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MedRxiv : the Preprint Server For... Jun 2024Chronic liver disease affects more than 1.5 billion adults worldwide, however the majority of cases are asymptomatic and undiagnosed. Echocardiography is broadly...
IMPORTANCE
Chronic liver disease affects more than 1.5 billion adults worldwide, however the majority of cases are asymptomatic and undiagnosed. Echocardiography is broadly performed and visualizes the liver; but this information is not leveraged.
OBJECTIVE
To develop and evaluate a deep learning algorithm on echocardiography videos to enable opportunistic screening for chronic liver disease.
DESIGN
Retrospective observational cohorts.
SETTING
Two large urban academic medical centers.
PARTICIPANTS
Adult patients who received echocardiography and abdominal imaging (either abdominal ultrasound or abdominal magnetic resonance imaging) with ≤30 days between tests, between July 4, 2012, to June 4, 2022.
EXPOSURE
Deep learning model predictions from a deep-learning computer vision pipeline that identifies subcostal view echocardiogram videos and detects the presence of cirrhosis or steatotic liver disease (SLD).
MAIN OUTCOME AND MEASURES
Clinical diagnosis by paired abdominal ultrasound or magnetic resonance imaging (MRI).
RESULTS
A total of 1,596,640 echocardiogram videos (66,922 studies from 24,276 patients) from Cedars-Sinai Medical Center (CSMC) were used to develop EchoNet-Liver, an automated pipeline that identifies high quality subcostal images from echocardiogram studies and detects the presence of cirrhosis or SLD. In the held-out CSMC test cohort, EchoNet-Liver was able to detect the presence of cirrhosis with an AUC of 0.837 (0.789 - 0.880) and SLD with an AUC of 0.799 (0.758 - 0.837). In a separate test cohort with paired abdominal MRIs, cirrhosis was detected with an AUC of 0.704 (0.689-0.718) and SLD was detected with an AUC of 0.726 (0.659-0.790). In an external test cohort of 106 patients (n = 5,280 videos), the model detected cirrhosis with an AUC of 0.830 (0.738 - 0.909) and SLD with an AUC of 0.768 (0.652 - 0.875).
CONCLUSIONS AND RELEVANCE
Deep learning assessment of clinical echocardiography enables opportunistic screening of SLD and cirrhosis. Application of this algorithm may identify patients who may benefit from further diagnostic testing and treatment for chronic liver disease.
KEY POINTS
Can a deep learning algorithm applied to echocardiography videos effectively identify chronic liver diseases including cirrhosis and steatotic liver disease (SLD)? This retrospective observational cohort study utilized 1,596,640 echocardiography videos from 66,922 studies of 24,276 patients. The deep learning model with a computer vision pipeline (EchoNet-Liver) demonstrated strong performance to detect cirrhosis and SLD. External validation at a geographically distinct site demonstrated similar discriminative ability. The application of EchoNet-Liver to echocardiography could aid opportunistic screening of chronic liver diseases, providing a unique cost-effective angle to improve patient management.
PubMed: 38947008
DOI: 10.1101/2024.06.13.24308898 -
Advances in Gerontology = Uspekhi... 2024A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly...
A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly people. The study included 678 participants of the ESSE-RF3 population study in the Arkhangelsk region in the age of 60-74 years. We used a questionnaire, including the hospital scale of anxiety and depression score (HADS), and the assessment of the ophthalmological status. It was found that all the study participants had diseases of the visual organ. Elevated depression scores were associated with sex, age, marital status (being single), and disability, elevated anxiety scores - with sex. The scores on the anxiety scale were on average 25% higher in participants whose visual acuity decreased to 0,5 units, and showed no independent associations with diagnosed ophthalmological diseases. The scores on the depression scale were on average 33% higher in participants with visual acuity 0,5 units, and 22% higher in the presence of retinopathy. In conclusion, anxiety and depression in the elderly people were more associated with visual deficits rather than with the presence of ophthalmological diseases underlying a decrease in functional status.
