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1.
Artigo em Inglês | MEDLINE | ID: mdl-33528445

RESUMO

Vertical bone augmentation (VBA) procedures for dental implant placement are biologically and technically challenging. Systematic reviews and meta-analyses of studies on VBA have failed to identify clinical procedures that provide superior results for treatment of the vertical ridge deficiencies. A decision tree was developed to guide clinicians on selecting treatment options based on reported vertical bone gains (< 5 mm, 5 to 8 mm, > 8 mm). The choice of a particular augmentation technique will also depend on other factors, including the size and morphology of the defect, location, and clinician or patient preferences. Surgeons should consider the advantages and disadvantages of each option for the clinical situation and select an approach with low complications, low cost, and the highest likelihood of success.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Implantes Dentários , Perda do Osso Alveolar/cirurgia , Transplante Ósseo , Árvores de Decisões , Implantação Dentária Endo-Óssea , Humanos
2.
J Environ Radioact ; 229-230: 106542, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33581483

RESUMO

We present a novel application of machine learning techniques to optimize the design of a radiation detection system. A decision tree-based algorithm is described which greedily optimizes partitioning of energy depositions based on a minimum detectable concentration metric - appropriate for radiation measurement. We apply this method to the task of optimizing sensitivity to radioxenon decays in the presence of a high rate of radon-progeny backgrounds (i.e., assuming no physical radon removal by traditional gas separation techniques). Assuming other backgrounds are negligible, and considering sensitivity to each xenon isotope separately (neglecting interference between isotopes), we find that, in general, high resolution readout and high spatial segmentation yield little additional capability to discriminate against radon backgrounds compared to simpler detector designs.


Assuntos
Poluentes Radioativos do Ar , Monitoramento de Radiação , Radônio , Poluentes Radioativos do Ar/análise , Árvores de Decisões , Radônio/análise , Radioisótopos de Xenônio/análise
3.
Urol Clin North Am ; 48(1): 91-101, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218597

RESUMO

Robotically assisted laparoscopic techniques may be used for proximal and distal ureteral strictures. Distal strictures may be approached with ureteroneocystotomy, psoas hitch, and Boari flap. Ureteroureterostomy, buccal mucosa graft ureteroplasty, and appendiceal flap ureteroplasty are viable techniques for strictures anywhere along the ureter. Ileal ureteral substitution is reserved for more extensive disease, and autotransplantation is reserved for salvage situations.


Assuntos
Constrição Patológica/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Algoritmos , Constrição Patológica/diagnóstico , Constrição Patológica/etiologia , Árvores de Decisões , Humanos , Íleo/transplante , Mucosa Bucal/transplante , Assistência Perioperatória , Procedimentos Cirúrgicos Reconstrutivos/instrumentação , Reimplante , Retalhos Cirúrgicos , Ureter/anatomia & histologia , Ureter/irrigação sanguínea , Obstrução Ureteral/diagnóstico , Obstrução Ureteral/etiologia , Procedimentos Cirúrgicos Urológicos/instrumentação
4.
J Surg Res ; 257: 118-127, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32823009

RESUMO

BACKGROUND: As the population ages, the incidence of traumatic falls has been increasing. We hypothesize that a machine learning algorithm can more accurately predict mortality after a fall compared with a standard logistic regression (LR) model based on immediately available admission data. Secondary objectives were to predict who would be discharged home and determine which variables had the largest effect on prediction. METHODS: All patients who were admitted for fall between 2012 and 2017 at our level 1 trauma center were reviewed. Fourteen variables describing patient demographics, injury characteristics, and physiology were collected at the time of admission and were used for prediction modeling. Algorithms assessed included LR, decision tree classifier (DTC), and random forest classifier (RFC). Area under the receiver operating characteristic curve (AUC) values were calculated for each algorithm for mortality and discharge to home. RESULTS: About 4725 patients met inclusion criteria. The mean age was 61 ± 20.5 y, Injury Severity Score 8 ± 7, length of stay 5.8 ± 7.6 d, intensive care unit length of stay 1.8± 5.2 d, and ventilator days 0.7 ± 4.2 d. The mortality rate was 3% and three times greater for elderly (aged 65 y and older) patients (5.0% versus 1.6%, P < 0.001). The AUC for predicting mortality for LR, DTC, and RFC was 0.78, 0.64, and 0.86, respectively. The AUC for predicting discharge to home for LR, DTC, and RFC was 0.72, 0.61, and 0.74, respectively. The top five variables that contribute to the prediction of mortality in descending order of importance are the Glasgow Coma Score (GCS) motor, GCS verbal, respiratory rate, GCS eye, and temperature. CONCLUSIONS: RFC can accurately predict mortality and discharge home after a fall. This predictive model can be implemented at the time of patient arrival and may help identify candidates for targeted intervention as well as improve prognostication and resource utilization.


