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With the rapid progress in Natural Language Processing (NLP), Pre-trained Language Models (PLM) such as BERT, BioBERT, and ChatGPT have shown great potential in various medical NLP tasks. This paper surveys the cutting-edge achievements in applying PLMs to various medical NLP tasks. Specifically, we first brief PLMS and outline the research of PLMs in medicine. Next, we categorise and discuss the types of tasks in medical NLP, covering text summarisation, question-answering, machine translation, sentiment analysis, named entity recognition, information extraction, medical education, relation extraction, and text mining. For each type of task, we first provide an overview of the basic concepts, the main methodologies, the advantages of applying PLMs, the basic steps of applying PLMs application, the datasets for training and testing, and the metrics for task evaluation. Subsequently, a summary of recent important research findings is presented, analysing their motivations, strengths vs weaknesses, similarities vs differences, and discussing potential limitations. Also, we assess the quality and influence of the research reviewed in this paper by comparing the citation count of the papers reviewed and the reputation and impact of the conferences and journals where they are published. Through these indicators, we further identify the most concerned research topics currently. Finally, we look forward to future research directions, including enhancing models' reliability, explainability, and fairness, to promote the application of PLMs in clinical practice. In addition, this survey also collect some download links of some model codes and the relevant datasets, which are valuable references for researchers applying NLP techniques in medicine and medical professionals seeking to enhance their expertise and healthcare service through AI technology. • Brief PLMs, highlighting their effectiveness in various NLP tasks in medicine • Explore the advanced applications of PLMs in various tasks of medical NLP • Summarise each task and review recent researches, especially their pros and cons • Identify future research, focusing on reliability, explainability, and fairness • Collect download links for datasets and codes, aiding the research of AI in medicine [ABSTRACT FROM AUTHOR]

There is evidence that reducing modifiable risk factors and strengthening medical and health interventions can reduce early mortality and economic losses from non-communicable diseases (NCDs). Machine learning (ML) algorithms have been successfully applied to preventing and controlling NCDs. Reinforcement learning (RL) is the most promising of these approaches because of its ability to dynamically adapt interventions to NCD disease progression and its commitment to achieving long-term intervention goals. This paper reviews the preferred algorithms, data sources, design details, and obstacles to clinical application in existing studies to facilitate the early application of RL algorithms in clinical practice research for NCD interventions. We screened 40 relevant papers for quantitative and qualitative analysis using the PRISMA review flow diagram. The results show that researchers tend to use Deep Q-Network (DQN) and Actor-Critic as well as their improved or hybrid algorithms to train and validate RL models on retrospective datasets. Often, the patient's physical condition is the main defining parameter of the state space, while interventions are the main defining parameter of the action space. Mostly, changes in the patient's physical condition are used as a basis for immediate rewards to the agent. Various attempts have been made to address the challenges to clinical application, and several approaches have been proposed from existing research. However, as there is currently no universally accepted solution, the use of RL algorithms in clinical practice for NCD interventions necessitates more comprehensive responses to the issues addressed in this paper, which are safety, interpretability, training efficiency, and the technical aspect of exploitation and exploration in RL algorithms. • Reinforcement learning (RL) approaches enhance strategies for managing non-communicable diseases (NCDs). • 40 relevant papers for quantitative and qualitative analysis using the PRISMA review flow diagram. • This review focuses on the methods, data sources, and challenges when building a RL model for NCDs interventions. [ABSTRACT FROM AUTHOR]

Healthcare organizations have realized that Artificial intelligence (AI) can provide a competitive edge through personalized patient experiences, improved patient outcomes, early diagnosis, augmented clinician capabilities, enhanced operational efficiencies, or improved medical service accessibility. However, deploying AI-driven tools in the healthcare ecosystem could be challenging. This paper categorizes AI applications in healthcare and comprehensively examines the challenges associated with deploying AI in medical practices at scale. As AI continues to make strides in healthcare, its integration presents various challenges, including production timelines, trust generation, privacy concerns, algorithmic biases, and data scarcity. The paper highlights that flawed business models and wrong workflows in healthcare practices cannot be rectified merely by deploying AI-driven tools. Healthcare organizations should re-evaluate root problems such as misaligned financial incentives (e.g., fee-for-service models), dysfunctional medical workflows (e.g., high rates of patient readmissions), poor care coordination between different providers, fragmented electronic health records systems, and inadequate patient education and engagement models in tandem with AI adoption. This study also explores the need for a cultural shift in viewing AI not as a threat but as an enabler that can enhance healthcare delivery and create new employment opportunities while emphasizing the importance of addressing underlying operational issues. The necessity of investments beyond finance is discussed, emphasizing the importance of human capital, continuous learning, and a supportive environment for AI integration. The paper also highlights the crucial role of clear regulations in building trust, ensuring safety, and guiding the ethical use of AI, calling for coherent frameworks addressing transparency, model accuracy, data quality control, liability, and ethics. Furthermore, this paper underscores the importance of advancing AI literacy within academia to prepare future healthcare professionals for an AI-driven landscape. Through careful navigation and proactive measures addressing these challenges, the healthcare community can harness AI's transformative power responsibly and effectively, revolutionizing healthcare delivery and patient care. The paper concludes with a vision and strategic suggestions for the future of healthcare with AI, emphasizing thoughtful, responsible, and innovative engagement as the pathway to realizing its full potential to unlock immense benefits for healthcare organizations, physicians, nurses, and patients while proactively mitigating risks. • This study categorizes AI applications in healthcare and analyzes their deployment challenges at scale in medical practices. • The paper emphasizes a cultural shift to view AI as a healthcare delivery enhancer and job creator, not a threat. • To integrate AI, investments in finance and human capital, continuous learning, and a supportive environment are needed. • Clear regulatory frameworks should be developed to build trust, ensure safety, and guide the ethical use of AI in healthcare. • The study provides strategic suggestions for responsible AI use in healthcare to maximize benefits and minimize risks. [ABSTRACT FROM AUTHOR]

