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Background: Essential proteins are an important part of the cell and closely related to the life activities of the cell. Hitherto, Protein-Protein Interaction (PPI) networks have been adopted by many computational methods to predict essential proteins. Most of the current approaches focus mainly on the topological structure of PPI networks. However, those methods relying solely on the PPI network have low detection accuracy for essential proteins. Therefore, it is necessary to integrate the PPI network with other biological information to identify essential proteins., Results: In this paper, we proposed a novel random walk method for identifying essential proteins, called HEPT. A three-dimensional tensor is constructed first by combining the PPI network of Saccharomyces cerevisiae with multiple biological data such as gene ontology annotations and protein domains. Then, based on the newly constructed tensor, we extended the Hyperlink-Induced Topic Search (HITS) algorithm from a two-dimensional to a three-dimensional tensor model that can be utilized to infer essential proteins. Different from existing state-of-the-art methods, the importance of proteins and the types of interactions will both contribute to the essential protein prediction. To evaluate the performance of our newly proposed HEPT method, proteins are ranked in the descending order based on their ranking scores computed by our method and other competitive methods. After that, a certain number of the ranked proteins are selected as candidates for essential proteins. According to the list of known essential proteins, the number of true essential proteins is used to judge the performance of each method. Experimental results show that our method can achieve better prediction performance in comparison with other nine state-of-the-art methods in identifying essential proteins., Conclusions: Through analysis and experimental results, it is obvious that HEPT can be used to effectively improve the prediction accuracy of essential proteins by the use of HITS algorithm and the combination of network topology with gene ontology annotations and protein domains, which provides a new insight into multi-data source fusion.

Background: Bayesian regression models are widely used in genomic prediction, where the effects of all markers are estimated simultaneously by combining the information from the phenotypic data with priors for the marker effects and other parameters such as variance components or membership probabilities. Inferences from most Bayesian regression models are based on Markov chain Monte Carlo methods, where statistics are computed from a Markov chain constructed to have a stationary distribution that is equal to the posterior distribution of the unknown parameters. In practice, chains of tens of thousands steps are typically used in whole-genome Bayesian analyses, which is computationally intensive., Methods: In this paper, we propose a fast parallelized algorithm for Bayesian regression models called independent intensive Bayesian regression models (BayesXII, "X" stands for Bayesian alphabet methods and "II" stands for "parallel") and show how the sampling of each marker effect can be made independent of samples for other marker effects within each step of the chain. This is done by augmenting the marker covariate matrix by adding p (the number of markers) new rows such that columns of the augmented marker covariate matrix are orthogonal. Ideally, the computations at each step of the MCMC chain can be accelerated by k times, where k is the number of computer processors, up to p times, where p is the number of markers., Results: We demonstrate the BayesXII algorithm using the prior for BayesC[Formula: see text], a Bayesian variable selection regression method, which is applied to simulated data with 50,000 individuals and a medium-density marker panel ([Formula: see text] 50,000 markers). To reach about the same accuracy as the conventional samplers for BayesC[Formula: see text] required less than 30 min using the BayesXII algorithm on 24 nodes (computer used as a server) with 24 cores on each node. In this case, the BayesXII algorithm required one tenth of the computation time of conventional samplers for BayesC[Formula: see text]. Addressing the heavy computational burden associated with Bayesian methods by parallel computing will lead to greater use of these methods.

Background: Recently, the intervention calculus when the DAG is absent (IDA) method was developed to estimate lower bounds of causal effects from observational high-dimensional data. Originally it was introduced to assess the effect of baseline biomarkers which do not vary over time. However, in many clinical settings, measurements of biomarkers are repeated at fixed time points during treatment and, therefore, this method needs to be extended. The purpose of this paper is to extend the first step of the IDA, the Peter Clarks (PC)-algorithm, to a time-dependent exposure in the context of a binary outcome., Methods: We generalised the so-called "PC-algorithm" to take into account the chronological order of repeated measurements of the exposure and proposed to apply the IDA with our new version, the chronologically ordered PC-algorithm (COPC-algorithm). The extension includes Firth's correction. A simulation study has been performed before applying the method for estimating causal effects of time-dependent immunological biomarkers on toxicity, death and progression in patients with metastatic melanoma., Results: The simulation study showed that the completed partially directed acyclic graphs (CPDAGs) obtained using COPC-algorithm were structurally closer to the true CPDAG than CPDAGs obtained using PC-algorithm. Also, causal effects were more accurate when they were estimated based on CPDAGs obtained using COPC-algorithm. Moreover, CPDAGs obtained by COPC-algorithm allowed removing non-chronological arrows with a variable measured at a time t pointing to a variable measured at a time t´ where t´ < t. Bidirected edges were less present in CPDAGs obtained with the COPC-algorithm, supporting the fact that there was less variability in causal effects estimated from these CPDAGs. In the example, a threshold of the per-comparison error rate of 0.5% led to the selection of an interpretable set of biomarkers., Conclusions: The COPC-algorithm provided CPDAGs that keep the chronological structure present in the data and thus allowed to estimate lower bounds of the causal effect of time-dependent immunological biomarkers on early toxicity, premature death and progression.

Background: Recently, a new algorithm for automatic computer certification of verbal autopsy data named InSilicoVA was published. The authors presented their algorithm as a statistical method and assessed its performance using a single set of model predictors and one age group., Methods: We perform a standard procedure for analyzing the predictive accuracy of verbal autopsy classification methods using the same data and the publicly available implementation of the algorithm released by the authors. We extend the original analysis to include children and neonates, instead of only adults, and test accuracy using different sets of predictors, including the set used in the original paper and a set that matches the released software., Results: The population-level performance (i.e., predictive accuracy) of the algorithm varied from 2.1 to 37.6% when trained on data preprocessed similarly as in the original study. When trained on data that matched the software default format, the performance ranged from -11.5 to 17.5%. When using the default training data provided, the performance ranged from -59.4 to -38.5%. Overall, the InSilicoVA predictive accuracy was found to be 11.6-8.2 percentage points lower than that of an alternative algorithm. Additionally, the sensitivity for InSilicoVA was consistently lower than that for an alternative diagnostic algorithm (Tariff 2.0), although the specificity was comparable., Conclusions: The default format and training data provided by the software lead to results that are at best suboptimal, with poor cause-of-death predictive performance. This method is likely to generate erroneous cause of death predictions and, even if properly configured, is not as accurate as alternative automated diagnostic methods.

Background: Power analysis is a critical aspect of the design of experiments to detect an effect of a given size. When multiple hypotheses are tested simultaneously, multiplicity adjustments to p-values should be taken into account in power analysis. There are a limited number of studies on power analysis in multiple testing procedures. For some methods, the theoretical analysis is difficult and extensive numerical simulations are often needed, while other methods oversimplify the information under the alternative hypothesis. To this end, this paper aims to develop a new statistical model for power analysis in multiple testing procedures., Methods: We propose a step-function-based p-value model under the alternative hypothesis, which is simple enough to perform power analysis without simulations, but not too simple to lose the information from the alternative hypothesis. The first step is to transform distributions of different test statistics (e.g., t, chi-square or F) to distributions of corresponding p-values. We then use a step function to approximate each of the p-value's distributions by matching the mean and variance. Lastly, the step-function-based p-value model can be used for theoretical power analysis., Results: The proposed model is applied to problems in multiple testing procedures. We first show how the most powerful critical constants can be chosen using the step-function-based p-value model. Our model is then applied to the field of multiple testing procedures to explain the assumption of monotonicity of the critical constants. Lastly, we apply our model to a behavioral weight loss and maintenance study to select the optimal critical constants., Conclusions: The proposed model is easy to implement and preserves the information from the alternative hypothesis.

Background: Computational modeling and simulation play an important role in analyzing the behavior of complex biological systems in response to the implantation of biomedical devices. Quantitative computational modeling discloses the nature of foreign body responses. Such understanding will shed insight on the cause of foreign body responses, which will lead to improved biomaterial design and will reduce foreign body reactions. One of the major obstacles in computational modeling is to build a mathematical model that represents the biological system and to quantitatively define the model parameters., Results: In this paper, we considered quantitative inter connections and logical relationships among diverse proteins and cells, which have been reported in biological experiments and literature. Based on the established biological discovery, we have built a mathematical model while unveiling the key components that contribute to biomaterial-mediated inflammatory responses. For the parameter estimation of the mathematical model, we proposed a global optimization algorithm, called Discrete Selection Levenberg-Marquardt (DSLM). This is an extension of Levenberg-Marquardt (LM) algorithm which is a gradient-based local optimization algorithm. The proposed DSLM suggests a new approach for the selection of optimal parameters in the discrete space with fast computational convergence., Conclusions: The computational modeling not only provides critical clues to recognize current knowledge of fibrosis development but also enables the prediction of yet-to-be observed biological phenomena.

