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At least 721 records · Page 40Linked to original sources
PubMed2001

Machine learning for medical diagnosis: history, state of the art and perspective.

The paper provides an overview of the development of intelligent data analysis in medicine from a machine learning perspective: a historical view, a state-of-the-art view, and a view on some future trends in this subfield of applied artificial intelligence. The paper is not intended to provide a comprehensive overview but rather describes some subareas and directions which from my personal point of view seem to be important for applying machine learning in medical diagnosis. In the historical overview, I emphasize the naive Bayesian classifier, neural networks and decision trees. I present a comparison of some state-of-the-art systems, representatives from each branch of machine learning, when applied to several medical diagnostic tasks. The future trends are illustrated by two case studies. The first describes a recently developed method for dealing with reliability of decisions of classifiers, which seems to be promising for intelligent data analysis in medicine. The second describes an approach to using machine learning in order to verify some unexplained phenomena from complementary medicine, which is not (yet) approved by the orthodox medical community but could in the future play an important role in overall medical diagnosis and treatment.

Artificial Intelligence↗
PubMed2002

[Contribution of ovarian and uterine color Doppler in medically assisted reproduction techniques (ART)].

Along the menstrual cycle and during pregnancy, small blood vessels proliferate within the uterus and the ovulating ovary. Angiogenic factors such as VEGF are involved in this phenomenon. In the ovulating ovary, neo-angiogenesis spreads progressively inside the dominant follicle wall and plays a role in the maintenance of the corpus luteum, under the influence of LH (or HCG during pregnancy). In ART, the measure of the blood flow is interesting since it correlates to the number and quality of harvested oocytes. Follicle hypoxia may impair chromosomal organization and separation within the oocyte. This neo-angiogenesis is also important in endometrium, in particular for embryo implantation. Ultrasounds with Doppler allow to estimate the endometrial receptivity, especially in IVF cycles. It is assumed that chance for ongoing pregnancy is almost zero if: endometrial thickness is < 8 mm; uterine pulsatility index (PI) is > 3. Doppler ultrasounds are a useful and even mandatory complement to standard vaginal ultrasonoghraphy in ART. It can be viewed as an indicator of the endometrial and follicular "well-being".

Endometrium↗
PubMed2002

[Above what limits is ART of no avail?].

Legal limits to assisted reproduction technologies are rather blurred. The law of July 1994 only says that people must be "in age of procreation"; medical opposable reference only says that infertility exploration must begin before 45 years. The guide of good practice in ART writes that over 37 only women with normal ovarian reserve must be included in ART programs. So physicians have to fix their own limits, according to success rate and this limit is often 42-43 years for women.

Adult↗
PubMed1999

START: a European state-of-the-art on-line instrument for clinical oncologists.

START ('State-of-the-Art Oncology in Europe'), a freely available resource on the Internet, is a European 'information base' of current clinical approaches to human tumours. Its aim is to help clinical oncologists make appropriate clinical decisions by providing them with updated information reflecting state-of-the-art cancer treatment as perceived by the European oncology community. It is based upon contributions from authors and internal reviewers from all over Europe as selected by START's editorial board under the supervision of an advisory board and a scientific committee. Close collaborations with the main European cancer societies are ongoing. An external feedback process augments the mechanisms for rendering START a truly European instrument. START is concerned with evidence-based cancer medicine, and the main clinical options are thus codified and their bases indicated in accord with a scale worked out from the perspective of clinical decision-making. Therapeutic options may be 'standard', 'investigational', or 'suitable for individual clinical use' (within the context of a decision made jointly by the patient and the physician). The goal of instruments such as START is to improve the quality of patient care. In addition, START hopes to make contributions to the methodology by which medical research is transformed into clinical decisions.

Decision Making↗
PubMed2025

Tracking HIV persistence across T cell lineages during early ART-treated HIV-1-infection using a reservoir-marking humanized mouse model.

Human immunodeficiency virus (HIV) infection depletes CD4 T-cells, and long-term persistence of latent virus prevents full clearance of HIV even in the presence of effective antiretroviral therapy (ART), Here we present the HIV-1-induced lineage tracing (HILT) system, a model that irreversibly marks infected cells within a humanized mouse model, which detects rare latently infected cells. Immunodeficient mice transplanted with genetically modified hematopoietic stem cells develop a human immune system, in which CD4 T-cells contain a genetic switch that permanently labels cells infected by HIV-1 expressing cre-recombinase. Through single-cell RNA sequencing of HILT-marked cells during acute infection and post-ART treatment, we identify distinct CD4+ T-cell transcriptional lineages enriched in either active or latent infections. Comparative gene expression analysis highlights common pathways modulated in both states, including EIF2, Sirtuin, and protein ubiquitination. Critical regulators of these pathways, including JUN, BCL2, and MDM2, change to opposite directions in the two states, highlighting gene expression programs that may support HIV persistence across T-cell lineages and states.