Heart failure has become a huge public health problem, and failure to accurately predict readmission will further lead to the disease's high cost and high mortality. The construction of readmission prediction model can assist doctors in making decisions to prevent patients from deteriorating and reduce the cost burden. This paper extracts the patient discharge records from the MIMIC-III database. It divides the patients into three research categories: no readmission, readmission within 30 days, and readmission after 30 days, to predict the readmission of patients. We propose the HR-BGCN model to predict the readmission of patients. First, we use the Adaptive-TMix to improve the prediction indicators of a few categories and reduce the impact of unbalanced categories. Then, the knowledge-informed graph attention mechanism is proposed. By introducing a document-level explicit diagram structure, the coding ability of graph node features is significantly improved. The paragraph-level representation obtained through graph learning is combined with the context token-level representation of BERT, and finally, the multi-classification task is carried out. We also compare several typical graph learning classification models to verify the model's effectiveness, such as the IA-GCN model, GAT model, etc. The results show that the average F1 score of the HR-BGCN model proposed in this paper for 30-day readmission of heart failure patients is 88.26%, and the average accuracy is 90.47%. The HR-BGCN model is significantly better than the graph learning classification model for predicting heart failure readmission. It can help doctors predict the 30-day readmission of patients, then reduce the readmission rate of patients. • The clinical notes (unstructured data) are used for prognostic prediction. • The Adaptive-TMix is proposed to reduce the impact of unbalanced categories. • The proposed knowledge-informed graph attention mechanism can improve coding ability of graph node features. • The model can complete a multi-class prediction task and perform well. [ABSTRACT FROM AUTHOR]

Cardiac arrhythmia is one of the prime reasons for death globally. Early diagnosis of heart arrhythmia is crucial to provide timely medical treatment. Heart arrhythmias are diagnosed by analyzing the electrocardiogram (ECG) of patients. Manual analysis of ECG is time-consuming and challenging. Hence, effective automated detection of heart arrhythmias is important to produce reliable results. Different deep-learning techniques to detect heart arrhythmias such as Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM), Transformer, and Hybrid CNN–LSTM were proposed. However, these techniques, when used individually, are not sufficient to effectively learn multiple features from the ECG signal. The fusion of CNN and LSTM overcomes the limitations of CNN in the existing studies as CNN–LSTM hybrids can extract spatiotemporal features. However, LSTMs suffer from long-range dependency issues due to which certain features may be ignored. Hence, to compensate for the drawbacks of the existing models, this paper proposes a more comprehensive feature fusion technique by merging CNN, LSTM, and Transformer models. The fusion of these models facilitates learning spatial, temporal, and long-range dependency features, hence, helping to capture different attributes of the ECG signal. These features are subsequently passed to a majority voting classifier equipped with three traditional base learners. The traditional learners are enriched with deep features instead of handcrafted features. Experiments are performed on the MIT-BIH arrhythmias database and the model performance is compared with that of the state-of-art models. Results reveal that the proposed model performs better than the existing models yielding an accuracy of 99.56%. • This paper proposes a rich feature fusion technique for cardiac arrhythmia detection from ECG by merging three deep learning models, namely, CNN, CNN–LSTM, and Transformer. • Integrating these models combines the advantages of all these individual models, overcomes their limitations, and learns significant features from the input ECG signal. • The deep spatial, temporal, and long-range dependency patterns learned by the aforementioned models are fused via concatenation and fed to a majority voting classifier with three traditional base learners: SVM, LR, and RF. • MIT-BIH Arrhythmia database is used for experimentation. A comparison of the results with the baseline models and state-of-the-art models shows that the proposed model outdoes the existing models achieving an accuracy of 95.56% and an F-score of 99.34%. • The results show that the proposed model outperforms the existing models in terms of precision, recall, F-score, and accuracy. [ABSTRACT FROM AUTHOR]

The Concordance Index (C-index) is a commonly used metric in Survival Analysis for evaluating the performance of a prediction model. In this paper, we propose a decomposition of the C-index into a weighted harmonic mean of two quantities: one for ranking observed events versus other observed events, and the other for ranking observed events versus censored cases. This decomposition enables a finer-grained analysis of the relative strengths and weaknesses between different survival prediction methods. The usefulness of this decomposition is demonstrated through benchmark comparisons against classical models and state-of-the-art methods, together with the new variational generative neural-network-based method (SurVED) proposed in this paper. The performance of the models is assessed using four publicly available datasets with varying levels of censoring. Using the C-index decomposition and synthetic censoring, the analysis shows that deep learning models utilize the observed events more effectively than other models. This allows them to keep a stable C-index in different censoring levels. In contrast to such deep learning methods, classical machine learning models deteriorate when the censoring level decreases due to their inability to improve on ranking the events versus other events. • The C-Index Decomposition is proposed as a weighted harmonic mean of the C-index of the events vs other events and the C-index of events vs censored cases. • The C-Index Decomposition gives a more detailed image of the survival model performance. • SurVED; a new survival model based on Variational inference formulation was shown to be better at improving performance with more observed event. • Models which seem to perform similarly using the C-index, showed different behavior with respect to the terms of the C-index decomposition. [ABSTRACT FROM AUTHOR]

