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  • 1
    Online Resource
    Online Resource
    SAGE Publications ; 2021
    In:  Pediatric and Developmental Pathology Vol. 24, No. 4 ( 2021-08), p. 351-360
    In: Pediatric and Developmental Pathology, SAGE Publications, Vol. 24, No. 4 ( 2021-08), p. 351-360
    Abstract: Sudden unexpected death in infancy (SUDI) represents the commonest presentation of postneonatal death. We explored whether machine learning could be used to derive data driven insights for prediction of infant autopsy outcome. Methods A paediatric autopsy database containing 〉 7,000 cases, with 〉 300 variables, was analysed by examination stage and autopsy outcome classified as ‘explained (medical cause of death identified)’ or ‘unexplained’. Decision tree, random forest, and gradient boosting models were iteratively trained and evaluated. Results Data from 3,100 infant and young child ( 〈 2 years) autopsies were included. Naïve decision tree using external examination data had performance of 68% for predicting an explained death. Core data items were identified using model feature importance. The most effective model was XG Boost, with overall predictive performance of 80%, demonstrating age at death, and cardiovascular and respiratory histological findings as the most important variables associated with determining medical cause of death. Conclusion This study demonstrates feasibility of using machine-learning to evaluate component importance of complex medical procedures (paediatric autopsy) and highlights value of collecting routine clinical data according to defined standards. This approach can be applied to a range of clinical and operational healthcare scenarios
    Type of Medium: Online Resource
    ISSN: 1093-5266 , 1615-5742
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 1480654-X
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  • 2
    In: Multiple Sclerosis Journal - Experimental, Translational and Clinical, SAGE Publications, Vol. 3, No. 3 ( 2017-09), p. 205521731772729-
    Abstract: Lowserum vitamin D levels are associated with susceptibility to, and severity of, multiple sclerosis. High dose vitamin D has been proposed as a potential immunomodulator in multiple sclerosis. Objectives We performed a single centre, investigator-led, exploratory, double-blind, randomised, placebo controlled, trial of vitamin D 3 in clinically isolated syndrome and healthy control participants to assess its immunological effects. Secondary end-points included clinical and magnetic resonance imaging outcomes and safety. Methods Clinically isolated syndrome patients and healthy control participants were randomised to: placebo, 5000 IU or 10,000 IU vitamin D 3 /day (Vigantol oil). Study duration was 24 weeks. Results The trial did not meet its primary end point, with no difference in the frequency of pro-inflammatory CD4 + T cells (interleukin (IL)-17 + /interferon (IFN)-γ + ) seen. A higher level of disease freedom (67% versus 50%) was seen in those with serum 1,25 (OH) vitamin D levels 〉 100 nmol/l but this did not reach significance. High dose vitamin D 3 was well tolerated with no safety signal. Conclusions High dose vitamin D 3 over 24 weeks was well tolerated but without immunological, magnetic resonance imaging or clinical evidence of benefit. The hypothesised therapeutic effects in clinically isolated syndrome or multiple sclerosis patients may require longer periods of administration or may only be seen in patients treated with vitamin D 3 as an adjunct to established disease modifying therapies.
    Type of Medium: Online Resource
    ISSN: 2055-2173 , 2055-2173
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2841884-0
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