Clinical and Host Biological Factors Predict Colectomy Risk in Children Newly Diagnosed With Ulcerative Colitis

Background Develop a clinical and biological predictive model for colectomy risk in children newly diagnosed with ulcerative colitis (UC). Methods This was a multicenter inception cohort study of children (ages 4-17 years) newly diagnosed with UC treated with standardized initial regimens of mesalamine or corticosteroids (CS) depending upon initial disease severity. Therapy escalation to immunomodulators or infliximab was based on predetermined criteria. Patients were phenotyped by clinical activity per the Pediatric Ulcerative Colitis Activity Index (PUCAI), disease extent, endoscopic/histologic severity, and laboratory markers. In addition, RNA sequencing defined pretreatment rectal gene expression and high density DNA genotyping by the Affymetrix UK Biobank Axiom Array. Coprimary outcomes were colectomy over 3 years and time to colectomy. Generalized linear models, Cox proportional hazards multivariate regression modeling, and Kaplan-Meier plots were used. Results Four hundred twenty-eight patients (mean age 13 years) started initial theapy with mesalamine (n = 136), oral CS (n = 144), or intravenous CS (n = 148). Twenty-five (6%) underwent colectomy at ≤1 year, 33 (9%) at ≤2 years, and 35 (13%) at ≤3 years. Further, 32/35 patients who had colectomy failed infliximab. An initial PUCAI ≥ 65 was highly associated with colectomy (P = 0.0001). A logistic regression model predicting colectomy using the PUCAI, hemoglobin, and erythrocyte sedimentation rate had a receiver operating characteristic area under the curve of 0.78 (95% confidence interval [0.73, 0.84]). Addition of a pretreatment rectal gene expression panel reflecting activation of the innate immune system and response to external stimuli and bacteria to the clinical model improved the receiver operating characteristic area under the curve to 0.87 (95% confidence interval [0.82, 0.91]). Conclusions A small group of children newly diagnosed with severe UC still require colectomy despite current therapies. Our gene signature observations suggest additional targets for management of those patients not responding to current medical therapies.

Machine Learning Models for Diagnostic Classification of Hepatitis C Tests

Introduction: Hepatitis C is a chronic infection caused by hepatitis c virus - a blood borne virus. Therefore, the infection occurs through exposure to small quantities of blood. It has been estimated by World Health Organization (WHO) to have affected 71 million people worldwide. This infection costs individual, groups and government a lot because no vaccine has been gotten yet for the treatment. This disease is likely to continue to affect more people because it’s long asymptotic phase which makes its early detection not feasible.Material and Methods: In this study, we have presented machine learning models to automatically classify the diagnosis test of hepatitis and also ranked the test features in order to know how they contribute to the classification which help in decision making process by the health care industry. The synthetic minority oversampling technique (SMOTE) was used to solve the problem of imbalance dataset.Results: The models were evaluated based on metrics such as Matthews correlation coefficient, F-measure, Precision-Recall curve and Receiver Operating Characteristic Area Under Curve. We found that using SMOTE techniques helped raise performance of the predictive models. Also, random forest (RF) had the best performance based on Matthews correlation coefficient (0.99), F-measure (0.99), Precision-Recall curve (1.00) and Receiver Operating Characteristic Area Under Curve (0.99).Conclusion: This discovery has the potential to impact on clinical practice, when health workers aim at classifying diagnosis result of disease at its early stage.

Serum syndecan-1, hyaluronan and thrombomodulin levels in patients with lupus nephritis

Objectives We investigated circulating syndecan-1, HA and thrombomodulin levels in patients with biopsy-proven Class III/IV ± V LN and their clinico-pathological associations. Patients with non-renal SLE or non-lupus chronic kidney disease, and healthy subjects served as controls. Methods Serum syndecan-1, HA and thrombomodulin levels were determined by ELISAs. Results Syndecan-1, HA and thrombomodulin levels were significantly higher during active LN compared with remission (P < 0.01, for all), and correlated with the level of proteinuria, estimated glomerular filtration rate, anti-dsDNA antibodies, complement 3 and serum creatinine. Longitudinal studies showed that syndecan-1 and thrombomodulin levels increased prior to clinical renal flare by 3.6 months, while HA level increased at the time of nephritic flare, and the levels decreased in parallel with treatment response. Receiver operating characteristic curve analysis showed that syndecan-1 and thrombomodulin levels distinguished patients with active LN from healthy subjects, LN patients in remission, patients with active non-renal lupus and patients with non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.98, 0.91, 0.82 and 0.95, respectively, for syndecan-1; and area under curve of 1.00, 0.84, 0.97 and 0.79, respectively, for thrombomodulin). HA level distinguished active LN from healthy subjects, LN patients in remission and non-lupus chronic kidney disease (receiver operating characteristic area under curve of 0.82, 0.71 and 0.90, respectively) but did not distinguish between renal vs non-renal lupus. Syndecan-1 and thrombomodulin levels correlated with the severity of interstitial inflammation, while HA level correlated with chronicity grading in kidney biopsies of active LN. Conclusion Our findings suggest potential utility of serum syndecan-1, thrombomodulin and HA levels in clinical management, and their potential contribution to LN pathogenesis.

