Development Of Clinical Models Research Articles

Combined with the semantic features of CT and selected clinical variables, a machine learning model for accurately predicting the prognosis of omicron was established

Abstract Objective To efficiently use medical resources and offer optimal personalized treatment for individuals with Omicron infection, it's vital to predict the disease's outcome early on. This research developed three machine learning models to foresee the results for Omicron-infected patients. Methods Data from 253 Omicron-infected patients, including their CT scans, clinical details, and relevant laboratory values, were studied. The patients were categorized into two groups based on their disease progression: favorable prognosis and unfavorable prognosis. Patients manifesting respiratory failure, acute liver or kidney impairment, or fatalities were placed in the “poor” group. Those lacking such symptoms were allocated to the “good” group. The participants were randomly split into training set (202) and validation set (51) with an 8:2 ratio. Radiomics features were produced using image processing, focused segmentation, feature extraction, and selection, leading to the establishment of a radiomics model. A univariate logistic regression method identified potential clinical factors contributing to a clinical model's development. Eventually, the fused feature set, integrating radiomics features and clinical indicators, was used for the combined model. The model's prediction performance was assessed using the area under the receiver operating characteristic curve (AUC). The model's clinical usefulness was evaluated by generating calibration and decision curves. Results Compared to other classification models, the combined model showcased the best classification performance. It achieved an AUC of 0.848 and accuracy of 0.763 in the training set, and 0.797 and 0.750 in the validation set, respectively. Conclusion This study employed machine learning model to accurately predict the prognosis of Omicron-infected patients. ADVANCES IN KNOWLEDGE： (1) Topic innovation: At present, there is a lack of research on the use of CT images to construct machine learning models to predict the prognosis of patients with Omicjon infection. This study intends to establish clinical, radiomics and combined models to provide more possibilities for the identification of the two. (2) Platform innovation: The feature extraction and screening and the establishment of omics model in this study will be completed in the intelligent scientific research platform, which can reduce the error caused by human error, simplify the operation steps and save the time of data processing time.

Predicting COVID-19 Re-Positive Cases in Malnourished Older Adults: A Clinical Model Development and Validation.

Building and validating a clinical prediction model for novel coronavirus (COVID-19) re-positive cases in malnourished older adults. Malnourished older adults from January to May 2023 were retrospectively collected from the Department of Geriatrics of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine. They were divided into a "non-re-positive" group and a "re-positive" group based on the number of COVID-19 infections, and into a training set and a validation set at a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to identify predictive factors for COVID-19 re-positivity in malnourished older adults, and a nomogram was constructed. Independent influencing factors were screened by multivariate logistic regression. The model's goodness-of-fit, discrimination, calibration, and clinical impact were assessed by Hosmer-Lemeshow test, area under the curve (AUC), calibration curve, decision curve analysis (DCA), and clinical impact curve analysis (CIC), respectively. We included 347 cases, 243 in the training set, and 104 in the validation set. We screened 10 variables as factors influencing the outcome. By multivariate logistic regression analysis, preliminary identified protective factors, risk factors, and independent influencing factors that affect the re-positive outcome. We constructed a clinical prediction model for COVID-19 re-positivity in malnourished older adults. The Hosmer-Lemeshow test yielded χ2 =5.916, P =0.657; the AUC was 0.881; when the threshold probability was >8%, using this model to predict whether malnourished older adults were re-positive for COVID-19 was more beneficial than implementing intervention programs for all patients; when the threshold was >80%, the positive estimated value was closer to the actual number of cases. This model can help identify the risk of COVID-19 re-positivity in malnourished older adults early, facilitate early clinical decision-making and intervention, and have important implications for improving patient outcomes. We also expect more large-scale, multicenter studies tofurther validate, refine, and update this model.

