Advancing digital healthcare research and machine learning-aided knowledge extraction amidst the COVID-19 pandemic

The rapid progression of biomedical research coupled with the explosion of scientific literature has generated an exigent need for efficient and reliable systems of knowledge extraction. This dissertation contends with this challenge through a concentrated investigation of digital health, Artificial Intelligence, and specifically Machine Learning and Natural Language Processing's (NLP) potential to expedite systematic literature reviews and refine the knowledge extraction process. The surge of COVID-19 complicated the efforts of scientists, policymakers, and medical professionals in identifying pertinent articles and assessing their scientific validity. This thesis presents a substantial solution in the form of the COKE Project, an initiative that interlaces machine reading with the rigorous protocols of Evidence-Based Medicine to streamline knowledge extraction. In the framework of the COKE (“COVID-19 Knowledge Extraction framework for next-generation discovery science”) Project, this thesis aims to underscore the capacity of machine reading to create knowledge graphs from scientific texts. The project is remarkable for its innovative use of NLP techniques such as a BERT + bi-LSTM language model. This combination is employed to detect and categorize elements within medical abstracts, thereby enhancing the systematic literature review process. The COKE project's outcomes show that NLP, when used in a judiciously structured manner, can significantly reduce the time and effort required to produce medical guidelines. These findings are particularly salient during times of medical emergency, like the COVID-19 pandemic, when quick and accurate research results are critical.

Network analysis and machine learning assist drug repurposing and safety assessment in neurological diseases

In recent decades, two prominent trends have influenced the data modeling field, namely network analysis and machine learning. This thesis explores the practical applications of these techniques within the domain of drug research, unveiling their multifaceted potential for advancing our comprehension of complex biological systems. The research undertaken during this PhD program is situated at the intersection of network theory, computational methods, and drug research. Across six projects presented herein, there is a gradual increase in model complexity. These projects traverse a diverse range of topics, with a specific emphasis on drug repurposing and safety in the context of neurological diseases. The aim of these projects is to leverage existing biomedical knowledge to develop innovative approaches that bolster drug research. The investigations have produced practical solutions, not only providing insights into the intricacies of biological systems, but also allowing the creation of valuable tools for their analysis. In short, the achievements are: • A novel computational algorithm to identify adverse events specific to fixed-dose drug combinations. • A web application that tracks the clinical drug research response to SARS-CoV-2. • A Python package for differential gene expression analysis and the identification of key regulatory "switch genes". • The identification of pivotal events causing drug-induced impulse control disorders linked to specific medications. • An automated pipeline for discovering potential drug repurposing opportunities. • The creation of a comprehensive knowledge graph and development of a graph machine learning model for predictions. Collectively, these projects illustrate diverse applications of data science and network-based methodologies, highlighting the profound impact they can have in supporting drug research activities.

Developing a radiomic based machine learning model to identify patients with resected non-small-cell lung cancer at high risk of relapse

Background There is a wide variation of recurrence risk of Non-small-cell lung cancer (NSCLC) within the same Tumor Node Metastasis (TNM) stage, suggesting that other parameters are involved in determining this probability. Radiomics allows extraction of quantitative information from images that can be used for clinical purposes. The primary objective of this study is to develop a radiomic prognostic model that predicts a 3 year disease free-survival (DFS) of resected Early Stage (ES) NSCLC patients. Material and Methods 56 pre-surgery non contrast Computed Tomography (CT) scans were retrieved from the PACS of our institution and anonymized. Then they were automatically segmented with an open access deep learning pipeline and reviewed by an experienced radiologist to obtain 3D masks of the NSCLC. Images and masks underwent to resampling normalization and discretization. From the masks hundreds Radiomic Features (RF) were extracted using Py-Radiomics. Hence, RF were reduced to select the most representative features. The remaining RF were used in combination with Clinical parameters to build a DFS prediction model using Leave-one-out cross-validation (LOOCV) with Random Forest. Results and Conclusion A poor agreement between the radiologist and the automatic segmentation algorithm (DICE score of 0.37) was found. Therefore, another experienced radiologist manually segmented the lesions and only stable and reproducible RF were kept. 50 RF demonstrated a high correlation with the DFS but only one was confirmed when clinicopathological covariates were added: Busyness a Neighbouring Gray Tone Difference Matrix (HR 9.610). 16 clinical variables (which comprised TNM) were used to build the LOOCV model demonstrating a higher Area Under the Curve (AUC) when RF were included in the analysis (0.67 vs 0.60) but the difference was not statistically significant (p=0,5147).

