1
|
Luo G, Chen T, Letterio JJ. LOCC: a novel visualization and scoring of cutoffs for continuous variables with hepatocellular carcinoma prognosis as an example. BMC Bioinformatics 2024; 25:314. [PMID: 39333873 PMCID: PMC11438210 DOI: 10.1186/s12859-024-05932-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The interpretation of large datasets, such as The Cancer Genome Atlas (TCGA), for scientific and research purposes, remains challenging despite their public availability. In this study, we focused on identifying gene expression profiles most relevant to patient prognosis and aimed to develop a method and database to address this issue. To achieve this, we introduced Luo's Optimization Categorization Curve (LOCC), an innovative tool for visualizing and scoring continuous variables against dichotomous outcomes. To demonstrate the efficacy of LOCC using real-world data, we analyzed gene expression profiles and patient data from TCGA hepatocellular carcinoma samples. RESULTS To showcase LOCC, we demonstrate an optimal cutoff for E2F1 expression in hepatocellular carcinoma, which was subsequently validated in an independent cohort. Compared to ROC curves and their AUC, LOCC offered a superior description of the predictive value of E2F1 expression across various cancer types. The LOCC score, comprised of factors representing significance, range, and impact of the biomarker, facilitated the ranking of all gene expression profiles in hepatocellular carcinoma, aiding in the evaluation and understanding of previously published prognostic gene signatures. We also demonstrate that LOCC does not have the same assumptions required of Cox proportional hazards modeling for accurate analysis. Repeated sampling demonstrated that LOCC scores outperformed ROC's AUC in discriminating predictors from non-predictors. Additionally, gene set enrichment analysis revealed significant associations between certain genes and prognosis, such as E2F target genes and G2M checkpoint with poor prognosis, and bile acid metabolism and oxidative phosphorylation with good prognosis. CONCLUSION In summary, we present LOCC as a novel visualization tool for the analysis of gene expression in cancer, particularly for understanding and selecting cutoffs. Our findings suggest that LOCC scores, which effectively rank genes based on their prognostic potential, represent a more suitable approach than ROC curves and Cox proportional hazard for prognostic modeling and understanding in cancer gene expression analysis. LOCC holds promise as an invaluable tool for advancing precision medicine and furthering biomarker research. Further research regarding multivariable integration and validation will help LOCC reach its full potential and establish its utility across diverse cancer types and clinical settings.
Collapse
Affiliation(s)
- George Luo
- Department of Pathology, Case Western Reserve University School of Medicine, 2103 Cornell Rd., Wolstein Research Bldg. Rm 3501, Cleveland, OH, 44106, USA.
| | - Toby Chen
- School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - John J Letterio
- The Angie Fowler Adolescent and Young Adult Cancer Institute, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, OH, USA
- The Case Comprehensive Cancer Center, Cleveland, OH, USA
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
2
|
Rahman J, Brankovic A, Khanna S. Machine learning model with output correction: Towards reliable bradycardia detection in neonates. Comput Biol Med 2024; 177:108658. [PMID: 38833801 DOI: 10.1016/j.compbiomed.2024.108658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 06/06/2024]
Abstract
Bradycardia is a commonly occurring condition in premature infants, often causing serious consequences and cardiovascular complications. Reliable and accurate detection of bradycardia events is pivotal for timely intervention and effective treatment. Excessive false alarms pose a critical problem in bradycardia event detection, eroding trust in machine learning (ML)-based clinical decision support tools designed for such detection. This could result in disregarding the algorithm's accurate recommendations and disrupting workflows, potentially compromising the quality of patient care. This article introduces an ML-based approach incorporating an output correction element, designed to minimise false alarms. The approach has been applied to bradycardia detection in preterm infants. We applied five ML-based autoencoder techniques, using recurrent neural network (RNN), long-short-term memory (LSTM), gated recurrent unit (GRU), 1D convolutional neural network (1D CNN), and a combination of 1D CNN and LSTM. The analysis is performed on ∼440 hours of real-time preterm infant data. The proposed approach achieved 0.978, 0.73, 0.992, 0.671 and 0.007 in AUC-ROC, AUC-PRC, recall, F1 score, and false positive rate (FPR) respectively and a false alarms reduction of 36% when compared with methods without the correction approach. This study underscores the imperative of cultivating solutions that alleviate alarm fatigue and encourage active engagement among healthcare professionals.
Collapse
|
3
|
Movahedi F, Antaki JF. Improving the Prediction of 1-Year Right Ventricular Failure After Left Ventricular Assist Device Implantation. ASAIO J 2024; 70:495-501. [PMID: 38346283 PMCID: PMC11147739 DOI: 10.1097/mat.0000000000002152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024] Open
Abstract
Previous predictive models for postimplant right heart failure (RHF) following left ventricular assist device (LVAD) implantation have demonstrated limited performance on validation datasets and are susceptible to overfitting. Thus, the objective of this study was to develop an improved predictive model with reduced overfitting and improved accuracy in predicting RHF in LVAD recipients. The study involved 11,967 patients who underwent continuous-flow LVAD implantation between 2008 and 2016, with an RHF incidence of 9% at 1 year. Using an eXtreme Gradient Boosting (XGBoost) algorithm, the training data were used to predict RHF at 1 year postimplantation, resulting in promising area under the curve (AUC)-receiver operating characteristic (ROC) of 0.8 and AUC-precision recall curve (PRC) of 0.24. The calibration plot showed that the predicted risk closely corresponded with the actual observed risk. However, the model based on data collected 48 hours before LVAD implantation exhibited high sensitivity but low precision, making it an excellent screening tool but not a diagnostic tool.
Collapse
Affiliation(s)
- Faezeh Movahedi
- From the Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James F Antaki
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
| |
Collapse
|
4
|
Dinnendahl R, Tschimmel D, Löw V, Cornely M, Hucho T. Non-obese lipedema patients show a distinctly altered quantitative sensory testing profile with high diagnostic potential. Pain Rep 2024; 9:e1155. [PMID: 38617100 PMCID: PMC11013692 DOI: 10.1097/pr9.0000000000001155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/26/2024] [Accepted: 02/20/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction and Objectives Lipedema is a widespread severe chronic disease affecting mostly women. Characterized by painful bilateral fat accumulation in extremities sparing hands and feet, objective measurement-based diagnosis is currently missing. We tested for characteristic psychometric and/or sensory alterations including pain and for their potential for medical routine diagnosis. Methods Pain psychometry was assessed using the German Pain Questionnaire. Sensory sensitivity toward painful and nonpainful stimuli was characterized in non-obese lipedema patients and matched controls using the validated quantitative sensory testing (QST) protocol of the German Research Network on Neuropathic Pain. Results Lipedema patients showed no overt psychometric abnormalities. Pain was reported as somatic rather than psychosomatic aversive. All QST measurements were normal, but the z-score of pressure pain thresholds (PPT) was twofold reduced and the z-score of vibration detection thresholds (VDT) was two and a half times increased. Both thresholds were selectively altered at the affected thigh but not the unaffected hand. Receiver operating characteristic analysis of the combination of PPT and VDT of thigh vs hand into a PVTH score (PPT, VDT, thigh, hand-score) shows high sensitivity and specificity, categorizing correctly 95.8% of the participants as lipedema patients or healthy controls. Bayesian inference analysis corroborated the diagnostic potential of such a combined PVTH score. Conclusion We propose to assess PPT and VDT at the painful thigh and the pain-free hand. Combination in a PVTH score may allow a convenient lipedema diagnosis early during disease development.
Collapse
Affiliation(s)
- Rebecca Dinnendahl
- Translational Pain Research, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Dominik Tschimmel
- Translational Pain Research, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Vanessa Löw
- Pain Center, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Manuel Cornely
- CG Lympha GmbH, Cologne, Germany
- Ly.Search GmbH, Cologne, Germany
| | - Tim Hucho
- Translational Pain Research, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
- Pain Center, Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
5
|
Ahmad D, Sá MP, Brown JA, Yousef S, Wang Y, Thoma F, Chu D, Kaczorowski DJ, West DM, Bonatti J, Yoon PD, Ferdinand FD, Serna-Gallegos D, Phillippi J, Sultan I. External validation of the ARCH score in patients undergoing aortic arch reconstruction under circulatory arrest. J Thorac Cardiovasc Surg 2024:S0022-5223(24)00383-0. [PMID: 38750690 DOI: 10.1016/j.jtcvs.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Aortic arch surgery with hypothermic circulatory arrest (HCA) carries a higher risk of morbidity and mortality compared to routine cardiac surgical procedures. The newly developed ARCH (arch reconstruction under circulatory arrest with hypothermia) score has not been externally validated. We sought to externally validate this score in our local population. METHODS All consecutive open aortic arch surgeries with HCA performed between 2014 and 2023 were included. Univariable and multivariable analyses were performed. Model discrimination was assessed by the C-statistic with 95% confidence intervals as part of the receiver operating characteristic (ROC) curve analysis. Model performance was visualized by a calibration plot and quantified by the Brier score. RESULTS A total of 760 patients (38.3% females) were included. The mean age was 61 (±13.6) years, with 56.4% of patients' age >60 years. The procedures were carried out mostly emergently or urgently (59.6%). Total arch replacement was performed in 32.5% of the patients, and aortic root procedures were carried out in 74.6%. In-hospital death occurred in 64 patients (8.4%), and stroke occurred in 5.4%. The C-statistic revealed a low discriminatory ability for predicting in-hospital mortality (area under the ROC curve, 0.62; 95% confidence interval, 0.54-0.69; P = .002); however, model calibration was found to be excellent (Brier score of 0.07). CONCLUSIONS The ARCH score for in-hospital mortality showed low discriminatory ability in our local population, although with excellent ability for prediction of mortality.
Collapse
Affiliation(s)
- Danial Ahmad
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Michel Pompeu Sá
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - James A Brown
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Sarah Yousef
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Yisi Wang
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Floyd Thoma
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Danny Chu
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - David J Kaczorowski
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - David M West
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Johannes Bonatti
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Pyongsoo D Yoon
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Francis D Ferdinand
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Derek Serna-Gallegos
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Julie Phillippi
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa
| | - Ibrahim Sultan
- Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa.
| |
Collapse
|
6
|
Lee J, Kolla L, Chen J. Towards optimal model evaluation: enhancing active testing with actively improved estimators. Sci Rep 2024; 14:10690. [PMID: 38724626 PMCID: PMC11082224 DOI: 10.1038/s41598-024-58633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/01/2024] [Indexed: 05/12/2024] Open
Abstract
With rapid advancements in machine learning and statistical models, ensuring the reliability of these models through accurate evaluation has become imperative. Traditional evaluation methods often rely on fully labeled test data, a requirement that is becoming increasingly impractical due to the growing size of datasets. In this work, we address this issue by extending existing work on active testing (AT) methods which are designed to sequentially sample and label data for evaluating pre-trained models. We propose two novel estimators: the Actively Improved Levelled Unbiased Risk (AILUR) and the Actively Improved Inverse Probability Weighting (AIIPW) estimators which are derived from nonparametric smoothing estimation. In addition, a model recalibration process is designed for the AIIPW estimator to optimize the sampling probability within the AT framework. We evaluate the proposed estimators on four real-world datasets and demonstrate that they consistently outperform existing AT methods. Our study also shows that the proposed methods are robust to changes in subsample sizes, and effective at reducing labeling costs.
Collapse
Affiliation(s)
- JooChul Lee
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Likhitha Kolla
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jinbo Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| |
Collapse
|
7
|
Valle C, Shrestha S, Godeke GJ, Hoogerwerf MN, Reimerink J, Eggink D, Reusken C. Multiplex Serology for Sensitive and Specific Flavivirus IgG Detection: Addition of Envelope Protein Domain III to NS1 Increases Sensitivity for Tick-Borne Encephalitis Virus IgG Detection. Viruses 2024; 16:286. [PMID: 38400061 PMCID: PMC10892675 DOI: 10.3390/v16020286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Tick-borne encephalitis is a vaccine-preventable disease of concern for public health in large parts of Europe, with EU notification rates increasing since 2018. It is caused by the orthoflavivirus tick-borne encephalitis virus (TBEV) and a diagnosis of infection is mainly based on serology due to its short viremic phase, often before symptom onset. The interpretation of TBEV serology is hampered by a history of orthoflavivirus vaccination and by previous infections with related orthoflaviviruses. Here, we sought to improve TBEV sero-diagnostics using an antigen combination of in-house expressed NS1 and EDIII in a multiplex, low-specimen-volume set-up for the detection of immune responses to TBEV and other clinically important orthoflaviviruses (i.e., West Nile virus, dengue virus, Japanese encephalitis virus, Usutu virus and Zika virus). We show that the combined use of NS1 and EDIII results in both a specific and sensitive test for the detection of TBEV IgG for patient diagnostics, vaccination responses and in seroprevalence studies. This novel approach potentially allows for a low volume-based, simultaneous analysis of IgG responses to a range of orthoflaviviruses with overlapping geographic circulations and clinical manifestations.
