RESUMO
The immunohistochemical (IHC) evaluation of epidermal growth factor 2 (HER2) for the diagnosis of breast cancer is still qualitative with a high degree of inter-observer variability, and thus requires the incorporation of complementary techniques such as fluorescent in situ hybridization (FISH) to resolve the diagnosis. Implementing automatic algorithms to classify IHC biomarkers is crucial for typifying the tumor and deciding on therapy for each patient with better performance. The present study aims to demonstrate that, using an explainable Machine Learning (ML) model for the classification of HER2 photomicrographs, it is possible to determine criteria to improve the value of IHC analysis. We trained a logistic regression-based supervised ML model with 393 IHC microscopy images from 131 patients, to discriminate between upregulated and normal expression of the HER2 protein. Pathologists' diagnoses (IHC only) vs. the final diagnosis complemented with FISH (IHC + FISH) were used as training outputs. Basic performance metrics and receiver operating characteristic curve analysis were used together with an explainability algorithm based on Shapley Additive exPlanations (SHAP) values to understand training differences. The model could discriminate amplified IHC from normal expression with better performance when the training output was the IHC + FISH final diagnosis (IHC vs. IHC + FISH: area under the curve, 0.94 vs. 0.81). This may be explained by the increased analytical impact of the membrane distribution criteria over the global intensity of the signal, according to SHAP value interpretation. The classification model improved its performance when the training input was the final diagnosis, downplaying the weighting of the intensity of the IHC signal, suggesting that to improve pathological diagnosis before FISH consultation, it is necessary to emphasize subcellular patterns of staining.
RESUMO
The population is aging worldwide, creating new challenges to the quality of life of older adults and their families. Falls are an increasing, but not inevitable, threat to older adults. Information technologies provide several solutions to address falls, but smart homes and the most available solutions require expensive and invasive infrastructures. In this study, we propose a novel approach to classify and detect falls of older adults in their homes through low-resolution infrared sensors that are affordable, non-intrusive, do not disturb privacy, and are more acceptable to older adults. Using data collected between 2019 and 2020 with the eHomeseniors platform, we determine activity scores of older adults moving across two rooms in a house and represent an older adult fall through skeletonization. We find that our twofold approach effectively detects activity patterns and precisely identifies falls. Our study provides insights to physicians about the daily activities of their older adults and could potentially help them make decisions in case of abnormal behavior.
Assuntos
Acidentes por Quedas , Qualidade de Vida , Acidentes por Quedas/prevenção & controle , Idoso , Envelhecimento , Marcha , Humanos , PrivacidadeRESUMO
Automatic fall detection is a very active research area, which has grown explosively since the 2010s, especially focused on elderly care. Rapid detection of falls favors early awareness from the injured person, reducing a series of negative consequences in the health of the elderly. Currently, there are several fall detection systems (FDSs), mostly based on predictive and machine-learning approaches. These algorithms are based on different data sources, such as wearable devices, ambient-based sensors, or vision/camera-based approaches. While wearable devices like inertial measurement units (IMUs) and smartphones entail a dependence on their use, most image-based devices like Kinect sensors generate video recordings, which may affect the privacy of the user. Regardless of the device used, most of these FDSs have been tested only in controlled laboratory environments, and there are still no mass commercial FDS. The latter is partly due to the impossibility of counting, for ethical reasons, with datasets generated by falls of real older adults. All public datasets generated in laboratory are performed by young people, without considering the differences in acceleration and falling features of older adults. Given the above, this article presents the eHomeSeniors dataset, a new public dataset which is innovative in at least three aspects: first, it collects data from two different privacy-friendly infrared thermal sensors; second, it is constructed by two types of volunteers: normal young people (as usual) and performing artists, with the latter group assisted by a physiotherapist to emulate the real fall conditions of older adults; and third, the types of falls selected are the result of a thorough literature review.