Learning Methods and Algorithms for Semantic Text Classification across Multiple Domains

Information is nowadays a key resource: machine learning and data mining techniques have been developed to extract high-level information from great amounts of data. As most data comes in form of unstructured text in natural languages, research on text mining is currently very active and dealing with practical problems. Among these, text categorization deals with the automatic organization of large quantities of documents in priorly defined taxonomies of topic categories, possibly arranged in large hierarchies. In commonly proposed machine learning approaches, classifiers are automatically trained from pre-labeled documents: they can perform very accurate classification, but often require a consistent training set and notable computational effort. Methods for cross-domain text categorization have been proposed, allowing to leverage a set of labeled documents of one domain to classify those of another one. Most methods use advanced statistical techniques, usually involving tuning of parameters. A first contribution presented here is a method based on nearest centroid classification, where profiles of categories are generated from the known domain and then iteratively adapted to the unknown one. Despite being conceptually simple and having easily tuned parameters, this method achieves state-of-the-art accuracy in most benchmark datasets with fast running times. A second, deeper contribution involves the design of a domain-independent model to distinguish the degree and type of relatedness between arbitrary documents and topics, inferred from the different types of semantic relationships between respective representative words, identified by specific search algorithms. The application of this model is tested on both flat and hierarchical text categorization, where it potentially allows the efficient addition of new categories during classification. Results show that classification accuracy still requires improvements, but models generated from one domain are shown to be effectively able to be reused in a different one.

Development and characterization of deep learning techniques for neuroimaging data

Deep learning methods are extremely promising machine learning tools to analyze neuroimaging data. However, their potential use in clinical settings is limited because of the existing challenges of applying these methods to neuroimaging data. In this study, first a data leakage type caused by slice-level data split that is introduced during training and validation of a 2D CNN is surveyed and a quantitative assessment of the model’s performance overestimation is presented. Second, an interpretable, leakage-fee deep learning software written in a python language with a wide range of options has been developed to conduct both classification and regression analysis. The software was applied to the study of mild cognitive impairment (MCI) in patients with small vessel disease (SVD) using multi-parametric MRI data where the cognitive performance of 58 patients measured by five neuropsychological tests is predicted using a multi-input CNN model taking brain image and demographic data. Each of the cognitive test scores was predicted using different MRI-derived features. As MCI due to SVD has been hypothesized to be the effect of white matter damage, DTI-derived features MD and FA produced the best prediction outcome of the TMT-A score which is consistent with the existing literature. In a second study, an interpretable deep learning system aimed at 1) classifying Alzheimer disease and healthy subjects 2) examining the neural correlates of the disease that causes a cognitive decline in AD patients using CNN visualization tools and 3) highlighting the potential of interpretability techniques to capture a biased deep learning model is developed. Structural magnetic resonance imaging (MRI) data of 200 subjects was used by the proposed CNN model which was trained using a transfer learning-based approach producing a balanced accuracy of 71.6%. Brain regions in the frontal and parietal lobe showing the cerebral cortex atrophy were highlighted by the visualization tools.

Learning with Kernels on Graphs: DAG-based kernels, data streams and RNA function prediction.