In recent years, Computer Aided Diagnosis (CAD) has become an important research area that attracted a lot of researchers. In medical diagnostic systems, several attempts have been made to build and enhance CAD applications to avoid errors that can cause dangerously misleading medical treatments. The most exciting opportunity for promoting the performance of CAD system can be accomplished by integrating Artificial Intelligence (AI) in medicine. This allows the effective automation of traditional manual workflow, which is slow, inaccurate and affected by human errors. This paper aims to provide a complete Computer Aided Disease Diagnosis (CAD2) strategy based on Machine Learning (ML) techniques that can help clinicians to make better medical decisions. The proposed CAD2 consists of three main sequential phases, namely; (i) Outlier Rejection Phase (ORP), (ii) Feature Selection Phase (FSP), and (iii) Classification Phase (CP). ORP is implemented to reject outliers using new Outlier Rejection Technique (ORT) that contains two sequential stages called Fast Outlier Rejection (FOR) and Accurate Outlier Rejection (AOR). The most informative features are selected through FSP using Hybrid Selection Technique (HST). HST includes two main stages called Quick Selection Stage (QS2) using fisher score as a filter method and Precise Selection Stage (PS2) using a Hybrid Bio-inspired Optimization (HBO) technique as a wrapper method. Finally, actual diagnose takes place through CP, which relies on Ensemble Classification Technique (ECT). The proposed CAD2 has been tested experimentally against recent disease diagnostic strategies using two different datasets in which the first contains several diseases, while the second includes data for Covid-19 patients only. Experimental results have proven the high efficiency of the proposed CAD2 in terms of accuracy, error, precision, and recall compared with other competitors. Additionally, CAD2 strategy provides the best Wilcoxon signed rank test and Friedman test measurements against other strategies according to both datasets. It is concluded that CAD2 strategy based on ORP, FSP, and CP gave an accurate diagnosis compared to other strategies because it gave the highest accuracy and the lowest error and implementation time. • This paper provides Computer Aided Disease Diagnosis (CAD2) strategy by AI methods. • CAD2 includes outlier rejection, feature selection, and classification phases. • Rejection phase eliminates outliers but selection phase selects the best features. • Actual diagnosis takes place through classification phase using AI techniques. • The provided CAD2 introduces the maximum diagnose accuracy. [ABSTRACT FROM AUTHOR]

Deep Brain Stimulation (DBS) is an implantable medical device used for electrical stimulation to treat neurological disorders. Traditional DBS devices provide fixed frequency pulses, but personalized adjustment of stimulation parameters is crucial for optimal treatment. This paper introduces a Basal Ganglia inspired Reinforcement Learning (BGRL) approach, incorporating a closed-loop feedback mechanism to suppress neural synchrony during neurological fluctuations. The BGRL approach leverages the resemblance between the Basal Ganglia region of brain by incorporating the actor–critic architecture of reinforcement learning (RL). Simulation results demonstrate that BGRL significantly reduces synchronous electrical pulses compared to other standard RL algorithms. BGRL algorithm outperforms existing RL methods in terms of suppression capability and energy consumption, validated through comparisons using ensemble oscillators. Results shown in the paper demonstrate BGRL suppressed the synchronous electrical pulses across three signaling regimes namely regular, chaotic and bursting by 40%, 146% and 40% respectively as compared to soft actor–critic model. BGRL shows promise in effectively suppressing neural synchrony in DBS therapy, providing an efficient alternative to open-loop methodologies. • Stabilize the synchronization and convergence points allowing for more accurate estimation. • Avoid overestimated bias to generalize the model well. • Adds noise to the target action to exploit the Q-function errors by smoothing out Q-values. • Ran simulations which capture the characteristics of closed loop DBS. [ABSTRACT FROM AUTHOR]

Heparin is a critical aspect of managing sepsis after abdominal surgery, which can improve microcirculation, protect organ function, and reduce mortality. However, there is no clinical evidence to support decision-making for heparin dosage. This paper proposes a model called SOFA-MDP, which utilizes SOFA scores as states of MDP, to investigate clinic policies. Different algorithms provide different value functions, making it challenging to determine which value function is more reliable. Due to ethical restrictions, we cannot test all policies on patients. To address this issue, we proposed two value function assessment methods: action similarity rate and relative gain. We experimented with heparin treatment policies for sepsis patients after abdominal surgery using MIMIC-IV. In the experiments, TD (0) shows the most reliable performance. Using the action similarity rate and relative gain to assess AI policy from TD (0) , the agreement rates between AI policy and "good" physician's actual treatment are 64.6% and 73.2%, while the agreement rates between AI policy and "bad" physician's actual treatment are 44.1% and 35.8%, the gaps are 20.5% and 37.4%, respectively. External validation using action similarity rate and relative gain based on eICU resulted in agreement rates of 61.5% and 69.1% with the "good" physician's treatment, and 45.2% and 38.3% with the "bad" physician's treatment, with gaps of 16.3% and 30.8%, respectively. In conclusion, the model provides instructive support for clinical decisions, and the evaluation methods accurately distinguish reliable and unreasonable outcomes. • This paper proposes a model called SOFA-MDP , which utilizes SOFA scores as states and the difference of SOFA scores of successive states as reward function, to investigate heparin treatment policy of patients with sepsis in ICU. • Moreover, we present two novel assessment methods: action similarity rate and relative gain , to estimate the clinic policies. The experimental results show that our SOFA-MDP model offers instructive support for clinical decisions of heparin treatment and our assessment methods can distinguish between reliable and unreasonable outcomes. [ABSTRACT FROM AUTHOR]

