Machine learning algorithms to predict breast cancer recurrence using structured and unstructured sources from electronic health records

Recurrence is a critical aspect of breast cancer (BC) that is inexorably tied to mortality. Reuse of healthcare data through Machine Learning (ML) algorithms offers great opportunities to improve the stratification of patients at risk of cancer recurrence. We hypothesized that combining features from structured and unstructured sources would provide better prediction results for 5-year cancer recurrence than either source alone. We collected and preprocessed clinical data from a cohort of BC patients, resulting in 823 valid subjects for analysis. We derived three sets of features: structured information, features from free text, and a combination of both. We evaluated the performance of five ML algorithms to predict 5-year cancer recurrence and selected the best-performing to test our hypothesis. The XGB (eXtreme Gradient Boosting) model yielded the best performance among the five evaluated algorithms, with precision = 0.900, recall = 0.907, F1-score = 0.897, and area under the receiver operating characteristic AUROC = 0.807. The best prediction results were achieved with the structured dataset, followed by the unstructured dataset, while the combined dataset achieved the poorest performance. ML algorithms for BC recurrence prediction are valuable tools to improve patient risk stratification, help with post-cancer monitoring, and plan more effective follow-up. Structured data provides the best results when fed to ML algorithms. However, an approach based on natural language processing offers comparable results while potentially requiring less mapping effort.European Union | Ref. 875406Fondo Europeo de Desarrollo Regional (FEDER)Xunta de Galici

Empowering reuse of digital cultural heritage in context-aware crosscuts of European history

The paper presents the H2020 CrossCult project, providing a short overview, a summary of the platform developed by the project, a description of the consortium, lessons learnt in three main dimensions (humanities, technology and business), the open challenges and the main tools developed by the project

Splenic size after division of the short gastric vessels in Nissen fundoplication in children

Item does not contain fulltextPURPOSE: Nissen fundoplication is an effective treatment for gastro-esophageal reflux disease (GERD). Mobilization of the gastric fundus during fundoplication requires division of short gastric vessels of the spleen, which may cause splenic ischemia. The aim of this study was to determine if Nissen fundoplication results in hypotrophy of the spleen. METHODS: We performed pre-operative and post-operative ultrasound measurements of the spleen in children undergoing Nissen fundoplication. During operation, the surgeon estimated the compromised blood flow by assessment of the percentage of discoloration of the spleen. RESULTS: Twenty-four consecutive children were analyzed. Discoloration of the upper pole of the spleen was observed in 11 patients (48%) of a median estimated splenic surface of 20% (range 5-50%). The median ratio for pre-operative and post-operative length, width, and area of the spleen was 0.97, 1.03, and 0.96, respectively. The percentage of the estimated perfusion defect during surgery was not correlated with the ratios. In three patients, the area ratio was smaller than 0.8 (0.67-0.75), meaning that the area decreased with at least 20% after surgery. In none of these patients a discoloration was observed. CONCLUSION: Discoloration of the spleen after Nissen fundoplication is not associated with post-operative splenic atrophy.1 maart 201

Abdominal pain in an adult with Type 2 diabetes: A case report

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Democratic experimentation in early childhood education

Qualifications of the early years workforce are a salient predictors of quality and therefore of children’s outcomes. International reports advise that a majority of staff is trained at Bachelor’s levels and rank countries according to this criterion. There is fewer consensus on what this professionalism should be. In a majority of countries, large numbers of professionals are untrained, unqualified and sometimes invisible in the official reports. Many of these unqualified “assistants” take up crucial “care” tasks, while the teacher’s tasks are defined as “education”. The separation between care and education occurs in split systems as well as in systems where education and care are supposed to be integrated. In addition, the growing diversity of families challenges our preconceived ideas about “the good life” for children. These observations urge us to rethink professionalism in terms of reflexivity and the capacity of co-constructing pedagogy with parents and children. A case study in Ghent shows how low qualified professionals develop research capacities. The analysis of their experience suggests that “learning” may be less a quality of the individual than a quality of the systemic relationships that are build in the teams as well as in the interaction between teams and their social contexts

Revista de Vertebrados de la Estación Biológica de Doñana

Catálogo descriptivo de los anfibios y reptiles de CubaEvolución estacional de la comunidad de aves en un robledal de Sierra NevadaComposición de la comunidad de aves en pinares del Parque Nacional de Doñana (suroeste de España).Alimentación de la pagaza piconegra (Gelochelidon nilotica) en las marismas del GuadalquivirContaminación xenobiótica del Parque Nacional de Doñana. III. Residuos de insecticidas organoclorados, bifenilos policlorados y metales pesados en ciconiformesAlimentación de la lechuza común Tyto alba en la cuenca del Duero, EspañaEstudio de una población rural de (Mus musculus L.) I. La probabilidad de captura y la estima numéricLa reproducción en Gazella dorcasIncidencia del Nemátodo parásito Skrjabingylus Leuckart, 1842 sobre el Mustela en España.Desplazamientos de ungulados silvestres a través de una zona de ecotono en Doñana.Etograma de la cabra montés (Capra pyrenaica) y comparación con otras especies.Sobre comportamiento agresivo de Triturus marmoratus en época de celoEmbarrancamiento masivo de ejemplares de tortuga lad (Dermochelys coriacea L.) en las costas de Ceuta (España, norte de África)Sobre un ejemplar melánico de Podarcis hispanica (Steindachner, 1870)Nuevos datos sobre la distribución de cuatro especies de reptiles en la provincia de Cádiz.Algunos datos sobre la nidificación de Ciconia nigra L. en sierra Morena (S. España)Observación del halcón de Eleonor (Falco eleonorae) en el centro de EspañaNueva localidad de cría del pájaro moscón (Remiz pendulinus) en la Península IbéricaRegistro de aves en el sur de BoliviaNidificación del paiño de Madeira Oceanodroma castro (Harcourt, 1851) en las Islas Canarias.Observación primaveral de Phalaropus fulicarius L. en el SO de EspañaNuevos datos sobre la presencia del nóctulo gigante Nyctalus lasiopterus (Chiroptera, vespertilionidae) en EspañaNote sur l'alimentation de Martes martes a Menorca (Baleares).Peer reviewe