Assuntos
Acidentes por Quedas/mortalidade , Acidentes por Quedas/estatística & dados numéricos , Aprendizado de Máquina , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Árvores de Decisões , Feminino , Escala de Coma de Glasgow , Humanos , Escala de Gravidade do Ferimento , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Curva ROC , Estudos Retrospectivos , Centros de Traumatologia
7.
Sports Health ; 13(1): 78-84, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32822265

RESUMO

CONTEXT: There is a renewed interest in diagnosing and treating subscapularis tears, but there is a paucity of clinical guidance to optimize diagnostic decision-making. OBJECTIVE: To perform a literature review to evaluate advanced maneuvers and special tests in the diagnosis of subscapularis tears and create a diagnostic algorithm for subscapularis pathology. DATA SOURCES: PubMed, MEDLINE, Ovid, and Cochrane Reviews databases. STUDY SELECTION: Inclusion criteria consisted of level 1 and 2 studies published in peer-reviewed scientific journals that focused on physical examination. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Individual test characteristics (bear hug, belly press, lift-off, Napoleon, and internal rotation lag sign) were combined in series and in parallel to maximize clinical sensitivity and specificity for any special test evaluated in at least 2 studies. A secondary analysis utilized subjective pretest probabilities to create a clinical decision tree algorithm and provide posttest probabilities. RESULTS: A total of 3174 studies were identified, and 5 studies met inclusion criteria. The special test combination of the bear hug and belly press demonstrated the highest positive likelihood ratio (18.29). Overall, 3 special test combinations in series demonstrated a significant impact on posttest probabilities. With parallel testing, the combination of bear hug and belly press had the highest sensitivity (84%) and lowest calculated negative likelihood ratio (0.21). CONCLUSION: The combined application of the bear hug and belly press physical examination maneuvers is an optimal combination for evaluating subscapularis pathology. Positive findings using this test combination in series with a likely pretest probability yield a 96% posttest probability; whereas, negative findings tested in parallel with an unlikely pretest probability yield a 12% posttest probability.


Assuntos
Exame Físico , Lesões do Manguito Rotador/diagnóstico , Algoritmos , Tomada de Decisão Clínica , Árvores de Decisões , Medicina Baseada em Evidências , Humanos , Sensibilidade e Especificidade
8.
Klin Mikrobiol Infekc Lek ; 26(1): 18-24, 2020 Mar.
Artigo em Tcheco | MEDLINE | ID: mdl-33326591

RESUMO

OBJECTIVES: To assess the cost-effectiveness of pharmacological pre-exposure prophylaxis (PrEP) using a combination of emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) with respect to HIV transmission in high-risk patients in the Czech Republic. MATERIAL AND METHODS: A pharmacoeconomic model was constructed to compare costs and outcomes in a cohort with and without PrEP. Initially, a decision tree is used to evaluate short-term benefits of PrEP (proportion of HIV-infected individuals), followed by Markov cycles to simulate the course of the disease based on CD4 lymphocyte counts. The efficacy of PrEP, probability of transition between HIV infection stages, costs per category and quality of life data were derived from the literature. The results are presented as an incremental cost effectiveness ratio of incremental costs and incremental quality adjusted life-years (ICER/QALY) in a lifetime horizon with a 3% annual discount rate of costs and benefits. RESULTS: The FTC/TDF prophylaxis is dominant, that is, it generates lower costs and higher benefits (expressed as QALYs) in comparison with the control group without prophylaxis. A sensitivity analysis modelled all relevant parameters and all scenarios confirmed the PrEP dominance. CONCLUSIONS: A cost-effectiveness analysis in the Czech Republic setting confirmed that pharmacological PrPE intervention is cost-effective, or cost-saving, in a high-risk population of men having sex with men, using a lifetime horizon.


