A foundation model for generalizable disease detection from retinal images

Nature, Год журнала: 2023, Номер 622(7981), С. 156 - 163

Опубликована: Сен. 13, 2023

Abstract Medical artificial intelligence (AI) offers great potential for recognizing signs of health conditions in retinal images and expediting the diagnosis eye diseases systemic disorders 1 . However, development AI models requires substantial annotation are usually task-specific with limited generalizability to different clinical applications 2 Here, we present RETFound, a foundation model that learns generalizable representations from unlabelled provides basis label-efficient adaptation several applications. Specifically, RETFound is trained on 1.6 million by means self-supervised learning then adapted disease detection tasks explicit labels. We show consistently outperforms comparison prognosis sight-threatening diseases, as well incident prediction complex such heart failure myocardial infarction fewer labelled data. solution improve performance alleviate workload experts enable broad imaging.

Язык: Английский

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Modulating Nitric Oxide: Implications for Cytotoxicity and Cytoprotection

Antioxidants, Год журнала: 2024, Номер 13(5), С. 504 - 504

Опубликована: Апрель 23, 2024

Despite the significant progress in fields of biology, physiology, molecular medicine, and pharmacology; designation properties nitrogen monoxide regulation life-supporting functions organism; numerous works devoted to this molecule, there are still many open questions field. It is widely accepted that nitric oxide (•NO) a unique molecule that, despite its extremely simple structure, has wide range body, including cardiovascular system, central nervous system (CNS), reproduction, endocrine respiration, digestion, etc. Here, we systematize •NO, contributing conditions physiological norms, as well various pathological processes, mechanisms cytoprotection cytodestruction. Current experimental clinical studies contradictory describing role •NO pathogenesis diseases CNS. We describe cytoprotective action associated with expression antiapoptotic chaperone proteins mitochondrial function. The most prominent cytodestruction—the initiation nitrosative oxidative stresses, production reactive oxygen species, participation apoptosis mitosis. formation endothelial dysfunction also considered. Moreover, focus on ways pharmacological modulation nitroxidergic allow for decrease cytodestructive increase ones.

Язык: Английский

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Look into my eyes: What can eye-based measures tell us about the relationship between physical activity and cognitive performance?

Journal of sport and health science/Journal of Sport and Health Science, Год журнала: 2023, Номер 12(5), С. 568 - 591

Опубликована: Май 5, 2023

There is a growing interest to understand the neurobiological mechanisms that drive positive associations of physical activity and fitness with measures cognitive performance. To better those mechanisms, several studies have employed eye-based (e.g., eye movement such as saccades, pupillary pupil dilation, vascular retinal vessel diameter) deemed be proxies for specific mechanisms. However, there currently no systematic review providing comprehensive overview these in field exercise-cognition science. Thus, this aimed address gap literature. identify eligible studies, we searched 5 electronic databases on October 23, 2022. Two researchers independently extracted data assessed risk bias using modified version Tool assEssment Study qualiTy reporting EXercise (TESTEX scale, interventional studies) critical appraisal tool from Joanna Briggs Institute (for cross-sectional studies). Our (n = 35 offers following main findings: (a) insufficient evidence available draw solid conclusions concerning gaze-fixation-based measures; (b) pupillometric measures, which are proxy noradrenergic system, can explain effect acute exercise cardiorespiratory performance mixed; (c) training- or fitness-related changes cerebrovascular system (operationalized via vasculature) are, general, positively associated improvements; (d) chronic exercises show based an oculomotor-based measure executive function antisaccade tasks); (e) association between partly mediated by dopaminergic spontaneous eye-blink rate). This confirmation provide valuable insight into may due limited number utilizing methods obtaining pupillometry, analysis, blink rate) investigating possible dose–response relationship, further research necessary before more nuanced drawn. Given economical non-invasive, hope will foster future application

Язык: Английский

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Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation

