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Biomedical subjects

M Buscema

Publications and source records attributed to M Buscema.

At least 19 recordsLinked to original sources

An optimized experimental protocol based on neuro-evolutionary algorithms application to the classification of dyspeptic patients and to the prediction of the effectiveness of their treatment.

OBJECTIVE: This paper aims to present a specific optimized experimental protocol (EP) for classification and/or prediction problems. The neuro-evolutionary algorithms on which it is based and its application with two selected real cases are described in detail. The first application addresses the problem of classifying the functional (FD) or organic (OD) forms of dyspepsia; the second relates to the problem of predicting the 6-month follow-up outcome of dyspeptic patients treated by helicobacter pylori (HP) eradication therapy. METHODS AND MATERIAL: The database built by the multicentre observational study, performed in Italy by the NUD-look Study Group, provided the material studied: a collection of data from 861 patients with previously uninvestigated dyspepsia, being referred for upper gastrointestinal endoscopy to 42 Italian Endoscopic Services. The proposed EP makes use of techniques based on advanced neuro-evolutionary systems (NESs) and is structured in phases and steps. The use of specific input selection (IS) and training and testing (T and T) techniques together with genetic doping (GenD) algorithm is described in detail, as well as the steps taken in the two benchmark and optimization protocol phases. RESULTS: In terms of accuracy results, a value of 79.64% was achieved during optimization, with mean benchmark values of 64.90% for the linear discriminant analysis (LDA) and 68.15% for the multi layer perceptron (MLP), for the classification task. A value of 88.61% was achieved during optimization for the prediction task, with mean benchmark values of 49.32% for the LDA and 70.05% for the MLP. CONCLUSIONS: The proposed EP has led to the construction of inductors that are viable and usable on medical data which is representative but highly not linear. In particular, for the classification problem, these new inductors may be effectively used on the basal examination data to support doctors in deciding whether to avoid endoscopic examinations; whereas, in the prediction problem, they may support doctors' decisions about the advisability of eradication therapy. In both cases the variables selected indicate the possibility of reducing the data collection effort and also of providing information that can be used for general investigations on symptom relevance.

Algorithms↗

Assessment of the role of genetic polymorphism in venous thrombosis through artificial neural networks.

PURPOSE: To assess the role of genetic polymorphisms in venous thrombosis events (VTE) using Artificial Neural Networks (ANNs), a model for solving non-linear problems frequently associated with complex biological systems, due to interactions between biological, genetic and environmental factors. METHODS: A database was generated from a case-control study of venous thrombosis, using 238 patients and 211 controls. The database of 64 variables included age, gender and a panel of 62 genetic variants. Three different ANNs were compared, with logistic regression for the accuracy of predicting cases and controls. RESULTS: ANNs yielded a better performance than the logistic regression algorithm. Indeed, through ANNs models, the 62 variables related to genetic variants were first reduced to a set of 9, and then of 3 (MTHFR 677 C/T, FV arg506gln, ICAM1 gly214arg). CONCLUSIONS: The findings of this study illustrate the power of ANN in evaluating multifactorial data, and show that the different sensitivities of the models of elaboration are related to the characteristics of the data. This may contribute to a better understanding of the role played by genetic polymorphisms in VTE, and help to define, if possible, a test panel of genetic variants to estimate an individual's probability of developing the disease.

Adolescent↗

Contribution of artificial neural networks to the classification and treatment of patients with uninvestigated dyspepsia.

OBJECTIVES: To verify whether symptoms reported by patients with uninvestigated dyspepsia might be helpful in either classifying functional from organic dyspepsia (1st experiment), or recognising which Helicobacter pylori infected patients may benefit from eradication therapy (2nd experiment). METHODS: We compared the performance of artificial neural networks and linear discriminant analysis in two experiments on a database including socio-demographic features, past medical history, alarming symptoms, and symptoms at presentation of 860 patients with uninvestigated dyspepsia enrolled in a large observational multi-centre Italian study. RESULTS: In the 1st experiment, the best prediction for organic disease was given by the Sine Net model (specificity of 87.6% with 13 patients misclassified) and the best prediction for functional dyspepsia by the FF Bp model (sensitivity of 83.4% with 56 patients misclassified). The highest global accuracy of linear discriminant analysis was 65.1%, with 150 patients misclassified. In the 2nd experiment, the highest predictive performance was provided by the SelfDASn model: all infected patients who became symptom-free after successful eradicating treatment were correctly classified, whereas nine errors were made in forecasting patients who did not benefit from such a therapy. The highest global performance of linear discriminant analysis was 53.2%, with 37 patients misclassified. CONCLUSIONS: In patients with uninvestigated dyspepsia, artificial neural networks might have potential for categorising those affected by either organic or functional dyspepsia, as well as for identifying all Helicobacter pylori infected dyspeptic patients who will benefit from eradication.

Adolescent↗

Improved artificial neural networks in prediction of malignancy of lesions in contrast-enhanced MR-mammography.

