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1.
J Neurol ; 2024 Apr 21.
Article in English | MEDLINE | ID: mdl-38644373

ABSTRACT

Amyotrophic lateral sclerosis (ALS) is an untreatable and clinically heterogeneous condition primarily affecting motor neurons. The ongoing quest for reliable biomarkers that mirror the disease status and progression has led to investigations that extend beyond motor neurons' pathology, encompassing broader systemic factors such as metabolism, immunity, and the microbiome. Our study contributes to this effort by examining the potential role of microbiome-related components, including viral elements, such as torque tenovirus (TTV), and various inflammatory factors, in ALS. In our analysis of serum samples from 100 ALS patients and 34 healthy controls (HC), we evaluated 14 cytokines, TTV DNA load, and 18 free fatty acids (FFA). We found that the evaluated variables are effective in differentiating ALS patients from healthy controls. In addition, our research identifies four unique patient clusters, each characterized by distinct biological profiles. Intriguingly, no correlations were found with site of onset, sex, progression rate, phenotype, or C9ORF72 expansion. A remarkable aspect of our findings is the discovery of a gender-specific relationship between levels of 2-ethylhexanoic acid and patient survival. In addition to contributing to the growing body of evidence suggesting altered peripheral immune responses in ALS, our exploratory research underscores metabolic diversity challenging conventional clinical classifications. If our exploratory findings are validated by further research, they could significantly impact disease understanding and patient care customization. Identifying groups based on biological profiles might aid in clustering patients with varying responses to treatments.

2.
Biometrics ; 80(1)2024 Jan 29.
Article in English | MEDLINE | ID: mdl-38364806

ABSTRACT

Precision medicine is an approach for disease treatment that defines treatment strategies based on the individual characteristics of the patients. Motivated by an open problem in cancer genomics, we develop a novel model that flexibly clusters patients with similar predictive characteristics and similar treatment responses; this approach identifies, via predictive inference, which one among a set of treatments is better suited for a new patient. The proposed method is fully model based, avoiding uncertainty underestimation attained when treatment assignment is performed by adopting heuristic clustering procedures, and belongs to the class of product partition models with covariates, here extended to include the cohesion induced by the normalized generalized gamma process. The method performs particularly well in scenarios characterized by considerable heterogeneity of the predictive covariates in simulation studies. A cancer genomics case study illustrates the potential benefits in terms of treatment response yielded by the proposed approach. Finally, being model based, the approach allows estimating clusters' specific response probabilities and then identifying patients more likely to benefit from personalized treatment.


Subject(s)
Models, Statistical , Neoplasms , Humans , Precision Medicine/methods , Probability , Computer Simulation , Neoplasms/genetics , Neoplasms/therapy , Bayes Theorem
3.
Small ; 20(10): e2306168, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37880910

ABSTRACT

Coronary artery disease (CAD) is the most common type of heart disease and represents the leading cause of death in both men and women worldwide. Early detection of CAD is crucial for decreasing mortality, prolonging survival, and improving patient quality of life. Herein, a non-invasive is described, nanoparticle-based diagnostic technology which takes advantages of proteomic changes in the nano-bio interface for CAD detection. Nanoparticles (NPs) exposed to biological fluids adsorb on their surface a layer of proteins, the "protein corona" (PC). Pathological changes that alter the plasma proteome can directly result in changes in the PC. By forming disease-specific PCs on six NPs with varying physicochemical properties, a PC-based sensor array is developed for detection of CAD using specific PC pattern recognition. While the PC of a single NP may not provide the required specificity, it is reasoned that multivariate PCs across NPs with different surface chemistries, can provide the desirable information to selectively discriminate the condition under investigation. The results suggest that such an approach can detect CAD with an accuracy of 92.84%, a sensitivity of 87.5%, and a specificity of 82.5%. These new findings demonstrate the potential of PC-based sensor array detection systems for clinical use.


