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      COMPUTATIONAL ANALYSIS BASED ON ARTIFICIAL NEURAL NETWORKS FOR AIDING IN DIAGNOSING OSTEOARTHRITIS OF THE LUMBAR SPINE

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          Abstract

          Objective: To ascertain the advantages of applying artificial neural networks to recognize patterns on lumbar spine radiographies in order to aid in the process of diagnosing primary osteoarthritis. Methods: This was a cross-sectional descriptive analytical study with a quantitative approach and an emphasis on diagnosis. The training set was composed of images collected between January and July 2009 from patients who had undergone lateral-view digital radiographies of the lumbar spine, which were provided by a radiology clinic located in the municipality of Criciúma (SC). Out of the total of 260 images gathered, those with distortions, those presenting pathological conditions that altered the architecture of the lumbar spine and those with patterns that were difficult to characterize were discarded, resulting in 206 images. The image data base (n = 206) was then subdivided, resulting in 68 radiographies for the training stage, 68 images for tests and 70 for validation. A hybrid neural network based on Kohonen self-organizing maps and on Multilayer Perceptron networks was used. Results: After 90 cycles, the validation was carried out on the best results, achieving accuracy of 62.85%, sensitivity of 65.71% and specificity of 60%. Conclusions: Even though the effectiveness shown was moderate, this study is still innovative. The values show that the technique used has a promising future, pointing towards further studies on image and cycle processing methodology with a larger quantity of radiographies.

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          Risk factors for progression of lumbar spine disc degeneration: the Chingford Study.

          Few data exist concerning the natural history of lumbar spine disc degeneration and associated risk factors. We therefore undertook this study to examine the radiographic progression of lumbar spine disc degeneration over the course of 9 years in a population-based inception cohort of women from the Chingford Study. Seven hundred ninety-six paired lumbar spine radiographs were read by a single reader for anterior osteophytes (AO) and disc space narrowing (DSN) using the Lane atlas at each lumbar disc space (L1-5). Disc degeneration was defined using thresholds of AO and DSN grade 1+ in one or more vertebrae (L1-5) within a subject. Progression was defined as an increase in grade in an affected year-1 vertebra. Potential risk factors were assessed using odds ratios and 95% confidence intervals adjusted for age, body mass index (BMI), and other potential confounders in logistic regression models using the STATA statistical package. The mean +/- SD age at baseline was 53.8 +/- 6.0 years, and mean +/- SD BMI was 25.4 +/- 4.1 kg/m(2). Progression rates for AO and DSN were 4% per annum and 3% per annum, respectively. Progression of DSN was predicted by age, back pain, and radiographic hip and knee osteoarthritis (OA). Progression of AO was predicted by age and radiographic hip OA, with borderline significance for BMI >30 kg/m(2). No significant effects were seen for smoking, physical activity, hormone replacement therapy use, multiparity, or hand OA. This is the first population-based longitudinal study to assess progression of the individual radiographic features of AO and DSN in lumbar spine disc degeneration. We demonstrated progression rates of 3-4% per annum, with important risk factors for progression, including age, back pain, and radiographic OA at the hip and knee.
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            Lumbar disc degeneration: association between osteophytes, end-plate sclerosis and disc space narrowing.

            Lumbar disc degeneration is characterised radiologically by the presence of osteophytes, end-plate sclerosis and disc space narrowing. To determine the strength of the association between increasing severity of combinations of these features in a population sample of men and women. Men and women aged >or=50 years were recruited from a primary care-based community health index in Aberdeen, UK. Participants had lateral spinal radiographs performed according to a standard protocol. The intervertebral disc spaces (L1/2-L4/5) were evaluated for the presence of anterior osteophytes, end-plate sclerosis and disc space narrowing using a graded semiquantitative score (grade 0-3). Log linear modelling was used to determine the associations (pairwise) between increasing severity of these features, with the results expressed as beta coefficients and 95% confidence intervals (CIs). There were 286 men (mean age 65.3 years) and 299 women (mean age 65.2 years) with spinal radiographs, yielding a total of 2340 assessable lumbar vertebral levels. In all, 73% of vertebral levels had evidence of osteophytes, 26% of sclerosis and 37% of disc space narrowing. Increasing severity of osteophyte grade was associated with an increasing severity both of sclerosis and of disc space narrowing, whereas the severity of sclerosis was associated with the severity of narrowing. This was true at all vertebral levels. The strongest association, however, was between osteophytes and sclerosis (beta coefficient = 2.7, 95% CI 2.4 to 3.1). For sclerosis and narrowing the beta coefficient was 1.9 (95% CI 1.7 to 2.1), whereas for osteophytes and narrowing the beta coefficient was much weaker at 1.2 (95% CI 1.1 to 1.3). There was no important influence of vertebral level on any of these associations. The association between increasing severity of osteophytes and end-plate sclerosis is stronger than for other combinations of radiographic features of lumbar disc degeneration.
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              Rede neural artificial para detecção de sobremortalidade atribuível à cólera no Ceará

