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At least 37 records · Page 2Linked to original sources

Federated learning for the pathogenicity annotation of genetic variants in multi-site clinical settings.

MOTIVATION: Rare diseases collectively affect 5% of the population. However, fewer than 50% of rare disease patients receive a molecular diagnosis after whole genome sequencing. Supervised machine learning is a valuable approach for the pathogenicity scoring of human genetic variants. However, existing methods are often trained on curated but limited central repositories, resulting in poor accuracy when tested on external cohorts. Yet, large collections of variants generated at hospitals and research institutions remain inaccessible to machine-learning purposes because of privacy and legal constraints. Federated learning (FL) algorithms have been recently developed enabling institutions to collaboratively train models without sharing their local datasets. RESULTS: Here, we present a proof-of-concept study evaluating the effectiveness of FL for the clinical classification of genetic variants. A comprehensive array of diverse FL strategies was assessed for coding and non-coding Single Nucleotide Variants as well as Copy Number Variants. Our results showed that federated models generally achieved comparable or superior performance to traditional centralized learning. In addition, federated models reached a robust generalization to independent sets with smaller data fractions as compared to their centralized model counterparts. Our findings support the adoption of FL to establish secure multi-institutional collaborations in human variant interpretation. AVAILABILITY AND IMPLEMENTATION: All source code required to reproduce the results presented in this article, implemented in Python, is available under the GNU General Public License v3 at https://github.com/RausellLab/FedLearnVar.

Humans

Hypothermia: pathophysiology, clinical settings, and management.

Hypothermia, defined as a core temperature less than 35 degrees C, is frequently not recognized, in part because of the inadequacy of standard thermometers. This entity has multiple causes and unique pathophysiologic consequences that complicate diagnosis and treatment. Understanding of the physiology of thermoregulation is important in light of recent advances in therapy using core rewarming. Pathophysiology, etiology and management of the hypothermia syndrome are reviewed.

Accidents

A new instrument for continuous recording of the evoked compound electromyogram in the clinical setting.

To study neuromuscular transmission, observation of the evoked compound electromyogram (EMG) has important advantages over observation of the evoked mechanical muscle contraction. Technically, however, recording of the evoked compound EMG, especially in continuous study of several hours duration, has been difficult. Investigators have employed various complicated systems, including tape recording, photorecording, and photographing for such purposes. The authors have applied modern computer technology to construction of an EMG analyzer which enables handling the evoked EMG even more easily than the evoked mechanical contraction. The principle involves digital dissection, storage with memory, readout with time expansion, and analog reconstruction of the compound EMG. The signal can be recorded with ease by use of any suitable hot-stylus or ink-writing oscillographic recorder. Both the waveform and the amplitutde of the EMG can be on-line recorded. The cost compares favorably with comparable devices for similar studies.

Electromyography

Evaluation of the counterimmunoelectrophoretic (CIE) procedure in a clinical laboratory setting.

The counterimmunoelectrophoretic (CIE) procedure was evaluated under clinical laboratory conditions to determine its validity and comparability with culture methods. The procedure was further evaluated to determine applicability to a variety of clinical samples. An inexpensive set-up was developed to utilize the CIE procedure at bench level. Results indicated the procedure to be sensitive in detecting Haemophilus influenzae, type b, and Neisseria meningitidis (meningococcus), group B. The procedure was more sensitive for detection of H. influenzae, type b, than for meningococcus, group B. The authors have confirmed the usefulness of the CIE procedure in the detection of group B streptococci, pneumococci and teichoic acid antibody to Staphylococcus aureus. Detection of Escherichia coli K 1 antigen was also accomplished by CIE. In the authors' laboratory the CIE procedure was superior to culture methods when used for the detection of H. influenzae, type b, and meningococcus group B.

Animals

Multiple pulmonary fibroleiomyomatous hamartomata in childhood.

A 9-yr-old girl with a history of rhabdomyosarcoma developed multiple pulmonary fibroleiomyomatous hamartomata. This clinical setting illustrates the tendency of these hamartomata to clinically mimic metastatic tumors. Further, this case represents the first description of multiple pulmonary fibroleiomyomatous hamartomata in a pediatric age group, and finally, in this clinical setting, supports the concept that these hamartomata represent a distinct entity apart from benign metastasizing uterine leiomyomata.

Abdominal Neoplasms

The quality of care in occupational therapy: an assessment of selected Michigan hospitals.

In this study, a methodology was developed and tested for assessing the quality of care in occupational therapy between educational and noneducational clinical settings, as measured by process and outcome. An instrument was constructed for an external audit of the hospital record. Standards drafted by the investigator were established as normative by a panel of experts for use in judging the programs. Hospital records of 84 patients with residual hemiparesis or hemiplegia in three noneducational settings and of 100 patients with similar diagnoses in two educational clinical settings from selected Michigan facilities were chosen by proportionate stratified random sampling. The process study showed that occupational therapy was of significantly higher quality in the educational settings. The outcome study did not show significant differences between types of settings. Implications for education and practice are discussed.

Adult