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Development of quantitative structure-activity relationships and classification models for anticonvulsant activity of hydantoin analogues.

Classification and QSAR analysis was performed on a large set of hydantoin derivatives with measured anticonvulsant activity in mice and rats. The classification set comprised 287 hydantoins having maximal electroshock (MES) activity expressed in qualitative form. A subset of 94 hydantoins with MES ED(50) values was used for QSAR analysis. Numerical descriptors were generated to encode topological, geometric/structural, electronic, and thermodynamic properties of molecules. Analyses were performed with training and test sets of diverse compounds selected using their representation in a principal component space. Cell- and distance metric-based selection methods were employed in this process. For QSAR, a genetic algorithm (GA) was used for selecting subsets of 5-9 descriptors that minimize the rms error on the training sets. The most predictive models have rms errors of 0.86 (r(2) = 0.64) and 0.73 (r(2) = 0.75) ln(1/ED(50)) units on the cell- and distance metric-derived test sets, respectively, and showed convergence in the selected descriptors. Classification models were developed using recursive partitioning (RP) and spline-fitting with a GA (SFGA), a novel method we have implemented. The most predictive RP and SFGA models have classification rates of 75% and 80% on the test sets; both methods produced models with similar discriminating features. For QSAR and classification, consensus schemes gave improved predictive accuracy.

Algorithms↗

Development of a chemical use classification system to facilitate reporting under the Toxic Substances Control Act.

A classification system was developed to enable manufacturers and processors of industrial chemicals to report categories of proposed categories of use of such chemicals to the Environmental Protection Agency in accordance with the Toxic Substances Control Act. To accommodate the two aspects of chemical use (i.e., function and application), a faceted classification scheme was designed. The function facet contains categories denoting the action for which a chemical is specially fitted or used, for example, adhesives or fuels. The application facet contains categories denoting the process or product in which a chemical is used, such as synthetic rubber manufacture. Linking these two facets in a single notation code provides a comprehensive indication of a chemical's use or uses. A variety of existing relevant classification schemes and reference tools were used as input sources for the chemical use classification. The practicability of the classification system was tested using a small sample of manufacturing and processing companies.

Chemical Phenomena↗

Floral classification of honey using mid-infrared spectroscopy and surface acoustic wave based z-Nose Sensor.

Fourier transform infrared spectroscopy (FTIR) and z-Nose were used as screening tools for the identification and classification of honey from different floral sources. Honey samples were scanned using microattenuated total reflectance spectroscopy in the region of 600-4000 cm(-1). Spectral data were analyzed by principal component analysis, canonical variate analysis, and artificial neural network for classification of the different honey samples from a range of floral sources. Classification accuracy near 100% was achieved for clover (South Dakota), buckwheat (Missouri), basswood (New York), wildflower (Pennsylvania), orange blossom (California), carrot (Louisiana), and alfalfa (California) honey. The same honey samples were also analyzed using a surface acoustic wave based z-Nose technology via a chromatogram and a spectral approach, corrected for time shift and baseline shifts. On the basis of the volatile components of honey, the seven different floral honeys previously mentioned were successfully discriminated using the z-Nose approach. Classification models for FTIR and z-Nose were successfully validated (near 100% correct classification) using 20 samples of unknown honey from various floral sources. The developed FTIR and z-Nose methods were able to detect the floral origin of the seven different honey samples within 2-3 min based on the developed calibrations.

Acoustics↗

QSAR and classification of murine and human soluble epoxide hydrolase inhibition by urea-like compounds.

