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Evaluation of the mqTrans view of the transcriptomic dataset
The test code uses eleven feature selection (FS) algorithms and seven classifiers to evaluate how the generated mqTrans view of the transcriptomic dataset contributes to the classification task (Figure 6). The test dataset consists of 317 colon adenocarcinoma (COAD) from The Cancer Genome Atlas (TCGA) database29. The COAD patients at stages I or II are regarded as the negative samples, while those at stages III or IV are the positive ones.
Eleven FS algorithms are implemented in the test code. There are three filter-based FS algorithms, including, select K best features by MIC (SK_mic), select K features by the FPR of MIC (SK_fpr), and select K features by the highest FDR of MIC (SK_fpr). Three tree-based FS algorithms evaluate the individual features by a decision tree with gini index (DT_gini), the adaptive boosted decision trees (AdaBoost) and the random forest (RF_fs), respectively. The FS pool of the test code also evaluates two wrappers recursive feature elimination (RFE) with the linear support vector classifier (SVC)(RFE_SVC) and RFE with the logistic regression classifier (RFE_LR), and two embedding algorithms linear SVC classifier with the top-ranked L1 feature importance values (lSVC_L1) and logistic regression classifier with the top-ranked L1 feature importance values (LR_L1).
The test code builds the classification models using seven classifiers, including linear support vector machine (SVC), Gaussian Naïve Bayes (GNB), logistic regression classifier (LR), k-nearest neighbor, k-5 by default (KNN), XGBoost, random forest (RF) and decision tree (DT).
Figure 6 shows the maximum test accuracy of the mqTrans features, the original mRNA features, and the combined subset of the mRNA and mqTrans features recommended by each FS algorithm.
The combined feature subsets (mRNA+mqTrans) have achieved the highest accuracy 0.7656 on the "SK_fpr" FS method, better than the individual feature types mqTrans (0.7188) and original mRNA (0.7188). Similar patterns can be observed for the other FS algorithms. The user can check the selected features in the output file Output-SelectedFeatures.csv.
Detecting the dark biomarkers
Previous studies showed the existence of the undifferentially expressed genes with significantly differentially represented mqTrans values between the phenotypic and control groups26,38,39. These genes are called dark biomarkers because traditional biomarker detection studies ignore them by their undifferential expressions. The statistical analysis function t.test in Microsoft Excel can be used to define a feature that is differentially expressed if its statistical p-value is smaller than 0.05.
Among the 3062 features with the generated mqTrans values 221 dark biomarkers were detected (Figure 7). The third-ranked gene ENSG00000163697 (APBB2, Amyloid Beta Precursor Protein Binding Family B Member 2) shows significantly differentially represented mqTrans values (mqTrans.P = 2.03 x 10-4) while its original expression level shows no differential expression (mRNA.P = 3.80 x 10-1). The keyword APBB2 hit 27 publications in the PubMed database40, but no connections with the colon or intestine were detected.
Another gene ENSG00000048052 (HDAC9, Histone Deacetylase 9) has the differentially represented mqTrans values (mqTrans.P = 6.09 x 10-3) while maintaining practically the same normal distributions between the phenotypic and control groups (mRNA.P = 9.62 x 10-1). The keyword HDAC9 hit 417 publications in the PubMed database. Three studies also mentioned the keywords "colon" or "intestine" in the abstracts41,42,43. But, none of them investigated the roles of HDAC9 in colon cancer.
The data suggested the necessity of further evaluations of these dark biomarkers from their post-transcription activities, e.g., the translated protein levels44,45.
Pan-cancer distributions of metabolism-related dark and traditional biomarkers
The metabolism-related traditional biomarkers were screened and compared against dark biomarkers across 26 cancer types in the TCGA dataset38. Both categories of biomarkers underwent statistical evaluation to discern significance levels across early (Stages I and II) and late (Stages III and IV) cancer stages. This evaluation employed Student's t-tests for p-values, subsequently corrected for multiple testing using false discovery rates (FDRs). Detailed data for each of the 26 cancer types are provided in Figure 8.
Genes yielding FDR-corrected p-values below 0.05 were classified as traditional biomarkers. In contrast, dark biomarkers were defined as those with FDR-corrected p-values below 0.05 in the mqTrans view while concurrently exhibiting no statistically significant differences in expression levels.
Figure 9 reveals a general scarcity of dark biomarkers in comparison to traditional biomarkers across most cancer types. Noteworthy exceptions include BRCA, MESO, and TGCT, which manifest a greater prevalence of dark biomarkers. It is revealed that various factors, including transcription factors, methylation patterns, gene mutations, and environmental conditions, could modulate the transcriptional dysregulation of these dark biomarkers. Further complexity may arise due to overlapping non-coding RNA transcripts that could confound the expression levels of dark biomarkers. Transcription dysregulations of some dark biomarkers were supported by their differential protein levels44,45. The dark biomarkers are often overlooked in traditional studies and present intriguing avenues for future mechanistic investigations.

