Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent int...Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent intergrated TCM and western medicine diagnosis of depression.Methods Using the Audio-Visual Emotion Challenge and Workshop(AVEC 2014)public dataset on depression,which conclude 150 interview videos,the samples were classified ac-cording to the TCM inspection of spirit classification:Deshen(得神,presence of spirit),Shaoshen(少神,insufficiency of spirit),and Shenluan(神乱,confusion of spirit).Meanwhile,based on Beck Depression Inventory-II(BDI-II)score for the severity grade of depression,the samples were divided into minimal(0-13,Q1),mild(14-19,Q2),moderate(20-28,Q3),and severe(29-63,Q4).Sixty-eight landmarks were extracted with a ResNet-50 network,and the feature extracion mode was stadardized.Random forest and support vectior machine(SVM)classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression,respectively.A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships.Results The analysis revealed a statistically significant and moderately strong association be-tween TCM spirit classification and the severity grade of depression,as confirmed by a Chi-square test(χ^(2)=14.04,P=0.029)with a Cramer’s V effect size of 0.243.Further exploration us-ing association rule mining identified the most compelling rule:“moderate depression(Q3)→Shenluan”.This rule demonstrated a support level of 5%,indicating this specific co-occur-rence was present in 5%of the cohort.Crucially,it achieved a high Confidence of 86%,mean-ing that among patients diagnosed with Q3,86%exhibited the Shenluan pattern according to TCM assessment.The substantial Lift of 2.37 signifies that the observed likelihood of Shenlu-an manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent-compelling evidence of a highly non-random association.Conse-quently,Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3,forming a clinically significant phenotype within this patient subgroup.展开更多
Objective To develop a facial image generation method based on a facial color-preserving generative adversarial network(FCP-GAN)that effectively decouples identity features from diagnostic facial complexion characteri...Objective To develop a facial image generation method based on a facial color-preserving generative adversarial network(FCP-GAN)that effectively decouples identity features from diagnostic facial complexion characteristics in traditional Chinese medicine(TCM)inspection,thereby addressing the critical challenge of privacy preservation in medical image analysis.Methods A facial image dataset was constructed from participants at Nanjing University of Chinese Medicine between April 23 and June 10,2023,using a TCM full-body inspection data acquisition equipment under controlled illumination.The proposed FCP-GAN model was designed to achieve the dual objectives of removing identity features and preserving colors through three key components:(i)a multi-space combination module that comprehensively extracts color attributes from red,green,blue(RGB),hue,saturation,value(HSV),and Lab spaces;(ii)a generator incorporating efficient channel attention(ECA)mechanism to enhance the representation of diagnostically critical color channels;and(iii)a dual-loss function that combines adversarial loss for de-identification with a dedicated color preservation loss.The model was trained and evaluated using a stratified 5-fold cross-validation strategy and evaluated against four baseline generative models:conditional GAN(CGAN),deep convolutional GAN(DCGAN),dual discriminator CGAN(DDCGAN),and medical GAN(MedGAN).Performance was assessed in terms of image quality[peak signal-to-noise ratio(PSNR)and structural similarity(SSIM)],distribution similarity[Fréchet inception distance(FID)],privacy protection(face recognition accuracy),and diagnostic consistency[mean squared error(MSE)and Pearson correlation coefficient(PCC)].Results The final analysis included facial images from 216 participants.Compared with baseline models,FCP-GAN achieved superior performance,with PSNR=31.02 dB and SSIM=0.908,representing an improvement of 1.21 dB and 0.034 in SSIM over the strongest baseline(MedGAN).The FID value(23.45)was also the lowest among all models,indicating superior distributional similarity to real images.The multi-space feature fusion and the ECA mechanism contributed significantly to these performance gains,as evidenced by ablation studies.The stratified 5-fold cross-validation confirmed the model’s robustness,with results reported as mean±standard deviation(SD)across all folds.The model effectively protected privacy by reducing face recognition accuracy from 95.2%(original images)to 60.1%(generated images).Critically,it maintained high diagnostic fidelity,as evidenced by a low MSE(<0.051)and a high PCC(>0.98)for key TCM facial features between original and generated images.Conclusion The FCP-GAN model provides an effective technical solution for ensuring privacy in TCM diagnostic imaging,successfully having removed identity features while preserving clinically vital facial color features.This study offers significant value for developing intelligent and secure TCM telemedicine systems.展开更多