The aim of this study was to evaluate the capability of improved artificial neural networks (ANN) and additional novel training methods in distinguishing between benign and malignant breast lesions in contrast-enhanced magnetic resonance-mammography (MRM). A total of 604 histologically proven cases of contrast-enhanced lesions of the female breast at MRI were analyzed. Morphological, dynamic and clinical parameters were collected and stored in a database. The data set was divided into several groups using random or experimental methods [Training & Testing (T&T) algorithm] to train and test different ANNs. An additional novel computer program for input variable selection was applied. Sensitivity and specificity were calculated and compared with a statistical method and an expert radiologist. After optimization of the distribution of cases among the training and testing sets by the T & T algorithm and the reduction of input variables by the Input Selection procedure a highly sophisticated ANN achieved a sensitivity of 93.6% and a specificity of 91.9% in predicting malignancy of lesions within an independent prediction sample set. The best statistical method reached a sensitivity of 90.5% and a specificity of 68.9%. An expert radiologist performed better than the statistical method but worse than the ANN (sensitivity 92.1%, specificity 85.6%). Features extracted out of dynamic contrast-enhanced MRM and additional clinical data can be successfully analyzed by advanced ANNs. The quality of the resulting network strongly depends on the training methods, which are improved by the use of novel training tools. The best results of an improved ANN outperform expert radiologists.

Algorithms↗

Artificial neural network assessment of substitutive pharmacological treatments in hospitalised intravenous drug users.

Artificial neural networks (ANNs) provide better solutions than linear discriminant analysis (LDA) to problems of classification and estimation involving a large number of non-homogeneous (categorical and metric) variables. In this study, we compared the ability of traditional LDA and a feed-forward back-propagation (FF-BP) ANN with self-momentum to predict pharmacological treatments received by intravenous drug users (IDUs) hospitalised for coexisting medical illness. When medical staff considered detoxification appropriate they usually suggested methadone (MET) and (or) benzodiazepines (BDZ). Given four different treatment options (MET, BDZ, MET+BDZ, no treatment) as dependent variables and 38 independent variables, the FF-BP ANN provided the best prediction of the consultant's decision (overall accuracy: 62.7%). It achieved the highest level of predictive accuracy for the BDZ option (90.5%), the lowest for no treatment (29.6), often misclassifying no treatment as BDZ. The LDA yielded a lower mean accuracy (50.3%). When the untreated group was excluded, ANN improved its absolute recognition rate by only 1.2% and the BDZ group remained the best predicted. In contrast, LDA improved its absolute recognition rate from 50.3 to 58.9%, maximum 65.7% for the BDZ group. In conclusion, the FF-BP ANN was more accurate than the statistical model (discriminant analysis) in predicting the pharmacological treatment of IDUs.

Adult↗

Artificial neural networks for drug vulnerability recognition and dynamic scenarios simulation.

Semeion researchers have developed and used different kinds of Artificial Neural Networks (ANN) in order to process selected, "standard" data coming from drug users and from people who never used drugs before. In the first step a collection of 112 general variables, not traditionally connected to drug user's behavior, were collected from a sample of 545 people (223 heroin addicted and 322 non-users). Different types of ANNs were used to test the capability of the system to classify the drug users and the non-drug users correctly. A special ANN tool, created by Semeion, was also used to prune the number of the independent variables. The ANN selected for this first experiment was a Supervised Feed Forward Network, whose equations were enhanced by Semeion researchers. For the validation of the capability of generalization of the ANN, the Training-Testing protocol was used. This ANN was able, in the Testing phase, to classify approximately 95% of the sample with accuracy. A special sensitivity tool selected only 47 among the 112 independent variables as necessary to train the ANN. In the second step, different types of ANN were tested on the new 47 variables to decide which kind of ANN was better able to classify the sample. This benchmark included the following ANNs: a) Back Propagation with Soft Max; b) Learning Vector Quantization; c) Logicon Projection; d) Radial Basis Function; e) Squash (Semeion Network); f) Fuzzy Art Map; g) Modular Neural Network. In the third step a Constraint Satisfaction Network, specifically created by Semeion, was used to simulate a dynamic fuzzy map of the drug user's world; that is, which fuzzy, or approximate, variables are critical to decide the fuzzy membership of a subject from the fuzzy membership of the drug users to the fuzzy membership of non-users and vice versa.

Artificial Intelligence↗

Application of artificial neural networks to eating disorders.

An experimental application of Artificial Neural Networks to Eating Disorders is presented. The sample, composed of 172 cases (all women) collected at the Centre for the Diagnosis and Treatment of Eating Disorders of the 1st Medical Division of the St. Eugenio Hospital of Rome, was subdivided, on the basis of the diagnosis made by the specialist of the St. Eugenio, into four classes: Anorexia Nervosa (AN), Nervous Bulimia (NB), Binge Eating Disorders (BED) and Psychogenic Eating Disorders that are Not Otherwise Specified (PED-NOS). The data base was composed of 124 different variables: generic information, alimentary behavior, eventual treatment and hospitalization, substance use, menstrual cycles, weight and height, hematochemical and instrumental examinations, psychodiagnostic tests, etc. The goal of this experiment was to verify the accuracy of the Neural Networks in recognising anorexic and bulimic patients. This article describes 6 experiments, using a Feed Forward Neural Network, each one using different variables. Starting from only the generic variables (life styles, family environment, etc.) and hematoclinical and instrumental examinations, a Neural Networks provided 86.94% of the prediction precision. This work is meant to be a first contribution to creating diagnostic procedures for Eating Disorders, that would be simple and easy-to-use by professionals who are neither psychologists nor psychiatrists nor psychotherapists but who are, however, among the first to meet these patients and who are therefore called upon to give such patients the very first pieces of advice on seeking proper treatment.