A data set of 348 urea-like compounds that inhibit the soluble epoxide hydrolase enzyme in mice and humans is examined. Compounds having IC(50) values ranging from 0.06 to >500 microM (murine) and 0.10 to >500 microM (human) are categorized as active or inactive for classification, while quantitation is performed on smaller compound subsets ranging from 0.07 to 431 microM (murine) and 0.11 to 490 microM (human). Each compound is represented by calculated structural descriptors that encode topological, geometrical, electronic, and polar surface features. Multiple linear regression (MLR) and computational neural networks (CNNs) are employed for quantitative models. Three classification algorithms, k-nearest neighbor (kNN), linear discriminant analysis (LDA), and radial basis function neural networks (RBFNN), are used to categorize compounds as active or inactive based on selected data split points. Quantitative modeling of human enzyme inhibition results in a nonlinear, five-descriptor model with root-mean-square errors (log units of IC(50) [microM]) of 0.616 (r(2) = 0.66), 0.674 (r(2) = 0.61), and 0.914 (r(2) = 0.33) for training, cross-validation, and prediction sets, respectively. The best classification results for human and murine enzyme inhibition are found using kNN. Human classification rates using a seven-descriptor model for training and prediction sets are 89.1% and 91.4%, respectively. Murine classification rates using a five-descriptor model for training and prediction sets are 91.5% and 88.6%, respectively.

Animals↗

Classification of pituitary adenomas.

This brief review summarizes various schemes which were introduced to classify pituitary tumors of adenohypophysial origin. Many different classifications were proposed. Pathologists prefer classifications based on the morphologic features of tumor cells. The gold standard is the light microscopic study of hematoxylin-eosin stained sections of formalin fixed and paraffin-embedded tissues. For correlation between hormone production, secretory activity and cytogenesis, immunohistochemical and transmission electron microscopic investigation is needed. We are convinced that in the future, molecular and genetic techniques will also be applied. We present here our five-tier scheme for classification of pituitary tumors which was accepted by the 'World Health Organization International Histological Classification of Tumours'. This classification takes into consideration the clinical and laboratory findings, imaging results, histologic, immunocytochemical and ultrastructural features of tumor cells. Despite several recent attempts to assess the growth rate, aggressiveness and invasiveness of pituitary tumors, more work is required to draw conclusions on their prognosis.

Adenoma↗

Congenital coronary artery anomalies angiographic classification revisited.

Many fragmental classification of coronary artery anomalies (CAAs) exist, but a simple practical angiographic classification for angiographers has been never proposed. This study is aimed to suggest a simplified angiographic classification of congenital CAAs based on just a few univocal common angiographic patterns. The authors reviewed 5100 coronary angiographies in order to select CAAs patients and identify simple common angiographic features. Sixty-two patients (1.21%, female/male 20/42, mean age 65.3 +/- 10.6 years) had CAA on coronary angiography. The authors identified seven classes for seven angiographic patterns: I--hypoplasia/atresia, II--hyperdominance, III--fistula, IV--originating from wrong sinus, V--originating from other arteries, VI--splitting, and VII--tunnelling. A, P, B, R, L, PA, AO refer to anterior, posterior or passage between the aorta and pulmonary artery and to right, left, pulmonary artery and aorta. Three blind observers were be able to categorize all the CAAs according to this classification with no inter-observer differences: 3.2% were classified as class I, 8.1% as class II, 3.2% as class III, 24.2% as class IV, 22.5% as class V, 29% as class VI, and finally 9.7% as class VII. Eleven patients (17.7%) had 'A' passage, 10 (16.1%) 'P' passage and 9 (14.5%) 'B' passage. Twelve patients (19.5%) had anomalous origin from the right sinus of Valsalva, 2 (3.2%) from the left. This simplified classification was applicable to all most significant CAAs and in the authors' view it may make for a more rapid and univocal CAA angiographic description.

Aged↗

A further discussion on revisiting the classification of household composition among elderly people.

This discussion is a reaction to the DeVos article on the classification of households also in the current issue of Journal of Cross-Cultural Gerontology. The need for cross-national and comparative gerontological research is growing. Household composition is a compelling subject for such research, but there is a concurrent increase in the need for flexible and valid classification schemes. The DeVos classification represents an excellent step toward understanding households on a global level. Additional considerations not covered by DeVos include the gender of the coresident child, pseudo-coresidence, and living with grandchildren. These additional issues may complicate classification and, in the end, it is up to the individual researcher to choose schemes based on research questions, guiding theory, and available data. Yer, having a standard as a starting point reduces the complexity of the task of defining a classification scheme to be used comparatively across societies.

Aged↗

The "high solubility" definition of the current FDA Guidance on Biopharmaceutical Classification System may be too strict for acidic drugs.