Collapse
Affiliation(s)
- Coralie Valle
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
- Unité des Virus Emergents (UVE), Aix-Marseille Université, IRD 190, Inserm 1207, 13005 Marseille, France
| | - Sandhya Shrestha
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| | - Gert-Jan Godeke
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| | - Marieke N. Hoogerwerf
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| | - Johan Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| | - Dirk Eggink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| | - Chantal Reusken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands (M.N.H.); (J.R.)
| |
Collapse
|
8
|
Mohammadi A, Chiang S, Li F, Wei F, Lau CS, Aziz M, Ibarrondo FJ, Fulcher JA, Yang OO, Chia D, Kim Y, Wong DT. Direct Detection of 4-Dimensions of SARS-CoV-2: Infection (vRNA), Infectivity (Antigen), Binding Antibody, and Functional Neutralizing Antibody in Saliva. RESEARCH SQUARE 2023:rs.3.rs-3745787. [PMID: 38234820 PMCID: PMC10793499 DOI: 10.21203/rs.3.rs-3745787/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
We developed a 4-parameter clinical assay using Electric Field Induced Release and Measurement (EFIRM) technology to simultaneously assess SARS-CoV-2 RNA (vRNA), nucleocapsid antigen, host binding (BAb) and neutralizing antibody (NAb) levels from a drop of saliva with performance that equals or surpasses current EUA-approved tests. The vRNA and antigen assays achieved lower limit of detection (LOD) of 100 copies/reaction and 3.5 TCID₅₀/mL, respectively. The vRNA assay differentiated between acutely infected (n=10) and infection-naïve patients (n=33) with an AUC of 0.9818, sensitivity of 90%, and specificity of 100%. The antigen assay similarly differentiated these patient populations with an AUC of 1.000. The BAb assay detected BAbs with an LOD of 39 pg/mL and distinguished acutely infected (n=35), vaccinated with prior infection (n=13), and vaccinated infection-naïve patients (n=13) from control (n=81) with AUC of 0.9481, 1.000, and 0.9962, respectively. The NAb assay detected NAbs with an LOD of 31.6 Unit/mL and differentiated between COVID-19 recovered or vaccinated patients (n=31) and pre-pandemic controls (n=60) with an AUC 0.923, sensitivity of 87.10%, and specificity of 86.67%. Our multiparameter assay represents a significant technological advancement to simultaneously address SARS-CoV-2 infection and immunity, and it lays the foundation for tackling potential future pandemics.
Collapse
Affiliation(s)
- Aida Mohammadi
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Samantha Chiang
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Feng Li
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Fang Wei
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Mohammad Aziz
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Francisco J. Ibarrondo
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Jennifer A. Fulcher
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Otto O. Yang
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - David Chia
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - Yong Kim
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| | - David T.W. Wong
- School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
9
|
Seok J, Jeong ST, Yoon SY, Lee JY, Kim S, Cho H, Kang WS. Novel nomogram for predicting paradoxical chest wall movement in patients with flail segment of traumatic rib fracture: a retrospective cohort study. Sci Rep 2023; 13:20251. [PMID: 37985825 PMCID: PMC10662329 DOI: 10.1038/s41598-023-47700-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023] Open
Abstract
Flail chest is a severe injury to the chest wall and is related to adverse outcomes. A flail chest is classified as the physiologic, paradoxical motion of a chest wall or flail segment of rib fracture (RFX). We hypothesized that patients with paradoxical chest wall movement would present different clinical features from patients with a flail segment. This retrospective observational study included patients with blunt chest trauma who visited our level 1 trauma center between January 2019 and October 2022 and were diagnosed with one or more flail segments by computed tomography. The primary outcome of our study was a clinically diagnosed visible, paradoxical chest wall motion. We used the least absolute shrinkage and selection operator (LASSO) logistic regression model to minimize overfitting. After a feature selection using the LASSO regression model, we constructed a multivariable logistic regression (MLR) model and nomogram. A total of five risk factors were selected in the LASSO model and applied to the multivariable logistic regression model. Of these, four risk factors were statistically significant: the total number of RFX (adjusted OR [aOR], 1.28; 95% confidence interval [CI], 1.09-1.49; p = 0.002), number of segmental RFX including Grade III fractures (aOR, 1.78; 95% CI, 1.14-2.79; p = 0.012), laterally located primary fracture lines (aOR, 4.00; 95% CI, 1.69-9.43; p = 0.002), and anterior-lateral flail segments (aOR, 4.20; 95% CI, 1.60-10.99; p = 0.004). We constructed a nomogram to predict the personalized probability of the flail motion. A novel nomogram was developed in patients with flail segments of traumatic RFX to predict paradoxical chest wall motion. The number of RFX, Grade III segmental RFX, and the location of the RFX were significant risk factors.
Collapse
Affiliation(s)
- Junepill Seok
- Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Cheongju, 28644, South Korea
| | - Soon Tak Jeong
- Department of Physical Medicine and Rehabilitation, Ansanhyo Hospital, Ansan City, Republic of Korea
| | - Su Young Yoon
- Department of Thoracic and Cardiovascular Surgery, Chungbuk National University Hospital, Cheongju, 28644, South Korea
| | - Jin Young Lee
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, 28644, South Korea
| | - Seheon Kim
- Department of Trauma Surgery, Chungbuk National University Hospital, Cheongju, 28644, South Korea
| | - Hyunmin Cho
- Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, 65, Doryeong-ro, Jeju-si, Jeju-do, Republic of Korea
| | - Wu Seong Kang
- Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, 65, Doryeong-ro, Jeju-si, Jeju-do, Republic of Korea.
| |
Collapse
|
10
|
Chandrashekar PB, Alatkar S, Wang J, Hoffman GE, He C, Jin T, Khullar S, Bendl J, Fullard JF, Roussos P, Wang D. DeepGAMI: deep biologically guided auxiliary learning for multimodal integration and imputation to improve genotype-phenotype prediction. Genome Med 2023; 15:88. [PMID: 37904203 PMCID: PMC10617196 DOI: 10.1186/s13073-023-01248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/16/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Genotypes are strongly associated with disease phenotypes, particularly in brain disorders. However, the molecular and cellular mechanisms behind this association remain elusive. With emerging multimodal data for these mechanisms, machine learning methods can be applied for phenotype prediction at different scales, but due to the black-box nature of machine learning, integrating these modalities and interpreting biological mechanisms can be challenging. Additionally, the partial availability of these multimodal data presents a challenge in developing these predictive models. METHOD To address these challenges, we developed DeepGAMI, an interpretable neural network model to improve genotype-phenotype prediction from multimodal data. DeepGAMI leverages functional genomic information, such as eQTLs and gene regulation, to guide neural network connections. Additionally, it includes an auxiliary learning layer for cross-modal imputation allowing the imputation of latent features of missing modalities and thus predicting phenotypes from a single modality. Finally, DeepGAMI uses integrated gradient to prioritize multimodal features for various phenotypes. RESULTS We applied DeepGAMI to several multimodal datasets including genotype and bulk and cell-type gene expression data in brain diseases, and gene expression and electrophysiology data of mouse neuronal cells. Using cross-validation and independent validation, DeepGAMI outperformed existing methods for classifying disease types, and cellular and clinical phenotypes, even using single modalities (e.g., AUC score of 0.79 for Schizophrenia and 0.73 for cognitive impairment in Alzheimer's disease). CONCLUSION We demonstrated that DeepGAMI improves phenotype prediction and prioritizes phenotypic features and networks in multiple multimodal datasets in complex brains and brain diseases. Also, it prioritized disease-associated variants, genes, and regulatory networks linked to different phenotypes, providing novel insights into the interpretation of gene regulatory mechanisms. DeepGAMI is open-source and available for general use.
Collapse
Affiliation(s)
- Pramod Bharadwaj Chandrashekar
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53076, USA
| | - Sayali Alatkar
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, 53076, USA
| | - Jiebiao Wang
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Gabriel E Hoffman
- Center for Disease Neurogenomics, Department of Psychiatry and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Chenfeng He
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53076, USA
| | - Ting Jin
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53076, USA
| | - Saniya Khullar
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53076, USA
| | - Jaroslav Bendl
- Center for Disease Neurogenomics, Department of Psychiatry and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - John F Fullard
- Center for Disease Neurogenomics, Department of Psychiatry and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Panos Roussos
- Center for Disease Neurogenomics, Department of Psychiatry and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Mental Illness Research, Education and Clinical Centers, James J. Peters VA Medical Center, Bronx, NY, 10468, USA
- Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - Daifeng Wang
- Waisman Center, University of Wisconsin-Madison, Madison, WI, 53705, USA.
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53076, USA.
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, 53076, USA.
| |
Collapse
|
11
|
Demirel ME, Akunal Türel C. The Role of the Multi-Inflammatory Index as a Novel Predictor of Hospital Mortality in Acute Ischemic Stroke. Cureus 2023; 15:e43258. [PMID: 37577267 PMCID: PMC10413012 DOI: 10.7759/cureus.43258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 08/15/2023] Open
Abstract
Background and objective Ischemic strokes account for the majority of all strokes. The severity of an acute ischemic stroke (AIS) can be estimated with the help of a number of different scoring systems. However, there is a need for bedside tests that will support the clinical diagnosis and thus help predict the severity of stroke. The research on the multi-inflammatory index (MII), which is calculated using hemogram parameters, has shown immense promise. In light of this, the aim of this study was to establish the association between MII and the severity of AIS. Methods The study included 452 ischemic stroke patients over the age of 18 years who presented to the hospital within 72 hours of the onset of symptoms. Demographic information such as patient age and gender, hemogram parameters, ratios, indices, hospitalization, and mortality status were all recorded. The demographic data, hemogram parameters, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein (CRP)/lymphocyte ratio (CLR), and MII 1, 2, and 3 were compared between surviving and deceased patients. Results The MII-1, MII-2, and MII-3 index values were determined to be significantly low in the patients with Glasgow Coma Scale (GCS) scores of 13-15 compared to those with GCS scores ≤8, and in patients with National Institutes of Health Stroke Scale (NIHSS) score of 1-4 compared to those with scores of 5-14, 15-20, and ≥21. The NLR, CLR, PLR, MII-1, MII-2, and MII-3 index values were significantly higher in the non-survivors (PLR: p=0.004, all other values: p<0.001). The performances of multiple models developed for the mortality cut-off points were evaluated. Together with other factors, Model 1 included the MII-1, Model 2 the MII-2, and Model 3 the MII-3. Although there was no significant difference between the AUC values of the models, the highest sensitivity rate was reached with Model 2 (74.48%), and the highest specificity rate with Model 3 (90.62%). Conclusion Based on our findings, MII is a simple and practical biomarker that can be easily obtained from NLR, PLR, and CRP, and can help in the early detection of poor prognosis in AIS. NLR was found to be superior to PLR and CLR in distinguishing fatal AIS cases.
Collapse
Affiliation(s)
- Mustafa E Demirel
- Emergency Medicine, Abant Izzet Baysal University Hospital, Bolu, TUR
| | | |
Collapse
|
12
|
Luo G, Letterio JJ. LOCC: a novel visualization and scoring of cutoffs for continuous variables. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.11.536461. [PMID: 37090530 PMCID: PMC10120642 DOI: 10.1101/2023.04.11.536461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Objective There is a need for new methods to select and analyze cutoffs employed to define genes that are most prognostic significant and impactful. We designed LOCC (Luo's Optimization Categorization Curve), a novel tool to visualize and score continuous variables for a dichotomous outcome. Methods To demonstrate LOCC with real world data, we analyzed TCGA hepatocellular carcinoma gene expression and patient data using LOCC. We compared LOCC visualization to receiver operating characteristic (ROC) curve for prognostic modeling to showcase its utility in understanding predictors in various TCGA datasets. Results Analysis of E2F1 expression in hepatocellular carcinoma using LOCC demonstrated appropriate cutoff selection and validation. In addition, we compared LOCC visualization and scoring to ROC curves and c-statistics, demonstrating that LOCC better described predictors. Analysis of a previously published gene signature showed large differences in LOCC scoring, and removing the lowest scoring genes did not affect prognostic modeling of the gene signature demonstrating LOCC scoring could distinguish which predictors were most critical. Conclusion Overall, LOCC is a novel visualization tool for understanding and selecting cutoffs, particularly for gene expression analysis in cancer. The LOCC score can be used to rank genes for prognostic potential and is more suitable than ROC curves for prognostic modeling.
