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SNP subset selection for genetic association studies.

Association studies for disease susceptibility genes rely on the high density of SNPs within candidate genes. However, the linkage disequilibrium between SNPs imply that not all SNPs identified in the candidate region need be genotyped. Here we develop several approaches to SNP subset selection, which can substantially reduce the number of SNPs to be genotyped in an association study. We apply clustering algorithms to pairwise linkage disequilibrium measures, with SNP subsets determined for different cut-off values of Delta using nearest and furthest neighbour clusters. Alternatively, SNP subsets may be determined by the proportion of haplotypes they identify. We also show how power calculations, based on the average power to identify a SNP as the disease susceptibility mutation using haplotype-based or logistic regression based statistical analyses, can be used to choose SNP subsets. All these methods provide a ranking method for subsets of a specific size, but do not provide criteria for overall choice of SNP subset size. We develop such criteria by incorporating power calculations into a decision analysis, where the choice of SNP subset size depends on the genotyping costs and the perceived benefits of identifying association. These methods are illustrated using eleven SNPs in the MMP2 gene.

Cluster Analysis↗

Electrocardiographic measures of repolarization revisited: why? what? how?

Ventricular repolarization continues to be an enigma to clinical cardiologists and cardiac electrophysiologists. On the one hand, a century of experience has documented an association between abnormal T-wave morphology, QT prolongation and dispersion, T-wave alternans, and nonspecific ST-T waves with arrhythmia risk or negative prognostic outcome. On the other hand, recent advances in molecular electrophysiology have definitively implicated abnormal function and structure of cardiac ion channels associated with repolarization as primary arrhythmogenic mechanisms in long QT syndrome, Brugada's Syndrome, and idiopathic ventricular fibrillation and ventricular tachycardia. In spite of this extensive clinical experience and newly established mechanistic knowledge, robust measurements of repolarization and sensitive algorithms for reliable assessment of risk and prediction of arrhythmia occurrence have remained elusive. New insights into electrocardiographic waveform that reflect and capture the underlying spatial and dynamic characteristics of repolarization offer opportunity to devise clinical indices of repolarization that might be more predictive of risk or outcome than those currently used. Experimental and model data show evidence that the location and size of repolarization lesions may be deduced from T waveform. The changes of repolarization induced by altered activation sequence, and cycle length mediated alterations to repolarization offer additional means to assess the magnitude and significance of such lesions that are linked to increased arrhythmogenic risk. This article explores indices of repolarization that are sensitive to repolarization and its change and that provide opportunity to better characterize and assess repolarization for risk stratification.

Arrhythmias, Cardiac↗

Control, Correction, and Modeling of Setup Errors and Organ Motion.

As advances in radiotherapy technology enable higher precision treatments, it becomes increasingly important to understand the factors that contribute to treatment uncertainty. The recent developments in imaging modalities and computer algorithms have made possible quantitative measurements of treatment uncertainties on statistically significant numbers of patients, which has led to new strategies for reducing as well as incorporating them into the treatment planning process. This article reviews the current literature on two sources of uncertainties deemed important in photon therapy, namely, patient localization (setup) errors and organ motion. In the area of patient localization there has been increasing work on protocols using electronic portal imaging devices to correct setup errors. These protocols are derived from probability analyses based on knowledge of setup errors for a population of patients in combination with defined clinical endpoints. Measurements of organ motion and methods to correct or control it have been more limited, due partly to the larger difficulties in imaging and motion characterization. We also review two paradigms for accounting for uncertainties in treatment plans: the conventional approach, which adds a margin around the tumor volume, and an alternative one, which includes uncertainties directly in the dose distributions of the tumor volume and nearby normal organs.

Journal Article↗

The application of new software tools to quantitative protein profiling via isotope-coded affinity tag (ICAT) and tandem mass spectrometry: II. Evaluation of tandem mass spectrometry methodologies for large-scale protein analysis, and the application of statistical tools for data analysis and interpretation.