Since depression often results in suicidal thoughts and leaves a person severely disabled daily, there is an elevated risk of premature mortality due to mental problems caused by depression. Therefore, it's crucial to identify the patient's mental illness as soon as possible. People are increasingly using social media platforms to express their opinions and share daily activities, which makes online platforms rich sources of early depression detection. The contribution of this paper is multifold. First , it presents five machine-learning models for Arabic and English depression detection using Twitter text. The best model for Arabic text achieved an f1-score of 96.6 % for binary classification to depressed and Non_dep. For English text without negation, the model achieved 92 % for binary classification and 88 % for multi-classification (depressed, indifferent, happy). For English text with negation, an 87 %, and 85 % f1 score was achieved for binary and multi-classification respectively. Second , the work introduced a manually annotated Arabic_Dep_tweets_10,000 corpus of 10.000 Arabic tweets, which covered neutral tweets as well as a variety of depressed and happy terms. In addition, two automatically annotated English corpora, Eng_without_negation_60.000 corpus of 60,172 English tweets and Eng_with_negation_57.000 corpus of 57,392 English tweets. Both covered a wide range of depressed and cheerful terms; however, Negation was included in the Eng_with_negation_57.000 corpus. Finally , this paper exposes a depression-detection web application which implements our optimal models to detect tweets that contain depression symptoms and predict depression trends for a person either using English or Arabic language. • More than two-thirds of suicides each year are caused by depression, which is the most common mental illness. • Social media posts can be a useful tool for tracking a variety of mental health conditions, including depression. • The lack of adequate Arabic corpora makes it difficult to use machine learning techniques in depression detection for the Arabic people. • Existing models for English language use binary classification only and does not handle negation in the text. • Twittpy is a web application developed to detect depression symptoms for persons using their text from Arabic or English tweets. [ABSTRACT FROM AUTHOR]

Hospitals use medical cyber-physical systems (MCPS) more often to give patients quality continuous care. MCPS isa life-critical, context-aware, networked system of medical equipment. It has been challenging to achieve high assurance in system software, interoperability, context-aware intelligence, autonomy, security and privacy, and device certifiability due to the necessity to create complicated MCPS that are safe and efficient. The MCPS system is shown in the paper as a newly developed application case study of artificial intelligence in healthcare. Applications for various CPS-based healthcare systems are discussed, such as telehealthcare systems for managing chronic diseases (cardiovascular diseases, epilepsy, hearing loss, and respiratory diseases), supporting medication intake management, and tele-homecare systems. The goal of this study is to provide a thorough overview of the essential components of the MCPS from several angles, including design, methodology, and important enabling technologies, including sensor networks, the Internet of Things (IoT), cloud computing, and multi-agent systems. Additionally, some significant applications are investigated, such as smart cities, which are regarded as one of the key applications that will offer new services for industrial systems, transportation networks, energy distribution, monitoring of environmental changes, business and commerce applications, emergency response, and other social and recreational activities.The four levels of an MCPS's general architecture—data collecting, data aggregation, cloud processing, and action—are shown in this study. Different encryption techniques must be employed to ensure data privacy inside each layer due to the variations in hardware and communication capabilities of each layer. We compare established and new encryption techniques based on how well they support safe data exchange, secure computing, and secure storage. Our thorough experimental study of each method reveals that, although enabling innovative new features like secure sharing and safe computing, developing encryption approaches significantly increases computational and storage overhead. To increase the usability of newly developed encryption schemes in an MCPS and to provide a comprehensive list of tools and databases to assist other researchers, we provide a list of opportunities and challenges for incorporating machine intelligence-based MCPS in healthcare applications in our paper's conclusion. [ABSTRACT FROM AUTHOR]

Large Language Models (LLMs) have the potential of facilitating the development of Artificial Intelligence technology to assist medical experts for interactive decision support. This potential has been illustrated by the state-of-the-art performance obtained by LLMs in Medical Question Answering, with striking results such as passing marks in licensing medical exams. However, while impressive, the required quality bar for medical applications remains far from being achieved. Currently, LLMs remain challenged by outdated knowledge and by their tendency to generate hallucinated content. Furthermore, most benchmarks to assess medical knowledge lack reference gold explanations which means that it is not possible to evaluate the reasoning of LLMs predictions. Finally, the situation is particularly grim if we consider benchmarking LLMs for languages other than English which remains, as far as we know, a totally neglected topic. In order to address these shortcomings, in this paper we present MedExpQA, the first multilingual benchmark based on medical exams to evaluate LLMs in Medical Question Answering. To the best of our knowledge, MedExpQA includes for the first time reference gold explanations, written by medical doctors, of the correct and incorrect options in the exams. Comprehensive multilingual experimentation using both the gold reference explanations and Retrieval Augmented Generation (RAG) approaches show that performance of LLMs, with best results around 75 accuracy for English, still has large room for improvement, especially for languages other than English, for which accuracy drops 10 points. Therefore, despite using state-of-the-art RAG methods, our results also demonstrate the difficulty of obtaining and integrating readily available medical knowledge that may positively impact results on downstream evaluations for Medical Question Answering. Data, code, and fine-tuned models will be made publicly available. 1 1 https://huggingface.co/datasets/HiTZ/MedExpQA. • MedExpQA: the first multilingual benchmark for MedicalQA including gold reference explanations. • Comparison of gold and automatically extracted medical knowledge via RAG techniques. • Fine-tuning makes redundant the external knowledge obtained via RAG. • Overall performance of LLMs with or without RAG still has large room for improvement. • Performance for French, Italian and Spanish lower for every LLM in every setting. [ABSTRACT FROM AUTHOR]

