Survival estimation of oral cancer using fuzzy deep learning.

BACKGROUND: Oral cancer is a deadly disease and a major cause of morbidity and mortality worldwide. The purpose of this study was to develop a fuzzy deep learning (FDL)-based model to estimate the survival time based on clinicopathologic data of oral cancer. METHODS: Electronic medical records of 581 oral squamous cell carcinoma (OSCC) patients, treated with surgery with or without radiochemotherapy, were collected retrospectively from the Oral and Maxillofacial Surgery Clinic and the Regional Cancer Center from 2011 to 2019. The deep learning (DL) model was trained to classify survival time classes based on clinicopathologic data. Fuzzy logic was integrated into the DL model and trained to create FDL-based models to estimate the survival time classes. RESULTS: The performance of the models was evaluated on a test dataset. The performance of the DL and FDL models for estimation of survival time achieved an accuracy of 0.74 and 0.97 and an area under the receiver operating characteristic (AUC) curve of 0.84 to 1.00 and 1.00, respectively. CONCLUSIONS: The integration of fuzzy logic into DL models could improve the accuracy to estimate survival time based on clinicopathologic data of oral cancer.

Forecasting COVID-19 cases using time series modeling and association rule mining.

BACKGROUND: The aim of this study was to evaluate the most effective combination of autoregressive integrated moving average (ARIMA), a time series model, and association rule mining (ARM) techniques to identify meaningful prognostic factors and predict the number of cases for efficient COVID-19 crisis management. METHODS: The 3685 COVID-19 patients admitted at Thailand's first university field hospital following the four waves of infections from March 2020 to August 2021 were analyzed using the autoregressive integrated moving average (ARIMA), its derivative to exogenous variables (ARIMAX), and association rule mining (ARM). RESULTS: The ARIMA (2, 2, 2) model with an optimized parameter set predicted the number of the COVID-19 cases admitted at the hospital with acceptable error scores (R2 = 0.5695, RMSE = 29.7605, MAE = 27.5102). Key features from ARM (symptoms, age, and underlying diseases) were selected to build an ARIMAX (1, 1, 1) model, which yielded better performance in predicting the number of admitted cases (R2 = 0.5695, RMSE = 27.7508, MAE = 23.4642). The association analysis revealed that hospital stays of more than 14 days were related to the healthcare worker patients and the patients presented with underlying diseases. The worsening cases that required referral to the hospital ward were associated with the patients admitted with symptoms, pregnancy, metabolic syndrome, and age greater than 65 years old. CONCLUSIONS: This study demonstrated that the ARIMAX model has the potential to predict the number of COVID-19 cases by incorporating the most associated prognostic factors identified by ARM technique to the ARIMA model, which could be used for preparation and optimal management of hospital resources during pandemics.

The Discovery of Oral Cancer Prognostic Factor Ranking Using Association Rule Mining.

OBJECTIVE: A 5-year survival rate is a predictor for the assessment of oral cancer prognosis. The purpose of this study is to analyze oral cancer data to discover and rank the prognostic factors associated with oral cancer 5-year survival using the association rule mining (ARM) technique. MATERIALS AND METHODS: This study is a retrospective analysis of 897 oral cancer patients from a regional cancer center between 2011 and 2017. The 5-year survival rate was assessed. The multivariable Cox proportional hazards analysis was performed to determine prognostic factors. ARM was applied to clinicopathologic and treatment modalities data to identify and rank the prognostic factors associated with oral cancer 5-year survival. RESULTS: The 5-year overall survival rate was 35.1%. Multivariable Cox proportional hazards analysis showed that tumor (T) stage, lymph node metastasis, surgical margin, extranodal extension, recurrence, and distant metastasis of tumor were significantly associated with overall survival rate (p < 0.05). The top associated death within 5 years rule was positive extranodal extension, followed by positive perineural and lymphovascular invasion, with confidence levels of 0.808, 0.808, and 0.804, respectively. CONCLUSION: This study has shown that extranodal extension, and perineural and lymphovascular invasion were the top ranking and major deadly prognostic factors affecting the 5-year survival of oral cancer.

Analysis of Characteristics and Clinical Outcomes for Crisis Management during the Four Waves of the COVID-19 Pandemic.

This study aims to analyze the patient characteristics and factors related to clinical outcomes in the crisis management of the COVID-19 pandemic in a field hospital. We conducted retrospective analysis of patient clinical data from March 2020 to August 2021 at the first university-based field hospital in Thailand. Multivariable logistic regression models were used to evaluate the factors associated with the field hospital discharge destination. Of a total of 3685 COVID-19 patients, 53.6% were women, with the median age of 30 years. General workers accounted for 97.5% of patients, while 2.5% were healthcare workers. Most of the patients were exposed to coronavirus from the community (84.6%). At the study end point, no patients had died, 97.7% had been discharged home, and 2.3% had been transferred to designated high-level hospitals due to their condition worsening. In multivariable logistic regression analysis, older patients with one or more underlying diseases who showed symptoms of COVID-19 and whose chest X-rays showed signs of pneumonia were in a worse condition than other patients. In conclusion, the university-based field hospital has the potential to fill acute gaps and prevent public agencies from being overwhelmed during crisis events.