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1.
Brief Bioinform ; 25(3)2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38647154

RESUMO

Molecular generative models have exhibited promising capabilities in designing molecules from scratch with high binding affinities in a predetermined protein pocket, offering potential synergies with traditional structural-based drug design strategy. However, the generative processes of such models are random and the atomic interaction information between ligand and protein are ignored. On the other hand, the ligand has high propensity to bind with residues called hotspots. Hotspot residues contribute to the majority of the binding free energies and have been recognized as appealing targets for designed molecules. In this work, we develop an interaction prompt guided diffusion model, InterDiff to deal with the challenges. Four kinds of atomic interactions are involved in our model and represented as learnable vector embeddings. These embeddings serve as conditions for individual residue to guide the molecular generative process. Comprehensive in silico experiments evince that our model could generate molecules with desired ligand-protein interactions in a guidable way. Furthermore, we validate InterDiff on two realistic protein-based therapeutic agents. Results show that InterDiff could generate molecules with better or similar binding mode compared to known targeted drugs.


Assuntos
Proteínas , Proteínas/química , Proteínas/metabolismo , Ligantes , Ligação Proteica , Desenho de Fármacos , Modelos Moleculares , Algoritmos , Sítios de Ligação , Simulação por Computador
2.
Brief Bioinform ; 25(5)2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39082648

RESUMO

Metabolic processes can transform a drug into metabolites with different properties that may affect its efficacy and safety. Therefore, investigation of the metabolic fate of a drug candidate is of great significance for drug discovery. Computational methods have been developed to predict drug metabolites, but most of them suffer from two main obstacles: the lack of model generalization due to restrictions on metabolic transformation rules or specific enzyme families, and high rate of false-positive predictions. Here, we presented MetaPredictor, a rule-free, end-to-end and prompt-based method to predict possible human metabolites of small molecules including drugs as a sequence translation problem. We innovatively introduced prompt engineering into deep language models to enrich domain knowledge and guide decision-making. The results showed that using prompts that specify the sites of metabolism (SoMs) can steer the model to propose more accurate metabolite predictions, achieving a 30.4% increase in recall and a 16.8% reduction in false positives over the baseline model. The transfer learning strategy was also utilized to tackle the limited availability of metabolic data. For the adaptation to automatic or non-expert prediction, MetaPredictor was designed as a two-stage schema consisting of automatic identification of SoMs followed by metabolite prediction. Compared to four available drug metabolite prediction tools, our method showed comparable performance on the major enzyme families and better generalization that could additionally identify metabolites catalyzed by less common enzymes. The results indicated that MetaPredictor could provide a more comprehensive and accurate prediction of drug metabolism through the effective combination of transfer learning and prompt-based learning strategies.


Assuntos
Simulação por Computador , Aprendizado Profundo , Humanos , Preparações Farmacêuticas/metabolismo , Preparações Farmacêuticas/química , Biologia Computacional/métodos , Descoberta de Drogas/métodos , Software , Algoritmos
3.
Brief Bioinform ; 25(5)2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39252594

RESUMO

Accurate prediction of molecular properties is crucial in drug discovery. Traditional methods often overlook that real-world molecules typically exhibit multiple property labels with complex correlations. To this end, we propose a novel framework, HiPM, which stands for Hierarchical Prompted Molecular representation learning framework. HiPM leverages task-aware prompts to enhance the differential expression of tasks in molecular representations and mitigate negative transfer caused by conflicts in individual task information. Our framework comprises two core components: the Molecular Representation Encoder (MRE) and the Task-Aware Prompter (TAP). MRE employs a hierarchical message-passing network architecture to capture molecular features at both the atom and motif levels. Meanwhile, TAP utilizes agglomerative hierarchical clustering algorithm to construct a prompt tree that reflects task affinity and distinctiveness, enabling the model to consider multi-granular correlation information among tasks, thereby effectively handling the complexity of multi-label property prediction. Extensive experiments demonstrate that HiPM achieves state-of-the-art performance across various multi-label datasets, offering a novel perspective on multi-label molecular representation learning.


