Preoperative Differentiation of HER2-Zero and HER2-Low from HER2-Positive Invasive Ductal Breast Cancers Using BI-RADS MRI Features and Machine Learning Modeling.

BACKGROUND: Accurate determination of human epidermal growth factor receptor 2 (HER2) is important for choosing optimal HER2 targeting treatment strategies. HER2-low is currently considered HER2-negative, but patients may be eligible to receive new anti-HER2 drug conjugates. PURPOSE: To use breast MRI BI-RADS features for classifying three HER2 levels, first to distinguish HER2-zero from HER2-low/positive (Task-1), and then to distinguish HER2-low from HER2-positive (Task-2). STUDY TYPE: Retrospective. POPULATION: 621 invasive ductal cancer, 245 HER2-zero, 191 HER2-low, and 185 HER2-positive. For Task-1, 488 cases for training and 133 for testing. For Task-2, 294 cases for training and 82 for testing. FIELD STRENGTH/SEQUENCE: 3.0 T; 3D T1-weighted DCE, short time inversion recovery T2, and single-shot EPI DWI. ASSESSMENT: Pathological information and BI-RADS features were compared. Random Forest was used to select MRI features, and then four machine learning (ML) algorithms: decision tree (DT), support vector machine (SVM), k-nearest neighbors (k-NN), and artificial neural nets (ANN), were applied to build models. STATISTICAL TESTS: Chi-square test, one-way analysis of variance, and Kruskal-Wallis test were performed. The P values <0.05 were considered statistically significant. For ML models, the generated probability was used to construct the ROC curves. RESULTS: Peritumoral edema, the presence of multiple lesions and non-mass enhancement (NME) showed significant differences. For distinguishing HER2-zero from non-zero (low + positive), multiple lesions, edema, margin, and tumor size were selected, and the k-NN model achieved the highest AUC of 0.86 in the training set and 0.79 in the testing set. For differentiating HER2-low from HER2-positive, multiple lesions, edema, and margin were selected, and the DT model achieved the highest AUC of 0.79 in the training set and 0.69 in the testing set. DATA CONCLUSION: BI-RADS features read by radiologists from preoperative MRI can be analyzed using more sophisticated feature selection and ML algorithms to build models for the classification of HER2 status and identify HER2-low. TECHNICAL EFFICACY: Stage 2.

Motion-artifact-augmented pseudo-label network for semi-supervised brain tumor segmentation.

MRI image segmentation is widely used in clinical practice as a prerequisite and a key for diagnosing brain tumors. The quest for an accurate automated segmentation method for brain tumor images, aiming to ease clinical doctors' workload, has gained significant attention as a research focal point. Despite the success of fully supervised methods in brain tumor segmentation, challenges remain. Due to the high cost involved in annotating medical images, the dataset available for training fully supervised methods is very limited. Additionally, medical images are prone to noise and motion artifacts, negatively impacting quality. In this work, we propose MAPSS, a motion-artifact-augmented pseudo-label network for semi-supervised segmentation. Our method combines motion artifact data augmentation with the pseudo-label semi-supervised training framework. We conduct several experiments under different semi-supervised settings on a publicly available dataset BraTS2020 for brain tumor segmentation. The experimental results show that MAPSS achieves accurate brain tumor segmentation with only a small amount of labeled data and maintains robustness in motion-artifact-influenced images. We also assess the generalization performance of MAPSS using the Left Atrium dataset. Our algorithm is of great significance for assisting doctors in formulating treatment plans and improving treatment quality.

Deep Learning-Based Multiparametric MRI Model for Preoperative T-Stage in Rectal Cancer.