              OBJETIVO: Avaliar as redes neurais recorrentes enquanto técnica preditiva para séries temporais em saúde. MÉTODOS: O estudo foi realizado durante uma epidemia de cólera ocorrida no Estado do Ceará, em 1993 e 1994, a partir da sobremortalidade tendo como causa básica as infecções intestinais mal definidas (CID-9). O número mensal de óbitos por essa causa, referente ao período de 1979 a 1995 no Estado do Ceará, foram obtidos do Sistema de Informação de Mortalidade (SIM) do Ministério da Saúde. Estruturou-se uma rede com dois neurônios na camada de entrada, 12 na camada oculta, um neurônio na camada de saída e um na camada de memória. Todas as funções de ativação eram a função logística. O treinamento foi realizado pelo método de backpropagation, com taxa de aprendizado de 0,01 e momentum de 0,9, com dados de janeiro de 1979 a junho de 1991. O critério para fim do treinamento foi atingir 22.000 epochs. Compararam-se os resultados com os de um modelo de regressão binomial negativa. RESULTADOS: A predição da rede neural a médio prazo foi adequada, em dezembro de 1993 e novembro e dezembro de 1994. O número de óbitos registrados foi superior ao limite do intervalo de confiança. Já o modelo regressivo detectou sobremortalidade a partir de março de 1992. CONCLUSÕES: A rede neural se mostrou capaz de predição, principalmente no início do período, como também ao detectar uma alteração concomitante e posterior à ocorrência da epidemia de cólera. No entanto, foi menos precisa do que o modelo de regressão binomial, que se mostrou mais sensível para detectar aberrações concomitantes à circulação da cólera.
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                Author and article information

                Contributors
                Role: Doctor
                Journal
                Rev Bras Ortop
                Rev Bras Ortop
                Revista Brasileira de Ortopedia
                Elsevier
                2255-4971
                06 December 2015
                Mar-Apr 2011
                06 December 2015
                : 46
                : 2
                : 195-199
                Affiliations
                [1 ]Undergraduate Student in Medicine - Universidade do Extremo Sul Catarinense (UNESC), SC, Brazil
                [2 ]PhD Student in Health Sciences - Universidade do Extremo Sul Catarinense (UNESC), Master's Degree in Computer Science - Universidade Federal de Santa Catarina (UFSC), Professor in Medical Informatics at the Universidade do Extremo Sul Catarinense (UNESC), SC, Brazil
                [3 ]Specialist in Orthopedics and Traumatology- Hospital Regional de São José, Specialist in Surgery of the Hand and Microsurgery at the Universidade de São Paulo (USP), Professor of Orthopedics at the Universidade do Extremo Sul Catarinense (UNESC), SC, Brazil
                [4 ]Master's Degree in Electrical Engineering - Universidade Federal de Santa Catarina, Bachelor's Degree in Computer Science - Universidade do Extremo Sul Catarinense (UNESC), SC, Brazil
                [5 ]Undergraduate Student in Medicine - Universidade do Extremo Sul Catarinense (UNESC)
                [6 ]PhD Student in Biomedical Engineering - Federal University of Santa Catarina (UFSC), Master's Degree in Computer Science - Federal University of Santa Catarina (UFSC), Professor of Artificial Intelligence at the Universidade do Extremo Sul Catarinense (UNESC), SC, Brazil
                [7 ]PhD Student in Information, Documentation and Knowledge - Universidade de Alcalá (UAH) - Spain
                [8 ]Master's Degree in Computer Sciences - Universidade Federal de Santa Catarina (UFSC), SC, Brazil
                Author notes
                [* ]Curso de Medicina, UNASAU, Avenida Universitária, 1105 – Bloco S – Bairro Universitário – 88806-000 – Criciúma – SCCurso de MedicinaUNASAUAvenida UniversitáriaBairro Universitário1105 - Bloco SCriciúmaSC88806-000 pri@ 123456unesc.net
                Article
                S2255-4971(15)30239-1
                10.1016/S2255-4971(15)30239-1
                4799207
                27027010
                bee40454-60d9-4bd9-8145-ef2115c9d53e
                © 2011 Sociedade Brasileira de Ortopedia e Traumatologia

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 18 April 2010
                : 7 June 2010
                Categories
                Original Article

                osteoarthritis,artificial intelligence,medical informatics,diagnosis, computer-assisted

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