Subject(s)
Coronary Artery Disease , Nanoparticles , Protein Corona , Female , Humans , Protein Corona/chemistry , Coronary Artery Disease/diagnosis , Proteomics , Quality of Life , Nanoparticles/chemistry , Proteome
4.
Stat Methods Appt ; 31(2): 197-225, 2022.
Article in English | MEDLINE | ID: mdl-35673326

ABSTRACT

Graphical models are powerful tools that are regularly used to investigate complex dependence structures in high-throughput biomedical datasets. They allow for holistic, systems-level view of the various biological processes, for intuitive and rigorous understanding and interpretations. In the context of large networks, Bayesian approaches are particularly suitable because it encourages sparsity of the graphs, incorporate prior information, and most importantly account for uncertainty in the graph structure. These features are particularly important in applications with limited sample size, including genomics and imaging studies. In this paper, we review several recently developed techniques for the analysis of large networks under non-standard settings, including but not limited to, multiple graphs for data observed from multiple related subgroups, graphical regression approaches used for the analysis of networks that change with covariates, and other complex sampling and structural settings. We also illustrate the practical utility of some of these methods using examples in cancer genomics and neuroimaging.

5.
J Natl Cancer Inst ; 114(2): 290-301, 2022 02 07.
Article in English | MEDLINE | ID: mdl-34524427

ABSTRACT

BACKGROUND: Approximately 20% of lung adenocarcinoma (LUAD) is negative for the lineage-specific oncogene Thyroid transcription factor 1 (TTF-1) and exhibits worse clinical outcome with a low frequency of actionable genomic alterations. To identify molecular features associated with TTF-1-negative LUAD, we compared the transcriptomic and proteomic profiles of LUAD cell lines. SRGN , a chondroitin sulfate proteoglycan Serglycin, was identified as a markedly overexpressed gene in TTF-1-negative LUAD. We therefore investigated the roles and regulation of SRGN in TTF-1-negative LUAD. METHODS: Proteomic and metabolomic analyses of 41 LUAD cell lines were done using mass spectrometry. The function of SRGN was investigated in 3 TTF-1-negative and 4 TTF-1-positive LUAD cell lines and in a syngeneic mouse model (n = 5 to 8 mice per group). Expression of SRGN was evaluated in 94 and 105 surgically resected LUAD tumor specimens using immunohistochemistry. All statistical tests were 2-sided. RESULTS: SRGN was markedly overexpressed at mRNA and protein levels in TTF-1-negative LUAD cell lines (P < .001 for both mRNA and protein levels). Expression of SRGN in LUAD tumor tissue was associated with poor outcome (hazard ratio = 4.22, 95% confidence interval = 1.12 to 15.86, likelihood ratio test, P = .03), and with higher expression of Programmed cell death 1 ligand 1 (PD-L1) in tumor cells and higher infiltration of Programmed cell death protein 1-positive lymphocytes. SRGN regulated expression of PD-L1 as well as proinflammatory cytokines, including Interleukin-6, Interleukin-8, and C-X-C motif chemokine 1 in LUAD cell lines; increased migratory and invasive properties of LUAD cells and fibroblasts; and enhanced angiogenesis. SRGN was induced by DNA demethylation resulting from Nicotinamide N-methyltransferase-mediated impairment of methionine metabolism. CONCLUSIONS: Our findings suggest that SRGN plays a pivotal role in tumor-stromal interaction and reprogramming into an aggressive and immunosuppressive tumor microenvironment in TTF-1-negative LUAD.


Subject(s)
Adenocarcinoma of Lung , DNA-Binding Proteins , Lung Neoplasms , Proteoglycans , Transcription Factors , Vesicular Transport Proteins , Adenocarcinoma of Lung/genetics , Animals , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Mice , Phenotype , Proteoglycans/metabolism , Proteomics , Thyroid Nuclear Factor 1/genetics , Tumor Microenvironment , Vesicular Transport Proteins/metabolism
6.
J Mach Learn Res ; 23(242)2022.
Article in English | MEDLINE | ID: mdl-37799290

ABSTRACT

We introduce Bayesian Gaussian graphical models with covariates (GGMx), a class of multivariate Gaussian distributions with covariate-dependent sparse precision matrix. We propose a general construction of a functional mapping from the covariate space to the cone of sparse positive definite matrices, which encompasses many existing graphical models for heterogeneous settings. Our methodology is based on a novel mixture prior for precision matrices with a non-local component that admits attractive theoretical and empirical properties. The flexible formulation of GGMx allows both the strength and the sparsity pattern of the precision matrix (hence the graph structure) change with the covariates. Posterior inference is carried out with a carefully designed Markov chain Monte Carlo algorithm, which ensures the positive definiteness of sparse precision matrices at any given covariates' values. Extensive simulations and a case study in cancer genomics demonstrate the utility of the proposed model.