Collapse
Affiliation(s)
- George Luo
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - John J. Letterio
- The Angie Fowler Adolescent and Young Adult Cancer Institute, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, Ohio
- The Case Comprehensive Cancer Center, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
13
|
Movahedi F, Padman R, Antaki JF. Limitations of receiver operating characteristic curve on imbalanced data: Assist device mortality risk scores. J Thorac Cardiovasc Surg 2023; 165:1433-1442.e2. [PMID: 34446286 PMCID: PMC8800945 DOI: 10.1016/j.jtcvs.2021.07.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE In the left ventricular assist device domain, the receiver operating characteristic is a commonly applied metric of performance of classifiers. However, the receiver operating characteristic can provide a distorted view of classifiers' ability to predict short-term mortality due to the overwhelmingly greater proportion of patients who survive, that is, imbalanced data. This study illustrates the ambiguity of the receiver operating characteristic in evaluating 2 classifiers of 90-day left ventricular assist device mortality and introduces the precision recall curve as a supplemental metric that is more representative of left ventricular assist device classifiers in predicting the minority class. METHODS This study compared the receiver operating characteristic and precision recall curve for 2 classifiers for 90-day left ventricular assist device mortality, HeartMate Risk Score and Random Forest for 800 patients (test group) recorded in the Interagency Registry for Mechanically Assisted Circulatory Support who received a continuous-flow left ventricular assist device between 2006 and 2016 (mean age, 59 years; 146 female vs 654 male patients), in whom 90-day mortality rate is only 8%. RESULTS The receiver operating characteristic indicates similar performance of Random Forest and HeartMate Risk Score classifiers with respect to area under the curve of 0.77 and Random Forest 0.63, respectively. This is in contrast to their precision recall curve with area under the curve of 0.43 versus 0.16 for Random Forest and HeartMate Risk Score, respectively. The precision recall curve for HeartMate Risk Score showed the precision rapidly decreased to only 10% with slightly increasing sensitivity. CONCLUSIONS The receiver operating characteristic can portray an overly optimistic performance of a classifier or risk score when applied to imbalanced data. The precision recall curve provides better insight about the performance of a classifier by focusing on the minority class.
Collapse
Affiliation(s)
- Faezeh Movahedi
- Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pa
| | - Rema Padman
- Heinz College, Carnegie Mellon University, Pittsburgh, Pa
| | - James F Antaki
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY.
| |
Collapse
|
14
|
Chicco D, Jurman G. The Matthews correlation coefficient (MCC) should replace the ROC AUC as the standard metric for assessing binary classification. BioData Min 2023; 16:4. [PMID: 36800973 PMCID: PMC9938573 DOI: 10.1186/s13040-023-00322-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/01/2023] [Indexed: 02/19/2023] Open
Abstract
Binary classification is a common task for which machine learning and computational statistics are used, and the area under the receiver operating characteristic curve (ROC AUC) has become the common standard metric to evaluate binary classifications in most scientific fields. The ROC curve has true positive rate (also called sensitivity or recall) on the y axis and false positive rate on the x axis, and the ROC AUC can range from 0 (worst result) to 1 (perfect result). The ROC AUC, however, has several flaws and drawbacks. This score is generated including predictions that obtained insufficient sensitivity and specificity, and moreover it does not say anything about positive predictive value (also known as precision) nor negative predictive value (NPV) obtained by the classifier, therefore potentially generating inflated overoptimistic results. Since it is common to include ROC AUC alone without precision and negative predictive value, a researcher might erroneously conclude that their classification was successful. Furthermore, a given point in the ROC space does not identify a single confusion matrix nor a group of matrices sharing the same MCC value. Indeed, a given (sensitivity, specificity) pair can cover a broad MCC range, which casts doubts on the reliability of ROC AUC as a performance measure. In contrast, the Matthews correlation coefficient (MCC) generates a high score in its [Formula: see text] interval only if the classifier scored a high value for all the four basic rates of the confusion matrix: sensitivity, specificity, precision, and negative predictive value. A high MCC (for example, MCC [Formula: see text] 0.9), moreover, always corresponds to a high ROC AUC, and not vice versa. In this short study, we explain why the Matthews correlation coefficient should replace the ROC AUC as standard statistic in all the scientific studies involving a binary classification, in all scientific fields.
Collapse
Affiliation(s)
- Davide Chicco
- Institute of Health Policy Management and Evaluation, University of Toronto, 155 College Street, M5T 3M7 Toronto, Ontario Canada
| | - Giuseppe Jurman
- Data Science for Health Unit, Fondazione Bruno Kessler, Via Sommarive 18, 38123 Povo, Trento, Italy
| |
Collapse
|
15
|
Alreni ASE, Aboalmaty HRA, De Hertogh W, Wakwak OSM, McLean SM. Construct validity of the Single Arm Military Press (SAMP) test for upper limb function in patients with neck pain. Musculoskelet Sci Pract 2023; 63:102707. [PMID: 36525941 DOI: 10.1016/j.msksp.2022.102707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neck pain (NP) is often associated with upper limb disability (ULD). A clinically feasible measure to evaluate ULD in NP patients is necessary. The Single Arm Military Press (SAMP) is a ULD performance-based measure, specifically for NP patients. The validity of the SAMP in patients is still unknown. OBJECTIVE To explore the construct validity (hypotheses testing) of the SAMP in NP patients. METHODS A total of 210 NP patients and 81 controls were recruited. The SAMP; Disability of the Arm, Shoulder, and Hand (DASH); and Neck Disability Index (NDI) were completed at baseline and 4-7 days later. The Visual Analogue Scale (VAS) was used to measure NP and ULD severity pre-testing in both occasions. Patients were divided into 4-subgroups based on their NDI score. Convergent validity was examined using Pearson correlation. The t-test and analysis of variance (ANOVA) were used to evaluate discriminant and known groups' validity. To determine SAMP cut-off scores, the sensitivity and specificity were explored. RESULTS A negative correlation between the SAMP and DASH/NDI scores was found in the patient group (r = -0.91 and -0.87, p < 0.01). The t-test revealed substantial differences (t = -23.96) in score between patients and controls. Also, ANOVA revealed substantial differences (f = 20.86) between the patients' subgroups. The area under the curve (AUC) for patients and controls exceeded 0.90 when sensitivity and specificity were at equal importance. CONCLUSION The SAMP can distinguish between NP patients and controls, and between different NP disability levels. The responsiveness of the SAMP needs to be investigated.
Collapse
Affiliation(s)
| | | | - Willem De Hertogh
- Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.
| | | | - Sionnadh Mairi McLean
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK.
| |
Collapse
|
16
|
PToPI: A Comprehensive Review, Analysis, and Knowledge Representation of Binary Classification Performance Measures/Metrics. SN COMPUTER SCIENCE 2023; 4:13. [PMID: 36267467 PMCID: PMC9569243 DOI: 10.1007/s42979-022-01409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
Although few performance evaluation instruments have been used conventionally in different machine learning-based classification problem domains, there are numerous ones defined in the literature. This study reviews and describes performance instruments via formally defined novel concepts and clarifies the terminology. The study first highlights the issues in performance evaluation via a survey of 78 mobile-malware classification studies and reviews terminology. Based on three research questions, it proposes novel concepts to identify characteristics, similarities, and differences of instruments that are categorized into 'performance measures' and 'performance metrics' in the classification context for the first time. The concepts reflecting the intrinsic properties of instruments such as canonical form, geometry, duality, complementation, dependency, and leveling, aim to reveal similarities and differences of numerous instruments, such as redundancy and ground-truth versus prediction focuses. As an application of knowledge representation, we introduced a new exploratory table called PToPI (Periodic Table of Performance Instruments) for 29 measures and 28 metrics (69 instruments including variant and parametric ones). Visualizing proposed concepts, PToPI provides a new relational structure for the instruments including graphical, probabilistic, and entropic ones to see their properties and dependencies all in one place. Applications of the exploratory table in six examples from different domains in the literature have shown that PToPI aids overall instrument analysis and selection of the proper performance metrics according to the specific requirements of a classification problem. We expect that the proposed concepts and PToPI will help researchers comprehend and use the instruments and follow a systematic approach to classification performance evaluation and publication.
Collapse
|
17
|
Chronic stress causes striatal disinhibition mediated by SOM-interneurons in male mice. Nat Commun 2022; 13:7355. [PMID: 36446783 PMCID: PMC9709160 DOI: 10.1038/s41467-022-35028-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
Chronic stress (CS) is associated with a number of neuropsychiatric disorders, and it may also contribute to or exacerbate motor function. However, the mechanisms by which stress triggers motor symptoms are not fully understood. Here, we report that CS functionally alters dorsomedial striatum (DMS) circuits in male mice, by affecting GABAergic interneuron populations and somatostatin positive (SOM) interneurons in particular. Specifically, we show that CS impairs communication between SOM interneurons and medium spiny neurons, promoting striatal overactivation/disinhibition and increased motor output. Using probabilistic machine learning to analyze animal behavior, we demonstrate that in vivo chemogenetic manipulation of SOM interneurons in DMS modulates motor phenotypes in stressed mice. Altogether, we propose a causal link between dysfunction of striatal SOM interneurons and motor symptoms in models of chronic stress.
Collapse
|
18
|
Paus MHJ, van den Heuvel ER, Meddens MJM. Binary disease prediction using tail quantiles of the distribution of continuous biomarkers. J Nonparametr Stat 2022. [DOI: 10.1080/10485252.2022.2141738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Michiel H. J. Paus
- Organon & Co., Oss, the Netherlands
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Edwin R. van den Heuvel
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands
| | | |
Collapse
|
19
|
Brankovic A, Rolls D, Boyle J, Niven P, Khanna S. Identifying patients at risk of unplanned re-hospitalisation using statewide electronic health records. Sci Rep 2022; 12:16592. [PMID: 36198757 PMCID: PMC9534931 DOI: 10.1038/s41598-022-20907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Preventing unplanned hospitalisations, including readmissions and re-presentations to the emergency department, is an important strategy for addressing the growing demand for hospital care. Significant successes have been reported from interventions put in place by hospitals to reduce their incidence. However, there is limited use of data-driven algorithms in hospital services to identify patients for enrolment into these intervention programs. Here we present the results of a study aiming to develop algorithms deployable at scale as part of a state government’s initiative to address rehospitalizations and which fills several gaps identified in the state-of-the-art literature. To the best of our knowledge, our study involves the largest-ever sample size for developing risk models. Logistic regression, random forests and gradient boosted techniques were explored as model candidates and validated retrospectively on five years of data from 27 hospitals in Queensland, Australia. The models used a range of predictor variables sourced from state-wide Emergency Department(ED), inpatient, hospital-dispensed medications and hospital-requested pathology databases. The investigation leads to several findings: (i) the advantage of looking at a longer patient data history, (ii) ED and inpatient datasets alone can provide useful information for predicting hospitalisation risk and the addition of medications and pathology test results leads to trivial performance improvements, (iii) predicting readmissions to the hospital was slightly easier than predicting re-presentations to ED after an inpatient stay, which was slightly easier again than predicting re-presentations to ED after an EDstay, (iv) a gradient boosted approach (XGBoost) was systematically the most powerful modelling approach across various tests.
Collapse
Affiliation(s)
- Aida Brankovic
- CSIRO, The Australian e-Health Research Centre, Brisbane, 4029, Australia.
| | - David Rolls
- CSIRO, The Australian e-Health Research Centre, Parkville, 3052, Australia
| | - Justin Boyle
- CSIRO, The Australian e-Health Research Centre, Brisbane, 4029, Australia
| | - Philippa Niven
- CSIRO, The Australian e-Health Research Centre, Parkville, 3052, Australia
| | - Sankalp Khanna
- CSIRO, The Australian e-Health Research Centre, Brisbane, 4029, Australia
| |
Collapse
|
20
|
Brankovic A, Hassanzadeh H, Good N, Mann K, Khanna S, Abdel-Hafez A, Cook D. Explainable machine learning for real-time deterioration alert prediction to guide pre-emptive treatment. Sci Rep 2022; 12:11734. [PMID: 35817885 PMCID: PMC9273762 DOI: 10.1038/s41598-022-15877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
The Electronic Medical Record (EMR) provides an opportunity to manage patient care efficiently and accurately. This includes clinical decision support tools for the timely identification of adverse events or acute illnesses preceded by deterioration. This paper presents a machine learning-driven tool developed using real-time EMR data for identifying patients at high risk of reaching critical conditions that may demand immediate interventions. This tool provides a pre-emptive solution that can help busy clinicians to prioritize their efforts while evaluating the individual patient risk of deterioration. The tool also provides visualized explanation of the main contributing factors to its decisions, which can guide the choice of intervention. When applied to a test cohort of 18,648 patient records, the tool achieved 100% sensitivity for prediction windows 2–8 h in advance for patients that were identified at 95%, 85% and 70% risk of deterioration.