In many application domains data can be naturally represented as graphs. When the application of analytical solutions for a given problem is unfeasible, machine learning techniques could be a viable way to solve the problem. Classical machine learning techniques are defined for data represented in a vectorial form. Recently some of them have been extended to deal directly with structured data. Among those techniques, kernel methods have shown promising results both from the computational complexity and the predictive performance point of view. Kernel methods allow to avoid an explicit mapping in a vectorial form relying on kernel functions, which informally are functions calculating a similarity measure between two entities. However, the definition of good kernels for graphs is a challenging problem because of the difficulty to find a good tradeoff between computational complexity and expressiveness. Another problem we face is learning on data streams, where a potentially unbounded sequence of data is generated by some sources. There are three main contributions in this thesis. The first contribution is the definition of a new family of kernels for graphs based on Directed Acyclic Graphs (DAGs). We analyzed two kernels from this family, achieving state-of-the-art results from both the computational and the classification point of view on real-world datasets. The second contribution consists in making the application of learning algorithms for streams of graphs feasible. Moreover,we defined a principled way for the memory management. The third contribution is the application of machine learning techniques for structured data to non-coding RNA function prediction. In this setting, the secondary structure is thought to carry relevant information. However, existing methods considering the secondary structure have prohibitively high computational complexity. We propose to apply kernel methods on this domain, obtaining state-of-the-art results.

Robotic Sensing and Manipulation of Deformable Linear Objects with Learning-based methods

Nowadays robotic applications are widespread and most of the manipulation tasks are efficiently solved. However, Deformable-Objects (DOs) still represent a huge limitation for robots. The main difficulty in DOs manipulation is dealing with the shape and dynamics uncertainties, which prevents the use of model-based approaches (since they are excessively computationally complex) and makes sensory data difficult to interpret. This thesis reports the research activities aimed to address some applications in robotic manipulation and sensing of Deformable-Linear-Objects (DLOs), with particular focus to electric wires. In all the works, a significant effort was made in the study of an effective strategy for analyzing sensory signals with various machine learning algorithms. In the former part of the document, the main focus concerns the wire terminals, i.e. detection, grasping, and insertion. First, a pipeline that integrates vision and tactile sensing is developed, then further improvements are proposed for each module. A novel procedure is proposed to gather and label massive amounts of training images for object detection with minimal human intervention. Together with this strategy, we extend a generic object detector based on Convolutional-Neural-Networks for orientation prediction. The insertion task is also extended by developing a closed-loop control capable to guide the insertion of a longer and curved segment of wire through a hole, where the contact forces are estimated by means of a Recurrent-Neural-Network. In the latter part of the thesis, the interest shifts to the DLO shape. Robotic reshaping of a DLO is addressed by means of a sequence of pick-and-place primitives, while a decision making process driven by visual data learns the optimal grasping locations exploiting Deep Q-learning and finds the best releasing point. The success of the solution leverages on a reliable interpretation of the DLO shape. For this reason, further developments are made on the visual segmentation.

Supporting Scientific Research Through Machine and Deep Learning: Fluorescence Microscopy and Operational Intelligence Use Cases

Although the debate of what data science is has a long history and has not reached a complete consensus yet, Data Science can be summarized as the process of learning from data. Guided by the above vision, this thesis presents two independent data science projects developed in the scope of multidisciplinary applied research. The first part analyzes fluorescence microscopy images typically produced in life science experiments, where the objective is to count how many marked neuronal cells are present in each image. Aiming to automate the task for supporting research in the area, we propose a neural network architecture tuned specifically for this use case, cell ResUnet (c-ResUnet), and discuss the impact of alternative training strategies in overcoming particular challenges of our data. The approach provides good results in terms of both detection and counting, showing performance comparable to the interpretation of human operators. As a meaningful addition, we release the pre-trained model and the Fluorescent Neuronal Cells dataset collecting pixel-level annotations of where neuronal cells are located. In this way, we hope to help future research in the area and foster innovative methodologies for tackling similar problems. The second part deals with the problem of distributed data management in the context of LHC experiments, with a focus on supporting ATLAS operations concerning data transfer failures. In particular, we analyze error messages produced by failed transfers and propose a Machine Learning pipeline that leverages the word2vec language model and K-means clustering. This provides groups of similar errors that are presented to human operators as suggestions of potential issues to investigate. The approach is demonstrated on one full day of data, showing promising ability in understanding the message content and providing meaningful groupings, in line with previously reported incidents by human operators.