Topics: Humans; Male; Female; Aged; Middle Aged; Russia; Anxiety; Visual Acuity; Depression; Eye Diseases; Surveys and Questionnaires; Vision Disorders
PubMed: 38944776
DOI: No ID Found -
Journal of the American Geriatrics... Jun 2024Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and...
BACKGROUND
Sensory disability in older adults is associated with increased rates of depressive symptoms and loneliness. Here, we examined the impact of hearing, vision, and olfaction disability on mental health outcomes in older US adults.
METHODS
We studied respondents from the first three rounds (2005/6, 2010/11, and 2015/16) of the National Social Life, Health and Aging Project, a nationally representative, longitudinal study of older US adults. Sensory function was assessed by structured interviewer ratings (hearing and vision) and objective assessment (olfaction). Cox proportional hazards models and one degree of freedom tests for trend were utilized to analyze the relationships between sensory disability and self-rated mental health, frequent depressive symptoms, frequent perceived stress, frequent anxiety symptoms, and frequent loneliness symptoms over time, adjusting for demographics, health behaviors, comorbidities, and cognitive function.
RESULTS
We analyzed data from 3940 respondents over 10 years of follow-up. A greater number of sensory disabilities was associated with greater hazard of low self-rated mental health, frequent depressive symptoms, frequent perceived stress, and frequent loneliness symptoms over time (p ≤ 0.003, all). After adjusting for covariates, older adults with a greater number of sensory disabilities had greater hazard of low self-rated mental health (HR = 1.22, CI = [1.08, 1.38], p = 0.002) and loneliness symptoms (HR = 1.13, CI = [1.05, 1.22], p = 0.003) over time in our tests for trend. In our Cox proportional hazards model, older adults with vision disability had greater hazard of low self-rated mental health (HR = 1.34, 95% CI = [1.05, 1.72], p = 0.02) and loneliness symptoms (HR = 1.21, CI = [1.04, 1.41], p = 0.01).
CONCLUSIONS
Older US adults with greater numbers of sensory disabilities face worse subsequent mental health. Future longitudinal studies dissecting the relationship of all five classical senses will be helpful in further understanding how improving sensory function might improve mental health in older adults.
PubMed: 38944677
DOI: 10.1111/jgs.19056 -
BMC Ophthalmology Jun 2024Glaucoma is a worldwide eye disease that can cause irreversible vision loss. Early detection of glaucoma is important to reduce vision loss, and retinal fundus image...
BACKGROUND
Glaucoma is a worldwide eye disease that can cause irreversible vision loss. Early detection of glaucoma is important to reduce vision loss, and retinal fundus image examination is one of the most commonly used solutions for glaucoma diagnosis due to its low cost. Clinically, the cup-disc ratio of fundus images is an important indicator for glaucoma diagnosis. In recent years, there have been an increasing number of algorithms for segmentation and recognition of the optic disc (OD) and optic cup (OC), but these algorithms generally have poor universality, segmentation performance, and segmentation accuracy.
METHODS
By improving the YOLOv8 algorithm for segmentation of OD and OC. Firstly, a set of algorithms was designed to adapt the REFUGE dataset's result images to the input format of the YOLOv8 algorithm. Secondly, in order to improve segmentation performance, the network structure of YOLOv8 was improved, including adding a ROI (Region of Interest) module, modifying the bounding box regression loss function from CIOU to Focal-EIoU. Finally, by training and testing the REFUGE dataset, the improved YOLOv8 algorithm was evaluated.
RESULTS
The experimental results show that the improved YOLOv8 algorithm achieves good segmentation performance on the REFUGE dataset. In the OD and OC segmentation tests, the F1 score is 0.999.
CONCLUSIONS
We improved the YOLOv8 algorithm and applied the improved model to the segmentation task of OD and OC in fundus images. The results show that our improved model is far superior to the mainstream U-Net model in terms of training speed, segmentation performance, and segmentation accuracy.