Anorexia Nervosa↗

A neural network investigation of the crucial facets of urban sustainability.

This paper focuses on the concept of a sustainable city and its theoretical implications for the Italian urban system. Urban sustainability is based on positive interactions among three different urban subsystems: social, economic and physical, where social well-being coexists with economic development and environmental quality. This utopian scenario does not appear in the existing cities. The aesthetic quality of natural and man-made environment is often associated with marginality and poverty, labor market variety and urban efficiency coexisting with pollution, criminality and high settlement costs. Moreover, since each city differs institutionally, historically, culturally and economically, few attempts have been implemented to build a comparative synthetic vision of the urban sustainability in different cities. The interactions among these selected systems are complex and unpredictable and present the opportunity for a new methodology of scientific investigation: the connectionistic approach. The dual aim of this study is to: investigate the underlying relationships among the three subsystems with a set of social, economic and physical attributes of the chief towns of a Province in Italy and ; verify if this underlying structure could reproduce the heterogeneity of urban realities, allowing one to distinguish groups of cities with different assets or drawbacks in their sustainability. The Data Base (DB), composed of 43 attributes for 95 cities, was processed by Self-Reflexive Neural Networks (SRNN) (Buscema, 1995). These Networks are a useful instrument of investigation and analogic questioning of the Data Base. Once the SRNN has learned the structure of the weights from the DB, by querying the network with the maximization or minimization of specific groups of attributes, it is possible to read the related properties and to rank the cities' urban profile.

Cities↗

[Iodine deficiency and iodine prophylaxis experience in Sicily].

Twenty years ago we described an area of goiter endemia in North-Eastern Sicily. In this area endemic goiter was associated to a variable degree of iodine deficiency and, in some places, also to an increased thiocyanate urine excretion. Our studies have demonstrated a strict relationship between iodine deficiency and congenital hypothyroidism (both permanent and transient), an increased prevalence of autonomously functioning thyroid nodules and an increased prevalence of thyroid cancer (follicular and anaplastic histotypes). A number of cases of endemic cretinism have also been described. An active iodine prophylaxis program has been carried in the town of Troina in the years 1979-87, by iodinating the municipal water supply. This intervention caused the disappearance of goiter in schoolchildren in only five years. In the last 20 years the prevalence of goiter has decreased in all endemic areas probably because of the "silent prophylaxis", due to improved socio-economic conditions and industrial food consumption. Today the persistence of endemic goiter confirms the inadequacy of the silent iodine prophylaxis and the need to immediately introduce an active iodine prophylaxis in Sicily.

Biomarkers↗

A general presentation of artificial neural networks. I.

This article, the first in a series, presents the use of a new processing technology: Artificial Neural Networks (ANN) Modeling. We introduce the reader, in an easy way, to types of problems for which researchers can use this technology. ANN represents a powerful way for understanding, predicting, and simulating complex and chaotic dynamics. We believe that social fields, human psychology, and behaviors, which are nonlinear in their essence, need an adequate methodology such as ANN in order to best investigate and comprehend them.

Computer Simulation↗

The Sonda Project: prevention, prediction, and psychological disorder.

The Sonda Project began in Italy in 1985 and was created by Semeion Research Center of Sciences of Communication. It has been operating in approximately 30 Italian cities, ranging from large to small, since 1986. The aim of the Sonda Project is to undertake primary prevention measures at the level of personality organization disorder. Cognitive and communication disorders are, in the context of the Sonda Project, the common ground for many expressions of cultural disorders labeled drug addiction, alcoholism, violence, etc. From the point of view of the Sonda Project, measures aimed at combating drug-addiction and alcoholism are no more than superficial strategies incapable of dealing with the causes of self and hetero-destruction (of others). Such abuses are the most evident political symptoms. The methodological aim of the Sonda Project, therefore, consists in understanding, predicting, and acting upon the incubation disorder of human beings; a disorder which subsequently transforms itself into more or less recognizable symptoms. In order to attain its aim, the Sonda Project has made use of two instruments: 1) a series of Intelligent Computerized Observatories, able to predict, in each community, the typology of people who are more likely to exhibit forms of destructive suffering; 2) a local team able to use such advanced technology and able to utilize territorial activation techniques. These are designed to reinsert into the arena of the social game those people who are more "at risk" in terms of self and heterodestruction, and who are most exposed to psychological and sociological levels of relational "fatigue."

Health Promotion↗