Artif Intell Med.

Segmentation of nerve fibers using multi-level gradient watershed and fuzzy systems.

Publication Date: 2012 Jan 10 PMID: 22239996
Authors: Wang, Y. Y. - Sun, Y. N. - Lin, C. C. - Ju, M. S.
Journal: Artif Intell Med

OBJECTIVE: This paper presents an algorithm based on multi-level watershed segmentation combined with three fuzzy systems to segment a large number of myelinated nerve fibers in microscope images. The method can estimate various geometrical parameters of myelinated nerve fibers in peripheral nerves. It is expected to be a promising tool for the quantitative assessment of myelinated nerve fibers in related research. MATERIALS AND METHODS: A novel multi-level watershed scheme iteratively detects pre-candidate nerve fibers. At each immersion level, watershed segmentation extracts the initial axon locations and obtains meaningful myelinated nerve fiber features. Thereafter, according to a priori characteristics of the myelinated nerve fibers, fuzzy rules reject unlikely pre-candidates and collect a set of candidates. Initial candidate boundaries are then refined by a fuzzy active contour model, which flexibly deforms contours according to the observed features of each nerve fiber. A final scan with a different set of fuzzy rules based on the a priori properties of the myelinated nerve fibers removes false detections. A particle swarm optimization method is employed to efficiently train the large number of parameters in the proposed fuzzy systems. RESULTS: The proposed method can automatically segment the transverse cross-sections of nerve fibers obtained from optical microscope images. Although the microscope image is usually noisy with weak or variable levels of contrast, the proposed system can handle images with a large number of myelinated nerve fibers and achieve a high fiber detection ratio. As compared to manual segmentation by experts, the proposed system achieved an average accuracy of 91% across different data sets. CONCLUSION: We developed an image segmentation system that automatically handles myelinated nerve fibers in microscope images. Experimental results showed the efficacy of this system and its superiority to other nerve fiber segmentation approaches. Moreover, the proposed method can be extended to other applications of automatic segmentation of microscopic images.

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Translation and localization of SNOMED CT in China: A pilot study.

Publication Date: 2012 Feb PMID: 22217426
Authors: Zhu, Y. - Pan, H. - Zhou, L. - Zhao, W. - Chen, A. - Andersen, U. - Pan, S. - Tian, L. - Lei, J.
Journal: Artif Intell Med

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Visually defining and querying consistent multi-granular clinical temporal abstractions.

Publication Date: 2012 Feb PMID: 22177662
Authors: Combi, C. - Oliboni, B.
Journal: Artif Intell Med

OBJECTIVE: The main goal of this work is to propose a framework for the visual specification and query of consistent multi-granular clinical temporal abstractions. We focus on the issue of querying patient clinical information by visually defining and composing temporal abstractions, i.e., high level patterns derived from several time-stamped raw data. In particular, we focus on the visual specification of consistent temporal abstractions with different granularities and on the visual composition of different temporal abstractions for querying clinical databases. BACKGROUND: Temporal abstractions on clinical data provide a concise and high-level description of temporal raw data, and a suitable way to support decision making. Granularities define partitions on the time line and allow one to represent time and, thus, temporal clinical information at different levels of detail, according to the requirements coming from the represented clinical domain. The visual representation of temporal information has been considered since several years in clinical domains. Proposed visualization techniques must be easy and quick to understand, and could benefit from visual metaphors that do not lead to ambiguous interpretations. Recently, physical metaphors such as strips, springs, weights, and wires have been proposed and evaluated on clinical users for the specification of temporal clinical abstractions. Visual approaches to boolean queries have been considered in the last years and confirmed that the visual support to the specification of complex boolean queries is both an important and difficult research topic. METHODOLOGY: We propose and describe a visual language for the definition of temporal abstractions based on a set of intuitive metaphors (striped wall, plastered wall, brick wall), allowing the clinician to use different granularities. A new algorithm, underlying the visual language, allows the physician to specify only consistent abstractions, i.e., abstractions not containing contradictory conditions on the component abstractions. Moreover, we propose a visual query language where different temporal abstractions can be composed to build complex queries: temporal abstractions are visually connected through the usual logical connectives AND, OR, and NOT. RESULTS: The proposed visual language allows one to simply define temporal abstractions by using intuitive metaphors, and to specify temporal intervals related to abstractions by using different temporal granularities. The physician can interact with the designed and implemented tool by point-and-click selections, and can visually compose queries involving several temporal abstractions. The evaluation of the proposed granularity-related metaphors consisted in two parts: (i) solving 30 interpretation exercises by choosing the correct interpretation of a given screenshot representing a possible scenario, and (ii) solving a complex exercise, by visually specifying through the interface a scenario described only in natural language. The exercises were done by 13 subjects. The percentage of correct answers to the interpretation exercises were slightly different with respect to the considered metaphors (54.4 - striped wall, 73.3 - plastered wall, 61 - brick wall, and 61 - no wall), but post hoc statistical analysis on means confirmed that differences were not statistically significant. The result of the user's satisfaction questionnaire related to the evaluation of the proposed granularity-related metaphors ratified that there are no preferences for one of them. The evaluation of the proposed logical notation consisted in two parts: (i) solving five interpretation exercises provided by a screenshot representing a possible scenario and by three different possible interpretations, of which only one was correct, and (ii) solving five exercises, by visually defining through the interface a scenario described only in natural language. Exercises had an increasing difficulty. The evaluation involved a total of 31 subjects. Results related to this evaluation phase confirmed us about the soundness of the proposed solution even in comparison with a well known proposal based on a tabular query form (the only significant difference is that our proposal requires more time for the training phase: 21min versus 14min). DISCUSSION AND CONCLUSIONS: In this work we have considered the issue of visually composing and querying temporal clinical patient data. In this context we have proposed a visual framework for the specification of consistent temporal abstractions with different granularities and for the visual composition of different temporal abstractions to build (possibly) complex queries on clinical databases. A new algorithm has been proposed to check the consistency of the specified granular abstraction. From the evaluation of the proposed metaphors and interfaces and from the comparison of the visual query language with a well known visual method for boolean queries, the soundness of the overall system has been confirmed; moreover, pros and cons and possible improvements emerged from the comparison of different visual metaphors and solutions.

