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V-cluster algorithm: a new algorithm for clustering molecules based upon numeric data.

Clustering molecules based on numeric data such as, gene-expression data, physiochemical properties, or theoretical data is very important in drug discovery and other life sciences. Most approaches use hierarchical clustering algorithms, non-hierarchical algorithms (for examples, K-mean and K-nearest neighbor), and other similar methods (for examples, the Self-Organization Mapping (SOM) and the Support Vector Machine (SVM)). These approaches are non-robust (results are not consistent) and, computationally expensive. This paper will report a new, non-hierarchical algorithm called the V-Cluster (V stands for vector) Algorithm. This algorithm produces rational, robust results while reducing computing complexity. Similarity measurement and data normalization rules are also discussed along with case studies. When molecules are represented in a set of numeric vectors, the V-Cluster Algorithm clusters the molecules in three steps: (1) ranking the vectors based upon their overall intensity levels, (2) computing cluster centers based upon neighboring density, and (3) assigning molecules to their nearest cluster center. The program is written in C/C++ language, and runs on Window95/NT and UNIX platforms. With the V-Cluster program, the user can quickly complete the clustering process and, easily examine the results by use of thumbnail graphs, superimposed intensity curves of vectors, and spreadsheets. Multi-functional query tools have also been implemented.

Algorithms↗

Effective Memetic Algorithms for VLSI design = Genetic Algorithms + local search + multi-level clustering.

Combining global and local search is a strategy used by many successful hybrid optimization approaches. Memetic Algorithms (MAs) are Evolutionary Algorithms (EAs) that apply some sort of local search to further improve the fitness of individuals in the population. Memetic Algorithms have been shown to be very effective in solving many hard combinatorial optimization problems. This paper provides a forum for identifying and exploring the key issues that affect the design and application of Memetic Algorithms. The approach combines a hierarchical design technique, Genetic Algorithms, constructive techniques and advanced local search to solve VLSI circuit layout in the form of circuit partitioning and placement. Results obtained indicate that Memetic Algorithms based on local search, clustering and good initial solutions improve solution quality on average by 35% for the VLSI circuit partitioning problem and 54% for the VLSI standard cell placement problem.

Algorithms↗

Hemodynamic and oxygen transport patterns for outcome prediction, therapeutic goals, and clinical algorithms to improve outcome. Feasibility of artificial intelligence to customize algorithms.

A generalized decision tree or clinical algorithm for treatment of high-risk elective surgical patients was developed from a physiologic model based on empirical data. First, a large data bank was used to do the following: (1) describe temporal hemodynamic and oxygen transport patterns that interrelate cardiac, pulmonary, and tissue perfusion functions in survivors and nonsurvivors; (2) define optimal therapeutic goals based on the supranormal oxygen transport values of high-risk postoperative survivors; (3) compare the relative effectiveness of alternative therapies in a wide variety of clinical and physiologic conditions; and (4) to develop criteria for titration of therapy to the endpoints of the supranormal optimal goals using cardiac index (CI), oxygen delivery (DO2), and oxygen consumption (VO2) as proxy outcome measures. Second, a general purpose algorithm was generated from these data and tested in preoperatively randomized clinical trials of high-risk surgical patients. Improved outcome was demonstrated with this generalized algorithm. The concept that the supranormal values represent compensations that have survival value has been corroborated by several other groups. We now propose a unique approach to refine the generalized algorithm to develop customized algorithms and individualized decision analysis for each patient's unique problems. The present article describes a preliminary evaluation of the feasibility of artificial intelligence techniques to accomplish individualized algorithms that may further improve patient care and outcome.

Algorithms↗

The TwoDay Algorithm: a new algorithm to identify the fertile time of the menstrual cycle.

Women who monitor their fertility signs and recognize when they are fertile can use this knowledge to conceive or to avoid pregnancy. Studies have shown that there is a rather small fertile window of several days during each menstrual cycle. Established methods of identifying the fertile window, such as the Ovulation and the Symptothermal methods of Natural Family Planning, can be very effective in helping couples avoid pregnancy. A new algorithm for identifying the fertile window has been developed, based on monitoring and recording of cervical secretions. The TwoDay Algorithm appears to be simpler to teach, learn, and use than current natural methods. A large existing data set from a World Health Organization study of the Ovulation Method, along with Natural Family Planning charts from women using the Ovulation Method and the Symptothermal Method, were used to determine the potential effectiveness of the TwoDay Algorithm in identifying the fertile window. Results suggest that the algorithm can be an effective alternative for low literacy populations or for programs that find current Natural Family Planning methods too time consuming or otherwise not feasible to incorporate into their services. Further studies are needed to determine the efficacy of the TwoDay Algorithm in avoiding pregnancy and to assess its acceptability to users and providers.