Background: Modelling disease outbreaks often involves integrating the wealth of data that are gathered during modern outbreaks into complex mathematical or computational models of transmission. Incorporating these data into simple compartmental epidemiological models is often challenging, requiring the use of more complex but also more efficient computational models. In this paper we introduce a new framework that allows for a more systematic and user-friendly way of building and running epidemiological models that efficiently handles disease data and reduces much of the boilerplate code that usually associated to these models. We introduce the framework by developing an SIR model on a simple network as an example., Results: We develop Broadwick, a modular, object-oriented epidemiological framework that efficiently handles large epidemiological datasets and provides packages for stochastic simulations, parameter inference using Approximate Bayesian Computation (ABC) and Markov Chain Monte Carlo (MCMC) methods. Each algorithm used is fully customisable with sensible defaults that are easily overridden by custom algorithms as required., Conclusion: Broadwick is an epidemiological modelling framework developed to increase the productivity of researchers by providing a common framework with which to develop and share complex models. It will appeal to research team leaders as it allows for models to be created prior to a disease outbreak and has the ability to handle large datasets commonly found in epidemiological modelling.

Background: The intracellular environment is a complex and crowded medium where the diffusion of proteins, metabolites and other molecules can be decreased. One of the most popular methodologies for the simulation of diffusion in crowding systems is the Monte Carlo algorithm (MC) which tracks the movement of each particle. This can, however, be computationally expensive for a system comprising a large number of molecules. On the other hand, the Lattice Boltzmann Method (LBM) tracks the movement of collections of molecules, which represents significant savings in computational time. Nevertheless in the classical manifestation of such scheme the crowding conditions are neglected., Methods: In this paper we use Scaled Particle Theory (SPT) to approximate the probability to find free space for the displacement of hard-disk molecules and in this way to incorporate the crowding effect to the LBM. This new methodology which couples SPT and LBM is validated using a kinetic Monte Carlo (kMC) algorithm, which is used here as our "computational experiment"., Results: The results indicate that LBM over-predicts the diffusion in 2D crowded systems, while the proposed coupled SPT-LBM predicts the same behaviour as the kinetic Monte Carlo (kMC) algorithm but with a significantly reduced computational effort. Despite the fact that small deviations between the two methods were observed, in part due to the mesoscopic and microscopic nature of each method, respectively, the agreement was satisfactory both from a qualitative and a quantitative point of view., Conclusions: A crowding-adaptation to LBM has been developed using SPT, allowing fast simulations of diffusion-systems of different size hard-disk molecules in two-dimensional space. This methodology takes into account crowding conditions; not only the space fraction occupied by the crowder molecules but also the influence of the size of the crowder which can affect the displacement of molecules across the lattice system.

Background: In clinical research prediction models are used to accurately predict the outcome of the patients based on some of their characteristics. For high-dimensional prediction models (the number of variables greatly exceeds the number of samples) the choice of an appropriate classifier is crucial as it was observed that no single classification algorithm performs optimally for all types of data. Boosting was proposed as a method that combines the classification results obtained using base classifiers, where the sample weights are sequentially adjusted based on the performance in previous iterations. Generally boosting outperforms any individual classifier, but studies with high-dimensional data showed that the most standard boosting algorithm, AdaBoost.M1, cannot significantly improve the performance of its base classier. Recently other boosting algorithms were proposed (Gradient boosting, Stochastic Gradient boosting, LogitBoost); they were shown to perform better than AdaBoost.M1 but their performance was not evaluated for high-dimensional data., Results: In this paper we use simulation studies and real gene-expression data sets to evaluate the performance of boosting algorithms when data are high-dimensional. Our results confirm that AdaBoost.M1 can perform poorly in this setting, often failing to improve the performance of its base classifier. We provide the explanation for this and propose a modification, AdaBoost.M1.ICV, which uses cross-validated estimates of the prediction errors and outperforms the original algorithm when data are high-dimensional. The use of AdaBoost.M1.ICV is advisable when the base classifier overfits the training data: the number of variables is large, the number of samples is small, and/or the difference between the classes is large. To a lesser extent also Gradient boosting suffers from similar problems. Contrary to the findings for the low-dimensional data, shrinkage does not improve the performance of Gradient boosting when data are high-dimensional, however it is beneficial for Stochastic Gradient boosting, which outperformed the other boosting algorithms in our analyses. LogitBoost suffers from overfitting and generally performs poorly., Conclusions: The results show that boosting can substantially improve the performance of its base classifier also when data are high-dimensional. However, not all boosting algorithms perform equally well. LogitBoost, AdaBoost.M1 and Gradient boosting seem less useful for this type of data. Overall, Stochastic Gradient boosting with shrinkage and AdaBoost.M1.ICV seem to be the preferable choices for high-dimensional class-prediction.

Background: Cut-point finding is a crucial step for clinical decision making when dealing with diagnostic (or prognostic) biomarkers. The extension of ROC-based cut-point finding methods to the case of censored failure time outcome is of interest when we are in the presence of a biomarker, measured at baseline, used to identify whether there will be the development, or not, of some disease condition within a given time point τ of clinical interest., Methods: Three widely used cut-point finding methods, namely the Youden index, the concordance probability and the point closest to-(0,1) corner in the ROC plane, are extended to the case of censored failure time outcome resorting to non-parametric estimators of the sensitivity and specificity that account for censoring. The performance of these methods in finding the optimal cut-point is compared under Normal and Gamma distributions of the biomarker (in subjects developing or not the disease condition). Normality ensures that estimators point theoretically to the same cut-point. Two motivating examples are provided in the paper., Results: The point closest-to-(0,1) corner approach has the best performance from simulations in terms of mean square error and relative bias., Conclusions: We discuss the use of the Youden index or concordance probability associated to the cut-point identified through the closest-to-(0,1) corner approach to ease interpretability of the classification performance of the dichotomized biomarker. In addition, the achieved performance of the dichotomized biomarker classification associated to the estimated cut-point can be represented through a confidence interval of the point on the ROC curve.

Background: Simulation of populations with specified characteristics such as allele frequencies, linkage disequilibrium etc., is an integral component of many studies, including in-silico breeding optimization. Since the accuracy and sensitivity of population simulation is critical to the quality of the output of the applications that use them, accurate algorithms are required to provide a strong foundation to the methods in these studies., Results: In this paper we present SimBA (Simulation using Best-fit Algorithm) a non-generative approach, based on a combination of stochastic techniques and discrete methods. We optimize a hill climbing algorithm and extend the framework to include multiple subpopulation structures. Additionally, we show that SimBA is very sensitive to the input specifications, i.e., very similar but distinct input characteristics result in distinct outputs with high fidelity to the specified distributions. This property of the simulation is not explicitly modeled or studied by previous methods., Conclusions: We show that SimBA outperforms the existing population simulation methods, both in terms of accuracy as well as time-efficiency. Not only does it construct populations that meet the input specifications more stringently than other published methods, SimBA is also easy to use. It does not require explicit parameter adaptations or calibrations. Also, it can work with input specified as distributions, without an exemplar matrix or population as required by some methods. SimBA is available at http://researcher.ibm.com/project/5669 .

Background: This paper presents a Tracer Liquid Image Velocimetry (TLIV) for multi-layer radial flow in bioreactors used for cells cultivation of tissue engineering. The goal of this approach is to use simple devices to get good measuring precision, specialized for the case in which the uniform level of fluid shear stress was required while fluid velocity varied smoothly., Methods: Compared to the widely used Particles Image Velocimetry (PIV), this method adopted a bit of liquid as tracer, without the need of laser source. Sub-pixel positioning algorithm was used to overcome the adverse effects of the tracer liquid deformation. In addition, a neighborhood smoothing algorithm was used to restrict the measurement perturbation caused by diffusion. Experiments were carried out in a parallel plates flow chamber. And mathematical models of the flow chamber and Computational Fluid Dynamics (CFD) simulation were separately employed to validate the measurement precision of TLIV., Results: The mean relative error between the simulated and measured data can be less than 2%, while in similar validations using PIV, the error was around 8.8%., Conclusions: TLIV avoided the contradiction between the particles' visibility and following performance with tested fluid, which is difficult to overcome in PIV. And TLIV is easier to popularize for its simple experimental condition and low cost.

