Cancer is a collection of diseases that involves growing abnormal cells with the potential to invade or spread to the body. Breast cancer is the second leading cause of cancer death among women. A method for 5-year breast cancer recurrence prediction is presented in this manuscript. Clinicopathologic characteristics of 579 breast cancer patients (recurrence prevalence of 19.3%) were analyzed and discriminative features were selected using statistical feature selection methods. They were further refined by Particle Swarm Optimization (PSO) as the inputs of the classification system with ensemble learning (Bagged Decision Tree: BDT). The proper combination of selected categorical features and also the weight (importance) of the selected interval-measurement-scale features were identified by the PSO algorithm. The performance of HPBCR (hybrid predictor of breast cancer recurrence) was assessed using the holdout and 4-fold cross-validation. Three other classifiers namely as supported vector machines, DT, and multilayer perceptron neural network were used for comparison. The selected features were diagnosis age, tumor size, lymph node involvement ratio, number of involved axillary lymph nodes, progesterone receptor expression, having hormone therapy and type of surgery. The minimum sensitivity, specificity, precision and accuracy of HPBCR were 77%, 93%, 95% and 85%, respectively in the entire cross-validation folds and the hold-out test fold. HPBCR outperformed the other tested classifiers. It showed excellent agreement with the gold standard (i.e. the oncologist opinion after blood tumor marker and imaging tests, and tissue biopsy). This algorithm is thus a promising online tool for the prediction of breast cancer recurrence.
This study was designed to develop a risk assessment chart for the clinical management and prevention of the risk of cardiovascular disease (CVD) in Iranian population, which is vital for developing national prevention programs. The Isfahan Cohort Study (ICS) is a population-based prospective study of 6504 Iranian adults ≥35 years old, followed-up for ten years, from 2001 to 2010. Behavioral and cardiometabolic risk factors were examined every five years, while biennial follow-ups for the occurrence of the events was performed by phone calls or by verbal autopsy. Among these participants, 5432 (2784 women, 51.3%) were CVD free at baseline examination and had at least one follow-up. Cox proportional hazard regression was used to predict the risk of ischemic CVD events, including sudden cardiac death due to unstable angina, myocardial infarction, and stroke. The model fit statistics such as area under the receiver-operating characteristic (AUROC), calibration chi-square and the overall bias were used to assess the model performance. We also tested the Framingham model for comparison. Seven hundred and five CVD events occurred during 49452.8 person-years of follow-up. The event probabilities were calculated and presented color-coded on each gender-specific PARS chart. The AUROC and Harrell’s C indices were 0.74 (95% CI, 0.72–0.76) and 0.73, respectively. In the calibration, the Nam-D’Agostino χ2 was 10.82 (p = 0.29). The overall bias of the proposed model was 95.60%. PARS model was also internally validated using cross-validation. The Android app and the Web-based risk assessment tool were also developed as to have an impact on public health. In comparison, the refitted and recalibrated Framingham models, estimated the CVD incidence with the overall bias of 149.60% and 128.23% for men, and 222.70% and 176.07% for women, respectively. In conclusion, the PARS risk assessment chart is a simple, accurate, and well-calibrated tool for predicting a 10-year risk of CVD occurrence in Iranian population and can be used in an attempt to develop national guidelines for the CVD management.
Despite the progress in understanding of neural codes, the studies of the cortico-muscular coupling still largely rely on interferential electromyographic (EMG) signal or its rectification for the assessment of motor neuron pool behavior. This assessment is non-trivial and should be used with precaution. Direct analysis of neural codes by decomposing the EMG, also known as neural decoding, is an alternative to EMG amplitude estimation. In this study, we propose a fully-deterministic hybrid surface EMG (sEMG) decomposition approach that combines the advantages of both template-based and Blind Source Separation (BSS) decomposition approaches, a.k.a. guided source separation (GSS), to identify motor unit (MU) firing patterns. We use the single-pass density-based clustering algorithm to identify possible cluster representatives in different sEMG channels. These cluster representatives are then used as initial points of modified gradient Convolution Kernel Compensation (gCKC) algorithm. Afterwards, we use the Kalman filter to reduce the noise impact and increase convergence rate of MU filter identification by gCKC. Moreover, we designed an adaptive soft-thresholding method to identify MU firing times out of estimated MU spike trains. We tested the proposed algorithm on a set of synthetic sEMG signals with known MU firing patterns. A grid of 9 × 10 monopolar surface electrodes with 5-mm inter-electrode distances in both directions was simulated. Muscle excitation was set to 10, 30, and 50%. Colored Gaussian zero-mean noise with the signal-to-noise ratio (SNR) of 10, 20, and 30 dB, respectively, was added to 16 s long sEMG signals that were sampled at 4,096 Hz. Overall, 45 simulated signals were analyzed. Our decomposition approach was compared with gCKC algorithm. Overall, in our algorithm, the average numbers of identified MUs and Rate-of-Agreement (RoA) were 16.41 ± 4.18 MUs and 84.00 ± 0.06%, respectively, whereas the gCKC identified 12.10 ± 2.32 MUs with the average RoA of 90.78 ± 0.08%. Therefore, the proposed GSS method identified more MUs than the gCKC, with comparable performance. Its performance was dependent on the signal quality but not the signal complexity at different force levels. The proposed algorithm is a promising new offline tool in clinical neurophysiology.
Dyslipidemia, the disorder of lipoprotein metabolism resulting in high lipid profile, is an important modifiable risk factor for coronary heart diseases. It is associated with more than four million worldwide deaths per year. Half of the children with dyslipidemia have hyperlipidemia during adulthood, and its prediction and screening are thus critical. We designed a new dyslipidemia diagnosis system. The sample size of 725 subjects (age 14.66 ± 2.61 years; 48% male; dyslipidemia prevalence of 42%) was selected by multistage random cluster sampling in Iran. Single nucleotide polymorphisms (rs1801177, rs708272, rs320, rs328, rs2066718, rs2230808, rs5880, rs5128, rs2893157, rs662799, and Apolipoprotein-E2/E3/E4), and anthropometric, life-style attributes, and family history of diseases were analyzed. A framework for classifying mixed-type data in imbalanced datasets was proposed. It included internal feature mapping and selection, re-sampling, optimized group method of data handling using convex and stochastic optimizations, a new cost function for imbalanced data and an internal validation. Its performance was assessed using hold-out and 4-foldcross-validation. Four other classifiers namely as supported vector machines, decision tree, and multilayer perceptron neural network and multiple logistic regression were also used. The average sensitivity, specificity, precision and accuracy of the proposed system were 93%, 94%, 94% and 92%, respectively in cross validation. It significantly outperformed the other classifiers and also showed excellent agreement and high correlation with the gold standard. A non-invasive economical version of the algorithm was also implemented suitable for low- and middle-income countries. It is thus a promising new tool for the prediction of dyslipidemia.
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