Collapse
Affiliation(s)
- Aida Brankovic
- CSIRO Australian e-Health Research Centre, Brisbane, QLD, 4029, Australia.
| | - Hamed Hassanzadeh
- CSIRO Australian e-Health Research Centre, Brisbane, QLD, 4029, Australia
| | - Norm Good
- CSIRO Australian e-Health Research Centre, Brisbane, QLD, 4029, Australia
| | - Kay Mann
- CSIRO Australian e-Health Research Centre, Brisbane, QLD, 4029, Australia
| | - Sankalp Khanna
- CSIRO Australian e-Health Research Centre, Brisbane, QLD, 4029, Australia
| | | | - David Cook
- Intensive Care Unit, Princess Alexandra Hospital, Brisbane, QLD, 4102, Australia
| |
Collapse
|
21
|
Zhang W, Zhang Q, Xie Z, Che L, Xia T, Cai X, Liu S. N6-Methyladenosine-Related Long Non-Coding RNAs Are Identified as a Potential Prognostic Biomarker for Lung Squamous Cell Carcinoma and Validated by Real-Time PCR. Front Genet 2022; 13:839957. [PMID: 35719401 PMCID: PMC9204524 DOI: 10.3389/fgene.2022.839957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/20/2022] [Indexed: 12/20/2022] Open
Abstract
Currently, the precise mechanism by which N6-methyladenosine (m6A) modification of long non-coding RNAs (lncRNAs) promotes the occurrence and development of lung squamous cell carcinoma (LUSC) and influences tumor microenvironment (TME) remains unclear. Therefore, we studied the prognostic value of m6A-related lncRNAs and their relationship with TME in 495 LUSC samples from The Cancer Genome Atlas (TCGA) database. Pearson’s correlation and univariate Cox regression analysis identified 6 m6A-related lncRNAs with prognostic values for LUSC patients. LUSC patients were divided into two subgroups (clusters 1 and 2) using principal component analysis. The expression of PD-L1 was lower in tumor tissues and cluster 2 of LUSC patients. Cluster 2 of LUSC patients had a high immune score, stromal score, and unique immune cell infiltration. The focal adhesion kinase (FAK) pathway and cytokine receptor pathways are enriched in cluster 1. The m6A-related lncRNA prognostic markers (m6A-LPMs) were established using the least absolute shrinkage and selection operator (LASSO) Cox regression analysis. The risk score was calculated by 4 m6A-LPMs and associated with OS, TME, clinicopathological characteristics of LUSC patients. After adjusting for age, gender, and stage, the risk score was also an independent prognostic factor for LUSC patients. Real-time PCR results showed that the expression of 4 m6A-LPMs was consistent with our prediction results. Our study found that 4 m6A-LPMs (AC138035.1, AC243919.2, HORMAD2-AS1, and AL122125.1) are closely associated with LUSC prognosis, in future, they may as novel diagnostic biomarkers for LUSC and provide new immunotherapy targets for LUSC patients.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, China
| | - Qian Zhang
- Department of Renal Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhefan Xie
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Che
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tingting Xia
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xingdong Cai
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shengming Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
- *Correspondence: Shengming Liu,
| |
Collapse
|
22
|
Kim WH, Lee JU, Jeon MJ, Park KH, Sim SJ. Three-dimensional hierarchical plasmonic nano-architecture based label-free surface-enhanced Raman spectroscopy detection of urinary exosomal miRNA for clinical diagnosis of prostate cancer. Biosens Bioelectron 2022; 205:114116. [DOI: 10.1016/j.bios.2022.114116] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/29/2022] [Accepted: 02/17/2022] [Indexed: 12/20/2022]
|
23
|
Whitney HM, Drukker K, Giger ML. Performance metric curve analysis framework to assess impact of the decision variable threshold, disease prevalence, and dataset variability in two-class classification. J Med Imaging (Bellingham) 2022; 9:035502. [PMID: 35656541 PMCID: PMC9152992 DOI: 10.1117/1.jmi.9.3.035502] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/11/2022] [Indexed: 08/23/2023] Open
Abstract
Purpose: The aim of this study is to (1) demonstrate a graphical method and interpretation framework to extend performance evaluation beyond receiver operating characteristic curve analysis and (2) assess the impact of disease prevalence and variability in training and testing sets, particularly when a specific operating point is used. Approach: The proposed performance metric curves (PMCs) simultaneously assess sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), and the 95% confidence intervals thereof, as a function of the threshold for the decision variable. We investigated the utility of PMCs using six example operating points associated with commonly used methods to select operating points (including the Youden index and maximum mutual information). As an example, we applied PMCs to the task of distinguishing between malignant and benign breast lesions using human-engineered radiomic features extracted from dynamic contrast-enhanced magnetic resonance images. The dataset had 1885 lesions, with the images acquired in 2015 and 2016 serving as the training set (1450 lesions) and those acquired in 2017 as the test set (435 lesions). Our study used this dataset in two ways: (1) the clinical dataset itself and (2) simulated datasets with features based on the clinical set but with five different disease prevalences. The median and 95% CI of the number of type I (false positive) and type II (false negative) errors were determined for each operating point of interest. Results: PMCs from both the clinical and simulated datasets demonstrated that PMCs could support interpretation of the impact of decision threshold choice on type I and type II errors of classification, particularly relevant to prevalence. Conclusion: PMCs allow simultaneous evaluation of the four performance metrics of sensitivity, specificity, PPV, and NPV as a function of the decision threshold. This may create a better understanding of two-class classifier performance in machine learning.
Collapse
Affiliation(s)
- Heather M. Whitney
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
- Wheaton College, Department of Physics, Wheaton, Illinois, United States
| | - Karen Drukker
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
| | - Maryellen L. Giger
- University of Chicago, Department of Radiology, Chicago, Illinois, United States
| |
Collapse
|
24
|
Calderon-Ramirez S, Murillo-Hernandez D, Rojas-Salazar K, Elizondo D, Yang S, Moemeni A, Molina-Cabello M. A real use case of semi-supervised learning for mammogram classification in a local clinic of Costa Rica. Med Biol Eng Comput 2022; 60:1159-1175. [PMID: 35239108 PMCID: PMC8892413 DOI: 10.1007/s11517-021-02497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/17/2021] [Indexed: 11/07/2022]
Abstract
The implementation of deep learning-based computer-aided diagnosis systems for the classification of mammogram images can help in improving the accuracy, reliability, and cost of diagnosing patients. However, training a deep learning model requires a considerable amount of labelled images, which can be expensive to obtain as time and effort from clinical practitioners are required. To address this, a number of publicly available datasets have been built with data from different hospitals and clinics, which can be used to pre-train the model. However, using models trained on these datasets for later transfer learning and model fine-tuning with images sampled from a different hospital or clinic might result in lower performance. This is due to the distribution mismatch of the datasets, which include different patient populations and image acquisition protocols. In this work, a real-world scenario is evaluated where a novel target dataset sampled from a private Costa Rican clinic is used, with few labels and heavily imbalanced data. The use of two popular and publicly available datasets (INbreast and CBIS-DDSM) as source data, to train and test the models on the novel target dataset, is evaluated. A common approach to further improve the model’s performance under such small labelled target dataset setting is data augmentation. However, often cheaper unlabelled data is available from the target clinic. Therefore, semi-supervised deep learning, which leverages both labelled and unlabelled data, can be used in such conditions. In this work, we evaluate the semi-supervised deep learning approach known as MixMatch, to take advantage of unlabelled data from the target dataset, for whole mammogram image classification. We compare the usage of semi-supervised learning on its own, and combined with transfer learning (from a source mammogram dataset) with data augmentation, as also against regular supervised learning with transfer learning and data augmentation from source datasets. It is shown that the use of a semi-supervised deep learning combined with transfer learning and data augmentation can provide a meaningful advantage when using scarce labelled observations. Also, we found a strong influence of the source dataset, which suggests a more data-centric approach needed to tackle the challenge of scarcely labelled data. We used several different metrics to assess the performance gain of using semi-supervised learning, when dealing with very imbalanced test datasets (such as the G-mean and the F2-score), as mammogram datasets are often very imbalanced. Description of the test-bed implemented in this work. Two different source data distributions were used to fine-tune the different models tested in this work. The target dataset is the in-house CR-Chavarria-2020 dataset. ![]()
Collapse
|
25
|
Domingo-Fernández D, Gadiya Y, Patel A, Mubeen S, Rivas-Barragan D, Diana CW, Misra BB, Healey D, Rokicki J, Colluru V. Causal reasoning over knowledge graphs leveraging drug-perturbed and disease-specific transcriptomic signatures for drug discovery. PLoS Comput Biol 2022; 18:e1009909. [PMID: 35213534 PMCID: PMC8906585 DOI: 10.1371/journal.pcbi.1009909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/09/2022] [Accepted: 02/09/2022] [Indexed: 12/29/2022] Open
Abstract
Network-based approaches are becoming increasingly popular for drug discovery as they provide a systems-level overview of the mechanisms underlying disease pathophysiology. They have demonstrated significant early promise over other methods of biological data representation, such as in target discovery, side effect prediction and drug repurposing. In parallel, an explosion of -omics data for the deep characterization of biological systems routinely uncovers molecular signatures of disease for similar applications. Here, we present RPath, a novel algorithm that prioritizes drugs for a given disease by reasoning over causal paths in a knowledge graph (KG), guided by both drug-perturbed as well as disease-specific transcriptomic signatures. First, our approach identifies the causal paths that connect a drug to a particular disease. Next, it reasons over these paths to identify those that correlate with the transcriptional signatures observed in a drug-perturbation experiment, and anti-correlate to signatures observed in the disease of interest. The paths which match this signature profile are then proposed to represent the mechanism of action of the drug. We demonstrate how RPath consistently prioritizes clinically investigated drug-disease pairs on multiple datasets and KGs, achieving better performance over other similar methodologies. Furthermore, we present two case studies showing how one can deconvolute the predictions made by RPath as well as predict novel targets.
Collapse
Affiliation(s)
| | - Yojana Gadiya
- Enveda Biosciences, Boulder, Colorado, United States of America
| | - Abhishek Patel
- Enveda Biosciences, Boulder, Colorado, United States of America
| | - Sarah Mubeen
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | | | - Chris W. Diana
- Enveda Biosciences, Boulder, Colorado, United States of America
| | | | - David Healey
- Enveda Biosciences, Boulder, Colorado, United States of America
| | - Joe Rokicki
- Enveda Biosciences, Boulder, Colorado, United States of America
| | - Viswa Colluru
- Enveda Biosciences, Boulder, Colorado, United States of America
| |
Collapse
|
26
|
A Comparative Analysis of Novel Biomarkers in Sepsis and Cardiovascular Disease. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Background: Sepsis still represents a major health care challenge, with mortality rates exceeding 25% in the western world. To further improve outcomes in this patient collective, new cardiovascular biomarkers present a promising opportunity as they target the paramount prognostic processes in sepsis: inflammation and ischemia. However, in contrast to cardiovascular diseases, a detailed analysis of novel biomarkers in sepsis is still lacking. (2) Objective: In this project, we aimed to perform a comparative analysis of biomarker levels in ischemic cardiovascular disease and sepsis. Analyzed markers comprised soluble suppression of tumorigenicity 2 (sST2; hemodynamics and inflammation), growth-differentiation factor 15 (GDF-15; injury, remodelling), soluble urokinase-type plasminogen activator receptor (suPAR; inflammation and remodeling) and heart-type fatty acid binding protein (H-FABP; myocardial ischemia). (3) Methods: In total, 311 patients were included in the study: 123 heart-failure (HF) patients, 60 patients with ST-segment elevation myocardial infarction (STEMI) and 53 sepsis patients. A total of 75 patients without coronary artery disease or signs of heart failure served as a control group. Plasma samples were analyzed by use of ELISA after informed consent. (4) Results: Patients with sepsis showed significantly increased plasma levels in all tested biomarkers compared to cardiovascular disease entities (sST2, suPAR, GDF-15: p < 0.001; H-FABP: compared to HF p < 0.001) and controls (sST2: 7.4-fold, suPAR: 3.4-fold, GDF-15: 6.5-fold and H-FABP: 15.3-fold increased plasma levels, p < 0.001). Moreover, in patients with sepsis, serum concentrations of sST2 and suPAR were significantly elevated in patients with HF and patients with STEMI (sST2: HF: 1.6-fold increase and STEMI: 2.5-fold increase, p < 0.001; suPAR: HF: 1.4-fold increase, p < 0.001 and STEMI: 1.4-fold increase, p < 0.01), whereas plasma levels of GDF-15 and H-FABP were markedly elevated in patients with STEMI only (GDF-15: 1.6-fold increase, H-FABP: 6.4-fold increase, p < 0.001). (5) Conclusions: All tested novel cardiac biomarkers showed significantly elevated levels in sepsis patients. Interestingly, a secretion pattern similar to STEMI was observed with regards to sST2 and HFABP. Thus, by providing an assessment tool especially covering the cardiovascular component of the disease, novel biomarkers offer a promising tool in sepsis patients.