Adult↗

A regional convolution kernel algorithm for scatter correction in dual-energy images: comparison to single-kernel algorithms.

Single kernel scatter correction algorithms are based on the model that the scatter field can be predicted by convolution of the primary intensity (Iprim) with a spatially invariant scatter point-spread function (PSF). Practical limitations (Iprim unknown) suggest the substitution of the total detected intensity (Idet) for Iprim as the source image in the convolution. In regions of high scatter fraction (SF), Idet is a poor approximation of Iprim, thereby causing an overestimation of scatter originating in the region. This contributes to errors in estimating detected scatter in the mediastinum and neighboring regions. A technique using a regionally variable point-spread function that significantly reduces RMS error in estimation of the primary image as compared to the single PSF method is investigated. The regionally variable convolution method employs a larger PSF in the mediastinum and a smaller PSF in the lungs to reduce the error in estimating the scatter throughout the image. The method to allow for patient differences has also been expanded and various implementations of these methods have been compared. Results show that the dual-kernel algorithm is always more effective than an equivalent single-kernel algorithm. The dual-kernel algorithm using a predicted scatter fraction curve gives an overall RMS error in the primary of as low as 20.8% which is equivalent to 8.7% RMS error in the scatter. The dual-kernel method using a predicted scatter fraction curve approaches the accuracy of the single-kernel method using patient specific scatter measurements. Because using individual scatter measurements is a less desirable method for clinical use, we feel that the dual-kernel algorithm which uses two regions specific convolution kernels and a variable scatter fraction curve is the preferable method.

Algorithms↗

Multi-layered greedy network-growing algorithm: extension of greedy network-growing algorithm to multi-layered networks.

In this paper, we extend our greedy network-growing algorithm to multi-layered networks. With multi-layered networks, we can solve many complex problems that single-layered networks fail to solve. In addition, the network-growing algorithm is used in conjunction with teacher-directed learning that produces appropriate outputs without computing errors between targets and outputs. Thus, the present algorithm is a very efficient network-growing algorithm. The new algorithm was applied to three problems: the famous vertical-horizontal lines detection problem, a medical data problem and a road classification problem. In all these cases, experimental results confirmed that the method could solve problems that single-layered networks failed to. In addition, information maximization makes it possible to extract salient features in input patterns.

Algorithms↗

Effectiveness and feasibility of a standardized stepwise drug treatment regimen algorithm for inpatients with depressive disorders: results of a 2-year observational algorithm study.

BACKGROUND: The goal of the Berlin Algorithm Project is to establish a standardized stepwise drug treatment regimen (SSTR) for the treatment of inpatients with depressive disorders. We are reporting on the first of 3 subsequent study phases evaluating effectiveness and feasibility of the SSTR in a naturalistic clinical setting. METHOD: Patients with depressive disorders (International Classification of Diseases, Ninth Revision criteria) admitted to an academic medical center for inpatient treatment were enrolled in the SSTR protocol that comprised an algorithm-guided sequential treatment process (including pharmacologic washout period, sleep deprivation, antidepressant monotherapy, lithium augmentation, monoamine oxidase inhibitor treatment, and electroconvulsive therapy) dependent on the scores of a standardized assessment of treatment outcome, the Bech Rafaelsen Melancholia Scale (BRMS). RESULTS: Of 248 patients with depression, 119 (48%) were enrolled in the SSTR protocol. One hundred twenty-nine patients (52%) were not included, mostly due to individualized treatment procedures. An intent-to-treat (ITT) analysis showed that 38% of enrolled patients achieved remission (BRMS score < or = 5), 34% achieved "classic" response (deltaBRMS score > or = 50%), 15% achieved "low" response (deltaBRMS score 26% to 49%), and 13% did not respond. The overall response rate (remitters and classic responders) of SSTR treatment was 72% of the ITT sample. Twenty-one patients (18%) dropped out from the SSTR as nonresponders and 19 patients (16%) dropped out as low responders due to protocol deviations. CONCLUSION: The acceptance of the antidepressive treatment algorithm among physicians not specifically trained was moderate, resulting in a relatively low enrollment rate. However, once patients were enrolled into the study, adherence to the algorithm-based rules resulted in a low dropout rate. Most importantly, algorithm-guided antidepressive treatment showed a favorable response in those depressed patients who were treated according to the SSTR protocol.