A microfluidic hemostatic diagnostics platform: Harnessing coagulation-induced adaptive-bubble behavioral perception

Clinical viscoelastic hemostatic assays, which have been used for decades, rely on measuring biomechanical responses to physical stimuli but face challenges related to high device and test cost, limited portability, and limited scalability.. Here, we report a differential pattern using self-induced adaptive-bubble behavioral perception to refresh it. The adaptive behaviors of bubble deformation during coagulation precisely describe the transformation of viscoelastic hemostatic properties, being free of the precise and complex physical devices. And the integrated bubble array chip allows microassays and enables multi-bubble tests with good reproducibility. Recognition of the developed bubble behaviors empowers automated and user-friendly diagnosis. In a prospective clinical study (clinical model development [n= 273]; clinical assay [n= 44]), we show that the diagnostic accuracies were 99.1% for key viscoelastic hemostatic assay indicators (reaction time [R], kinetics time [K], alpha angle [Angle], maximum amplitude [MA], lysis at 30min [LY30]; n= 220) and 100% (n= 44) for hypercoagulation, healthy, and hypocoagulation diagnoses. This should provide fresh insight into existing paradigms and help more clinical needs.

Frailty: understanding the difference between age and ageing.

In the past, illness and dependence were viewed as inevitable consequences of old age. Now, we understand that there is a difference between age (the passing of chronological time) and ageing (the increased risk of adverse outcomes over time). Over the last 50 years, 'frailty' research has established that ageing is heterogeneous, variable and malleable. Significant advances have been made in frailty measurement (description of clinical features and development of clinical models), mechanisms (insights into pathogenesis) and management (development of interventions to reduce and/or prevent progression). Subsequently, the concept of frailty has informed health policy and clinical practice and started to change perceptions of older age held by the general public and the health sector. Here, we overview key achievements in frailty research and clinical practice and highlight the considerable number of known unknowns that may be addressed in the future.

Editorial introductions

Current Opinion in Supportive and Palliative Care was launched in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of supportive and palliative care are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Aminah Jatoi Aminah Jatoi, MD is a practicing oncologist at the Mayo Clinic in Rochester, Minnesota, USA. She carries a strong interest in a variety of cancer-related palliative care issues, including the management of weight loss in patients with advanced cancer. Florian StrasserFlorian StrasserFlorian Strasser, MD ABHPM Associate Professor (PD), Head Oncological Palliative Medicine, Clinic for Oncology/Haematology, Dept. Internal Medicine and Palliative Center, Cantonal Hospital St.Gallen, Switzerland, is a medical doctor with board certification in internal medicine, medical oncology and palliative medicine and dedicates his work to clinical and research activities of integrated oncology and palliative care and cancer cachexia/nutrition/rehabilitation, as well as capacity building in multi-professional teams. His interests lie in the development of clinical models, clinical practice tools, and quality indicators to integrate oncology and palliative care. This work is also affiliated with international organizations with functions as chair or other responsibilities in the European Society of Medical Oncology (ESMO), Multinational Association of Supportive Care and Cancer (MASCC), European Association of Palliative Care (EAPC), American Society of Clinical Oncology (ASCO), and The Society on Sarcopenia, Cachexia and Wasting Disorders (SCWD). Gustavo de SimoneGustavo de SimoneGustavo de Simone was born in Argentina in 1955 and graduated as a physician in 1979 completing his specialty in medical oncology. He was appointed Medical Director of the Palliative Care Program at Mainetti Comprehensive Cancer Centre in La Plata, Argentina, in 1991. Since then he has contributed to the development of specialist palliative care services in Buenos Aires and other cities in Argentina. He has led development of palliative care education mainly at postgraduate level within the University of La Plata, Argentina, from 1992 to 1997 and Universidad del Salvador, Argentina, from 1998 to present, and has been involved in the development of the research and development programs. He is Medical Director of Pallium Latinoamerica Study Centre (NGO), which has had academic links with Oxford International Centre for Palliative Care since 1993. In June 2005, Dr De Simone was made Coordinator of Post-graduated Training in Palliative Care (Residence Program) within the Ministry of Health, Buenos Aires Government. He is currently Chief of Education and Research Department at the Bonorino Udaondo Public Hospital in Buenos Aires. In 1998 he became Honorary Professor of Palliative Medicine at the Universidad del Salvador, Buenos Aires, and Director of the Career of Medical Oncology. This is the first Chair in Palliative Medicine in Argentina and provides a focal point for educational developments in South America. Based on his commitments to education, he got the 2003 International Association for Hospice and Palliative Care (IAHPC) Annual “Vittorio Ventafridda Award”. In 2009 he was made Director of the working group on End of Life Decisions at the Medical Ethics Committee of the National Academy of Medicine, and from 2008 to 2011 he was Argentina's country leader for the EU project “OPCARE9” Since 2011 he is the Director of MSc in Palliative Care at the Universidad del Salvador, and has been re-elected President of the Argentinean Association for Palliative Care from 2012 to 2014.