Proteomic approaches to biological research that will prove the most useful and productive require robust, sensitive, and reproducible technologies for both the qualitative and quantitative analysis of complex protein mixtures. Here we applied the isotope-coded affinity tag (ICAT) approach to quantitative protein profiling, in this case proteins that copurified with lipid raft plasma membrane domains isolated from control and stimulated Jurkat human T cells. With the ICAT approach, cysteine residues of the two related protein isolates were covalently labeled with isotopically normal and heavy versions of the same reagent, respectively. Following proteolytic cleavage of combined labeled proteins, peptides were fractionated by multidimensional chromatography and subsequently analyzed via automated tandem mass spectrometry. Individual tandem mass spectrometry spectra were searched against a human sequence database, and a variety of recently developed, publicly available software applications were used to sort, filter, analyze, and compare the results of two repetitions of the same experiment. In particular, robust statistical modeling algorithms were used to assign measures of confidence to both peptide sequences and the proteins from which they were likely derived, identified via the database searches. We show that by applying such statistical tools to the identification of T cell lipid raft-associated proteins, we were able to estimate the accuracy of peptide and protein identifications made. These tools also allow for determination of the false positive rate as a function of user-defined data filtering parameters, thus giving the user significant control over and information about the final output of large-scale proteomic experiments. With the ability to assign probabilities to all identifications, the need for manual verification of results is substantially reduced, thus making the rapid evaluation of large proteomic datasets possible. Finally, by repeating the experiment, information relating to the general reproducibility and validity of this approach to large-scale proteomic analyses was also obtained.

Amino Acid Sequence↗

New digital method for quantitative assessment of nasal morphology.

Our aim was to develop and validate a new method to assess objectively and quantitatively the morphology of the nostrils after nasal or nasolabial surgery. We used digital analysis using specific mathematical algorithms to assess several geometric measurements, particularly of facial asymmetry, expressed in adimensional units. Forty-five patients with no facial anomalies (control group) were used initially to evaluate the method and to obtain variables for statistical reference. Thirty-five patients operated on for unilateral cleft lip and palate (cleft group) were then analysed and compared with the control group. Individual scores were obtained for each patient, computed, and correlated with those established by a lay panel. Statistical analysis showed good sensitivity and reliability (R>0.8).

Child↗

FDTD analysis of dielectric-loaded longitudinally slotted rectangular waveguides.

A versatile electromagnetic (EM) computational algorithm, based on the Finite-Difference Time-Domain (FDTD) technique, is developed to analyze longitudinally oriented, square-ended, single slot fixtures and slot-pair configurations cut in the broad wall of a WR-975 guide operating at a frequency of 915 MHz. The finite conductivity of the waveguide walls is accounted for by employing a time-domain Surface-Impedance Boundary Conditions (SIBC) formulation. The proposed FDTD algorithm has been validated against measurements performed on a probe-excited slot cut along the center line of the broad wall of a WR-284 guide and available experimental data for energy coupled from a longitudinal slot pair in the broad wall of a WR-340 guide. Numerical results are-presented to exploit the influence of the constitutive parameters of the processed material as well as protective insulating window slabs mounted on the exterior surface of the slots. Particular attention is given to the resonant length, scattering parameters, and the electric field distribution within lossy objects placed in the near-field region over a range of slot offsets and workloads with extensive results being reported for the first time. It is shown that the FDTD technique can accurately predict the coupling and power absorption characteristics in loads located in the near field zone of the slotted waveguide structures and, therefore, should prove to be a powerful design tool applicable to a wide class of slotted waveguide applicators that may be difficult to analyze using other available techniques.

Computer Simulation↗

Detecting periodic patterns in biological sequences.

MOTIVATION: The search for repeated patterns in DNA and protein sequences is important in sequence analysis. The rapid increase in available sequences, in particular from large-scale genome sequencing projects, makes it relevant to develop sensitive automatic methods for the identification of repeats. RESULTS: A new method for finding periodic patterns in biological sequences is presented. The method is based on evolutionary distance and 'phase shifts' corresponding to insertions and deletions. A given sequence is aligned to itself in a certain sense, trying to minimize a distance to periodicity. Relationships between different such periodicity measures are discussed. An iterative algorithm is used, and the running time is nearly proportional to the sequence length. The alignment produces a periodic consensus pattern. A 'phase score' is used to indicate a statistical significance of the periodicity. Three examples using both DNA and protein sequences illustrate how the method can be used to find patterns. AVAILABILITY: On request from the authors. CONTACT: evindc@mat nu.no; finn.drablos@unimed.sintef.no

Algorithms↗

Adaptive quality-based clustering of gene expression profiles.

