Studies on machine learning-based aid for residency training and time difficulty in ophthalmology

兵庫県立大学大学院工学(博士)2023doctoral thesi

Data-Driven Classification Methods for Craniosynostosis Using 3D Surface Scans

Diese Arbeit befasst sich mit strahlungsfreier Klassifizierung von Kraniosynostose mit zusätzlichem Schwerpunkt auf Datenaugmentierung und auf die Verwendung synthetischer Daten als Ersatz für klinische Daten. Motivation: Kraniosynostose ist eine Erkrankung, die Säuglinge betrifft und zu Kopfdeformitäten führt. Diagnose mittels strahlungsfreier 3D Oberflächenscans ist eine vielversprechende Alternative zu traditioneller computertomographischer Bildgebung. Aufgrund der niedrigen Prävalenz und schwieriger Anonymisierbarkeit sind klinische Daten nur spärlich vorhanden. Diese Arbeit adressiert diese Herausforderungen, indem sie neue Klassifizierungsalgorithmen vorschlägt, synthetische Daten für die wissenschaftliche Gemeinschaft erstellt und zeigt, dass es möglich ist, klinische Daten vollständig durch synthetische Daten zu ersetzen, ohne die Klassifikationsleistung zu beeinträchtigen. Methoden: Ein Statistisches Shape Modell (SSM) von Kraniosynostosepatienten wird erstellt und öffentlich zugänglich gemacht. Es wird eine 3D-2D-Konvertierung von der 3D-Gittergeometrie in ein 2D-Bild vorgeschlagen, die die Verwendung von Convolutional Neural Networks (CNNs) und Datenaugmentierung im Bildbereich ermöglicht. Drei Klassifizierungsansätze (basierend auf cephalometrischen Messungen, basierend auf dem SSM, und basierend auf den 2D Bildern mit einem CNN) zur Unterscheidung zwischen drei Pathologien und einer Kontrollgruppe werden vorgeschlagen und bewertet. Schließlich werden die klinischen Trainingsdaten vollständig durch synthetische Daten aus einem SSM und einem generativen adversarialen Netz (GAN) ersetzt. Ergebnisse: Die vorgeschlagene CNN-Klassifikation übertraf konkurrierende Ansätze in einem klinischen Datensatz von 496 Probanden und erreichte einen F1-Score von 0,964. Datenaugmentierung erhöhte den F1-Score auf 0,975. Zuschreibungen der Klassifizierungsentscheidung zeigten hohe Amplituden an Teilen des Kopfes, die mit Kraniosynostose in Verbindung stehen. Das Ersetzen der klinischen Daten durch synthetische Daten, die mit einem SSM und einem GAN erstellt wurden, ergab noch immer einen F1-Score von über 0,95, ohne dass das Modell ein einziges klinisches Subjekt gesehen hatte. Schlussfolgerung: Die vorgeschlagene Umwandlung von 3D-Geometrie in ein 2D-kodiertes Bild verbesserte die Leistung bestehender Klassifikatoren und ermöglichte eine Datenaugmentierung während des Trainings. Unter Verwendung eines SSM und eines GANs konnten klinische Trainingsdaten durch synthetische Daten ersetzt werden. Diese Arbeit verbessert bestehende diagnostische Ansätze auf strahlungsfreien Aufnahmen und demonstriert die Verwendbarkeit von synthetischen Daten, was klinische Anwendungen objektiver, interpretierbarer, und weniger kostspielig machen

Abnormal Brain Connectivity in the Primary Visual Pathway in Human Albinism

In albinism, the ipsilateral projection of retinal axons is significantly reduced, and most fibres project contralaterally. The retina and optic chiasm have been proposed as sites for misrouting. The number of lateral geniculate nucleus (LGN) relay neurons has been linked to LGN volume, suggesting a correlation between LGN size and the number of tracts traveling through the optic radiation (OR) to the primary visual cortex (V1). Using diffusion data and both deterministic and probabilistic tractography, we studied differences in OR between albinism and controls. Statistical analyses measured white matter integrity in areas corresponding to the OR, as well as LGN to V1 connectivity. Results revealed reduced white matter integrity and connectivity in the OR region in albinism compared to controls, suggesting altered structural development. Previous reports of smaller LGN and the altered thalamo-cortical connectivity reported here demonstrate the effect of misrouting on structural organization of the visual pathway in albinism