Animals↗
PubMed2000

Collaborative evaluation of the analytical state-of-the-art of platinum, palladium and rhodium determinations in road dust.

In order to control the quality of platinum, palladium and rhodium determinations in road dust, the Standards, Measurements and Testing Programme (formerly BCR) of the European Commission has started a project, the final aim of which is to certify a road dust reference material for its contents of platinum group elements. The first part of this project consisted of an interlaboratory study, which aimed to test the feasibility of the preparation of a candidate road dust reference material and to detect and remove most of the pitfalls observed in platinum, palladium and rhodium determinations. This paper presents the main results of this interlaboratory study carried out prior to the certification campaign. The concordance of the data obtained by the participating laboratories for the three elements was considered to reflect the state-of-the-art and was encouraging enough to decide on the organization of a certification campaign to be conducted during the year 2000. The progress made with respect to the analytical state-of-the-art for these elements will be of great benefit to the quality of measurements carried out in environmental monitoring in this particular field.

Dust↗
PubMed1999

Random reflections on science, art and technique applied to medicine and its evaluation.

Science is aimed at universal knowledge. Art is aimed at action for solving concrete and local problems. Can medical practice therefore ever be a science even when employing important aspects of scientific practice such as precise concepts and vocabulary, and a demand for well-validated facts together with rational reasoning? Evaluation of medical and clinical practices in general has an ambiguous status. According to the domain to be evaluated, it can reach a level of science in providing results of universal value but more often it is closer to art, the results remaining of local interest. There is no strict correlation between the universal-local axis and the practical interest for public health. Epidemiologists should consider these matters very seriously and aim to contribute to, rather than discard, their significance for the advancement of clinical practice.

Clinical Medicine↗
PubMed2003

Details from dignity to decay: facial expression lines in visual arts.

BACKGROUND: A number of dermatologic procedures are intended to reduce facial wrinkles. This article is about wrinkles as a statement of art. OBJECTIVE: This article explores how frown lines and other facial wrinkles are used in visual art to feature personal peculiarities and accentuate specific feelings or moods. Facial lines as an artistic element emerged with advanced painting techniques evolving during the Renaissance and following periods. The skill to paint fine details, the use of light and shadow, and the understanding of space that allowed for a three-dimensional presentation of the human face were essential prerequisites. Painters used facial lines to emphasize respected values such as dignity, determination, diligence, and experience. Facial lines, however, were often accentuated to portrait negative features such as anger, fear, aggression, sadness, exhaustion, and decay. This has reinforced a cultural stigma of facial wrinkles expressing not only age but also misfortune, dismay, or even tragedy. CONCLUSION: Removing wrinkles by dermatologic procedures may not only aim to make people look younger but also to liberate them from unwelcome negative connotations. On the other hand, consideration and care must be taken-especially when interfering with facial muscles-to preserve a natural balance of emotional facial expressions.

Adult↗
PubMed2002

Training and educational approaches to minimally invasive surgery: state of the art.

Current training in minimally invasive surgery (MIS) is inadequate given the demands of patients on practitioners and the number of surgeons and residents who still need to be trained. The training that is provided is neither widespread nor is it standardized, resulting in graduate surgeons with a wide range of competence. There is little guidance in what a training program needs to be effective. We provide a brief review of the state of the art of MIS training with some emphasis given to training methods including perceptual motor training, MIS learning laboratories, virtual reality, evaluation and assessment, cost, simulation fidelity, credentialing, certification, privileging, and ergonomics. We conclude that the state of the art is left wanting.

Certification↗
PubMed2005

[State of the art management of BPSD in dementia].

OBJECTIVE: To obtain a cross-sectional overview of therapeutic practice concerning non-cognitive, behavioral signs and symptoms of dementia (BPSD) in Germany, Austria, and Switzerland. METHOD: We selected 24 psychiatrists (8 from each country) for a questionnaire-based survey with 28 detailed practical questions. RESULTS: Attitudes and preferences were in line with the state of the art as documented in the literature, with the exception of the fact that 30 % of the physicians favored a too brief therapeutic trial with selective serotonin re-uptake inhibitors (SSRIs) for agitation. According to the international literature the preferred treatment of psychotic symptoms in Parkinsons's disease is also a little bit different. Modern atypical antipsychotics, and particularly risperidone, were highly favored for agitation, delirium, psychotic symptoms, and rage outbursts; benzodiazepines (oxazepam and lorazepam), and to an extent also low-potency conventional antipsychotics, were favored only for brief ad hoc medication courses. Anxiety and depressive symptoms were preferentially treated with SSRI, with the exception of short-term therapy of generalized anxiety where benzodiazepines were favored. Benzodiazepines and zolpidem were favored for insomnia without pronounced nocturnal agitation. CONCLUSION: Psychiatrists at memory clinics in German-speaking Europe have therapeutic attitudes and practices that are consistent with the current state of the art.