Angiogenesis, Год журнала: 2023, Номер 26(4), С. 547 - 563

Опубликована: Июль 28, 2023

Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in high impact on the daily life of patients. Understanding pathophysiology PCS public health priority, it still poses diagnostic treatment challenge for physicians.In this prospective observational cohort study, we analyzed retinal microcirculation using Retinal Vessel Analysis (RVA) patients compared to an age- gender-matched healthy (n = 41, matched out n 204).PCS exhibit persistent endothelial dysfunction (ED), indicated by significantly lower venular flicker-induced dilation (vFID; 3.42% ± 1.77% vs. 4.64% 2.59%; p 0.02), narrower central artery equivalent (CRAE; 178.1 [167.5-190.2] 189.1 [179.4-197.2], 0.01) arteriolar-venular ratio (AVR; (0.84 [0.8-0.9] 0.88 [0.8-0.9], 0.007). When combining AVR vFID, predicted scores reached good ability discriminate groups (area under curve: 0.75). Higher severity correlated (R - 0.37 0.017). The association microvascular changes were amplified exhibiting higher levels inflammatory parameters.Our results demonstrate that prolonged hallmark PCS, impairments seem explain As potential therapies emerge, RVA parameters may become relevant clinical biomarkers diagnosis therapy management.This study was previously registered at ClinicalTrials ("All Eyes PCS-Analysis Microvasculature Patients Syndrome". NCT05635552. https://clinicaltrials.gov/ct2/show/NCT05635552 ). Persistent post-COVID-19 syndrome. Acute SARS-CoV-2 infection indirectly or directly causes endotheliitis N 41 recruited vessel analysis performed assess function. Images SVA DVA are illustrative data analysis. For each patient cohort, diameter three measurement cycles calculated plotted diameter-time curve. exhibited reduced veins (vFID) measured dynamic (DVA) arteriolar (CRAE) (AVR) tendency towards (CRVE) when naïve participants. Created BioRender.com.

Язык: Английский

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Neurovascular coupling impairment as a mechanism for cognitive deficits in COVID-19

Brain Communications, Год журнала: 2024, Номер 6(2)

Опубликована: Янв. 1, 2024

Abstract Components that comprise our brain parenchymal and cerebrovascular structures provide a homeostatic environment for proper neuronal function to ensure normal cognition. Cerebral insults (e.g. ischaemia, microbleeds infection) alter cellular physiologic processes within the neurovascular unit contribute cognitive dysfunction. COVID-19 has posed significant complications during acute convalescent stages in multiple organ systems, including brain. Cognitive impairment is prevalent complication patients, irrespective of severity SARS-CoV-2 infection. Moreover, overwhelming evidence from vitro, preclinical clinical studies reported SARS-CoV-2-induced pathologies components are associated with impairment. Neurovascular disruption alters coupling response, critical mechanism regulates cerebromicrovascular blood flow meet energetic demands locally active neurons. Normal processing achieved through response involves coordinated action cells (i.e. neurons glia) cell types endothelia, smooth muscle pericytes). However, current work on COVID-19-induced yet investigate as causal factor. Hence, this review, we aim describe SARS-CoV-2's effects how they can impact decline disease. Additionally, explore potential therapeutic interventions mitigate Given great both individuals public health, necessity effort fundamental scientific research application becomes imperative. This integrated endeavour crucial mitigating deficits induced by its subsequent burden especially vulnerable population.

