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Carlton K, Zhang J, Cabacungan E, Herrera S, Koop J, Yan K, Cohen S. Machine learning risk stratification for high-risk infant follow-up of term and late preterm infants. Pediatr Res 2024:10.1038/s41390-024-03338-6. [PMID: 38926547 DOI: 10.1038/s41390-024-03338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 05/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Term and late preterm infants are not routinely referred to high-risk infant follow-up programs at neonatal intensive care unit (NICU) discharge. We aimed to identify NICU factors associated with abnormal developmental screening and develop a risk-stratification model using machine learning for high-risk infant follow-up enrollment. METHODS We performed a retrospective cohort study identifying abnormal developmental screening prior to 6 years of age in infants born ≥34 weeks gestation admitted to a level IV NICU. Five machine learning models using NICU predictors were developed by classification and regression tree (CART), random forest, gradient boosting TreeNet, multivariate adaptive regression splines (MARS), and regularized logistic regression analysis. Performance metrics included sensitivity, specificity, accuracy, precision, and area under the receiver operating curve (AUC). RESULTS Within this cohort, 87% (1183/1355) received developmental screening, and 47% had abnormal results. Common NICU predictors across all models were oral (PO) feeding, follow-up appointments, and medications prescribed at NICU discharge. Each model resulted in an AUC > 0.7, specificity >70%, and sensitivity >60%. CONCLUSION Stratification of developmental risk in term and late preterm infants is possible utilizing machine learning. Applying machine learning algorithms allows for targeted expansion of high-risk infant follow-up criteria. IMPACT This study addresses the gap in knowledge of developmental outcomes of infants ≥34 weeks gestation requiring neonatal intensive care. Machine learning methodology can be used to stratify early childhood developmental risk for these term and late preterm infants. Applying the classification and regression tree (CART) algorithm described in the study allows for targeted expansion of high-risk infant follow-up enrollment to include those term and late preterm infants who may benefit most.
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Affiliation(s)
- Katherine Carlton
- Department of Pediatrics, Division of Neonatology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jian Zhang
- Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Erwin Cabacungan
- Department of Pediatrics, Division of Neonatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Jennifer Koop
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ke Yan
- Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Susan Cohen
- Department of Pediatrics, Division of Neonatology, Medical College of Wisconsin, Milwaukee, WI, USA
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Narayanan D, Bartley B, Landes J, Moore SA, Kulkarni V, He Q, Simonette R, Doan HQ, Rady PL, Tyring SK. The effect of selinexor on prostaglandin synthesis in virus-positive Merkel cell carcinoma cell lines. Arch Dermatol Res 2024; 316:312. [PMID: 38822924 DOI: 10.1007/s00403-024-03108-8] [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: 03/17/2024] [Revised: 03/17/2024] [Accepted: 04/26/2024] [Indexed: 06/03/2024]
Abstract
Merkel cell carcinoma (MCC) is an aggressive neuroendocrine skin cancer with high rates of metastasis and mortality. In vitro studies suggest that selinexor (KPT-330), an inhibitor of exportin 1, may be a targeted therapeutic option for MCC. This selective inhibitor prevents the transport of oncogenic mRNA out of the nucleus. Of note, 80% of MCC tumors are integrated with Merkel cell polyomavirus (MCPyV), and virally encoded tumor-antigens, small T (sT) and large T (LT) mRNAs may require an exportin transporter to relocate to the cytoplasm and modulate host tumor-suppressing pathways. To explore selinexor as a targeted therapy for MCC, we examine its ability to inhibit LT and sT antigen expression in vitro and its impact on the prostaglandin synthesis pathway. Protein expression was determined through immunoblotting and quantified by densitometric analysis. Statistical significance was determined with t-test. Treatment of MCPyV-infected cell lines with selinexor resulted in a significant dose-dependent downregulation of key mediators of the prostaglandin synthesis pathway. Given the role of prostaglandin synthesis pathway in MCC, our findings suggest that selinexor, alone or in combination with immunotherapy, could be a promising treatment for MCPyV-infected MCC patients who are resistant to chemotherapy and immunotherapy.
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Affiliation(s)
- Deepika Narayanan
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Brooke Bartley
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Jennifer Landes
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Stephen A Moore
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Veda Kulkarni
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Qin He
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Rebecca Simonette
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Hung Q Doan
- Department of Dermatology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Peter L Rady
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA
| | - Stephen K Tyring
- Department of Dermatology, The University of Texas Health Science Center at Houston, 6431 Fannin St., MSB Room 1.178, Houston, TX, 77070, USA.