PURPOSE: The purpose of this study was to assess if the definition of high solubility as proposed in the FDA Guidance on Biopharmaceutical Classification System (BCS) is too strict for highly permeable acidic drugs. METHODS: The solubility and permeability values of 20 (18 acidic and 2 non-acidic) nonsteroidal anti-inflammatory drugs (NSAID) were determined. The NSAIDs were grouped into three different sets having acetic acid, propionic acid, or other acidic moieties such as fenamate, oxicam, and salicylate. Two nonacidic NSAIDs (celecoxib and rofecoxib) were also included for comparison purposes. Equilibrium solubility values were determined at pH 1.2, 5.0, 7.4, and in biorelevant media simulating fed intestinal fluid at pH 5.0. For a select number of acids, we also measured solubility values in media simulating gastric and fasted intestinal fluids. Permeability classification was established relative to that of reference drugs in the Caco-2 cell permeability model. Permeability coefficients for all drugs were measured at concentrations corresponding to the lowest and highest marketed dose strengths dissolved in 250 ml volume, and their potential interaction with cellular efflux pumps was investigated. RESULTS: All NSAIDs with different acidic functional groups were classified as highly permeable based on their Caco-2 cell permeability. Only ketorolac appeared to have a potential for interaction with cellular efflux pumps. Solubility classification was based on comparison of equilibrium solubility at pH 1.2, 5.0. and 7.4 relative to marketed dose strengths in 250 ml. The pKa values for the acidic NSAIDs studied were between 3.5 and 5.1. and, as expected, their solubility increased dramatically at pH 7.4 compared to pH 1.2. Only three NSAIDs, ketorolac, ketoprofen. and acetyl salicylic acid, meet the current criteria for high solubility over the entire pH range. However, with the exception of ibuprofen, oxaprozin, and mefenamic acid, the remaining compounds can be classified as Class I drugs (high solubility-high permeability) relative to solubility at pH 7.4. The use of bio-relevant media simulating gastric and intestinal milieu for solubility measurements or increasing the dose volume to 500 ml did not provide for a better boundary for solubility classification. CONCLUSIONS: Based on the current definition of solubility, 15 of the 18 acidic NSAIDs in this study will be classified as Class II compounds as the solubility criteria applies to the entire pH range of 1.2 to 7.4, although the low solubility criteria does not hold true over the entire pH range. Whence, of the 18 acidic drugs, 15 can be classified as Class I based on the pH 7.4 solubility alone. This finding is intriguing because these drugs exhibit Class I behavior as their absorption does not seem to be dissolution or solubility limited. It could then be argued that for acidic drugs, the boundaries for solubility are too restrictive. Solubility at pH > 5 (pH in duodenum) may be more appropriate because most compounds are mainly absorbed in the intestinal region. Consideration for an intermediate solubility classification for highly permeable ionizable compounds that reflects physiological conditions seems warranted.

Acids↗

Classification for coding procedures in the intensive care unit.

BACKGROUND: There is no commonly accepted coding system for non-operative procedures in general, including intensive care unit (ICU) procedures. In order to create a classification of codes for ICU procedures, a system developed at the University Hospital of Bergen was evaluated in four Nordic countries. METHODS: Classification codes were constructed using seven main groups of related procedures that were given a letter from A to G. Within each group major procedures were given a number from 00 to 99, with the possibility of up to 10 subclassifications within each procedure. A simple questionnaire regarding the use of coding general ICU procedures and some specific procedures was sent to 171 ICUs in Sweden, Finland, Denmark, and Norway. They were also asked to give their comments on the new classification coding system, which was attached. RESULTS: One hundred and fifty-four questionnaires were returned (response rate 90%). Some or most of the ICU procedures were registered in the ICUs (82.2%). However 38% did not use any coding system and 24% used a specific internal system. The new classification coding system was well received, and was given a mean value of 7.5 using a VAS scale from 0 to 10 (best). Most ICUs would consider using this system if introduced at a national level. CONCLUSION: Most Nordic ICUs do register some or most of the procedures performed. Such procedures are however, registered in very different ways, using several different systems, and are often home-made. The new classification system of ICU procedures was well rated.

Critical Care↗

A model of perceptual classification in children and adults.

