ABSTRACT
Hypomimia and voice changes are soft signs preceding classical motor disability in patients with Parkinson's disease (PD). We aim to investigate whether an analysis of acoustic and facial expressions with machine-learning algorithms assist early identification of patients with PD. We recruited 371 participants, including a training cohort (112 PD patients during "on" phase, 111 controls) and a validation cohort (74 PD patients during "off" phase, 74 controls). All participants underwent a smartphone-based, simultaneous recording of voice and facial expressions, while reading an article. Nine different machine learning classifiers were applied. We observed that integrated facial and voice features could discriminate early-stage PD patients from controls with an area under the receiver operating characteristic (AUROC) diagnostic value of 0.85. In the validation cohort, the optimal diagnostic value (0.90) maintained. We concluded that integrated biometric features of voice and facial expressions could assist the identification of early-stage PD patients from aged controls.
ABSTRACT
PURPOSE: To examine the diagnostic effect of immediate on-site cytopathologic evaluation of tissue core touch preparations in computed tomographic (CT)-guided coaxial needle biopsy. MATERIALS AND METHODS: The authors reviewed the records of 430 patients and included 413 patients with 432 biopsies (210 in the lungs, 222 in other locations). Each time the guiding needle was moved to a new location in the lesion for tissue core procurement with the cutting needle, it represented a new session. Core specimen touch preparations were obtained and immediately evaluated on-site for specimen adequacy and preliminary diagnosis. New sessions were considered and/or executed in the case of inconclusive cytopathologic readings. Each final diagnosis was reached according to the pathology report showing "positive for malignancy," "negative but with a specific diagnosis," or "unclear" for further surgical resection specimen or radiologic follow-up. RESULTS: The accuracy of on-site cytopathologic examination of touch preparations was 80.6% for the first session and increased to 85.9% and 86.3%, respectively, for the second and third sessions. The corresponding accuracies for biopsy were 88.2%, 93.8%, and 94.9%. The overall accuracy was 97.1% for lesions in the lungs and 92.8% for lesions at other sites. More biopsy sessions were deemed necessary in lesions measuring 2 cm or smaller (P = .0045). During CT-guided lung biopsy, 10 patients (4.8%) had major complications that necessitated chest tube insertion. CONCLUSIONS: The diagnostic accuracy of CT-guided needle biopsy can be increased through repeated sessions with immediate on-site cytologic evaluation, especially for lesions of 2 cm or smaller and those from nonpulmonary sites.
Subject(s)
Biopsy, Needle , Neoplasms/pathology , Radiography, Interventional , Staining and Labeling , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Needle/adverse effects , Child , Female , Humans , Male , Middle Aged , Neoplasms/diagnostic imaging , Predictive Value of Tests , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Young AdultABSTRACT
This paper reports the strategy and effectiveness of an emergency control program conducted in Pingtung City, Taiwan in response to dengue outbreaks. In our control strategy, we carried out 3 insecticide space sprays with an interval of 6-7 days and 2 source reductions to cover the entire duration of dengue virus exposure in humans and mosquito vectors. The control effect was demonstrated by a significant reduction in the Breteau (51.1%) and larval (80.0%) indices, but no such effect was demonstrated by alterations in the adult index (54.9%), house index (45.0%), container index (33.8%), or by indoor (15.8%), outdoor (31.2%), or total water-filled containers (22.7%) per 100 premises examined. The contribution made by the reduction in the number of positive containers was primarily in the outdoor (77.2%), and not the indoor containers (-6.0%). This reduction attributed to an overall reduction of 96.0% Aedes albopictus larvae and 71.0% Aedes aegypti. Therefore, 4 weeks after this extensive emergency control measure, the number of dengue cases dropped to one. Finally, due to both the decrease in temperature resulting from the upcoming winter, and to the sustained effort toward source reduction, the transmission cycle of DENV-2 in Pingtung City was interrupted at the beginning of 2003, and no additional cases were identified in late 2003.