Background: In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. A number of the trials, however, reported the study using the median, the minimum and maximum values, and/or the first and third quartiles. Hence, in order to combine results, one may have to estimate the sample mean and standard deviation for such trials., Methods: In this paper, we propose to improve the existing literature in several directions. First, we show that the sample standard deviation estimation in Hozo et al.'s method (BMC Med Res Methodol 5:13, 2005) has some serious limitations and is always less satisfactory in practice. Inspired by this, we propose a new estimation method by incorporating the sample size. Second, we systematically study the sample mean and standard deviation estimation problem under several other interesting settings where the interquartile range is also available for the trials., Results: We demonstrate the performance of the proposed methods through simulation studies for the three frequently encountered scenarios, respectively. For the first two scenarios, our method greatly improves existing methods and provides a nearly unbiased estimate of the true sample standard deviation for normal data and a slightly biased estimate for skewed data. For the third scenario, our method still performs very well for both normal data and skewed data. Furthermore, we compare the estimators of the sample mean and standard deviation under all three scenarios and present some suggestions on which scenario is preferred in real-world applications., Conclusions: In this paper, we discuss different approximation methods in the estimation of the sample mean and standard deviation and propose some new estimation methods to improve the existing literature. We conclude our work with a summary table (an Excel spread sheet including all formulas) that serves as a comprehensive guidance for performing meta-analysis in different situations.

Background: What kind of neural computation is actually performed by the primary visual cortex and how is this represented mathematically at the system level? It is an important problem in the visual information processing, but has not been well answered. In this paper, according to our understanding of retinal organization and parallel multi-channel topographical mapping between retina and primary visual cortex V1, we divide an image into orthogonal and orderly array of image primitives (or patches), in which each patch will evoke activities of simple cells in V1. From viewpoint of information processing, this activated process, essentially, involves optimal detection and optimal matching of receptive fields of simple cells with features contained in image patches. For the reconstruction of the visual image in the visual cortex V1 based on the principle of minimum mean squares error, it is natural to use the inner product expression in neural computation, which then is transformed into matrix form., Results: The inner product is carried out by using Kronecker product between patches and function architecture (or functional column) in localized and oriented neural computing. Compared with Fourier Transform, the mathematical description of Kronecker product is simple and intuitive, so is the algorithm more suitable for neural computation of visual cortex V1. Results of computer simulation based on two-dimensional Gabor pyramid wavelets show that the theoretical analysis and the proposed model are reasonable., Conclusions: Our results are: 1. The neural computation of the retinal image in cortex V1 can be expressed to Kronecker product operation and its matrix form, this algorithm is implemented by the inner operation between retinal image primitives and primary visual cortex's column. It has simple, efficient and robust features, which is, therefore, such a neural algorithm, which can be completed by biological vision. 2. It is more suitable that the function of cortical column in cortex V1 is considered as the basic unit of visual image processing (such unit can implement basic multiplication of visual primitives, such as contour, line, and edge), rather than a set of tiled array filter. Fourier Transformation is replaced with Kronecker product, which greatly reduces the computational complexity. The neurobiological basis of this idea is that a visual image can be represented as a linear combination of orderly orthogonal primitive image containing some local feature. In the visual pathway, the image patches are topographically mapped onto cortex V1 through parallel multi-channels and then are processed independently by functional columns. Clearly, the above new perspective has some reference significance to exploring the neural mechanisms on the human visual information processing.

Background: The minimum variance (MV) beamformer can significantly improve the image resolution in ultrasound imaging, but it has limited performance in noise reduction. We recently proposed the covariance matrix-based statistical beamforming (CMSB) for medical ultrasound imaging to reduce sidelobes and incoherent clutter.Methods: In this paper, we aim to improve the imaging performance of the MV beamformer by introducing a new pixel-based adaptive weighting approach based on CMSB, which is named as covariance matrix-based adaptive weighting (CMSAW). The proposed CMSAW estimates the mean-to-standard-deviation ratio (MSR) of a modified covariance matrix reconstructed by adaptive spatial smoothing, rotary averaging, and diagonal reducing. Moreover, adaptive diagonal reducing based on the aperture coherence is introduced in CMSAW to enhance the performance in speckle preservation.Results: The proposed CMSAW-weighted MV (CMSAW-MV) was validated through simulation, phantom experiments, and in vivo studies. The phantom experimental results show that CMSAW-MV obtains resolution improvement of 21.3% and simultaneously achieves average improvements of 96.4% and 71.8% in average contrast and generalized contrast-to-noise ratio (gCNR) for anechoic cyst, respectively, compared with MV. in vivo studies indicate that CMSAW-MV improves the noise reduction performance of MV beamformer.Conclusion: Simulation, experimental, and in vivo results all show that CMSAW-MV can improve resolution and suppress sidelobes and incoherent clutter and noise. These results demonstrate the effectiveness of CMSAW in improving the imaging performance of MV beamformer. Moreover, the proposed CMSAW with a computational complexity of [Formula: see text] has the potential to be implemented in real time using the graphics processing unit. [ABSTRACT FROM AUTHOR]

Background: With the invention of fitness trackers, it has been possible to continuously monitor a user's biometric data such as heart rates, number of footsteps taken, and amount of calories burned. This paper names the time series of these three types of biometric data, the user's "activeness", and investigates the feasibility in modeling and predicting the long-term activeness of the user.Methods: The dataset used in this study consisted of several months of biometric time-series data gathered by seven users independently. Four recurrent neural network (RNN) architectures-as well as a deep neural network and a simple regression model-were proposed to investigate the performance on predicting the activeness of the user under various length-related hyper-parameter settings. In addition, the learned model was tested to predict the time period when the user's activeness falls below a certain threshold.Results: A preliminary experimental result shows that each type of activeness data exhibited a short-term autocorrelation; and among the three types of data, the consumed calories and the number of footsteps were positively correlated, while the heart rate data showed almost no correlation with neither of them. It is probably due to this characteristic of the dataset that although the RNN models produced the best results on modeling the user's activeness, the difference was marginal; and other baseline models, especially the linear regression model, performed quite admirably as well. Further experimental results show that it is feasible to predict a user's future activeness with precision, for example, a trained RNN model could predict-with the precision of 84%-when the user would be less active within the next hour given the latest 15 min of his activeness data.Conclusions: This paper defines and investigates the notion of a user's "activeness", and shows that forecasting the long-term activeness of the user is indeed possible. Such information can be utilized by a health-related application to proactively recommend suitable events or services to the user. [ABSTRACT FROM AUTHOR]

Background: Gene networks in living cells can change depending on various conditions such as caused by different environments, tissue types, disease states, and development stages. Identifying the differential changes in gene networks is very important to understand molecular basis of various biological process. While existing algorithms can be used to infer two gene networks separately from gene expression data under two different conditions, and then to identify network changes, such an approach does not exploit the similarity between two gene networks, and it is thus suboptimal. A desirable approach would be clearly to infer two gene networks jointly, which can yield improved estimates of network changes. Results: In this paper, we developed a proximal gradient algorithm for differential network (ProGAdNet) inference, that jointly infers two gene networks under different conditions and then identifies changes in the network structure. Computer simulations demonstrated that our ProGAdNet outperformed existing algorithms in terms of inference accuracy, and was much faster than a similar approach for joint inference of gene networks. Gene expression data of breast tumors and normal tissues in the TCGA database were analyzed with our ProGAdNet, and revealed that 268 genes were involved in the changed network edges. Gene set enrichment analysis identified a significant number of gene sets related to breast cancer or other types of cancer that are enriched in this set of 268 genes. Network analysis of the kidney cancer data in the TCGA database with ProGAdNet also identified a set of genes involved in network changes, and the majority of the top genes identified have been reported in the literature to be implicated in kidney cancer. These results corroborated that the gene sets identified by ProGAdNet were very informative about the cancer disease status. A software package implementing the ProGAdNet, computer simulations, and real data analysis is available as Additional file 1. Conclusion: With its superior performance over existing algorithms, ProGAdNet provides a valuable tool for finding changes in gene networks, which may aid the discovery of gene-gene interactions changed under different conditions. [ABSTRACT FROM AUTHOR]