Accurate prediction of Kirsten rat sarcoma (KRAS) mutation status is crucial for personalized treatment of advanced colorectal cancer patients. However, despite the excellent performance of deep learning models in certain aspects, they often overlook the synergistic promotion among multiple tasks and the consideration of both global and local information, which can significantly reduce prediction accuracy. To address these issues, this paper proposes an innovative method called the Multi-task Global–Local Collaborative Hybrid Network (CHNet) aimed at more accurately predicting patients' KRAS mutation status. CHNet consists of two branches that can extract global and local features from segmentation and classification tasks, respectively, and exchange complementary information to collaborate in executing these tasks. Within the two branches, we have designed a Channel-wise Hybrid Transformer (CHT) and a Spatial-wise Hybrid Transformer (SHT). These transformers integrate the advantages of both Transformer and CNN, employing cascaded hybrid attention and convolution to capture global and local information from the two tasks. Additionally, we have created an Adaptive Collaborative Attention (ACA) module to facilitate the collaborative fusion of segmentation and classification features through guidance. Furthermore, we introduce a novel Class Activation Map (CAM) loss to encourage CHNet to learn complementary information between the two tasks. We evaluate CHNet on the T2-weighted MRI dataset, and achieve an accuracy of 88.93% in KRAS mutation status prediction, which outperforms the performance of representative KRAS mutation status prediction methods. The results suggest that our CHNet can more accurately predict KRAS mutation status in patients via a multi-task collaborative facilitation and considering global–local information way, which can assist doctors in formulating more personalized treatment strategies for patients. • Two tasks collaborate to predict KRAS mutation status in colorectal cancer. • New Hybrid Transformers capture global and local information. • Fusion Mechanisms for the guidance of advanced semantic segmentation features. • A novel Class Activation Map loss based on modeling the correlation between global features. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most prevalent cause of dementia, characterized by a steady decline in mental, behavioral, and social abilities and impairs a person's capacity for independent functioning. It is a fatal neurodegenerative disease primarily affecting older adults. The purpose of this literature review is to investigate various AD detection techniques, datasets, input modalities, algorithms, libraries, and performance evaluation metrics used to determine which model or strategy may provide superior performance. The initial search yielded 807 papers, but only 100 research articles were chosen after applying the inclusion-exclusion criteria. This SLR analyzed research items published between January 2019 and December 2022. The ACM, Elsevier, IEEE Xplore Digital Library, PubMed, Springer and Taylor & Francis were systematically searched. The current study considers articles that used Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), APOe4 genotype, Diffusion Tensor Imaging (DTI) and Cerebrospinal Fluid (CSF) biomarkers. The study was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. According to the literature survey, most studies (n = 76) used the DL strategy. The datasets used by studies were primarily derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. The majority of studies (n = 73) used single-modality neuroimaging data, while the remaining used multi-modal input data. In a multi-modality approach, the combination of MRI and PET scans is commonly preferred. Also, Regarding the algorithm used, Convolution Neural Network (CNN) showed the highest accuracy, 100 %, in classifying AD vs. CN subjects whereas the SVM was the most common ML algorithm, with a maximum accuracy of 99.82 %. • The review of 100 studies were selected for Classification of AD, CN and MCI with ML and DL Algo. • Studies on Machine Learning, Deep Learning for Neuroimaging (MRI, PET), Apoe4 genetic, and CSF biomarkers for disease detection are compared. • MRI and PET are the most widely used biomarkers. The ADNI database is the most prominent dataset for detecting AD • Study results showed that CNN achieved 100% accuracy for ADD. Other evaluation parameters discussed include Precision, Sensitivity, Specificity, F1 score, and AUC. • This review is valuable for researchers working on AI and medical applications with ML/DL-based AD detection. [ABSTRACT FROM AUTHOR]

And sentences associated with these attributes and relationships have been neglected. in this paper ►We propose an end-to-end model called K nowledge G raph E nhanced neural net work (KGENet) to address the above shortcomings. specifically ►We first construct a disease knowledge graph that focuses on the multi-view disease attributes of ICD codes and the disease relationships between these codes. we also use a long sequence encoder to get EHR document representation. most importantly ►KGENet leverages multi-view disease attributes and structured disease relationships for knowledge enhancement through hybrid attention and graph propagation ►Respectively. furthermore ►The above processes can provide attribute-aware and relationship-augmented explainability for the model prediction results based on our disease knowledge graph. experiments conducted on the MIMIC-III benchmark dataset show that KGENet outperforms state-of-the-art models in both model effectiveness and explainability Electronic health record (EHR) coding assigns International Classification of Diseases (ICD) codes to each EHR document. These standard medical codes represent diagnoses or procedures and play a critical role in medical applications. However, EHR is a long medical text that is difficult to represent, the ICD code label space is large, and the labels have an extremely unbalanced distribution. These factors pose challenges to automatic EHR coding. Previous studies have not explored the disease attributes (e.g., symptoms, tests, medications) of ICD codes and the disease relationships (e.g., causes, risk factors, comorbidities) between them. In addition, the important roles of medical • Disease Knowledge Graph with multi-view attributes and relationships. • Hybrid Attention Module for label-specific feature extraction. • Graph Propagation Module for interactive feature extraction. • Attribute-aware and relationship-augmented explainability. [ABSTRACT FROM AUTHOR]

Chinese medicine is a unique and complex medical system with complete and rich scientific theories. The textual data of Traditional Chinese Medicine (TCM) contains a large amount of relevant knowledge in the field of TCM, which can serve as guidance for accurate disease diagnosis as well as efficient disease prevention and treatment. Existing TCM texts are disorganized and lack a uniform standard. For this reason, this paper proposes a joint extraction framework by using graph convolutional networks to extract joint entity relations on document-level TCM texts to achieve TCM entity relation mining. More specifically, we first finetune the pre-trained language model by using the TCM domain knowledge to obtain the task-specific model. Taking the integrity of TCM into account, we extract the complete entities as well as the relations corresponding to diagnosis and treatment from the document-level medical cases by using multiple features such as word fusion coding, TCM lexicon information, and multi-relational graph convolutional networks. The experimental results show that the proposed method outperforms the state-of-the-art methods. It has an F1-score of 90.7% for Name Entity Recognization and 76.14% for Relation Extraction on the TCM dataset, which significantly improves the ability to extract entity relations from TCM texts. Code is available at https://github.com/xxxxwx/TCMERE. • The proposed method could alleviate entity nesting and relation overlapping. • A large amount data is collected to obtain model in TCM domain. • The multi-type TCM dictionaries are built. [ABSTRACT FROM AUTHOR]

