Search results for: clinical prediction rule

Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

Abstract:

The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

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Authors: Suzan Wedyan

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Data mining is one of the main phases in the Knowledge Discovery Database (KDD) which is responsible of finding hidden and useful knowledge from databases. There are many different tasks for data mining including regression, pattern recognition, clustering, classification, and association rule. In recent years a promising data mining approach called associative classification (AC) has been proposed, AC integrates classification and association rule discovery to build classification models (classifiers). This paper surveys and critically compares several AC algorithms with reference of the different procedures are used in each algorithm, such as rule learning, rule sorting, rule pruning, classifier building, and class allocation for test cases.

Keywords: associative classification, classification, data mining, learning, rule ranking, rule pruning, prediction

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Authors: Grace Titilayo, Kolawole-Amao

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Influence and authority of law within society should be respected by all and sundry regardless of individual status. Rule of law implies that every citizen is subject to the law. In a society governed by the rule of law, government and its officials and agents are also held subject to and accountable under the law. Law should not be employed to suit individual tenets. Where the rule of law operates, the government is the government of law and not of men. Corruption is a factor that kills the growth of the rule of law. Where corruption flourishes, the rule of law fails, simply put, corruption is a threat to the rule of law. It bastardized and undermines the rule of law and good governance principles - where men rule at their discretion rather than the use of the rule of law which makes governance processes ineffective. Corruption is prevalent all over the world, and has extremely far reaching effects. Many of the world’s greatest challenges have been amplified by corruption, for example poverty, unequal distribution of wealth and resources, and world hunger and it weakens the application and the entrenchment of the rule of law. It saps citizens' trust in their governments and undercuts government credibility. This paper will discuss the rule of law in the present democratic system in Nigeria, the impact of corruption on the rule of law in Nigeria and how corruption undermines and subverts the entrenchment of the rule of law in the present day Nigeria.

Keywords: rule of law, corruption, Nigeria, influence, authority

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Authors: Sahin Emrah Amrahov, Fatih Aybar, Serhat Dogan

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In this paper we consider the rule reduct generation problem. Rule Reduct Generation (RG) and Modified Rule Generation (MRG) algorithms, that are used to solve this problem, are well-known. Alternative to these algorithms, we develop Pruning Rule Generation (PRG) algorithm. We compare the PRG algorithm with RG and MRG.

Keywords: rough sets, decision rules, rule induction, classification

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Authors: B. Chandra

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In Association Rule Mining, much attention has been paid for developing algorithms for large (frequent/closed/maximal) itemsets but very little attention has been paid to improve the performance of rule generation algorithms. Rule generation is an important part of Association Rule Mining. In this paper, a novel approach named NARG (Association Rule using Antecedent Support) has been proposed for rule generation that uses memory resident data structure named FCET (Frequent Closed Enumeration Tree) to find frequent/closed itemsets. In addition, the computational speed of NARG is enhanced by giving importance to the rules that have lower antecedent support. Comparative performance evaluation of NARG with fast association rule mining algorithm for rule generation has been done on synthetic datasets and real life datasets (taken from UCI Machine Learning Repository). Performance analysis shows that NARG is computationally faster in comparison to the existing algorithms for rule generation.

Keywords: knowledge discovery, association rule mining, antecedent support, rule generation

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Authors: P. Bharathiraja

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Computer Aided decision making system is used to enhance diagnosis and prognosis of diseases and also to assist clinicians and junior doctors in clinical decision making. Medical Data used for decision making should be definite and consistent. Data Mining and soft computing techniques are used for cleaning the data and for incorporating human reasoning in decision making systems. Fuzzy rule based inference technique can be used for classification in order to incorporate human reasoning in the decision making process. In this work, missing values are imputed using the mean or mode of the attribute. The data are normalized using min-ma normalization to improve the design and efficiency of the fuzzy inference system. The fuzzy inference system is used to handle the uncertainties that exist in the medical data. Equal-width-partitioning is used to partition the attribute values into appropriate fuzzy intervals. Fuzzy rules are generated using Class Based Associative rule mining algorithm. The system is trained and tested using heart disease data set from the University of California at Irvine (UCI) Machine Learning Repository. The data was split using a hold out approach into training and testing data. From the experimental results it can be inferred that classification using fuzzy inference system performs better than trivial IF-THEN rule based classification approaches. Furthermore it is observed that the use of fuzzy logic and fuzzy inference mechanism handles uncertainty and also resembles human decision making. The system can be used in the absence of a clinical expert to assist junior doctors and clinicians in clinical decision making.