Mesenchymal stem cell therapy in nonhematopoietic diseases.

The extensive clinical experiments with stem cells, particularly in the treatment of oncohematological diseases, opened up the possibility of trying out stem cells with nonhematopoietic diseases. Mesenchymal stem cells (MSCs) subsequently emerged as a promising source for the regeneration and repair of various tissues in the treatment of a range of diseases due to their presence in all derived mesenchymal tissues in the adult solid organs as well as in mesoderm from embryonic tissue. This, plus their pluripotentiality and the fact that they were easily obtainable, meant that MSCs represented an important source for studies in regenerative medicine. MSCs have been shown to be capable of differentiating in various types of mesoderm derived cells as well as ectoderm cells, such as skeletal muscle cells, neurons, cardiomyocytes, osteocytes, chondrocytes, and others. MSCs in specific cultivation conditions in vitro and in host transplanted tissue, being niche dependent, arouse clinical interest in stem-cell therapy for regeneration in nonhematopoietic tissue diseases and the prospect of creating a mesenchymal stem-cell bank for research and subsequent clinical use. In the development of clinical models, always preceded by preclinical studies, there are various requirements to guarantee the safety of therapy with stem cells and their products, including the GMP procedures, cytogenetic control, identification and characterization of cells by immune cytometric analysis, and demonstration of their pluripotentiality for the prospective use of MSC for tissue regeneration in nonhematopoietic diseases [1]. In the study of MSCs, the intrinsic properties—molecular, immunocytochemistry, isolation, expansion, differentiation, and cryopreservation—have made great advances and need further discussion. The fact that MSCs do not express the antigens of histocompatibility means that they can be used in allogeneic transplantation. The development of methods for isolating the subpopulations of MSC fractions together with the perspective with this subpopulation could obtain better results than the total population in replacement therapy for correction of determined specific function [2]. Researchers and physicians are looking into the physiopathology of some diseases in light of the intrinsic cell conditions on the development of each disease and are proposing therapies based on the cells themselves or on cell-based products. Some diseases are triggered in their physiopathology by autoimmune mechanisms that could be stabilized with the paracrine effects of MSCs, such as the anti-inflammatory effect [3]; other diseases are triggered by the senescence of the cells, as in conditions of cellular apoptosis, and the MSC cells could act with the paracrine effects such as antiapoptosis and by cell replacement; there are some diseases which result from the loss of the production of certain molecules and MSCs could differentiate in cells capable of producing the molecule [4]; in other diseases, there is an interruption in signals between the tissue cells, and the MSC paracrine effects could promote the connections through the production of growth factors [5]. On the other hand, in ischemic diseases, MSCs could be differentiated in specific types of specialized cells, such as vessels and contractile cells, cardiomyocytes [6]; in genetic diseases, MSCs could ensure the delivery of genes for gene therapy [7] and could act in immunomodulation with vaccines [8]. This issue provides discussions of the points described above and takes a look into the future of cell therapy in nonhematopoetic diseases, showing that it is nearer than we expect! It is reality! Katherine Athayde Teixeira de Carvalho Gustav Steinhoff Juan Carlos Chachques