The developmental trend from overall-similarity to dimensional-identity classifications is explained by a quantitative model. I begin with the assumption that objects are represented in terms of constituent dimensions and that the representation of objects changes little with development. Given this assumption, the model has three major parts. First, the similarity between objects is a function of the combination of the constituent dimensional differences. I propose developmental change in the likelihood that dimensions are differentially weighted in the calculation of similarity. Second, the perceived similarities between objects are valued for the purpose of constructing classifications. I propose that similarities are valued more dichotomously with age, such that identity becomes increasingly special. Third, the valued similarities are used to choose the best classification of those possible. The model provides good qualitative fits to the extant data. Three experiments examining classifications in 2- to 8-year-olds and in adults support specific new claims of the model. The data and the model provide new insights about development, classification, and similarity.

Adult↗

Application of different prognostic scoring systems and comparison of the FAB and WHO classifications in Korean patients with myelodysplastic syndrome.

We retrospectively studied 227 patients with MDS (1) to identify the prognostic factors of survival and acute leukemia evolution in Korean patients with MDS, (2) to apply different prognostic scoring systems to the same group of patients, and (3) to compare the FAB with the WHO classification. Six scoring systems were applied to the patients, and the FAB and WHO classifications were compared. The patients' median age was 57 years. The median survival time was 21 months, and age, dysgranulopoiesis and the IPSS cytogenetic groups were independent prognostic factors for survival. Acute leukemia occurred in 34 patients, and the cumulative incidence was 27.1% at 3 years. Marrow blast percentage was the only independent prognostic factor for acute leukemia evolution. Most scoring systems successfully discriminated risk groups for survival and acute leukemia evolution, but patient distribution into risk groups varied according to the scoring systems. Refractory cytopenia with multilineage dysplasia and RAEB II seemed to have different prognoses from RA or RARS and RAEB I, respectively. In summary, our MDS patients had different disease natures from those of Western countries regarding clinical features, prognostic factors and cytogenetic profiles. Although the WHO classification seems to improve the FAB classification, further studies are warranted to validate the utility of the WHO classification before it is accepted for routine clinical use. Our study has the limitations of retrospective analysis, and our results should be verified in future prospective studies.

Actuarial Analysis↗

Classification of adults for family studies of developmental language disorders.

A variety of approaches has been used to classify the status of adult subjects in familial studies of developmental language disorders. In this report, we directly compare the results of four different methods that appear in the research literature. Two of the approaches rely on case history reports, and two are performance-based methods. Subjects included 24 parents (12 mothers, 12 fathers) of children with developmental language disorders and 24 unrelated adult control subjects (12 female, 12 male) who completed case history items and standardized language testing designed for classification purposes. All classification methods identified more parents than control subjects as "affected". However, classification by case history methods resulted in fewer affected adults than classification through standardized testing. This outcome suggests that the variability in classification rates in studies to date may be the result of method rather than subject sample differences.

Adult↗

Agreement between the clinical Oxfordshire Community Stroke Project classification and CT findings in Poland.

The Oxfordshire Community Stroke Project (OCSP) classification provides a simple means of classifying the clinical syndromes associated with acute stroke. The validity of the classification can depend on many factors. Accuracy and time of the clinical and radiological examination are very important. It was used in the International Stroke Trial (IST). The study was conducted in 467 hospitals in 34 countries. Our aim was to assess how well the OCSP classification could predict infarct site and size on computed tomography (CT) scan when performed in a trial within 48 h after the onset of stroke and the clinical assessment was carried out by different doctors in different hospitals. We examined data on the patients randomized in the IST by the seven participating hospitals in Poland. Patients admitted to the hospital were examined by the doctor on duty. Eight aspects of the neurological deficit present just before randomization were recorded. The computer system in the randomization centre employed a validated algorithm to assign the patient to one of the four infarct syndromes: lacunar syndrome (LACS), partial anterior circulation syndrome (PACS), total anterior circulation syndrome (TACS) and posterior circulation syndrome (POCS). We assessed the localization and extent of the recent infarction on available CT scans and correlated these with the computer-assigned OCSP category. CT scans were available for 558/759 (74%) of the patients randomized in Poland. In 458 (82%) of cases, CT was carried out in the first 24 h after the onset of stroke. In 444 (80%) scans, a recent infarct was visible. These radiological lesions were appropriate to the clinical classification in 56% of patients with TACS, 73% with PACS, 61% with LACS and 59% with POCS. In Polish centres in IST, amongst the patients with infarction visible on CT, the OCSP subtype predicted the size and site of the infarct in about two-thirds of cases. These data suggest that, provided its limitations are taken into account, the classification can be usefully applied in multicentre clinical trials (or epidemiological studies) and to aspects of the routine clinical care of patients with acute stroke.