Keywords: decision making, data mining, normalization, fuzzy rule, classification

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Authors: Thi Thao Nguyen, Andrew McLennan, Shino Takayama

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We study the probabilistic allocation of finitely many indivisible objects to finitely many agents. Well known allocation rules for this problem include random priority, the market mechanism proposed by Hylland and Zeckhauser [1979], and the probabilistic serial rule of Bogomolnaia and Moulin [2001]. We propose a new allocation rule, which we call the lexico-graphic (serial) rule, that is tailored for situations in which each agent's primary concern is to maximize the probability of receiving her favourite object. Three axioms, lex efficiency, lex envy freeness and fairness, are proposed and fully characterize the lexicographic serial rule. We also discuss how our axioms and the lexicographic rule are related to other allocation rules, particularly the probabilistic serial rule.

Keywords: Efficiency, Envy free, Lexicographic, Probabilistic Serial Rule

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: T. Bouchabchoub, A. Bendahmane, A. Haouriqui, N. Attou

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This paper presents simulation results of Forex predicting model equations in order to give approximately a prevision of interest rates. First, Hall-Taylor (HT) equations have been used with Taylor rule (TR) to adapt them to European and American Forex Markets. Indeed, initial Taylor Rule equation is conceived for all Forex transactions in every States: It includes only one equation and six parameters. Here, the model has been used with Hall-Taylor equations, initially including twelve equations which have been reduced to only three equations. Analysis has been developed on the following base macroeconomic variables: Real change rate, investment wages, anticipated inflation, realized inflation, real production, interest rates, gap production and potential production. This model has been used to specifically study the impact of an inflation shock on macroeconomic director interest rates.

Keywords: interest rate, Forex, Taylor rule, production, European Central Bank (ECB), Federal Reserve System (FED).

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Authors: Sophie N. Selby-Pham, Yudie Wang, Louise Bennett

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Consumption of grapes promotes health and reduces the risk of chronic diseases due to the action of grape phytochemicals in regulation of Oxidative Stress and Inflammation (OSI). The bioefficacy of phytochemicals depends on their absorption in the human body. The time required for phytochemicals to achieve maximal plasma concentration (Tₘₐₓ) after oral intake reflects the time window of maximal bioefficacy of phytochemicals, with Tₘₐₓ dependent on physicochemical properties of phytochemicals. This research collated physicochemical properties of grape phytochemicals from white and red grapes to predict their Tₘₐₓ using pharmacokinetic modelling. The predicted values of Tₘₐₓ were then compared to the measured Tₘₐₓ collected from clinical studies to determine the accuracy of prediction. In both liquid and solid intake forms, white grapes exhibit a shorter Tₘₐₓ range (0.5-2.5 h) versus red grapes (1.5-5h). The prediction accuracy of Tₘₐₓ for grape phytochemicals was 33.3% total error of prediction compared to the mean, indicating high prediction accuracy. Pharmacokinetic modelling allows prediction of Tₘₐₓ without costly clinical trials, informing dosing frequency for sustained presence of phytochemicals in the body to optimize the health benefits of phytochemicals.

Keywords: absorption kinetics, phytochemical, phytochemical absorption prediction model, Vitis vinifera

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Authors: Jeena R. S., Sukesh Kumar A.

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Stroke is one of the major reasons of adult disability and morbidity in many of the developing countries like India. Early diagnosis of stroke is essential for timely prevention and cure. Various conventional statistical methods and computational intelligent models have been developed for predicting the risk and outcome of stroke. This research work focuses on a multilevel approach for predicting the occurrence of stroke based on various risk factors and invasive techniques like retinal imaging. This risk prediction model can aid in clinical decision making and help patients to have an improved and reliable risk prediction.

Keywords: prediction, retinal imaging, risk factors, stroke

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Authors: Daniela Piana

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This work casts light on what lies underneath the rule of law. In order to do so it unfolds the arguments in three main steps. The first one is a pars destruens: the mainstreaming scholarship on judicial independence and judicial accountability is questioned under the large amount of data we have at our disposal (this step is accomplished in the first two paragraphs). The second step is the reframe of the concept of the rule of law and the consequent rise of a hidden dimension, which has been so far largely underexplored: responsiveness. The third step consists into offering the readers empirical support and drawing thereby consequences in terms of policy design and citizens engagement into the rule of law implementation (these two steps are accomplished in the third paragraph).