With Artificial Intelligence (AI) increasingly permeating various aspects of society, including healthcare, the adoption of the Transformers neural network architecture is rapidly changing many applications. Transformer is a type of deep learning architecture initially developed to solve general-purpose Natural Language Processing (NLP) tasks and has subsequently been adapted in many fields, including healthcare. In this survey paper, we provide an overview of how this architecture has been adopted to analyze various forms of healthcare data, including clinical NLP, medical imaging, structured Electronic Health Records (EHR), social media, bio-physiological signals, biomolecular sequences. Furthermore, which have also include the articles that used the transformer architecture for generating surgical instructions and predicting adverse outcomes after surgeries under the umbrella of critical care. Under diverse settings, these models have been used for clinical diagnosis, report generation, data reconstruction, and drug/protein synthesis. Finally, we also discuss the benefits and limitations of using transformers in healthcare and examine issues such as computational cost, model interpretability, fairness, alignment with human values, ethical implications, and environmental impact. • Transformers in clinical NLP, Electronic Health Records, and social media data • Transformers in medical imaging (image segmentation, registration, captioning, synthesis) • Transformers for analyzing bio-signals (human activity, EEG, ECG) and biomolecular sequence. • Detailed explanation of basic Transformer Architecture and some popular variants • Discussion on computational costs and the necessity of AI alignment [ABSTRACT FROM AUTHOR]

Predictive modeling is becoming an essential tool for clinical decision support, but health systems with smaller sample sizes may construct suboptimal or overly specific models. Models become over-specific when beside true physiological effects, they also incorporate potentially volatile site-specific artifacts. These artifacts can change suddenly and can render the model unsafe. To obtain safer models, health systems with inadequate sample sizes may adopt one of the following options. First, they can use a generic model, such as one purchased from a vendor, but often such a model is not sufficiently specific to the patient population and is thus suboptimal. Second, they can participate in a research network. Paradoxically though, sites with smaller datasets contribute correspondingly less to the joint model, again rendering the final model suboptimal. Lastly, they can use transfer learning, starting from a model trained on a large data set and updating this model to the local population. This strategy can also result in a model that is over-specific. In this paper we present the consensus modeling paradigm, which uses the help of a large site (source) to reach a consensus model at the small site (target). We evaluate the approach on predicting postoperative complications at two health systems with 9,044 and 38,045 patients (rare outcomes at about 1% positive rate), and conduct a simulation study to understand the performance of consensus modeling relative to the other three approaches as a function of the available training sample size at the target site. We found that consensus modeling exhibited the least over-specificity at either the source or target site and achieved the highest combined predictive performance. • Health systems with inadequate data may build suboptimal or overly specific models. • Over-specialized models are not robust to institutional changes and can cause harm. • Consensus modeling reduces over-specialization for small health systems. • Consensus modeling improves equity in AI capability and can reduce health disparity. [ABSTRACT FROM AUTHOR]

Diabetic Retinopathy (DR) is the most popular debilitating impairment of diabetes and it progresses symptom-free until a sudden loss of vision occurs. Understanding the progression of DR is a pressing issue in clinical research and practice. In this systematic review of articles on Machine Learning (ML) based risk prediction models for DR progression, ever since the use of Artificial Intelligence (AI) for DR detection, there have been more cross-sectional studies with different algorithms of use of AI, there haven't been many longitudinal studies for the AI based risk prediction models. This paper proposes a novel review to fill in the gaps identified in current reviews and facilitate other researchers with current research solutions for developing AI-based risk prediction models for DR progression and closely related problems; synthesize the current results from these studies and identify research challenges, limitations and gaps to inform the selection of machine learning techniques and predictors to build novel prediction models. Additionally, this paper suggested six (6) deep AI-related technical and critical discussion of the adopted strategies and approaches. The Systematic Literature Review (SLR) methodology was employed to gather relevant studies. We searched IEEE Xplore, PubMed, Springer Link, Google Scholar, and Science Direct electronic databases for papers published from January 2017 to 30th April 2023. Thirteen (13) studies were chosen on the basis of their relevance to the review questions and satisfying the selection criteria. However, findings from the literature review exposed some critical research gaps that need to be addressed in future research to improve on the performance of risk prediction models for DR progression. [ABSTRACT FROM AUTHOR]