Background: Ultrasound computed tomography (USCT) is usually realized with a ring array. It can provide better imaging performance and more tissue information by emitting and receiving the ultrasound signal in different directions simultaneously. However, USCT imaging is usually applied with the synthetic aperture (SA) emission method, which leads to a long scanning time with a large number of elements on the ring array. The echo image can provide the structural information, and has a higher resolution than maps of other parameters in USCT. Hence, we proposed plane wave (PW) imaging for ring array to acquire the echo wave and reduce the scanning time considerably.Results: In this paper, an emitting and receiving process was proposed to realize plane wave imaging with a ring array. With the proposed scanning method, the number of emission events can be reduced greatly. A beamforming method based on the eigenspace-based minimum variance (ESBMV) was also combined with the scanning method. With ESBMV beamformer, the resolution and contrast ratio of reconstruction result can be maintained or even improved under a fewer-emissions condition. We validated the method using both computer simulations with Field II and phantom experiments with a ring array of 512 elements. The Verasonics® system was used to transmit and receive the ultrasound signal in the phantom experiments.Conclusions: According to the results of the experiments, the imaging results will have a better contrast ratio with a higher emitting energy. Additionally, the scanning time with the proposed method can be only one-tenth of that with the SA emission method, while the echo imaging performance still remains at a similar level or even better. [ABSTRACT FROM AUTHOR]

Background: Systems biology models tend to become large since biological systems often consist of complex networks of interacting components, and since the models usually are developed to reflect various mechanistic assumptions of those networks. Nevertheless, not all aspects of the model are equally interesting in a given setting, and normally there are parts that can be reduced without affecting the relevant model performance. There are many methods for model reduction, but few or none of them allow for a restoration of the details of the original model after the simplified model has been simulated. Results: We present a reduction method that allows for such a back-translation from the reduced to the original model. The method is based on lumping of states, and includes a general and formal algorithm for both determining appropriate lumps, and for calculating the analytical back-translation formulas. The lumping makes use of efficient methods from graph-theory and _-decomposition and is derived and exemplified on two published models for fluorescence emission in photosynthesis. The bigger of these models is reduced from 26 to 6 states, with a negligible deviation from the reduced model simulations, both when comparing simulations in the states of the reduced model and when comparing back-translated simulations in the states of the original model. The method is developed in a linear setting, but we exemplify how the same concepts and approaches can be applied to non-linear problems. Importantly, the method automatically provides a reduced model with back-translations. Also, the method is implemented as a part of the systems biology toolbox for matlab, and the matlab scripts for the examples in this paper are available in the supplementary material. Conclusions: Our novel lumping methodology allows for both automatic reduction of states using lumping, and for analytical retrieval of the original states and parameters without performing a new simulation. The two models can thus be considered as two degrees of zooming of the same model. This is a conceptually new development of model reduction approaches, which we think will stimulate much further research and will prove to be very useful in future modelling projects. [ABSTRACT FROM AUTHOR]

Background: The sample size required to power a study to a nominal level in a paired comparative diagnostic accuracy study, i.e. studies in which the diagnostic accuracy of two testing procedures is compared relative to a gold standard, depends on the conditional dependence between the two tests - the lower the dependence the greater the sample size required. A priori, we usually do not know the dependence between the two tests and thus cannot determine the exact sample size required. One option is to use the implied sample size for the maximal negative dependence, giving the largest possible sample size. However, this is potentially wasteful of resources and unnecessarily burdensome on study participants as the study is likely to be overpowered. A more accurate estimate of the sample size can be determined at a planned interim analysis point where the sample size is re-estimated.Methods: This paper discusses a sample size estimation and re-estimation method based on the maximum likelihood estimates, under an implied multinomial model, of the observed values of conditional dependence between the two tests and, if required, prevalence, at a planned interim. The method is illustrated by comparing the accuracy of two procedures for the detection of pancreatic cancer, one procedure using the standard battery of tests, and the other using the standard battery with the addition of a PET/CT scan all relative to the gold standard of a cell biopsy. Simulation of the proposed method illustrates its robustness under various conditions.Results: The results show that the type I error rate of the overall experiment is stable using our suggested method and that the type II error rate is close to or above nominal. Furthermore, the instances in which the type II error rate is above nominal are in the situations where the lowest sample size is required, meaning a lower impact on the actual number of participants recruited.Conclusion: We recommend multinomial model maximum likelihood estimation of the conditional dependence between paired diagnostic accuracy tests at an interim to reduce the number of participants required to power the study to at least the nominal level.Trial Registration: ISRCTN ISRCTN73852054 . Registered 9th of January 2015. Retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: Bivariate random-effects models represent a widely accepted and recommended approach for meta-analysis of test accuracy studies. Standard likelihood methods routinely used for inference are prone to several drawbacks. Small sample size can give rise to unreliable inferential conclusions and convergence issues make the approach unappealing. This paper suggests a different methodology to address such difficulties.Methods: A SIMEX methodology is proposed. The method is a simulation-based technique originally developed as a correction strategy within the measurement error literature. It suits the meta-analysis framework as the diagnostic accuracy measures provided by each study are prone to measurement error. SIMEX can be straightforwardly adapted to cover different measurement error structures and to deal with covariates. The effortless implementation with standard software is an interesting feature of the method.Results: Extensive simulation studies highlight the improvement provided by SIMEX over likelihood approach in terms of empirical coverage probabilities of confidence intervals under different scenarios, independently of the sample size and the values of the correlation between sensitivity and specificity. A remarkable amelioration is obtained in case of deviations from the normality assumption for the random-effects distribution. From a computational point of view, the application of SIMEX is shown to be neither involved nor subject to the convergence issues affecting likelihood-based alternatives. Application of the method to a diagnostic review of the performance of transesophageal echocardiography for assessing ascending aorta atherosclerosis enables overcoming limitations of the likelihood procedure.Conclusions: The SIMEX methodology represents an interesting alternative to likelihood-based procedures for inference in meta-analysis of diagnostic accuracy studies. The approach can provide more accurate inferential conclusions, while avoiding convergence failure and numerical instabilities. The application of the method in the R programming language is possible through the code which is made available and illustrated using the real data example. [ABSTRACT FROM AUTHOR]

: Comparing incidental dose distributions (i.e. images) of patients with different outcomes is a straightforward way to explore dose-response hypotheses in radiotherapy. In this paper, we introduced a permutation test that compares images, such as dose distributions from radiotherapy, while tackling the multiple comparisons problem. A test statistic Tmax was proposed that summarizes the differences between the images into a single value and a permutation procedure was employed to compute the adjusted p-value. We demonstrated the method in two retrospective studies: a prostate study that relates 3D dose distributions to failure, and an esophagus study that relates 2D surface dose distributions of the esophagus to acute esophagus toxicity. As a result, we were able to identify suspicious regions that are significantly associated with failure (prostate study) or toxicity (esophagus study). Permutation testing allows direct comparison of images from different patient categories and is a useful tool for data mining in radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Medical evidence from more recent observational studies may significantly alter our understanding of disease incidence and progression, and would require recalibration of existing computational and predictive disease models. However, it is often challenging to perform recalibration when there are a large number of model parameters to be estimated. Moreover, comparing the fitting performances of candidate parameter designs can be difficult due to significant variation in simulated outcomes under limited computational budget and long runtime, even for one simulation replication.Methods: We developed a two-phase recalibration procedure. As a proof-of-the-concept study, we verified the procedure in the context of sex-specific colorectal neoplasia development. We considered two individual-based state-transition stochastic simulation models, estimating model parameters that govern colorectal adenoma occurrence and its growth through three preclinical states: non-advanced precancerous polyp, advanced precancerous polyp, and cancerous polyp. For the calibration, we used a weighted-sum-squared error between three prevalence values reported in the literature and the corresponding simulation outcomes. In phase 1 of the calibration procedure, we first extracted the baseline parameter design from relevant studies on the same model. We then performed sampling-based searches within a proper range around the baseline design to identify the initial set of good candidate designs. In phase 2, we performed local search (e.g., the Nelder-Mead algorithm), starting from the candidate designs identified at the end of phase 1. Further, we investigated the efficiency of exploring dimensions of the parameter space sequentially based on our prior knowledge of the system dynamics.Results: The efficiency of our two-phase re-calibration procedure was first investigated with CMOST, a relatively inexpensive computational model. It was then further verified with the V/NCS model, which is much more expensive. Overall, our two-phase procedure showed a better goodness-of-fit than the straightforward employment of the Nelder-Mead algorithm, when only a limited number of simulation replications were allowed. In addition, in phase 2, performing local search along parameter space dimensions sequentially was more efficient than performing the search over all dimensions concurrently.Conclusion: The proposed two-phase re-calibration procedure is efficient at estimating parameters of computationally expensive stochastic dynamic disease models. [ABSTRACT FROM AUTHOR]