7.
Stat Methods Appt ; 30(5): 1285-1288, 2021.
Article in English | MEDLINE | ID: mdl-34776825

ABSTRACT

The special issue on Statistical Analysis of Networks aspires to convey the breadth and depth of statistical learning with networks, ranging from networks that are observed to networks that are unobserved and learned from data. It includes ten select papers with methodological and theoretical advances, and demonstrates the usefulness of the network paradigm by applications to current problems.

8.
J Am Stat Assoc ; 116(534): 605-618, 2021.
Article in English | MEDLINE | ID: mdl-34239216

ABSTRACT

Integrative network modeling of data arising from multiple genomic platforms provides insight into the holistic picture of the interactive system, as well as the flow of information across many disease domains including cancer. The basic data structure consists of a sequence of hierarchically ordered datasets for each individual subject, which facilitates integration of diverse inputs, such as genomic, transcriptomic, and proteomic data. A primary analytical task in such contexts is to model the layered architecture of networks where the vertices can be naturally partitioned into ordered layers, dictated by multiple platforms, and exhibit both undirected and directed relationships. We propose a multi-layered Gaussian graphical model (mlGGM) to investigate conditional independence structures in such multi-level genomic networks in human cancers. We implement a Bayesian node-wise selection (BANS) approach based on variable selection techniques that coherently accounts for the multiple types of dependencies in mlGGM; this flexible strategy exploits edge-specific prior knowledge and selects sparse and interpretable models. Through simulated data generated under various scenarios, we demonstrate that BANS outperforms other existing multivariate regression-based methodologies. Our integrative genomic network analysis for key signaling pathways across multiple cancer types highlights commonalities and differences of p53 integrative networks and epigenetic effects of BRCA2 on p53 and its interaction with T68 phosphorylated CHK2, that may have translational utilities of finding biomarkers and therapeutic targets.

9.
Nutrients ; 13(3)2021 Feb 26.
Article in English | MEDLINE | ID: mdl-33652681

ABSTRACT

Altered circulating levels of free fatty acids (FFAs), namely short chain fatty acids (SCFAs), medium chain fatty acids (MCFAs), and long chain fatty acids (LCFAs), are associated with metabolic, gastrointestinal, and malignant diseases. Hence, we compared the serum FFA profile of patients with celiac disease (CD), adenomatous polyposis (AP), and colorectal cancer (CRC) to healthy controls (HC). We enrolled 44 patients (19 CRC, 9 AP, 16 CD) and 16 HC. We performed a quantitative FFA evaluation with the gas chromatography-mass spectrometry method (GC-MS), and we performed Dirichlet-multinomial regression in order to highlight disease-specific FFA signature. HC showed a different composition of FFAs than CRC, AP, and CD patients. Furthermore, the partial least squares discriminant analysis (PLS-DA) confirmed perfect overlap between the CRC and AP patients and separation of HC from the diseased groups. The Dirichlet-multinomial regression identified only strong positive association between CD and butyric acid. Moreover, CD patients showed significant interactions with age, BMI, and gender. In addition, among patients with the same age and BMI, being male compared to being female implies a decrease of the CD effect on the (log) prevalence of butyric acid in FFA composition. Our data support GC-MS as a suitable method for the concurrent analysis of circulating SCFAs, MCFAs, and LCFAs in different gastrointestinal diseases. Furthermore, and notably, we suggest for the first time that butyric acid could represent a potential biomarker for CD screening.