Krüppel-Like Factor 6 Expression Changes during Trophoblast Syncytialization and Transactivates ßhCG and PSG Placental Genes

BACKGROUND: Krüppel-like factor-6 (KLF6) is a widely expressed member of the Sp1/KLF family of transcriptional regulators involved in differentiation, cell cycle control and proliferation in several cell systems. Even though the highest expression level of KLF6 has been detected in human and mice placenta, its function in trophoblast physiology is still unknown. METHODOLOGY/PRINCIPAL FINDINGS: Herein, we explored KLF6 expression and sub-cellular distribution in human trophoblast cells differentiating into the syncytial pathway, and its role in the regulation of genes associated with placental development and pregnancy maintenance. Confocal immunofluorescence microscopy demonstrated that KLF6 is expressed throughout human cytotrophoblast differentiation showing no evident modifications in its nuclear and cytoplasmic localization pattern. KLF6 transcript and protein peaked early during the syncytialization process as determined by qRT-PCR and western blot assays. Overexpression of KLF6 in trophoblast-derived JEG-3 cells showed a preferential nuclear signal correlating with enhanced expression of human β-chorionic gonadotropin (βhCG) and pregnancy-specific glycoprotein (PSG) genes. Moreover, KLF6 transactivated βhCG5, PSG5 and PSG3 gene promoters. Deletion of KLF6 Zn-finger DNA binding domain or mutation of the consensus KLF6 binding site abolished transactivation of the PSG5 promoter. CONCLUSIONS/SIGNIFICANCE: Results are consistent with KLF6 playing a role as transcriptional regulator of relevant genes for placental differentiation and physiology such as βhCG and PSG, in agreement with an early and transient increase of KLF6 expression during trophoblast syncytialization

DNA Barcode Detects High Genetic Structure within Neotropical Bird Species

BACKGROUND: Towards lower latitudes the number of recognized species is not only higher, but also phylogeographic subdivision within species is more pronounced. Moreover, new genetically isolated populations are often described in recent phylogenies of Neotropical birds suggesting that the number of species in the region is underestimated. Previous COI barcoding of Argentinean bird species showed more complex patterns of regional divergence in the Neotropical than in the North American avifauna. METHODS AND FINDINGS: Here we analyzed 1,431 samples from 561 different species to extend the Neotropical bird barcode survey to lower latitudes, and detected even higher geographic structure within species than reported previously. About 93% (520) of the species were identified correctly from their DNA barcodes. The remaining 41 species were not monophyletic in their COI sequences because they shared barcode sequences with closely related species (N = 21) or contained very divergent clusters suggestive of putative new species embedded within the gene tree (N = 20). Deep intraspecific divergences overlapping with among-species differences were detected in 48 species, often with samples from large geographic areas and several including multiple subspecies. This strong population genetic structure often coincided with breaks between different ecoregions or areas of endemism. CONCLUSIONS: The taxonomic uncertainty associated with the high incidence of non-monophyletic species and discovery of putative species obscures studies of historical patterns of species diversification in the Neotropical region. We showed that COI barcodes are a valuable tool to indicate which taxa would benefit from more extensive taxonomic revisions with multilocus approaches. Moreover, our results support hypotheses that the megadiversity of birds in the region is associated with multiple geographic processes starting well before the Quaternary and extending to more recent geological periods

Paleodistributions and Comparative Molecular Phylogeography of Leafcutter Ants (Atta spp.) Provide New Insight into the Origins of Amazonian Diversity

The evolutionary basis for high species diversity in tropical regions of the world remains unresolved. Much research has focused on the biogeography of speciation in the Amazon Basin, which harbors the greatest diversity of terrestrial life. The leading hypotheses on allopatric diversification of Amazonian taxa are the Pleistocene refugia, marine incursion, and riverine barrier hypotheses. Recent advances in the fields of phylogeography and species-distribution modeling permit a modern re-evaluation of these hypotheses. Our approach combines comparative, molecular phylogeographic analyses using mitochondrial DNA sequence data with paleodistribution modeling of species ranges at the last glacial maximum (LGM) to test these hypotheses for three co-distributed species of leafcutter ants (Atta spp.). The cumulative results of all tests reject every prediction of the riverine barrier hypothesis, but are unable to reject several predictions of the Pleistocene refugia and marine incursion hypotheses. Coalescent dating analyses suggest that population structure formed recently (Pleistocene-Pliocene), but are unable to reject the possibility that Miocene events may be responsible for structuring populations in two of the three species examined. The available data therefore suggest that either marine incursions in the Miocene or climate changes during the Pleistocene—or both—have shaped the population structure of the three species examined. Our results also reconceptualize the traditional Pleistocene refugia hypothesis, and offer a novel framework for future research into the area