Boosting the Performance of Artificial Intelligence-Driven Models in Predicting COVID-19 Mortality in Ethiopia

Like other nations around the world, Ethiopia has suffered negative effects from COVID-19. The objective of this study was to predict COVID-19 mortality using Artificial Intelligence (AI)-driven models. Two-year daily recorded data related to COVID-19 were trained and tested to predict mortality using machine learning algorithms. Normalization of features, sensitivity analysis for feature selection, modelling of AI-driven models, and comparing the boosting model with single AI-driven models were the main activities performed in this study. Prediction of COVID-19 mortality was conducted using a combination of four dominant feature variables, and hence, the best determination of coefficient (DC) of AdaBoost, KNN, ANN-6, and SVM in the prediction process were 0.9422, 0.8618, 0.8629, and 0.7171, respectively. The Boosting model improved the performance of the individual AI-driven models KNN, SVM, and ANN-6 by 7.94, 22.51, and 8.02 percent, respectively, at the verification stage using the testing dataset. This suggests that the boosting model has the best performance for prediction of COVID-19 mortality in Ethiopia. As a result, it suggests a promising potential performance of boosting ensemble model to be applied in predicting mortality and cases from similarly recorded daily data to predict mortality due to COVID-19 in other parts of the world.

Increased discharge heart rate might be associated with increased short-term mortality after acute coronary syndrome

BACKGROUND

In acute coronary syndrome (ACS) patients there are mostly studies evaluating prognostic value of admission heart rate. We tried to understand the prognostic value of discharge heart rate in a spectrum of ACS patients.

METHODS

A total of 473 consecutive ACS patients were included in the study. Forty-three (9.1%) of them were unstable angina pectoris, 268 (56.7%) were non-ST elevation myocardial infarction and 162 (34.2%) of them were ST elevation myocardial infarction patients. Discharge heart rates of the patients were recorded and the patients were followed-up for 1 year. The primary end-point was all-cause mortality.

RESULTS

The mean age of the patients was 64 ± 12. The patients were divided into three subgroups according to discharge heart rates (<78, 78-89, ≥90 beats per minute). Patients with a higher discharge heart rate had higher serum troponin, glucose levels and higher admission heart rates, had lower ejection fraction values and had acute heart failure complication more frequently than the patients with a lower discharge heart rate. A total of 72(16%) patients died during 1 year follow-up. In multivariate logistic regression analysis, an increased discharge heart rate was independently associated with 1-month mortality after ACS, but it was not independently associated with 6-month or 1-year mortality after ACS. Every 1 bpm increase in discharge heart rate resulted in a significant increased risk of 8.2% in 1-month all-cause mortality.

CONCLUSION

Increased heart rate at discharge is an independent predictor of 1-month mortality in ACS patients. This relationship disappears after 1-month through 1-year follow-up.

In vitro Anti-Leishmanial Activity of Essential Oils Extracted from Plants Growing in Northern Cyprus Against Leishmania tropica

OBJECTIVE

Natural plant products are considered as a source of novel and effective compounds for the treatment of leishmaniasis. In this study, the in vitro activities of essential oils obtained from Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) and Laurus nobilis (LN) plants in Northern Cyprus were investigated against Leishmania tropica.

METHODS

Leishmania tropica strain (MHOM/TR/2012/CBCL-LT) was obtained. RPMI-1640 was added to 96-well plates in 100 μL aliquots, 100 μg/mL essential oil was added to the first well of each row and serial 2-fold dilutions were performed. A promastigote suspension was pipetted into all wells, and the plates were incubated. The promastigotes were enumerated using a haemocytometer.

RESULTS

OD essential oil was effective at killing all promastigotes at a minimum inhibitor height (MIC)=0.2 μg/mL and had high activity at the lowest concentrations. Both SF and LN oils had MIC=1.56 μg/mL and LD₅₀=0.78 μg/mL. SF was observed to impair promastigote morphology at the lowest concentrations, while LN did not exert any effect at concentrations <0.2 μg/mL. OM essential oil was found to have a MIC=3.13 μg/mL and a LD₅₀=1.56 μg/mL.