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Intelligent quotient estimation of mental retarded people from different psychometric instruments using artificial neural networks.

Publication Date: 2012 Feb PMID: 22153923
Authors: Di Nuovo, A. G. - Nuovo, S. D. - Buono, S.
Journal: Artif Intell Med

OBJECTIVE: The estimation of a person's intelligence quotient (IQ) by means of psychometric tests is indispensable in the application of psychological assessment to several fields. When complex tests as the Wechsler scales, which are the most commonly used and universally recognized parameter for the diagnosis of degrees of retardation, are not applicable, it is necessary to use other psycho-diagnostic tools more suited for the subject's specific condition. But to ensure a homogeneous diagnosis it is necessary to reach a common metric, thus, the aim of our work is to build models able to estimate accurately and reliably the Wechsler IQ, starting from different psycho-diagnostic tools. METHODS AND MATERIALS: Four different psychometric tests (Leiter international performance scale; coloured progressive matrices test; the mental development scale; psycho educational profile), along with the Wechsler scale, were administered to a group of 40 mentally retarded subjects, with various pathologies, and control persons. The obtained database is used to evaluate Wechsler IQ estimation models starting from the scores obtained in the other tests. Five modelling methods, two statistical and three from machine learning, that belong to the family of artificial neural networks (ANNs) are employed to build the estimator. RESULTS: Several error metrics for estimated IQ and for retardation level classification are defined to compare the performance of the various models with univariate and multivariate analyses. Eight empirical studies show that, after ten-fold cross-validation, best average estimation error is of 3.37 IQ points and mental retardation level classification error of 7.5%. Furthermore our experiments prove the superior performance of ANN methods over statistical regression ones, because in all cases considered ANN models show the lowest estimation error (from 0.12 to 0.9 IQ points) and the lowest classification error (from 2.5% to 10%). CONCLUSIONS: : Since the estimation performance is better than the confidence interval of Wechsler scales (five IQ points), we consider models built very accurate and reliable and they can be used into help clinical diagnosis. Therefore a computer software based on the results of our work is currently used in a clinical center and empirical trails confirm its validity. Furthermore positive results in our multivariate studies suggest new approaches for clinicians.

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Improved modeling of clinical data with kernel methods.

Publication Date: 2012 Feb PMID: 22134094
Authors: Daemen, A. - Timmerman, D. - Van den Bosch, T. - Bottomley, C. - Kirk, E. - Van Holsbeke, C. - Valentin, L. - Bourne, T. - De Moor, B.
Journal: Artif Intell Med