Feasibility and visualization of deep learning detection and classification of inferior vena cava filters

PurposeThis study assesses the feasibility of deep learning detection and classification of 3 retrievable inferior vena cava filters with similar radiographic appearances and emphasizes the importance of visualization methods to confirm proper detection and classification.Materials and MethodsThe fast.ai library with ResNet-34 architecture was used to train a deep learning classification model. A total of 442 fluoroscopic images (N=144 patients) from inferior vena cava filter placement or removal were collected. Following image preprocessing, the training set included 382 images (110 Celect, 149 Denali, 123 Günther Tulip), of which 80% were used for training and 20% for validation. Data augmentation was performed for regularization. A random test set of 60 images (20 images of each filter type), not included in the training or validation set, was used for evaluation. Total accuracy and receiver operating characteristic area under the curve were used to evaluate performance. Feature heatmaps were visualized using guided backpropagation and gradient-weighted class activation mapping.ResultsThe overall accuracy was 80.2% with mean receiver operating characteristic area under the curve of 0.96 for the validation set (N=76), and 85.0% with mean receiver operating characteristic area under the curve of 0.94 for the test set (N=60). Two visualization methods were used to assess correct filter detection and classification.ConclusionsA deep learning model can be used to automatically detect and accurately classify inferior vena cava filters on radiographic images. Visualization techniques should be utilized to ensure deep learning models function as intended.

CD177 Enhances the Detection of Myelodysplastic Syndrome by Flow Cytometry

Objectives Previously we demonstrated that a decreased percentage of CD177-positive granulocytes detected by flow cytometry (FCM) was associated with myelodysplastic syndrome (MDS). Here we expand on those findings to more rigorously evaluate the utility of CD177 for the detection of MDS. Methods Two hundred patient samples (100 MDS and 100 controls) were evaluated for granulocyte expression of CD177 and 11 other flow cytometric parameters known to be associated with MDS. Results We show that CD177, as a single analyte, is highly correlated with MDS with a receiver operating characteristic area under curve value of 0.8. CD177 expression below 30% demonstrated a sensitivity of 51% and a specificity of 94% for detecting MDS with a positive predictive value of 89.5%. In multivariate analysis of 12 MDS-associated FCM metrics, CD177 and the Ogata parameters were significant indicators of MDS, and CD177 increased sensitivity of the Ogata score by 16% (63%-79%) for predicting MDS. Finally, diagnostic criteria incorporating these parameters with a 1% blast cutoff level and CD177 resulted in a sensitivity of 90% and specificity of 91% for detecting MDS. Conclusions The findings indicate CD177 is a useful FCM marker for MDS.

Optimal Deep Learning Model to Identify the Development of Pomegranate Fruit in Farms

In this study, estimating the maturing condition in gardens helps to enhance the process of post-harvesting. Collecting fruits on the basis of their developmental stage will minimize storage costs and maximize market value. Additionally, estimated ripeness of the fruits can be more useful for indicators for detecting water shortage and to determine the water used during irrigation. The purpose of the study is to develop the new direction of technology to detect the ripeness stage between two classes: ripe and unripe. We employ deep Neural Network (DNN) classifiers for the prediction of ripe and unripe class. The results of our proposed classifiers give the sensitivity 96.2%, specificity 94.2% with accuracy of results 94.5%, over a dataset of 200 images of each class. The ROC (receiver operating characteristic) area values curve close to 0.98 in all-class during training. We believe this is a notable performance that allows a suitable non-intrusive maturing prediction that will enhance cultivation techniques.

Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia

We describe the validation of a serum-based test developed by Rules-Based Medicine which can be used to help confirm the diagnosis of schizophrenia. In preliminary studies using multiplex immunoassay profiling technology, we identified a disease signature comprised of 51 analytes which could distinguish schizophrenia (n = 250) from control (n = 230) subjects. In the next stage, these analytes were developed as a refined 51-plex immunoassay panel for validation using a large independent cohort of schizophrenia (n = 577) and control (n = 229) subjects. The resulting test yielded an overall sensitivity of 83% and specificity of 83% with a receiver operating characteristic area under the curve (ROC-AUC) of 89%. These 51 immunoassays and the associated decision rule delivered a sensitive and specific prediction for the presence of schizophrenia in patients compared to matched healthy controls.