MOTIVATION: Microarray experiments generate a considerable amount of data, which analyzed properly help us gain a huge amount of biologically relevant information about the global cellular behaviour. Clustering (grouping genes with similar expression profiles) is one of the first steps in data analysis of high-throughput expression measurements. A number of clustering algorithms have proved useful to make sense of such data. These classical algorithms, though useful, suffer from several drawbacks (e.g. they require the predefinition of arbitrary parameters like the number of clusters; they force every gene into a cluster despite a low correlation with other cluster members). In the following we describe a novel adaptive quality-based clustering algorithm that tackles some of these drawbacks. RESULTS: We propose a heuristic iterative two-step algorithm: First, we find in the high-dimensional representation of the data a sphere where the "density" of expression profiles is locally maximal (based on a preliminary estimate of the radius of the cluster-quality-based approach). In a second step, we derive an optimal radius of the cluster (adaptive approach) so that only the significantly coexpressed genes are included in the cluster. This estimation is achieved by fitting a model to the data using an EM-algorithm. By inferring the radius from the data itself, the biologist is freed from finding an optimal value for this radius by trial-and-error. The computational complexity of this method is approximately linear in the number of gene expression profiles in the data set. Finally, our method is successfully validated using existing data sets. AVAILABILITY: http://www.esat.kuleuven.ac.be/~thijs/Work/Clustering.html

Algorithms↗

Global snapshot of a protein interaction network-a percolation based approach.

MOTIVATION: Biologically significant information can be revealed by modeling large-scale protein interaction data using graph theory based network analysis techniques. However, the methods that are currently being used draw conclusions about the global features of the network from local connectivity data. A more systematic approach would be to define global quantities that measure (1) how strongly a protein ties with the other parts of the network and (2) how significantly an interaction contributes to the integrity of the network, and connect them with phenotype data from other sources. In this paper, we introduce such global connectivity measures and develop a stochastic algorithm based upon percolation in random graphs to compute them. RESULTS: We show that, in terms of global connectivities, the distribution of essential proteins is distinct from the background. This observation highlights a fundamental difference between the essential and the non-essential proteins in the network. We also find that the interaction data obtained from different experimental methods such as immunoprecipitation and two-hybrid techniques contribute differently to network integrities. Such difference between different experimental methods can provide insight into the systematic bias present among these techniques. SUPPLEMENTARY INFORMATION: The full list of our results can be found in the supplemental web site http://www.nas.nasa.gov/Groups/SciTech/nano/msamanta/projects/percolation/index.php

Algorithms↗

Use of a treatment protocol in the management of community-acquired lower respiratory tract infection.

The aim of the present study was to examine the impact of an antimicrobial prescribing protocol on clinical and economic outcome measures in hospitalized patients with community-acquired lower respiratory tract infection (LRTI). The study was performed as a prospective controlled clinical trial within the medical wards at Antrim Area Hospital, Northern Ireland. Data were collected on all hospitalized adult patients with a primary diagnosis of LRTI during the period December 1994 to February 1995 (normal hospital practice; control group; n = 112). After an LRTI management protocol (medical, microbiological and pharmacy staff) had been developed, all hospitalized adult patients with a primary diagnosis of LRTI over the period December 1995 to February 1996 formed the intervention group (treated according to the protocol; n = 115). The results showed a statistically significant impact of the protocol in terms of clinical and economic outcome measures. Patients treated using the algorithmic prescribing protocol had significant reductions in length of hospital stay (geometric mean 4.5 versus 9.2 days), iv drug administration (34.8% versus 61.6%), duration of iv therapy (geometric mean 2.1 versus 5.7 days) and treatment failures (7.8% versus 31.3%). Healthcare costs were also significantly reduced. The use of the protocol was a major factor in streamlining the prescribing of antimicrobial therapy for community-acquired LRTI and led to more cost-effective patient management.

Aged↗

Dynamic cortical activation in mental image processing revealed by biomagnetic measurement.

The mental rotation task has been reported to activate the human parietal and extra-striate areas, based on the results of fMRI and PET analysis. In the present study, we investigated the dynamic properties of the distributed cortical activity related to mental rotation processes at high temporal resolution by means of brain magnetic field measurements and a linear inversion algorithm. Distributed neural activities during the mental rotation and control tasks were estimated for six subjects, and the differences in the activity distribution were analyzed. Statistically significant differences in the parietal and lateral posterior temporal region were detected 200-300 ms after the visual stimulus, indicating that the dorsal and ventral pathway were included in the mental image processing.

Adult↗

Peroneal latency in normal and injured ankles at varying angles of perturbation.

