Applications of machine learning tools for ultra-sensitive detection of lipoarabinomannan with plasmonic grating biosensors in clinical samples of tuberculosis.

BACKGROUND: Tuberculosis is one of the top ten causes of death globally and the leading cause of death from a single infectious agent. Eradicating the Tuberculosis epidemic by 2030 is one of the top United Nations Sustainable Development Goals. Early diagnosis is essential to achieving this goal because it improves individual prognosis and reduces transmission rates of asymptomatic infected. We aim to support this goal by developing rapid and sensitive diagnostics using machine learning algorithms to minimize the need for expert intervention. METHODS AND FINDINGS: A single molecule fluorescence immunosorbent assay was used to detect Tuberculosis biomarker lipoarabinomannan from a set of twenty clinical patient samples and a control set of spiked human urine. Tuberculosis status was separately confirmed by GeneXpert MTB/RIF and cell culture. Two machine learning algorithms, an automatic and a semiautomatic model, were developed and trained by the calibrated lipoarabinomannan titration assay data and then tested against the ground truth patient data. The semiautomatic model differed from the automatic model by an expert review step in the former, which calibrated the lower threshold to determine single molecules from background noise. The semiautomatic model was found to provide 88.89% clinical sensitivity, while the automatic model resulted in 77.78% clinical sensitivity. CONCLUSIONS: The semiautomatic model outperformed the automatic model in clinical sensitivity as a result of the expert intervention applied during calibration and both models vastly outperformed manual expert counting in terms of time-to-detection and completion of analysis. Meanwhile, the clinical sensitivity of the automatic model could be improved significantly with a larger training dataset. In short, semiautomatic, and automatic Gaussian Mixture Models have a place in supporting rapid detection of Tuberculosis in resource-limited settings without sacrificing clinical sensitivity.

A Spatiotemporal Analytical Outlook of the Exposure to Air Pollution and COVID-19 Mortality in the USA.

The world is experiencing a pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), also known as COVID-19. The USA is also suffering from a catastrophic death toll from COVID-19. Several studies are providing preliminary evidence that short- and long-term exposure to air pollution might increase the severity of COVID-19 outcomes, including a higher risk of death. In this study, we develop a spatiotemporal model to estimate the association between exposure to fine particulate matter PM2.5 and mortality accounting for several social and environmental factors. More specifically, we implement a Bayesian zero-inflated negative binomial regression model with random effects that vary in time and space. Our goal is to estimate the association between air pollution and mortality accounting for the spatiotemporal variability that remained unexplained by the measured confounders. We applied our model to four regions of the USA with weekly data available for each county within each region. We analyze the data separately for each region because each region shows a different disease spread pattern. We found a positive association between long-term exposure to PM2.5 and the mortality from the COVID-19 disease for all four regions with three of four being statistically significant. Data and code are available at our GitHub repository. Supplementary materials accompanying this paper appear on-line. Supplementary Information: The online version contains supplementary material available at 10.1007/s13253-022-00487-1.

Lag time between state-level policy interventions and change points in COVID-19 outcomes in the United States.

State-level policy interventions have been critical in managing the spread of the new coronavirus. Here, we study the lag time between policy interventions and change in COVID-19 outcome trajectory in the United States. We develop a stepwise drifts random walk model to account for non-stationarity and strong temporal correlation and subsequently apply a change-point detection algorithm to estimate the number and times of change points in the COVID-19 outcome data. Furthermore, we harmonize data on the estimated change points with non-pharmaceutical interventions adopted by each state of the United States, which provides us insights regarding the lag time between the enactment of a policy and its effect on COVID-19 outcomes. We present the estimated change points for each state and the District of Columbia and find five different emerging trajectory patterns. We also provide insight into the lag time between the enactment of a policy and its effect on COVID-19 outcomes.

A Practical Overview and Reporting Strategies for Statistical Analysis of Survival Studies.

Survival (time-to-event) analysis is commonly used in clinical research. Key features of performing a survival analysis include checking proportional hazards assumptions, reporting CIs for hazards ratios and relative risks, graphically displaying the findings, and analyzing with consideration of competing risks. This article provides a brief overview of important statistical considerations for survival analysis. Censoring schemes, different methods of survival function estimation, and ways to compare survival curves are described. We also explain competing risk and how to model survival data in the presence of it. Different kinds of bias that influence survival estimation and avenues to model the data under these circumstances are also described. Several analysis techniques are accompanied by graphical representations illustrating proper reporting strategies. We provide a list of guiding statements for researchers and reviewers.