Assuntos
Fármacos Anti-HIV , Análise Custo-Benefício , Infecções por HIV , Profilaxia Pré-Exposição/economia , Fármacos Anti-HIV/uso terapêutico , República Tcheca/epidemiologia , Árvores de Decisões , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Humanos , Masculino , Modelos Econômicos , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Minorias Sexuais e de Gênero
9.
Lancet Digit Health ; 2(5): e240-e249, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-33328056

RESUMO

BACKGROUND: Deep learning is a novel machine learning technique that has been shown to be as effective as human graders in detecting diabetic retinopathy from fundus photographs. We used a cost-minimisation analysis to evaluate the potential savings of two deep learning approaches as compared with the current human assessment: a semi-automated deep learning model as a triage filter before secondary human assessment; and a fully automated deep learning model without human assessment. METHODS: In this economic analysis modelling study, using 39 006 consecutive patients with diabetes in a national diabetic retinopathy screening programme in Singapore in 2015, we used a decision tree model and TreeAge Pro to compare the actual cost of screening this cohort with human graders against the simulated cost for semi-automated and fully automated screening models. Model parameters included diabetic retinopathy prevalence rates, diabetic retinopathy screening costs under each screening model, cost of medical consultation, and diagnostic performance (ie, sensitivity and specificity). The primary outcome was total cost for each screening model. Deterministic sensitivity analyses were done to gauge the sensitivity of the results to key model assumptions. FINDINGS: From the health system perspective, the semi-automated screening model was the least expensive of the three models, at US$62 per patient per year. The fully automated model was $66 per patient per year, and the human assessment model was $77 per patient per year. The savings to the Singapore health system associated with switching to the semi-automated model are estimated to be $489 000, which is roughly 20% of the current annual screening cost. By 2050, Singapore is projected to have 1 million people with diabetes; at this time, the estimated annual savings would be $15 million. INTERPRETATION: This study provides a strong economic rationale for using deep learning systems as an assistive tool to screen for diabetic retinopathy. FUNDING: Ministry of Health, Singapore.


Assuntos
Inteligência Artificial , Análise Custo-Benefício , Retinopatia Diabética/diagnóstico , Técnicas de Diagnóstico Oftalmológico/economia , Processamento de Imagem Assistida por Computador/economia , Modelos Biológicos , Telemedicina/economia , Adulto , Idoso , Árvores de Decisões , Diabetes Mellitus , Retinopatia Diabética/economia , Custos de Cuidados de Saúde , Humanos , Aprendizado de Máquina , Programas de Rastreamento/economia , Pessoa de Meia-Idade , Oftalmologia/economia , Fotografação , Exame Físico , Retina/patologia , Sensibilidade e Especificidade , Singapura , Telemedicina/métodos
10.
Artigo em Inglês | MEDLINE | ID: mdl-33322123

RESUMO

Substances that do not degrade over time have proven to be harmful to the environment and are dangerous to living organisms. Being able to predict the biodegradability of substances without costly experiments is useful. Recently, the quantitative structure-activity relationship (QSAR) models have proposed effective solutions to this problem. However, the molecular descriptor datasets usually suffer from the problems of unbalanced class distribution, which adversely affects the efficiency and generalization of the derived models. Accordingly, this study aims at validating the performances of balanced random trees (RTs) and boosted C5.0 decision trees (DTs) to construct QSAR models to classify the ready biodegradation of substances and their abilities to deal with unbalanced data. The balanced RTs model algorithm builds individual trees using balanced bootstrap samples, while the boosted C5.0 DT is modeled using cost-sensitive learning. We employed the two-dimensional molecular descriptor dataset, which is publicly available through the University of California, Irvine (UCI) machine learning repository. The molecular descriptors were ranked according to their contributions to the balanced RTs classification process. The performance of the proposed models was compared with previously reported results. Based on the statistical measures, the experimental results showed that the proposed models outperform the classification results of the support vector machine (SVM), K-nearest neighbors (KNN), and discrimination analysis (DA). Classification measures were analyzed in terms of accuracy, sensitivity, specificity, precision, false positive rate, false negative rate, F1 score, receiver operating characteristic (ROC) curve, and area under the ROC curve (AUROC).