BACKGROUND: Conventional MRI staging can be challenging in the preoperative assessment of rectal cancer. Deep learning methods based on MRI have shown promise in cancer diagnosis and prognostication. However, the value of deep learning in rectal cancer T-staging is unclear. PURPOSE: To develop a deep learning model based on preoperative multiparametric MRI for evaluation of rectal cancer and to investigate its potential to improve T-staging accuracy. STUDY TYPE: Retrospective. POPULATION: After cross-validation, 260 patients (123 with T-stage T1-2 and 134 with T-stage T3-4) with histopathologically confirmed rectal cancer were randomly divided to the training (N = 208) and test sets (N = 52). FIELD STRENGTH/SEQUENCE: 3.0 T/Dynamic contrast enhanced (DCE), T2-weighted imaging (T2W), and diffusion-weighted imaging (DWI). ASSESSMENT: The deep learning (DL) model of multiparametric (DCE, T2W, and DWI) convolutional neural network were constructed for evaluating preoperative diagnosis. The pathological findings served as the reference standard for T-stage. For comparison, the single parameter DL-model, a logistic regression model composed of clinical features and subjective assessment of radiologists were used. STATISTICAL TESTS: The receiver operating characteristic curve (ROC) was used to evaluate the models, the Fleiss' kappa for the intercorrelation coefficients, and DeLong test for compare the diagnostic performance of ROCs. P-values less than 0.05 were considered statistically significant. RESULTS: The Area Under Curve (AUC) of the multiparametric DL-model was 0.854, which was significantly higher than the radiologist's assessment (AUC = 0.678), clinical model (AUC = 0.747), and the single parameter DL-models including T2W-model (AUC = 0.735), DWI-model (AUC = 0.759), and DCE-model (AUC = 0.789). DATA CONCLUSION: In the evaluation of rectal cancer patients, the proposed multiparametric DL-model outperformed the radiologist's assessment, the clinical model as well as the single parameter models. The multiparametric DL-model has the potential to assist clinicians by providing more reliable and precise preoperative T staging diagnosis. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

Mechanism of balloon burst during transcatheter aortic valve replacement pre-dilatation: Image observation and validation by finite element analysis.

BACKGROUND: Balloon burst during transcatheter aortic valve replacement (TAVR) is serious complication. This study pioneers a novel approach by combining image observation and computer simulation validation to unravel the mechanism of balloon burst in a patient with bicuspid aortic valve (BAV) stenosis. METHOD: A new computational model for balloon pre-dilatation was developed by incorporating the element failure criteria according to the Law of Laplace. The effects of calcification and aortic tissue material parameters, friction coefficients, balloon types and aortic anatomy classification were performed to validate and compare the expansion behavior and rupture mode of actual balloon. RESULTS: Balloon burst was dissected into three distinct stages based on observable morphological changes. The mechanism leading to the complete transverse burst of the non-compliant balloon initiated at the folding edges, where contacted with heavily calcified masses at the right coronary sinus, resulting in high maximum principal stress. Local sharp spiked calcifications facilitated rapid crack propagation. The elastic moduli of calcification significantly influenced balloon expansion behavior and crack morphology. The simulation case of the calcific elastic modulus was set at 12.6 MPa could closely mirror clinical appearance of expansion behavior and crack pattern. Furthermore, the case of semi-compliant balloons introduced an alternative rupture mechanism as pinhole rupture, driven by local sharp spiked calcifications. CONCLUSIONS: The computational model of virtual balloons could effectively simulate balloon dilation behavior and burst mode during TAVR pre-dilation. Further research with a larger cohort is needed to investigate the balloon morphology during pre-dilation by using this method to guide prosthesis sizing for potential favorable outcomes.

Magnetic Resonance Imaging Features Associated with a High and Low Expression of Tumor-Infiltrating Lymphocytes: A Stratified Analysis According to Molecular Subtypes.

A total of 457 patients, including 241 HR+/HER2- patients, 134 HER2+ patients, and 82 TN patients, were studied. The percentage of TILs in the stroma adjacent to the tumor cells was assessed using a 10% cutoff. The low TIL percentages were 82% in the HR+ patients, 63% in the HER2+ patients, and 56% in the TN patients (p < 0.001). MRI features such as morphology as mass or non-mass enhancement (NME), shape, margin, internal enhancement, presence of peritumoral edema, and the DCE kinetic pattern were assessed. Tumor sizes were smaller in the HR+/HER2- group (p < 0.001); HER2+ was more likely to present as NME (p = 0.031); homogeneous enhancement was mostly seen in HR+ (p < 0.001); and the peritumoral edema was present in 45% HR+, 71% HER2+, and 80% TN (p < 0.001). In each subtype, the MR features between the high- vs. low-TIL groups were compared. In HR+/HER2-, peritumoral edema was more likely to be present in those with high TILs (70%) than in those with low TILs (40%, p < 0.001). In TN, those with high TILs were more likely to present a regular shape (33%) than those with low TILs (13%, p = 0.029) and more likely to present the circumscribed margin (19%) than those with low TILs (2%, p = 0.009).