Algorithms↗

Evaluation of an EMS algorithm system. American College of Emergency Physicians Algorithm Review Subcommitte.

The American College of Emergency Physicians algorithm project was a pilot study designed to identify a method for evaluating algorithms by peer review and field test. The intent of the pilot project was to make recommendations which would permit a more extensive evaluation of the logic, usefulness, and safety of various algorithms. The project yielded a report which summarized the research design and suggests possible revisions to the phases of peer review, algorithm assignment, and field test. It is anticipated that the report will be used by the National Center for Health Services Research in developing a method to carefully assess the various algorithms developed to date prior to their widespread use. Presented here is the executive summary of the report.

Decision Making↗

Sensitivity of Swedish interactive threshold algorithm compared with standard full threshold algorithm in Humphrey visual field testing.

OBJECTIVE: To compare the sensitivity of Swedish interactive threshold algorithm (SITA) strategies with the standard full threshold algorithm in the Humphrey Field Analyzer. DESIGN: Observational case series. PARTICIPANTS: Forty-eight glaucoma patients who were experienced in automated perimetry. TESTING: Central field testing was performed with the 30-2 program using standard full threshold (SFT), SITA standard (SS), and SITA fast (SF) strategies. All three tests were carried out on each of four different days in a span of 4 weeks. MAIN OUTCOME MEASURES: Sensitivity, repeatability, time saved, and the extent of defect in the SITA strategies were compared with those of the SFT. RESULTS: The sensitivity of SS and SF were 95.12% and 92.68%, respectively. The time saved in SS and SF was 53.12+/-9.51% and 70.69+/-8.81%, respectively. The repeatability as assessed by intraclass correlation showed excellent repeatability for the SFT and SS strategies and excellent to poor repeatability with the SF strategy. With increasing mean deviation, the defects (significant at P<0.5%) in the pattern deviation plots tended to be more in the SITA strategies as compared with SFT. CONCLUSIONS: Swedish interactive threshold algorithm strategies have good sensitivity and are significantly faster as compared with the standard threshold algorithm. The repeatability of the SFT and SS strategies are excellent, whereas that of the SF strategy is variable.

Algorithms↗

A genetic algorithm for the automated generation of small organic molecules: drug design using an evolutionary algorithm.

Rational drug design involves finding solutions to large combinatorial problems for which an exhaustive search is impractical. Genetic algorithms provide a novel tool for the investigation of such problems. These are a class of algorithms that mimic some of the major characteristics of Darwinian evolution. LEA has been designed in order to conceive novel small organic molecules which satisfy quantitative structure-activity relationship based rules (fitness). The fitness consists of a sum of constraints that are range properties. The algorithm takes an initial set of fragments and iteratively improves them by means of crossover and mutation operators that are related to those involved in Darwinian evolution. The basis of the algorithm, its implementation and parameterization, are described together with an application in de novo molecular design of new retinoids. The results may be promising for chemical synthesis and show that this tool may find extensive applications in de novo drug design projects.

Algorithms↗

New learning automata based algorithms for adaptation of backpropagation algorithm parameters.

One popular learning algorithm for feedforward neural networks is the backpropagation (BP) algorithm which includes parameters, learning rate (eta), momentum factor (alpha) and steepness parameter (lambda). The appropriate selections of these parameters have large effects on the convergence of the algorithm. Many techniques that adaptively adjust these parameters have been developed to increase speed of convergence. In this paper, we shall present several classes of learning automata based solutions to the problem of adaptation of BP algorithm parameters. By interconnection of learning automata to the feedforward neural networks, we use learning automata scheme for adjusting the parameters eta, alpha, and lambda based on the observation of random response of the neural networks. One of the important aspects of the proposed schemes is its ability to escape from local minima with high possibility during the training period. The feasibility of proposed methods is shown through simulations on several problems.

Algorithms↗

The Texas Medication Algorithm Project: development and implementation of the schizophrenia algorithm.

The Texas Medication Algorithm Project is a program designed to improve the quality of care of persons with serious mental disorders across sites in the Texas public mental health system and to create a uniform clinical environment from which cost estimates can be made. This paper describes the process of developing a pharmacological treatment algorithm for schizophrenia that addresses use of antipsychotics as well as other medications for side effects and co-existing symptoms. Input from clinicians, consultants, and consumers informed development of the algorithm, which was based on existing expert consensus guidelines. Information about the project can be found on the Internet at www.mhmr.state.tx.us/meds/tmap.htm. The authors present and describe the original and current versions of the algorithm, outline the feedback process by which it will be refined, and discuss how new medications will be incorporated as they enter the market.