Lesion detection and classification in breast cancer: evaluation of approaches based on morphological features, tracer kinetic modelling and semi-quantitative parameters in MR functional imaging (DCE-MRI)

The diagnosis, grading and classification of tumours has benefited considerably from the development of DCE-MRI which is now essential to the adequate clinical management of many tumour types due to its capability in detecting active angiogenesis. Several strategies have been proposed for DCE-MRI evaluation. Visual inspection of contrast agent concentration curves vs time is a very simple yet operator dependent procedure, therefore more objective approaches have been developed in order to facilitate comparison between studies. In so called model free approaches, descriptive or heuristic information extracted from time series raw data have been used for tissue classification. The main issue concerning these schemes is that they have not a direct interpretation in terms of physiological properties of the tissues. On the other hand, model based investigations typically involve compartmental tracer kinetic modelling and pixel-by-pixel estimation of kinetic parameters via non-linear regression applied on region of interests opportunely selected by the physician. This approach has the advantage to provide parameters directly related to the pathophysiological properties of the tissue such as vessel permeability, local regional blood flow, extraction fraction, concentration gradient between plasma and extravascular-extracellular space. Anyway, nonlinear modelling is computational demanding and the accuracy of the estimates can be affected by the signal-to-noise ratio and by the initial solutions. The principal aim of this thesis is investigate the use of semi-quantitative and quantitative parameters for segmentation and classification of breast lesion. The objectives can be subdivided as follow: describe the principal techniques to evaluate time intensity curve in DCE-MRI with focus on kinetic model proposed in literature; to evaluate the influence in parametrization choice for a classic bi-compartmental kinetic models; to evaluate the performance of a method for simultaneous tracer kinetic modelling and pixel classification; to evaluate performance of machine learning techniques training for segmentation and classification of breast lesion.

Continual learning for computer vision applications

One of the most visionary goals of Artificial Intelligence is to create a system able to mimic and eventually surpass the intelligence observed in biological systems including, ambitiously, the one observed in humans. The main distinctive strength of humans is their ability to build a deep understanding of the world by learning continuously and drawing from their experiences. This ability, which is found in various degrees in all intelligent biological beings, allows them to adapt and properly react to changes by incrementally expanding and refining their knowledge. Arguably, achieving this ability is one of the main goals of Artificial Intelligence and a cornerstone towards the creation of intelligent artificial agents. Modern Deep Learning approaches allowed researchers and industries to achieve great advancements towards the resolution of many long-standing problems in areas like Computer Vision and Natural Language Processing. However, while this current age of renewed interest in AI allowed for the creation of extremely useful applications, a concerningly limited effort is being directed towards the design of systems able to learn continuously. The biggest problem that hinders an AI system from learning incrementally is the catastrophic forgetting phenomenon. This phenomenon, which was discovered in the 90s, naturally occurs in Deep Learning architectures where classic learning paradigms are applied when learning incrementally from a stream of experiences. This dissertation revolves around the Continual Learning field, a sub-field of Machine Learning research that has recently made a comeback following the renewed interest in Deep Learning approaches. This work will focus on a comprehensive view of continual learning by considering algorithmic, benchmarking, and applicative aspects of this field. This dissertation will also touch on community aspects such as the design and creation of research tools aimed at supporting Continual Learning research, and the theoretical and practical aspects concerning public competitions in this field.