Assuntos
Algoritmos , Descoberta de Drogas/métodos , Análise por Conglomerados , Aprendizado de Máquina , Biologia Computacional/métodos
4.
Brief Bioinform ; 25(5)2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39177261

RESUMO

Large language models (LLMs) are sophisticated AI-driven models trained on vast sources of natural language data. They are adept at generating responses that closely mimic human conversational patterns. One of the most notable examples is OpenAI's ChatGPT, which has been extensively used across diverse sectors. Despite their flexibility, a significant challenge arises as most users must transmit their data to the servers of companies operating these models. Utilizing ChatGPT or similar models online may inadvertently expose sensitive information to the risk of data breaches. Therefore, implementing LLMs that are open source and smaller in scale within a secure local network becomes a crucial step for organizations where ensuring data privacy and protection has the highest priority, such as regulatory agencies. As a feasibility evaluation, we implemented a series of open-source LLMs within a regulatory agency's local network and assessed their performance on specific tasks involving extracting relevant clinical pharmacology information from regulatory drug labels. Our research shows that some models work well in the context of few- or zero-shot learning, achieving performance comparable, or even better than, neural network models that needed thousands of training samples. One of the models was selected to address a real-world issue of finding intrinsic factors that affect drugs' clinical exposure without any training or fine-tuning. In a dataset of over 700 000 sentences, the model showed a 78.5% accuracy rate. Our work pointed to the possibility of implementing open-source LLMs within a secure local network and using these models to perform various natural language processing tasks when large numbers of training examples are unavailable.


Assuntos
Processamento de Linguagem Natural , Humanos , Redes Neurais de Computação , Aprendizado de Máquina
5.
Methods ; 222: 133-141, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38242382

RESUMO

The versatility of ChatGPT in performing a diverse range of tasks has elicited considerable interest on its potential applications within professional fields. Taking drug discovery as a testbed, this paper provides a comprehensive evaluation of ChatGPT's ability on molecule property prediction. The study focuses on three aspects: 1) Effects of different prompt settings, where we investigate the impact of varying prompts on the prediction outcomes of ChatGPT; 2) Comprehensive evaluation on molecule property prediction, where we conduct a comprehensive evaluation on 53 ADMET-related endpoints; 3) Analysis of ChatGPT's potential and limitations, where we make comparisons with models tailored for molecule property prediction, thus gaining a more accurate understanding of ChatGPT's capabilities and limitations in this area. Through comprehensive evaluation, we find that 1) With appropriate prompt settings, ChatGPT can attain satisfactory prediction outcomes that are competitive with specialized models designed for those tasks. 2) Prompt settings significantly affect ChatGPT's performance. Among all prompt settings, the strategy of selecting examples in few-shot has the greatest impact on results. Scaffold sampling greatly outperforms random sampling. 3) The capacity of ChatGPT to accomplish high-precision predictions is significantly influenced by the quality of examples provided, which may constrain its practical applicability in real-world scenarios. This work highlights ChatGPT's potential and limitations on molecule property prediction, which we hope can inspire future design and evaluation of Large Language Models within scientific domains.


Assuntos
Descoberta de Drogas , Projetos de Pesquisa
6.
BMC Bioinformatics ; 25(1): 281, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39192204