Anticancer drug preparation by pharmacists is a critical task directly related to medical incidents. This study examined the factors influencing medical errors in chemotherapy, that is, errors by specialist pharmacist...Anticancer drug preparation by pharmacists is a critical task directly related to medical incidents. This study examined the factors influencing medical errors in chemotherapy, that is, errors by specialist pharmacists (CPh) and pharmacists in other departments (NCPh), by measuring their gaze during the preparation of anticancer drugs. The eye-tracking results showed that the gazing time of NCPh was significantly longer than that of CPh for items such as “preparation of a closed-system device” and “preparation of the syringe” and all preparation times (P < 0.05). The NCPh were not assigned to prepare drugs on a regular basis, indicating their lack of familiarity with the process. There was no significant difference in gaze ratio between CPh and NCPh. This outcome was suggested to be a result of the use of an anticancer drug preparation support system. The results for the pupil diameter variation rate showed that NCPh were significantly more mydriatic in the “mixing injections” category than CPh. However, CPh tended to be more mydriatic in the “checking” category. CPh exhibited a smooth workflow and focused on the important items to be checked. This study showed that the differences in procedure flow and concentration points may lead to errors. Furthermore, the results are of interest from the perspective of medical incident prevention. They will be useful in identifying potential human factors, such as where the pharmacist focuses their attention by measuring eye movements.展开更多
OBJECTIVE：The morphological and color characteristics of the tongue sublingual veins（SLVs）can manifest differently within the subjects,depending on the way their tongue is curled upward.This study was conducted in ...OBJECTIVE：The morphological and color characteristics of the tongue sublingual veins（SLVs）can manifest differently within the subjects,depending on the way their tongue is curled upward.This study was conducted in order to investigate the clinical relevancy of tongue SLV diagnosis in relation to menstrual clinical symptoms（pain,clots,heavy,and scanty）,using three different inspection procedures（IP1,IP2,and IP3）.METHODS：Three-hundred and seventy-seven female patients were asked to stick out their tongues in three specifi c ways which were intended to create different tongue protrusion angles.The SLV parameters for thickness（TK）,length（LE）,color（CL）,shape（SP）,and nodules（ND）were then evaluated.RESULTS：According to the results of the Waldχ2test,IP1 provides the best model for pain（R2=0.155）,IP3 for clots（R2=0.437）,IP2 for heavy（R2=0.268）,and scanty（R2=0.192）.Abnormal SLV diagnostic parameters were most strongly associated with the clinical symptom of clots（R2=0.492）.CONCLUSION：While the study showed the relations between tongue SLV features and menstrual clinical symptoms,as well it showed that IP2 was the best overall predictor for the symptomatic indexes used in this study,and using one particular SLV inspection procedure may not be suffi cient.The application of a particular inspection method alone may cause under-or over-estimation of SLV abnormalities.展开更多
Objective：To study the differences in a special region（SR） corresponding to five internal organs between the young and the elderly and to verify the effectiveness of a developed system for objectifying research in ...Objective：To study the differences in a special region（SR） corresponding to five internal organs between the young and the elderly and to verify the effectiveness of a developed system for objectifying research in colour inspections of Chinese medicine（CICM）.Methods：An image acquisition device imitating daylight to meet the requirement of CICM was designed.Image processing software based on CICM theory was developed.A total of 83 normal people were sampled and assigned to two groups.The first group（Group I）included 30 people with an average age of 24 ±2,and the second group（Group Ⅱ） included 53 people with an average age of 74 ±4.After image processing,the chromaticity of 10 SRs corresponding to five internal organs was calculated.R,G,and B represent the chromaticity of color red,green,and blue,L indicates color brightness,whereas a and b denote red and yellow respectively.The difference between the young and the elderly was analyzed.Results：（1） The chromaticity of each SR corresponding to five organs was obtained.The average R,G,B,L,a,and b of the sample were 194.4,147.6,119.3,65.2,15.5,and 22.3,respectively.（2） The R,G,B,and L of the young were greater than those of the elderly,but the a and b of the young were less than those of the elderly.（3） A statistically significant difference in each SR was found between the young and the elderly（P0.05）.The total differences for the Lung（Fei）,Heart（Xin）,Liver（Gan）,Spleen（Pi）,and Kidney（Shen） were 50%（3/6）,66.7%（4/6）,66.7%（4/6）,83.3%（5/6）,and 91.7%（33/36）,respectively.However,the Kidney SR had the greatest statistical discrepancy.Conclusion：The old Chinese saying that human Kidney deficiency worsens with age was verified by the results.The objectifying system used to examine CICM was effective.Thus,this system may be used as a basis for further research.展开更多