Cell division cycle 42 effector protein 4 inhibits prostate cancer progression by suppressing ERK signaling pathway.

Prostate cancer (PCa) is the most common malignancy among men worldwide. The cell division cycle 42 effector protein 4 (CDC42EP4) functions downstream of CDC42, yet its role and molecular mechanisms in PCa remain unexplored. This study aimed to elucidate the role of CDC42EP4 in the progression of PCa and its underlying mechanisms. Bioinformatical analysis indicated that CDC42EP4 expression was significantly lower in PCa tissue compared to normal prostate tissue. Cellular phenotyping analysis suggested that CDC42EP4 markedly inhibited the proliferation, migration, and invasion of PCa cells. Xenograft tumor assays further demonstrated that CDC42EP4 suppressed the growth of PCa cells in vivo. Mechanistically, the study established that CDC42EP4 inhibited the ERK pathway in PCa cells. Additionally, the ERK pathway inhibitor PD0325901 was employed, revealing that PD0325901 significantly nullified the effects of CDC42EP4 on PCa cell proliferation, migration, and invasion. Collectively, our findings demonstrate that CDC42EP4 acts as a critical tumor suppressor gene, inhibiting PCa cell proliferation, migration, and invasion through the ERK pathway, thereby presenting potential targets for PCa therapy.

Development of a deep learning model for early gastric cancer diagnosis using preoperative computed tomography images.

Background: Gastric cancer is a highly prevalent and fatal disease. Accurate differentiation between early gastric cancer (EGC) and advanced gastric cancer (AGC) is essential for personalized treatment. Currently, the diagnostic accuracy of computerized tomography (CT) for gastric cancer staging is insufficient to meet clinical requirements. Many studies rely on manual marking of lesion areas, which is not suitable for clinical diagnosis. Methods: In this study, we retrospectively collected data from 341 patients with gastric cancer at the First Affiliated Hospital of Wenzhou Medical University. The dataset was randomly divided into a training set (n=273) and a validation set (n=68) using an 8:2 ratio. We developed a two-stage deep learning model that enables fully automated EGC screening based on CT images. In the first stage, an unsupervised domain adaptive segmentation model was employed to automatically segment the stomach on unlabeled portal phase CT images. Subsequently, based on the results of the stomach segmentation model, the image was cropped out of the stomach area and scaled to a uniform size, and then the EGC and AGC classification models were built based on these images. The segmentation accuracy of the model was evaluated using the dice index, while the classification performance was assessed using metrics such as the area under the curve (AUC) of the receiver operating characteristic (ROC), accuracy, sensitivity, specificity, and F1 score. Results: The segmentation model achieved an average dice accuracy of 0.94 on the hand-segmented validation set. On the training set, the EGC screening model demonstrated an AUC, accuracy, sensitivity, specificity, and F1 score of 0.98, 0.93, 0.92, 0.92, and 0.93, respectively. On the validation set, these metrics were 0.96, 0.92, 0.90, 0.89, and 0.93, respectively. After three rounds of data regrouping, the model consistently achieved an AUC above 0.9 on both the validation set and the validation set. Conclusion: The results of this study demonstrate that the proposed method can effectively screen for EGC in portal venous CT images. Furthermore, the model exhibits stability and holds promise for future clinical applications.

An enhanced grey wolf optimizer boosted machine learning prediction model for patient-flow prediction.

Large and medium-sized general hospitals have adopted artificial intelligence big data systems to optimize the management of medical resources to improve the quality of hospital outpatient services and decrease patient wait times in recent years as a result of the development of medical information technology and the rise of big medical data. However, owing to the impact of several elements, including the physical environment, patient, and physician behaviours, the real optimum treatment effect does not meet expectations. In order to promote orderly patient access, this work provides a patient-flow prediction model that takes into account shifting dynamics and objective rules of patient-flow to handle this issue and forecast patients' medical requirements. First, we propose a high-performance optimization method (SRXGWO) and integrate the Sobol sequence, Cauchy random replacement strategy, and directional mutation mechanism into the grey wolf optimization (GWO) algorithm. The patient-flow prediction model (SRXGWO-SVR) is then proposed using SRXGWO to optimize the parameters of support vector regression (SVR). Twelve high-performance algorithms are examined in the benchmark function experiments' ablation and peer algorithm comparison tests, which are intended to validate SRXGWO's optimization performance. In order to forecast independently in the patient-flow prediction trials, the data set is split into training and test sets. The findings demonstrated that SRXGWO-SVR outperformed the other seven peer models in terms of prediction accuracy and error. As a result, SRXGWO-SVR is anticipated to be a reliable and efficient patient-flow forecast system that may help hospitals manage medical resources as effectively as possible.