Topics: Optic Disk; Humans; Algorithms; Fundus Oculi; Glaucoma
PubMed: 38943095
DOI: 10.1186/s12886-024-03532-4 -
Journal of Speech, Language, and... Jun 2024This study aims at investigating the phonological development of the six guttural consonants of Jordanian Arabic, /χ/, /ʁ/, /ħ/, /ʕ/, /ʔ/, and /h/.
PURPOSE
This study aims at investigating the phonological development of the six guttural consonants of Jordanian Arabic, /χ/, /ʁ/, /ħ/, /ʕ/, /ʔ/, and /h/.
METHOD
An articulation test is designed to involve two tasks: picture naming and repetition. The test includes 54 words for picture naming and 18 words for repetition, representing all possible positions of the targeted guttural sounds. Samples are collected from 40 typically developing Ammani-Jordanian Arabic-speaking monolingual children, living in Amman, Jordan. Respondents are equally divided into eight age-related trajectories: 2-2;6, 2;6-3, 3-3;6, 3;6-4, 4-4;6, 4;6-5, 5-5;6, and 5;6-6 (years;months). No child with a history of hearing, speech, or vision disorders is included. The data are analyzed using , where the three developmental trajectories of production (customary, acquisition, and mastery) are determined for each guttural, and , addressed based on perceptual judgments, providing details of every mispronounced or deleted guttural.
RESULTS
The results show that /χ/, /ħ/, /ʕ/, and /ʔ/ are acquired before the age of 6 years, while /ʁ/ and /h/ are still not acquired by this age. Respondents use relatively variant alternatives for the mispronounced cognates, including guttural, nonguttural sounds, and vowel substitution. The /ʁ/ is the guttural with the highest number of alternatives, while /ʔ/ gets the least. The analysis also reveals patterns of guttural deletion, with variations across different guttural sounds and positions. Despite errors/deviations made, respondents score accuracy percentages that gradually increase in correlation with age. The guttural /ʁ/ starts with the lowest accuracy percentages, while /ʔ/ and /ħ/ start with the highest.
CONCLUSIONS
These findings illuminate on the developmental trajectory of guttural acquisition and enrich our understanding of children's evolving perception and production abilities. They offer valuable insights into the patterns of guttural sound production in Jordanian Arabic-speaking children, laying the groundwork for further research and the development of targeted assessment and intervention strategies to support phonological development in this population.
PubMed: 38941556
DOI: 10.1044/2024_JSLHR-23-00085 -
PloS One 2024Medaka fish (Oryzias latipes) is a powerful model to study genetics underlying the developmental and functional traits of the vertebrate visual system. We established a...
Medaka fish (Oryzias latipes) is a powerful model to study genetics underlying the developmental and functional traits of the vertebrate visual system. We established a simple and high-throughput optomotor response (OMR) assay utilizing medaka larvae to study visual functions including visual acuity and contrast sensitivity. Our assay presents multiple adjustable stripes in motion to individual fish in a linear arena. For that the OMR assay employs a tablet display and the Fish Stripes software to adjust speed, width, color, and contrast of the stripes. Our results demonstrated that optomotor responses were robustly induced by black and white stripes presented from below in the linear-pool-arena. We detected robust strain specific differences in the OMR when comparing long established medaka inbred strains. We observed an interesting training effect upon the initial exposure of larvae to thick stripes, which allowed them to better respond to narrower stripes. The OMR setup and protocol presented here provide an efficient tool for quantitative phenotype mapping, addressing visual acuity, trainability of cortical neurons, color sensitivity, locomotor response, retinal regeneration and others. Our open-source setup presented here provides a crucial prerequisite for ultimately addressing the genetic basis of those processes.
