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Using polygenic scores and clinical data for bipolar disorder patient stratification and lithium response prediction: machine learning approach – CORRIGENDUM
- Micah Cearns, Azmeraw T. Amare, Klaus Oliver Schubert, Anbupalam Thalamuthu, Joseph Frank, Fabian Streit, Mazda Adli, Nirmala Akula, Kazufumi Akiyama, Raffaella Ardau, Bárbara Arias, JeanMichel Aubry, Lena Backlund, Abesh Kumar Bhattacharjee, Frank Bellivier, Antonio Benabarre, Susanne Bengesser, Joanna M. Biernacka, Armin Birner, Clara Brichant-Petitjean, Pablo Cervantes, HsiChung Chen, Caterina Chillotti, Sven Cichon, Cristiana Cruceanu, Piotr M. Czerski, Nina Dalkner, Alexandre Dayer, Franziska Degenhardt, Maria Del Zompo, J. Raymond DePaulo, Bruno Étain, Peter Falkai, Andreas J. Forstner, Louise Frisen, Mark A. Frye, Janice M. Fullerton, Sébastien Gard, Julie S. Garnham, Fernando S. Goes, Maria Grigoroiu-Serbanescu, Paul Grof, Ryota Hashimoto, Joanna Hauser, Urs Heilbronner, Stefan Herms, Per Hoffmann, Andrea Hofmann, Liping Hou, Yi-Hsiang Hsu, Stephane Jamain, Esther Jiménez, Jean-Pierre Kahn, Layla Kassem, Po-Hsiu Kuo, Tadafumi Kato, John Kelsoe, Sarah Kittel-Schneider, Sebastian Kliwicki, Barbara König, Ichiro Kusumi, Gonzalo Laje, Mikael Landén, Catharina Lavebratt, Marion Leboyer, Susan G. Leckband, Mario Maj, the Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Mirko Manchia, Lina Martinsson, Michael J. McCarthy, Susan McElroy, Francesc Colom, Marina Mitjans, Francis M. Mondimore, Palmiero Monteleone, Caroline M. Nievergelt, Markus M. Nöthen, Tomas Novák, Claire O'Donovan, Norio Ozaki, Vincent Millischer, Sergi Papiol, Andrea Pfennig, Claudia Pisanu, James B. Potash, Andreas Reif, Eva Reininghaus, Guy A. Rouleau, Janusz K. Rybakowski, Martin Schalling, Peter R. Schofield, Barbara W. Schweizer, Giovanni Severino, Tatyana Shekhtman, Paul D. Shilling, Katzutaka Shimoda, Christian Simhandl, Claire M. Slaney, Alessio Squassina, Thomas Stamm, Pavla Stopkova, Fasil TekolaAyele, Alfonso Tortorella, Gustavo Turecki, Julia Veeh, Eduard Vieta, Stephanie H. Witt, Gloria Roberts, Peter P. Zandi, Martin Alda, Michael Bauer, Francis J. McMahon, Philip B. Mitchell, Thomas G. Schulze, Marcella Rietschel, Scott R. Clark, Bernhard T. Baune
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- Journal:
- The British Journal of Psychiatry / Volume 221 / Issue 2 / August 2022
- Published online by Cambridge University Press:
- 04 May 2022, p. 494
- Print publication:
- August 2022
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Using polygenic scores and clinical data for bipolar disorder patient stratification and lithium response prediction: machine learning approach
- Micah Cearns, Azmeraw T. Amare, Klaus Oliver Schubert, Anbupalam Thalamuthu, Joseph Frank, Fabian Streit, Mazda Adli, Nirmala Akula, Kazufumi Akiyama, Raffaella Ardau, Bárbara Arias, Jean-Michel Aubry, Lena Backlund, Abesh Kumar Bhattacharjee, Frank Bellivier, Antonio Benabarre, Susanne Bengesser, Joanna M. Biernacka, Armin Birner, Clara Brichant-Petitjean, Pablo Cervantes, Hsi-Chung Chen, Caterina Chillotti, Sven Cichon, Cristiana Cruceanu, Piotr M. Czerski, Nina Dalkner, Alexandre Dayer, Franziska Degenhardt, Maria Del Zompo, J. Raymond DePaulo, Bruno Étain, Peter Falkai, Andreas J. Forstner, Louise Frisen, Mark A. Frye, Janice M. Fullerton, Sébastien Gard, Julie S. Garnham, Fernando S. Goes, Maria Grigoroiu-Serbanescu, Paul Grof, Ryota Hashimoto, Joanna Hauser, Urs Heilbronner, Stefan Herms, Per Hoffmann, Andrea Hofmann, Liping Hou, Yi-Hsiang Hsu, Stephane Jamain, Esther Jiménez, Jean-Pierre Kahn, Layla Kassem, Po-Hsiu Kuo, Tadafumi Kato, John Kelsoe, Sarah Kittel-Schneider, Sebastian Kliwicki, Barbara König, Ichiro Kusumi, Gonzalo Laje, Mikael Landén, Catharina Lavebratt, Marion Leboyer, Susan G. Leckband, Mario Maj, the Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Mirko Manchia, Lina Martinsson, Michael J. McCarthy, Susan McElroy, Francesc Colom, Marina Mitjans, Francis M. Mondimore, Palmiero Monteleone, Caroline M. Nievergelt, Markus M. Nöthen, Tomas Novák, Claire