A Practical Overview of Case-Control Studies in Clinical Practice.

Case-control studies are one of the major observational study designs for performing clinical research. The advantages of these study designs over other study designs are that they are relatively quick to perform, economical, and easy to design and implement. Case-control studies are particularly appropriate for studying disease outbreaks, rare diseases, or outcomes of interest. This article describes several types of case-control designs, with simple graphical displays to help understand their differences. Study design considerations are reviewed, including sample size, power, and measures associated with risk factors for clinical outcomes. Finally, we discuss the advantages and disadvantages of case-control studies and provide a checklist for authors and a framework of considerations to guide reviewers' comments.

Functional modeling of pedaling kinematics for the Stroke patients.

Understanding deficits in motor control through the analysis of pedaling biomechanics plays a key role in the treatment of stroke patients. A thorough study of the impact of different exercise patterns and workloads on the change between pre- and post-treatment movement patterns in the patients is therefore of utmost importance to the clinicians. The objective of this study was to analyze the difference between pre- and post-treatment pedaling torques when the patients are subject to different exercise groups with varying workloads. The effects of affected vs unaffected side along with the covariates age and BMI have also been accounted for in this work. Two different three-way ANOVA-based approaches have been implemented here. In the first approach, a random projection-based ANOVA technique has been performed treating the pedaling torques as functional response, whereas the second approach utilizes distance measures to summarize the difference between pre- and post-treatment torques and perform nonparametric tests on it. Bayesian bootstrap has been used here to perform tests on the median distance. A group of stroke patients have been studied in the Cleveland Clinic categorizing them into different exercise groups and workload patterns. The data obtained have been analyzed with the aforementioned techniques, and the results have been reported here. These techniques turn out to be promising and will help clinicians recommend personalized treatment to stroke patients for optimal results.

Erratum: Author Correction: Evolutionary history of plant hosts and fungal symbionts predicts the strength of mycorrhizal mutualism.

[This corrects the article DOI: 10.1038/s42003-018-0120-9.].

Evolutionary history of plant hosts and fungal symbionts predicts the strength of mycorrhizal mutualism.

Most plants engage in symbioses with mycorrhizal fungi in soils and net consequences for plants vary widely from mutualism to parasitism. However, we lack a synthetic understanding of the evolutionary and ecological forces driving such variation for this or any other nutritional symbiosis. We used meta-analysis across 646 combinations of plants and fungi to show that evolutionary history explains substantially more variation in plant responses to mycorrhizal fungi than the ecological factors included in this study, such as nutrient fertilization and additional microbes. Evolutionary history also has a different influence on outcomes of ectomycorrhizal versus arbuscular mycorrhizal symbioses; the former are best explained by the multiple evolutionary origins of ectomycorrhizal lifestyle in plants, while the latter are best explained by recent diversification in plants; both are also explained by evolution of specificity between plants and fungi. These results provide the foundation for a synthetic framework to predict the outcomes of nutritional mutualisms.

Heritable genotype contrast mining reveals novel gene associations specific to autism subgroups.

Though the genetic etiology of autism is complex, our understanding can be improved by identifying genes and gene-gene interactions that contribute to the development of specific autism subtypes. Identifying such gene groupings will allow individuals to be diagnosed and treated according to their precise characteristics. To this end, we developed a method to associate gene combinations with groups with shared autism traits, targeting genetic elements that distinguish patient populations with opposing phenotypes. Our computational method prioritizes genetic variants for genome-wide association, then utilizes Frequent Pattern Mining to highlight potential interactions between variants. We introduce a novel genotype assessment metric, the Unique Inherited Combination support, which accounts for inheritance patterns observed in the nuclear family while estimating the impact of genetic variation on phenotype manifestation at the individual level. High-contrast variant combinations are tested for significant subgroup associations. We apply this method by contrasting autism subgroups defined by severe or mild manifestations of a phenotype. Significant associations connected 286 genes to the subgroups, including 193 novel autism candidates. 71 pairs of genes have joint associations with subgroups, presenting opportunities to investigate interacting functions. This study analyzed 12 autism subgroups, but our informatics method can explore other meaningful divisions of autism patients, and can further be applied to reveal precise genetic associations within other phenotypically heterogeneous disorders, such as Alzheimer's disease.