RESUMO

BACKGROUND: Mining the vast pool of biomedical literature to extract accurate responses and relevant references is challenging due to the domain's interdisciplinary nature, specialized jargon, and continuous evolution. Early natural language processing (NLP) approaches often led to incorrect answers as they failed to comprehend the nuances of natural language. However, transformer models have significantly advanced the field by enabling the creation of large language models (LLMs), enhancing question-answering (QA) tasks. Despite these advances, current LLM-based solutions for specialized domains like biology and biomedicine still struggle to generate up-to-date responses while avoiding "hallucination" or generating plausible but factually incorrect responses. RESULTS: Our work focuses on enhancing prompts using a retrieval-augmented architecture to guide LLMs in generating meaningful responses for biomedical QA tasks. We evaluated two approaches: one relying on text embedding and vector similarity in a high-dimensional space, and our proposed method, which uses explicit signals in user queries to extract meaningful contexts. For robust evaluation, we tested these methods on 50 specific and challenging questions from diverse biomedical topics, comparing their performance against a baseline model, BM25. Retrieval performance of our method was significantly better than others, achieving a median Precision@10 of 0.95, which indicates the fraction of the top 10 retrieved chunks that are relevant. We used GPT-4, OpenAI's most advanced LLM to maximize the answer quality and manually accessed LLM-generated responses. Our method achieved a median answer quality score of 2.5, surpassing both the baseline model and the text embedding-based approach. We developed a QA bot, WeiseEule ( https://github.com/wasimaftab/WeiseEule-LocalHost ), which utilizes these methods for comparative analysis and also offers advanced features for review writing and identifying relevant articles for citation. CONCLUSIONS: Our findings highlight the importance of prompt enhancement methods that utilize explicit signals in user queries over traditional text embedding-based approaches to improve LLM-generated responses for specialized queries in specialized domains such as biology and biomedicine. By providing users complete control over the information fed into the LLM, our approach addresses some of the major drawbacks of existing web-based chatbots and LLM-based QA systems, including hallucinations and the generation of irrelevant or outdated responses.


Assuntos
Mineração de Dados , Processamento de Linguagem Natural , Mineração de Dados/métodos , Armazenamento e Recuperação da Informação/métodos
7.
Psychooncology ; 33(1): e6295, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38282221

RESUMO

AIM: We aimed to develop two question prompt lists (QPLs), one for Indian cancer patients undergoing radiation therapy and the second for their primary family caregivers. METHODS: The study comprised three phases: (1) qualitative interviews with patients (n = 65) and PFCs (n = 39) to identify their information needs, queries and concerns regarding RT; (2) development of draft QPLs using conventional content analysis and translation into Hindi and Marathi using European Organisation Research and Treatment of Cancer guidelines; and, (3) A readability analysis, and acceptability study with patients (n = 22), PFCs (n = 26) and Radiation Oncology (RO) staff (n = 20) exploring barriers to QPL implementation. RESULTS AND DISCUSSION: Analysis in Phase I identified questions patients and PFCs asked or wanted to ask their physician. A list of 125 and 136 questions were generated for patients and PFCs, respectively. After five iterations, the draft QPLs were finalised, translated, and back-translated from English into Hindi and Marathi (Phase II). In Phase III, most patients and PFCs reported the QPLs were easy to read, they did not find it difficult to ask the questions, and the questions were not emotionally upsetting. Conversely, RO staff reported concerns that patients may find it difficult to discuss the questions with their physician. CONCLUSION: The study highlights the need to empower patients and PFCs to ask questions and for staff to feel comfortable answering them. Implementing physician-endorsed QPLs could achieve these aims.


Assuntos
Comunicação , Neoplasias , Humanos , Cuidadores , Inquéritos e Questionários , Relações Médico-Paciente , Participação do Paciente , Neoplasias/psicologia
8.
J Biomed Inform ; 153: 104630, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38548007

RESUMO

OBJECTIVE: To develop soft prompt-based learning architecture for large language models (LLMs), examine prompt-tuning using frozen/unfrozen LLMs, and assess their abilities in transfer learning and few-shot learning. METHODS: We developed a soft prompt-based learning architecture and compared 4 strategies including (1) fine-tuning without prompts; (2) hard-prompting with unfrozen LLMs; (3) soft-prompting with unfrozen LLMs; and (4) soft-prompting with frozen LLMs. We evaluated GatorTron, a clinical LLM with up to 8.9 billion parameters, and compared GatorTron with 4 existing transformer models for clinical concept and relation extraction on 2 benchmark datasets for adverse drug events and social determinants of health (SDoH). We evaluated the few-shot learning ability and generalizability for cross-institution applications. RESULTS AND CONCLUSION: When LLMs are unfrozen, GatorTron-3.9B with soft prompting achieves the best strict F1-scores of 0.9118 and 0.8604 for concept extraction, outperforming the traditional fine-tuning and hard prompt-based models by 0.6 âˆ¼ 3.1 % and 1.2 âˆ¼ 2.9 %, respectively; GatorTron-345 M with soft prompting achieves the best F1-scores of 0.8332 and 0.7488 for end-to-end relation extraction, outperforming other two models by 0.2 âˆ¼ 2 % and 0.6 âˆ¼ 11.7 %, respectively. When LLMs are frozen, small LLMs have a big gap to be competitive with unfrozen models; scaling LLMs up to billions of parameters makes frozen LLMs competitive with unfrozen models. Soft prompting with a frozen GatorTron-8.9B model achieved the best performance for cross-institution evaluation. We demonstrate that (1) machines can learn soft prompts better than hard prompts composed by human, (2) frozen LLMs have good few-shot learning ability and generalizability for cross-institution applications, (3) frozen LLMs reduce computing cost to 2.5 âˆ¼ 6 % of previous methods using unfrozen LLMs, and (4) frozen LLMs require large models (e.g., over several billions of parameters) for good performance.