Figure 1: An overview of the HealthModel and feature selection modules in this protocol. Replace the specific algorithms in the feature selection pool and the classifier pool if the user is familiar with the Python programming. Please click here to view a larger version of this figure.

Figure 2: Complete Code Flow for this Protocol. (A) Prepare Python Environment. To begin, create a virtual environment and install essential packages. For comprehensive instructions, refer to Section 1. (B) Generate mqTrans Features. Obtain mqTrans features by executing the provided code step by step. Detailed explanations can be found in Section 2. (C) Select mqTrans Features. This section focuses on assessing the mqTrans features. Refer to Section 3 for in-depth details. Please click here to view a larger version of this figure.

Figure 3: Prepare environment for Python. (A) The command to create healthmodel. (B) Enter y during the creating VE process. (C) The most common command for activating the VE. (D) The command for installing torch 1.13.1. (E) Install additional libraries for torch-geometric package. (F) Install torch-geometric package. Please click here to view a larger version of this figure.

Figure 4: Run the HealthModel to get mqTrans feature. (A) Download the code. (B) The example of data file. Each column has all the values of a regulatory factor, and the first item is the gene ID. Each row gives the values of a given sample, with the first item being the sample name. (C) The example of a label file. The first column gives the sample names, and the class label of each sample is given in the column titled label. The 0 value in the label column means this sample is alive, 1 means dead. (D) the outputs of mqTrans. Please click here to view a larger version of this figure.

Figure 5: Run the feature selection algorithm for the mqTrans feature. The results of the feature selection algorithm are shown to the user. Please click here to view a larger version of this figure.

Figure 6: The maximum test set accuracy of each feature selection algorithm. The horizontal axis lists the feature selection algorithms, and the vertical axis gives the values of accuracies. The histograms show the experimental data of the three settings, i.e., mqTrans, mRNA, mRNA+mqTrans. Please click here to view a larger version of this figure.

Figure 7: Top 50 dark biomarkers with the smallest p-values in the mqTrans view. The column "Dark Biomarker" gives the dark biomarker names. The columns "mRNA.P" and "mqTrans.P" are the statistical t-test p-values between the phenotypic and control groups. The background colors of the p-values are colored between the p-values 1.00 (blue) and 0.00 (red), and the white color represents p-value = 0.05. Please click here to view a larger version of this figure.

Figure 8: The details of the 26 cancers in The Cancer Genome Atlas (TCGA) at different stages. The columns "Cohort" and "Disease Tissue" describe the patient group and the tissues with disease for each dataset. The last four columns give the numbers of samples in the developmental stages I, II, III, and IV, respectively. Please click here to view a larger version of this figure.

Figure 9: The numbers of dark biomarkers and traditional biomarkers in 26 cancers. The horizontal axis lists the 26 cancer types. The vertical axis gives the numbers of dark biomarkers and traditional biomarkers for these cancer types. Please click here to view a larger version of this figure.
Supplementary Coding File 1: HealthModel-mqTrans-v1-00.tar Please click here to download this File.