Background: Assistive technologies aim to increase quality of life, reduce dependence on care giver and on the long term care system. Several studies have demonstrated the effectiveness in the use of assistive technology for environment control and communication systems. The progress of brain-computer interfaces (BCI) research together with exoskeleton enable a person with motor impairment to interact with new elements in the environment. This paper aims to evaluate the environment control interface (ECI) developed under the AIDE project conditions, a multimodal interface able to analyze and extract relevant information from the environments as well as from the identification of residual abilities, behaviors, and intentions of the user.Methods: This study evaluated the ECI in a simulated scenario using a two screen layout: one with the ECI and the other with a simulated home environment, developed for this purpose. The sensorimotor rhythms and the horizontal oculoversion, acquired through BCI2000, a multipurpose standard BCI platform, were used to online control the ECI after the user training and system calibration. Eight subjects with different neurological diseases and spinal cord injury participated in this study. The subjects performed simulated activities of daily living (ADLs), i.e. actions in the simulated environment as drink, switch on a lamp or raise the bed head, during ten minutes in two different modes, AIDE mode, using a prediction model, to recognize the user intention facilitating the scan, and Manual mode, without a prediction model.Results: The results show that the mean task time spent in the AIDE mode was less than in the Manual, i.e the users were able to perform more tasks in the AIDE mode during the same time. The results showed a statistically significant differences with p<0.001. Regarding the steps, i.e the number of abstraction levels crossed in the ECI to perform an ADL, the users performed one step in the 90% of the tasks using the AIDE mode and three steps, at least, were necessary in the Manual mode. The user's intention prediction was performed through conditional random fields (CRF), with a global accuracy about 87%.Conclusions: The environment analysis and the identification of the user's behaviors can be used to predict the user intention opening a new paradigm in the design of the ECIs. Although the developed ECI was tested only in a simulated home environment, it can be easily adapted to a real environment increasing the user independence at home. [ABSTRACT FROM AUTHOR]

Background: Risk prediction models for time-to-event outcomes play a vital role in personalized decision-making. A patient's biomarker values, such as medical lab results, are often measured over time but traditional prediction models ignore their longitudinal nature, using only baseline information. Dynamic prediction incorporates longitudinal information to produce updated survival predictions during follow-up. Existing methods for dynamic prediction include joint modeling, which often suffers from computational complexity and poor performance under misspecification, and landmarking, which has a straightforward implementation but typically relies on a proportional hazards model. Random survival forests (RSF), a machine learning algorithm for time-to-event outcomes, can capture complex relationships between the predictors and survival without requiring prior specification and has been shown to have superior predictive performance.Methods: We propose an alternative approach for dynamic prediction using random survival forests in a landmarking framework. With a simulation study, we compared the predictive performance of our proposed method with Cox landmarking and joint modeling in situations where the proportional hazards assumption does not hold and the longitudinal marker(s) have a complex relationship with the survival outcome. We illustrated the use of the RSF landmark approach in two clinical applications to assess the performance of various RSF model building decisions and to demonstrate its use in obtaining dynamic predictions.Results: In simulation studies, RSF landmarking outperformed joint modeling and Cox landmarking when a complex relationship between the survival and longitudinal marker processes was present. It was also useful in application when there were several predictors for which the clinical relevance was unknown and multiple longitudinal biomarkers were present. Individualized dynamic predictions can be obtained from this method and the variable importance metric is useful for examining the changing predictive power of variables over time. In addition, RSF landmarking is easily implementable in standard software and using suggested specifications requires less computation time than joint modeling.Conclusions: RSF landmarking is a nonparametric, machine learning alternative to current methods for obtaining dynamic predictions when there are complex or unknown relationships present. It requires little upfront decision-making and has comparable predictive performance and has preferable computational speed. [ABSTRACT FROM AUTHOR]

Background: Gene circuits are important in many aspects of biology, and perform a wide variety of different functions. For example, some circuits oscillate (e.g. the cell cycle), some are bistable (e.g. as cells differentiate), some respond sharply to environmental signals (e.g. ultrasensitivity), and some pattern multicellular tissues (e.g. Turing's model). Often, one starts from a given circuit, and using simulations, asks what functions it can perform. Here we want to do the opposite: starting from a prescribed function, can we find a circuit that executes this function? Whilst simple in principle, this task is challenging from a computational perspective, since gene circuit models are complex systems with many parameters. In this work, we adapted machine-learning algorithms to significantly accelerate gene circuit discovery. Results: We use gradient-descent optimization algorithms from machine learning to rapidly screen and design gene circuits. With this approach, we found that we could rapidly design circuits capable of executing a range of different functions, including those that: (1) recapitulate important in vivo phenomena, such as oscillators, and (2) perform complex tasks for synthetic biology, such as counting noisy biological events. Conclusions: Our computational pipeline will facilitate the systematic study of natural circuits in a range of contexts, and allow the automatic design of circuits for synthetic biology. Our method can be readily applied to biological networks of any type and size, and is provided as an open-source and easy-to-use python module, GeneNet. [ABSTRACT FROM AUTHOR]

A conference paper about CaliBayes is presented. CaliBayes is an integration of GRID based simulation and data resources for Bayesian calibration of biological models. The goal is to find a combination of parameters that give the best match to available experimental data, together with some idea of the uncertainty in the parameter value. The calibration algorithm selects parameter combinations at which the simulator will be run.

Background: Multiple imputation is a recommended method to handle missing data. For significance testing after multiple imputation, Rubin's Rules (RR) are easily applied to pool parameter estimates. In a logistic regression model, to consider whether a categorical covariate with more than two levels significantly contributes to the model, different methods are available. For example pooling chi-square tests with multiple degrees of freedom, pooling likelihood ratio test statistics, and pooling based on the covariance matrix of the regression model. These methods are more complex than RR and are not available in all mainstream statistical software packages. In addition, they do not always obtain optimal power levels. We argue that the median of the p-values from the overall significance tests from the analyses on the imputed datasets can be used as an alternative pooling rule for categorical variables. The aim of the current study is to compare different methods to test a categorical variable for significance after multiple imputation on applicability and power.Methods: In a large simulation study, we demonstrated the control of the type I error and power levels of different pooling methods for categorical variables.Results: This simulation study showed that for non-significant categorical covariates the type I error is controlled and the statistical power of the median pooling rule was at least equal to current multiple parameter tests. An empirical data example showed similar results.Conclusions: It can therefore be concluded that using the median of the p-values from the imputed data analyses is an attractive and easy to use alternative method for significance testing of categorical variables. [ABSTRACT FROM AUTHOR]

Background: Missing data is a common problem in epidemiological studies, and is particularly prominent in longitudinal data, which involve multiple waves of data collection. Traditional multiple imputation (MI) methods (fully conditional specification (FCS) and multivariate normal imputation (MVNI)) treat repeated measurements of the same time-dependent variable as just another 'distinct' variable for imputation and therefore do not make the most of the longitudinal structure of the data. Only a few studies have explored extensions to the standard approaches to account for the temporal structure of longitudinal data. One suggestion is the two-fold fully conditional specification (two-fold FCS) algorithm, which restricts the imputation of a time-dependent variable to time blocks where the imputation model includes measurements taken at the specified and adjacent times. To date, no study has investigated the performance of two-fold FCS and standard MI methods for handling missing data in a time-varying covariate with a non-linear trajectory over time - a commonly encountered scenario in epidemiological studies.Methods: We simulated 1000 datasets of 5000 individuals based on the Longitudinal Study of Australian Children (LSAC). Three missing data mechanisms: missing completely at random (MCAR), and a weak and a strong missing at random (MAR) scenarios were used to impose missingness on body mass index (BMI) for age z-scores; a continuous time-varying exposure variable with a non-linear trajectory over time. We evaluated the performance of FCS, MVNI, and two-fold FCS for handling up to 50% of missing data when assessing the association between childhood obesity and sleep problems.Results: The standard two-fold FCS produced slightly more biased and less precise estimates than FCS and MVNI. We observed slight improvements in bias and precision when using a time window width of two for the two-fold FCS algorithm compared to the standard width of one.Conclusion: We recommend the use of FCS or MVNI in a similar longitudinal setting, and when encountering convergence issues due to a large number of time points or variables with missing values, the two-fold FCS with exploration of a suitable time window. [ABSTRACT FROM AUTHOR]