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Li S, Yi H, Leng Q, Wu Y, Mao Y. New perspectives on cancer clinical research in the era of big data and machine learning. Surg Oncol 2024; 52:102009. [PMID: 38215544 DOI: 10.1016/j.suronc.2023.102009] [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: 08/29/2023] [Accepted: 10/16/2023] [Indexed: 01/14/2024]
Abstract
In the 21st century, the development of medical science has entered the era of big data, and machine learning has become an essential tool for mining medical big data. The establishment of the SEER database has provided a wealth of epidemiological data for cancer clinical research, and the number of studies based on SEER and machine learning has been growing in recent years. This article reviews recent research based on SEER and machine learning and finds that the current focus of such studies is primarily on the development and validation of models using machine learning algorithms, with the main directions being lymph node metastasis prediction, distant metastasis prediction, and prognosis-related research. Compared to traditional models, machine learning algorithms have the advantage of stronger adaptability, but also suffer from disadvantages such as overfitting and poor interpretability, which need to be weighed in practical applications. At present, machine learning algorithms, as the foundation of artificial intelligence, have just begun to emerge in the field of cancer clinical research. The future development of oncology will enter a more precise era of cancer research, characterized by larger data, higher dimensions, and more frequent information exchange. Machine learning is bound to shine brightly in this field.
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Affiliation(s)
- Shujun Li
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, 410008, China; National Clinical Research Center for Geriatric Diseases (Xiangya Hospital), China; Hunan Hematology Oncology Clinical Medical Research Center, China
| | - Hang Yi
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Qihao Leng
- Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan Province, China
| | - You Wu
- Institute for Hospital Management, School of Medicine, Tsinghua University, 30 Shuangqing Rd, Haidian District, Beijing, China; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Luo N, Zhong X, Su L, Cheng Z, Ma W, Hao P. Artificial intelligence-assisted dermatology diagnosis: From unimodal to multimodal. Comput Biol Med 2023; 165:107413. [PMID: 37703714 DOI: 10.1016/j.compbiomed.2023.107413] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023]
Abstract
Artificial Intelligence (AI) is progressively permeating medicine, notably in the realm of assisted diagnosis. However, the traditional unimodal AI models, reliant on large volumes of accurately labeled data and single data type usage, prove insufficient to assist dermatological diagnosis. Augmenting these models with text data from patient narratives, laboratory reports, and image data from skin lesions, dermoscopy, and pathologies could significantly enhance their diagnostic capacity. Large-scale pre-training multimodal models offer a promising solution, exploiting the burgeoning reservoir of clinical data and amalgamating various data types. This paper delves into unimodal models' methodologies, applications, and shortcomings while exploring how multimodal models can enhance accuracy and reliability. Furthermore, integrating cutting-edge technologies like federated learning and multi-party privacy computing with AI can substantially mitigate patient privacy concerns in dermatological datasets and further fosters a move towards high-precision self-diagnosis. Diagnostic systems underpinned by large-scale pre-training multimodal models can facilitate dermatology physicians in formulating effective diagnostic and treatment strategies and herald a transformative era in healthcare.
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Affiliation(s)
- Nan Luo
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
| | - Xiaojing Zhong
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
| | - Luxin Su
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
| | - Zilin Cheng
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
| | - Wenyi Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
| | - Pingsheng Hao
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610075, Sichuan, China.
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Malek-Ahmadi M, Duff K, Chen K, Su Y, King JB, Koppelmans V, Schaefer SY. Volumetric regional MRI and neuropsychological predictors of motor task variability in cognitively unimpaired, Mild Cognitive Impairment, and probable Alzheimer's disease older adults. Exp Gerontol 2023; 173:112087. [PMID: 36639062 PMCID: PMC9974847 DOI: 10.1016/j.exger.2023.112087] [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: 09/22/2022] [Revised: 12/24/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The mechanisms linking motor function to Alzheimer's disease (AD) progression have not been well studied, despite evidence of AD pathology within motor brain regions. Thus, there is a need for new motor measure that is sensitive and specific to AD. METHODS In a sample of 121 older adults (54 cognitive unimpaired [CU], 35 amnestic Mild Cognitive Impairment [aMCI], and 32 probable mild AD), intrasubject standard deviation (ISD) across six trials of a novel upper-extremity motor task was predicted with volumetric regional gray matter and neuropsychological scores using classification and regression tree (CART) analyses. RESULTS Both gray matter and neuropsychological CART models indicated that motor task ISD (our measure of motor learning) was related to cortical regions and cognitive test scores associated with memory, executive function, and visuospatial skills. CART models also accurately distinguished motor task ISD of MCI and probable mild AD from CU. DISCUSSION Variability in motor task performance across practice trials may be valuable for understanding preclinical and early-stage AD.
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Affiliation(s)
- Michael Malek-Ahmadi
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America; Department of Biomedical Informatics, University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85006, United States of America
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging, & Research, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States of America
| | - Jace B King
- Center for Alzheimer's Care, Imaging, & Research, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Vincent Koppelmans
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, United States of America
| | - Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85287, United States of America.
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Optimization of biodiesel production from oil using a novel green catalyst via development of a predictive model. ARAB J CHEM 2023. [DOI: 10.1016/j.arabjc.2023.104785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
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