Assuntos
Árvores de Decisões , Aprendizado de Máquina , Máquina de Vetores de Suporte , Algoritmos , Análise Discriminante , Humanos , Curva ROC
11.
PLoS One ; 15(12): e0243907, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33320890

RESUMO

One of the fundamental challenges when dealing with medical imaging datasets is class imbalance. Class imbalance happens where an instance in the class of interest is relatively low, when compared to the rest of the data. This study aims to apply oversampling strategies in an attempt to balance the classes and improve classification performance. We evaluated four different classifiers from k-nearest neighbors (k-NN), support vector machine (SVM), multilayer perceptron (MLP) and decision trees (DT) with 73 oversampling strategies. In this work, we used imbalanced learning oversampling techniques to improve classification in datasets that are distinctively sparser and clustered. This work reports the best oversampling and classifier combinations and concludes that the usage of oversampling methods always outperforms no oversampling strategies hence improving the classification results.


Assuntos
Diabetes Mellitus/diagnóstico por imagem , Neuropatias Diabéticas/diagnóstico por imagem , Aprendizado de Máquina , Imagem por Ressonância Magnética , Algoritmos , Árvores de Decisões , Diabetes Mellitus/classificação , Diabetes Mellitus/patologia , Neuropatias Diabéticas/classificação , Neuropatias Diabéticas/patologia , Feminino , Humanos , Masculino , Neuroimagem/métodos , Máquina de Vetores de Suporte
12.
Rev. enferm. UERJ ; 28: e42285, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1120154

RESUMO

Objetivo: comparar o custo entre coberturas com filme transparente versus gaze estéril e fita adesiva microporosa em curativos de acesso venoso central. Método: estudo estatístico, prospectivo, observacional, com abordagem quantitativa à luz da avaliação econômica de saúde. Foram avaliadas 109 coberturas com filme e 168 com gaze, durante 27 dias. Na análise utilizouse o Software Tree Age para se calcular a probabilidade de cada decisão. Resultado: a média de uso das coberturas por dia foi de 2,22 inserções cobertas com filme e 3,43 com gaze. Houve necessidade de troca extra em 38 (23%) das coberturas com gaze e em 16 (15%) das coberturas com filme transparente. Observou-se custo final médio para gaze (R$389,44) 3,7 vezes maior que o filme transparente (R$104,95) durante o período estudado. Conclusão: cobertura com filme transparente tem menor custo quando comparado com cobertura com gaze estéril.


Objective: to compare the cost of transparent film and sterile gauze fixed by microporous adhesive tape in central venous access dressings. Method: quantitative, prospective, observational, statistical study in the light of health economics. A total of 109 film and 168 gauze covers were evaluated for 27 days. Tree Age software was used to calculate the probability of each decision. Results: coverings used per day averaged 2.22 with transparent film-covered inserts and 3.43 with gauze. Additional changes were necessary in 38 (23%) coverings with gauze and 16 (15%) with transparent film. During the study period, the average final cost of gauze (R$ 389.44) was 3.7 times higher than transparent film (R$104.95). Conclusion: transparent film dressing is less expensive than sterile gauze covering.


Objetivo: comparar el costo de la película transparente y la gasa estéril fijada con cinta adhesiva microporosa en apósitos de acceso venoso central. Método: estudio cuantitativo, prospectivo, observacional, estadístico a la luz de la economía de la salud. Se evaluaron un total de 109 películas y 168 cubiertas de gasa durante 27 días. Se utilizó el software Tree Age para calcular la probabilidad de cada decisión. Resultados: los recubrimientos utilizados por día promediaron 2,22 con inserciones transparentes recubiertas con película y 3,43 con gasas. Fueron necesarios cambios adicionales en 38 (23%) revestimientos con gasa y 16 (15%) con película transparente. Durante el período de estudio, el costo final promedio de la gasa (R $ 389,44) fue 3,7 veces superior al de la película transparente (R $ 104,95). Conclusión: el apósito de película transparente es menos costoso que el recubrimiento de gasa estéril.


