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Severe, early-onset fetal growth restriction is a leading cause of medically indicated preterm birth and substantially increases the risk for perinatal death or disability. No treatments exist to improve fetal growth or safely prolong pregnancy. Furthermore, wide-ranging phenotypes limit the accurate prediction of pregnancy outcome. In this issue of the JCI, Spencer and colleagues combine a discovery-science approach with ultrasound parameters to identify the most discriminative models for predicting either the primary outcome of fetal or neonatal death, or a secondary outcome of death or delivery at 28 weeks of gestation or earlier. Their findings can better individualize patient counseling but, just as compellingly, provide the capacity to identify those pregnancies that are at such considerable risk as to justify enrollment in paradigm-shifting interventional trials that are in the pipeline.

Background The risk factors of diabetic retinopathy (DR) were investigated extensively in the past studies, but it remains unknown which risk factors were more associated with the DR than others. If we can detect the DR related risk factors more accurately, we can then exercise early prevention strategies for diabetic retinopathy in the most high-risk population. The purpose of this study is to build a prediction model for the DR in type 2 diabetes mellitus using data mining techniques including the support vector machines, decision trees, artificial neural networks, and logistic regressions. Results Experimental results demonstrated that prediction performance by support vector machines performed better than the other machine learning algorithms and achieved 79.5% and 0.839 in accuracy and area under the receiver operating characteristic curve using percentage split (i.e., data set divided into 80% as trainning and 20% as test), respectively. Evaluated by three-way data split scheme (i.e., data set divided into 60% as training, 20% as validation, and 20% as independent test), our method obtained slightly lower performance compared to percentage split, which suggested that three-way data split is a better way to evaluate the real performance and prevent overestimation. Moreover, we incorporated approaches proposed in previous studies to evaluate our data set and our prediction performance outperformed the other previous studies in most evaluation measures. This lends support to our assumption that appropriate machine learning algorithms combined with discriminative clinical features can effectively detect diabetic retinopathy. Conclusions Our method identifies use of insulin and duration of diabetes as novel interpretable features to assist with clinical decisions in identifying the high-risk populations for diabetic retinopathy. If duration of DM increases by 1 year, the odds ratio to have DMR is increased by 9.3%. The odds ratio to have DR is increased by 3.561 times for patients who use insulin compared to patients who do not use insulin. Our results can be used to facilitate development of clinical decision support systems for clinical practice in the future.

The 15-item Geriatric Depression Scale (GDS-15) is widely used to screen for depressive symptoms among older populations. This study aimed to develop and validate a questionnaire-free, machine-learning model as an alternative triage test for the GDS-15 among community-dwelling older adults. The best models were the random forest (RF) and deep-insight visible neural network by internal validation, but both performances were undifferentiated by external validation. The AUROC of the RF model was 0.619 (95% CI 0.610 to 0.627) for the external validation set with a non-local ethnic group. Our triage test can allow healthcare professionals to preliminarily screen for depressive symptoms in older adults without using a questionnaire. If the model shows positive results, then the GDS-15 can be used for follow-up measures. This preliminary screening will save a lot of time and energy for healthcare providers and older adults, especially those persons who are illiterate.

Public health agencies have suggested nonpharmaceutical interventions to curb the spread of the COVID-19 infections. The study intended to explore the information-seeking behavior and information needs on preventive measures for COVID-19 in the Philippine context. The search interests and related queries for COVID-19 terms and each of the preventive measures for the period from December 31, 2019 to April 6, 2020 were generated from Google Trends. The search terms employed for COVID-19 were coronavirus, ncov, covid-19, covid19 and “covid 19.” The search terms of the preventive measures considered for this study included “community quarantine”, “cough etiquette”, “face mask” or facemask, “hand sanitizer”, handwashing or “hand washing” and “social distancing.” Spearman’s correlation was employed between the new daily COVID-19 cases, COVID-19 terms and the different preventive measures. The relative search volume for the coronavirus disease showed an increase up to the pronouncement of the country’s first case of COVID-19. An uptrend was also evident after the country’s first local transmission was confirmed. A strong positive correlation (r s = .788, p < .001) was observed between the new daily cases and search interests for COVID-19. The search interests for the different measures and the new daily cases were also positively correlated. Similarly, the search interests for the different measures and the COVID-19 terms were all positively correlated. The search interests for “face mask” or facemask, “hand sanitizer” and handwashing or “hand washing” were more correlated with the search interest for COVID-19 than with the number of new daily COVID-19 cases. The search interests for “cough etiquette”, “social distancing” and “community quarantine” were more correlated with the number of new daily COVID-19 cases than with the search interest for COVID-19. The public sought for additional details such as type, directions for proper use, and where to purchase as well as do-it-yourself alternatives for personal protective items. Personal protective or community measures were expected to be accompanied with definitions and guidelines as well as be available in translated versions. Google Trends could be a viable option to monitor and address the information needs of the public during a disease outbreak. Capturing and analyzing the search interests of the public could support the design and timely delivery of appropriate information essential to drive preventive measures during a disease outbreak.