Aged↗

The World Health Organization classification of malignant lymphoma: incidence and clinical prognosis in HTLV-1-endemic area of Fukuoka.

New insights into the pathogenesis of lymphoid malignancies have been gained through novel genetic, molecular and immunological techniques. A new classification system for lymphoid malignancies, known as the new World Health Organization (WHO) classification, has been proposed recently based on these findings. The relative incidence of the subtypes of malignant lymphoma is known to differ according to geographic location. Adult T-cell leukemia/lymphoma (ATLL) is a human malignancy associated with human T-cell leukemia virus type 1 (HTLV-1), and the Kyushu islands are an HTLV-1 endemic area. To clarify the relationship between the histological classification and prognosis of lymphoid malignancies, we reclassified previous cases in our department and summarized our previous reports using the WHO classification. Of 933 cases of lymphoid malignancies, 471 (50%) were B-cell lymphoma, 396 (42%) T/natural killer (NK)-cell lymphoma and 41 (4%) Hodgkin lymphoma (HL). Analysis of clinical outcome showed favorable prognosis for HL, intermediate for B-cell lymphoma and poor prognosis for T-cell lymphoma. Among B-cell lymphomas, the commonest type was diffuse large B-cell lymphoma (n = 281; 60%). Marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) was diagnosed in 82 cases (17%), follicular lymphoma in 52 (11%) and mantle cell lymphoma in 24 (5%). Other less common lymphomas were Burkitt lymphoma (n = 9; 2%) and lymphoblastic lymphoma (n = 5; 1%). Using overall survival rates, the various B-cell lymphoma types could be divided into three broad groups for prognostic purposes: (i) low-risk group comprising follicular lymphoma and MALT; (ii) intermediate-risk group comprising diffuse large B-cell lymphoma and Burkitt lymphoma; and (iii) high-risk group comprising mantle cell lymphoma and lymphoblastic lymphoma. Among the T/NK-cell lymphomas, the commonest type was ATLL (n = 191; 48%), followed by peripheral T-cell lymphoma, unspecified (n = 83; 21%), angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) (n = 38; 10%), anaplastic large cell lymphoma (ALCL) (n = 22; 6%). Less common types were lymphoblastic lymphoma (n = 17; 4%), nasal and nasal-type NK/T-cell lymphoma (n = 17; 4%), mycosis fungoides (MF) (n = 9; 2%) and other rare types. With respect to clinical prognosis, T/NK-cell lymphomas fell into three groups: (i) relative low-risk group comprising ALCL, AILD, MF and lymphoblastic lymphoma; (ii) relative intermediate-risk group comprising NK/T-cell lymphoma and unspecified lymphoma; and (iii) extremely high-risk group comprising ATLL. Among the lymphoblastic lymphomas, B-cell type and T-cell type lymphomas exhibited different clinical outcomes. We conclude that the histological, phenotypic and genotypic classification of the new WHO system should be beneficial for the clinical approach to these tumors.

Endemic Diseases↗

Multifactorial classification of male and female androgenetic alopecia.

BACKGROUND: Various classifications of male androgenetic alopecia have been described. In fact, all the classification schemes proposed so far are only topographic. A more objective, accurate, and detailed approach to classifying baldness is needed. OBJECTIVE: To propose a dynamic multifactorial classification of certain parameters that can be quantitated and computerized. METHODS: A multifactorial classification has been developed to study parameters such as fixed distances of the face, scalp mobility and thickness, and covering power of hair. This includes density, caliber, shape, length, growth rate, and hair color. RESULTS: Classification proved to be efficient during the fluctuations of different parameters in hormonal and minoxidil treatments. It also helps to determine surgical indications of hair transplant and the stage of maximal baldness. CONCLUSION: This approach will lead to a better evaluation of the evolution of androgenetic alopecia in both sexes, either spontaneously or under treatment.

