Treatment Algorithm for the Resorption of Calcific Tendinitis Using Extracorporeal Shockwave Therapy: A Data Mining Study.

Background: Although evidence indicates that extracorporeal shockwave therapy (ESWT) is effective in treating calcifying shoulder tendinitis, incomplete resorption and dissatisfactory results are still reported in many cases. Data mining techniques have been applied in health care in the past decade to predict outcomes of disease and treatment. Purpose: To identify the ideal data mining technique for the prediction of ESWT-induced shoulder calcification resorption and the most accurate algorithm for use in the clinical setting. Study Design: Case-control study. Methods: Patients with painful calcified shoulder tendinitis treated by ESWT were enrolled. Seven clinical factors related to shoulder calcification were adopted as the input attributes: sex, age, side affected, symptom duration, pretreatment Constant-Murley score, and calcification size and type. The 5 data mining techniques assessed were multilayer perceptron (neural network), naïve Bayes, sequential minimal optimization, logistic regression, and the J48 decision tree classifier. Results: A total of 248 patients with calcified shoulder tendinitis were enrolled in this study. Shorter symptom duration yielded the highest gain ratio (0.374), followed by smaller calcification size (0.336) and calcification type (0.253). With the J48 decision tree method, the accuracy of 3 input attributes was 89.5% by 10-fold cross-validation, indicating satisfactory accuracy. A treatment algorithm using the J48 decision tree indicated that a symptom duration of ≤10 months was the most positive indicator of calcification resorption, followed by a calcification size of ≤10.82 mm. Conclusion: The J48 decision tree method demonstrated the highest precision and accuracy in the prediction of shoulder calcification resorption by ESWT. A symptom duration of ≤10 months or calcification size of ≤10.82 mm represented the clinical scenarios most likely to show resorption after ESWT.

Prediction of vancomycin initial dosage using artificial intelligence models applying ensemble strategy.

BACKGROUND: Antibiotic resistance has become a global concern. Vancomycin is known as the last line of antibiotics, but its treatment index is narrow. Therefore, clinical dosing decisions must be made with the utmost care; such decisions are said to be "suitable" only when both "efficacy" and "safety" are considered. This study presents a model, namely the "ensemble strategy model," to predict the suitability of vancomycin regimens. The experimental data consisted of 2141 "suitable" and "unsuitable" patients tagged with a vancomycin regimen, including six diagnostic input attributes (sex, age, weight, serum creatinine, dosing interval, and total daily dose), and the dataset was normalized into a training dataset, a validation dataset, and a test dataset. AdaBoost.M1, Bagging, fastAdaboost, Neyman-Pearson, and Stacking were used for model training. The "ensemble strategy concept" was then used to arrive at the final decision by voting to build a model for predicting the suitability of vancomycin treatment regimens. RESULTS: The results of the tenfold cross-validation showed that the average accuracy of the proposed "ensemble strategy model" was 86.51% with a standard deviation of 0.006, and it was robust. In addition, the experimental results of the test dataset revealed that the accuracy, sensitivity, and specificity of the proposed method were 87.54%, 89.25%, and 85.19%, respectively. The accuracy of the five algorithms ranged from 81 to 86%, the sensitivity from 81 to 92%, and the specificity from 77 to 88%. Thus, the experimental results suggest that the model proposed in this study has high accuracy, high sensitivity, and high specificity. CONCLUSIONS: The "ensemble strategy model" can be used as a reference for the determination of vancomycin doses in clinical treatment.

Robust optimization of convolutional neural networks with a uniform experiment design method: a case of phonocardiogram testing in patients with heart diseases.

BACKGROUND: Heart sound measurement is crucial for analyzing and diagnosing patients with heart diseases. This study employed phonocardiogram signals as the input signal for heart disease analysis due to the accessibility of the respective method. This study referenced preprocessing techniques proposed by other researchers for the conversion of phonocardiogram signals into characteristic images composed using frequency subband. Image recognition was then conducted through the use of convolutional neural networks (CNNs), in order to classify the predicted of phonocardiogram signals as normal or abnormal. However, CNN requires the tuning of multiple hyperparameters, which entails an optimization problem for the hyperparameters in the model. To maximize CNN robustness, the uniform experiment design method and a science-based methodical experiment design were used to optimize CNN hyperparameters in this study. RESULTS: An artificial intelligence prediction model was constructed using CNN, and the uniform experiment design method was proposed to acquire hyperparameters for optimal CNN robustness. The results indicate Filters ([Formula: see text]), Stride ([Formula: see text]), Activation functions ([Formula: see text]), and Dropout ([Formula: see text]) to be significant factors considerably influencing the ability of CNN to distinguish among heart sound states. Finally, the confirmation experiment was conducted, and the hyperparameter combination for optimal model robustness was Filters ([Formula: see text]) = 32, Kernel Size ([Formula: see text] = 3 × 3, Stride ([Formula: see text]) = (1,1), Padding ([Formula: see text] as same, Optimizer ([Formula: see text] as the stochastic gradient descent, Activation functions ([Formula: see text]) as relu, and Dropout ([Formula: see text]) = 0.544. With this combination of parameters, the model had an average prediction accuracy rate of 0.787 and standard deviation of 0. CONCLUSION: In this study, phonocardiogram signals were used for the early prediction of heart diseases. The science-based and methodical uniform experiment design was used for the optimization of CNN hyperparameters to construct a CNN with optimal robustness. The results revealed that the constructed model exhibited robustness and an acceptable accuracy rate. Other literature has failed to address hyperparameter optimization problems in CNN; a method is subsequently proposed for robust CNN optimization, thereby solving this problem.