CONCLUSION

All tested essential oils inhibited promastigotes of Leishmania tropica. OD essential oil demonstrated the highest anti-leishmanial activity.

AMAÇ

Bitkilerden elde edilen doğal ürünlerin leishmaniasis tedavisi için yeni ve etkili bileşiklerin üretilmesine öncülük edeceği düşünülmektedir. Çalışmamızda, Kuzey Kıbrıs’ta yetişen Origanum dubium (OD), Origanum majorana (OM), Salvia fruticosa (SF) ve Laurus nobilis (LN) bitkilerinden elde edilen uçucu yağların Leishmania tropica’ya karşı in vitro etkinlikleri araştırılmıştır.

YÖNTEMLER

Çalışmamızda, Leishmania tropica suşu (MHOM/TR/2012/CBCL-LT) kullanıldı. Düz tabanlı 96’lık plaklarda, tüm kuyucuklara 100 μL RPMI-1640 ve ilk kuyucuklara 100 μg/mL uçucu yağlar eklenerek, seri dilüsyonları yapıldı. Ardından tüm kuyucuklara Leishmania tropica promastigot süspansiyonundan pipetlendi ve inkübe edildi. Hemositometre yöntemiyle promastigotların sayısı incelendi.

BULGULAR

OD yağının minimum inhibitör konsantrasyonu (MİK)=0,2 μg/mL’de tüm promastigotları öldürürken, en düşük konsantrasyonlarda bile etkili olduğu görülmüştür. SF ve LN uçucu yağlarının ikisinde de MİK=1,56 μg/mL, LD₅₀=0,78 μg/mL olarak saptanmıştır. SF’nin en düşük konsantrasyonlarının bile promastigot morfolojisini bozduğu görülürken, Laurus nobilis’in ise 0,2 μg/mL’den sonraki konsantrasyonlarda etkisini kaybettiği belirlenmiştir. OM uçucu yağının MİK=3,13 μg/mL, LD₅₀=1,56 μg/mL olduğu görülmüştür.

SONUÇ

Kullanılan tüm uçucu yağların Leishmania tropica promastigotlarını inhibe ettiği görülürken, en yüksek anti-leishmanial etkinlik Origanum dubium uçucu yağında bulunmuştur.

HER-2/Neu and Hormone Receptor Analysis in Breast Carcinomas and Their Association with Clinicopathologic Parameters

Objective

Invasive breast carcinomas of no special type (IC-NST) are the heterogeneous tumours showing distinct prognostic features even in patients with similar clinicopathological characteristics. To date, many clinicopathological data have been analyzed to make a guess about prognosis and to determine treatment modality. In this study, HER-2/neu status was analyzed by using both immunohistochemical (IHC) and fluorescence in situ hybridization (FISH) methods, and its correlations with hormone receptor status and clinicopathological parameters were investigated.

Materials and Methods

The study was included 112 female patients with diagnosis of IC-NST. FISH for HER-2/neu was applied in only primary tumour tissues, while IHC analyses for HER-2/neu, estrogen (ER) and progesterone receptors (PR) were applied on both primary and metastatic lymph node foci. The results were compared with appropriate statistical methods.

Results

Our rates of HER-2/neu overexpression and gene amplification in the overall study group were 22.3 and 25%, respectively. In the metastatic group, these rates were higher than those of the overall study group (34% and 40%, respectively). Gene amplification rate of the axilla positive group was 40%, while this rate in non-metastatic group was 6.7% (p=0.015). Overexpression and amplification results were compliant (χ²=77,591, p<0.001). The concordance rates in HER-2/neu negative and overexpression groups were 95.3% and 88%, respectively. Our false negativity rate was 4.7%. While 36% of score 3+ cases were ER positive, 67.1% of HER-2/neu negative cases showed ER positivity (p=0.01). The increase of gene amplification rate in ER negative cases over 50 years age was more than two times and statistically significant (p=0.014).