Concepts and methods for efficient decentralized learning in federated settings

Deep Neural Networks (DNNs) have revolutionized a wide range of applications beyond traditional machine learning and artificial intelligence fields, e.g., computer vision, healthcare, natural language processing and others. At the same time, edge devices have become central in our society, generating an unprecedented amount of data which could be used to train data-hungry models such as DNNs. However, the potentially sensitive or confidential nature of gathered data poses privacy concerns when storing and processing them in centralized locations. To this purpose, decentralized learning decouples model training from the need of directly accessing raw data, by alternating on-device training and periodic communications. The ability of distilling knowledge from decentralized data, however, comes at the cost of facing more challenging learning settings, such as coping with heterogeneous hardware and network connectivity, statistical diversity of data, and ensuring verifiable privacy guarantees. This Thesis proposes an extensive overview of decentralized learning literature, including a novel taxonomy and a detailed description of the most relevant system-level contributions in the related literature for privacy, communication efficiency, data and system heterogeneity, and poisoning defense. Next, this Thesis presents the design of an original solution to tackle communication efficiency and system heterogeneity, and empirically evaluates it on federated settings. For communication efficiency, an original method, specifically designed for Convolutional Neural Networks, is also described and evaluated against the state-of-the-art. Furthermore, this Thesis provides an in-depth review of recently proposed methods to tackle the performance degradation introduced by data heterogeneity, followed by empirical evaluations on challenging data distributions, highlighting strengths and possible weaknesses of the considered solutions. Finally, this Thesis presents a novel perspective on the usage of Knowledge Distillation as a mean for optimizing decentralized learning systems in settings characterized by data heterogeneity or system heterogeneity. Our vision on relevant future research directions close the manuscript.

Anticancer drug discovery using artificial intelligence: an application in pharmacological activity prediction

Hematological cancers are a heterogeneous family of diseases that can be divided into leukemias, lymphomas, and myelomas, often called “liquid tumors”. Since they cannot be surgically removable, chemotherapy represents the mainstay of their treatment. However, it still faces several challenges like drug resistance and low response rate, and the need for new anticancer agents is compelling. The drug discovery process is long-term, costly, and prone to high failure rates. With the rapid expansion of biological and chemical "big data", some computational techniques such as machine learning tools have been increasingly employed to speed up and economize the whole process. Machine learning algorithms can create complex models with the aim to determine the biological activity of compounds against several targets, based on their chemical properties. These models are defined as multi-target Quantitative Structure-Activity Relationship (mt-QSAR) and can be used to virtually screen small and large chemical libraries for the identification of new molecules with anticancer activity. The aim of my Ph.D. project was to employ machine learning techniques to build an mt-QSAR classification model for the prediction of cytotoxic drugs simultaneously active against 43 hematological cancer cell lines. For this purpose, first, I constructed a large and diversified dataset of molecules extracted from the ChEMBL database. Then, I compared the performance of different ML classification algorithms, until Random Forest was identified as the one returning the best predictions. Finally, I used different approaches to maximize the performance of the model, which achieved an accuracy of 88% by correctly classifying 93% of inactive molecules and 72% of active molecules in a validation set. This model was further applied to the virtual screening of a small dataset of molecules tested in our laboratory, where it showed 100% accuracy in correctly classifying all molecules. This result is confirmed by our previous in vitro experiments.

Development of unsupervised learning methods with applications to life sciences data

Machine Learning makes computers capable of performing tasks typically requiring human intelligence. A domain where it is having a considerable impact is the life sciences, allowing to devise new biological analysis protocols, develop patients’ treatments efficiently and faster, and reduce healthcare costs. This Thesis work presents new Machine Learning methods and pipelines for the life sciences focusing on the unsupervised field. At a methodological level, two methods are presented. The first is an “Ab Initio Local Principal Path” and it is a revised and improved version of a pre-existing algorithm in the manifold learning realm. The second contribution is an improvement over the Import Vector Domain Description (one-class learning) through the Kullback-Leibler divergence. It hybridizes kernel methods to Deep Learning obtaining a scalable solution, an improved probabilistic model, and state-of-the-art performances. Both methods are tested through several experiments, with a central focus on their relevance in life sciences. Results show that they improve the performances achieved by their previous versions. At the applicative level, two pipelines are presented. The first one is for the analysis of RNA-Seq datasets, both transcriptomic and single-cell data, and is aimed at identifying genes that may be involved in biological processes (e.g., the transition of tissues from normal to cancer). In this project, an R package is released on CRAN to make the pipeline accessible to the bioinformatic Community through high-level APIs. The second pipeline is in the drug discovery domain and is useful for identifying druggable pockets, namely regions of a protein with a high probability of accepting a small molecule (a drug). Both these pipelines achieve remarkable results. Lastly, a detour application is developed to identify the strengths/limitations of the “Principal Path” algorithm by analyzing Convolutional Neural Networks induced vector spaces. This application is conducted in the music and visual arts domains.