Язык: Английский

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Retinal Imaging-Based Oculomics: Artificial Intelligence as a Tool in the Diagnosis of Cardiovascular and Metabolic Diseases

Biomedicines, Год журнала: 2024, Номер 12(9), С. 2150 - 2150

Опубликована: Сен. 23, 2024

Cardiovascular diseases (CVDs) are a major cause of mortality globally, emphasizing the need for early detection and effective risk assessment to improve patient outcomes. Advances in oculomics, which utilize relationship between retinal microvascular changes systemic vascular health, offer promising non-invasive approach assessing CVD risk. Retinal fundus imaging optical coherence tomography/angiography (OCT/OCTA) provides critical information diagnosis, with parameters such as vessel caliber, tortuosity, branching patterns identified key biomarkers. Given large volume data generated during routine eye exams, there is growing automated tools aid diagnosis prediction. The study demonstrates that AI-driven analysis images can accurately predict cardiovascular factors, events, metabolic diseases, surpassing traditional diagnostic methods some cases. These models achieved area under curve (AUC) values ranging from 0.71 0.87, sensitivity 71% 89%, specificity 40% 70%, This highlights potential component personalized medicine, enabling more precise earlier intervention. It not only aids detecting abnormalities may precede events but also offers scalable, non-invasive, cost-effective solution widespread screening. However, article emphasizes further research standardize protocols validate clinical utility these biomarkers across different populations. By integrating oculomics into practice, healthcare providers could significantly enhance management ultimately improving Fundus image thus represents valuable tool future precision medicine health management.

Язык: Английский

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Standardization and clinical applications of retinal imaging biomarkers for cardiovascular disease: a Roadmap from an NHLBI workshop

Nature Reviews Cardiology, Год журнала: 2024, Номер 22(1), С. 47 - 63

Опубликована: Июль 22, 2024

Язык: Английский

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Retinal microcirculation: A window into systemic circulation and metabolic disease

Experimental Eye Research, Год журнала: 2024, Номер 242, С. 109885 - 109885

Опубликована: Апрель 3, 2024

Язык: Английский

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Non-Invasive Retinal Vessel Analysis as a Predictor for Cardiovascular Disease

Journal of Personalized Medicine, Год журнала: 2024, Номер 14(5), С. 501 - 501

Опубликована: Май 9, 2024

Cardiovascular disease (CVD) is the most frequent cause of death worldwide. The alterations in microcirculation may predict cardiovascular mortality. retinal vasculature can be used as a model to study vascular associated with disease. In order quantify microvascular changes non-invasive way, fundus images taken and analysed. central arteriolar (CRAE), venular (CRVE) diameter arteriolar-to-venular ratio (AVR) biomarkers A narrower CRAE, wider CRVE lower AVR have been increased events. Dynamic vessel analysis (DRVA) allows quantification using digital image sequences response visual stimulation flicker light. This article not just review current literature, it also aims discuss methodological benefits identify research gaps. It highlights potential use for screening treatment monitoring Artificial intelligence (AI), such Quantitative Analysis Retinal Topology size (QUARTZ), SIVA–deep learning system (SIVA-DLS), seems efficient extracting information from photographs has advantage increasing diagnosis accuracy improving patient care by complementing role physicians. imaging AI help risk, an important tool primary prevention. Further should explore clinical application biomarkers, assess systemic health status,

Язык: Английский

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Endothelial dysfunction in the kidney transplant population: Current evidence and management strategies

World Journal of Transplantation, Год журнала: 2024, Номер 15(1)

Опубликована: Ноя. 26, 2024

The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators. Endothelial dysfunction (ED), characterized by impaired vasodilation, inflammation, thrombosis, triggers future cardiovascular (CV) diseases. Chronic kidney disease, state chronic inflammation caused oxidative stress, metabolic abnormalities, infection, uremic toxins damages the endothelium. ED is also associated with decline in estimated glomerular filtration rate. After transplantation, endothelial functions undergo immediate but partial restoration, promising graft longevity enhanced CV health. However, anticipated outcomes do not happen due various transplant-related unrelated risk factors for ED, culminating poor health survival. transplant recipients an under-recognized poorly studied entity. diseases are leading cause death among candidates functioning grafts. contributes pathogenesis many Various biomarkers vasoreactivity tests available study functions. With increasing number transplants happening every year, improved rejection rates availability effective immunosuppressants, focus has now shifted protection prevention, early recognition, treatment

Язык: Английский

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