Aplicação de técnicas de data mining para suporte ao diagnóstico de cancro da mama

More than ever, there is an increase of the number of decision support methods and computer aided diagnostic systems applied to various areas of medicine. In breast cancer research, many works have been done in order to reduce false-positives when used as a double reading method. In this study, we aimed to present a set of data mining techniques that were applied to approach a decision support system in the area of breast cancer diagnosis. This method is geared to assist clinical practice in identifying mammographic findings such as microcalcifications, masses and even normal tissues, in order to avoid misdiagnosis. In this work a reliable database was used, with 410 images from about 115 patients, containing previous reviews performed by radiologists as microcalcifications, masses and also normal tissue findings. Throughout this work, two feature extraction techniques were used: the gray level co-occurrence matrix and the gray level run length matrix. For classification purposes, we considered various scenarios according to different distinct patterns of injuries and several classifiers in order to distinguish the best performance in each case described. The many classifiers used were Naïve Bayes, Support Vector Machines, k-nearest Neighbors and Decision Trees (J48 and Random Forests). The results in distinguishing mammographic findings revealed great percentages of PPV and very good accuracy values. Furthermore, it also presented other related results of classification of breast density and BI-RADS® scale. The best predictive method found for all tested groups was the Random Forest classifier, and the best performance has been achieved through the distinction of microcalcifications. The conclusions based on the several tested scenarios represent a new perspective in breast cancer diagnosis using data mining techniques.Cada vez mais assistimos a um aumento global do número de métodos de apoio a decisão e diagnóstico assistido por computador, aplicados a diversas áreas da medicina. Na área de investigação do cancro da mama muitos são os trabalhos que têm sido desenvolvidos como segunda leitura de modo a reduzir o número de falsos positivos no diagnóstico. Neste estudo é apresentado um conjunto de técnicas de data mining que poderão ser aplicadas a um sistema de apoio à decisão na área do diagnóstico de cancro da mama. Esta abordagem tem por objetivo ajudar os clínicos na identificação de achados mamográficos como microcalcificações, massas e mesmo tecidos normais, de forma a evitar diagnósticos errados. Para isso, neste trabalho é usada uma base de dados fidedigna, de 410 imagens correspondentes a 115 pacientes, contendo análises prévias, realizadas por radiologistas, de microcalcificações, massas e tecidos considerados normais. Ao longo deste trabalho são utilizadas duas técnicas de extração de características, a matriz de coocorrência de níveis de cinza e a matriz de comprimento da linha de níveis de cinza. Para a classificação foram considerados diferentes cenários de acordo com diferentes padrões de distinção de lesões e ainda vários classificadores de forma a distinguir as melhores performances em cada caso descrito. Os vários classificadores usados foram Naïve Bayes, Support Vector Machines, k-nearest Neighbors e Decision Trees (J48 e Random Forests). Os resultados obtidos na distinção dos achados mamográficos revelaram percentagens de valor preditivo positivo e de precisão bastante boas. São ainda apresentados outros resultados relacionados com sistemas de classificação de densidade mamária e escala BI-RADS®. O melhor método de previsão encontrado, perante todos os grupos testados, foi o classificador Random Forest e o melhor desempenho foi conseguido através da distinção de microcalcificações. As conclusões feitas ao longo dos vários cenários testados foram interessantes em termos que representam uma nova perspetiva no diagnóstico do cancro da mama, utilizando técnicas de data mining

ENDOMET database – A means to identify novel diagnostic and prognostic tools for endometriosis