Assuntos
Humanos , Avaliação em Saúde/economia , Cateteres Venosos Centrais , Curativos Oclusivos/economia , Brasil , Árvores de Decisões , Estudos Prospectivos , Custos e Análise de Custo , Estudo Observacional , Curativos Oclusivos/estatística & dados numéricos
13.
Farm. hosp ; 44(6): 279-287, nov.-dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197696

RESUMO

OBJETIVO: La esplenectomía, los agonistas del receptor de trombopo-yetina y el rituximab son los tratamientos de segunda línea para la trombocitopenia inmune primaria. Los dos últimos se están convirtiendo en los más utilizados para evitar los efectos adversos de la esplenectomía. Sin embargo, la elección entre ambos no está clara. El coste puede ser de interés para priorizar el tratamiento. Nuestro objetivo es determinar el coste por paciente respondedor después de 6 meses de tratamiento de la trombocitopenia inmune primaria crónica con rituximab frente al agonista del receptor de trombopoyetina eltrombopag en el Sistema Nacional de Salud español. MÉTODO: Se desarrolló un modelo de árbol de decisión de 26 semanas para evaluar el coste de la respuesta al tratamiento con eltrombopag y rituximab en pacientes adultos con trombocitopenia inmune primaria crónica refractaria a esteroides. Debido al corto periodo de evaluación, no se aplicó tasa de descuento. RESULTADOS: El coste medio por paciente tras 6 meses de tratamiento fue ligeramente superior para eltrombopag (13.089,40 (Euro)) que para rituximab (11.852,60 (Euro)). Sin embargo, la mayor tasa de respuesta de eltrombopag disminuye los costes de hemorragia, lo que se traduce en un coste por paciente respondedor un 29% mayor con rituximab (18.964,15 (Euro)) que con eltrombopag (14.732,65 (Euro)). Este resultado concuerda con los de los 15 análisis de sensibilidad realizados, donde eltrombopag siempre representa un menor coste por paciente respondedor, excepto cuando el tratamiento con eltrombopag se realiza en su dosis máxima (75 mg). Sólo en este caso, el coste por respondedor a eltrombopag es 48 (Euro) más caro que el del rituximab. En coherencia con lo anterior, la mayor diferencia a favor de eltrombopag se da en el escenario que utiliza la dosis mínima de éste -25 mg- (eltrombopag 7.622,14 (Euro) frente a 18.964,15 (Euro) de rituximab). Así, el coste por paciente respondedor es menor en eltrombopag aunque no se realice un segundo ciclo de retratamiento con rituximab (14.732,65 (Euro) frente a 15.298,61 (Euro)). CONCLUSIONES: El coste del tratamiento con rituximab, incluidos los costes de monitorización y sangrado, es más alto que el de eltrombopag, lo cual favorece a este último por encima de rituximab


OBJECTIVE: Splenectomy, thrombopoietin receptor agonists and rituximab are the second-line treatments for steroid-resistant adult primary immune thrombocytopenia. The last two are becoming the most widely used treatments to avoid splenectomy adverse effects and inconveniences. However, the choice between rituximab and thrombopoietin receptor agonists is unclear. Therefore, the treatment cost may be of particular interest to prioritize the therapy option. Our aim is to determine the cost per responding-patient after 6 months of use of rituximab compared to thrombopoietin receptor agonists eltrombopag in the treatment of chronic primary immune thrombocytopenia in the Spanish National Health Service. METHOD: A 26-week decision tree model was developed to assess the cost of treatment response of adult patients with chronic-refractory primary immune thrombocytopenia to eltrombopag and rituximab from the perspective of the Spanish National Health System. Effectiveness was obtained from the literature, and cost was obtained from the official rates. Costs were expressed in (Euro) (2018). Due to the short period of assessment, no discount rate was applied. RESULTS: The average cost per patient after 6 months of treatment was slightly higher for eltrombopag ((Euro)13,089.40) than for rituximab ((Euro)11,852.60). However, the greater response rate of eltrombopag decreases the bleeding costs, resulting in a 29% higher cost per responding-patient with rituximab ((Euro)18,964.15) than for eltrombopag ((Euro)14,732.65). This result is consistent with the results of the 15 sensitivity analyses carried out where eltrombopag always represents a lower cost per responding patient, except in the sensitivity analysis in which treatment with eltrombopag is performed at its maximum dose (75mg). Only in this case, the cost per responder of eltrombopag is (Euro)48 more expensive than that of rituximab. Likewise, the greatest difference in favor of eltrombopag occurs in the scenario that uses the minimum dose of this drug -25mg- (eltrombopag (Euro)7,622.14 compared to (Euro)18,964.15 for rituximab). Thus, the cost per responding patient is lower in eltrombopag even if a second cycle of retreatment with rituximab is not performed ((Euro)14,732.65 versus (Euro)15,298.61). CONCLUSIONS: The treatment cost of rituximab, including monitoring and bleeding costs, is higher than eltrombopag, favoring the latter over rituximab treatment