Topics: Animals; Oryzias; Larva; Visual Acuity; Photic Stimulation; Contrast Sensitivity; Vision, Ocular; High-Throughput Screening Assays
PubMed: 38941325
DOI: 10.1371/journal.pone.0302092 -
International Ophthalmology Jun 2024Compared to Shack-Hartmann wavefront sensor (SHWS), the parameters of virtual SHWS (vSHWS) can be easily adjusted to obtain the optimal performance of aberration...
PURPOSE
Compared to Shack-Hartmann wavefront sensor (SHWS), the parameters of virtual SHWS (vSHWS) can be easily adjusted to obtain the optimal performance of aberration measurement. Its current optimal parameters are obtained with only a set of statistical aberrations and not statistically significant. Whether the above parameters are consistent with the statistical results of the optimal parameters corresponding to each set of aberrations, and which performance is better if not? The purpose of this study was to answer these questions.
METHODS
The optimal parameters to reconstruct 624 sets of clinical ocular aberrations in the highest accuracy, including the numbers of sub-apertures (NSAs) and the expansion ratios (ERs) of electric field zero-padding, were determined sequentially in this work. By using wavefront-reconstruction accuracy as an evaluation index, the statistical optimal parameter configuration was selected from some possible configurations determined by the optimal NSAs and ERs.
RESULTS
The statistical optimal parameters are consistent for normal and abnormal eyes. They are different from the optimal parameters obtained with a set of statistical aberrations from the same 624 sets of aberrations, and the performance using the former is better than that using the latter. The performance using a fixed set of statistical optimal parameters is even close to that using the respective optimal parameters corresponding to each set of aberrations.
CONCLUSION
The vSHWS configured with a fixed set of statistical optimal parameters can be used for high-precision aberration measurement of both normal and abnormal eyes. The statistical optimal parameters are more suitable for vSHWS than the parameters obtained with a set of statistical aberrations. These conclusions are significant for the designs of vSHWS and also SHWS.
Topics: Humans; Corneal Wavefront Aberration; Corneal Topography; Aberrometry; Refraction, Ocular; Visual Acuity
PubMed: 38940969
DOI: 10.1007/s10792-024-03176-9 -
International Ophthalmology Jun 2024This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM). (Review)
Review
PURPOSE
This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up, and therapeutic approach of uveitic epiretinal membranes (ERM).
METHODS
A thorough investigation of the literature was conducted using the PubMed database. Additionally, a complementary search was carried out on Google Scholar to ensure the inclusion of all relevant items in the collection.
RESULTS
ERM is an abnormal layer at the vitreoretinal interface, resulting from myofibroblastic cell proliferation along the inner surface of the central retina, causing visual impairment. Known by various names, ERM has diverse causes, including idiopathic or secondary factors, with ophthalmic imaging techniques like OCT improving detection. In uveitis, ERM occurrence is common, and surgical intervention involves pars plana vitrectomy with ERM peeling, although debates persist on optimal approaches.
CONCLUSIONS
Histopathological studies and OCT advancements improved ERM understanding, revealing a diverse group of diseases without a unified model. Consensus supports surgery for uveitic ERM in progressive cases, but variability requires careful consideration and effective inflammation management. OCT biomarkers, deep learning, and surgical advances may enhance outcomes, and medical interventions and robotics show promise for early ERM intervention.
Topics: Humans; Epiretinal Membrane; Uveitis; Vitrectomy; Tomography, Optical Coherence; Visual Acuity; Disease Management
PubMed: 38940960
DOI: 10.1007/s10792-024-03199-2 -
Journal of Imaging Informatics in... Jun 2024To assess the effectiveness of the vViT model for predicting postoperative renal function decline by leveraging clinical data, medical images, and image-derived...
Predicting EGFR Status After Radical Nephrectomy or Partial Nephrectomy for Renal Cell Carcinoma on CT Using a Self-attention-based Model: Variable Vision Transformer (vViT).
OBJECTIVE
To assess the effectiveness of the vViT model for predicting postoperative renal function decline by leveraging clinical data, medical images, and image-derived features; and to identify the most dominant factor influencing this prediction.