Alzheimer Disease↗
PubMed2001

Finely crafted distinctions and the art of clinical ethics.

Making finely crafted distinctions and deploying them in intellectually rigorous and clinically applicable judgments define, to a considerable degree, the art of clinical ethics. The papers in this "Clinical Ethics" number of the Journal of Medicine and Philosophy demonstrate the art of clinical ethics in their consideration of respect for autonomy vs. respect for persons, the role of risk in triggering assessment of decisional capacity vs. the role of risk in the concept and assessment of decisional capacity, intention vs. foresight in the clinical management of ectopic pregnancy, preserving life vs. relieving suffering in physician-assisted suicide, and what is essential vs. non-essential in defining the "core areas" of ethics education for members of hospital ethics committees.

Bioethics↗
PubMed2003

State-of-the-art hand hygiene in community medicine.

Hand hygiene becomes more important in community medicine not only since antibiotic resistant bacteria such as MRSA spread within the community. Hands may be colonized with transient microorganism in up to 75%. Among those transient pathogens S. aureus, C. difficile or the hepatitis C virus may be found. During patient care the number of microorganisms on the hands steadily increases. In addition hands may be contaminated with different kinds of germs even if only "clean" activities are carried out. Gloves may be worn but do not provide complete protection from contamination due to leaks. Therefore hands should always be treated after gloves are taken off. State-of-the-art treatment of hands is the hygienic hand disinfection with alcohol-based hand rubs. They are more effective, quicker to carry out, better tolerated by the skin, with a positive effect on compliance, and cost effective in comparison to antiseptic soaps based on chlorhexidine or triclosan and in comparison to normal non-medicated soaps. Healthy skin easily tolerates alcohol-based products from the beginning on. Only health care workers with an underlying irritative contact dermatitis which is often caused by bar or liquid antiseptic soaps may have difficulties to use alcohol-based products initially. In such a case treatment of the underlying skin condition is the way to go and not staying with a preparation which has caused the dermatitis. All this knowledge is now reflected in current guidelines on hand hygiene. Beside liquids alcohol-based gels can be used if they have an antimicrobial activity equal to alcohol-based liquid preparations. Hand hygiene remains the single most important tool to avoid cross transmission of microorganisms between patients. This state-of-the-art hand hygiene should also be emphasized more in community medicine. This review may help to go the first step into this direction.

Alcohols↗
PubMedDate not supplied

Toward building a composite of college student influences with body art.

Body piercing and tattooing flourish on American campuses. The theoretical framework of symbolic interaction and subculture identity were used to examine two similar studies (methods, sample, and tools) for building a composite of influences associated with body art and further understand the psychosocial dimensions. In data from Armstrong, Owen, Roberts, and Koch (2002a, 2002b), and the described study within, four groups of college students (N=908) were formed; those without tattooing (n=419, 81%), and with tattooing (n=97, 19%), and those without body piercing (n=247, 55%) and with body piercing (N=145, 32%). Influences (purpose, image, identity, cues, barriers, family, friends) were examined. All four student groups reported a positive image for the body art. Friends provided major support, whereas family were not as influential. Uniqueness was important, with the major purposes "I just wanted one, express myself, feel unique, be myself, I don't need to impress anyone anymore, and it helps me feel independent."

Adolescent↗
PubMed2000

The importance of the Child Health Services to the health of children: summary of the state-of-the-art document from the Sigtuna conference on Child Health Services with a view to the future.

In September 1999, a state-of-the-art conference was held in Sigtuna outside Stockholm, Sweden. The subject of the conference was the future of the Child Health Services. The approximately 40 participants included researchers from all professions with a link to child healthcare. The conference was prepared by a working committee consisting of Claes Sundelin (chairman), Uppsala, Sven Bremberg, Huddinge, Gisela Dahlqvist, Umeå, Kerstin Hedberg Nyqvist, Uppsala, Anders Håkansson, Malmö, Gunilla Lindmark, Uppsala, Birgitta Wickberg, Göteborg and Maria Nyström Peck (secretary), Stockholm. The state-of-the-art report has recently been published by the National Council for Medical Research and is briefly summarized below.

Child↗
PubMed2000

Tomographic reconstruction of tracer gas concentration profiles in a room with the use of a single OP-FTIR and two iterative algorithms: ART and PWLS.