The medication recommendation (MR) or medication combination prediction task aims to predict effective prescriptions given accurate patient representations derived from electronic health records (EHRs), which contributes to improving the quality of clinical decision-making, especially for patients with multi-morbidity. Although in recent years deep learning technology has achieved great success in MR, the performance of current multi-label based MR solutions is unsatisfactory. They mainly focus on improving the patient representation module and modeling the medication label dependencies such as drug–drug interaction (DDI) correlation and co-occurrence relationship. However, the hierarchical dependency among medication labels and diversity of difficulty among MR training examples lack sufficient consideration. In this paper, we propose a framework of Curriculum learning Enhanced Hierarchical multi-label classification for MR (CEHMR). Motivated by the category hierarchy of medications which organizes standard medication codes in a hierarchical structure, we utilize it to provide more trustworthy prior knowledge for modeling label dependency. Specifically, we design a hierarchical multi-label classifier with a learnable gate fusion layer, to simultaneously capture the level-independent (local) and level-dependent (global) hierarchical information in the medication hierarchy. In addition, to overcome the diversity of training example difficulties, and progressively achieve a smoother training process, we introduce a bootstrap-based curriculum learning strategy. Hence, the example difficulty can be measured based on the predictive performance of the MR model, and then all training examples would be retrained from easy to hard under the guidance of a predefined training scheduler. Experiments on the real-world medical MIMIC-III database demonstrate that the proposed framework can achieve state-of-the-art performance compared with seven representative baselines, and extensive ablation studies validate the effectiveness of each component of CEHMR. [Display omitted] • This paper formulates the medication recommendation task as a hierarchical multi-label classification problem. • The proposed CEHMR models the medication dependency by enabling classifiers to learn the prior hierarchy. • CEHMR measures the difficulty of each training example and progressively achieves a smoother training process. • The experimental testing performed on the MIMIC-III data set confirms the advantages of CEHMR. • Extensive experiments demonstrate its potential in dealing with the diversity of training example difficulties. [ABSTRACT FROM AUTHOR]

The world has recently been exposed to a fierce attack from many viral diseases, such as Covid-19, that exhausted medical systems around the world. Such attack had a negative impact not only on the health status of people or the high death rate, but also had a bad impact on the economic situation, which affected all countries of the world especially the poor and the developing ones. Monkeypox is one of the latest viral diseases that may cause a pandemic in the near future if not dealt and diagnosed with appropriately. This paper provides a new strategy for diagnosing monkeypox, which is called; Accurate Monkeypox Diagnosing Strategy (AMDS). The proposed AMDS consists of two phases, which are; (i) pre-processing and (ii) classification. During the pre-processing phase, the most effective feature are selected using Binary Tiki-Taka Algorithm (BTTA). On the other hand, in the classification phase, ensemble classification is used for diagnosing new cases, which combines evidence from three different new classifiers, namely; (a) Layered K-Nearest Neighbors (LKNN), (b) Statistical Naïve Bayes (SNB), and (c) Deep Learning Classifier (DLC). Moreover, the decisions of the proposed classifiers are merged in a new voting scheme called Fuzzified Voting Scheme (FVS). AMDS has been compared against recent diagnostic strategies. Experimental results have proven that AMDS outperforms other monkeypox diagnostic strategies as it introduces the most accurate diagnosis according to two different datasets. • This paper provides Accurate Monkeypox Diagnosing Strategy (AMDS). • AMDS consists of pre-processing and classification phases. • In pre-processing phase, binary Tiki-Taka algorithm as feature selection is used. • In the classification phase, ensemble classification is used to diagnose new cases. • Results have proven that AMDS outperforms other monkeypox diagnostic strategies. [ABSTRACT FROM AUTHOR]

Over the past decade, machine learning (ML) and artificial intelligence (AI) have become increasingly prevalent in the medical field. In the United States, the Food and Drug Administration (FDA) is responsible for regulating AI algorithms as "medical devices" to ensure patient safety. However, recent work has shown that the FDA approval process may be deficient. In this study, we evaluate the evidence supporting FDA-approved neuroalgorithms, the subset of machine learning algorithms with applications in the central nervous system (CNS), through a systematic review of the primary literature. Articles covering the 53 FDA-approved algorithms with applications in the CNS published in PubMed, EMBASE, Google Scholar and Scopus between database inception and January 25, 2022 were queried. Initial searches identified 1505 studies, of which 92 articles met the criteria for extraction and inclusion. Studies were identified for 26 of the 53 neuroalgorithms, of which 10 algorithms had only a single peer-reviewed publication. Performance metrics were available for 15 algorithms, external validation studies were available for 24 algorithms, and studies exploring the use of algorithms in clinical practice were available for 7 algorithms. Papers studying the clinical utility of these algorithms focused on three domains: workflow efficiency, cost savings, and clinical outcomes. Our analysis suggests that there is a meaningful gap between the FDA approval of machine learning algorithms and their clinical utilization. There appears to be room for process improvement by implementation of the following recommendations: the provision of compelling evidence that algorithms perform as intended, mandating minimum sample sizes, reporting of a predefined set of performance metrics for all algorithms and clinical application of algorithms prior to widespread use. This work will serve as a baseline for future research into the ideal regulatory framework for AI applications worldwide. • Of the 52 "neuroalgorithms" studied, primary literature could be identified for 26 of them. • Fifteen of the algorithms had primary literature reporting algorithmic performance metrics. • Heterogeneity in study design between papers made definitive assessment of algorithmic performance difficult. • Clinical adoption of algorithms was hampered by the relative lack of patient-centered research testing each algorithm. • Few papers provided a comprehensive overview of all notable limitations for a single algorithm. [ABSTRACT FROM AUTHOR]