Attention guided neural ODE network for breast tumor segmentation in medical images.

Breast cancer is the most common cancer in women. Ultrasound is a widely used screening tool for its portability and easy operation, and DCE-MRI can highlight the lesions more clearly and reveal the characteristics of tumors. They are both noninvasive and nonradiative for assessment of breast cancer. Doctors make diagnoses and further instructions through the sizes, shapes and textures of the breast masses showed on medical images, so automatic tumor segmentation via deep neural networks can to some extent assist doctors. Compared to some challenges which the popular deep neural networks have faced, such as large amounts of parameters, lack of interpretability, overfitting problem, etc., we propose a segmentation network named Att-U-Node which uses attention modules to guide a neural ODE-based framework, trying to alleviate the problems mentioned above. Specifically, the network uses ODE blocks to make up an encoder-decoder structure, feature modeling by neural ODE is completed at each level. Besides, we propose to use an attention module to calculate the coefficient and generate a much refined attention feature for skip connection. Three public available breast ultrasound image datasets (i.e. BUSI, BUS and OASBUD) and a private breast DCE-MRI dataset are used to assess the efficiency of the proposed model, besides, we upgrade the model to 3D for tumor segmentation with the data selected from Public QIN Breast DCE-MRI. The experiments show that the proposed model achieves competitive results compared with the related methods while mitigates the common problems of deep neural networks.

Ribosomal protein L22-like1 promotes prostate cancer progression by activating PI3K/Akt/mTOR signalling pathway.

Prostate cancer (PCa) is one of the most common malignancies in men. Ribosomal protein L22-like1 (RPL22L1), a component of the ribosomal 60 S subunit, is associated with cancer progression, but the role and potential mechanism of RPL22L1 in PCa remain unclear. The aim of this study was to investigate the role of RPL22L1 in PCa progression and the mechanisms involved. Bioinformatics and immunohistochemistry analysis showed that the expression of RPL22L1 was significantly higher in PCa tissues than in normal prostate tissues. The cell function analysis revealed that RPL22L1 significantly promoted the proliferation, migration and invasion of PCa cells. The data of xenograft tumour assay suggested that the low expression of RPL22L1 inhibited the growth and invasion of PCa cells in vivo. Mechanistically, the results of Western blot proved that RPL22L1 activated PI3K/Akt/mTOR pathway in PCa cells. Additionally, LY294002, an inhibitor of PI3K/Akt pathway, was used to block this pathway. The results showed that LY294002 remarkably abrogated the oncogenic effect of RPL22L1 on PCa cell proliferation and invasion. Taken together, our study demonstrated that RPL22L1 is a key gene in PCa progression and promotes PCa cell proliferation and invasion via PI3K/Akt/mTOR pathway, thus potentially providing a new target for PCa therapy.

Development and evaluation of machine learning models and nomogram for the prediction of severe acute pancreatitis.

BACKGROUND AND AIM: Severe acute pancreatitis (SAP) in patients progresses rapidly and can cause multiple organ failures associated with high mortality. We aimed to train a machine learning (ML) model and establish a nomogram that could identify SAP, early in the course of acute pancreatitis (AP). METHODS: In this retrospective study, 631 patients with AP were enrolled in the training cohort. For predicting SAP early, five supervised ML models were employed, such as random forest (RF), K-nearest neighbors (KNN), and naive Bayes (NB), which were evaluated by accuracy (ACC) and the areas under the receiver operating characteristic curve (AUC). The nomogram was established, and the predictive ability was assessed by the calibration curve and AUC. They were externally validated by an independent cohort of 109 patients with AP. RESULTS: In the training cohort, the AUC of RF, KNN, and NB models were 0.969, 0.954, and 0.951, respectively, while the AUC of the Bedside Index for Severity in Acute Pancreatitis (BISAP), Ranson and Glasgow scores were only 0.796, 0.847, and 0.837, respectively. In the validation cohort, the RF model also showed the highest AUC, which was 0.961. The AUC for the nomogram was 0.888 and 0.955 in the training and validation cohort, respectively. CONCLUSIONS: Our findings suggested that the RF model exhibited the best predictive performance, and the nomogram provided a visual scoring model for clinical practice. Our models may serve as practical tools for facilitating personalized treatment options and improving clinical outcomes through pre-treatment stratification of patients with AP.