Alopecia↗

Identification and classification of the causes of events in transfusion medicine.

BACKGROUND: Transfusion medicine lacks a standard method for the systematic collection and analysis of event reports. Review of event reports from the Food and Drug Administration (FDA) showed a relative paucity of information on event causation. Thus, a causal analysis method was developed as part of a prototype Medical Event Reporting System for Transfusion Medicine (MERS-TM). STUDY DESIGN AND METHODS: MERS-TM functions within existing quality assurance systems and utilizes descriptive coding and causal classification schemes. The descriptive classification system, based upon current FDA coding, was modified to meet participant needs. The Eindhoven Classification Model (Medical Version) was adopted for causal classification and analysis. Inter-rater reliability for the MERS-TM and among participating organizations was performed with the development group in the United States and with a safety science research group in the Netherlands. The MERS-TM was then tested with events reported by participants. RESULTS: Data from 503 event reports from two blood centers and two transfusion services are discussed. The data showed multiple causes for events and more latent causes than previously recognized. The distribution of causes was remarkably similar to that in an industrial setting outside of medicine that uses the same classification approach. There was a high degree of inter-rater reliability when the same events were analyzed by quality assurance personnel in different participating organizations. These personnel found the method practical and useful for providing new insights into conditions producing undesired events. CONCLUSION: A generally applicable and reliable method for identifying and quantifying problems that exist throughout transfusion medicine will be a valuable addition to event reporting activity. By using a common taxonomy, participants can compare their experience with that of others. If proven as readily implementable and useful as shown in initial studies, MERS-TM is a potential standard for transfusion medicine.

Causality↗

Introduction to, and classification of, the systemic vasculitides.

This overview serves as an introduction to the systemic vasculitides, which are a group of heterogeneous disorders sharing a common pathophysiological mechanism leading to blood vessel inflammation and tissue necrosis. Our lack of understanding of the aetiology for most forms of vasculitis has resulted in the development of a classification system, which is primarily based on vessel size. Such a system assists in the grouping together of similar conditions for the purposes of multi-centre studies. Difficulties arise in classification of the vasculitides due to considerable overlap of clinico-pathological features; for example, microscopic polyangiitis (MPA), Wegener's granulomatosis (WG) and Churg-Strauss syndrome (CSS) may all cause the identical renal lesion of necrotizing glomerulonephritis. The rationale for treatment often depends on the type of vasculitis and on the extent of organ involvement. Treatment may be similar for different types of disease. The lack of validated diagnostic criteria has, however, resulted in the application of classification criteria in their place, and has highlighted the limited usefulness of classification criteria in clinical practice. Classification systems should assist in the determination of therapy and prediction of outcomes, but have many limitations, which are discussed further in this review.

Humans↗

Does the new TNM classification (1997) improve prognostic stratification in gastric cancer submitted to R0 surgery?

AIMS: To determine the eventual advantage of the new 1997 TNM as prognosis predictor for gastric cancer patients submitted to an R0 resection and to compare it with two other lymph-node involvement classifications, the 1990 TNM and the Okusa system. METHODS: From January 1980 to December 1995, an R0 resection was performed as primary therapy in 275 cases of gastric cancer. These operations consisted of a total or sub-total gastrectomy and of a D2 type lymph-node dissection. Tumour classification was performed according to 1990 and 1997 TNM systems, and to the Okusa lymph node classification. The statistical methods used to evaluate prognostic value were: Kaplan-Meier survival estimates; the log-rank test for univariate analysis; and Cox's model for multivariate analysis. RESULTS: The 1990 TNM showed the best stratification power in univariate analysis. In multivariate analysis, the Okusa classification was identified as the best prognostic index (P<0.01). The 1997 TNM showed worse stratification capability than the two other systems. CONCLUSIONS: In the present series, the new TNM (1997) did not improve the prognostic stratification of lymph-node involvement. An adequate and universal system for lymph-node stratification is necessary and further validation of these classifications is needed.

Aged↗