Conclusion

The concordance rates between the results of IHC and FISH in the HER-2 negative and the overexpression categories were compatible with the literature and lower than the literature, respectively. In the case of ER negativity, the patient's age over 50 years was associated with a higher rate of gene amplification.

Immunohistochemical Analysis of the Extrinsic Apoptosis Process in the Non-Neoplastic and Neoplastic Prostate

OBJECTIVE

Deviations in the apoptotic process have been demonstrated in prostate carcinogenesis. We aimed to evaluate especially the process of extrinsic apoptosis in the spectrum of neoplastic lesions of the prostate epithelium so as to reveal the variations in the apoptotic process.

MATERIAL AND METHOD

The study included 20 benign prostatic hyperplasia, 8 high-grade prostatic intraepithelial neoplasia and 82 prostatic carcinoma patients. Immunohistochemistry was performed on sections obtained from materials of suprapubic prostatectomy, tru-cut biopsy, transurethral resection and radical prostatectomy. While Fas and FasL were evaluated in glandular and stromal areas, DcR1 and FLIP were evaluated in only glandular areas. Intensity and extent of immunostaining for Fas and FasL antibodies were separately scored and both scores were summarized. The total score of ≥ 4 both for Fas and FasL, expressions of FLIP and DcR1determined in more than 5% of glandular areas were accepted as positive.

RESULTS

Glandular FasL positivity was observed in 63.8 and 20% of the cases with prostatic carcinoma and benign prostatic hyperplasia, respectively (p=0.001). The loss of stromal Fas expression in PCa was obvious (p < 0.001). FLIP positivity was more frequently seen in high-grade prostatic intraepithelial neoplasia and PCa.

CONCLUSION

In prostatic carcinoma, decreased stromal Fas expression, contrary to higher glandular FasL positivity, supports the assertion that sensitivity of epithelial and stromal cells to apoptosis and their protective pathways against apoptosis undergo alterations. Increased FLIP expressions in high-grade prostatic intraepithelial neoplasia and prostatic carcinoma can also be interpreted accordingly.

Comorbidity of Adult Attention Deficit and Hyperactivity Disorder in Bipolar and Unipolar Patients

INTRODUCTION

The co-occurrence of attention deficit hyperactivity disorder (ADHD) in affective disorder patients is considerably high. The aims of the present study were to search for the frequency and impact of ADHD co-occurrence on the clinical features of affective disorders and to examine the relationship between the dominant affective temperaments and ADHD.

METHODS

In total, 100 patients with bipolar disorder (BD), 100 patients with major depressive disorder (MDD), and 100 healthy controls (HC) were included. All diagnoses were assigned according to DSM-IV-TR criteria. The Adult Attention Deficit and Hyperactivity Self-Report Scale (ASRS); Wender Utah Rating Scale (WURS); and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were applied to all participants.

RESULTS

The percentage of BD patients meeting the criteria for a diagnosis of current ADHD was 48% compared with the percentage of MDD patients and HCC subjects, i.e., 25% and 12%, respectively. ADHD was significantly more frequent in bipolar adults than in not only HC but also depressive patients. In the BD group, patients with a comorbid ADHD diagnosis had significantly more suicidal history than those without ADHD. The scores of the temperament traits, namely depressive, cyclothymic, irritable, and anxious, were significantly higher in subjects with ADHD in all groups, including in HC.

CONCLUSION

The most important findings of the present study were the observations that (1) the frequency of ADHD is considerably high among bipolar patients; (2) the frequency of suicide attempts is high in the bipolar patient group with comorbid ADHD; and (3) depressive, cyclothymic, irritable, and anxious temperaments are significantly associated with ADHD comorbidity in bipolar and depressive patients as well as in HC. The high comorbidity and chronic course of ADHD and its possible negative influence on the course of both disorders increase the importance of screening for adult ADHD.