Editorial introductions

Current Opinion in Supportive and Palliative Care was launched in 2007. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of supportive and palliative care are divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Aminah Jatoi Aminah Jatoi, MD, is a practicing oncologist at the Mayo Clinic in Rochester, Minnesota, USA. She carries a strong interest in a variety of cancer-related palliative care issues, including the management of weight loss in patients with advanced cancer. Florian StrasserFlorian StrasserFlorian Strasser, MD, is a medical doctor with board certification in internal medicine, medical oncology and palliative medicine, and dedicates his work on clinical and research activities of integrated oncology and palliative care and cancer cachexia / nutrition / rehabilitation, as well as capacity building in multi-professional teams. His interest lies in the development of clinical models, clinical practice tools, and quality indicators to integrate oncology and palliative care. This work is also affiliated with international organizations, with functions as Chair or other responsibilities, in the European Society of Medical Oncology (ESMO), Multinational Association of Supportive Care and Cancer (MASCC), European Association of Palliative Care (EAPC), American Society of Clinical Oncology (ASCO), or the International Association of Hospice and Palliative Medicine (IAHPC). Florian Strasser is based in the Oncology Department of the Internal Medicine and Palliative Centre at Cantonal Hospital St.Gallen, Switzerland. Gustavo de SimoneGustavo de SimoneGustavo De Simone was born in Argentina in 1955 and graduated as a physician in 1979 completing his specialty in medical oncology. He was appointed Medical Director of the Palliative Care Program at Mainetti Comprehensive Cancer Centre in La Plata, Argentina in 1991. Since then he has contributed to the development of specialist palliative care services in Buenos Aires and other cities in Argentina. He has led development of palliative care education mainly at postgraduate level within the University of La Plata, Argentina (1992 to 1997) and Universidad del Salvador, Argentina (1998 to present), and has been involved in the development of the research and development programs. He is Medical Director of Pallium Latinoamerica Study Centre (NGO), which has had academic links with Oxford International Centre for Palliative Care since 1993. In June 2005, Dr De Simone was made Coordinator of Post-graduated Training in Palliative Care (Residence Program) within the Ministry of Health, Buenos Aires Government. He is currently Chief of Education and Research Department at the “Bonorino Udaondo” Public Hospital in Buenos Aires. In 1998 he became Honorary Professor of Palliative Medicine at the Universidad del Salvador, Buenos Aires, and Director of the Career of Medical Oncology. This is the first Chair in Palliative Medicine in Argentina and provides a focal point for educational developments in South America. Based on his commitments to education, he got the 2003 International Association for Hospice and Palliative Care (IAHPC) Annual “Vittorio Ventafridda Award”. In 2009 he was made Director of the working group on End of Life Decisions at the Medical Ethics Committee of the National Academy of Medicine.

Immunity, Pathophysiology, and Diagnosis of Equine Protozoal Myeloencephalitis

Our understanding of the pathophysiology of equine protozoal myeloencephalitis (EPM) remains incomplete, yet the development of clinical models, engineered mice, and molecular techniques have contributed markedly to our knowledge of this illness. Research confirms that the most important mediator of immunity to EPM is interferon-gamma, while the humoral immune system also contributes via inactivation of specific protozoal surface proteins. Diagnosis of EPM remains a clinical challenge, yet careful consideration of the clinical examination, coupled with ancillary diagnostic tests such as the cerebrospinal fluid evaluation, and various immunodiagnostic tests (Western blot, indirect fluorescent antibody) provide support for a clinical diagnosis.

Neurochemical Substrates of Human Aging and Dementia

Further development of clinical models of dementia to augment present unsatisfactory animal models, is of central importance to the understanding of the neurochemistry of dementia. Furthermore, present definitions of the neurotoxic processes underlying dementing disorders will need to be improved. Routine clinical markers will be necessary for the development of any therapy beyond present attempts for symptomatic treatment with neurotransmitter replacement.

Empirical Guidelines for Group Therapy: Pretraining, Cohesion, and Modeling

Group therapy has traditionally been viewed as more an art than a science. This paper suggests that the field is reaching a level of empirical sophistication which permits the development of clinical models from empirical data. Pretherapy -training, cohesion, and modeling are suggested as significant parameters of effective group treatment. The evidence defining the properties and effects of those variables is reviewed and their theoretical and practical implications are discussed.