Assuntos
Processamento de Linguagem Natural , Humanos , Aprendizado de Máquina , Mineração de Dados/métodos , Algoritmos , Determinantes Sociais da Saúde , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
9.
J Biomed Inform ; 157: 104717, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39209087

RESUMO

BACKGROUND AND OBJECTIVE: Biomedical relation extraction aims to reveal the relation between entities in medical texts. Currently, the relation extraction models that have attracted much attention are mainly to fine-tune the pre-trained language models (PLMs) or add template prompt learning, which also limits the ability of the model to deal with grammatical dependencies. Graph convolutional networks (GCNs) can play an important role in processing syntactic dependencies in biomedical texts. METHODS: In this work, we propose a biomedical relation extraction model that fuses GCNs enhanced prompt learning to handle limitations in syntactic dependencies and achieve good performance. Specifically, we propose a model that combines prompt learning with GCNs for relation extraction, by integrating the syntactic dependency information analyzed by GCNs into the prompt learning model, by predicting the correspondence with [MASK] tokens labels for relation extraction. RESULTS: Our model achieved F1 scores of 85.57%, 80.15%, 95.10%, and 84.11% in the biomedical relation extraction datasets GAD, ChemProt, PGR, and DDI, respectively, all of which outperform some existing baseline models. CONCLUSIONS: In this paper, we propose enhancing prompt learning through GCNs, integrating syntactic information into biomedical relation extraction tasks. Experimental results show that our proposed method achieves excellent performance in the biomedical relation extraction task.


Assuntos
Processamento de Linguagem Natural , Redes Neurais de Computação , Algoritmos , Humanos , Mineração de Dados/métodos , Aprendizado de Máquina
10.
Support Care Cancer ; 32(4): 231, 2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38492095

RESUMO

BACKGROUND: Enhanced communication in end-of-life care (EOL) improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. Question prompt list (QPL) has been shown to enhance physician-patient communication in patients with cancer, but there is a lack of systematic review and meta-analysis for those with advanced cancer. Enhanced communication in end-of-life care improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. OBJECTIVE: To review the effectiveness of QPL intervention on physician-patient communication and health outcomes during consultation in patients with advanced cancer. METHODS: CINAHL, Embase, Scopus, and PsycINFO databases were undertaken using inclusion criteria for relevant articles up to August 2021. Pooled standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool and modified Jadad scale to assess the quality of the studies. RESULTS: Seven RCTs with 1059 participants were included, of which six studies were eligible for the meta-analysis. The pooled meta-analysis results indicated that QPL in patients with advanced cancer had a significant positive effect on the total number of questions asked (SMD, 0.73; 95% CI, 0.28 to 1.18; I2 = 83%) and on the patients' expectations for the future (SMD, 0.67; 95% CI, 0.08 to 1.25; I2 = 88%). There were no significant improvements in health-related outcomes such as end of life, anxiety, and quality of life. CONCLUSIONS: Using QPL in advanced cancer consultations boosts patient questions which helps communication but not health-related indicators. Optimal results depend on full reading, but timing varies. Future research should examine the relationship between communication and health outcomes, including patient/physician behavior and social context.