Background Antimicrobial peptides (AMPs) are oligopeptides that act as crucial components of innate immunity, naturally occur in all multicellular organisms, and are involved in the first line of defense function. Recent studies showed that AMPs perpetuate great potential that is not limited to antimicrobial activity. They are also crucial regulators of host immune responses that can modulate a wide range of activities, such as immune regulation, wound healing, and apoptosis. However, a microorganism's ability to adapt and to resist existing antibiotics triggered the scientific community to develop alternatives to conventional antibiotics. Therefore, to address this issue, we proposed Co-AMPpred, an in silico-aided AMP prediction method based on compositional features of amino acid residues to classify AMPs and non-AMPs. Results In our study, we developed a prediction method that incorporates composition-based sequence and physicochemical features into various machine-learning algorithms. Then, the boruta feature-selection algorithm was used to identify discriminative biological features. Furthermore, we only used discriminative biological features to develop our model. Additionally, we performed a stratified tenfold cross-validation technique to validate the predictive performance of our AMP prediction model and evaluated on the independent holdout test dataset. A benchmark dataset was collected from previous studies to evaluate the predictive performance of our model. Conclusions Experimental results show that combining composition-based and physicochemical features outperformed existing methods on both the benchmark training dataset and a reduced training dataset. Finally, our proposed method achieved 80.8% accuracies and 0.871 area under the receiver operating characteristic curve by evaluating on independent test set. Our code and datasets are available at https://github.com/onkarS23/CoAMPpred .

Assisted reproductive technology has been proposed for women with infertility. Moreover, in vitro fertilization (IVF) cycles are increasing. Factors contributing to successful pregnancy have been widely explored. In this study, we used machine learning algorithms to construct prediction models for clinical pregnancies in IVF. A total of 24,730 patients entered IVF and intracytoplasmic sperm injection cycles with clinical pregnancy outcomes at Taipei Medical University Hospital. Data used included patient characteristics and treatment. We used machine learning methods to develop prediction models for clinical pregnancy and explored how each variable affects the outcome of interest using partial dependence plots. Experimental results showed that the random forest algorithm outperforms logistic regression in terms of areas under the receiver operating characteristics curve. The ovarian stimulation protocol is the most important factor affecting pregnancy outcomes. Long and ultra-long protocols have shown positive effects on clinical pregnancy among all protocols. Furthermore, total frozen and transferred embryos are positive for a clinical pregnancy, but female age and duration of infertility have negative effects on clinical pregnancy. Our findings show the importance of variables and propensity of each variable by random forest algorithm for clinical pregnancy in the assisted reproductive technology cycle. This study provides a ranking of variables affecting clinical pregnancy and explores the effects of each treatment on successful pregnancy. Our study has the potential to help clinicians evaluate the success of IVF in patients.

South Korea is among the best-performing countries in tackling the coronavirus pandemic by using mass drive-through testing, face mask use, and extensive social distancing. However, understanding the patterns of risk perception could also facilitate effective risk communication to minimize the impacts of disease spread during this crisis. We attempt to explore patterns of community health risk perceptions of COVID-19 in South Korea using internet search data. Google Trends (GT) and NAVER relative search volumes (RSVs) data were collected using COVID-19-related terms in the Korean language and were retrieved according to time, gender, age groups, types of device, and location. Online queries were compared to the number of daily new COVID-19 cases and tests reported in the Kaggle open-access data set for the time period of December 5, 2019, to May 31, 2020. Time-lag correlations calculated by Spearman rank correlation coefficients were employed to assess whether correlations between new COVID-19 cases and internet searches were affected by time. We also constructed a prediction model of new COVID-19 cases using the number of COVID-19 cases, tests, and GT and NAVER RSVs in lag periods (of 1-3 days). Single and multiple regressions were employed using backward elimination and a variance inflation factor of <5. The numbers of COVID-19-related queries in South Korea increased during local events including local transmission, approval of coronavirus test kits, implementation of coronavirus drive-through tests, a face mask shortage, and a widespread campaign for social distancing as well as during international events such as the announcement of a Public Health Emergency of International Concern by the World Health Organization. Online queries were also stronger in women (r=0.763-0.823; P<.001) and age groups ≤29 years (r=0.726-0.821; P<.001), 30-44 years (r=0.701-0.826; P<.001), and ≥50 years (r=0.706-0.725; P<.001). In terms of spatial distribution, internet search data were higher in affected areas. Moreover, greater correlations were found in mobile searches (r=0.704-0.804; P<.001) compared to those of desktop searches (r=0.705-0.717; P<.001), indicating changing behaviors in searching for online health information during the outbreak. These varied internet searches related to COVID-19 represented community health risk perceptions. In addition, as a country with a high number of coronavirus tests, results showed that adults perceived coronavirus test-related information as being more important than disease-related knowledge. Meanwhile, younger, and older age groups had different perceptions. Moreover, NAVER RSVs can potentially be used for health risk perception assessments and disease predictions. Adding COVID-19-related searches provided by NAVER could increase the performance of the model compared to that of the COVID-19 case-based model and potentially be used to predict epidemic curves. The use of both GT and NAVER RSVs to explore patterns of community health risk perceptions could be beneficial for targeting risk communication from several perspectives, including time, population characteristics, and location.