The aim of this study was to determine whether there was a difference in latency of the peroneus longus muscle at varying amplitudes of ankle inversion perturbation and between individuals with and without a history of ankle injury. Thirty-four male athletes from different football codes (soccer, rugby) received four random tilts to their left ankles at 5 degrees, 10 degrees, and 15 degrees in the frontal plane on a dual platform trap door. Peroneal latency was defined as the time difference between onset of the trap door movement, as detected by an accelerometer, and the onset of muscle activation above a resting baseline, as recorded using surface electromyography. Latency was determined using an algorithm. A series of repeated measures analyses of variance indicated that the latency was reliable between trials. There was no statistical evidence that history of injury or subjective ankle instability influenced the latency; however, there was a systematic difference between dominant and nondominant legs (dominant, 6.3 ms faster), and there was a small systematic effect (3 ms) for the angle of inversion perturbation. Muscle latency responses in male football players are thought to be influenced more by dominance than by history of injury or amplitude of perturbation.

Adolescent↗

Limitations of a structured psychiatric diagnostic instrument in assessing somatization among Latino patients in primary care.

BACKGROUND: The Composite International Diagnostic Interview (CIDI) has been developed as a state-of-the-art, structured diagnostic instrument, designed to diagnose psychiatric disorders across cultures and languages. Partly because it has been validated in a number of countries and cultural settings, the CIDI has become widely accepted as a diagnostic instrument in epidemiologic and clinical research. OBJECTIVES: As part of a larger study of psychiatric disorders in a multi-ethnic, primary care setting, we tried to clarify the limitations of the CIDI in diagnosing somatoform symptoms among Latino patients. DESIGN: Relevant sections of the CIDI were administered in English or Spanish to new patients seeking primary care services at an inner-city, university-affiliated community clinic. Interviews were tape recorded and pertinent passages were transcribed for qualitative analysis. SUBJECTS: One thousand, four hundred and fifty six new patients, comprising 4 ethnic groups: Central American; Mexican; Chicano; and non-Latino White. MEASURES: The CIDI's diagnostic algorithms for somatization were examined in relation to the transcriptions of interviews for Latino patients whom the CIDI diagnosed as somatizers. RESULTS: The CIDI led to the inaccurate identification of somatoform symptoms resulting from such issues as financial barriers to healthcare access, cultural syndromes that were not recognized by Western medicine, and language differences between patients and physicians. Like other structured instruments, the CIDI also forced a range of complex experience into a fixed-choice interview format. CONCLUSIONS: Despite the advantages of such structured instruments as the CIDI, their capacity to reach accurate psychiatric diagnoses in some cultural groups and clinical settings requires clarification. These findings also call into question the relatively high rates of somatization among Latino patients reported in previous studies that have used structured psychiatric diagnostic instruments.

Algorithms↗

Is a lung perfusion scan obtained by using single photon emission computed tomography able to improve the radionuclide diagnosis of pulmonary embolism?

Planar pulmonary scintigraphy is still regularly performed for the evaluation of pulmonary embolism (PE). However, only about 50-80% of cases can be resolved by this approach. This study evaluates the ability of tomographic acquisition (single photon emission computed tomography, SPECT) of the perfusion scan to improve the radionuclide diagnosis of PE. One hundred and fourteen consecutive patients with a suspicion of PE underwent planar and SPECT lung perfusion scans as well as planar ventilation scans. The final diagnosis was obtained by using an algorithm, including D-dimer measurement, leg ultrasonography, a V/Q scan and chest spiral computed tomography, as well as the patient outcome. A planar perfusion scan was considered positive for PE in the presence of one or more wedge shaped defect, while SPECT was considered positive with one or more wedge shaped defect with sharp borders, three-plane visualization, whatever the photopenia. A definite diagnosis was achieved in 70 patients. After exclusion of four 'non-diagnostic' SPECT images, the prevalence of PE was 23% (n =15). Intraobserver and interobserver reproducibilities were 91%/94% and 79%/88% for planar/SPECT images, respectively. The sensitivities for PE diagnosis were similar for planar and SPECT perfusion scans (80%), whereas SPECT had a higher specificity (96% vs 78%; P =0.01). SPECT correctly classified 8/9 intermediate and 31/32 low probability V/Q scans as negative. It is concluded that lung perfusion SPECT is readily performed and reproducible. A negative study eliminates the need for a combined V/Q study and most of the 'non-diagnostic' V/Q probabilities can be solved with a perfusion image obtained by using tomography.

Adult↗

Magnetic resonance anatomic study of iliocava junction and left iliac vein positions related to L5-S1 disc.