OBJECTIVE: Despite the rise of high-throughput technologies, clinical data such as age, gender and medical history guide clinical management for most diseases and examinations. To improve clinical management, available patient information should be fully exploited. This requires appropriate modeling of relevant parameters. METHODS: When kernel methods are used, traditional kernel functions such as the linear kernel are often applied to the set of clinical parameters. These kernel functions, however, have their disadvantages due to the specific characteristics of clinical data, being a mix of variable types with each variable its own range. We propose a new kernel function specifically adapted to the characteristics of clinical data. RESULTS: The clinical kernel function provides a better representation of patients' similarity by equalizing the influence of all variables and taking into account the range r of the variables. Moreover, it is robust with respect to changes in r. Incorporated in a least squares support vector machine, the new kernel function results in significantly improved diagnosis, prognosis and prediction of therapy response. This is illustrated on four clinical data sets within gynecology, with an average increase in test area under the ROC curve (AUC) of 0.023, 0.021, 0.122 and 0.019, respectively. Moreover, when combining clinical parameters and expression data in three case studies on breast cancer, results improved overall with use of the new kernel function and when considering both data types in a weighted fashion, with a larger weight assigned to the clinical parameters. The increase in AUC with respect to a standard kernel function and/or unweighted data combination was maximum 0.127, 0.042 and 0.118 for the three case studies. CONCLUSION: For clinical data consisting of variables of different types, the proposed kernel function - which takes into account the type and range of each variable - has shown to be a better alternative for linear and non-linear classification problems.

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A characterization of electrocardiogram signals through optimal allocation of information granularity.

Publication Date: 2012 Feb PMID: 22000296
Authors: Gacek, A. - Pedrycz, W.
Journal: Artif Intell Med

OBJECTIVE: We propose and develop a concept of a granular representation of a collection of signals (patterns) where a prototype (representative) of such numeric signals is formed as a certain information granule (say, a set, fuzzy set, rough set, and alike) instead of a single numeric entity. As being more abstract, the granular format of the representative of the family of signals is more in rapport with the nature of the representation task itself. It is instrumental in quantifying the diversity of data and capture their inherent distribution characteristics. METHODS AND MATERIALS: In the realization of the granular representation of the signals, we introduce a certain level of granularity (supplied in advance), which in the construction of the granular representative is regarded as an essential important modeling asset. A two-phase design is developed whose ultimate goal is to optimally allocate (distribute) the predefined level of granularity to the individual elements of the universe of discourse over which the signals are described. Given the nature of the required optimization, the ensuing optimization problem is solved by engaging a machinery of population-based optimization, namely Particle Swarm Optimization (PSO). Furthermore a number of information granularity distribution protocols are proposed. The numerical experiments completed for synthetic data and ECG MIT-BIH database signals are used to demonstrate the performance of the overall optimization algorithm and quantify the effectiveness of the allocation of information granularity realized by the PSO. An area under curve (AUC) criterion is proposed as a measure to express the quality of the overall optimization framework. RESULTS: For both synthetic as well as ECG signals, it is shown that the method endowed with the PSO identifies the best prototype and spans the lower and upper bounds of its granular counterpart. In addition to the numeric quantification of the best (optimized) granular prototype, the method helps visualizing its bounds. The relative difference in mapping performance between the best and the weakest granular prototypes is in the range of 18% (for normal ECG complexes) and over 26% in case of complexes of premature ventricular contraction. CONCLUSIONS: A complete algorithm of the construction of granular prototypes is presented. Treating the granular prototype as a template of a given class of electrocardiogram (ECG) signals, a matching process is facilitated and used as a basis for the design of signal classification algorithms. Various realizations of granular prototypes can be completed with the use of fuzzy sets or rough sets.

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Bayesian tracking of intracranial pressure signal morphology.

Publication Date: 2012 Feb PMID: 21968205
Authors: Scalzo, F. - Asgari, S. - Kim, S. - Bergsneider, M. - Hu, X.
Journal: Artif Intell Med

BACKGROUND: The waveform morphology of intracranial pressure (ICP) pulses holds essential informations about intracranial and cerebrovascular pathophysiological variations. Most of current ICP pulse analysis frameworks process each pulse independently and therefore do not exploit the temporal dependency existing between successive pulses. We propose a probabilistic framework that exploits this temporal dependency to track ICP waveform morphology in terms of its three peaks. MATERIAL: ICP and electrocardiogram (ECG) signals were recorded from a total of 128 patients treated for various intracranial pressure related conditions. METHODS: The tracking is posed as inference in a graphical model that associates a random variable to the position of each peak. A key contribution is to exploit a nonparametric Bayesian inference algorithm that offers robustness and real time performance. A simple, yet effective learning procedure estimates the statistical, nonlinear, dependencies between the peaks in a nonparametric way using evidence collected from manually annotated pulses. RESULTS: Experiments demonstrate the effectiveness of the tracking framework on real ICP pulses and its robustness to occlusion and missing peaks. On artificialy distorted ICP sequences, the average error in latency in comparision with MOCAIP detector was reduced as follows: 11.88-8.09ms, 11.80-6.90ms, and 11.76-7.46ms for the first, second, and third peak, respectively. CONCLUSION: The proposed tracking algorithm sucessfuly increases the temporal resolution of detecting ICP pulse morphological changes from the minute-level to the beat-level.

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