Collapse
|
27
|
Al-Nema M, Gaurav A, Lee VS, Gunasekaran B, Lee MT, Okechukwu P, Nimmanpipug P. Structure-based discovery and bio-evaluation of a cyclopenta[4,5]thieno[2,3- d]pyrimidin-4-one as a phosphodiesterase 10A inhibitor. RSC Adv 2022; 12:1576-1591. [PMID: 35425186 PMCID: PMC8979230 DOI: 10.1039/d1ra07649c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/06/2021] [Indexed: 12/29/2022] Open
Abstract
Phosphodiesterase10A (PDE10A) is a potential therapeutic target for the treatment of several neurodegenerative disorders. Thus, extensive efforts of medicinal chemists have been directed toward developing potent PDE10A inhibitors with minimal side effects. However, PDE10A inhibitors are not approved as a treatment for neurodegenerative disorders, possibly due to the lack of research in this area. Therefore, the discovery of novel and diverse scaffolds targeting PDE10A is required. In this study, we described the identification of a new PDE10A inhibitor by structure-based virtual screening combining pharmacophore modelling, molecular docking, molecular dynamics simulations, and biological evaluation. Zinc42657360 with a cyclopenta[4,5]thieno[2,3-d]pyrimidin-4-one scaffold from the zinc database exhibited a significant inhibitory activity of 1.60 μM against PDE10A. The modelling studies demonstrated that Zinc42657360 is involved in three hydrogen bonds with ASN226, THR187 and ASP228, and two aromatic interactions with TYR78 and PHE283, besides the common interactions with the P-clamp residues PHE283 and ILE246. The novel scaffold of Zinc42657360 can be used for the rational design of PDE10A inhibitors with improved affinity. Phosphodiesterase10A (PDE10A) is a potential therapeutic target for the treatment of several neurodegenerative disorders.![]()
Collapse
Affiliation(s)
- Mayasah Al-Nema
- Faculty of Pharmaceutical Sciences, UCSI University Kuala Lumpur 56000 Malaysia
| | - Anand Gaurav
- Faculty of Pharmaceutical Sciences, UCSI University Kuala Lumpur 56000 Malaysia
| | - Vannajan Sanghiran Lee
- Department of Chemistry, Faculty of Science, University of Malaya Kuala Lumpur 50603 Malaysia
| | | | - Ming Tatt Lee
- Faculty of Pharmaceutical Sciences, UCSI University Kuala Lumpur 56000 Malaysia .,Office of Postgraduate Studies, UCSI University Kuala Lumpur 56000 Malaysia.,Graduate Institute of Pharmacology, College of Medicine, National Taiwan University 10051 Taipei Taiwan
| | - Patrick Okechukwu
- Faculty of Applied Sciences, UCSI University Kuala Lumpur 56000 Malaysia
| | - Piyarat Nimmanpipug
- Department of Chemistry, Faculty of Science, Chiang Mai University Chiang Mai 50200 Thailand.,Center of Excellence for Innovation in Analytical Science and Technology for Biodiversity-based Economic and Society (I-ANALY-S-T_B.BES-CMU), Chiang Mai University 50200 Thailand
| |
Collapse
|
28
|
Robinson RLM, Sarimveis H, Doganis P, Jia X, Kotzabasaki M, Gousiadou C, Harper SL, Wilkins T. Identifying diverse metal oxide nanomaterials with lethal effects on embryonic zebrafish using machine learning. BEILSTEIN JOURNAL OF NANOTECHNOLOGY 2021; 12:1297-1325. [PMID: 34934606 PMCID: PMC8649207 DOI: 10.3762/bjnano.12.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/28/2021] [Indexed: 06/14/2023]
Abstract
Manufacturers of nanomaterial-enabled products need models of endpoints that are relevant to human safety to support the "safe by design" paradigm and avoid late-stage attrition. Increasingly, embryonic zebrafish (Danio Rerio) are recognised as a key human safety relevant in vivo test system. Hence, machine learning models were developed for identifying metal oxide nanomaterials causing lethality to embryonic zebrafish up to 24 hours post-fertilisation, or excess lethality in the period of 24-120 hours post-fertilisation, at concentrations of 250 ppm or less. Models were developed using data from the Nanomaterial Biological-Interactions Knowledgebase for a dataset of 44 diverse, coated and uncoated metal or, in one case, metalloid oxide nanomaterials. Different modelling approaches were evaluated using nested cross-validation on this dataset. Models were initially developed for both lethality endpoints using multiple descriptors representing the composition of the core, shell and surface functional groups, as well as particle characteristics. However, interestingly, the 24 hours post-fertilisation data were found to be harder to predict, which could reflect different exposure routes. Hence, subsequent analysis focused on the prediction of excess lethality at 120 hours-post fertilisation. The use of two data augmentation approaches, applied for the first time in nano-QSAR research, was explored, yet both failed to boost predictive performance. Interestingly, it was found that comparable results to those originally obtained using multiple descriptors could be obtained using a model based upon a single, simple descriptor: the Pauling electronegativity of the metal atom. Since it is widely recognised that a variety of intrinsic and extrinsic nanomaterial characteristics contribute to their toxicological effects, this is a surprising finding. This may partly reflect the need to investigate more sophisticated descriptors in future studies. Future studies are also required to examine how robust these modelling results are on truly external data, which were not used to select the single descriptor model. This will require further laboratory work to generate comparable data to those studied herein.
Collapse
Affiliation(s)
| | - Haralambos Sarimveis
- School of Chemical Engineering, National Technical University of Athens, 9 Heroon Polytechniou str. Zografou Campus, 15780 Athens, Greece
| | - Philip Doganis
- School of Chemical Engineering, National Technical University of Athens, 9 Heroon Polytechniou str. Zografou Campus, 15780 Athens, Greece
| | - Xiaodong Jia
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Marianna Kotzabasaki
- School of Chemical Engineering, National Technical University of Athens, 9 Heroon Polytechniou str. Zografou Campus, 15780 Athens, Greece
| | - Christiana Gousiadou
- School of Chemical Engineering, National Technical University of Athens, 9 Heroon Polytechniou str. Zografou Campus, 15780 Athens, Greece
| | - Stacey Lynn Harper
- School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, Oregon, USA
- Department of Environmental and Molecular Toxicology, Oregon State University, Corvallis, Oregon, USA
- Oregon Nanoscience and Microtechnologies Institute, Eugene, Oregon, USA
| | - Terry Wilkins
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, United Kingdom
| |
Collapse
|
29
|
Nascimento EJM, Norwood B, Parker A, Braun R, Kpamegan E, Dean HJ. Development and Characterization of a Multiplex Assay to Quantify Complement-Fixing Antibodies against Dengue Virus. Int J Mol Sci 2021; 22:ijms222112004. [PMID: 34769432 PMCID: PMC8584793 DOI: 10.3390/ijms222112004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 12/30/2022] Open
Abstract
Antibodies capable of activating the complement system (CS) when bound with antigen are referred to as "complement-fixing antibodies" and are involved in protection against Flaviviruses. A complement-fixing antibody test has been used in the past to measure the ability of dengue virus (DENV)-specific serum antibodies to activate the CS. As originally developed, the test is time-consuming, cumbersome, and has limited sensitivity for DENV diagnosis. Here, we developed and characterized a novel multiplex anti-DENV complement-fixing assay based on the Luminex platform to quantitate serum antibodies against all four serotypes (DENV1-4) that activate the CS based on their ability to fix the complement component 1q (C1q). The assay demonstrated good reproducibility and showed equivalent performance to a DENV microneutralization assay that has been used to determine DENV serostatus. In non-human primates, antibodies produced in response to primary DENV1-4 infection induced C1q fixation on homologous and heterologous serotypes. Inter-serotype cross-reactivity was associated with homology of the envelope protein. Interestingly, the antibodies produced following vaccination against Zika virus fixed C1q on DENV. The anti-DENV complement fixing antibody assay represents an alternative approach to determine the quality of functional antibodies produced following DENV natural infection or vaccination and a biomarker for dengue serostatus, while providing insights about immunological cross-reactivity among different Flaviviruses.
Collapse
|
30
|
Golriz Khatami S, Mubeen S, Bharadhwaj VS, Kodamullil AT, Hofmann-Apitius M, Domingo-Fernández D. Using predictive machine learning models for drug response simulation by calibrating patient-specific pathway signatures. NPJ Syst Biol Appl 2021; 7:40. [PMID: 34707117 PMCID: PMC8551267 DOI: 10.1038/s41540-021-00199-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
The utility of pathway signatures lies in their capability to determine whether a specific pathway or biological process is dysregulated in a given patient. These signatures have been widely used in machine learning (ML) methods for a variety of applications including precision medicine, drug repurposing, and drug discovery. In this work, we leverage highly predictive ML models for drug response simulation in individual patients by calibrating the pathway activity scores of disease samples. Using these ML models and an intuitive scoring algorithm to modify the signatures of patients, we evaluate whether a given sample that was formerly classified as diseased, could be predicted as normal following drug treatment simulation. We then use this technique as a proxy for the identification of potential drug candidates. Furthermore, we demonstrate the ability of our methodology to successfully identify approved and clinically investigated drugs for four different cancers, outperforming six comparable state-of-the-art methods. We also show how this approach can deconvolute a drugs' mechanism of action and propose combination therapies. Taken together, our methodology could be promising to support clinical decision-making in personalized medicine by simulating a drugs' effect on a given patient.
Collapse
Affiliation(s)
- Sepehr Golriz Khatami
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany.
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, 53115, Bonn, Germany.
| | - Sarah Mubeen
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, 53115, Bonn, Germany
- Fraunhofer Center for Machine Learning, Sankt Augustin, Germany
| | - Vinay Srinivas Bharadhwaj
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, 53115, Bonn, Germany
| | - Alpha Tom Kodamullil
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany
| | - Martin Hofmann-Apitius
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany
- Bonn-Aachen International Center for Information Technology (B-IT), University of Bonn, 53115, Bonn, Germany
| | - Daniel Domingo-Fernández
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, 53757, Germany.
- Fraunhofer Center for Machine Learning, Sankt Augustin, Germany.
- Enveda Biosciences, Boulder, CO, 80301, USA.
| |
Collapse
|
31
|
Keogan A, Nguyen TNQ, Phelan JJ, O'Farrell N, Lynam‐Lennon N, Doyle B, O'Toole D, Reynolds JV, O'Sullivan J, Meade AD. Chemical imaging and machine learning for sub‐classification of oesophageal tissue histology. TRANSLATIONAL BIOPHOTONICS 2021. [DOI: 10.1002/tbio.202100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Abigail Keogan
- Radiation and Environmental Science Centre Focas Research Institute, Technological University Dublin Dublin Ireland
| | - Thi Nguyet Que Nguyen
- Radiation and Environmental Science Centre Focas Research Institute, Technological University Dublin Dublin Ireland
- School of Physics and Clinical and Optometric Sciences Technological University Dublin Dublin Ireland
| | - James J. Phelan
- Department of Surgery Trinity Translational Medicine Institute, Trinity College Dublin Dublin Ireland
| | - Naoimh O'Farrell
- Department of Surgery Trinity Translational Medicine Institute, Trinity College Dublin Dublin Ireland
| | - Niamh Lynam‐Lennon
- Department of Surgery Trinity Translational Medicine Institute, Trinity College Dublin Dublin Ireland
| | - Brendan Doyle
- Department of Histopathology Beaumont Hospital Dublin Ireland
| | - Dermot O'Toole
- School of Clinical Medicine Trinity College Dublin Dublin Ireland
| | - John V. Reynolds
- Department of Surgery Trinity Translational Medicine Institute, Trinity College Dublin Dublin Ireland
| | - Jacintha O'Sullivan
- Department of Surgery Trinity Translational Medicine Institute, Trinity College Dublin Dublin Ireland
| | - Aidan D. Meade
- Radiation and Environmental Science Centre Focas Research Institute, Technological University Dublin Dublin Ireland
- School of Physics and Clinical and Optometric Sciences Technological University Dublin Dublin Ireland
| |
Collapse
|
32
|
Uhlig M, Hein M, Habigt MA, Tolba RH, Braunschweig T, Helmedag MJ, Klinge U, Koch A, Trautwein C, Mechelinck M. Acute myocardial injury secondary to severe acute liver failure: A retrospective analysis supported by animal data. PLoS One 2021; 16:e0256790. [PMID: 34460845 PMCID: PMC8405020 DOI: 10.1371/journal.pone.0256790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/17/2021] [Indexed: 11/29/2022] Open
Abstract
To investigate whether acute liver failure (ALF) leads to secondary acute myocardial injury, 100 ALF patients that were retrospectively identified in a single center based on ICD 10 codes and 8 rats from an experimental study that died early after bile duct ligation (BDL) were examined. Creatine kinase (CK), creatine kinase-MB isoenzyme (CKMB) and cardiac troponin-I (cTnI) were analyzed as markers of myocardial injury. For histological analysis, hematoxylin-eosin (HE), elastic Van Gieson (EVG), CD41 and myeloperoxidase were used to stain rat hearts. Major adverse cardiac events (MACEs) were a critical factor for mortality (p = 0.037) in human ALF. Deceased patients exhibited higher levels of CKMB than survivors (p = 0.023). CKMB was a predictor of mortality in ALF (p = 0.013). Animals that died early after BDL exhibited increased cTnI, CKMB, tumor necrosis factor α (TNFα) and interleukin-6 (IL-6) levels compared to controls (cTnI: p = 0.011, CKMB: p = 0.008, TNFα: p = 0.003, IL-6: p = 0.006). These animals showed perivascular lesions and wavy fibers, microthrombi and neutrophilic infiltration in the heart. MACEs are decisive for mortality in human ALF, and elevated CKMB values indicate that this might be due to structural myocardial damage. Accordingly, CKMB was found to have predictive value for mortality in ALF. The results are substantiated by data from a rat BDL model demonstrating diffuse myocardial injury.