Subject(s)
Adenomatous Polyposis Coli/blood , Butyric Acid/blood , Celiac Disease/blood , Colorectal Neoplasms/blood , Fatty Acids, Nonesterified/blood , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers/blood , Body Mass Index , Case-Control Studies , Female , Humans , Male , Middle Aged , Regression Analysis , Sex Factors
10.
Stat Med ; 39(30): 4745-4766, 2020 12 30.
Article in English | MEDLINE | ID: mdl-32969059

ABSTRACT

Graphical modeling represents an established methodology for identifying complex dependencies in biological networks, as exemplified in the study of co-expression, gene regulatory, and protein interaction networks. The available observations often exhibit an intrinsic heterogeneity, which impacts on the network structure through the modification of specific pathways for distinct groups, such as disease subtypes. We propose to infer the resulting multiple graphs jointly in order to benefit from potential similarities across groups; on the other hand our modeling framework is able to accommodate group idiosyncrasies. We consider directed acyclic graphs (DAGs) as network structures, and develop a Bayesian method for structural learning of multiple DAGs. We explicitly account for Markov equivalence of DAGs, and propose a suitable prior on the collection of graph spaces that induces selective borrowing strength across groups. The resulting inference allows in particular to compute the posterior probability of edge inclusion, a useful summary for representing flow directions within the network. Finally, we detail a simulation study addressing the comparative performance of our method, and present an analysis of two protein networks together with a substantive interpretation of our findings.


Subject(s)
Bayes Theorem , Causality , Computer Simulation , Humans
11.
Biometrics ; 76(4): 1120-1132, 2020 12.
Article in English | MEDLINE | ID: mdl-32026459

ABSTRACT

Alzheimer's disease is the most common neurodegenerative disease. The aim of this study is to infer structural changes in brain connectivity resulting from disease progression using cortical thickness measurements from a cohort of participants who were either healthy control, or with mild cognitive impairment, or Alzheimer's disease patients. For this purpose, we develop a novel approach for inference of multiple networks with related edge values across groups. Specifically, we infer a Gaussian graphical model for each group within a joint framework, where we rely on Bayesian hierarchical priors to link the precision matrix entries across groups. Our proposal differs from existing approaches in that it flexibly learns which groups have the most similar edge values, and accounts for the strength of connection (rather than only edge presence or absence) when sharing information across groups. Our results identify key alterations in structural connectivity that may reflect disruptions to the healthy brain, such as decreased connectivity within the occipital lobe with increasing disease severity. We also illustrate the proposed method through simulations, where we demonstrate its performance in structure learning and precision matrix estimation with respect to alternative approaches.


Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Neurodegenerative Diseases , Alzheimer Disease/diagnostic imaging , Bayes Theorem , Cognitive Dysfunction/diagnostic imaging , Disease Progression , Humans , Magnetic Resonance Imaging
12.
Front Immunol ; 11: 573158, 2020.
Article in English | MEDLINE | ID: mdl-33488574

ABSTRACT

Background and aim: Gut microbiota (GM) can support colorectal cancer (CRC) progression by modulating immune responses through the production of both immunostimulatory and/or immunosuppressive cytokines. The role of IL-9 is paradigmatic because it can either promote tumor progression in hematological malignancies or inhibit tumorigenesis in solid cancers. Therefore, we investigate the microbiota-immunity axis in healthy and tumor mucosa, focusing on the correlation between cytokine profile and GM signature. Methods: In this observational study, we collected tumor (CRC) and healthy (CRC-S) mucosa samples from 45 CRC patients, who were undergoing surgery in 2018 at the Careggi University Hospital (Florence, Italy). First, we characterized the tissue infiltrating lymphocyte subset profile and the GM composition. Subsequently, we evaluated the CRC and CRC-S molecular inflammatory response and correlated this profile with GM composition, using Dirichlet multinomial regression. Results: CRC samples displayed higher percentages of Th17, Th2, and Tregs. Moreover, CRC tissues showed significantly higher levels of MIP-1α, IL-1α, IL-1ß, IL-2, IP-10, IL-6, IL-8, IL-17A, IFN-γ, TNF-α, MCP-1, P-selectin, and IL-9. Compared to CRC-S, CRC samples also showed significantly higher levels of the following genera: Fusobacteria, Proteobacteria, Fusobacterium, Ruminococcus2, and Ruminococcus. Finally, the abundance of Prevotella spp. in CRC samples negatively correlated with IL-17A and positively with IL-9. On the contrary, Bacteroides spp. presence negatively correlated with IL-9. Conclusions: Our data consolidate antitumor immunity impairment and the presence of a distinct microbiota profile in the tumor microenvironment compared with the healthy mucosa counterpart. Relating the CRC cytokine profile with GM composition, we confirm the presence of bidirectional crosstalk between the immune response and the host's commensal microorganisms. Indeed, we document, for the first time, that Prevotella spp. and Bacteroides spp. are, respectively, positively and negatively correlated with IL-9, whose role in CRC development is still under debate.