Keywords: rule of law, accountability, trust, citizens

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Authors: Seyed Jafar Hosseini, Rahim Vakilzadeh, Hassan Movassagi

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‘Negation of insinuation’ or ‘negation of dominance’ Rule is considered as one of the most important principles governing the policies and external relations of Islamic and religious countries. The stable and influential role which this rule puts on the behavior and policies of the Islamic religion and foreign policies of Islamic countries shows the importance of the presented topic. Among Islamic scholars, Imam Khomeini (RA) has been paid most attention to this rule on governing issues. In the present study, we are going to investigate the nature and dimensions of Negation of insinuation rule in Imam Khomeini's ideas with an analytical and descriptive method. The obtained results show that Negation of insinuation rule is an effective and main guidance in Imam's thoughts and behavior.

Keywords: negation of insinuation Rule, Imam Khomeini (RA), cultural domination, political domination, economic domination

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Authors: Leonardo Juan Ramírez López, Javier Oswaldo Rodriguez Velasquez

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We have designed a Holter that measures the heart´s activity for over 24 hours, implemented a prediction methodology, and generate alarms as well as indicators to patients and treating physicians. Various diagnostic advances have been developed in clinical cardiology thanks to Holter implementation; however, their interpretation has largely been conditioned to clinical analysis and measurements adjusted to diverse population characteristics, thus turning it into a subjective examination. This, however, requires vast population studies to be validated that, in turn, have not achieved the ultimate goal: mortality prediction. Given this context, our Insight Research Group developed a mathematical methodology that assesses cardiac dynamics through entropy and probability, creating a numerical and geometrical attractor which allows quantifying the normalcy of chronic and acute disease as well as the evolution between such states, and our Tigum Research Group developed a holter device with 12 channels and advanced computer software. This has been shown in different contexts with 100% sensitivity and specificity results.

Keywords: attractor , cardiac, entropy, holter, mathematical , prediction

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Authors: Kwan Hee Han, Jun Woo Lee, Sung Moon Bae, Twae Kyung Park

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ECA (Event-Condition-Action) languages are largely adopted for event processing since they are an intuitive and powerful paradigm for programming reactive systems. However, there are some limitations about ECA rules for processing of complex events such as coupling of event producer and consumer. The objective of this paper is to propose an ECA rule pattern to improve the current limitations of ECA rule, and to develop a prototype system. In this paper, conventional ECA rule is separated into 3 parts and each part is extended to meet the requirements of CEP. Finally, event processing logic is established by combining the relevant elements of 3 parts. The usability of proposed extended ECA rule is validated by a test scenario in this study.

Keywords: complex event processing, ECA rule, Event processing system, event-driven architecture, internet of things

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Authors: Wheyming Song, Hung-Hsiang Lin, Scott Lian

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In this research, we investigate the optimal dispatching rule for machines and manpower allocation in the solar ingot-wafer systems. The performance of the method is measured by the sales profit for each dollar paid to the operators in a one week at steady-state. The decision variables are identification-number of machines and operators when each job is required to be served in each process. We propose a rule which is a function of operator’s ability, corresponding salary, and standing location while in the factory. The rule is named ‘Multi-nominal distribution dispatch rule’. The proposed rule performs better than many traditional rules including generic algorithm and particle swarm optimization. Simulation results show that the proposed Multi-nominal distribution dispatch rule improvement on the sales profit dramatically.

Keywords: dispatching, solar ingot, simulation, flexsim

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Authors: Osama Elsarrar, Marjorie Darrah, Richard Devin

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This paper discusses the idea of capturing an expert’s knowledge in the form of human understandable rules and then inserting these rules into a dynamic cell structure (DCS) neural network. The DCS is a form of self-organizing map that can be used for many purposes, including classification and prediction. This particular neural network is considered to be a topology preserving network that starts with no pre-structure, but assumes a structure once trained. The DCS has been used in mission and safety-critical applications, including adaptive flight control and health-monitoring in aerial vehicles. The approach is to insert expert knowledge into the DCS before training. Rules are translated into a pre-structure and then training data are presented. This idea has been demonstrated using the well-known Iris data set and it has been shown that inserting the pre-structure results in better accuracy with the same training.

