Objective: The paper describes the use of expert's knowledge in practice and the efficiency of a recently developed technique called argument-based machinelearning (ABML) in the knowledge elicitation process. We are developinga neurological decision support system to help the neurologists differentiate between three types of tremors: Parkinsonian, essential, and mixed tremor (comorbidity). The system is intended to act as a second opinion for the neurologists, and most importantly to help them reduce the number of patients in the "gray area" that require a very costly further examination (DaTSCAN). We strive to elicit comprehensible and medically meaningful knowledge in such a way that it does not come at the cost of diagnostic accuracy. Materials and methods: To alleviate the difficult problem of knowledge elicitation from data and domain experts, we used ABML. ABML guidesthe expert to explain critical special cases which cannot be handled automatically by machine learning. This very efficiently reduces the expert'sworkload, and combines expert's knowledge with learning data. 122 patients were enrolled into the study. Results: The classification accuracy ofthe final model was 91%. Equally important, the initial and the final modelswere also evaluated for their comprehensibility by the neurologists. All13 rules of the final model were deemed as appropriate to be able to support its decisions with good explanations. Conclusion: The paper demonstrates ABML's advantage in combining machine learning and expert knowledge. The accuracy of the system is very high with respect to the currentstate-of-the-art in clinical practice, and the system's knowledge base is assessed to be very consistent from a medical point of view. This opens upthe possibility to use the system also as a teaching tool.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 30199257The study evaluated the possible effects of ultrasound (US) on gene expression in brain tissue of rat embryos. Four groups (n = 5 each) of pregnant Wistar Han rats were exposed to US of different durations (55, 100, 145, and 195 seconds) via a multifrequency transducer in the 2dimensional imaging mode with a pulse duration of 1.29 microseconds, a pulse repetition frequency of 1 kHz, and a derated spatialpeak pulseaverage intensity of 222.4 W/cm(2) on day 5, 9, 7, or 13 of gestation. Gene expression profiling was performed in fetal brain tissue by quantitative reverse transcriptionpolymerase chain reaction arrays. The results indicated substantial alterations in gene expression. The most differentially expressed genes were Adamts5, Gadd45a, Npy2r, and Chrna1, which are implicated in important developmental signaling pathways. On the basis of our findings, routine short US examinations for monitoring fetal development are not contraindicated, but prolonged exposures should be used only when needed to obtain important diagnostic information.
F.22 Improvement to existing health/diagnostic methods/procedures
COBISS.SI-ID: 3532666We evaluated the efficacy and robustness of a second generation implantable stimulator for correcting drop foot (DF) in a patient with left-sided hemiplegia over 20 years of functional electrical stimulation (FES) of the common peroneal nerve (CPN). Dorsal flexion and eversion of the affected foot was partially restored by FES of the superficial region of the CPN innervating mostly the tibialis anterior (TA) and partly peroneus longus (PL) and peroneus brevis (PB) muscles. The reasons for implant failure during the long-term follow-up assessment were analyzed and resolving procedures were identified. The stimulator had an average failure rate of once every three years, due to repetitive mechanical load on the lead wires of its internal and/or external unit, and had to be serviced once per year to replace the heel switch integrated into the shoe sole. FES-associated mechanical trauma to the CPN elicited a thickening of the connective tissue around the CPN and a slightly compromised conduction velocity of the CPN. FES of the CPN, with the second generation implantable stimulator, improved gait parameters of the affected leg during the 20 years period. Long-term, daily FES enables a functional and reliable recruitment of nerve fibers, thus providing a sufficient dorsal flexion and optimal eversion of the affected foot to sustain unassisted, almost normal gait. Therefore, the presented implant is suitable for very long-term FES of the CPN.
F.06 Development of a new product
COBISS.SI-ID: 32616921MicroRNAs (miRNAs) form a large class of non-coding RNAs that function in repression of gene expression in eukaryotes. By recognizing short stretches of nucleotides within the untranslated regions of mRNAs, miRNAs recruit partner proteins to individual transcripts, leading to mRNA cleavage or hindering of translation. Bioinformatic predictions and a wealth of data from wet laboratory studies indicate that miRNAs control expression of a large proportion of protein-coding genes, implying involvement of miRNAs in regulation of most biologic processes. In this review we discuss the biology of miRNAs and present examples of how manipulation of miRNA expression or activity can be exploited to attain the desired phenotypic traits in cell engineering as well as achieve therapeutic outcomes in treatment of a diverse set of diseases.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 3197041A prospective study was performed to evaluate the impact of surgical decompression (SD) and instrumented fusion within 8h versus 8-24h after injury on neurological recovery after cervical traumatic spinal cord injury (tSCI) in patients operated on in the UMC Ljubljana, Slovenia. Only patients with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A through C and with MRI-confirmed spinal cord compression were enrolled. The primary outcome was the change in AIS grade at the 6-month follow-up. Of the 48 enrolled patients, 22 patients who underwent surgery within 8h (group 8h) and 20 patients who underwent surgery between 8 and 24h (Group 8-24h) after injury concluded the study. At admission, there was no statistically significant difference in AIS grade between the study groups. At the 6-month follow-up, an improvement of at least two AIS grades was found in 45.5% of patients in group 8h and in 10% of patients in group 8-24h (p=0.017). The median improvement in the ASIA motor score was 38.5 (10.0-61.0) motor points in group 8h and 15.0 (8.8-34.0) motor points in group 8-24h (p=0.0468). In a multivariate analysis, adjusted for the preoperative AIS grade and the degree of spinal canal compromise, the odds of an at least two-grade AIS improvement were at least 106% higher for patients in group 8h than for patients in group 8-24h (odds ratio=11.08, p=0.004). No statistically significant difference was found in the rate of perioperative complications, pneumonia, and the number of ventilator-dependent days or the mortality between the groups. Our results suggest that the patients with tSCI who undergo SD within 8h after injury have superior neurological outcomes than patients who undergo SD 8-24h after injury, without any increase in the rate of adverse effects.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 32159705