Assuntos
Humanos , Trombocitopenia/tratamento farmacológico , Trombocitopenia/economia , Rituximab/administração & dosagem , Receptores de Trombopoetina , Rituximab/economia , Espanha , Árvores de Decisões , Tomada de Decisões , Tempo de Internação/economia
14.
Artigo em Inglês | MEDLINE | ID: mdl-33198392

RESUMO

This paper analyzes a sample of patients hospitalized with COVID-19 in the region of Madrid (Spain). Survival analysis, logistic regression, and machine learning techniques (both supervised and unsupervised) are applied to carry out the analysis where the endpoint variable is the reason for hospital discharge (home or deceased). The different methods applied show the importance of variables such as age, O2 saturation at Emergency Rooms (ER), and whether the patient comes from a nursing home. In addition, biclustering is used to globally analyze the patient-drug dataset, extracting segments of patients. We highlight the validity of the classifiers developed to predict the mortality, reaching an appreciable accuracy. Finally, interpretable decision rules for estimating the risk of mortality of patients can be obtained from the decision tree, which can be crucial in the prioritization of medical care and resources.


Assuntos
Infecções por Coronavirus/mortalidade , Aprendizado de Máquina , Pneumonia Viral/mortalidade , Betacoronavirus , Árvores de Decisões , Humanos , Pandemias , Espanha/epidemiologia
15.
Clín. salud ; 31(3): 137-145, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197169

RESUMO

Este estudio evalúa si el sexo, la dependencia a la nicotina y variables emocionales (ansiedad, depresión e ira) permiten describir un perfil de paciente que pueda beneficiarse de una terapia cognitivo-conductual para abandonar la adicción al tabaco. Se analizaron los resultados de una muestra de 120 fumadores adultos que voluntariamente recibieron TCC. Se valoró la adherencia de los pacientes y el éxito del programa a través de árboles de decisión. Los resultados indicaron que la adherencia al tratamiento ya implica alta probabilidad de éxito (86.4%), aumentando hasta el 95.6% cuando los participantes presentaban altos niveles de ira externa. Además, la adherencia al tratamiento fue completa (100%) cuando la ansiedad en contexto de evaluación, la ansiedad fisiológica y la motivación fueron altas. La obtención de este tipo de perfiles diferenciales permite determinar qué personas son más indicadas para cada tratamiento, lo que incrementaría la eficacia de los mismos


The aim of this study is to analyse if gender, nicotine dependence, and emotional variables (anxiety, depression, and anger) help to describe a patient profile that could benefit from a cognitive behavioral therapy (CBT) to quit tobacco addiction. The sample consisted of 120 adult smokers who voluntarily received the CBT. Decision trees were used to assess patients' treatment adherence and program success. Data showed that just programme adherence implied a high success probability (86.4%), increasing to 95.6% when participants showed a high anger response. Besides, treatment adherence was 100% when anxiety in an evaluative context, physiologic anxiety, and motivation were high. Finding these differential profiles would help to determine the patient profile that would benefit most from treatment, and would increase their effectiveness


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Terapia Cognitivo-Comportamental/métodos , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Ansiedade/terapia , Depressão/terapia , Fatores Sexuais , Escalas de Graduação Psiquiátrica , Algoritmos , Cooperação e Adesão ao Tratamento , Resultado do Tratamento , Árvores de Decisões
16.
Huan Jing Ke Xue ; 41(11): 5060-5072, 2020 Nov 08.
Artigo em Chinês | MEDLINE | ID: mdl-33124249