Background: Joints kinematics assessment based on inertial measurement systems, which include attitude and heading reference system (AHRS), are quickly gaining in popularity for research and clinical applications. The variety of the tasks and contexts they are used in require a deep understanding of the AHRS accuracy for optimal data interpretation. However, published accuracy studies on AHRS are mostly limited to a single task measured on a limited number of segments and participants. This study assessed AHRS sensors kinematics accuracy at multiple segments and joints through a variety of tasks not only to characterize the system's accuracy in these specific conditions, but also to extrapolate the accuracy results to a broader range of conditions using the characteristics of the movements (i.e. velocity and type of motion). Twenty asymptomatic adults ([Formula: see text] = 49.9) performed multiple 5 m timed up and go. Participants' head, upper trunk, pelvis, thigh, shank and foot were simultaneously tracked using AHRS and an optical motion capture system (gold standard). Each trial was segmented into basic tasks (sit-to-stand, walk, turn).Results: At segment level, results revealed a mean root-mean-squared-difference [Formula: see text] varying between 1.1° and 5.5° according to the segment tracked and the task performed, with a good to excellent agreement between the systems. Relative sensor kinematics accuracy (i.e. joint) varied between 1.6° and 13.6° over the same tasks. On a global scheme, analysis of the effect of velocity on sensor kinematics accuracy showed that AHRS are better adapted to motions performed between 50°/s and 75°/s (roughly thigh and shank while walking).Conclusion: Results confirmed that pairing of modules to obtain joint kinematics affects the accuracy compared to segment kinematics. Overall, AHRS are a suitable solution for clinical evaluation of biomechanics under the multi-segment tasks performed although the variation in accuracy should be taken into consideration when judging the clinical meaningfulness of the observed changes. [ABSTRACT FROM AUTHOR]

Background: In the active shape model framework, principal component analysis (PCA) based statistical shape models (SSMs) are widely employed to incorporate high-level a priori shape knowledge of the structure to be segmented to achieve robustness. A crucial component of building SSMs is to establish shape correspondence between all training shapes, which is a very challenging task, especially in three dimensions.Methods: We propose a novel mesh-to-volume registration based shape correspondence establishment method to improve the accuracy and reduce the computational cost. Specifically, we present a greedy algorithm based deformable simplex mesh that uses vector field convolution as the external energy. Furthermore, we develop an automatic shape initialization method by using a Gaussian mixture model based registration algorithm, to derive an initial shape that has high overlap with the object of interest, such that the deformable models can then evolve more locally. We apply the proposed deformable surface model to the application of femur statistical shape model construction to illustrate its accuracy and efficiency.Results: Extensive experiments on ten femur CT scans show that the quality of the constructed femur shape models via the proposed method is much better than that of the classical spherical harmonics (SPHARM) method. Moreover, the proposed method achieves much higher computational efficiency than the SPHARM method.Conclusions: The experimental results suggest that our method can be employed for effective statistical shape model construction. [ABSTRACT FROM AUTHOR]

Background: Clinical data repositories (CDR) have great potential to improve outcome prediction and risk modeling. However, most clinical studies require careful study design, dedicated data collection efforts, and sophisticated modeling techniques before a hypothesis can be tested. We aim to bridge this gap, so that clinical domain users can perform first-hand prediction on existing repository data without complicated handling, and obtain insightful patterns of imbalanced targets for a formal study before it is conducted. We specifically target for interpretability for domain users where the model can be conveniently explained and applied in clinical practice.Methods: We propose an interpretable pattern model which is noise (missing) tolerant for practice data. To address the challenge of imbalanced targets of interest in clinical research, e.g., deaths less than a few percent, the geometric mean of sensitivity and specificity (G-mean) optimization criterion is employed, with which a simple but effective heuristic algorithm is developed.Results: We compared pattern discovery to clinically interpretable methods on two retrospective clinical datasets. They contain 14.9% deaths in 1 year in the thoracic dataset and 9.1% deaths in the cardiac dataset, respectively. In spite of the imbalance challenge shown on other methods, pattern discovery consistently shows competitive cross-validated prediction performance. Compared to logistic regression, Naïve Bayes, and decision tree, pattern discovery achieves statistically significant (p-values < 0.01, Wilcoxon signed rank test) favorable averaged testing G-means and F1-scores (harmonic mean of precision and sensitivity). Without requiring sophisticated technical processing of data and tweaking, the prediction performance of pattern discovery is consistently comparable to the best achievable performance.Conclusions: Pattern discovery has demonstrated to be robust and valuable for target prediction on existing clinical data repositories with imbalance and noise. The prediction results and interpretable patterns can provide insights in an agile and inexpensive way for the potential formal studies. [ABSTRACT FROM AUTHOR]

Background: The attributable risk (AR) measures the proportion of disease cases that can be attributed to an exposure in the population. Several definitions and estimation methods have been proposed for survival data.Methods: Using simulations, we compared four methods for estimating AR defined in terms of survival functions: two nonparametric methods based on Kaplan-Meier's estimator, one semiparametric based on Cox's model, and one parametric based on the piecewise constant hazards model, as well as one simpler method based on estimated exposure prevalence at baseline and Cox's model hazard ratio. We considered a fixed binary exposure with varying exposure probabilities and strengths of association, and generated event times from a proportional hazards model with constant or monotonic (decreasing or increasing) Weibull baseline hazard, as well as from a nonproportional hazards model. We simulated 1,000 independent samples of size 1,000 or 10,000. The methods were compared in terms of mean bias, mean estimated standard error, empirical standard deviation and 95% confidence interval coverage probability at four equally spaced time points.Results: Under proportional hazards, all five methods yielded unbiased results regardless of sample size. Nonparametric methods displayed greater variability than other approaches. All methods showed satisfactory coverage except for nonparametric methods at the end of follow-up for a sample size of 1,000 especially. With nonproportional hazards, nonparametric methods yielded similar results to those under proportional hazards, whereas semiparametric and parametric approaches that both relied on the proportional hazards assumption performed poorly. These methods were applied to estimate the AR of breast cancer due to menopausal hormone therapy in 38,359 women of the E3N cohort.Conclusion: In practice, our study suggests to use the semiparametric or parametric approaches to estimate AR as a function of time in cohort studies if the proportional hazards assumption appears appropriate. [ABSTRACT FROM AUTHOR]

Background: The risk of a disease or psychiatric disorder is frequently measured by the age-specific cumulative incidence. Cumulative incidence estimates are often derived in cohort studies with individuals recruited over calendar time and with the end of follow-up governed by a specific date. It is common practice to apply the Kaplan-Meier or Aalen-Johansen estimator to the total sample and report either the estimated cumulative incidence curve or just a single point on the curve as a description of the disease risk.Methods: We argue that, whenever the disease or disorder of interest is influenced by calendar time trends, the total sample Kaplan-Meier and Aalen-Johansen estimators do not provide useful estimates of the general risk in the target population. We present some alternatives to this type of analysis.Results: We show how a proportional hazards model may be used to extrapolate disease risk estimates if proportionality is a reasonable assumption. If not reasonable, we instead advocate that a more useful description of the disease risk lies in the age-specific cumulative incidence curves across strata given by time of entry or perhaps just the end of follow-up estimates across all strata. Finally, we argue that a weighted average of these end of follow-up estimates may be a useful summary measure of the disease risk within the study period.Conclusions: Time trends in a disease risk will render total sample estimators less useful in observational studies with staggered entry and administrative censoring. An analysis based on proportional hazards or a stratified analysis may be better alternatives. [ABSTRACT FROM AUTHOR]

Background: Many continuous item responses (CIRs) are encountered in healthcare settings, but no one uses item response theory's (IRT) probabilistic modeling to present graphical presentations for interpreting CIR results. A computer module that is programmed to deal with CIRs is required. To present a computer module, validate it, and verify its usefulness in dealing with CIR data, and then to apply the model to real healthcare data in order to show how the CIR that can be applied to healthcare settings with an example regarding a safety attitude survey.Methods: Using Microsoft Excel VBA (Visual Basic for Applications), we designed a computer module that minimizes the residuals and calculates model's expected scores according to person responses across items. Rasch models based on a Wright map and on KIDMAP were demonstrated to interpret results of the safety attitude survey.Results: The author-made CIR module yielded OUTFIT mean square (MNSQ) and person measures equivalent to those yielded by professional Rasch Winsteps software. The probabilistic modeling of the CIR module provides messages that are much more valuable to users and show the CIR advantage over classic test theory.Conclusions: Because of advances in computer technology, healthcare users who are familiar to MS Excel can easily apply the study CIR module to deal with continuous variables to benefit comparisons of data with a logistic distribution and model fit statistics. [ABSTRACT FROM AUTHOR]