Rapid culture-based detection of living mycobacteria using microchannel electrical impedance spectroscopy (m-EIS).

BACKGROUND: Multiple techniques exist for detecting Mycobacteria, each having its own advantages and drawbacks. Among them, automated culture-based systems like the BACTEC-MGIT™ are popular because they are inexpensive, reliable and highly accurate. However, they have a relatively long "time-to-detection" (TTD). Hence, a method that retains the reliability and low-cost of the MGIT system, while reducing TTD would be highly desirable. METHODS: Living bacterial cells possess a membrane potential, on account of which they store charge when subjected to an AC-field. This charge storage (bulk capacitance) can be estimated using impedance measurements at multiple frequencies. An increase in the number of living cells during culture is reflected in an increase in bulk capacitance, and this forms the basis of our detection. M. bovis BCG and M. smegmatis suspensions with differing initial loads are cultured in MGIT media supplemented with OADC and Middlebrook 7H9 media respectively, electrical "scans" taken at regular intervals and the bulk capacitance estimated from the scans. Bulk capacitance estimates at later time-points are statistically compared to the suspension's baseline value. A statistically significant increase is assumed to indicate the presence of proliferating mycobacteria. RESULTS: Our TTDs were 60 and 36 h for M. bovis BCG and 20 and 9 h for M. smegmatis with initial loads of 1000 CFU/ml and 100,000 CFU/ml respectively. The corresponding TTDs for the commercial BACTEC MGIT 960 system were 131 and 84.6 h for M. bovis BCG and 41.7 and 12 h for M smegmatis, respectively. CONCLUSION: Our culture-based detection method using multi-frequency impedance measurements is capable of detecting mycobacteria faster than current commercial systems.

Rapid culture-based detection of living mycobacteria using microchannel electrical impedance spectroscopy (m-EIS)

BACKGROUND: Multiple techniques exist for detecting Mycobacteria, each having its own advantages and drawbacks. Among them, automated culture-based systems like the BACTEC-MGIT™ are popular because they are inexpensive, reliable and highly accurate. However, they have a relatively long "time-to-detection" (TTD). Hence, a method that retains the reliability and low-cost of the MGIT system, while reducing TTD would be highly desirable. METHODS: Living bacterial cells possess a membrane potential, on account of which they store charge when subjected to an AC-field. This charge storage (bulk capacitance) can be estimated using impedance measurements at multiple frequencies. An increase in the number of living cells during culture is reflected in an increase in bulk capacitance, and this forms the basis of our detection. M. bovis BCG and M. smegmatis suspensions with differing initial loads are cultured in MGIT media supplemented with OADC and Middlebrook 7H9 media respectively, electrical "scans" taken at regular intervals and the bulk capacitance estimated from the scans. Bulk capacitance estimates at later time-points are statistically compared to the suspension's baseline value. A statistically significant increase is assumed to indicate the presence of proliferating mycobacteria. RESULTS: Our TTDs were 60 and 36 h for M. bovis BCG and 20 and 9 h for M. smegmatis with initial loads of 1000 CFU/ml and 100,000 CFU/ml respectively. The corresponding TTDs for the commercial BACTEC MGIT 960 system were 131 and 84.6 h for M. bovis BCG and 41.7 and 12 h for M smegmatis, respectively. CONCLUSION: Our culture-based detection method using multi-frequency impedance measurements is capable of detecting mycobacteria faster than current commercial systems.

Serum miR-30e and miR-223 as Novel Noninvasive Biomarkers for Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is one of the most aggressive cancers and is the third leading cause of all cancer-related death. Limited noninvasive biomarkers are available for HCC detection. Early detection is the key in improving the survival of HCC patients. In this study, we tested the hypothesis that serum miRNAs can be used as a potential biomarker for HCC. Quantitative RT-PCR for miRNA analysis was performed using 70 serum samples. Receiver operating characteristic analysis was performed to measure the prognostic power of the miRNAs. The miRNA expression level was also measured from liver biopsy samples. Our study revealed that two miRNAs, miR-30e and miR-223, were expressed at significantly lower levels (P < 0.003) in the sera of HCC patients compared with healthy volunteers. Furthermore, expression of these miRNAs was compared between sera from chronic liver disease and sera from HCC patients. miR-30e and miR-223 expression was significantly lower in HCC sera compared with sera from chronic liver disease patients. Both miRNA expression levels were lower in HCC liver biopsy specimens compared with normal liver RNA. Taken together, our results suggested that serum miR-30e and miR-223 are useful biomarkers of HCC, irrespective of etiology, and deserve further study for their diagnostic value.