Identificazione e classificazione delle lesioni endocavitarie uterine dalle immagini isteroscopiche con il deep learning

Anche se l'isteroscopia con la biopsia endometriale è il gold standard nella diagnosi della patologia intracavitaria uterina, l'esperienza dell’isteroscopista è fondamentale per una diagnosi corretta. Il Deep Learning (DL) come metodica di intelligenza artificiale potrebbe essere un aiuto per superare questo limite. Sono disponibili pochi studi con risultati preliminari e mancano ricerche che valutano le prestazioni dei modelli di DL nell'identificazione delle lesioni intrauterine e il possibile aiuto derivato dai fattori clinici. Obiettivo: Sviluppare un modello di DL per identificare e classificare le patologie endocavitarie uterine dalle immagini isteroscopiche. Metodi: È stato eseguito uno studio di coorte retrospettivo osservazionale monocentrico su una serie consecutiva di casi isteroscopici di pazienti con patologia intracavitaria uterina confermata all’esame istologico eseguiti al Policlinico S. Orsola. Le immagini isteroscopiche sono state usate per costruire un modello di DL per la classificazione e l'identificazione delle lesioni intracavitarie con e senza l'aiuto di fattori clinici (età, menopausa, AUB, terapia ormonale e tamoxifene). Come risultati dello studio abbiamo calcolato le metriche diagnostiche del modello di DL nella classificazione e identificazione delle lesioni uterine intracavitarie con e senza l'aiuto dei fattori clinici. Risultati: Abbiamo esaminato 1.500 immagini provenienti da 266 casi: 186 pazienti avevano lesioni focali benigne, 25 lesioni diffuse benigne e 55 lesioni preneoplastiche/neoplastiche. Sia per quanto riguarda la classificazione che l’identificazione, le migliori prestazioni sono state raggiunte con l'aiuto dei fattori clinici, complessivamente con precision dell'80,11%, recall dell'80,11%, specificità del 90,06%, F1 score dell’80,11% e accuratezza dell’86,74% per la classificazione. Per l’identificazione abbiamo ottenuto un rilevamento complessivo dell’85,82%, precision 93,12%, recall del 91,63% ed F1 score del 92,37%. Conclusioni: Il modello DL ha ottenuto una bassa performance nell’identificazione e classificazione delle lesioni intracavitarie uterine dalle immagini isteroscopiche. Anche se la migliore performance diagnostica è stata ottenuta con l’aiuto di fattori clinici specifici, questo miglioramento è stato scarso.

Statistical methods for biomedical signal analysis and processing

Statistical modelling and statistical learning theory are two powerful analytical frameworks for analyzing signals and developing efficient processing and classification algorithms. In this thesis, these frameworks are applied for modelling and processing biomedical signals in two different contexts: ultrasound medical imaging systems and primate neural activity analysis and modelling. In the context of ultrasound medical imaging, two main applications are explored: deconvolution of signals measured from a ultrasonic transducer and automatic image segmentation and classification of prostate ultrasound scans. In the former application a stochastic model of the radio frequency signal measured from a ultrasonic transducer is derived. This model is then employed for developing in a statistical framework a regularized deconvolution procedure, for enhancing signal resolution. In the latter application, different statistical models are used to characterize images of prostate tissues, extracting different features. These features are then uses to segment the images in region of interests by means of an automatic procedure based on a statistical model of the extracted features. Finally, machine learning techniques are used for automatic classification of the different region of interests. In the context of neural activity signals, an example of bio-inspired dynamical network was developed to help in studies of motor-related processes in the brain of primate monkeys. The presented model aims to mimic the abstract functionality of a cell population in 7a parietal region of primate monkeys, during the execution of learned behavioural tasks.