们纳入了骨关节炎倡议(OAI)数据库中的2408名患者和多中心骨关节炎研究(MOST)数据库中的629名患者。临床数据集包括 18 个临床特征,而成像数据集则包括另外 10 个成像特征。最小临床意义差异(MCID)设定为 24,反映了有意义的身体损伤。临床数据集和成像数据集模型产生了相似的曲线下面积(AUC)得分,突出显示了较低的性能差异(AUC < 0.025)。对于临床和成像数据集,梯度提升机(GBM)模型在外部验证中表现最佳,其临床可接受的 AUC 分别为 0.734(95% CI 0.687-0.781)和 0.747(95% CI 0.701-0.792)。确定的五个特征包括教育背景、骨关节炎家族史、合并疾病、使用骨质疏松症药物和既往膝关节手术。这是第一项证明有成像特征和无成像特征的 ML 模型性能相当的研究。
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