Application of artificial intelligence ensemble learning model in early prediction of atrial fibrillation.

BACKGROUND: Atrial fibrillation is a paroxysmal heart disease without any obvious symptoms for most people during the onset. The electrocardiogram (ECG) at the time other than the onset of this disease is not significantly different from that of normal people, which makes it difficult to detect and diagnose. However, if atrial fibrillation is not detected and treated early, it tends to worsen the condition and increase the possibility of stroke. In this paper, P-wave morphology parameters and heart rate variability feature parameters were simultaneously extracted from the ECG. A total of 31 parameters were used as input variables to perform the modeling of artificial intelligence ensemble learning model. RESULTS: This paper applied three artificial intelligence ensemble learning methods, namely Bagging ensemble learning method, AdaBoost ensemble learning method, and Stacking ensemble learning method. The prediction results of these three artificial intelligence ensemble learning methods were compared. As a result of the comparison, the Stacking ensemble learning method combined with various models finally obtained the best prediction effect with the accuracy of 92%, sensitivity of 88%, specificity of 96%, positive predictive value of 95.7%, negative predictive value of 88.9%, F1 score of 0.9231 and area under receiver operating characteristic curve value of 0.911. CONCLUSION: In feature extraction, this paper combined P-wave morphology parameters and heart rate variability parameters as input parameters for model training, and validated the value of the proposed parameters combination for the improvement of the model's predicting effect. In the calculation of the P-wave morphology parameters, the hybrid Taguchi-genetic algorithm was used to obtain more accurate Gaussian function fitting parameters. The prediction model was trained using the Stacking ensemble learning method, so that the model accuracy had better results, which can further improve the early prediction of atrial fibrillation.

Artificial intelligence classification model for macular degeneration images: a robust optimization framework for residual neural networks.

BACKGROUND: The prevalence of chronic disease is growing in aging societies, and artificial-intelligence-assisted interpretation of macular degeneration images is a topic that merits research. This study proposes a residual neural network (ResNet) model constructed using uniform design. The ResNet model is an artificial intelligence model that classifies macular degeneration images and can assist medical professionals in related tests and classification tasks, enhance confidence in making diagnoses, and reassure patients. However, the various hyperparameters in a ResNet lead to the problem of hyperparameter optimization in the model. This study employed uniform design-a systematic, scientific experimental design-to optimize the hyperparameters of the ResNet and establish a ResNet with optimal robustness. RESULTS: An open dataset of macular degeneration images ( https://data.mendeley.com/datasets/rscbjbr9sj/3 ) was divided into training, validation, and test datasets. According to accuracy, false negative rate, and signal-to-noise ratio, this study used uniform design to determine the optimal combination of ResNet hyperparameters. The ResNet model was tested and the results compared with results obtained in a previous study using the same dataset. The ResNet model achieved higher optimal accuracy (0.9907), higher mean accuracy (0.9848), and a lower mean false negative rate (0.015) than did the model previously reported. The optimal ResNet hyperparameter combination identified using the uniform design method exhibited excellent performance. CONCLUSION: The high stability of the ResNet model established using uniform design is attributable to the study's strict focus on achieving both high accuracy and low standard deviation. This study optimized the hyperparameters of the ResNet model by using uniform design because the design features uniform distribution of experimental points and facilitates effective determination of the representative parameter combination, reducing the time required for parameter design and fulfilling the requirements of a systematic parameter design process.

Expression regulation of MALATE SYNTHASE involved in glyoxylate cycle during protocorm development in Phalaenopsis aphrodite (Orchidaceae).

Orchid (Orchidaceae) is one of the largest families in angiosperms and presents exceptional diversity in lifestyle. Their unique reproductive characteristics of orchid are attracted by scientist for centuries. One of the synapomorphies of orchid plants is that their seeds do not contain endosperm. Lipids are used as major energy storage in orchid seeds. However, regulation and mobilization of lipid usage during early seedling (protocorm) stage of orchid is not understood. In this study, we compared transcriptomes from developing Phalaenopsis aphrodite protocorms grown on 1/2-strength MS medium with sucrose. The expression of P. aphrodite MALATE SYNTHASE (PaMLS), involved in the glyoxylate cycle, was significantly decreased from 4 days after incubation (DAI) to 7 DAI. On real-time RT-PCR, both P. aphrodite ISOCITRATE LYASE (PaICL) and PaMLS were down-regulated during protocorm development and suppressed by sucrose treatment. In addition, several genes encoding transcription factors regulating PaMLS expression were identified. A gene encoding homeobox transcription factor (named PaHB5) was involved in positive regulation of PaMLS. This study showed that sucrose regulates the glyoxylate cycle during orchid protocorm development in asymbiotic germination and provides new insights into the transcription factors involved in the regulation of malate synthase expression.