International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder

© 2019 The Authors Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press Aim: These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice. Method: Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on ‘mechanisms’, ‘assessment’, and ‘intervention’ were updated since the last recommendations in 2012. New searches were conducted for ‘psychosocial issues’ and ‘adolescents/adults’. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1–4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations. Results: Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on ‘assessment’, five on ‘intervention’). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD. Interpretation: The CPR–DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR–DCD may serve as a basis for national guidelines. What this paper adds: Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD

Early development of sensory perception in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are co-occurring neurodevelopmental disorders emerging early in development. Molecular genetics research suggests that common sensory vulnerabilities underlie the emergence of both disorders, yet no research examined the same sensory markers as potential infant predictors of ASD or ADHD traits in toddlerhood. This thesis examines the early development of sensory perception in infants at elevated likelihood of ASD and/or ADHD and infants at typical likelihood of the disorders. Chapters 1-2 present, respectively, a theoretical introduction and methodological considerations for the investigation of sensory perception in these conditions. Chapter 3 presents evidence from an EEG tactile repetition suppression task administered to 10-month-old infants, prospectively re-assessed at 24 months. Results indicate that reduced repetition suppression is a marker of ASD in infancy and predicts ASD traits in toddlerhood. Results further suggest that early enhanced parent-reported tactile sensory seeking mitigates the association between tactile atypicality and later ASD traits. Chapter 4 presents evidence from an EEG visual task administered to 10-month-old infants, prospectively re-assessed at 24 months. Results indicate that enhanced responsiveness to visual input is a marker of ASD or ADHD in infancy and predicts concurrent parent-reported visual sensory seeking. Results further indicate that enhanced responsiveness to incoming stimulation in infants with later higher ASD traits results from reduced prioritization of ongoing information. Chapter 5 presents a proof-of-concept demonstration that variation in responsiveness to visual input also reflects variation in engagement with ongoing information in an independent cohort of 10-month-old infants at typical likelihood of the conditions. Chapter 6 adopts an individual differences approach and reports on the concurrent/longitudinal associations between markers of information prioritization emerged from Chapter 5 and parent-reported sensory seeking, ASD and ADHD traits in the same participant sample, prospectively re-assessed at 16 months. Chapter 7 discusses contributions and implications for research on the early development of sensory perception in ASD and ADHD

Advance Nanomaterials for Biosensors

The book provides a comprehensive overview of nanostructures and methods used to design biosensors, as well as applications for these biosensor nanotechnologies in the biological, chemical, and environmental monitoring fields. Biological sensing has proven to be an essential tool for understanding living systems, but it also has practical applications in medicine, drug discovery, food safety, environmental monitoring, defense, personal security, etc. In healthcare, advancements in telecommunications, expert systems, and distributed diagnostics are challenging current delivery models, while robust industrial sensors enable new approaches to research and development. Experts from around the world have written five articles on topics including:Diagnosing and treating intraocular cancers such as retinoblastoma; Nanomedicine in cancer management; Engineered nanomaterials in osteosarcoma diagnosis and treatment; Practical design of nanoscale devices; Detect alkaline phosphatase quantitatively in clinical diagnosis; Progress in the area of non-enzymatic sensing of dual/multi biomolecules; Developments in non-enzymatic glucose and H2O2 (NEGH) sensing; Multi-functionalized nanocarrier therapies for targeting retinoblastoma; Galactose functionalized nanocarriers; Sensing performance, electro-catalytic mechanism, and morphology and design of electrode materials; Biosensors along with their applications and the benefits of machine learning; Innovative approaches to improve the NEGH sensitivity, selectivity, and stability in real-time applications; Challenges and solutions in the field of biosensors

Cognitive Maps

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