Computed tomographic (CT) reconstructions of air contaminant concentration fields were conducted in a room-sized chamber employing a single open-path Fourier transform infrared (OP-FTIR) instrument and a combination of 52 flat mirrors and 4 retroreflectors. A total of 56 beam path data were repeatedly collected for around 1 hr while maintaining a stable concentration gradient. The plane of the room was divided into 195 pixels (13 x 15) for reconstruction. The algebraic reconstruction technique (ART) failed to reconstruct the original concentration gradient patterns for most cases. These poor results were caused by the "highly underdetermined condition" in which the number of unknown values (156 pixels) exceeds that of known data (56 path integral concentrations) in the experimental setting. A new CT algorithm, called the penalized weighted least-squares (PWLS), was applied to remedy this condition. The peak locations were correctly positioned in the PWLS-CT reconstructions. A notable feature of the PWLS-CT reconstructions was a significant reduction of highly irregular noise peaks found in the ART-CT reconstructions. However, the peak heights were slightly reduced in the PWLS-CT reconstructions due to the nature of the PWLS algorithm. PWLS could converge on the original concentration gradient even when a fairly high error was embedded into some experimentally measured path integral concentrations. It was also found in the simulation tests that the PWLS algorithm was very robust with respect to random errors in the path integral concentrations. This beam geometry and the use of a single OP-FTIR scanning system, in combination with the PWLS algorithm, is a system applicable to both environmental and industrial settings.

Air Pollution, Indoor↗
PubMed1979

Application of ART to time-coded emission tomography.

Devices for single-photon emission tomography currently take projections either in a plane over a full angular range (0--360 degrees) or in a volume with a limited angular range. The planar, pseudo-random, time-coded aperture, in conjunction with an Anger camera, is a device of the limited angular range type. It employs multiple pinholes whose transmission varies as a function of time. Previously, image reconstruction was accomplished by simple back-projection of coefficients obtained by time-correlating pinhole transmission with detector-element count rate, resulting in a low-contrast image. Using the Algebraic Reconstruction Technique (ART) a method is introduced for division of the correlation coefficients into subsets allowing the three-dimensional reconstruction to be accomplished on a minicomputer. Results from simulations and experimental phantom data show that ART improves depth resolution compared to back-projection, that under-relaxation produces better images in the case of noisy data, and that the division of the correlation coefficients into subsets has no effect on quality. The images depict the expected resolution degradation in the direction normal to the detector plane due to the limited angular range of projections but yield quantitative results whose relative values are good, even though attenuation is neglected.

Mathematics↗
PubMed1996

Computed tomography using algebraic reconstruction techniques (ARTs) with different projection access schemes: a comparison study under practical situations.

In a previous report we presented a novel ART technique with the projections arranged and accessed in a multilevel scheme (MLS) for efficient algebraic image reconstruction, but whether the scheme is still superior in real situations where the data are noisy is unknown. In this paper, we make a detailed comparison between MLS and the other two conventional projection access orderings in ART: the random permutation scheme (RPS) and the sequential access scheme (SAS). By simulating reconstructions of a human head using different sizes of detector, taking different numbers of projections, each measurement under a different number of photons, a full mapping of the reconstruction accuracy measured by correlation coefficient for the three schemes has been made. Test results demonstrate that one-iteration MLS produces the best reconstruction in many situations. It outperforms one-iteration RPS when the noise level is low. SAS in many cases can never attain the image quality of one-iteration MLS, even with many more iterations. A convergence test using different initial guesses also demonstrates that MLS has less initial dependence. In the Fourier domain, it also represents an efficient and fast implementation of the Fourier slice theorem.

Adult↗
PubMed1998

Feasibility of megavoltage portal CT using an electronic portal imaging device (EPID) and a multi-level scheme algebraic reconstruction technique (MLS-ART).

Although electronic portal imaging devices (EPIDs) are efficient tools for radiation therapy verification, they only provide images of overlapped anatomic structures. We investigated using a fluorescent screen/CCD-based EPID, coupled with a novel multi-level scheme algebraic reconstruction technique (MLS-ART), for a feasibility study of portal computed tomography (CT) reconstructions. The CT images might be useful for radiation treatment planning and verification. We used an EPID, set it to work at the linear dynamic range and collimated 6 MV photons from a linear accelerator to a slit beam of 1 cm wide and 25 cm long. We performed scans under a total of approximately 200 monitor units (MUs) for several phantoms in which we varied the number of projections and MUs per projection. The reconstructed images demonstrated that using the new MLS-ART technique megavoltage portal CT with a total of 200 MUs can achieve a contrast detectibility of approximately 2.5% (object size 5 mm x 5 mm) and a spatial resolution of 2.5 mm.

Algorithms↗