Background The human immunodeficiency virus type 1 (HIV-1) aspartic protease is an important enzyme owing to its imperative part in viral development and a causative agent of deadliest disease known as acquired immune deficiency syndrome (AIDS). Development of HIV-1 protease inhibitors can help understand the specificity of substrates which can restrain the replication of HIV-1, thus antagonize AIDS. However, experimental methods in identification of HIV-1 protease cleavage sites are generally time-consuming and labor-intensive. Therefore, using computational methods to predict cleavage sites has become highly desirable. Results In this study, we propose a prediction method in which sequence, structural, and physicochemical features are incorporated in various machine learning algorithms. Then, a bidirectional stepwise selection algorithm is incorporated in feature selection to identify discriminative features. Further, only the selected features are calculated by various encoding schemes and used as input for decision trees, logistic regression, and artificial neural networks. Moreover, a more rigorous three-way data split procedure is applied to evaluate the objective performance of cleavage site prediction. Four benchmark datasets collected from previous studies are used to evaluate the predictive performance. Conclusions Experiment results showed that combinations of sequence, structure, and physicochemical features performed better than single feature type for identification of HIV-1 protease cleavage sites. In addition, incorporation of stepwise feature selection is effective to identify interpretable biological features to depict specificity of the substrates. Moreover, artificial neural networks perform significantly better than the other two classifiers. Finally, the proposed method achieved 80.0% ~ 97.4% in accuracy and 0.815 ~ 0.995 evaluated by independent test sets in a three-way data split procedure.

Given the increasing burden of chronic diseases in Indonesia, characteristics of chronic multimorbidities have not been comprehensively explored. Therefore, this research evaluated chronic multimorbidity patterns among Indonesians using Indonesian National Health Insurance (INHI) sample data. We included 46 chronic diseases and analyzed their distributions using population-weighted variables provided in the datasets. Results showed that chronic disease patients accounted for 39.7% of total patients who attended secondary health care in 2015–2016. In addition, 43.1% of those were identified as having chronic multimorbidities. Findings also showed that multimorbidities were strongly correlated with an advanced age, with large numbers of patients and visits in all provinces, beyond those on Java island. Furthermore, hypertension was the leading disease, and the most common comorbidities were diabetes mellitus, cerebral ischemia/chronic stroke, and chronic ischemic heart disease. In addition, disease proportions for certain disease dyads differed according to age group and gender. Compared to survey methods, claims data are more economically efficient and are not influenced by recall bias. Claims data can be a promising data source in the next few years as increasing percentages of Indonesians utilize health insurance coverage. Nevertheless, some adjustments in the data structure are accordingly needed to utilize claims data for disease control and surveillance purposes.

Background Dengue fever is a well-studied vector-borne disease in tropical and subtropical areas of the world. Several methods for predicting the occurrence of dengue fever in Taiwan have been proposed. However, to the best of our knowledge, no study has investigated the relationship between air quality indices (AQIs) and dengue fever in Taiwan. Results This study aimed to develop a dengue fever prediction model in which meteorological factors, a vector index, and AQIs were incorporated into different machine learning algorithms. A total of 805 meteorological records from 2013 to 2015 were collected from government open-source data after preprocessing. In addition to well-known dengue-related factors, we investigated the effects of novel variables, including particulate matter with an aerodynamic diameter < 10 µm (PM 10 ), PM 2.5 , and an ultraviolet index, for predicting dengue fever occurrence. The collected dataset was randomly divided into an 80% training set and a 20% test set. The experimental results showed that the random forests achieved an area under the receiver operating characteristic curve of 0.9547 for the test set, which was the best compared with the other machine learning algorithms. In addition, the temperature was the most important factor in our variable importance analysis, and it showed a positive effect on dengue fever at < 30 °C but had less of an effect at > 30 °C. The AQIs were not as important as temperature, but one was selected in the process of filtering the variables and showed a certain influence on the final results. Conclusions Our study is the first to demonstrate that AQI negatively affects dengue fever occurrence in Taiwan. The proposed prediction model can be used as an early warning system for public health to prevent dengue fever outbreaks.