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Developing models to predict patient outcomes in children with severe illness

28 December 2020 | Story André Damons | Photo Supplied

A lecturer from the University of the Free State’s (UFS) department of Paediatrics and Child Health is investigating the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness.

Dr Michael Pienaar, senior lecturer and specialist, is conducting this research as part of his doctoral research and the study deals primarily with the development of models that are designed and calibrated for use in South Africa. These artificial neural networks are computer programs designed to mimic some of the learning characteristics of biological neurons.

The potential applications of models

According to Dr Pienaar these models have traditionally been developed in high-income nations using conventional statistical methods.

“The potential applications of such models in the clinical setting include triage, medical research, guidance of resource allocation and quality control. Having initially begun this research investigating the prediction of mortality outcomes in the paediatric intensive care unit (PICU) I have broadened my scope to patients outside of PICU, seeking to identify children early during their illnesses who are at risk of serious illness requiring PICU,” says Dr Pienaar.

The research up until now has been directed towards the identification of characteristics that are both unique to children with serious illness in South Africa, but also accessible to clinicians in settings where expertise and technical resources are limited.

Research still in the early changes

The research is still in its early stages but next year a series of expert review panels will be held to investigate the selection of variables for the model, after which the collection of clinical data will begin. Once the data has been collected and prepared, a number of candidate models will be developed and evaluated. This should be concluded by the end of 2022.

Says Dr Pienaar: “The need to engage with the rapid proliferation of technology, particularly in the realms of machine learning, mobile technology, automation and the Internet of Things is as great in medical research now as it is in any academic discipline.

“It is critical that research, particularly in South Africa, engage with this in order to take advantage of the opportunities offered and avoid the dangers that go paired with them. Together with the technology as such, it has been essential to pursue this project as an interdisciplinary undertaking involving clinicians, biostatisticians and computer engineers.”

Hope for the research

Dr Pienaar says he was very fortunate and grateful to be the recipient of a generous interdisciplinary grant from the UFS which has allowed him to procure software and equipment that is critical to this project.

“The hope for this research is that the best performing of these models can be integrated with a mobile application that assists practitioners in a wide range of settings in the identification, treatment and early referral of children at high risk of severe illness. I would like to expand this research project to include other countries in Africa and South America and to use it as a bridge to collaboration with other clinical researchers in the Global South,” says Dr Pienaar.

As an early career researcher, Dr Pienaar hopes that this research can serve as a platform to build a body of research that uses the rapid technological advances of these times together with a wide range of collaborations with other disciplines in the pursuit of better child health.

He concludes by saying that he has had excellent support thus far from his supervisors, Prof Stephen Brown (Faculty of Health Sciences, UFS), Dr Nicolaas Luwes (Faculty of Computer Science and Engineering, Central University of Technology) and Dr Elizabeth George (Medical Research Council Clinical Trials Unit, University College London). I have also been supported by the Robert Frater Institute in the Faculty of Health Sciences.

News Archive

Carbon dioxide makes for more aromatic decaffeinated coffee

2017-10-27

The Inorganic Group in the Department of Chemistry
at the UFS is systematically researching the utilisation
of carbon dioxide. From the left, are, Dr Ebrahiem Botha,
Postdoctoral Fellow; Mahlomolo Khasemene, MSc student;
Prof André Roodt; Dr Marietjie Schutte-Smith, Senior Lecturer;
and Mokete Motente, MSc student.
Photo: Charl Devenish

Several industries in South Africa are currently producing hundreds of thousands of tons of carbon dioxide a year, which are released directly into the air. A typical family sedan doing around 10 000 km per year, is annually releasing more than one ton of carbon dioxide into the atmosphere.

The Inorganic Chemistry Research Group in the Department of Chemistry at the University of the Free State (UFS), in collaboration with the University of Zurich in Switzerland, has focused in recent years on using carbon dioxide – which is regarded as a harmful and global warming gas – in a meaningful way.

According to Prof André Roodt, Head of Inorganic Chemistry at the UFS, the Department of Chemistry has for the past five decades been researching natural products that could be extracted from plants. These products are manufactured by plants through photosynthesis, in other words the utilisation of sunlight and carbon dioxide, nitrogen, and other nutrients from the soil.

Caffeine and chlorophyll
“The Inorganic group is systematically researching the utilisation of carbon dioxide. Carbon dioxide is absorbed by plants through chlorophyll and used to make interesting and valuable compounds and sugars, which in turn could be used for the production of important new medicines,” says Prof Roodt.

Caffeine, a major energy enhancer, is also manufactured through photosynthesis in plants. It is commonly found in tea and coffee, but also (artificially added) in energy drinks. Because caffeine is a stimulant of the central nervous system and reduces fatigue and drowsiness, some people prefer decaffeinated coffee when enjoying this hot drink late at night.

Removing caffeine from coffee could be expensive and time-consuming, but also environmentally unfriendly, because it involves the use of harmful and flammable liquids. Some of the Inorganic Group’s research focus areas include the use of carbon dioxide for the extraction of compounds, such as caffeine from plants.

“Therefore, the research could lead to the availability of more decaffeinated coffee products. Although decaffeinated coffee is currently aromatic, we want to investigate further to ensure better quality flavours,” says Prof Roodt.

Another research aspect the team is focusing on is the use of carbon dioxide to extract chlorophyll from plants which have medicinal properties themselves. Chemical suppliers sell chlorophyll at R3 000 a gram. “In the process of investigating chlorophyll, our group discovered simpler techniques to comfortably extract larger quantities from green vegetables and other plants,” says Prof Roodt.

Medicines
In addition, the Inorganic Research Group is also looking to use carbon dioxide as a building block for more valuable compounds. Some of these compounds will be used in the Inorganic Group’s research focus on radiopharmaceutical products for the identification and possibly even the treatment of diseases such as certain cancers, tuberculosis, and malaria.

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