Microcystin­leucine arginine promotes colorectal cancer cell proliferation by activating the PI3K/Akt/Wnt/ß­catenin pathway.

Microcystin­leucine arginine (MC­LR) is an environmental toxin produced by cyanobacteria and is considered to be a potent carcinogen. However, to the best of our knowledge, the effect of MC­LR on colorectal cancer (CRC) cell proliferation has never been studied. The aim of the present study was to investigate the effect of MC­LR on CRC cell proliferation and the underlying mechanisms. Firstly, a Cell Counting Kit­8 (CCK­8) assay was conducted to determine cell viability at different concentrations, and 50 nM MC­LR was chosen for further study. Subsequently, a longer CCK­8 assay and a cell colony formation assay showed that MC­LR promoted SW620 and HT29 cell proliferation. Furthermore, western blotting analysis showed that MC­LR significantly upregulated protein expression of PI3K, p­Akt (Ser473), p­GSK3ß (Ser9), ß­catenin, c­myc and cyclin D1, suggesting that MC­LR activated the PI3K/Akt and Wnt/ß­catenin pathways in SW620 and HT29 cells. Finally, the pathway inhibitors LY294002 and ICG001 were used to validate the role of the PI3K/Akt and Wnt/ß­catenin pathways in MC­LR­accelerated cell proliferation. The results revealed that MC­LR activated Wnt/ß­catenin through the PI3K/Akt pathway to promote cell proliferation. Taken together, these data showed that MC­LR promoted CRC cell proliferation by activating the PI3K/Akt/Wnt/ß­catenin pathway. The present study provided a novel insight into the toxicological mechanism of MC­LR.

Differential evolution-assisted salp swarm algorithm with chaotic structure for real-world problems.

There is a new nature-inspired algorithm called salp swarm algorithm (SSA), due to its simple framework, it has been widely used in many fields. But when handling some complicated optimization problems, especially the multimodal and high-dimensional optimization problems, SSA will probably have difficulties in convergence performance or dropping into the local optimum. To mitigate these problems, this paper presents a chaotic SSA with differential evolution (CDESSA). In the proposed framework, chaotic initialization and differential evolution are introduced to enrich the convergence speed and accuracy of SSA. Chaotic initialization is utilized to produce a better initial population aim at locating a better global optimal. At the same time, differential evolution is used to build up the search capability of each agent and improve the sense of balance of global search and intensification of SSA. These mechanisms collaborate to boost SSA in accelerating convergence activity. Finally, a series of experiments are carried out to test the performance of CDESSA. Firstly, IEEE CEC2014 competition fuctions are adopted to evaluate the ability of CDESSA in working out the real-parameter optimization problems. The proposed CDESSA is adopted to deal with feature selection (FS) problems, then five constrained engineering optimization problems are also adopted to evaluate the property of CDESSA in dealing with real engineering scenarios. Experimental results reveal that the proposed CDESSA method performs significantly better than the original SSA and other compared methods.

Machine learning-based radiomics for multiple primary prostate cancer biological characteristics prediction with 18F-PSMA-1007 PET: comparison among different volume segmentation thresholds.

BACKGROUND: PET-based radiomics features could predict the biological characteristics of primary prostate cancer (PCa). However, the optimal thresholds to predict the biological characteristics of PCa are unknown. This study aimed to compare the predictive power of 18F-PSMA-1007 PET radiomics features at different thresholds for predicting multiple biological characteristics. METHODS: One hundred and seventy-three PCa patients with complete preoperative 18F-PSMA-1007 PET examination and clinical data before surgery were collected. The prostate lesions' volumes of interest were semi-automatically sketched with thresholds of 30%, 40%, 50%, and 60% maximum standardized uptake value (SUVmax). The radiomics features were respectively extracted. The prediction models of Gleason score (GS), extracapsular extension (ECE), and vascular invasion (VI) were established using the support vector machine. The performance of models from different thresholding regions was assessed using receiver operating characteristic curve and confusion matrix-derived indexes. RESULTS: For predicting GS, the 50% SUVmax model showed the best predictive performance in training (AUC, 0.82 [95%CI 0.74-0.88]) and testing cohorts (AUC, 0.80 [95%CI 0.66-0.90]). For predicting ECE, the 40% SUVmax model exhibit the best predictive performance (AUC, 0.77 [95%CI 0.68-0.84] and 0.77 [95%CI 0.63-0.88]). As for VI, the 50% SUVmax model had the best predictive performance (AUC, 0.74 [95%CI 0.65-0.82] and 0.74 [95%CI 0.56-0.82]). CONCLUSION: The 18F-1007-PSMA PET-based radiomics features at 40-50% SUVmax showed the best predictive performance for multiple PCa biological characteristics evaluation. Compared to the single PSA model, radiomics features may provide additional benefits in predicting the biological characteristics of PCa.

