A Predictive Model for Assessment of Successful Outcome in Posterior Spinal Fusion Surgery

Background: Low back pain is a common problem in many people. Neurosurgeons recommend posterior spinal fusion (PSF) surgery as one of the therapeutic strategies to the patients with low back pain. Due to the high risk of this type of surgery and the critical importance of making the right decision, accurate prediction of the surgical outcome is one of the main concerns for the neurosurgeons.Methods: In this study, 12 types of multi-layer perceptron (MLP) networks and 66 radial basis function (RBF) networks as the types of artificial neural network methods and a logistic regression (LR) model created and compared to predict the satisfaction with PSF surgery as one of the most well-known spinal surgeries.Results: The most important clinical and radiologic features as twenty-seven factors for 480 patients (150 males, 330 females; mean age 52.32 ± 8.39 years) were considered as the model inputs that included: age, sex, type of disorder, duration of symptoms, job, walking distance without pain (WDP), walking distance without sensory (WDS) disorders, visual analog scale (VAS) scores, Japanese Orthopaedic Association (JOA) score, diabetes, smoking, knee pain (KP), pelvic pain (PP), osteoporosis, spinal deformity and etc. The indexes such as receiver operating characteristic–area under curve (ROC-AUC), positive predictive value, negative predictive value and accuracy calculated to determine the best model. Postsurgical satisfaction was 77.5% at 6 months follow-up. The patients divided into the training, testing, and validation data sets.Conclusion: The findings showed that the MLP model performed better in comparison with RBF and LR models for prediction of PSF surgery.Keywords: Posterior spinal fusion surgery (PSF); Prediction, Surgical satisfaction; Multi-layer perceptron (MLP); Logistic regression (LR) (PDF) A Predictive Model for Assessment of Successful Outcome in Posterior Spinal Fusion Surgery. Available from: https://www.researchgate.net/publication/325679954_A_Predictive_Model_for_Assessment_of_Successful_Outcome_in_Posterior_Spinal_Fusion_Surgery [accessed Jul 11 2019].Peer reviewe

The cultural psychology of obesity: diffusion of pathological norms from Western to East Asian societies

We examine the accelerating worldwide obesity epidemic using a mathematical model relating a cognitive hypothalamic-pituitary-adrenal axis tuned by embedding cultural context to a signal of chronic, structured, psychosocial threat. The obesity epidemic emerges as a distorted physiological image of ratcheting social pathology involving massive, policy-driven, economic and social 'structural adjustment' causing increasing individual, family, and community insecurity. The resulting, broadly developmental, disorder, while stratified by expected divisions of class, ethnicity, and culture, is nonetheless relentlessly engulfing even affluent majority populations across the globe. The progression of analogous epidemics in affluent Western and East Asian socieities is particularly noteworthy since these enjoy markedly different cultural structures known to influence even such fundamental psychophysical phenomena as change blindness. Indeed, until recently population patterns of obesity were quite different for these cultures. We attribute the entrainment of East Asian societies into the obesity epidemic to the diffusion of Western socioeconomic practices whose imposed resource uncertainties and exacerbation of social and economic divisions constitute powerful threat signals. We find that individual-oriented 'therapeutic' interventions will be largely ineffective since the therapeutic process itself (e.g. relinace on drug treatments) embodies the very threats causing the epidemic

Immune cognition, social justice and asthma: structured stress and the developing immune system

We explore the implications of IR Cohen's work on immune cognition for understanding rising rates of asthma morbidity and mortality in the US. Immune cognition is conjoined with central nervous system cognition, and with the cognitive function of the embedding sociocultural networks by which individuals are acculturated and through which they work with others to meet challenges of threat and opportunity. Using a mathematical model, we find that externally- imposed patterns of 'structured stress' can, through their effect on a child's socioculture, become synergistic with the development of immune cognition, triggering the persistence of an atopic Th2 phenotype, a necessary precursor to asthma and other immune disease. Reversal of the rising tide of asthma and related chronic diseases in the US thus seems unlikely without a 21st Century version of the earlier Great Urban Reforms which ended the scourge of infectious diseases

Explaining Machine Learning Classifiers through Diverse Counterfactual Explanations

Post-hoc explanations of machine learning models are crucial for people to understand and act on algorithmic predictions. An intriguing class of explanations is through counterfactuals, hypothetical examples that show people how to obtain a different prediction. We posit that effective counterfactual explanations should satisfy two properties: feasibility of the counterfactual actions given user context and constraints, and diversity among the counterfactuals presented. To this end, we propose a framework for generating and evaluating a diverse set of counterfactual explanations based on determinantal point processes. To evaluate the actionability of counterfactuals, we provide metrics that enable comparison of counterfactual-based methods to other local explanation methods. We further address necessary tradeoffs and point to causal implications in optimizing for counterfactuals. Our experiments on four real-world datasets show that our framework can generate a set of counterfactuals that are diverse and well approximate local decision boundaries, outperforming prior approaches to generating diverse counterfactuals. We provide an implementation of the framework at https://github.com/microsoft/DiCE.Comment: 13 page

Using multiple classifiers for predicting the risk of endovascular aortic aneurysm repair re-intervention through hybrid feature selection.

Feature selection is essential in medical area; however, its process becomes complicated with the presence of censoring which is the unique character of survival analysis. Most survival feature selection methods are based on Cox's proportional hazard model, though machine learning classifiers are preferred. They are less employed in survival analysis due to censoring which prevents them from directly being used to survival data. Among the few work that employed machine learning classifiers, partial logistic artificial neural network with auto-relevance determination is a well-known method that deals with censoring and perform feature selection for survival data. However, it depends on data replication to handle censoring which leads to unbalanced and biased prediction results especially in highly censored data. Other methods cannot deal with high censoring. Therefore, in this article, a new hybrid feature selection method is proposed which presents a solution to high level censoring. It combines support vector machine, neural network, and K-nearest neighbor classifiers using simple majority voting and a new weighted majority voting method based on survival metric to construct a multiple classifier system. The new hybrid feature selection process uses multiple classifier system as a wrapper method and merges it with iterated feature ranking filter method to further reduce features. Two endovascular aortic repair datasets containing 91% censored patients collected from two centers were used to construct a multicenter study to evaluate the performance of the proposed approach. The results showed the proposed technique outperformed individual classifiers and variable selection methods based on Cox's model such as Akaike and Bayesian information criterions and least absolute shrinkage and selector operator in p values of the log-rank test, sensitivity, and concordance index. This indicates that the proposed classifier is more powerful in correctly predicting the risk of re-intervention enabling doctor in selecting patients' future follow-up plan