O'Donovan, Norio Ozaki, Vincent Millischer, Sergi Papiol, Andrea Pfennig, Claudia Pisanu, James B. Potash, Andreas Reif, Eva Reininghaus, Guy A. Rouleau, Janusz K. Rybakowski, Martin Schalling, Peter R. Schofield, Barbara W. Schweizer, Giovanni Severino, Tatyana Shekhtman, Paul D. Shilling, Katzutaka Shimoda, Christian Simhandl, Claire M. Slaney, Alessio Squassina, Thomas Stamm, Pavla Stopkova, Fasil Tekola-Ayele, Alfonso Tortorella, Gustavo Turecki, Julia Veeh, Eduard Vieta, Stephanie H. Witt, Gloria Roberts, Peter P. Zandi, Martin Alda, Michael Bauer, Francis J. McMahon, Philip B. Mitchell, Thomas G. Schulze, Marcella Rietschel, Scott R. Clark, Bernhard T. Baune
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- Journal:
- The British Journal of Psychiatry / Volume 220 / Issue 4 / April 2022
- Published online by Cambridge University Press:
- 28 February 2022, pp. 219-228
- Print publication:
- April 2022
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Background
Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment.
AimsTo use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder.
MethodThis study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework.
ResultsThe best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data.
ConclusionsUsing PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.
Everolimus for cardiac rhabdomyomas in children with tuberous sclerosis. The ORACLE study protocol (everOlimus for caRdiac rhAbdomyomas in tuberous sCLErosis): a randomised, multicentre, placebo-controlled, double-blind phase II trial
- Erica V. Stelmaszewski, Daniella B. Parente, Alberto Farina, Anna Stein, Anthony Gutierrez, Antonio F. Raquelo-Menegassio, Carla Manterola, Carolina F. de Sousa, Carolina Victor, Dina Maki, Elias M. Morón, Fabiano F. de Abrantes, Fatima Iqbal, Jazmin Camacho-Vilchez, Joanna Jimenez-Pavón, Juan P. Polania, Lorenzo Thompson, Lygia Bonanato, Matthias Diebold, Maria V. C. P. Da Silva, Mariam W. J. Nashwan, Marianna A. G. Galvani, Osama E. A. Idris, Pierina Danos, Rocio Ortiz-Lopez, Rofida A. A. Mahmoud, Sergio Gresse, Jr, Karla L. Loss
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- Journal:
- Cardiology in the Young / Volume 30 / Issue 3 / March 2020
- Published online by Cambridge University Press:
- 27 January 2020, pp. 337-345
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Introduction:
Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hamartomas in multiple organs, including cardiac rhabdomyomas. Children with symptomatic cardiac rhabdomyoma require frequent admissions to intensive care units, have major complications, namely, arrhythmias, cardiac outflow tract obstruction and heart failure, affecting the quality of life and taking on high healthcare cost. Currently, there is no standard pharmacological treatment for this condition, and the management includes a conservative approach and supportive care. Everolimus has shown positive effects on subependymal giant cell astrocytomas, renal angiomyolipoma and refractory seizures associated with tuberous sclerosis complex. However, evidence supporting efficacy in symptomatic cardiac rhabdomyoma is limited to case reports. The ORACLE trial is the first randomised clinical trial assessing the efficacy of everolimus as a specific therapy for symptomatic cardiac rhabdomyoma.
Methods:ORACLE is a phase II, prospective, randomised, placebo-controlled, double-blind, multicentre protocol trial. A total of 40 children with symptomatic cardiac rhabdomyoma secondary to tuberous sclerosis complex will be randomised to receive oral everolimus or placebo for 3 months. The primary outcome is 50% or more reduction in the tumour size related to baseline. As secondary outcomes we include the presence of arrhythmias, pericardial effusion, intracardiac obstruction, adverse events, progression of tumour reduction and effect on heart failure.
Conclusions:ORACLE protocol addresses a relevant unmet need in children with tuberous sclerosis complex and cardiac rhabdomyoma. The results of the trial will potentially support the first evidence-based therapy for this condition.