Assuntos
Comunicação , Neoplasias , Relações Médico-Paciente , Qualidade de Vida , Assistência Terminal , Humanos , Neoplasias/psicologia , Neoplasias/terapia , Assistência Terminal/métodos , Assistência Terminal/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
J Pharmacokinet Pharmacodyn ; 51(2): 101-108, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37952004

RESUMO

To systematically assess the ChatGPT large language model on diverse tasks relevant to pharmacokinetic data analysis. ChatGPT was evaluated with prototypical tasks related to report writing, code generation, non-compartmental analysis, and pharmacokinetic word problems. The writing task consisted of writing an introduction for this paper from a draft title. The coding tasks consisted of generating R code for semi-logarithmic graphing of concentration-time profiles and calculating area under the curve and area under the moment curve from time zero to infinity. Pharmacokinetics word problems on single intravenous, extravascular bolus, and multiple dosing were taken from a pharmacokinetics textbook. Chain-of-thought and problem separation were assessed as prompt engineering strategies when errors occurred. ChatGPT showed satisfactory performance on the report writing, code generation tasks and provided accurate information on the principles and methods underlying pharmacokinetic data analysis. However, ChatGPT had high error rates in numerical calculations involving exponential functions. The outputs generated by ChatGPT were not reproducible: the precise content of the output was variable albeit not necessarily erroneous for different instances of the same prompt. Incorporation of prompt engineering strategies reduced but did not eliminate errors in numerical calculations. ChatGPT has the potential to become a powerful productivity tool for writing, knowledge encapsulation, and coding tasks in pharmacokinetic data analysis. The poor accuracy of ChatGPT in numerical calculations require resolution before it can be reliably used for PK and pharmacometrics data analysis.


Assuntos
Análise de Dados , Idioma , Administração Intravenosa , Injeções Intravenosas
12.
J Med Internet Res ; 26: e60501, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39255030

RESUMO

BACKGROUND: Prompt engineering, focusing on crafting effective prompts to large language models (LLMs), has garnered attention for its capabilities at harnessing the potential of LLMs. This is even more crucial in the medical domain due to its specialized terminology and language technicity. Clinical natural language processing applications must navigate complex language and ensure privacy compliance. Prompt engineering offers a novel approach by designing tailored prompts to guide models in exploiting clinically relevant information from complex medical texts. Despite its promise, the efficacy of prompt engineering in the medical domain remains to be fully explored. OBJECTIVE: The aim of the study is to review research efforts and technical approaches in prompt engineering for medical applications as well as provide an overview of opportunities and challenges for clinical practice. METHODS: Databases indexing the fields of medicine, computer science, and medical informatics were queried in order to identify relevant published papers. Since prompt engineering is an emerging field, preprint databases were also considered. Multiple data were extracted, such as the prompt paradigm, the involved LLMs, the languages of the study, the domain of the topic, the baselines, and several learning, design, and architecture strategies specific to prompt engineering. We include studies that apply prompt engineering-based methods to the medical domain, published between 2022 and 2024, and covering multiple prompt paradigms such as prompt learning (PL), prompt tuning (PT), and prompt design (PD). RESULTS: We included 114 recent prompt engineering studies. Among the 3 prompt paradigms, we have observed that PD is the most prevalent (78 papers). In 12 papers, PD, PL, and PT terms were used interchangeably. While ChatGPT is the most commonly used LLM, we have identified 7 studies using this LLM on a sensitive clinical data set. Chain-of-thought, present in 17 studies, emerges as the most frequent PD technique. While PL and PT papers typically provide a baseline for evaluating prompt-based approaches, 61% (48/78) of the PD studies do not report any nonprompt-related baseline. Finally, we individually examine each of the key prompt engineering-specific information reported across papers and find that many studies neglect to explicitly mention them, posing a challenge for advancing prompt engineering research. CONCLUSIONS: In addition to reporting on trends and the scientific landscape of prompt engineering, we provide reporting guidelines for future studies to help advance research in the medical field. We also disclose tables and figures summarizing medical prompt engineering papers available and hope that future contributions will leverage these existing works to better advance the field.