Collapse
Affiliation(s)
- Moritz Uhlig
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marc Hein
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Moriz A. Habigt
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - René H. Tolba
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Till Braunschweig
- Department of Pathology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Marius J. Helmedag
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Uwe Klinge
- Department of General, Visceral and Transplantation Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Alexander Koch
- Department of Gastroenterology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Christian Trautwein
- Department of Gastroenterology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Mare Mechelinck
- Department of Anesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| |
Collapse
|
33
|
Im H, Hwang SH, Kim BS, Choi SH. Pathogenic potential assessment of the Shiga toxin-producing Escherichia coli by a source attribution-considered machine learning model. Proc Natl Acad Sci U S A 2021; 118:e2018877118. [PMID: 33986113 PMCID: PMC8157976 DOI: 10.1073/pnas.2018877118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Instead of conventional serotyping and virulence gene combination methods, methods have been developed to evaluate the pathogenic potential of newly emerging pathogens. Among them, the machine learning (ML)-based method using whole-genome sequencing (WGS) data are getting attention because of the recent advances in ML algorithms and sequencing technologies. Here, we developed various ML models to predict the pathogenicity of Shiga toxin-producing Escherichia coli (STEC) isolates using their WGS data. The input dataset for the ML models was generated using distinct gene repertoires from positive (pathogenic) and negative (nonpathogenic) control groups in which each STEC isolate was designated based on the source attribution, the relative risk potential of the isolation sources. Among the various ML models examined, a model using the support vector machine (SVM) algorithm, the SVM model, discriminated between the two control groups most accurately. The SVM model successfully predicted the pathogenicity of the isolates from the major sources of STEC outbreaks, the isolates with the history of outbreaks, and the isolates that cannot be assessed by conventional methods. Furthermore, the SVM model effectively differentiated the pathogenic potentials of the isolates at a finer resolution. Permutation importance analyses of the input dataset further revealed the genes important for the estimation, proposing the genes potentially essential for the pathogenicity of STEC. Altogether, these results suggest that the SVM model is a more reliable and broadly applicable method to evaluate the pathogenic potential of STEC isolates compared with conventional methods.
Collapse
Affiliation(s)
- Hanhyeok Im
- National Research Laboratory of Molecular Microbiology and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea
- Department of Agricultural Biotechnology and Center for Food Safety and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea
| | - Seung-Ho Hwang
- National Research Laboratory of Molecular Microbiology and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea
- Department of Agricultural Biotechnology and Center for Food Safety and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea
| | - Byoung Sik Kim
- Department of Food Science and Engineering, Ewha Womans University, 03760 Seoul, Republic of Korea
| | - Sang Ho Choi
- National Research Laboratory of Molecular Microbiology and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea;
- Department of Agricultural Biotechnology and Center for Food Safety and Toxicology, Seoul National University, 08826 Seoul, Republic of Korea
- Center for Food and Bioconvergence, Seoul National University, 08826 Seoul, Republic of Korea
| |
Collapse
|
34
|
Micarelli A, Viziano A, Micarelli B, Giulia DF, Alessandrini M. Usefulness of postural sway spectral analysis in the diagnostic route and clinical integration of cervicogenic and vestibular sources of dizziness: A cross-sectional preliminary study. J Vestib Res 2021; 31:353-364. [PMID: 33843709 DOI: 10.3233/ves-190729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Posturography power spectra (PS) implementation has been proven to discriminate between sensory inputs detriment of vestibular and proprioceptive origin. OBJECTIVE To deepen the role of posturography testing in the diagnostic route of dizzy conditions, by comparing two groups of patients -93 affected by cervicogenic dizziness (CGD) and 72 by unilateral vestibular hypofunction (UVH) -with a group of 98 age- and gender-matched healthy subjects, serving as control group (CON). METHODS All participants underwent otoneurological testing including video head impulse test (vHIT) and posturography testing with PS analysis. They also filled in Dizziness Handicap Inventory (DHI), Tampa Scale for Kinesiophobia and Hospital Anxiety and Depression Scale questionnaires. RESULTS UVH and CGD patients were found to have significant increase in vestibular- and proprioceptive-related PS values when compared with CON. Receiver operating characteristic curves found PS values to reliably discriminate both groups from CON. Positive and negative correlations were respectively found between vestibular-/proprioceptive-related PS domain and DHI in both groups and between PS and vHIT scores in UVH patients. CONCLUSIONS PS analysis demonstrated to be useful in differentiating CGD and UVH patients each other and when compared to CON, to objectively represent perceived symptoms filled along the DHI scale and to corroborate the rate of vestibular deficit in UVH patients.
Collapse
Affiliation(s)
- Alessandro Micarelli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.,ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Andrea Viziano
- University of Rome Tor Vergata -Department of Clinical Sciences and Translational Medicine -Italy
| | - Beatrice Micarelli
- ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy
| | - Di Fulvio Giulia
- University of Rome Tor Vergata -Department of Clinical Sciences and Translational Medicine -Italy
| | - Marco Alessandrini
- University of Rome Tor Vergata -Department of Clinical Sciences and Translational Medicine -Italy
| |
Collapse
|
35
|
Zhao Y, Coulson EJ, Su X, Zhang J, Sha B, Xu H, Deng Y, Chen Y, Cao J, Wang Y, Wang S. Identification of 14-3-3 epsilon as a regulator of the neural apoptotic pathway for chronic-stress-induced depression. iScience 2021; 24:102043. [PMID: 33537655 PMCID: PMC7840470 DOI: 10.1016/j.isci.2021.102043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 11/24/2022] Open
Abstract
Major depression is a prevalent and long-lasting psychiatric illness with severe functional impairment and high suicide rate. We have previously shown that the ventrolateral orbital cortex (VLO) plays a key role in the stress responses in mice, but the underlying mechanisms remains unclear. Here, we used proteomic method to identify differentially expressed proteins in VLO of chronic unpredictable mild stress (CUMS) mice. Of 4,953 quantified proteins, 45 proteins were differentially expressed following CUMS. The integrated pathway analyses identified 14-3-3ε and TrkB signaling as differentially downregulated in association with stress-induced depressive-like behaviors. 14-3-3ε overexpression in VLO relieved the depressive-like behaviors by rescue of Bad-mediated apoptosis. Moreover, treatment with the 14-3-3ε stabilizer FC-A precluded neuronal apoptotic signaling in VLO of depressed mice. Because 14-3-3ε provides significant protection against chronic stress, boosting 14-3-3ε expression, pharmacological stabilization of 14-3-3s (e.g. with FC-A) is identified as an exciting therapeutic target for major depression. Novel screening of chronic mild stress-induced depression phenotypes in mice Proteomics identify 14-3-3ε as a key modulator of depressive behaviors in VLO 14-3-3ε partially reversed depressive behaviors through neural apoptotic pathway 14-3-3ε stabilizer FC-A ameliorates depression phenotypes after chronic mild stress
Collapse
Affiliation(s)
- Yan Zhao
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Elizabeth J Coulson
- School of Biomedical Sciences, Faculty of Medicine and Queensland Brain Institute, the University of Queensland, Brisbane, QLD 4072, Australia
| | - Xingli Su
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Junfeng Zhang
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Baoyong Sha
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Hao Xu
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Yating Deng
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Yulong Chen
- Institute of Basic and Translational Medicine, Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Jian Cao
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| | - Yunpeng Wang
- College of Forensic Science, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Shuang Wang
- Institute of Basic Medicine Science & Shaanxi Key Laboratory of Brain Disorders, Xi'an Medical University, Xi'an, Shaanxi 710021, China
| |
Collapse
|
36
|
Immune variations throughout the course of tuberculosis treatment and its relationship with adrenal hormone changes in HIV-1 patients co-infected with Mycobacterium tuberculosis. Tuberculosis (Edinb) 2021; 127:102045. [PMID: 33434785 DOI: 10.1016/j.tube.2020.102045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 01/08/2023]
Abstract
HIV infection is a major risk factor predisposing for Mycobacterium tuberculosis infection and progression to active tuberculosis (TB). As host immune response defines the course of infection, we aimed to identify immuno-endocrine changes over six-months of anti-TB chemotherapy in HIV+ people. Plasma levels of cortisol, DHEA and DHEA-S, percentages of CD4+ regulatory T cell subsets and number of IFN-γ-secreting cells were determined. Several cytokines, chemokines and C-reactive protein levels were measured. Results were correlated with clinical parameters as predictors of infection resolution and compared to similar data from HIV+ individuals, HIV-infected persons with latent TB infection and healthy donors. Throughout the course of anti-TB/HIV treatment, DHEA and DHEA-S plasma levels raised while cortisol diminished, which correlated to predictive factors of infection resolution. Furthermore, the balance between cortisol and DHEA, together with clinical assessment, may be considered as an indicator of clinical outcome after anti-TB treatment in HIV+ individuals. Clinical improvement was associated with reduced frequency of unconventional Tregs, increment in IFN-γ-secreting cells, diminution of systemic inflammation and changes of circulating cytokines and chemokines. This study suggests that the combined anti-HIV/TB therapies result in partial restoration of both, immune function and adrenal hormone plasma levels.
Collapse
|
37
|
Rivas-Barragan D, Mubeen S, Guim Bernat F, Hofmann-Apitius M, Domingo-Fernández D. Drug2ways: Reasoning over causal paths in biological networks for drug discovery. PLoS Comput Biol 2020; 16:e1008464. [PMID: 33264280 PMCID: PMC7735677 DOI: 10.1371/journal.pcbi.1008464] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 12/14/2020] [Accepted: 10/23/2020] [Indexed: 12/24/2022] Open
Abstract
Elucidating the causal mechanisms responsible for disease can reveal potential therapeutic targets for pharmacological intervention and, accordingly, guide drug repositioning and discovery. In essence, the topology of a network can reveal the impact a drug candidate may have on a given biological state, leading the way for enhanced disease characterization and the design of advanced therapies. Network-based approaches, in particular, are highly suited for these purposes as they hold the capacity to identify the molecular mechanisms underlying disease. Here, we present drug2ways, a novel methodology that leverages multimodal causal networks for predicting drug candidates. Drug2ways implements an efficient algorithm which reasons over causal paths in large-scale biological networks to propose drug candidates for a given disease. We validate our approach using clinical trial information and demonstrate how drug2ways can be used for multiple applications to identify: i) single-target drug candidates, ii) candidates with polypharmacological properties that can optimize multiple targets, and iii) candidates for combination therapy. Finally, we make drug2ways available to the scientific community as a Python package that enables conducting these applications on multiple standard network formats.