Transcriptomic analysis of floral organs from Phalaenopsis orchid by using oligonucleotide microarray.

Orchids are one of the most species rich of all angiosperm families. Their extraordinary floral diversity, especially conspicuous labellum morphology, makes them the successful species during evolution process. Because of the fine and delicate development of the perianth, orchid provides a rich subject for studying developmental biology. However, study on molecular mechanism underling orchid floral development is still in its infancy. In this study, we developed an oligomicroarray containing 14,732 unigenes based on the information of expressed sequence tags derived from Phalaenopsis orchids. We applied the oligomicroarray to compare transcriptome among different types of floral organs including sepal, petal and labellum. We discovered that 173, 11, and 285 unigenes were highly differentially expressed in sepal, petal, and labellum, respectively. These unigenes were annotated with Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and transcription factor family. Unigenes involved in energy metabolism, lipid metabolism, and terpenoid metabolism are significantly differentially distributed between labellum and two types of tepal (sepal and petal). Labellum-dominant unigenes encoding MADS-box and sepal-dominant unigenes encoding WRKY transcription factors were also identified. Further studies are required but data suggest that it will be possible to identify genes better adapted to sepal, petal and labellum function. The developed functional genomic tool will narrow the gap between approaches based on model organisms with plenty genomic resources and species that are important for developmental and evolutionary studies.

Prediction of EST functional relationships via literature mining with user-specified parameters.

The massive amount of expressed sequence tags (ESTs) gathered over recent years has triggered great interest in efficient applications for genomic research. In particular, EST functional relationships can be used to determine a possible gene network for biological processes of interest. In recent years, many researchers have tried to determine EST functional relationships by analyzing the biological literature. However, it has been challenging to find efficient prediction methods. Moreover, an annotated EST is usually associated with many functions, so successful methods must be able to distinguish between relevant and irrelevant functions based on user specifications. This paper proposes a method to discover functional relationships between ESTs of interest by analyzing literature from the Medical Literature Analysis and Retrieval System Online, with user-specified parameters for selecting keywords. This method performs better than the multiple kernel documents method in setting up a specific threshold for gathering materials. The method is also able to uncover known functional relationships, as shown by a comparison with the Kyoto Encyclopedia of Genes and Genomes database. The reliable EST relationships predicted by the proposed method can help to construct gene networks for specific biological functions of interest.

Comparison of transcripts in Phalaenopsis bellina and Phalaenopsis equestris (Orchidaceae) flowers to deduce monoterpene biosynthesis pathway.

BACKGROUND: Floral scent is one of the important strategies for ensuring fertilization and for determining seed or fruit set. Research on plant scents has hampered mainly by the invisibility of this character, its dynamic nature, and complex mixtures of components that are present in very small quantities. Most progress in scent research, as in other areas of plant biology, has come from the use of molecular and biochemical techniques. Although volatile components have been identified in several orchid species, the biosynthetic pathways of orchid flower fragrance are far from understood. We investigated how flower fragrance was generated in certain Phalaenopsis orchids by determining the chemical components of the floral scent, identifying floral expressed-sequence-tags (ESTs), and deducing the pathways of floral scent biosynthesis in Phalaneopsis bellina by bioinformatics analysis. RESULTS: The main chemical components in the P. bellina flower were shown by gas chromatography-mass spectrometry to be monoterpenoids, benzenoids and phenylpropanoids. The set of floral scent producing enzymes in the biosynthetic pathway from glyceraldehyde-3-phosphate (G3P) to geraniol and linalool were recognized through data mining of the P. bellina floral EST database (dbEST). Transcripts preferentially expressed in P. bellina were distinguished by comparing the scent floral dbEST to that of a scentless species, P. equestris, and included those encoding lipoxygenase, epimerase, diacylglycerol kinase and geranyl diphosphate synthase. In addition, EST filtering results showed that transcripts encoding signal transduction and Myb transcription factors and methyltransferase, in addition to those for scent biosynthesis, were detected by in silico hybridization of the P. bellina unigene database against those of the scentless species, rice and Arabidopsis. Altogether, we pinpointed 66% of the biosynthetic steps from G3P to geraniol, linalool and their derivatives. CONCLUSION: This systems biology program combined chemical analysis, genomics and bioinformatics to elucidate the scent biosynthesis pathway and identify the relevant genes. It integrates the forward and reverse genetic approaches to knowledge discovery by which researchers can study non-model plants.