MATERIALS AND METHODS
We developed two models, eGFR10 and eGFR20, to identify patients with a postoperative reduction in eGFR of more than 10 and more than 20, respectively, among renal cell carcinoma patients. The eGFR10 model was trained on 75 patients and tested on 27, while the eGFR20 model was trained on 77 patients and tested on 24. The vViT model inputs included class token, patient characteristics (age, sex, BMI), comorbidities (peripheral vascular disease, diabetes, liver disease), habits (smoking, alcohol), surgical details (ischemia time, blood loss, type and procedure of surgery, approach, operative time), radiomics, and tumor and kidney imaging. We used permutation feature importance to evaluate each sector's contribution. The performance of vViT was compared with CNN models, including VGG16, ResNet50, and DenseNet121, using McNemar and DeLong tests.
RESULTS
The eGFR10 model achieved an accuracy of 0.741 and an AUC-ROC of 0.692, while the eGFR20 model attained an accuracy of 0.792 and an AUC-ROC of 0.812. The surgical and radiomics sectors were the most influential in both models. The vViT had higher accuracy and AUC-ROC than VGG16 and ResNet50, and higher AUC-ROC than DenseNet121 (p < 0.05). Specifically, the vViT did not have a statistically different AUC-ROC compared to VGG16 (p = 1.0) and ResNet50 (p = 0.7) but had a statistically different AUC-ROC compared to DenseNet121 (p = 0.87) for the eGFR10 model. For the eGFR20 model, the vViT did not have a statistically different AUC-ROC compared to VGG16 (p = 0.72), ResNet50 (p = 0.88), and DenseNet121 (p = 0.64).
CONCLUSION
The vViT model, a transformer-based approach for multimodal data, shows promise for preoperative CT-based prediction of eGFR status in patients with renal cell carcinoma.
PubMed: 38940889
DOI: 10.1007/s10278-024-01180-0 -
Investigative Ophthalmology & Visual... Jun 2024The purpose of this study was to investigate the functional effects of peripheral refractive errors on mobility performance through a stair negotiation task.
PURPOSE
The purpose of this study was to investigate the functional effects of peripheral refractive errors on mobility performance through a stair negotiation task.
METHODS
Twenty-one young, normal sighted subjects navigated through an obstacle with steps, wearing spectacles that altered only their peripheral refraction. Lenses were used to induce positive defocus (+2 diopters [D] and +4 D), negative defocus (-2 D and -4 D), or astigmatism (+1.75 D and -3.75 D, axis 45 degrees) in the periphery. Feet trajectories were analyzed, and several gait assessment parameters were obtained. Statistical tests were conducted to determine significant performance differences between the lenses. Peripheral refraction in each subject was measured using a scanning Hartmann-Shack wavefront sensor to assess the impact of intrinsic peripheral refraction on the experiment.
RESULTS
Statistically significant differences in performance appeared when peripheral errors were superimposed. Crossing time with respect to plano lenses increased by 6.2%, 7.6%, 19.2%, and 29.6% for the -2 D, +2 D, -4 D, and +4 D lenses, respectively (P < 0.05 in the last 3 cases). Subjects exhibited slower walking speeds, increased step count, and adopted precautionary measures. High-power positive defocus lenses had the biggest impact on performance, and differences were observed in distance to steps between induced positive and negative defocus.
CONCLUSIONS
In this laboratory-based study without an adaptation period, peripheral refractive errors affected stair negotiation, causing cautious behavior in subjects. Performance differences among types of peripheral defocus may result from magnification effects and intrinsic peripheral refraction. These results highlight the importance of understanding the effects of induced peripheral errors by myopia control and intraocular lenses.
Topics: Humans; Male; Female; Adult; Refraction, Ocular; Refractive Errors; Young Adult; Eyeglasses; Visual Acuity; Gait; Walking
PubMed: 38940761
DOI: 10.1167/iovs.65.6.42