Background: Confidence intervals for the between study variance are useful in random-effects meta-analyses because they quantify the uncertainty in the corresponding point estimates. Methods for calculating these confidence intervals have been developed that are based on inverting hypothesis tests using generalised heterogeneity statistics. Whilst, under the random effects model, these new methods furnish confidence intervals with the correct coverage, the resulting intervals are usually very wide, making them uninformative.Methods: We discuss a simple strategy for obtaining 95 % confidence intervals for the between-study variance with a markedly reduced width, whilst retaining the nominal coverage probability. Specifically, we consider the possibility of using methods based on generalised heterogeneity statistics with unequal tail probabilities, where the tail probability used to compute the upper bound is greater than 2.5 %. This idea is assessed using four real examples and a variety of simulation studies. Supporting analytical results are also obtained.Results: Our results provide evidence that using unequal tail probabilities can result in shorter 95 % confidence intervals for the between-study variance. We also show some further results for a real example that illustrates how shorter confidence intervals for the between-study variance can be useful when performing sensitivity analyses for the average effect, which is usually the parameter of primary interest.Conclusions: We conclude that using unequal tail probabilities when computing 95 % confidence intervals for the between-study variance, when using methods based on generalised heterogeneity statistics, can result in shorter confidence intervals. We suggest that those who find the case for using unequal tail probabilities convincing should use the '1-4 % split', where greater tail probability is allocated to the upper confidence bound. The 'width-optimal' interval that we present deserves further investigation. [ABSTRACT FROM AUTHOR]

Background: Geographic perspectives of disease and the human condition often involve point-based observations and questions of clustering or dispersion within a spatial context. These problems involve a finite set of point observations and are constrained by a larger, but finite, set of locations where the observations could occur. Developing a rigorous method for pattern analysis in this context requires handling spatial covariates, a method for constrained finite spatial clustering, and addressing bias in geographic distance measures. An approach, based on Ripley's K and applied to the problem of clustering with deliberate self-harm (DSH), is presented.Methods: Point-based Monte-Carlo simulation of Ripley's K, accounting for socio-economic deprivation and sources of distance measurement bias, was developed to estimate clustering of DSH at a range of spatial scales. A rotated Minkowski L1 distance metric allowed variation in physical distance and clustering to be assessed. Self-harm data was derived from an audit of 2 years' emergency hospital presentations (n = 136) in a New Zealand town (population ~50,000). Study area was defined by residential (housing) land parcels representing a finite set of possible point addresses.Results: Area-based deprivation was spatially correlated. Accounting for deprivation and distance bias showed evidence for clustering of DSH for spatial scales up to 500 m with a one-sided 95 % CI, suggesting that social contagion may be present for this urban cohort.Conclusions: Many problems involve finite locations in geographic space that require estimates of distance-based clustering at many scales. A Monte-Carlo approach to Ripley's K, incorporating covariates and models for distance bias, are crucial when assessing health-related clustering. The case study showed that social network structure defined at the neighbourhood level may account for aspects of neighbourhood clustering of DSH. Accounting for covariate measures that exhibit spatial clustering, such as deprivation, are crucial when assessing point-based clustering. [ABSTRACT FROM AUTHOR]

Background: The continual reassessment method (CRM) requires an underlying model of the dose-toxicity relationship ("prior skeleton") and there is limited guidance of what this should be when little is known about this association. In this manuscript the impact of applying the CRM with different prior skeleton approaches and the 3 + 3 method are compared in terms of ability to determine the true maximum tolerated dose (MTD) and number of patients allocated to sub-optimal and toxic doses.Methods: Post-hoc dose-escalation analyses on real-life clinical trial data on an early oncology compound (AZD3514), using the 3 + 3 method and CRM using six different prior skeleton approaches.Results: All methods correctly identified the true MTD. The 3 + 3 method allocated six patients to both sub-optimal and toxic doses. All CRM approaches allocated four patients to sub-optimal doses. No patients were allocated to toxic doses from sigmoidal, two from conservative and five from other approaches.Conclusions: Prior skeletons for the CRM for phase 1 clinical trials are proposed in this manuscript and applied to a real clinical trial dataset. Highly accurate initial skeleton estimates may not be essential to determine the true MTD, and, as expected, all CRM methods out-performed the 3 + 3 method. There were differences in performance between skeletons. The choice of skeleton should depend on whether minimizing the number of patients allocated to suboptimal or toxic doses is more important.Trial Registration: NCT01162395 , Trial date of first registration: July 13, 2010. [ABSTRACT FROM AUTHOR]

Background: In observational studies, matched case-control designs are routinely conducted to improve study precision. How to select covariates for match or adjustment, however, is still a great challenge for estimating causal effect between the exposure E and outcome D.Methods: From the perspective of causal diagrams, 9 scenarios of causal relationships among exposure (E), outcome (D) and their related covariates (C) were investigated. Further various simulation strategies were performed to explore whether match or adjustment should be adopted. The "do calculus" and "back-door criterion" were used to calculate the true causal effect (β) of E on D on the log-odds ratio scale. 1:1 matching method was used to create matched case-control data, and the conditional or unconditional logistic regression was utilized to get the estimators ([Formula: see text]) of causal effect. The bias ([Formula: see text]) and standard error ([Formula: see text]) were used to evaluate their performances.Results: When C is exactly a confounder for E and D, matching on it did not illustrate distinct improvement in the precision; the benefit of match was to greatly reduce the bias for β though failed to completely remove the bias; further adjustment for C in matched case-control designs is still essential. When C is associated with E or D, but not a confounder, including an independent cause of D, a cause of E but has no direct causal effect on D, a collider of E and D, an effect of exposure E, a mediator of causal path from E to D, arbitrary match or adjustment of this kind of plausible confounders C will create unexpected bias. When C is not a confounder but an effect of D, match or adjustment is unnecessary. Specifically, when C is an instrumental variable, match or adjustment could not reduce the bias due to existence of unobserved confounders U.Conclusions: Arbitrary match or adjustment of the plausible confounder C is very dangerous before figuring out the possible causal relationships among E, D and their related covariates. [ABSTRACT FROM AUTHOR]

Background: Functional connectivity analyses of multiple neurons provide a powerful bottom-up approach to reveal functions of local neuronal circuits by using simultaneous recording of neuronal activity. A statistical methodology, generalized linear modeling (GLM) of the spike response function, is one of the most promising methodologies to reduce false link discoveries arising from pseudo-correlation based on common inputs. Although recent advancement of fluorescent imaging techniques has increased the number of simultaneously recoded neurons up to the hundreds or thousands, the amount of information per pair of neurons has not correspondingly increased, partly because of the instruments' limitations, and partly because the number of neuron pairs increase in a quadratic manner. Consequently, the estimation of GLM suffers from large statistical uncertainty caused by the shortage in effective information.Results: In this study, we propose a new combination of GLM and empirical Bayesian testing for the estimation of spike response functions that enables both conservative false discovery control and powerful functional connectivity detection. We compared our proposed method's performance with those of sparse estimation of GLM and classical Granger causality testing. Our method achieved high detection performance of functional connectivity with conservative estimation of false discovery rate and q values in case of information shortage due to short observation time. We also showed that empirical Bayesian testing on arbitrary statistics in place of likelihood-ratio statistics reduce the computational cost without decreasing the detection performance. When our proposed method was applied to a functional multi-neuron calcium imaging dataset from the rat hippocampal region, we found significant functional connections that are possibly mediated by AMPA and NMDA receptors.Conclusions: The proposed empirical Bayesian testing framework with GLM is promising especially when the amount of information per a neuron pair is small because of growing size of observed network. [ABSTRACT FROM AUTHOR]

Background: Although covariate adjustment in the analysis of randomised trials can be beneficial, adjustment for continuous covariates is complicated by the fact that the association between covariate and outcome must be specified. Misspecification of this association can lead to reduced power, and potentially incorrect conclusions regarding treatment efficacy.Methods: We compared several methods of adjustment to determine which is best when the association between covariate and outcome is unknown. We assessed (a) dichotomisation or categorisation; (b) assuming a linear association with outcome; (c) using fractional polynomials with one (FP1) or two (FP2) polynomial terms; and (d) using restricted cubic splines with 3 or 5 knots. We evaluated each method using simulation and through a re-analysis of trial datasets.Results: Methods which kept covariates as continuous typically had higher power than methods which used categorisation. Dichotomisation, categorisation, and assuming a linear association all led to large reductions in power when the true association was non-linear. FP2 models and restricted cubic splines with 3 or 5 knots performed best overall.Conclusions: For the analysis of randomised trials we recommend (1) adjusting for continuous covariates even if their association with outcome is unknown; (2) keeping covariates as continuous; and (3) using fractional polynomials with two polynomial terms or restricted cubic splines with 3 to 5 knots when a linear association is in doubt. [ABSTRACT FROM AUTHOR]