Assuntos
Processamento de Linguagem Natural , Humanos , Informática Médica/métodos
13.
J Med Internet Res ; 26: e52758, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39151163

RESUMO

BACKGROUND: The screening process for systematic reviews is resource-intensive. Although previous machine learning solutions have reported reductions in workload, they risked excluding relevant papers. OBJECTIVE: We evaluated the performance of a 3-layer screening method using GPT-3.5 and GPT-4 to streamline the title and abstract-screening process for systematic reviews. Our goal is to develop a screening method that maximizes sensitivity for identifying relevant records. METHODS: We conducted screenings on 2 of our previous systematic reviews related to the treatment of bipolar disorder, with 1381 records from the first review and 3146 from the second. Screenings were conducted using GPT-3.5 (gpt-3.5-turbo-0125) and GPT-4 (gpt-4-0125-preview) across three layers: (1) research design, (2) target patients, and (3) interventions and controls. The 3-layer screening was conducted using prompts tailored to each study. During this process, information extraction according to each study's inclusion criteria and optimization for screening were carried out using a GPT-4-based flow without manual adjustments. Records were evaluated at each layer, and those meeting the inclusion criteria at all layers were subsequently judged as included. RESULTS: On each layer, both GPT-3.5 and GPT-4 were able to process about 110 records per minute, and the total time required for screening the first and second studies was approximately 1 hour and 2 hours, respectively. In the first study, the sensitivities/specificities of the GPT-3.5 and GPT-4 were 0.900/0.709 and 0.806/0.996, respectively. Both screenings by GPT-3.5 and GPT-4 judged all 6 records used for the meta-analysis as included. In the second study, the sensitivities/specificities of the GPT-3.5 and GPT-4 were 0.958/0.116 and 0.875/0.855, respectively. The sensitivities for the relevant records align with those of human evaluators: 0.867-1.000 for the first study and 0.776-0.979 for the second study. Both screenings by GPT-3.5 and GPT-4 judged all 9 records used for the meta-analysis as included. After accounting for justifiably excluded records by GPT-4, the sensitivities/specificities of the GPT-4 screening were 0.962/0.996 in the first study and 0.943/0.855 in the second study. Further investigation indicated that the cases incorrectly excluded by GPT-3.5 were due to a lack of domain knowledge, while the cases incorrectly excluded by GPT-4 were due to misinterpretations of the inclusion criteria. CONCLUSIONS: Our 3-layer screening method with GPT-4 demonstrated acceptable level of sensitivity and specificity that supports its practical application in systematic review screenings. Future research should aim to generalize this approach and explore its effectiveness in diverse settings, both medical and nonmedical, to fully establish its use and operational feasibility.


Assuntos
Revisões Sistemáticas como Assunto , Humanos , Idioma
14.
J Med Internet Res ; 26: e55388, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38648104

RESUMO

In this cross-sectional study, we evaluated the completeness, readability, and syntactic complexity of cardiovascular disease prevention information produced by GPT-4 in response to 4 kinds of prompts.


Assuntos
Doenças Cardiovasculares , Estudos Transversais , Humanos , Idioma
15.
J Med Internet Res ; 26: e51108, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38502177

RESUMO

BACKGROUND: School canteens are a recommended setting to influence adolescent nutrition due to their scope to improve student food choices. Online lunch ordering systems ("online canteens") are increasingly used and represent attractive infrastructure to implement choice architecture interventions that nudge users toward healthier food choices. A recent cluster randomized controlled trial demonstrated the short-term effectiveness (2-month follow-up) of a choice architecture intervention to increase the healthiness of foods purchased by high school students from online canteens. However, there is little evidence regarding the long-term effectiveness of choice architecture interventions targeting adolescent food purchases, particularly those delivered online. OBJECTIVE: This study aimed to determine the long-term effectiveness of a multi-strategy choice architecture intervention embedded within online canteen infrastructure in high schools at a 15-month follow-up. METHODS: A cluster randomized controlled trial was undertaken with 1331 students (from 9 high schools) in New South Wales, Australia. Schools were randomized to receive the automated choice architecture intervention (including menu labeling, positioning, feedback, and prompting strategies) or the control (standard online ordering). The foods purchased were classified according to the New South Wales Healthy Canteen strategy as either "everyday," "occasional," or "should not be sold." Primary outcomes were the average proportion of "everyday," "occasional," and "should not be sold" items purchased per student. Secondary outcomes were the mean energy, saturated fat, sugar, and sodium content of purchases. Outcomes were assessed using routine data collected by the online canteen. RESULTS: From baseline to 15-month follow-up, on average, students in the intervention group ordered significantly more "everyday" items (+11.5%, 95% CI 7.3% to 15.6%; P<.001), and significantly fewer "occasional" (-5.4%, 95% CI -9.4% to -1.5%; P=.007) and "should not be sold" items (-6%, 95% CI -9.1% to -2.9%; P<.001), relative to controls. There were no between-group differences over time in the mean energy, saturated fat, sugar, or sodium content of lunch orders. CONCLUSIONS: Given their longer-term effectiveness, choice architecture interventions delivered via online canteens may represent a promising option for policy makers to support healthy eating among high school students. TRIAL REGISTRATION: Australian Clinical Trials ACTRN12620001338954, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380546 ; Open Science Framework osf.io/h8zfr, https://osf.io/h8zfr/.


