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Register a new userTransient-evoked otoacoustic emission signals predicting outcomes of acute sensorineural hearing loss in patients with Menieres Disease
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Background: Fluctuating hearing loss is characteristic of Menieres Disease (MD) during acute episodes. However, no reliable audiometric hallmarks are available for counselling the hearing recovery possibility. Aims/Objectives: To find parameters for predicting MD hearing outcomes. Material and Methods: We applied machine learning techniques to analyse transient-evoked otoacoustic emission (TEOAE) signals recorded from patients with MD. Thirty unilateral MD patients were recruited prospectively after onset of acute cochleo-vestibular symptoms. Serial TEOAE and pure-tone audiogram (PTA) data were recorded longitudinally. Denoised TEOAE signals were projected onto the three most prominent principal directions through a linear transformation. Binary classification was performed using a support vector machine (SVM). TEOAE signal parameters, including signal energy and group delay, were compared between improved and nonimproved groups using Welchs t-test. Results: Signal energy did not differ (p = 0.64) but a significant difference in 1-kHz (p = 0.045) group delay was recorded between improved and nonimproved groups. The SVM achieved a cross-validated accuracy of >80% in predicting hearing outcomes. Conclusions and Significance: This study revealed that baseline TEOAE parameters obtained during acute MD episodes, when processed through machine learning technology, may provide information on outer hair cell function to predict hearing recovery.
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The linear part of transient evoked (TE) otoacoustic emission (OAE) is thought to be generated via coherent reflection near the characteristic place of constituent wave components. Because of the tonotopic organization of the cochlea, high frequency emissions return earlier than low frequencies; however, due to the random nature of coherent reflection, the instantaneous frequency (IF) and amplitude envelope of TEOAEs both fluctuate. Multiple reflection components and synchronized spontaneous emissions can further make it difficult to extract the IF by linear transforms. In this paper, we propose to model TEOAEs as a sum of {em intrinsic mode-type functions} and analyze it by a {nonlinear-type time-frequency analysis} technique called concentration of frequency and time (ConceFT). When tested with synthetic OAE signals {with possibly multiple oscillatory components}, the present method is able to produce clearly visualized traces of individual components on the time-frequency plane. Further, when the signal is noisy, the proposed method is compared with existing linear and bilinear methods in its accuracy for estimating the fluctuating IF. Results suggest that ConceFT outperforms the best of these methods in terms of optimal transport distance, reducing the error by 10 to {21%} when the signal to noise ratio is 10 dB or below.
Survival analysis is a technique to predict the times of specific outcomes, and is widely used in predicting the outcomes for intensive care unit (ICU) trauma patients. Recently, deep learning models have drawn increasing attention in healthcare. However, there is a lack of deep learning methods that can model the relationship between measurements, clinical notes and mortality outcomes. In this paper we introduce BERTSurv, a deep learning survival framework which applies Bidirectional Encoder Representations from Transformers (BERT) as a language representation model on unstructured clinical notes, for mortality prediction and survival analysis. We also incorporate clinical measurements in BERTSurv. With binary cross-entropy (BCE) loss, BERTSurv can predict mortality as a binary outcome (mortality prediction). With partial log-likelihood (PLL) loss, BERTSurv predicts the probability of mortality as a time-to-event outcome (survival analysis). We apply BERTSurv on Medical Information Mart for Intensive Care III (MIMIC III) trauma patient data. For mortality prediction, BERTSurv obtained an area under the curve of receiver operating characteristic curve (AUC-ROC) of 0.86, which is an improvement of 3.6% over baseline of multilayer perceptron (MLP) without notes. For survival analysis, BERTSurv achieved a concordance index (C-index) of 0.7. In addition, visualizations of BERTs attention heads help to extract patterns in clinical notes and improve model interpretability by showing how the model assigns weights to different inputs.
Alzheimers disease (AD) and Parkinsons disease (PD) are the two most common neurodegenerative disorders in humans. Because a significant percentage of patients have clinical and pathological features of both diseases, it has been hypothesized that the patho-cascades of the two diseases overlap. Despite this evidence, these two diseases are rarely studied in a joint manner. In this paper, we utilize clinical, imaging, genetic, and biospecimen features to cluster AD and PD patients into the same feature space. By training a machine learning classifier on the combined feature space, we predict the disease stage of patients two years after their baseline visits. We observed a considerable improvement in the prediction accuracy of Parkinsons dementia patients due to combined training on Alzheimers and Parkinsons patients, thereby affirming the claim that these two diseases can be jointly studied.
Motor-Imagery based BCI (MI-BCI) neurorehabilitation can improve locomotor ability and reduce the deficit symptoms in Parkinsons Disease patients. Advanced Motor-Imagery BCI methods are needed to overcome the accuracy and time-related MI BCI calibration challenges in such patients. In this study, we proposed a Multi-session FBCSP (msFBCSP) based on inter-session transfer learning and we investigated its performance compared to the single-session based FBSCP. The main result of this study is the significantly improved accuracy obtained by proposed msFBCSP compared to single-session FBCSP in PD patients (median 81.3%, range 41.2-100.0% vs median 61.1%, range 25.0-100.0%, respectively; p<0.001). In conclusion, this study proposes a transfer learning-based multi-session based FBCSP approach which allowed to significantly improve calibration accuracy in MI BCI performed on PD patients.
The volume of stroke lesion is the gold standard for predicting the clinical outcome of stroke patients. However, the presence of stroke lesion may cause neural disruptions to other brain regions, and these potentially damaged regions may affect the clinical outcome of stroke patients. In this paper, we introduce the tractographic feature to capture these potentially damaged regions and predict the modified Rankin Scale (mRS), which is a widely used outcome measure in stroke clinical trials. The tractographic feature is built from the stroke lesion and average connectome information from a group of normal subjects. The tractographic feature takes into account different functional regions that may be affected by the stroke, thus complementing the commonly used stroke volume features. The proposed tractographic feature is tested on a public stroke benchmark Ischemic Stroke Lesion Segmentation 2017 and achieves higher accuracy than the stroke volume and the state-of-the-art feature on predicting the mRS grades of stroke patients. In addition, the tractographic feature also yields a lower average absolute error than the commonly used stroke volume feature.
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