Collapse
Affiliation(s)
- Daniel Rivas-Barragan
- Barcelona Supercomputing Center, Barcelona, Spain
- Computer Architecture Department, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Sarah Mubeen
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, Germany
- Fraunhofer Center for Machine Learning, Germany
| | | | - Martin Hofmann-Apitius
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, Germany
| | - Daniel Domingo-Fernández
- Department of Bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing, Sankt Augustin, Germany
- Fraunhofer Center for Machine Learning, Germany
| |
Collapse
|
38
|
McGarry BL, Damion RA, Chew I, Knight MJ, Harston GW, Carone D, Jezzard P, Sitaram A, Muir KW, Clatworthy P, Kauppinen RA. A Comparison of T 2 Relaxation-Based MRI Stroke Timing Methods in Hyperacute Ischemic Stroke Patients: A Pilot Study. J Cent Nerv Syst Dis 2020; 12:1179573520943314. [PMID: 32963473 PMCID: PMC7488882 DOI: 10.1177/1179573520943314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/29/2020] [Indexed: 12/25/2022] Open
Abstract
Background: T2 relaxation-based magnetic resonance imaging (MRI) signals may provide onset time for acute ischemic strokes with an unknown onset. The ability of visual and quantitative MRI-based methods in a cohort of hyperacute ischemic stroke patients was studied. Methods: A total of 35 patients underwent 3T (3 Tesla) MRI (<9-hour symptom onset). Diffusion-weighted (DWI), apparent diffusion coefficient (ADC), T1-weighted (T1w), T2-weighted (T2w), and T2 relaxation time (T2) images were acquired. T2-weighted fluid attenuation inversion recovery (FLAIR) images were acquired for 17 of these patients. Image intensity ratios of the average intensities in ischemic and non-ischemic reference regions were calculated for ADC, DWI, T2w, T2 relaxation, and FLAIR images, and optimal image intensity ratio cut-offs were determined. DWI and FLAIR images were assessed visually for DWI/FLAIR mismatch. Results: The T2 relaxation time image intensity ratio was the only parameter with significant correlation with stroke duration (r = 0.49, P = .003), an area under the receiver operating characteristic curve (AUC = 0.77, P < .0001), and an optimal cut-off (T2 ratio = 1.072) that accurately identified patients within the 4.5-hour thrombolysis treatment window with sensitivity of 0.74 and specificity of 0.74. In the patients with the additional FLAIR, areas under the precision-recall-gain curve (AUPRG) and F1 scores showed that the T2 relaxation time ratio (AUPRG = 0.60, F1 = 0.73) performed considerably better than the FLAIR ratio (AUPRG = 0.39, F1 = 0.57) and the visual DWI/FLAIR mismatch (F1 = 0.25). Conclusions: Quantitative T2 relaxation time is the preferred MRI parameter in the assessment of patients with unknown onset for treatment stratification.
Collapse
Affiliation(s)
- Bryony L McGarry
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Robin A Damion
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Isabel Chew
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Michael J Knight
- School of Psychological Science, University of Bristol, Bristol, UK
| | - George Wj Harston
- Acute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Davide Carone
- Acute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Peter Jezzard
- Acute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Amith Sitaram
- Institute of Neuroscience and Psychology, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, UK
| | - Keith W Muir
- Institute of Neuroscience and Psychology, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, UK
| | - Philip Clatworthy
- Stroke Neurology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | | |
Collapse
|
39
|
Boonchai W, Chaiyabutr C, Charoenpipatsin N, Sukakul T. Pediatric contact allergy: A comparative study with adults. Contact Dermatitis 2020; 84:34-40. [PMID: 32696982 DOI: 10.1111/cod.13672] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric allergic contact dermatitis is increasing. The patch test allergens included in pediatric baseline series vary globally. The worldwide prevalence of pediatric reactions to allergens needs clarification. OBJECTIVES Identify the prevalence, associated factors, and culprit allergens for contact allergy among patch-tested Thai children, and compare with those for adults. METHODS Baseline series patch test results from 2010-2019 were collected for patients younger than 18 years of age. As a control group, sex-matched adult patients were randomly selected. The results and characteristics of the two groups were compared. RESULTS The median age of 112 patch tested pediatric patients was 16 (range 2-17) years. Of the children, 35.5% had at least one positive reaction, significantly less than the 56.6% for adults. The five most common pediatric allergens were nickel sulfate (12.1%), potassium dichromate (8.0%), methylisothiazolinone (7.1%), fragrance mix II (6.0%), and carba mix (5.4%). Although similar, the 10 most common allergens of the groups differed in order. Positive reactions to cosmetic allergens were significantly less frequent among the children. Many allergens remained entirely negative. CONCLUSIONS The prevalence of positive reactions was lower in children, varying by population and region. The top-10 pediatric and adult causative allergens were almost identical. We recommend using the same baseline patch test series for children and adults in our region.
Collapse
Affiliation(s)
- Waranya Boonchai
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chayada Chaiyabutr
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Norramon Charoenpipatsin
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thanisorn Sukakul
- Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.,Department of Occupational and Environmental Dermatology, Lund University, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
40
|
Chacón L, Barrantes K, Santamaría-Ulloa C, Solano M, Reyes L, Taylor L, Valiente C, Symonds EM, Achí R. A Somatic Coliphage Threshold Approach To Improve the Management of Activated Sludge Wastewater Treatment Plant Effluents in Resource-Limited Regions. Appl Environ Microbiol 2020; 86:e00616-20. [PMID: 32591380 PMCID: PMC7440787 DOI: 10.1128/aem.00616-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/06/2020] [Indexed: 11/20/2022] Open
Abstract
Effective wastewater management is crucial to ensure the safety of water reuse projects and effluent discharge into surface waters. Multiple studies have demonstrated that municipal wastewater treatment with conventional activated sludge processes is inefficient for the removal of a wide spectrum of viruses in sewage. In this study, a well-accepted statistical approach was used to investigate the relationship between viral indicators and human enteric viruses during wastewater treatment in a resource-limited region. Influent and effluent samples from five urban wastewater treatment plants (WWTPs) in Costa Rica were analyzed for somatic coliphage and human enterovirus, hepatitis A virus, norovirus genotypes I and II, and rotavirus. All WWTPs provide primary treatment followed by conventional activated sludge treatment prior to discharge into surface waters that are indirectly used for agricultural irrigation. The results revealed a statistically significant relationship between the detection of at least one of the five human enteric viruses and somatic coliphage. Multiple logistic regression and receiver operating characteristic curve analysis identified a threshold of 3.0 × 103 (3.5 log10) somatic coliphage PFU per 100 ml, which corresponded to an increased likelihood of encountering enteric viruses above the limit of detection (>1.83 × 102 virus targets/100 ml). Additionally, quantitative microbial risk assessment was executed for farmers indirectly reusing WWTP effluent that met the proposed threshold. The resulting estimated median cumulative annual disease burden complied with World Health Organization recommendations. Future studies are needed to validate the proposed threshold for use in Costa Rica and other regions.IMPORTANCE Effective wastewater management is crucial to ensure safe direct and indirect water reuse; nevertheless, few countries have adopted the virus log reduction value management approach established by the World Health Organization. In this study, we investigated an alternative and/or complementary approach to the virus log reduction value framework for the indirect reuse of activated sludge-treated wastewater effluent. Specifically, we employed a well-accepted statistical approach to identify a statistically sound somatic coliphage threshold value which corresponded to an increased likelihood of human enteric virus detection. This study demonstrates an alternative approach to the virus log reduction value framework which can be applied to improve wastewater reuse practices and effluent management.
Collapse
Affiliation(s)
- Luz Chacón
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Kenia Barrantes
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Carolina Santamaría-Ulloa
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Melissa Solano
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Liliana Reyes
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Lizeth Taylor
- College of Microbiology (Facultad de Microbiología), Universidad de Costa Rica, Montes de Oca, Costa Rica
| | - Carmen Valiente
- National Water Laboratory (Laboratorio Nacional de Aguas), Costa Rican Institute of Aqueducts and Sewerage (Instituto Costarricense de Acueductos y Alcantarillados), Tres Ríos, Costa Rica
| | - Erin M Symonds
- College of Marine Science, University of South Florida, St. Petersburg, Florida, USA
| | - Rosario Achí
- Health Sciences Research Institute (Instituto de Investigaciones en Salud [INISA]), Universidad de Costa Rica, Montes de Oca, Costa Rica
| |
Collapse
|
41
|
Chavez-Badiola A, Mendizabal-Ruiz G, Flores-Saiffe Farias A, Garcia-Sanchez R, Drakeley AJ. Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer. Hum Reprod 2020; 35:482. [PMID: 32053171 DOI: 10.1093/humrep/dez263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Chavez-Badiola
- Computational Biology, New Hope Fertility Center Mexico, Guadalajara, Mexico.,Research and Development, Darwin Technologies Ltd, Liverpool, UK
| | - G Mendizabal-Ruiz
- Departamento de Ciencias Computacionales, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - R Garcia-Sanchez
- Computational Biology, New Hope Fertility Center Mexico, Guadalajara, Mexico
| | - Andrew J Drakeley
- Hewitt Centre for Reproductive Medicine, Liverpool Women's Hospital, Liverpool, UK
| |
Collapse
|
42
|
Lee J, Hong N, Kim BM, Kim DJ, Yun M, Jeong JJ, Rhee Y. Evaluation of an optimal cutoff of parathyroid venous sampling gradient for localizing primary hyperparathyroidism. J Bone Miner Metab 2020; 38:570-580. [PMID: 32100109 DOI: 10.1007/s00774-020-01085-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 01/17/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Parathyroid venous sampling (PVS) has been reported to be a useful adjunctive test in localizing lesions in elusive cases of primary hyperparathyroidism (PHPT). Conventional cutoff (twofold) is now widely being used, but optimal cutoff threshold for PVS gradient based on discriminatory performance remains unclear. MATERIALS AND METHODS Among a total of 197 consecutive patients (mean age 58.2 years, female 74.6%) with PHPT who underwent parathyroidectomy at a tertiary center between 2012 and 2018, we retrospectively analyzed 59 subjects who underwent PVS for persistent or recurrent disease after previous parathyroidectomy, or for equivocal or negative results from conventional imaging modalities including ultrasonography (US) and Tc99m-Sestamibi SPECT-CT (MIBI). True parathyroid lesions were confirmed by combination of surgical, pathological findings, and intraoperative parathyroid hormone (PTH) changes. Optimal PVS cutoff were determined by receiver-operating characteristics (ROC) analysis with Youden and Liu method. RESULTS Compared to subjects who did not require PVS, PVS group tends to have lower PTH (119.8 pg/mL vs 133.7 pg/mL, p = 0.075). A total of 79 culprit parathyroid lesions (left 40; right 39) from 59 patients (left 24; right 26; bilateral 9) were confirmed by surgery. The optimal cutoff for PVS gradient was estimated as 1.5-fold gradient (1.5 ×) with sensitivity of 61.8% and specificity of 84%. When 1.5 × cutoff was applied, PVS improved the discrimination for true parathyroid lesions substantially based on area under ROC (0.892 to 0.942, p < 0.001) when added to US and MIBI. CONCLUSION Our findings suggest that PVS with cutoff threshold 1.5 × can provide useful complementary information for pre-operative localization in selected cases.
Collapse
Affiliation(s)
- Jooyeon Lee
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Namki Hong
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Byung Moon Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Joon Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jong Ju Jeong
- Department of Surgery, Thyroid Cancer Clinic, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
| |
Collapse
|
43
|
Christopher M, Nakahara K, Bowd C, Proudfoot JA, Belghith A, Goldbaum MH, Rezapour J, Weinreb RN, Fazio MA, Girkin CA, Liebmann JM, De Moraes G, Murata H, Tokumo K, Shibata N, Fujino Y, Matsuura M, Kiuchi Y, Tanito M, Asaoka R, Zangwill LM. Effects of Study Population, Labeling and Training on Glaucoma Detection Using Deep Learning Algorithms. Transl Vis Sci Technol 2020; 9:27. [PMID: 32818088 PMCID: PMC7396194 DOI: 10.1167/tvst.9.2.27] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/04/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose To compare performance of independently developed deep learning algorithms for detecting glaucoma from fundus photographs and to evaluate strategies for incorporating new data into models. Methods Two fundus photograph datasets from the Diagnostic Innovations in Glaucoma Study/African Descent and Glaucoma Evaluation Study and Matsue Red Cross Hospital were used to independently develop deep learning algorithms for detection of glaucoma at the University of California, San Diego, and the University of Tokyo. We compared three versions of the University of California, San Diego, and University of Tokyo models: original (no retraining), sequential (retraining only on new data), and combined (training on combined data). Independent datasets were used to test the algorithms. Results The original University of California, San Diego and University of Tokyo models performed similarly (area under the receiver operating characteristic curve = 0.96 and 0.97, respectively) for detection of glaucoma in the Matsue Red Cross Hospital dataset, but not the Diagnostic Innovations in Glaucoma Study/African Descent and Glaucoma Evaluation Study data (0.79 and 0.92; P < .001), respectively. Model performance was higher when classifying moderate-to-severe compared with mild disease (area under the receiver operating characteristic curve = 0.98 and 0.91; P < .001), respectively. Models trained with the combined strategy generally had better performance across all datasets than the original strategy. Conclusions Deep learning glaucoma detection can achieve high accuracy across diverse datasets with appropriate training strategies. Because model performance was influenced by the severity of disease, labeling, training strategies, and population characteristics, reporting accuracy stratified by relevant covariates is important for cross study comparisons. Translational Relevance High sensitivity and specificity of deep learning algorithms for moderate-to-severe glaucoma across diverse populations suggest a role for artificial intelligence in the detection of glaucoma in primary care.