Boosted Sine Cosine Algorithm with Application to Medical Diagnosis.

The sine cosine algorithm (SCA) was proposed for solving optimization tasks, of which the way to obtain the optimal solution is mainly through the continuous iteration of the sine and cosine update formulas. However, SCA also faces low population diversity and stagnation of locally optimal solutions. Hence, we try to eliminate these problems by proposing an enhanced version of SCA, named ESCA_PSO. ESCA_PSO is proposed based on hybrid SCA and particle swarm optimization (PSO) by incorporating multiple mutation strategies into the original SCA_PSO. To validate the effect of ESCA_PSO in handling global optimization problems, ESCA_PSO was compared with quality algorithms on various types of benchmark functions. In addition, the proposed ESCA_PSO was employed to tune the best parameters of support vector machines for dealing with medical diagnosis tasks. The results prove the efficiency of the proposed algorithms in solving optimization problems.

Moderate-Severe White Matter Lesion Predicts Delayed Intraventricular Hemorrhage in Intracerebral Hemorrhage.

BACKGROUND: Most existing studies have focused on the correlation between white matter lesion (WML) and baseline intraventricular hemorrhage (IVH) in patients with intracerebral hemorrhage (ICH), whereas few studies have investigated the relationship between WML severity and delayed IVH after admission. This study aimed to investigate the correlation between WML severity and delayed IVH and to verify the association between WML and baseline IVH. METHODS: A total of 480 patients with spontaneous ICH from February 2018 to October 2020 were selected. WML was scored using the Van Swieten Scale, with scores of 0-2 representing nonslight WML and scores of 3-4 representing moderate-severe WML. We determined the presence of IVH on baseline (< 6 h) and follow-up computed tomography (< 72 h) images. Univariate analysis and multiple logistic regression were used to analyze the influencing factors of baseline and delayed IVH. RESULTS: Among 480 patients with ICH, 172 (35.8%) had baseline IVH, and there was a higher proportion of moderate-severe WML in patients with baseline IVH (20.3%) than in those without baseline IVH (12.7%) (P = 0.025). Among 308 patients without baseline IVH, delayed IVH was found in 40 patients (12.9%), whose proportion of moderate-severe WML (25.0%) was higher than that in patients without delayed IVH (10.8%) (P = 0.012). Multiple logistic regression results showed that moderate-severe WML was independently correlated with baseline IVH (P = 0.006, odds ratio = 2.266, 95% confidence interval = 1.270-4.042) and delayed IVH (P = 0.002, odds ratio = 7.009, 95% confidence interval = 12.086-23.552). CONCLUSIONS: Moderate-severe WML was an independent risk factor for delayed IVH as well as baseline IVH.

Microcystin-LR induced microfilament rearrangement and cell invasion by activating ERK/VASP/ezrin pathway in DU145 cells.

Microcystin-LR (MC-LR) is an environmental toxin that is synthesized by cyanobacteria and considered a potential human carcinogen. However, the role of MC-LR in prostate cancer progression has not been elucidated. The purpose of this study was to investigate the effect of MC-LR on prostate cancer cell invasion and its underlying mechanisms. Transwell assay was performed, and the result showed that MC-LR increased DU145 cell invasion in a concentration-dependent manner. The result of Western blot showed that MC-LR promoted ERK phosphorylation, while enhancing VASP and ezrin phosphorylation. Moreover, PD0325901 was used to verify the role of the ERK/VASP/ezrin axis in MC-LR-promoted cell invasion. The results revealed that MC-LR promoted microfilament rearrangement and cell invasion by activating the ERK/VASP/ezrin pathway in DU145 cells. Finally, in vivo assay was performed, and the result suggested that MC-LR promoted p-ERK, p-VASP and p-ezrin expression and local invasion in nude mice model. Taken together, our data proved that MC-LR induced microfilament rearrangement and cell invasion by activating the ERK/VASP/ezrin pathway in DU145 cells.