Keywords: neural network, self-organizing map, rule extraction, rule insertion

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Authors: Mbuzeni Mathenjwa

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Upon their independence, most African countries adopted constitutions that proclaim respect for the rule of law. The decision to constitutionalise the rule of law is basically informed by the countries’ experience during the colonial era which was characterised by discrimination on various grounds including race, gender and religion. Despite the promise to be bound by and adhere to the rule of law, disrespect for the rule of law has become a norm in the African continent. This is evident from the reported incidence of abuse of power, failure to perform obligations imposed by law and flagrant disregard of the law by the Executive including the heads of states in the continent. In some African countries including South Africa, the courts of law have been approached to rule on the legality of the decisions of the executives, taken contrary to the prescripts of the law. South African Courts have laid down a number of decisions wherein they found that the conduct of the executive contravenes the rule of law. Consequently decisions of the executive have been declared invalid by courts. In this regard courts have become a safety net in preserving the rule of law in. Accordingly, this paper discusses the role of the courts in preserving the rule of law in Africa. This it does by explaining the notion of judicial independence and the doctrine of the rule of law. The explanation on the notion of judicial independence is relevant because only an independent judiciary can effectively review and set aside the decision of the executive including the president of a country. Furthermore, a comparative overview of the enforcement of the rule of law in African countries is done. The methods used for this research is literature review, and study of legislation and case law in selected African countries relating to the independence of the judiciary and the rule of law. Finally, a conclusion is drawn on the role of the independent judiciary to preserve the rule of law in Africa.

Keywords: Africa, constitutions, independence, judiciary

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Authors: Rihab Idoudi, Karim Saheb Ettabaa, Basel Solaiman, Kamel Hamrouni

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Medical association rules induction is used to discover useful correlations between pertinent concepts from large medical databases. Nevertheless, ARs algorithms produce huge amount of delivered rules and do not guarantee the usefulness and interestingness of the generated knowledge. To overcome this drawback, we propose an ontology based interestingness measure for ARs ranking. According to domain expert, the goal of the use of ARs is to discover implicit relationships between items of different categories such as ‘clinical features and disorders’, ‘clinical features and radiological observations’, etc. That’s to say, the itemsets which are composed of ‘similar’ items are uninteresting. Therefore, the dissimilarity between the rule’s items can be used to judge the interestingness of association rules; the more different are the items, the more interesting the rule is. In this paper, we design a distinct approach for ranking semantically interesting association rules involving the use of an ontology knowledge mining approach. The basic idea is to organize the ontology’s concepts into a hierarchical structure of conceptual clusters of targeted subjects, where each cluster encapsulates ‘similar’ concepts suggesting a specific category of the domain knowledge. The interestingness of association rules is, then, defined as the dissimilarity between corresponding clusters. That is to say, the further are the clusters of the items in the AR, the more interesting the rule is. We apply the method in our domain of interest – mammographic domain- using an existing mammographic ontology called Mammo with the goal of deriving interesting rules from past experiences, to discover implicit relationships between concepts modeling the domain.

Keywords: association rule, conceptual clusters, interestingness measures, ontology knowledge mining, ranking

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Authors: Suzan Arslanturk, Mohammad-Reza Siadat, Theophilus Ogunyemi, Ananias Diokno

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Missing data is a common challenge in statistical analyses of most clinical survey datasets. A variety of methods have been developed to enable analysis of survey data to deal with missing values. Imputation is the most commonly used among the above methods. However, in order to minimize the bias introduced due to imputation, one must choose the right imputation technique and apply it to the correct type of missing data. In this paper, we have identified different types of missing values: missing data due to skip pattern (SPMD), undetermined missing data (UMD), and genuine missing data (GMD) and applied rough set imputation on only the GMD portion of the missing data. We have used rough set imputation to evaluate the effect of such imputation on prediction by generating several simulation datasets based on an existing epidemiological dataset (MESA). To measure how well each dataset lends itself to the prediction model (logistic regression), we have used p-values from the Wald test. To evaluate the accuracy of the prediction, we have considered the width of 95% confidence interval for the probability of incontinence. Both imputed and non-imputed simulation datasets were fit to the prediction model, and they both turned out to be significant (p-value < 0.05). However, the Wald score shows a better fit for the imputed compared to non-imputed datasets (28.7 vs. 23.4). The average confidence interval width was decreased by 10.4% when the imputed dataset was used, meaning higher precision. The results show that using the rough set method for missing data imputation on GMD data improve the predictive capability of the logistic regression. Further studies are required to generalize this conclusion to other clinical survey datasets.