基金Research and Development Plan of Key Areas of Hunan Science and Technology Department (2022SK2044)Clinical Research Center for Depressive Disorder in Hunan Province (2021SK4022)。
文摘Objective To determine the correlation between traditional Chinese medicine(TCM)inspec-tion of spirit classification and the severity grade of depression based on facial features,offer-ing insights for intelligent intergrated TCM and western medicine diagnosis of depression.Methods Using the Audio-Visual Emotion Challenge and Workshop(AVEC 2014)public dataset on depression,which conclude 150 interview videos,the samples were classified ac-cording to the TCM inspection of spirit classification:Deshen(得神,presence of spirit),Shaoshen(少神,insufficiency of spirit),and Shenluan(神乱,confusion of spirit).Meanwhile,based on Beck Depression Inventory-II(BDI-II)score for the severity grade of depression,the samples were divided into minimal(0-13,Q1),mild(14-19,Q2),moderate(20-28,Q3),and severe(29-63,Q4).Sixty-eight landmarks were extracted with a ResNet-50 network,and the feature extracion mode was stadardized.Random forest and support vectior machine(SVM)classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression,respectively.A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships.Results The analysis revealed a statistically significant and moderately strong association be-tween TCM spirit classification and the severity grade of depression,as confirmed by a Chi-square test(χ^(2)=14.04,P=0.029)with a Cramer’s V effect size of 0.243.Further exploration us-ing association rule mining identified the most compelling rule:“moderate depression(Q3)→Shenluan”.This rule demonstrated a support level of 5%,indicating this specific co-occur-rence was present in 5%of the cohort.Crucially,it achieved a high Confidence of 86%,mean-ing that among patients diagnosed with Q3,86%exhibited the Shenluan pattern according to TCM assessment.The substantial Lift of 2.37 signifies that the observed likelihood of Shenlu-an manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent-compelling evidence of a highly non-random association.Conse-quently,Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3,forming a clinically significant phenotype within this patient subgroup.
基金National Key Research and Development Program of China(2022YFC3502302)Graduate Research Innovation Program of Jiangsu Province(KYCX25_2269)。
文摘Objective To develop a facial image generation method based on a facial color-preserving generative adversarial network(FCP-GAN)that effectively decouples identity features from diagnostic facial complexion characteristics in traditional Chinese medicine(TCM)inspection,thereby addressing the critical challenge of privacy preservation in medical image analysis.Methods A facial image dataset was constructed from participants at Nanjing University of Chinese Medicine between April 23 and June 10,2023,using a TCM full-body inspection data acquisition equipment under controlled illumination.The proposed FCP-GAN model was designed to achieve the dual objectives of removing identity features and preserving colors through three key components:(i)a multi-space combination module that comprehensively extracts color attributes from red,green,blue(RGB),hue,saturation,value(HSV),and Lab spaces;(ii)a generator incorporating efficient channel attention(ECA)mechanism to enhance the representation of diagnostically critical color channels;and(iii)a dual-loss function that combines adversarial loss for de-identification with a dedicated color preservation loss.The model was trained and evaluated using a stratified 5-fold cross-validation strategy and evaluated against four baseline generative models:conditional GAN(CGAN),deep convolutional GAN(DCGAN),dual discriminator CGAN(DDCGAN),and medical GAN(MedGAN).Performance was assessed in terms of image quality[peak signal-to-noise ratio(PSNR)and structural similarity(SSIM)],distribution similarity[Fréchet inception distance(FID)],privacy protection(face recognition accuracy),and diagnostic consistency[mean squared error(MSE)and Pearson correlation coefficient(PCC)].Results The final analysis included facial images from 216 participants.Compared with baseline models,FCP-GAN achieved superior performance,with PSNR=31.02 dB and SSIM=0.908,representing an improvement of 1.21 dB and 0.034 in SSIM over the strongest baseline(MedGAN).The FID value(23.45)was also the lowest among all models,indicating superior distributional similarity to real images.The multi-space feature fusion and the ECA mechanism contributed significantly to these performance gains,as evidenced by ablation studies.The stratified 5-fold cross-validation confirmed the model’s robustness,with results reported as mean±standard deviation(SD)across all folds.The model effectively protected privacy by reducing face recognition accuracy from 95.2%(original images)to 60.1%(generated images).Critically,it maintained high diagnostic fidelity,as evidenced by a low MSE(<0.051)and a high PCC(>0.98)for key TCM facial features between original and generated images.Conclusion The FCP-GAN model provides an effective technical solution for ensuring privacy in TCM diagnostic imaging,successfully having removed identity features while preserving clinically vital facial color features.This study offers significant value for developing intelligent and secure TCM telemedicine systems.