Chaotic simulated annealing multi-verse optimization enhanced kernel extreme learning machine for medical diagnosis.

Classification models such as Multi-Verse Optimization (MVO) play a vital role in disease diagnosis. To improve the efficiency and accuracy of MVO, in this paper, the defects of MVO are mitigated and the improved MVO is combined with kernel extreme learning machine (KELM) for effective disease diagnosis. Although MVO obtains some relatively good results on some problems of interest, it suffers from slow convergence speed and local optima entrapment for some many-sided basins, especially multi-modal problems with high dimensions. To solve these shortcomings, in this study, a new chaotic simulated annealing overhaul of MVO (CSAMVO) is proposed. Based on MVO, two approaches are adopted to offer a relatively stable and efficient convergence speed. Specifically, a chaotic intensification mechanism (CIP) is applied to the optimal universe evaluation stage to increase the depth of the universe search. After obtaining relatively satisfactory results, the simulated annealing algorithm (SA) is employed to reinforce the capability of MVO to avoid local optima. To evaluate its performance, the proposed CSAMVO approach was compared with a wide range of classical algorithms on thirty-nine benchmark functions. The results show that the improved MVO outperforms the other algorithms in terms of solution quality and convergence speed. Furthermore, based on CSAMVO, a hybrid KELM model termed CSAMVO-KELM is established for disease diagnosis. To evaluate its effectiveness, the new hybrid system was compared with a multitude of competitive classifiers on two disease diagnosis problems. The results demonstrate that the proposed CSAMVO-assisted classifier can find solutions with better learning potential and higher predictive performance.

Performance optimization of support vector machine with oppositional grasshopper optimization for acute appendicitis diagnosis.

Preoperative differentiation of complicated and uncomplicated appendicitis is challenging. The research goal was to construct a new intelligent diagnostic rule that is accurate, fast, noninvasive, and cost-effective, distinguishing between complicated and uncomplicated appendicitis. Overall, 298 patients with acute appendicitis from the Wenzhou Central Hospital were recruited, and information on their demographic characteristics, clinical findings, and laboratory data was retrospectively reviewed and applied in this study. First, the most significant variables, including C-reactive protein (CRP), heart rate, body temperature, and neutrophils discriminating complicated from uncomplicated appendicitis, were identified using random forest analysis. Second, an improved grasshopper optimization algorithm-based support vector machine was used to construct the diagnostic model to discriminate complicated appendicitis (CAP) from uncomplicated appendicitis (UAP). The resultant optimal model can produce an average of 83.56% accuracy, 81.71% sensitivity, 85.33% specificity, and 0.6732 Matthews correlation coefficients. Based on existing routinely available markers, the proposed intelligent diagnosis model is highly reliable. Thus, the model can potentially be used to assist doctors in making correct clinical decisions.

Evolving kernel extreme learning machine for medical diagnosis via a disperse foraging sine cosine algorithm.

Kernel extreme learning machine (KELM) has been widely used in the fields of classification and identification since it was proposed. As the parameters in the KELM model have a crucial impact on performance, they must be optimized before the model can be applied in practical areas. In this study, to improve optimization performance, a new parameter optimization strategy is proposed, based on a disperse foraging sine cosine algorithm (DFSCA), which is utilized to force some portions of search agents to explore other potential regions. Meanwhile, DFSCA is integrated into KELM to establish a new machine learning model named DFSCA-KELM. Firstly, using the CEC2017 benchmark suite, the exploration and exploitation capabilities of DFSCA were demonstrated. Secondly, evaluation of the model DFSCA-KELM on six medical datasets extracted from the UCI machine learning repository for medical diagnosis proved the effectiveness of the proposed model. At last, the model DFSCA-KELM was applied to solve two real medical cases, and the results indicate that DFSCA-KELM can also deal with practical medical problems effectively. Taken together, these results show that the proposed technique can be regarded as a promising tool for medical diagnosis.