RESUMO

Remote sensing monitoring of black-odor water is an important method for understanding the current status of urban water quality, and comprehensively evaluating the effect of urban water environment treatment. A total of 171 samples were collected in Nanjing, Changzhou, Wuxi, and Yangzhou cities and water quality parameters and optical parameters were measured simultaneously. Based on the analysis of the water color and optical characteristics of the black-odor water and non-black-odor water (denoted as general water), a decision tree was constructed to identify the severe, mild black-odor water, and general water as green and yellow water. The results found that:①According to the water color, the water bodies can be divided into six types. Among them, type 1 to 4 water bodies are black-odor water, which are gray black, dark gray, gray, and light gray water, respectively, and type 5 and 6 water bodies are general water, which are green and yellow water, respectively; ②Type 1 water body contains high contents of non-pigmented particulate matter and colored dissolved organic matter(CDOM), however, the absorption of pigmented particulate matter is not dominant. Type 2 and 5 water bodies are dominated by pigmented particulate matter. Type 3, 4, and 6 water bodies are dominated by non-pigmented particulate matter; ③After water color classification, and according to the differences of the reflection spectrums of the six types of water bodies, the difference of black-odorous water index (DBWI), green-red-nir area water index (G-R-NIR AWI), the green band reflectance and the normalized difference black-odorous water index (NDBWI) were used to construct a decision tree to identify the severe, mild black-odor water, and general water; ④The decision tree was applied to the PlanetScope satellite image of Yangzhou City on April 9, 2019, and 10 synchronous sampling points were used for verification. The overall recognition accuracy reached 80.00%, and the K value reached 0.67. The urban water classification model, after water color classification, can be applied to other similar water bodies, and provides a technical method for the supervision of black-odor water bodies.


Assuntos
Tecnologia de Sensoriamento Remoto , Água , Cidades , Árvores de Decisões , Monitoramento Ambiental , Odorantes
17.
PLoS One ; 15(10): e0241332, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33112931

RESUMO

In this work we present a three-stage Machine Learning strategy to country-level risk classification based on countries that are reporting COVID-19 information. A K% binning discretisation (K = 25) is used to create four risk groups of countries based on the risk of transmission (coronavirus cases per million population), risk of mortality (coronavirus deaths per million population), and risk of inability to test (coronavirus tests per million population). The four risk groups produced by K% binning are labelled as 'low', 'medium-low', 'medium-high', and 'high'. Coronavirus-related data are then removed and the attributes for prediction of the three types of risk are given as the geopolitical and demographic data describing each country. Thus, the calculation of class label is based on coronavirus data but the input attributes are country-level information regardless of coronavirus data. The three four-class classification problems are then explored and benchmarked through leave-one-country-out cross validation to find the strongest model, producing a Stack of Gradient Boosting and Decision Tree algorithms for risk of transmission, a Stack of Support Vector Machine and Extra Trees for risk of mortality, and a Gradient Boosting algorithm for the risk of inability to test. It is noted that high risk for inability to test is often coupled with low risks for transmission and mortality, therefore the risk of inability to test should be interpreted first, before consideration is given to the predicted transmission and mortality risks. Finally, the approach is applied to more recent risk levels to data from September 2020 and weaker results are noted due to the growth of international collaboration detracting useful knowledge from country-level attributes which suggests that similar machine learning approaches are more useful prior to situations later unfolding.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Planejamento em Desastres , Aprendizado de Máquina , Modelos Teóricos , Pandemias , Pneumonia Viral/epidemiologia , Medição de Risco/métodos , Algoritmos , Classificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/transmissão , Árvores de Decisões , Previsões , Saúde Global , Humanos , Cooperação Internacional , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/transmissão , Kit de Reagentes para Diagnóstico/provisão & distribução , Máquina de Vetores de Suporte
18.
PLoS One ; 15(10): e0237658, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33057328