Subject(s)
Adenocarcinoma/immunology , Adenocarcinoma/microbiology , Bacteroides/isolation & purification , Colorectal Neoplasms/immunology , Colorectal Neoplasms/microbiology , Gastrointestinal Microbiome , Intestinal Mucosa/immunology , Intestinal Mucosa/microbiology , Prevotella/isolation & purification , Adenocarcinoma/metabolism , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Case-Control Studies , Colorectal Neoplasms/metabolism , Colorectal Neoplasms/surgery , Female , Humans , Interleukin-9/metabolism , Intestinal Mucosa/metabolism , Intestinal Mucosa/surgery , Lymphocytes, Tumor-Infiltrating/immunology , Lymphocytes, Tumor-Infiltrating/metabolism , Male , Middle Aged , Ribotyping , T-Lymphocytes/immunology , T-Lymphocytes/metabolism , Tumor Microenvironment
13.
Biostatistics ; 21(3): 561-576, 2020 07 01.
Article in English | MEDLINE | ID: mdl-30590505

ABSTRACT

In this article, we develop a graphical modeling framework for the inference of networks across multiple sample groups and data types. In medical studies, this setting arises whenever a set of subjects, which may be heterogeneous due to differing disease stage or subtype, is profiled across multiple platforms, such as metabolomics, proteomics, or transcriptomics data. Our proposed Bayesian hierarchical model first links the network structures within each platform using a Markov random field prior to relate edge selection across sample groups, and then links the network similarity parameters across platforms. This enables joint estimation in a flexible manner, as we make no assumptions on the directionality of influence across the data types or the extent of network similarity across the sample groups and platforms. In addition, our model formulation allows the number of variables and number of subjects to differ across the data types, and only requires that we have data for the same set of groups. We illustrate the proposed approach through both simulation studies and an application to gene expression levels and metabolite abundances on subjects with varying severity levels of chronic obstructive pulmonary disease. Bayesian inference; Chronic obstructive pulmonary disease (COPD); Data integration; Gaussian graphical model; Markov random field prior; Spike and slab prior.


Subject(s)
Biomedical Research/methods , Biostatistics/methods , Data Interpretation, Statistical , Models, Statistical , Bayes Theorem , Computer Simulation , Datasets as Topic , Gene Expression/physiology , Humans , Markov Chains , Metabolome/physiology , Pulmonary Disease, Chronic Obstructive/genetics , Pulmonary Disease, Chronic Obstructive/metabolism , Severity of Illness Index
14.
Stat Methods Med Res ; 29(4): 1181-1196, 2020 04.
Article in English | MEDLINE | ID: mdl-31172886

ABSTRACT

Human cancer cell line experiments are valuable for investigating drug sensitivity biomarkers. The number of biomarkers measured in these experiments is typically on the order of several thousand, whereas the number of samples is often limited to one or at most three replicates for each experimental condition. We have developed an innovative Bayesian approach that efficiently identifies clusters of proteins that exhibit similar patterns of expression. Motivated by the availability of ion mobility mass spectrometry data on cell line experiments in myelodysplastic syndrome and acute myeloid leukemia, our methodology can identify proteins that follow biologically meaningful trends of expression. Extensive simulation studies demonstrate good performance of the proposed method even in the presence of relatively small effects and sample sizes.


Subject(s)
Leukemia, Myeloid, Acute , Myelodysplastic Syndromes , Bayes Theorem , Cell Line , Humans , Leukemia, Myeloid, Acute/drug therapy , Sample Size
15.
World J Gastroenterol ; 25(36): 5543-5558, 2019 Sep 28.
Article in English | MEDLINE | ID: mdl-31576099