Relation between serum quantitative HBsAg, ALT and HBV DNA levels in HBeAg negative chronic HBV infection

BACKGROUND/AIMS

In this study, we aimed to investigate whether quantitative HBsAg and alanine aminotransferase (ALT) levels correlated with Hepatitis B Virus (HBV) DNA levels in patients with HBeAg negative chronic HBV infection.

MATERIALS AND METHODS

Ninetynine patients were divided into two groups; inactive HBsAg carriers (IC) and active carriers (AC) with HBV DNA>2000 IU/mL. These two groups were compared in terms of ALT and HBsAg levels. Quantitative HBsAg measurements were performed with Elecsys HBsAg II Quant assay (Roche Diagnostic).

RESULTS

Mean age of patients was 43.11±14.79 years. HBsAg and ALT values of IC and AC patients were 2.47±1.35 log10 IU/mL, 3.59±0.97 log10 IU/mL (p=0.0001), and 25.94±13.06 IU/mL, 55.54±82.38 IU/mL (p=0.015), respectively and the difference was significant. When ROC analysis was performed to determine the most appropriate quantitative HBsAg value to define inactive carrier patients, the area under the ROC curve for HBsAg was 0.738 (95% CI:0.637-0.840). A cut-off of 2147 IU/mL revealed sensitivity of 76% and specificity of 70% for diagnosing the IC. Also, a significant correlation was also found between levels of HBV DNA (log) and HBsAg (log) (r: 0.503, p=0.0001).

CONCLUSION

It has been concluded that quantitative measurements of HBsAg could be used to differentiate between IC and AC patients.

Effects of platelet-rich fibrin and piezosurgery on impacted mandibular third molar surgery outcomes

Introduction

The aim of this study was the comparision of postoperative outcomes in impacted mandibular third molars that were treated using either platelet-rich fibrin (PRF), a combination of PRF and piezosurgery, or conventional rotatory osteotomy.

Patient and methods

The study included 20 patients; 40 extractions of impacted mandibular third molars were performed. Patients were divided into two main groups. In group A (n = 20), traditional surgery was performed on one side (Group 1, n = 10); traditional surgery was performed, and PRF was administered to the extracted socket on the other side of same patient (Group 2, n = 10). In group B (n = 20), on one side, piezosurgery was used for osteotomy, and PRF was administered (Group 3, n = 10); on the other side of same patient, traditional surgery was performed (Group 4, n = 10). Parameters assessed at baseline for each patient included pain, the number of analgesics taken, trismus, and cheek swelling. These variables were also assessed on postoperative days 1, 2, 3, and 7.

Results

Statistical analysis revealed a significant reduction in postoperative pain (sum of 1^st, 2^nd, 3^rd and 7^th days) and trismus (on postoperative day 1) in group 2 (traditional surgery + PRF group), and in postoperative pain, the number of analgesics taken (sum of 1^st, 2^nd,3^rd and 7^th days) and trismus (on postoperative day 1) in group 3 (piezosurgery + PRF group) compared to groups 1 and 4 (traditional surgery groups), (p ≤ 0.05). However, swelling on postoperative days 1, 3, and 7 did not differ among the groups (p > 0.05). Only difference was on second day between groups 1–4 and 2–4 (p ≤ 0.05).

Conclusions

The results of our study have shown that the use of PRF with traditional surgery and PRF combined with piezosurgery significantly reduced pain during the postoperative period. In addition, PRF in combination with piezosurgery significantly decreased the number of analgesics taken. Both operations also significantly decreased trismus 24 h after the surgery. As a result of this study, PRF and combination use of PRF and piezosurgery have positive effects in reducing postoperative outcomes after impacted third molar surgery.