Algorithms↗

Impact of active versus usual algorithmic titration of basal insulin and point-of-care versus laboratory measurement of HbA1c on glycemic control in patients with type 2 diabetes: the Glycemic Optimization with Algorithms and Labs at Point of Care (GOAL A1C) trial.

OBJECTIVE: The objective of this study was to assess the impact of active versus usual monitoring of algorithmic insulin titration and point-of-care (POC) versus laboratory HbA1c (A1C) measurement on glycemic control in primary care. RESEARCH DESIGN AND METHODS: The Glycemic Optimization with Algorithms and Labs at Point of Care (GOAL A1C) study was a 24-week, randomized, parallel-group, four-arm, open-label study of 7,893 adults with type 2 diabetes uncontrolled by oral antidiabetic agents and requiring insulin. Patients were randomly assigned by investigators from 2,164 sites in the U.S. to insulin glargine with either 1) usual (no unsolicited contact between visits) insulin titration using a simple algorithm with laboratory A1C testing, 2) usual titration with POC A1C testing, 3) active (weekly monitored) titration with laboratory A1C testing, or 4) active titration with POC A1C testing. Outcome measures included a change in A1C and fasting self-monitoring of blood glucose (SMBG) levels, percentage of patients achieving A1C <7.0%, and hypoglycemia frequency. RESULTS: Significant A1C and SMBG reductions were observed in all arms (P < 0.0001). Compared with usual insulin titration, active titration achieved greater A1C reduction (1.5 vs. 1.3%; P < 0.0001), SMBG reduction (88 vs. 79 mg/dl; P < 0.0001), and proportion of patients achieving A1C <7.0% (38 vs. 30%; P < 0.0001). Among patients receiving active titration, POC A1C testing was associated with an increase in the proportion achieving an A1C <7.0% (41% for POC vs. 36% for laboratory; P < 0.0001). Hypoglycemia rates were low (usual vs. active groups: 3.7 vs. 6.0 all confirmed episodes/patient-year [P < 0.001]; 0.09 vs. 0.14 severe episodes/patient-year [NS]). CONCLUSIONS: In a predominantly primary care setting, addition of insulin glargine using a simple algorithm achieved significant improvements in glycemic control in patients with type 2 diabetes in all four study arms. Active titration resulted in significant incremental improvements in glycemic control, and, among patients receiving active titration, POC A1C testing resulted in a greater portion achieving A1C <7.0%.

Administration, Oral↗

The Texas Medication Algorithm Project (TMAP) schizophrenia algorithms.

BACKGROUND: In the Texas Medication Algorithm Project (TMAP), detailed guidelines for medication management of schizophrenia and related disorders, bipolar disorders, and major depressive disorders have been developed and implemented. DISCUSSION: This article describes the algorithms developed for medication treatment of schizophrenia and related disorders. The guidelines recommend a sequence of medications and discuss dosing, duration, and switch-over tactics. They also specify response criteria at each stage of the algorithm for both positive and negative symptoms. The rationale and evidence for each aspect of the algorithms are presented.

Algorithms↗

An algorithm for the treatment of schizophrenia in the correctional setting: the Forensic Algorithm Project.

The Forensic Algorithm Project (FAP) was born of the need for a holistic approach in the treatment of the inmate with schizophrenia. Schizophrenia was chosen as the first entity to be addressed by the algorithm because of its refractory nature and high rate of recidivism in the correctional setting. Schizophrenia is regarded as a spectrum disorder, with symptom clusters and behaviors ranging from positive to negative symptoms to neurocognitive dysfunction and affective instability. Furthermore, the clinical picture is clouded by Axis II symptomatology (particularly prominent in the inmate population), comorbid Axis I disorders, and organicity. Four subgroups of schizophrenia were created to coincide with common clinical presentations in the forensic inpatient facility and also to parallel 4 tracks of intervention, consisting of pharmacologic management and programming recommendations. The algorithm begins with any antipsychotic medication and proceeds to atypical neuroleptic usage, augmentation with other psychotropic agents, and, finally, the use of clozapine as the common pathway for refractory schizophrenia. Outcome measurement of pharmacologic intervention is assessed every 6 weeks through the use of a 4-item subscale, specific for each forensic subgroup. A "floating threshold" of 40% symptom severity reduction on Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale items over a 6-week period is considered an indication for neuroleptic continuation. The forensic algorithm differs from other clinical practice guidelines in that specific programming in certain prison environments is stipulated. Finally, a social commentary on the importance of state-of-the-art psychiatric treatment for all members of society is woven into the clinical tapestry of this article.