Predicting disease risks from highly imbalanced data using random forest.

BACKGROUND: We present a method utilizing Healthcare Cost and Utilization Project (HCUP) dataset for predicting disease risk of individuals based on their medical diagnosis history. The presented methodology may be incorporated in a variety of applications such as risk management, tailored health communication and decision support systems in healthcare. METHODS: We employed the National Inpatient Sample (NIS) data, which is publicly available through Healthcare Cost and Utilization Project (HCUP), to train random forest classifiers for disease prediction. Since the HCUP data is highly imbalanced, we employed an ensemble learning approach based on repeated random sub-sampling. This technique divides the training data into multiple sub-samples, while ensuring that each sub-sample is fully balanced. We compared the performance of support vector machine (SVM), bagging, boosting and RF to predict the risk of eight chronic diseases. RESULTS: We predicted eight disease categories. Overall, the RF ensemble learning method outperformed SVM, bagging and boosting in terms of the area under the receiver operating characteristic (ROC) curve (AUC). In addition, RF has the advantage of computing the importance of each variable in the classification process. CONCLUSIONS: In combining repeated random sub-sampling with RF, we were able to overcome the class imbalance problem and achieve promising results. Using the national HCUP data set, we predicted eight disease categories with an average AUC of 88.79%.

ComPhy: prokaryotic composite distance phylogenies inferred from whole-genome gene sets.

BACKGROUND: With the increasing availability of whole genome sequences, it is becoming more and more important to use complete genome sequences for inferring species phylogenies. We developed a new tool ComPhy, 'Composite Distance Phylogeny', based on a composite distance matrix calculated from the comparison of complete gene sets between genome pairs to produce a prokaryotic phylogeny. RESULTS: The composite distance between two genomes is defined by three components: Gene Dispersion Distance (GDD), Genome Breakpoint Distance (GBD) and Gene Content Distance (GCD). GDD quantifies the dispersion of orthologous genes along the genomic coordinates from one genome to another; GBD measures the shared breakpoints between two genomes; GCD measures the level of shared orthologs between two genomes. The phylogenetic tree is constructed from the composite distance matrix using a neighbor joining method. We tested our method on 9 datasets from 398 completely sequenced prokaryotic genomes. We have achieved above 90% agreement in quartet topologies between the tree created by our method and the tree from the Bergey's taxonomy. In comparison to several other phylogenetic analysis methods, our method showed consistently better performance. CONCLUSION: ComPhy is a fast and robust tool for genome-wide inference of evolutionary relationship among genomes. It can be downloaded from http://digbio.missouri.edu/ComPhy.

Bayesian neural networks for bivariate binary data: an application to prostate cancer study.

Prostate cancer is one of the most common cancers in American men. The cancer could either be locally confined, or it could spread outside the organ. When locally confined, there are several options for treating and curing this disease. Otherwise, surgery is the only option, and in extreme cases of outside spread, it could very easily recur within a short time even after surgery and subsequent radiation therapy. Hence, it is important to know, based on pre-surgery biopsy results how likely the cancer is organ-confined or not. The paper considers a hierarchical Bayesian neural network approach for posterior prediction probabilities of certain features indicative of non-organ confined prostate cancer. In particular, we find such probabilities for margin positivity (MP) and seminal vesicle (SV) positivity jointly. The available training set consists of bivariate binary outcomes indicating the presence or absence of the two. In addition, we have certain covariates such as prostate specific antigen (PSA), gleason score and the indicator for the cancer to be unilateral or bilateral (i.e. spread on one or both sides) in one data set and gene expression microarrays in another data set. We take a hierarchical Bayesian neural network approach to find the posterior prediction probabilities for a test and validation set, and compare these with the actual outcomes for the first data set. In case of the microarray data we use leave one out cross-validation to access the accuracy of our method. We also demonstrate the superiority of our method to the other competing methods through a simulation study. The Bayesian procedure is implemented by an application of the Markov chain Monte Carlo numerical integration technique. For the problem at hand, our Bayesian bivariate neural network procedure is shown to be superior to the classical neural network, Radford Neal's Bayesian neural network as well as bivariate logistic models to predict jointly the MP and SV in a patient in both the data sets as well as in the simulation study.