Endometriosis is a common benign hormone reliant inflammatory gynecological disease that affects fertile aged women and has a considerable economic impact on healthcare systems. Symptoms include intense menstrual pain, persistent pelvic pain, and infertility. It is defined by the existence of endometrium-like tissue developing in ectopic locations outside the uterine cavity and inflammation in the peritoneal cavity. Endometriosis presents with multifactorial etiology, and despite extensive research the etiology is still poorly understood. Diagnostic delay from the onset of the disease to when a conclusive diagnosis is reached is between 7–12 years. There is no known cure, although symptoms can be improved with hormonal medications (which often have multiple side effects and prevent pregnancy), or through surgery which carries its own risk. Current non-invasive tools for diagnosis are not sufficiently dependable, and a definite diagnosis is achieved through laparoscopy or laparotomy. This study was based on two prospective cohorts: The ENDOMET study, including 137 endometriosis patients scheduled for surgery and 62 healthy women, and PROENDO that included 138 endometriosis patients and 33 healthy women. Our long-term goal with the current study was to support the discovery of innovative new tools for efficient diagnosis of endometriosis as well as tools to further understand the etiology and pathogenesis of the disease. We set about achieving this goal by creating a database, EndometDB, based on a relational data model, implemented with PostgreSQL programming language. The database allows e.g., for the exploration of global genome-wide expression patterns in the peritoneum, endometrium, and in endometriosis lesions of endometriosis patients as well as in the peritoneum and endometrium of healthy control women of reproductive age. The data collected in the EndometDB was also used for the development and validation of a symptom and biomarker-based predictive model designed for risk evaluation and early prediction of endometriosis without invasive diagnostic methods. Using the data in the EndometDB we discovered that compared with the eutopic endometrium, the WNT- signaling pathway is one of the molecular pathways that undergo strong changes in endometriosis. We then evaluated the potential role for secreted frizzled-related protein 2 (SFRP-2, a WNT-signaling pathway modulator), in improving endometriosis lesion border detection. The SFRP-2 expression visualizes the lesion better than previously used markers and can be used to better define lesion size and that the surgical excision of the lesions is complete.ENDOMET tietokanta – Keino tunnistaa uusi diagnostinen ja ennustava työkalu endometrioosille Endometrioosi on yleinen hyvänlaatuinen, hormoneista riippuvainen tulehduksellinen lisääntymisikäisten naisten gynekologinen sairaus, joka kuormittaa terveydenhuoltojärjestelmää merkittävästi. Endometrioositaudin oireita ovat mm. voimakas kuukautiskipu, jatkuva lantion alueen kipu ja hedelmättömyys. Sairaus määritellään kohdun limakalvon kaltaisen kudoksen esiintymisenä kohdun ulkopuolella sekä siihen liittyvänä vatsakalvon tulehduksena. Endometrioosin etiologia on monitahoinen, ja laajasta tutkimuksesta huolimatta edelleen huonosti tunnettu. Kesto taudin puhkeamisesta lopullisen diagnoosin saamiseen on usein jopa 7–12 vuotta. Sairauteen ei tunneta parannuskeinoa, mutta oireita voidaan lievittää esimerkiksi hormonaalisilla lääkkeillä (joilla on usein monia sivuvaikutuksia ja jotka estävät raskauden) tai leikkauksella, johon liittyy omat tunnetut riskit. Nykyiset ei-invasiiviset diagnoosityökalut eivät ole riittävän luotettavia sairauden tunnistamiseen, ja varma endometrioosin diagnoosi saavutetaan laparoskopian tai laparotomian avulla. Tämä tutkimus perustui kahteen prospektiiviseen kohorttiin: ENDOMET-tutkimuk-seen, johon osallistui 137 endometrioosipotilasta ja 62 terveellistä naista, sekä PROENDO-tutkimukseen, johon osallistui 138 endometrioosipotilasta ja 33 terveellistä naista. Tässä tutkimuksessa pitkän aikavälin tavoitteemme oli löytää uusia työkalujen endometrioosin diagnosointiin, sekä ymmärtää endometrioosin etiologiaa ja patogeneesiä. Ensimmäisessä vaiheessa loimme EndometDB –tietokannan PostgreSQL-ohjelmointi-kielellä. Tämän osittain avoimeen käyttöön vapautetun tietokannan avulla voidaan tutkia genomin, esimerkiksi kaikkien tunnettujen geenien ilmentymistä peritoneumissa, endo-metriumissa ja endometrioosipotilaiden endometrioosileesioissa EndometDB-tietokantaan kerättyjä tietoja käytettiin oireiden ja biomarkkeripohjaisen ennustemallin kehittämiseen ja validointiin. Malli tuottaa riskinarvioinnin endometrioositaudin varhaiseen ennustamiseen ilman laparoskopiaa. Käyttäen EndometDB-tietokannan tietoja havaitsimme, että endo-metrioositautikudoksessa tapahtui voimakkaita geeni-ilmentymisen muutoksia erityisesti geeneissä, jotka liittyvät WNT-signalointireitin säätelyyn. Keskeisin löydös oli, että SFRP-2 proteiinin ilmentyminen oli huomattavasti koholla endometrioosikudoksessa ja SFRP-2 proteiinin immunohistokemiallinen värjäys erottaa endometrioosin tautikudoksen terveestä kudoksesta aiempia merkkiaineita paremmin. Löydetyllä menetelmällä voidaan siten selvittää tautikudoksen laajuus ja tarvittaessa osoittaa, että leikkauksella on kyetty poistamaan koko sairas kudos

Efecto de diferentes factores ambientales, del riesgo de depredación y de los niveles de testosterona sobre la modulación de las respuestas comportamental y de estrés fisiológico en el ratón de campo (Apodemus sylvaticus)

Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias, Departamento de Biología. Fecha de lectura: 23-02-2018Esta tesis tiene embargado el acceso al texto completo hasta el 23-08-201

Integrated Framework of Knowledge Discovery and Knowledge Management for E-health In Saudi Arabia: Supporting Citizens with Diabetes Mellitus

Saudi Arabia experiences insufficient effort in terms of patients’ education in relation to a number of prevalent diseases, including diabetes mellitus, musculoskeletal disorders and upper respiratory tract infections. In addition, the number of studies related to e-health initiatives to support patients in the Kingdom are limited and only benefit patients of a few hospitals. This situation leads to deficient application of self-management and education strategies to empower patients to manage their diseases. Unfortunately, such a deficiency can affect the health status in the Kingdom negatively as diabetes mellitus is reported as the first cause of death in the Kingdom among all other prevalent diseases. Although knowledge management has been proven to be a valuable approach to sharing knowledge and educating users to manage their illnesses, it has not been implemented appropriately to support the increasing number of diabetic citizens in Saudi Arabia. In this research, knowledge management is integrated with knowledge discovery to support specific needs of the diabetic community in the Kingdom. Such an integration constitutes an e-health initiative to support diabetic citizens and healthcare professionals to manage this expanding illness in Saudi Arabia. Knowledge discovery is implemented through data mining to elicit useful knowledge related to specific diabetes complications encountered by diabetic citizens in the Kingdom. The integrated framework applies the SECI model to capture and disseminate useful diabetes self-management and educational expertise to support the management of diabetes complications. This integrated approach to knowledge management and knowledge discovery has provided a valuable tool implemented in terms of a web portal. This has facilitated the exchange and dissemination of tacit and explicit knowledge of the diabetic community in the forms of strategies, guidelines and best practices. It has also overcome the issues faced by the organisational and national cultures affecting knowledge management practice in Saudi Arabia