Assuntos
Pessoal Administrativo , Alimentos , Adolescente , Humanos , Austrália , Açúcares , Sódio
16.
Med Teach ; : 1-3, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39285517

RESUMO

Diagnostic error is a significant category within preventable patient harm, and it takes many years of effort to develop proficiency in diagnostic reasoning. One of the key challenges medical schools must address is preparing students for the complexity, uncertainty and clinical responsibility in going from student to doctor. Recognising the importance of both cognitive and systems-related factors in diagnostic accuracy, we designed the QUID Prompt (Questions to Use for Improving Diagnosis) for students to refer to at the bedside. This set of questions prompts careful consideration, analysis, and signposting of decision-making processes, to assist students in transitioning from medical school to the real-world of work and achieving diagnostic excellence in clinical settings.

17.
J Appl Clin Med Phys ; 25(7): e14371, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38682540

RESUMO

PURPOSE: To create and evaluate a three-dimensional (3D) Prompt-nnUnet module that utilizes the prompts-based model combined with 3D nnUnet for producing the rapid and consistent autosegmentation of high-risk clinical target volume (HR CTV) and organ at risk (OAR) in high-dose-rate brachytherapy (HDR BT) for patients with postoperative endometrial carcinoma (EC). METHODS AND MATERIALS: On two experimental batches, a total of 321 computed tomography (CT) scans were obtained for HR CTV segmentation from 321 patients with EC, and 125 CT scans for OARs segmentation from 125 patients. The numbers of training/validation/test were 257/32/32 and 87/13/25 for HR CTV and OARs respectively. A novel comparison of the deep learning neural network 3D Prompt-nnUnet and 3D nnUnet was applied for HR CTV and OARs segmentation. Three-fold cross validation and several quantitative metrics were employed, including Dice similarity coefficient (DSC), Hausdorff distance (HD), 95th percentile of Hausdorff distance (HD95%), and intersection over union (IoU). RESULTS: The Prompt-nnUnet included two forms of parameters Predict-Prompt (PP) and Label-Prompt (LP), with the LP performing most similarly to the experienced radiation oncologist and outperforming the less experienced ones. During the testing phase, the mean DSC values for the LP were 0.96 ± 0.02, 0.91 ± 0.02, and 0.83 ± 0.07 for HR CTV, rectum and urethra, respectively. The mean HD values (mm) were 2.73 ± 0.95, 8.18 ± 4.84, and 2.11 ± 0.50, respectively. The mean HD95% values (mm) were 1.66 ± 1.11, 3.07 ± 0.94, and 1.35 ± 0.55, respectively. The mean IoUs were 0.92 ± 0.04, 0.84 ± 0.03, and 0.71 ± 0.09, respectively. A delineation time < 2.35 s per structure in the new model was observed, which was available to save clinician time. CONCLUSION: The Prompt-nnUnet architecture, particularly the LP, was highly consistent with ground truth (GT) in HR CTV or OAR autosegmentation, reducing interobserver variability and shortening treatment time.