ABSTRACT

BACKGROUND: An altered (dysbiosis) and unhealthy status of the gut microbiota is usually responsible for a reduction of short chain fatty acids (SCFAs) concentration. SCFAs obtained from the carbohydrate fermentation processes are crucial in maintaining gut homeostasis and their determination in stool samples could provide a faster, reliable and cheaper method to highlight the presence of an intestinal dysbiosis and a biomarker for various gut diseases. We hypothesize that different intestinal diseases, such as celiac disease (CD), adenomatous polyposis (AP) and colorectal cancer (CRC) could display a particular fecal SCFAs' signature. AIM: To compare the fecal SCFAs' profiles of CD, AP, CRC patients and healthy controls, using the same analytical method. METHODS: In this cross-sectional study, we defined and compared the SCFAs' concentration in fecal samples of 9 AP, 16 CD, 19 CRC patients and 16 healthy controls (HC). The SCFAs' analysis were performed using a gas-chromatography coupled with mass spectrometry method. Data analysis was carried out using Wilcoxon rank-sum test to assess pairwise differences of SCFAs' profiles, partial least squares-discriminate analysis (PLS-DA) to determine the status membership based on distinct SCFAs' profiles, and Dirichlet regression to determine factors influencing concentration levels of SCFAs. RESULTS: We have not observed any difference in the SCFAs' amount and composition between CD and healthy control. On the contrary, the total amount of SCFAs was significantly lower in CRC patients compared to HC (P = 0.044) and CD (P = 0.005). Moreover, the SCFAs' percentage composition was different in CRC and AP compared to HC. In detail, HC displayed higher percentage of acetic acid (P value = 1.3 × 10-6) and a lower amount of butyric (P value = 0.02192), isobutyric (P value = 7.4 × 10-5), isovaleric (P value = 0.00012) and valeric (P value = 0.00014) acids compared to CRC patients. AP showed a lower abundance of acetic acid (P value = 0.00062) and higher percentages of propionic (P value = 0.00433) and isovaleric (P value = 0.00433) acids compared to HC. Moreover, AP showed higher levels of propionic acid (P value = 0.03251) and a lower level of isobutyric acid (P value = 0.00427) in comparison to CRC. The PLS-DA model demonstrated a significant separation of CRC and AP groups from HC, although some degree of overlap was observed between CRC and AP. CONCLUSION: Analysis of fecal SCFAs shows the potential to provide a non-invasive means of diagnosis to detect patients with CRC and AP, while CD patients cannot be discriminated from healthy subjects.


Subject(s)
Adenomatous Polyposis Coli/diagnosis , Celiac Disease/diagnosis , Colorectal Neoplasms/diagnosis , Dysbiosis/metabolism , Fatty Acids, Volatile/analysis , Adenomatous Polyposis Coli/metabolism , Adenomatous Polyposis Coli/microbiology , Adolescent , Adult , Aged , Aged, 80 and over , Celiac Disease/metabolism , Celiac Disease/microbiology , Colorectal Neoplasms/metabolism , Colorectal Neoplasms/microbiology , Cross-Sectional Studies , Dysbiosis/microbiology , Fatty Acids, Volatile/metabolism , Feces/chemistry , Female , Gas Chromatography-Mass Spectrometry , Gastrointestinal Microbiome/physiology , Healthy Volunteers , Humans , Male , Middle Aged , Young Adult
16.
J Am Stat Assoc ; 114(525): 48-60, 2019.
Article in English | MEDLINE | ID: mdl-31178611

ABSTRACT

Identifying patient-specific prognostic biomarkers is of critical importance in developing personalized treatment for clinically and molecularly heterogeneous diseases such as cancer. In this article, we propose a novel regression framework, Bayesian hierarchical varying-sparsity regression (BEHAVIOR) models to select clinically relevant disease markers by integrating proteogenomic (proteomic+genomic) and clinical data. Our methods allow flexible modeling of protein-gene relationships as well as induces sparsity in both protein-gene and protein-survival relationships, to select ge-nomically driven prognostic protein markers at the patient-level. Simulation studies demonstrate the superior performance of BEHAVIOR against competing method in terms of both protein marker selection and survival prediction. We apply BEHAV-IOR to The Cancer Genome Atlas (TCGA) proteogenomic pan-cancer data and find several interesting prognostic proteins and pathways that are shared across multiple cancers and some that exclusively pertain to specific cancers.