STUDY DESIGN: An in vivo anatomic study analyzing the venous anatomy in the lumbosacral area was performed. OBJECTIVES: To obtain in vivo data concerning iliocava junction and left common iliac vein positions at L5-S1. SUMMARY OF BACKGROUND DATA: The left common iliac vein and the iliocava junction are at risk during L5-S1 anterior lumbar interbody fusion. Anatomic studies have demonstrated great interindividual variability in this vascular anatomy. METHODS: Magnetic resonance angiography was used to study 134 patients. Image processing was carried out with maximum intensity projection algorithm and the maximum intensity projection and addition algorithm. Iliocava junction position was measured in the maximum intensity projection and addition image. Four groups of junction position were established: very high, high, low, and very low. The left common iliac vein position was measured in axial magnetic resonance images, and three groups were established: lateral, intermediate, and medial. To describe the operative window delimited by the venous structures at L5-S1, the study population was classified into 12 configurations by combining junction position and vein position values. RESULTS: Very high lateral included 3.76% of the patients, high lateral 48.12%, high intermediate 10.53%, high medial 0.75%, low lateral 15.04%, low intermediate 4.51%, low medial 6.77%, very low lateral 0.75%, very low intermediate 2.26%, and very low medial 7.52%. Medial vein position was significantly more frequent in men. CONCLUSIONS: In 18.05% of the study population, the venous structures overlapped the center of the L5-S1 disc, reducing the operative window.

Adolescent↗

Electrical impedance tomography of complex conductivity distributions with noncircular boundary.

Electrical impedance tomography (EIT) uses low-frequency current and voltage measurements made on the boundary of a body to compute the conductivity distribution within the body. Since the permittivity distribution inside the body also contributes significantly to the measured voltages, the present reconstruction algorithm images complex conductivity distributions. A finite element model (FEM) is used to solve the forward problem, using a 6017-node mesh for a piecewise-linear potential distribution. The finite element solution using this mesh is compared with the analytical solution for a homogeneous field and a maximum error of 0.05% is observed in the voltage distribution. The boundary element method (BEM) is also used to generate the voltage data for inhomogeneous conductivity distributions inside regions with noncircular boundaries. An iterative reconstruction algorithm is described for approximating both the conductivity and permittivity distributions from this data. The results for an off-centered inhomogeneity showed a 35% improvement in contrast from that seen with only one iteration, for both the conductivity and the permittivity values. It is also shown that a significant improvement in images results from accurately modeling a noncircular boundary. Both static and difference images are distorted by assuming a circular boundary and the amount of distortion increases significantly as the boundary shape becomes more elliptical. For a homogeneous field in an elliptical body with axis ratio of 0.73, an image reconstructed assuming the boundary to be circular has an artifact at the center of the image with an error of 20%. This error increased to 37% when the axis ratio was 0.64. A reconstruction algorithm which used a mesh with the same axis ratio as the elliptical boundary reduced the error in the conductivity values to within 0.5% of the actual values.

Algorithms↗

Three-dimensional EIT imaging of breast tissues: system design and clinical testing.

Results of development and testing of the new medical imaging system are described. The system uses a planar array consisting of 256 electrodes and enables obtaining images of the three-dimensional conductivity distribution in regions below the skin's surface up to several centimeters deep. The developed measuring system and image reconstruction algorithm can be used for breast tissue imaging and diagnostics, in particular for malignant tumor detection. Examples of tomographic images obtained in vivo during clinical tests are presented. The mammary gland, being an organ-target, alters at the background with such physiological events as menstrual cycle, pregnancy, lactation, and postmenopause. The objectives of this paper include estimation of the possibilities of electrical impedance mammography for investigation of mammary glands' state among women with different hormonal status. We found that electrical impedance mammograms from different groups had clear visual distinctions and statistically significant differences in mammary glands' conductivity. Our data on conductivity distribution in the mammary gland during different physiological periods will allow us to use it as normal values in the future, to continue this research on mammary glands with different pathology.

Adolescent↗

A versatile wavelet domain noise filtration technique for medical imaging.

In this paper, we propose a robust wavelet domain method for noise filtering in medical images. The proposed method adapts itself to various types of image noise as well as to the preference of the medical expert; a single parameter can be used to balance the preservation of (expert-dependent) relevant details against the degree of noise reduction. The algorithm exploits generally valid knowledge about the correlation of significant image features across the resolution scales to perform a preliminary coefficient classification. This preliminary coefficient classification is used to empirically estimate the statistical distributions of the coefficients that represent useful image features on the one hand and mainly noise on the other. The adaptation to the spatial context in the image is achieved by using a wavelet domain indicator of the local spatial activity. The proposed method is of low complexity, both in its implementation and execution time. The results demonstrate its usefulness for noise suppression in medical ultrasound and magnetic resonance imaging. In these applications, the proposed method clearly outperforms single-resolution spatially adaptive algorithms, in terms of quantitative performance measures as well as in terms of visual quality of the images.

Algorithms↗