Algorithms↗

Efficient computational algorithms for docking and for generating and matching a library of functional epitopes I. Rigid and flexible hinge-bending docking algorithms.

In this, and the next review article (1), we present highly efficient, computer-vision and robotics based algorithms for docking and for the generation and matching of epitopes on molecular surfaces. We start with descriptions of molecular surfaces, and proceed to utilize these in both rigid-body and flexible matching routines. These algorithms originate in the computer vision and robotics disciplines. Frequently used approaches, both in searches for molecular similarity and for docking, i.e., molecular complementarity, strive to obtain highly accurate correspondence of respective molecular surfaces. However, owing to molecular surface variability in solution, to mutational events, and to the need to use modeled structures in addition to high resolution ones, utilization of epitopes might prove to be a judicious approach to follow. Furthermore, through the deployment of libraries of epitopes which represent recurring features, or motifs in a given family of receptors or of enzymes, in principle we a priori focus on the more critical groups of atoms, or amino acids, essential for the binding of the two molecules. Utilization of recurring motifs may prove more robust than single molecule matchings. In addition, via utilization of epitopes one can make use of information derived from evolutionary related molecules. All of the above combine to represent an approach which may be highly advantageous. Combinatorial approaches have proven their immense utility in the wet laboratory. The combination of efficient computational approaches and the utilization of such libraries may well be particularly profitable. Our highly efficient techniques are amenable to such a task. In this review we focus on rigid and flexible docking algorithms. In the second review (1) we address the generation of epitopes in families of molecules. These may be used by the docking algorithms to identify the more likely bound interfaces.

Algorithms↗

Reducing polypharmacy through the introduction of a treatment algorithm: use of a treatment algorithm on the impact on polypharmacy.

INTRODUCTION: Polypharmacy is very common in the psychiatric setting despite the lack of evidence to justify its use. The objective of this study was to review the prescription patterns in a tertiary mental health institute in Asia and evaluate the impact of a treatment algorithm for patients with first-episode psychosis (FEP) on the use of polypharmacy. MATERIALS AND METHODS: A treatment algorithm was implemented for patients accepted into an Early Psychosis Intervention Programme (EPIP) and the prescription patterns of these patients were compared with a comparator group (pre-EPIP) before the use of the algorithm. The prescribing pattern was established at 2 points: at baseline after the diagnosis was made, and 3 months later. RESULTS: There were 68 subjects in the comparator group and 483 EPIP patients; the latter were on the average younger. None in the comparator group was diagnosed to have an affective psychosis. There was a significant reduction in the rate of antipsychotic polypharmacy, prolonged use of benzodiazepines and anticholinergic medication in EPIP patients. This group also had an increase in the use of second-generation antipsychotics and received lower doses of antipsychotics. CONCLUSION: The implementation of a treatment algorithm coupled with audit has changed the trend towards polypharmacy among patients with FEP.

Adult↗

[Evaluation of the Swedish Interactive Thresholding Algorithm, a new thresholding algorithm, of the Humphrey field analyzer in normal subjects].

The Swedish Interactive Thresholding Algorithm (SITA) is a new thresholding algorithm that aims to obtain the same quality of visual fields in a shorter examination time than with the conventional up-and-down method. We investigated the correlation between thresholds measured with the SITA algorithm and those with the conventional up-and-down method in 47 eyes of 47 normal subjects. In each test point, thresholds with the SITA accurate and with the SITA fast showed significant correlation with those of the conventional method (r = 0.693, p < 0.0001 and r = 0.689, p < 0.0001, respectively). The mean deviation (MD) in the conventional method and the difference between MD values of the conventional method and SITA accurate and SITA fast were significantly correlated (r = -0.442, p < 0.006 and r = -0.509, p < 0.00092, respectively). The examination times of the SITA accurate and SITA fast were 48% and 27% of the conventional method. Although the new thresholding algorithm enables us to perform perimetric examination with relatively high accuracy, further investigations should be conducted before we apply it to glaucoma cases.

Algorithms↗