17.
Biom J ; 61(4): 902-917, 2019 07.
Article in English | MEDLINE | ID: mdl-30786040

ABSTRACT

The evolution of "informatics" technologies has the potential to generate massive databases, but the extent to which personalized medicine may be effectuated depends on the extent to which these rich databases may be utilized to advance understanding of the disease molecular profiles and ultimately integrated for treatment selection, necessitating robust methodology for dimension reduction. Yet, statistical methods proposed to address challenges arising with the high-dimensionality of omics-type data predominately rely on linear models and emphasize associations deriving from prognostic biomarkers. Existing methods are often limited for discovering predictive biomarkers that interact with treatment and fail to elucidate the predictive power of their resultant selection rules. In this article, we present a Bayesian predictive method for personalized treatment selection that is devised to integrate both the treatment predictive and disease prognostic characteristics of a particular patient's disease. The method appropriately characterizes the structural constraints inherent to prognostic and predictive biomarkers, and hence properly utilizes these complementary sources of information for treatment selection. The methodology is illustrated through a case study of lower grade glioma. Theoretical considerations are explored to demonstrate the manner in which treatment selection is impacted by prognostic features. Additionally, simulations based on an actual leukemia study are provided to ascertain the method's performance with respect to selection rules derived from competing methods.


Subject(s)
Biometry/methods , Precision Medicine , Bayes Theorem , Glioma/diagnosis , Glioma/drug therapy , Glioma/pathology , Glioma/radiotherapy , Humans , Neoplasm Grading , Probability , Prognosis
19.
J Am Stat Assoc ; 114(525): 184-197, 2019.
Article in English | MEDLINE | ID: mdl-36937091

ABSTRACT

We consider the problem of modeling conditional independence structures in heterogeneous data in the presence of additional subject-level covariates - termed Graphical Regression. We propose a novel specification of a conditional (in)dependence function of covariates - which allows the structure of a directed graph to vary flexibly with the covariates; imposes sparsity in both edge and covariate selection; produces both subject-specific and predictive graphs; and is computationally tractable. We provide theoretical justifications of our modeling endeavor, in terms of graphical model selection consistency. We demonstrate the performance of our method through rigorous simulation studies. We illustrate our approach in a cancer genomics-based precision medicine paradigm, where-in we explore gene regulatory networks in multiple myeloma taking prognostic clinical factors into account to obtain both population-level and subject-level gene regulatory networks.

20.
J Appl Clin Med Phys ; 20(1): 331-339, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30426664

ABSTRACT

Aluminum oxide based optically stimulated luminescent dosimeters (OSLD) have been recognized as a useful dosimeter for measuring CT dose, particularly for patient dose measurements. Despite the increasing use of this dosimeter, appropriate dosimeter calibration techniques have not been established in the literature; while the manufacturer offers a calibration procedure, it is known to have relatively large uncertainties. The purpose of this work was to evaluate two clinical approaches for calibrating these dosimeters for CT applications, and to determine the uncertainty associated with measurements using these techniques. Three unique calibration procedures were used to calculate dose for a range of CT conditions using a commercially available OSLD and reader. The three calibration procedures included calibration (a) using the vendor-provided method, (b) relative to a 120 kVp CT spectrum in air, and (c) relative to a megavoltage beam (implemented with 60 Co). The dose measured using each of these approaches was compared to dose measured using a calibrated farmer-type ion chamber. Finally, the uncertainty in the dose measured using each approach was determined. For the CT and megavoltage calibration methods, the dose measured using the OSLD nanoDot was within 5% of the dose measured using an ion chamber for a wide range of different CT scan parameters (80-140 kVp, and with measurements at a range of positions). When calibrated using the vendor-recommended protocol, the OSLD measured doses were on average 15.5% lower than ion chamber doses. Two clinical calibration techniques have been evaluated and are presented in this work as alternatives to the vendor-provided calibration approach. These techniques provide high precision for OSLD-based measurements in a CT environment.


Subject(s)
Calibration , Nanotechnology/instrumentation , Optically Stimulated Luminescence Dosimetry/instrumentation , Phantoms, Imaging , Tomography, X-Ray Computed/instrumentation , Computer Simulation , Equipment Design , Humans , Image Processing, Computer-Assisted/methods , Nanotechnology/methods , Optically Stimulated Luminescence Dosimetry/methods , Radiation Dosage , Tomography, X-Ray Computed/methods , Uncertainty
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