Keywords: rough set, imputation, clinical survey data simulation, genuine missing data, predictive index

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Authors: Avinash S. Jagtap, Sharad D. Gore, Rajendra G. Gurao

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Decision rules become more and more complex as the number of conditions increase. As a consequence, the complexity of the decision rule also influences the time complexity of computer implementation of such a rule. Consider, for example, a decision that depends on four conditions A, B, C and D. For simplicity, suppose each of these four conditions is binary. Even then the decision rule will consist of 16 lines, where each line will be of the form: If A and B and C and D, then action 1. If A and B and C but not D, then action 2 and so on. While executing this decision rule, each of the four conditions will be checked every time until all the four conditions in a line are satisfied. The minimum number of logical comparisons is 4 whereas the maximum number is 64. This paper proposes to present a complex decision rule in the form of a decision tree. A decision tree divides the cases into branches every time a condition is checked. In the form of a decision tree, every branching eliminates half of the cases that do not satisfy the related conditions. As a result, every branch of the decision tree involves only four logical comparisons and hence is significantly simpler than the corresponding complex decision rule. The conclusion of this paper is that every complex decision rule can be represented as a decision tree and the decision tree is mathematically equivalent but computationally much simpler than the original complex decision rule

Keywords: strategic, tactical, operational, adaptive, innovative

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Authors: Rodrigo S. Piera, Jailson Sales Ara´ujo, Gabriela B. Lemos, Matthew B. Weiss, John B. DeBrota, Gabriel H. Aguilar, Jacques L. Pienaar

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The Born rule was historically viewed as an independent axiom of quantum mechanics until Gleason derived it in 1957 by assuming the Hilbert space structure of quantum measurements [1]. In subsequent decades there have been diverse proposals to derive the Born rule starting from even more basic assumptions [2]. In this work, we demonstrate that a simple reinforcement-learning algorithm, having no pre-programmed assumptions about quantum theory, will nevertheless converge to a behaviour pattern that accords with the Born rule, when tasked with predicting the output of a quantum optical implementation of a symmetric informationally-complete measurement (SIC). Our findings support a hypothesis due to QBism (the subjective Bayesian approach to quantum theory), which states that the Born rule can be thought of as a normative rule for making decisions in a quantum world [3].

Keywords: quantum Bayesianism, quantum theory, quantum information, quantum measurement

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Authors: B. Suraj Aravind, M. H. M. Krishna Prasad

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There exist emerging applications of data streams that require association rule mining, such as network traffic monitoring, web click streams analysis, sensor data, data from satellites etc. Data streams typically arrive continuously in high speed with huge amount and changing data distribution. This raises new issues that need to be considered when developing association rule mining techniques for stream data. This paper proposes to introduce an improved data stream association rule mining algorithm by eliminating the limitation of resources. For this, the concept of cloud computing is used. Inclusion of this may lead to additional unknown problems which needs further research.

Keywords: data stream, association rule mining, cloud computing, frequent itemsets

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Authors: Monty Vacura

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Hamilton’s Rule is a universal law of biology expressed in protists, plants and animals. When applied to human populations, this model explains: 1) Origin of religion in society as a biopsychological need selected to increase population size; 2) Instincts of racism expressed through intergroup competition; 3) Simultaneous selection for human cooperation and conflict, love and hate; 4) Connection between sporting events and instinctive social messaging for stimulating offensive and defensive responses; 5) Pathway to reduce human sacrifice. This chapter discusses the deep psychological influences of Hamilton’s Rule. Suggestions are provided to reduce human deaths via our instinctive sacrificial behavior, by consciously monitoring Hamilton’s Rule variables highlighted throughout our media outlets.