Collapse
Affiliation(s)
- Mark Christopher
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | | | - Christopher Bowd
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - James A Proudfoot
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Akram Belghith
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Michael H Goldbaum
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Jasmin Rezapour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA.,Department of Ophthalmology, University Medical Center Mainz, Germany
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| | - Massimo A Fazio
- School of Medicine, University of Alabama-Birmingham, Birmingham, AL, USA
| | | | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
| | - Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY, USA
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Kana Tokumo
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | | | - Yuri Fujino
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Science, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Masato Matsuura
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Science, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Masaki Tanito
- Department of Ophthalmology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan.,Seirei Hamamatsu General Hospital, Seirei Christopher University, Hamamatsu, Japan
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA
| |
Collapse
|
44
|
Russell LE, Zhou Y, Lauschke VM, Kim RB. In Vitro Functional Characterization and in Silico Prediction of Rare Genetic Variation in the Bile Acid and Drug Transporter, Na+-Taurocholate Cotransporting Polypeptide (NTCP, SLC10A1). Mol Pharm 2020; 17:1170-1181. [DOI: 10.1021/acs.molpharmaceut.9b01200] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Laura E. Russell
- Department of Physiology & Pharmacology, Western University, Medical Sciences Building, Rm 216, N6A 5C1 London, Ontario, Canada
| | - Yitian Zhou
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Volker M. Lauschke
- Department of Physiology and Pharmacology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Richard B. Kim
- Department of Physiology & Pharmacology, Western University, Medical Sciences Building, Rm 216, N6A 5C1 London, Ontario, Canada
- Division of Clinical Pharmacology, Department of Medicine, Western University, 339 Windermere Rd, N6A 5A5 London, Ontario, Canada
| |
Collapse
|
45
|
Sighting acute myocardial infarction through platelet gene expression. Sci Rep 2019; 9:19574. [PMID: 31863085 PMCID: PMC6925116 DOI: 10.1038/s41598-019-56047-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 12/06/2019] [Indexed: 11/20/2022] Open
Abstract
Acute myocardial infarction is primarily due to coronary atherosclerotic plaque rupture and subsequent thrombus formation. Platelets play a key role in the genesis and progression of both atherosclerosis and thrombosis. Since platelets are anuclear cells that inherit their mRNA from megakaryocyte precursors and maintain it unchanged during their life span, gene expression profiling at the time of an acute myocardial infarction provides information concerning the platelet gene expression preceding the coronary event. In ST-segment elevation myocardial infarction (STEMI), a gene-by-gene analysis of the platelet gene expression identified five differentially expressed genes: FKBP5, S100P, SAMSN1, CLEC4E and S100A12. The logistic regression model used to combine the gene expression in a STEMI vs healthy donors score showed an AUC of 0.95. The same five differentially expressed genes were externally validated using platelet gene expression data from patients with coronary atherosclerosis but without thrombosis. Platelet gene expression profile highlights five genes able to identify STEMI patients and to discriminate them in the background of atherosclerosis. Consequently, early signals of an imminent acute myocardial infarction are likely to be found by platelet gene expression profiling before the infarction occurs.
Collapse
|
46
|
Cerniauskas I, Winterer J, de Jong JW, Lukacsovich D, Yang H, Khan F, Peck JR, Obayashi SK, Lilascharoen V, Lim BK, Földy C, Lammel S. Chronic Stress Induces Activity, Synaptic, and Transcriptional Remodeling of the Lateral Habenula Associated with Deficits in Motivated Behaviors. Neuron 2019; 104:899-915.e8. [PMID: 31672263 DOI: 10.1016/j.neuron.2019.09.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 07/21/2019] [Accepted: 09/06/2019] [Indexed: 01/04/2023]
Abstract
Chronic stress (CS) is a major risk factor for the development of depression. Here, we demonstrate that CS-induced hyperactivity in ventral tegmental area (VTA)-projecting lateral habenula (LHb) neurons is associated with increased passive coping (PC), but not anxiety or anhedonia. LHb→VTA neurons in mice with increased PC show increased burst and tonic firing as well as synaptic adaptations in excitatory inputs from the entopeduncular nucleus (EP). In vivo manipulations of EP→LHb or LHb→VTA neurons selectively alter PC and effort-related motivation. Conversely, dorsal raphe (DR)-projecting LHb neurons do not show CS-induced hyperactivity and are targeted indirectly by the EP. Using single-cell transcriptomics, we reveal a set of genes that can collectively serve as biomarkers to identify mice with increased PC and differentiate LHb→VTA from LHb→DR neurons. Together, we provide a set of biological markers at the level of genes, synapses, cells, and circuits that define a distinctive CS-induced behavioral phenotype.
Collapse
Affiliation(s)
- Ignas Cerniauskas
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jochen Winterer
- Brain Research Institute, University of Zurich, Zürich 8057, Switzerland
| | - Johannes W de Jong
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - David Lukacsovich
- Brain Research Institute, University of Zurich, Zürich 8057, Switzerland
| | - Hongbin Yang
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Fawwad Khan
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - James R Peck
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Sophie K Obayashi
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Varoth Lilascharoen
- Neurobiology Section, Division of Biological Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Byung Kook Lim
- Neurobiology Section, Division of Biological Sciences, University of California, San Diego, La Jolla, CA 92037, USA
| | - Csaba Földy
- Brain Research Institute, University of Zurich, Zürich 8057, Switzerland.
| | - Stephan Lammel
- Department of Molecular and Cell Biology and Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA 94720, USA.
| |
Collapse
|
47
|
Koromina M, Pandi MT, Patrinos GP. Rethinking Drug Repositioning and Development with Artificial Intelligence, Machine Learning, and Omics. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2019; 23:539-548. [PMID: 31651216 DOI: 10.1089/omi.2019.0151] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pharmaceutical industry and the art and science of drug development are sorely in need of novel transformative technologies in the current age of digital health and artificial intelligence (AI). Often described as game-changing technologies, AI and machine learning algorithms have slowly but surely begun to revolutionize pharmaceutical industry and drug development over the past 5 years. In this expert review, we describe the most frequently used machine learning algorithms in drug development pipelines and the -omics databases well poised to support machine learning and drug discovery. Subsequently, we analyze the emerging new computational approaches to drug discovery and the in silico pipelines for drug repositioning and the synergies among -omics system sciences, AI and machine learning. As with system sciences, AI and machine learning embody a system scale and Big Data driven vision for drug discovery and development. We conclude with a future outlook on the ways in which machine learning approaches can be implemented to buttress and expedite drug discovery and precision medicine. As AI and machine learning are rapidly entering pharmaceutical industry and the art and science of drug development, we need to critically examine the attendant prospects and challenges to benefit patients and public health.
Collapse
Affiliation(s)
- Maria Koromina
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Maria-Theodora Pandi
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - George P Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.,Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, Abu Dhabi.,Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, Abu Dhabi
| |
Collapse
|
48
|
Huang L, Shea AL, Qian H, Masurkar A, Deng H, Liu D. Patient clustering improves efficiency of federated machine learning to predict mortality and hospital stay time using distributed electronic medical records. J Biomed Inform 2019; 99:103291. [PMID: 31560949 DOI: 10.1016/j.jbi.2019.103291] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 12/19/2022]
Abstract
Electronic medical records (EMRs) support the development of machine learning algorithms for predicting disease incidence, patient response to treatment, and other healthcare events. But so far most algorithms have been centralized, taking little account of the decentralized, non-identically independently distributed (non-IID), and privacy-sensitive characteristics of EMRs that can complicate data collection, sharing and learning. To address this challenge, we introduced a community-based federated machine learning (CBFL) algorithm and evaluated it on non-IID ICU EMRs. Our algorithm clustered the distributed data into clinically meaningful communities that captured similar diagnoses and geographical locations, and learnt one model for each community. Throughout the learning process, the data was kept local at hospitals, while locally-computed results were aggregated on a server. Evaluation results show that CBFL outperformed the baseline federated machine learning (FL) algorithm in terms of Area Under the Receiver Operating Characteristic Curve (ROC AUC), Area Under the Precision-Recall Curve (PR AUC), and communication cost between hospitals and the server. Furthermore, communities' performance difference could be explained by how dissimilar one community was to others.
Collapse
Affiliation(s)
- Li Huang
- Academy of Arts and Design, Tsinghua University, Beijing 10084, China; The Future Laboratory, Tsinghua University, Beijing 10084, China
| | - Andrew L Shea
- Computer Science & Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - Huining Qian
- College of Applied Mathematical and Physical Science, Beijing University of Technology, Beijing 100124, China
| | - Aditya Masurkar
- School of Engineering, Northeastern University, Boston, MA 02115, United States
| | - Hao Deng
- Department Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston 02115, United States; School of Public Health, Johns Hopkins University, United States; Boston Children's Hospital, Boston, MA 02115, United States
| | - Dianbo Liu
- Computer Science & Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, United States; Boston Children's Hospital, Boston, MA 02115, United States; Medical School, Harvard University, Boston, MA 02115, United States.
| |
Collapse
|
49
|
Grenier B, Hackl M, Skalicky S, Thamhesl M, Moll WD, Berrios R, Schatzmayr G, Nagl V. MicroRNAs in porcine uterus and serum are affected by zearalenone and represent a new target for mycotoxin biomarker discovery. Sci Rep 2019; 9:9408. [PMID: 31253833 PMCID: PMC6598998 DOI: 10.1038/s41598-019-45784-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/14/2019] [Indexed: 12/17/2022] Open
Abstract
The mycotoxin zearalenone (ZEN) poses a risk to animal health because of its estrogenic effects. Diagnosis of ZEN-induced disorders remains challenging due to the lack of appropriate biomarkers. In this regard, circulating microRNAs (small non-coding RNAs) have remarkable potential, as they can serve as indicators for pathological processes in tissue. Thus, we combined untargeted and targeted transcriptomics approaches to investigate the effects of ZEN on the microRNA expression in porcine uterus, jejunum and serum, respectively. To this end, twenty-four piglets received uncontaminated feed (Control) or feed containing 0.17 mg/kg ZEN (ZEN low), 1.46 mg/kg ZEN (ZEN medium) and 4.58 mg/kg ZEN (ZEN high). After 28 days, the microRNA expression in the jejunum remained unaffected, while significant changes in the uterine microRNA profile were observed. Importantly, 14 microRNAs were commonly and dose-dependently affected in both the ZEN medium and ZEN high group, including microRNAs from the miR-503 cluster (i.e. ssc-miR-424-5p, ssc-miR-450a, ssc-miR-450b-5p, ssc-miR-450c-5p, ssc-miR-503 and ssc-miR-542-3p). Predicted target genes for those microRNAs are associated with regulation of gene expression and signal transduction (e.g. cell cycle). Although the effects in serum were less pronounced, receiver operating characteristic analysis revealed that several microRNA ratios were able to discriminate properly between non-exposed and ZEN-exposed pigs (e.g. ssc-miR-135a-5p/ssc-miR-432-5p, ssc-miR-542-3p/ssc-miR-493-3p). This work sheds new light on the molecular mechanisms of ZEN, and fosters biomarker discovery.
Collapse
Affiliation(s)
| | | | | | | | | | - Roger Berrios
- BIOMIN Holding GmbH, Erber Campus 1, 3131, Getzersdorf, Austria
| | | | - Veronika Nagl
- BIOMIN Research Center, Technopark 1, 3430, Tulln, Austria
| |
Collapse
|
50
|
A urinary microRNA panel that is an early predictive biomarker of delayed graft function following kidney transplantation. Sci Rep 2019; 9:3584. [PMID: 30837502 PMCID: PMC6401030 DOI: 10.1038/s41598-019-38642-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 12/18/2018] [Indexed: 01/02/2023] Open
Abstract
Predicting immediate and subsequent graft function is important in clinical decision-making around kidney transplantation, but is difficult using available approaches. Here we have evaluated urinary microRNAs as biomarkers in this context. Profiling of 377 microRNAs in the first urine passed post-transplantation identified 6 microRNAs, confirmed to be upregulated by RT-qPCR in an expanded cohort (miR-9, -10a, -21, -29a, -221, and -429, n = 33, P < 0.05 for each). Receiver operating characteristic analysis showed Area Under the Curve 0.94 for this panel. To establish whether this early signal was sustained, miR-21 was measured daily for 5 days post-transplant, and was consistently elevated in those developing Delayed Graft Function (n = 165 samples from 33 patients, p < 0.05). The biomarker panel was then evaluated in an independent cohort, sampled at varying times in the first week post-transplantation in a separate transplant center. When considered individually, all miRs in the panel showed a trend to increase or a significant increase in those developing delayed Graft Function (miR-9: P = 0.068, mIR-10a: P = 0.397, miR-21: P = 0.003, miR-29a: P = 0.019, miR-221: P = 0.1, and miR-429: P = 0.013, n = 47) with Area Under the Curve 0.75 for the panel. In conclusion, combined measurement of six microRNAs had predictive value for delayed graft function following kidney transplantation.
Collapse
|