Predicting Choroidal Nevus Transformation to Melanoma Using Machine Learning

PURPOSE: To develop and validate machine learning (ML) models to predict choroidal nevus transformation to melanoma based on multimodal imaging at initial presentation. DESIGN: Retrospective multicenter study. PARTICIPANTS: Patients diagnosed with choroidal nevus on the Ocular Oncology Service at Wills Eye Hospital (2007-2017) or Mayo Clinic Rochester (2015-2023). METHODS: Multimodal imaging was obtained, including fundus photography, fundus autofluorescence, spectral domain OCT, and B-scan ultrasonography. Machine learning models were created (XGBoost, LGBM, Random Forest, Extra Tree) and optimized for area under receiver operating characteristic curve (AUROC). The Wills Eye Hospital cohort was used for training and testing (80% training-20% testing) with fivefold cross validation. The Mayo Clinic cohort provided external validation. Model performance was characterized by AUROC and area under precision-recall curve (AUPRC). Models were interrogated using SHapley Additive exPlanations (SHAP) to identify the features most predictive of conversion from nevus to melanoma. Differences in AUROC and AUPRC between models were tested using 10 000 bootstrap samples with replacement and results. MAIN OUTCOME MEASURES: Area under receiver operating curve and AUPRC for each ML model. RESULTS: There were 2870 nevi included in the study, with conversion to melanoma confirmed in 128 cases. Simple AI Nevus Transformation System (SAINTS; XGBoost) was the top-performing model in the test cohort [pooled AUROC 0.864 (95% confidence interval (CI): 0.864-0.865), pooled AUPRC 0.244 (95% CI: 0.243-0.246)] and in the external validation cohort [pooled AUROC 0.931 (95% CI: 0.930-0.931), pooled AUPRC 0.533 (95% CI: 0.531-0.535)]. Other models also had good discriminative performance: LGBM (test set pooled AUROC 0.831, validation set pooled AUROC 0.815), Random Forest (test set pooled AUROC 0.812, validation set pooled AUROC 0.866), and Extra Tree (test set pooled AUROC 0.826, validation set pooled AUROC 0.915). A model including only nevi with at least 5 years of follow-up demonstrated the best performance in AUPRC (test: pooled 0.592 (95% CI: 0.590-0.594); validation: pooled 0.656 [95% CI: 0.655-0.657]). The top 5 features in SAINTS by SHAP values were: tumor thickness, largest tumor basal diameter, tumor shape, distance to optic nerve, and subretinal fluid extent. CONCLUSIONS: We demonstrate accuracy and generalizability of a ML model for predicting choroidal nevus transformation to melanoma based on multimodal imaging. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article

Differential inflammatory microRNA and cytokine expression in pulmonary sarcoidosis

Sarcoidosis is a granulomatous disease of unknown etiology. The disease has an important inflammatory and immune component; however, its immunopathogenesis is not completely understood. Recently, the role of microRNAs (miRNAs), the small non-coding RNAs, has attracted attention as both being involved in pathogenesis and serving as disease markers. Accordingly, changes in the expression of some miRNAs have been also associated with different autoimmune pathologies. However, not much is known about the role of miRNAs in sarcoidosis. Therefore, the aim of this study was to compare the level of expression of selected miRNAs in healthy individuals and patients with sarcoidosis. We detected significantly increased level of miR-34a in peripheral blood mononuclear cells isolated from sarcoidosis patients. Moreover, significantly up-regulated levels of interferon (IFN)-γ, IFN-γ inducible protein (IP-10) and vascular endothelial growth factor were detected in sera of patients when compared to healthy subjects. Our results add to a known inflammatory component in sarcoidosis. Changes in the levels of miR-34a may suggest its involvement in the pathology of this disease

Pinski Zoo

A truly original contemporary jazz outfit from the UK. Almost impossible to categorize they swing from virtuosic jazz to gritty funk with freedom and movement, veering into leftfleld territory and returning with snappy anthem-like tunes. Unpredictable and exciting, they carved a unique style in the UK and won praise from critics at home and abroad. Their eclectic fusion of style foreshadowed the move towards mixing influences in much of today's modern music. With 8 albums and extensive touring in Europe, Poland and New York in the late 80's and 90's and a "Best British Band" at the British International Jazz Awards in '91 they are back after several years of individual projects

Nutritive value and non-toxicity of Botryosphaeria zeae-infected wheat for weaner pigs

A novel fungal infection of wheat by Botryosphaeria zeae was identified on the Darling Downs of Queensland, Australia and called 'white grain' because of its bleached appearance. The only nutritional changes in the wheat grain infected with B. zeae were decreases in nitrogen and total amino acids (∼5%), and slight increases in the lysine, fibre and fat content, with starch unaffected. Nutrient digestibility and potential toxicity were assessed in weaner pigs housed in metabolism crates and fed this grain over a 4-week period, as they grew from 15 to 35 kg. Digestibility of energy and nitrogen in white grain was not different from that of normal wheat. The piglets were then bled for biochemical and haematological testing, slaughtered and the entire viscera subjected to gross pathological inspection, followed by histological examination of the liver, kidney, pancreas, spleen, heart, lung, muscle and intestine. White grain did not affect palatability of diets, pig growth rates; no abnormalities were detected in tissues, while biochemical and haematological parameters did not suggest any toxic effect. Hence, wheat with white grain appears suitable for use in pig diets, but the use of this wheat for human food should be restricted until additional longer term studies are conducted. © 2008 The State of Queensland, Department of Primary Industries and Fisheries. Journal compilation © 2008 Blackwell Verlag GmbH