Keywords: psychology, Hamilton’s rule, evolution, human instincts

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Authors: Yosra Baaziz, Moez Labidi

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Given limited research on monetary policy rules in revolutionary countries, this paper challenges the suitability of the Taylor rule in characterizing the monetary policy behavior of the Tunisian Central Bank (BCT), especially in turbulent times. More specifically, we investigate the possibility that the Taylor rule should be formulated as a threshold process and examine the validity of such nonlinear Taylor rule as a robust rule for conducting monetary policy in Tunisia. Using quarterly data from 1998:Q4 to 2013:Q4 to analyze the movement of nominal short-term interest rate of the BCT, we find that the nonlinear Taylor rule improves its performance with the advent of special events providing thus a better description of the Tunisian interest rate setting. In particular, our results show that the adoption of an appropriate nonlinear approach leads to a reduction in the errors of 150 basis points in 1999 and 2009, and 60 basis points in 2011, relative to the linear approach.

Keywords: policy rule, central bank, exchange rate, taylor rule, nonlinearity

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

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Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Kevin Yeo, Christine Hall, Babinchak Tim

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BAT® [Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine)] anti-toxin is a mixture of equine immune globulin fragments indicated for the treatment of symptomatic botulism in adult and pediatric patients. The effectiveness of BAT anti-toxin is based on efficacy studies conducted in animal models. A general explanation of the pivotal animal studies, post market surveillance and outcomes of an observational patient registry for patients treated with BAT product distributed in the USA is briefly discussed. Overall it took 20 animal studies for two well-designed and appropriately powered pivotal efficacy studies – one in which the effectiveness of BAT was assessed against all 7 serotypes in the guinea pig, and the other where efficacy is confirmed in the Rhesus macaque using Serotype A. Clinical Experience for BAT to date involves approximately 600 adult and pediatric patients with suspected botulism. In pre-licensure, patient data was recorded under the US CDC expanded access program (259 adult and pediatric patients between 10 days to 88 years of age). In post licensure, greater than 350 patients to date have received BAT and been followed up by enhanced expanded access program. The analysis of the post market surveillance data provided a unique opportunity to demonstrate clinical benefit in the field study required by the animal rule. While the animal rule is applied because human efficacy studies are not ethical or feasible, a post-marketing requirement is to conduct a study to evaluate safety and clinical benefit when circumstances arise and demonstrate the favourable benefit-risk profile that supported licensure.

Keywords: botulism, threat, clinical benefit, observational patient registry

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Authors: Chiung-Ju Huang, Yuan-Hong Ho

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This study utilizes the International Monetary Fund (IMF) Fiscal Rules Dataset focusing on four specific fiscal rules such as expenditure rule, revenue rule, budget balance rule, and debt rule and five main characteristics of each fiscal rule those are monitoring, enforcement, coverage, legal basis, and escape clause to construct the Fiscal Rule Index for nine countries in the Asia-Pacific region from 1996 to 2015. After constructing the fiscal rule index for each country, we utilize the Panel Generalized Method of Moments (Panel GMM) by using the constructed fiscal rule index to examine the effectiveness of fiscal rules in reducing procyclicality. Empirical results show that national fiscal rules have a significantly negative impact on procyclicality of government expenditure. Additionally, stricter fiscal rules combined with high government effectiveness are effective in reducing procyclicality of government expenditure. Results of this study indicate that for nine Asia-Pacific countries, policymakers’ use of fiscal rules and government effectiveness to reducing procyclicality of fiscal policy are effective.

Keywords: counter-cyclical policy, fiscal rules, government efficiency, procyclical policy

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Authors: Kamalpreet Kaur, Renu Dhir

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Climate prediction is an essential component of climate research, which helps evaluate possible effects on economies, communities, and ecosystems. Climate prediction involves short-term weather prediction, seasonal prediction, and long-term climate change prediction. Climate prediction can use the information gathered from satellites, ground-based stations, and ocean buoys, among other sources. The paper's four architectures, such as ResNet50, VGG19, Inception-v3, and Xception, have been combined using an ensemble approach for overall performance and robustness. An ensemble of different models makes a prediction, and the majority vote determines the final prediction. The various architectures such as ResNet50, VGG19, Inception-v3, and Xception efficiently classify the dataset RSI-CB256, which contains satellite images into cloudy and non-cloudy. The generated ensembled S-E model (Sar-ensembled model) provides an accuracy of 99.25%.

Keywords: climate, satellite images, prediction, classification

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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