Assuntos
Braquiterapia , Aprendizado Profundo , Neoplasias do Endométrio , Órgãos em Risco , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador , Tomografia Computadorizada por Raios X , Humanos , Feminino , Neoplasias do Endométrio/radioterapia , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Braquiterapia/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Órgãos em Risco/efeitos da radiação , Tomografia Computadorizada por Raios X/métodos , Imageamento Tridimensional/métodos , Radioterapia de Intensidade Modulada/métodos , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Prognóstico
18.
Sensors (Basel) ; 24(12)2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38931703

RESUMO

Universal image restoration (UIR) aims to accurately restore images with a variety of unknown degradation types and levels. Existing methods, including both learning-based and prior-based approaches, heavily rely on low-quality image features. However, it is challenging to extract degradation information from diverse low-quality images, which limits model performance. Furthermore, UIR necessitates the recovery of images with diverse and complex types of degradation. Inaccurate estimations further decrease restoration performance, resulting in suboptimal recovery outcomes. To enhance UIR performance, a viable approach is to introduce additional priors. The current UIR methods have problems such as poor enhancement effect and low universality. To address this issue, we propose an effective framework based on a diffusion model (DM) for universal image restoration, dubbed ETDiffIR. Inspired by the remarkable performance of text prompts in the field of image generation, we employ text prompts to improve the restoration of degraded images. This framework utilizes a text prompt corresponding to the low-quality image to assist the diffusion model in restoring the image. Specifically, a novel text-image fusion block is proposed by combining the CLIP text encoder and the DA-CLIP image controller, which integrates text prompt encoding and degradation type encoding into time step encoding. Moreover, to reduce the computational cost of the denoising UNet in the diffusion model, we develop an efficient restoration U-shaped network (ERUNet) to achieve favorable noise prediction performance via depthwise convolution and pointwise convolution. We evaluate the proposed method on image dehazing, deraining, and denoising tasks. The experimental results indicate the superiority of our proposed algorithm.

19.
Sensors (Basel) ; 24(11)2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38894344

RESUMO

This research presents an innovative methodology aimed at monitoring jet trajectory during the jetting process using imagery captured by unmanned aerial vehicles (UAVs). This approach seamlessly integrates UAV imagery with an offline learnable prompt vector module (OPVM) to enhance trajectory monitoring accuracy and stability. By leveraging a high-resolution camera mounted on a UAV, image enhancement is proposed to solve the problem of geometric and photometric distortion in jet trajectory images, and the Faster R-CNN network is deployed to detect objects within the images and precisely identify the jet trajectory within the video stream. Subsequently, the offline learnable prompt vector module is incorporated to further refine trajectory predictions, thereby improving monitoring accuracy and stability. In particular, the offline learnable prompt vector module not only learns the visual characteristics of jet trajectory but also incorporates their textual features, thus adopting a bimodal approach to trajectory analysis. Additionally, OPVM is trained offline, thereby minimizing additional memory and computational resource requirements. Experimental findings underscore the method's remarkable precision of 95.4% and efficiency in monitoring jet trajectory, thereby laying a solid foundation for advancements in trajectory detection and tracking. This methodology holds significant potential for application in firefighting systems and industrial processes, offering a robust framework to address dynamic trajectory monitoring challenges and augment computer vision capabilities in practical scenarios.

20.
Sensors (Basel) ; 24(12)2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38931605

RESUMO

The rapid advancement of sensor technologies and deep learning has significantly advanced the field of image captioning, especially for complex scenes. Traditional image captioning methods are often unable to handle the intricacies and detailed relationships within complex scenes. To overcome these limitations, this paper introduces Explicit Image Caption Reasoning (ECR), a novel approach that generates accurate and informative captions for complex scenes captured by advanced sensors. ECR employs an enhanced inference chain to analyze sensor-derived images, examining object relationships and interactions to achieve deeper semantic understanding. We implement ECR using the optimized ICICD dataset, a subset of the sensor-oriented Flickr30K-EE dataset containing comprehensive inference chain information. This dataset enhances training efficiency and caption quality by leveraging rich sensor data. We create the Explicit Image Caption Reasoning Multimodal Model (ECRMM) by fine-tuning TinyLLaVA with the ICICD dataset. Experiments demonstrate ECR's effectiveness and robustness in processing sensor data, outperforming traditional methods.

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