文摘Anticancer drug preparation by pharmacists is a critical task directly related to medical incidents. This study examined the factors influencing medical errors in chemotherapy, that is, errors by specialist pharmacists (CPh) and pharmacists in other departments (NCPh), by measuring their gaze during the preparation of anticancer drugs. The eye-tracking results showed that the gazing time of NCPh was significantly longer than that of CPh for items such as “preparation of a closed-system device” and “preparation of the syringe” and all preparation times (P < 0.05). The NCPh were not assigned to prepare drugs on a regular basis, indicating their lack of familiarity with the process. There was no significant difference in gaze ratio between CPh and NCPh. This outcome was suggested to be a result of the use of an anticancer drug preparation support system. The results for the pupil diameter variation rate showed that NCPh were significantly more mydriatic in the “mixing injections” category than CPh. However, CPh tended to be more mydriatic in the “checking” category. CPh exhibited a smooth workflow and focused on the important items to be checked. This study showed that the differences in procedure flow and concentration points may lead to errors. Furthermore, the results are of interest from the perspective of medical incident prevention. They will be useful in identifying potential human factors, such as where the pharmacist focuses their attention by measuring eye movements.
文摘OBJECTIVE：The morphological and color characteristics of the tongue sublingual veins（SLVs）can manifest differently within the subjects,depending on the way their tongue is curled upward.This study was conducted in order to investigate the clinical relevancy of tongue SLV diagnosis in relation to menstrual clinical symptoms（pain,clots,heavy,and scanty）,using three different inspection procedures（IP1,IP2,and IP3）.METHODS：Three-hundred and seventy-seven female patients were asked to stick out their tongues in three specifi c ways which were intended to create different tongue protrusion angles.The SLV parameters for thickness（TK）,length（LE）,color（CL）,shape（SP）,and nodules（ND）were then evaluated.RESULTS：According to the results of the Waldχ2test,IP1 provides the best model for pain（R2=0.155）,IP3 for clots（R2=0.437）,IP2 for heavy（R2=0.268）,and scanty（R2=0.192）.Abnormal SLV diagnostic parameters were most strongly associated with the clinical symptom of clots（R2=0.492）.CONCLUSION：While the study showed the relations between tongue SLV features and menstrual clinical symptoms,as well it showed that IP2 was the best overall predictor for the symptomatic indexes used in this study,and using one particular SLV inspection procedure may not be suffi cient.The application of a particular inspection method alone may cause under-or over-estimation of SLV abnormalities.
基金Supported by Nanjing University of Aeronautics and Astronautics Innovation Team FundChinese Medical Association-L'Oreal Chinese Healthy Skin/Hair Research Project(S10)
文摘Objective：To study the differences in a special region（SR） corresponding to five internal organs between the young and the elderly and to verify the effectiveness of a developed system for objectifying research in colour inspections of Chinese medicine（CICM）.Methods：An image acquisition device imitating daylight to meet the requirement of CICM was designed.Image processing software based on CICM theory was developed.A total of 83 normal people were sampled and assigned to two groups.The first group（Group I）included 30 people with an average age of 24 ±2,and the second group（Group Ⅱ） included 53 people with an average age of 74 ±4.After image processing,the chromaticity of 10 SRs corresponding to five internal organs was calculated.R,G,and B represent the chromaticity of color red,green,and blue,L indicates color brightness,whereas a and b denote red and yellow respectively.The difference between the young and the elderly was analyzed.Results：（1） The chromaticity of each SR corresponding to five organs was obtained.The average R,G,B,L,a,and b of the sample were 194.4,147.6,119.3,65.2,15.5,and 22.3,respectively.（2） The R,G,B,and L of the young were greater than those of the elderly,but the a and b of the young were less than those of the elderly.（3） A statistically significant difference in each SR was found between the young and the elderly（P0.05）.The total differences for the Lung（Fei）,Heart（Xin）,Liver（Gan）,Spleen（Pi）,and Kidney（Shen） were 50%（3/6）,66.7%（4/6）,66.7%（4/6）,83.3%（5/6）,and 91.7%（33/36）,respectively.However,the Kidney SR had the greatest statistical discrepancy.Conclusion：The old Chinese saying that human Kidney deficiency worsens with age was verified by the results.The objectifying system used to examine CICM was effective.Thus,this system may be used as a basis for further research.