Background: Understanding trends in the distribution of body mass index (BMI) is a critical aspect of monitoring the global overweight and obesity epidemic. Conventional population health metrics often only focus on estimating and reporting the mean BMI and the prevalence of overweight and obesity, which do not fully characterize the distribution of BMI. In this study, we propose a novel method which allows for the estimation of the entire distribution. Methods: The proposed method utilizes the optimization algorithm, L-BFGS-B, to derive the distribution of BMI from three commonly available population health statistics: mean BMI, prevalence of overweight, and prevalence of obesity. We conducted a series of simulations to examine the properties, accuracy, and robustness of the method. We then illustrated the practical application of the method by applying it to the 2011-2012 US National Health and Nutrition Examination Survey (NHANES). Results: Our method performed satisfactorily across various simulation scenarios yielding empirical (estimated) distributions which aligned closely with the true distributions. Application of the method to the NHANES data also showed a high level of consistency between the empirical and true distributions. In situations where there were considerable outliers, the method was less satisfactory at capturing the extreme values. Nevertheless, it remained accurate at estimating the central tendency and quintiles. Conclusion: The proposed method offers a tool that can efficiently estimate the entire distribution of BMI. The ability to track the distributions of BMI will improve our capacity to capture changes in the severity of overweight and obesity and enable us to better monitor the epidemic. [ABSTRACT FROM AUTHOR]

Background: To reduce the occurrence of wheelchair falls and to develop effective protection systems, we aimed to quantify sideways tip and fall dynamics of electric power wheelchairs (EPWs). We hypothesized that driving speed, curb height and angle of approach would affect impact forces and head injury risk for wheelchair riders. We further expected that fall dynamics and head injury risk would be greater for unrestrained riders compared to restrained riders.Methods: Sideways wheelchair tip and fall dynamics were reconstructed using a remotely operated rear wheel drive EPW and a Hybrid III test dummy driving at different approach angles (5 to 63°) over an adjustable height curb (0.30 to 0.41 m) at speeds of 0.6-1.5 m/s. Rigid body dynamics models (Madymo, TASS International, Livonia, MI) were developed in parallel with the experiments to systematically study and quantify the impact forces and the sideways tip or fall of an EPW user in different driving conditions.Results: Shallower approach angles (25°) (p < 0.05) and higher curbs (0.4 m) (p < 0.05) were the most significant predictors of tipping for restrained passengers. Unrestrained passengers were most affected by higher curbs (0.4 m) (p < 0.005) and fell forward from the upright wheelchair when the approach angle was 60°. Head impact forces were greater in unrestrained users (6181 ± 2372 N) than restrained users (1336 ± 827 N) (p = 0.00053). Unrestrained users had significantly greater head impact severities than restrained users (HIC = 610 ± 634 vs HIC = 29 ± 38, p = 0.00013) and several tip events resulted in HICs > 1000 (severe head injury) in unrestrained users.Conclusions: Sideways tips and forward falls from wheelchairs were most sensitive to curb height and approach angle but were not affected by driving speed. Sideways tips and falls resulted in impact forces that could result in concussions or traumatic brain injury and require injury prevention strategies. Seat belts eliminated the risk of falling from an upright chair and reduced head impact forces in sideways wheelchair tips in this study; however, their use must be considered within the ethical and legal definitions of restraints. [ABSTRACT FROM AUTHOR]

Background: While mathematical models are often used to predict progression of cancer and treatment outcomes, there is still uncertainty over how to best model tumor growth. Seven ordinary differential equation (ODE) models of tumor growth (exponential, Mendelsohn, logistic, linear, surface, Gompertz, and Bertalanffy) have been proposed, but there is no clear guidance on how to choose the most appropriate model for a particular cancer.Methods: We examined all seven of the previously proposed ODE models in the presence and absence of chemotherapy. We derived equations for the maximum tumor size, doubling time, and the minimum amount of chemotherapy needed to suppress the tumor and used a sample data set to compare how these quantities differ based on choice of growth model.Results: We find that there is a 12-fold difference in predicting doubling times and a 6-fold difference in the predicted amount of chemotherapy needed for suppression depending on which growth model was used.Conclusion: Our results highlight the need for careful consideration of model assumptions when developing mathematical models for use in cancer treatment planning. [ABSTRACT FROM AUTHOR]

Background: Despite randomization, baseline imbalance and confounding bias may occur in cluster randomized trials (CRTs). Covariate imbalance may jeopardize the validity of statistical inferences if they occur on prognostic factors. Thus, the diagnosis of a such imbalance is essential to adjust statistical analysis if required.Methods: We developed a tool based on the c-statistic of the propensity score (PS) model to detect global baseline covariate imbalance in CRTs and assess the risk of confounding bias. We performed a simulation study to assess the performance of the proposed tool and applied this method to analyze the data from 2 published CRTs.Results: The proposed method had good performance for large sample sizes (n =500 per arm) and when the number of unbalanced covariates was not too small as compared with the total number of baseline covariates (≥40% of unbalanced covariates). We also provide a strategy for pre selection of the covariates needed to be included in the PS model to enhance imbalance detection.Conclusion: The proposed tool could be useful in deciding whether covariate adjustment is required before performing statistical analyses of CRTs. [ABSTRACT FROM AUTHOR]

Background: In many studies, some information might not be available for the whole cohort, some covariates, or even the outcome, might be ascertained in selected subsamples. These studies are part of a broad category termed two-phase studies. Common examples include the nested case-control and the case-cohort designs. For two-phase studies, appropriate weighted survival estimates have been derived; however, no estimator of cumulative incidence accounting for competing events has been proposed. This is relevant in the presence of multiple types of events, where estimation of event type specific quantities are needed for evaluating outcome.Methods: We develop a non parametric estimator of the cumulative incidence function of events accounting for possible competing events. It handles a general sampling design by weights derived from the sampling probabilities. The variance is derived from the influence function of the subdistribution hazard.Results: The proposed method shows good performance in simulations. It is applied to estimate the crude incidence of relapse in childhood acute lymphoblastic leukemia in groups defined by a genotype not available for everyone in a cohort of nearly 2000 patients, where death due to toxicity acted as a competing event. In a second example the aim was to estimate engagement in care of a cohort of HIV patients in resource limited setting, where for some patients the outcome itself was missing due to lost to follow-up. A sampling based approach was used to identify outcome in a subsample of lost patients and to obtain a valid estimate of connection to care.Conclusions: A valid estimator for cumulative incidence of events accounting for competing risks under a general sampling design from an infinite target population is derived. [ABSTRACT FROM AUTHOR]

Background: Advances in molecular technology have shifted new drug development toward targeted therapy for treatments expected to benefit subpopulations of patients. Adaptive signature design (ASD) has been proposed to identify the most suitable target patient subgroup to enhance efficacy of treatment effect. There are two essential aspects in the development of biomarker adaptive designs: 1) an accurate classifier to identify the most appropriate treatment for patients, and 2) statistical tests to detect treatment effect in the relevant population and subpopulations. We propose utilization of classification methods to identity patient subgroups and present a statistical testing strategy to detect treatment effects.Methods: The diagonal linear discriminant analysis (DLDA) is used to identify targeted and non-targeted subgroups. For binary endpoints, DLDA is directly applied to classify patient into two subgroups; for continuous endpoints, a two-step procedure involving model fitting and determination of a cutoff-point is used for subgroup classification. The proposed strategy includes tests for treatment effect in all patients and in a marker-positive subgroup, with a possible follow-up estimation of treatment effect in the marker-negative subgroup. The proposed method is compared to the ASD classification method using simulated datasets and two publically available cancer datasets.Results: The DLDA-based classifier performs well in terms of sensitivity, specificity, positive and negative predictive values, and accuracy in the simulation data and the two cancer datasets, with superior accuracy compared to the ASD method. The subgroup testing strategy is shown to be useful in detecting treatment effect in terms of power and control of study-wise error.Conclusion: Accuracy of a classifier is essential for adaptive designs. A poor classifier not only assigns patients to inappropriate treatments, but also reduces the power of the test, resulting in incorrect conclusions. The proposed procedure provides an effective approach for subgroup identification and subgroup analysis. [ABSTRACT FROM AUTHOR]