Constructional morphology, origin, and evolution of the gastropod operculum
- Antonio G. Checa, Antonio P. Jiménez-Jiménez
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- Journal:
- Paleobiology / Volume 24 / Issue 1 / Winter 1998
- Published online by Cambridge University Press:
- 08 February 2016, pp. 109-132
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Gastropod opercula are classified here on a new morphogenetic basis, which distinguishes three main types: (1) flexiclaudent spiral (mostly multispiral) operculum, the shape of which does not coincide with that of the aperture, (2) rigiclaudent spiral (usually paucispiral) operculum, the shape of which fits that of the aperture, and (3) rigiclaudent concentric operculum, also aperture-fitting. The first type fits by flexing into the aperture and is secreted when the soft parts are partly or wholly extended (i.e., when the operculum is not in a closed position). The other two types do not flex upon retraction (except at the very margin) and grow when the operculum closes over the aperture, with or without rotation. A study of opercular types at the family level confirms the systematic and evolutionary significance of opercula. Types 1 and 2 are the only ones present in archaeogastropods, Type 1 being predominant. Opercula (if present) in Neritopsina are always rigiclaudent. Within Caenogastropoda, Type 2 predominates; the only flexiclaudent spiral opercula are found in certain basal cerithioidean families. Concentric opercula are predominant in higher neotaenioglossans and exclusive in neogastropods. Except for one family, opercula in Heterostropha are always rigiclaudent spiral. Morphological, systematic, and histological criteria point to the flexiclaudent spiral operculum as the ancestral form. This leads us to propose the “periostracum shaving” model in prosobranchs to account for the origin of this kind of operculum. According to this model, in the earliest trochospiral gastropods the periostracum ceased to serve a shell-formation function at the band of overlap between whorls (the parietal band). The periostracal band was then extruded from the shell to constitute an incipient operculum, taking on the appearance of a spiral strip coiling opposite to the shell. The parietal segment of the periostracal groove migrated toward the epipodium and became independent from the rest of the mantle. The concomitant development of an opercular disc allowed the successive turns of periostracal strip to seal together. In this way, a spiral operculum emerged, coiling counterclockwise without matching the aperture shape. During the course of prosobranch evolution, rigiclaudent spiral opercula emerged several times from the ancestral flexiclaudent type, although they were always restricted to apertures with a spiral-shaped outer (labral) edge. Such opercula enlarged the range of shell morphologies for which the operculum constituted an efficient protective barrier to include those of neritoidean or naticoidean type. The onset of calcification in opercula took place with the rigiclaudent type. Concentric opercula also evolved independently from rigiclaudent spiral opercula in several gastropod groups, thus further broadening the spectrum of apertures and, hence, of shell morphologies using opercula for protection. From the standpoint of adaptation, the concentric type was probably the only one available to neogastropods having long and wide siphonal canals.
COMPLEMENTATION AND EMBEDDINGS OF c0(I) IN BANACH SPACES
- SPIROS A. ARGYROS, JESÚS F. CASTILLO, ANTONIO S. GRANERO, MAR JIMÉNEZ, JOSÉ P. MORENO
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- Journal:
- Proceedings of the London Mathematical Society / Volume 85 / Issue 3 / November 2002
- Published online by Cambridge University Press:
- 14 October 2002, pp. 742-768
- Print publication:
- November 2002
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We investigate in this paper the complementation of copies of $c_0(I)$ in some classes of Banach spaces (in the class of weakly compactly generated (WCG) Banach spaces, in the larger class $\mathcal{V}$ of Banach spaces which are subspaces of some $C(K)$ space with $K$ a Valdivia compact, and in the Banach spaces $C([1, \alpha ])$, where $\alpha$ is an ordinal) and the embedding of $c_0(I)$ in the elements of the class $\mathcal{C}$ of complemented subspaces of $C(K)$ spaces. Two of our results are as follows:
(i) in a Banach space $X \in \mathcal{V}$ every copy of $c_0(I)$ with $\# I < \aleph _{\omega}$ is complemented;
(ii) if $\alpha _0 = \aleph _0$, $\alpha _{n+1} = 2^{\alpha _n}$, $n \geq 0$, and $\alpha = \sup \{\alpha _n : n \geq 0\}$ there exists a WCG Banach space with an uncomplemented copy of $c_0(\alpha )$.
So, under the generalized continuum hypothesis (GCH), $\aleph _{\omega}$ is the greatest cardinal $\tau$ such that every copy of $c_0(I)$ with $\# I < \tau$ is complemented in the class $\mathcal{V}$. If $T : c_0(I) \to C([1,\alpha ])$ is an isomorphism into its image, we prove that:
(i) $c_0(I)$ is complemented, whenever $\| T \| ,\| T^{-1} \| < (3/2)^{\frac 12}$;
(ii) there is a finite partition $\{I_1, \dots , I_k\}$ of $I$ such that each copy $T(c_0(I_k))$ is complemented.
Concerning the class $\mathcal{C}$, we prove that an already known property of $C(K)$ spaces is still true for this class, namely, if $X \in \mathcal{C}$, the following are equivalent:
(i) there is a weakly compact subset $W \subset X$ with ${\rm Dens}(W) = \tau$;
(ii) $c_0(\tau )$ is isomorphically embedded into $X$.
This yields a new characterization of a class of injective Banach spaces.
2000 Mathematical Subject Classification: 46B20, 46B26.