RESUMO

Breast cancer is the most common invasive cancer and the second leading cause of cancer death in women. and regrettably, this rate is increasing every year. One of the aspects of all cancers, including breast cancer, is the recurrence of the disease, which causes painful consequences to the patients. Moreover, the practical application of data mining in the field of breast cancer can help to provide some necessary information and knowledge required by physicians for accurate prediction of breast cancer recurrence and better decision-making. The main objective of this study is to compare different data mining algorithms to select the most accurate model for predicting breast cancer recurrence. This study is cross-sectional and data gathering of this research performed from June 2018 to June 2019 from the official statistics of Ministry of Health and Medical Education and the Iran Cancer Research Center for patients with breast cancer who had been followed for a minimum of 5 years from February 2014 to April 2019, including 5471 independent records. After initial pre-processing in dataset and variables, seven new and conventional data mining algorithms have been applied that each one represents one kind of data mining approach. Results show that the C5.0 algorithm possibly could be a helpful tool for the prediction of breast cancer recurrence at the stage of distant recurrence and nonrecurrence, especially in the first to third years. also, LN involvement rate, Her2 value, Tumor size, free or closed tumor margin were found to be the most important features in our dataset to predict breast cancer recurrence.


Assuntos
Algoritmos , Neoplasias da Mama/patologia , Mineração de Dados/métodos , Recidiva Local de Neoplasia/patologia , Neoplasias da Mama/metabolismo , Estudos Transversais , Bases de Dados Factuais , Árvores de Decisões , Feminino , Humanos , Bloqueio Interatrial , Irã (Geográfico) , Metástase Linfática/patologia , Modelos Biológicos , Recidiva Local de Neoplasia/etiologia , Recidiva Local de Neoplasia/metabolismo , Redes Neurais de Computação , Receptor ErbB-2/metabolismo , Máquina de Vetores de Suporte
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5494-5497, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019223

RESUMO

Anterior cruciate ligament (ACL) injury rates in female adolescents are increasing. Irrespective of treatment options, approximately 1/3 will suffer secondary ACL injuries following their return to activity (RTA). Despite this, there are no evidence-informed RTA guidelines to aid clinicians in deciding when this should occur. The first step towards these guidelines is to identify relevant and feasible measures to assess the functional status of these patients. The purpose of this study was therefore to evaluate tests frequently used to assess functional capacity following surgery using a Reduced Error Pruning Tree (REPT). Thirty-six healthy and forty-two ACLinjured adolescent females performed a series of functional tasks. Motion analysis along with spatiotemporal measures were used to extract thirty clinically relevant variables. The REPT reduced these variables down to two limb symmetry measures (maximum anterior hop and maximum lateral hop), capable of classifying injury status between the healthy and ACL injured participants with a 69% sensitivity, 78% specificity and kappa statistic of 0.464. We, therefore, conclude that the REPT model was able to evaluate functional capacity as it relates to injury status in adolescent females. We also recommend considering these variables when developing RTA assessments and guidelines.Clinical Relevance- Our results indicate that spatiotemporal measures may differentiate ACL-injured and healthy female adolescents with moderate confidence using a REPT. The identified tests may reasonably be added to the clinical evaluation process when evaluating functional capacity and readiness to return to activity.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Traumatismos do Joelho , Adolescente , Algoritmos , Árvores de Decisões , Feminino , Humanos , Joelho , Traumatismos do Joelho/diagnóstico
20.
Bull Cancer ; 107(10): 1024-1041, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33004179

RESUMO

The association of a germline mutation in the BRCA1/2 genes in breast cancer leads to a higher genomic instability and, thus, a potential higher sensitivity to poly(ADP-ribose) polymerase (PARP) inhibitors. In this review, we will summarize the different DNA-repair pathways including PARP-dependent mechanisms that support the use of PARP inhibitors. We will present clinical trials evaluating PARP inhibitors alone or in combination in early or advanced stage breast cancer. We will then discuss the different mechanisms involved in the resistance to PARP inhibitors. We will also introduce the concept of BRCAness by which the use of PARP inhibitors could be extended to BRCA1/2-wild type patients. Finally, we will describe the new channels implemented for the theranostic genetic screening.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Neoplasias da Mama/genética , Reparo do DNA , Árvores de Decisões , Feminino , Humanos
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