Evolutionary algorithms have been successfully employed to find the best structure for many learning algorithms including neural networks. Due to their flexibility and promising results, Convolutional Neural Networks (CNNs) have found their application in many image processing applications. The structure of CNNs greatly affects the performance of these algorithms both in terms of accuracy and computational cost, thus, finding the best architecture for these networks is a crucial task before they are employed. In this paper, we develop a genetic programming approach for the optimization of CNN structure in diagnosing COVID-19 cases via X-ray images. A graph representation for CNN architecture is proposed and evolutionary operators including crossover and mutation are specifically designed for the proposed representation. The proposed architecture of CNNs is defined by two sets of parameters, one is the skeleton which determines the arrangement of the convolutional and pooling operators and their connections and one is the numerical parameters of the operators which determine the properties of these operators like filter size and kernel size. The proposed algorithm in this paper optimizes the skeleton and the numerical parameters of the CNN architectures in a co-evolutionary scheme. The proposed algorithm is used to identify covid-19 cases via X-ray images. • A novel optimization algorithm is proposed for image thresholding. • Three different fitness functions are used for optimization. • Experimental analysis are performed. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine (TCM) has gradually played an indispensable role in people's health maintenance, especially in the treatment of chronic diseases. However, there is always uncertainty and hesitation in the judgment and understanding of diseases by doctors, which affects the status recognition and optimal diagnosis and treatment decision-making of patients. In order to overcome the above problems, we lead into probabilistic double hierarchy linguistic term set (PDHLTS) to accurately describe language information in traditional Chinese medicine and make decisions. In this paper, a multi-criteria group decision making (MCGDM) model is constructed based on the MSM-MCBAC (Maclaurin symmetric mean-MultiCriteria Border Approximation area Comparison) method in the PDHL environment. Firstly, a PDHL weighted Maclaurin symmetric mean (PDHLWMSM) operator is proposed to aggregate the evaluation matrices of multiple experts. Then, combined with the BWM and maximizing deviation method, a comprehensive weight determination method is put forward to calculate the weights of criteria. Furthermore, we propose PDHL MSM-MCBAC method based on the Multi-Attributive Border Approximation area Comparison (MABAC) method and the PDHLWMSM operator. Finally, an example of a selection of TCM prescriptions is used and some comparative analyses are made to verify the effectiveness and superiority of this paper. • The PDHLWMSM operator is put forward to aggregate the evaluation matrices given by multiple experts. • A comprehensive weight determination method based on the BWM and the maximizing deviation in the PDHL environment is proposed. • We propose the PDHL MSM-MCBAC method for MCGDM involving the selection of TCM prescriptions. [ABSTRACT FROM AUTHOR]

Computational modeling involves the use of computer simulations and models to study and understand real-world phenomena. Its application is particularly relevant in the study of potential interactions between biological elements. It is a promising approach to understand complex biological processes and predict their behavior under various conditions. This paper is a review of the recent literature on computational modeling of biological systems. Our study focuses on the field of oncology and the use of artificial intelligence (AI) and, in particular, agent-based modeling (ABM), between 2010 and May 2023. Most of the articles studied focus on improving the diagnosis and understanding the behaviors of biological entities, with metaheuristic algorithms being the models most used. Several challenges are highlighted regarding increasing and structuring knowledge about biological systems, developing holistic models that capture multiple scales and levels of organization, reproducing emergent behaviors of biological systems, validating models with experimental data, improving computational performance of models and algorithms, and ensuring privacy and personal data protection are discussed. • Use of multi-agent systems to study biological interactions in oncology. • Multi-agent systems enable modeling of cell signaling network dynamics. • Review of multi-agent systems application for personalized therapeutic strategies. • Meta-heuristic algorithms found to be the most used models in recent studies. [ABSTRACT FROM AUTHOR]

Hematology is the study of diagnosis and treatment options for blood diseases, including cancer. Cancer is considered one of the deadliest diseases across all age categories. Diagnosing such a deadly disease at the initial stage is essential to cure the disease. Hematologists and pathologists rely on microscopic evaluation of blood or bone marrow smear images to diagnose blood-related ailments. The abundance of overlapping cells, cells of varying densities among platelets, non-illumination levels, and the amount of red and white blood cells make it more difficult to diagnose illness using blood cell images. Pathologists are required to put more effort into the traditional, time-consuming system. Nowadays, it becomes possible with machine learning and deep learning techniques, to automate the diagnostic processes, categorize microscopic blood cells, and improve the accuracy of the procedure and its speed as the models developed using these methods may guide an assisting tool. In this article, we have acquired, analyzed, scrutinized, and finally selected around 57 research papers from various machine learning and deep learning methodologies that have been employed in the diagnosis of leukemia and its classification over the past 20 years, which have been published between the years 2003 and 2023 by PubMed, IEEE, Science Direct, Google Scholar and other pertinent sources. Our primary emphasis is on evaluating the advantages and limitations of analogous research endeavors to provide a concise and valuable research directive that can be of significant utility to fellow researchers in the field. • Use of machine learning techniques for the diagnostic purpose • Diagnosis and classification of leukemia using computer aided methods • Systematic review of the work done so far in the field of leukemia research • Machine learning and deep learning are capable to proceed large amount of data for higher accuracy. [ABSTRACT FROM AUTHOR]

For the diagnosis and outcome prediction of gastric cancer (GC), machine learning methods based on whole slide pathological images (WSIs) have shown promising performance and reduced the cost of manual analysis. Nevertheless, accurate prediction of GC outcome may rely on multiple modalities with complementary information, particularly gene expression data. Thus, there is a need to develop multimodal learning methods to enhance prediction performance. In this paper, we collect a dataset from Ruijin Hospital and propose a multimodal learning method for GC diagnosis and outcome prediction, called GaCaMML, which is featured by a cross-modal attention mechanism and Per-Slide training scheme. Additionally, we perform feature attribution analysis via integrated gradient (IG) to identify important input features. The proposed method improves prediction accuracy over the single-modal learning method on three tasks, i.e., survival prediction (by 4.9% on C-index), pathological stage classification (by 11.6% on accuracy), and lymph node classification (by 12.0% on accuracy). Especially, the Per-Slide strategy addresses the issue of a high WSI-to-patient ratio and leads to much better results compared with the Per-Person training scheme. For the interpretable analysis, we find that although WSIs dominate the prediction for most samples, there is still a substantial portion of samples whose prediction highly relies on gene expression information. This study demonstrates the great potential of multimodal learning in GC-related prediction tasks and investigates the contribution of WSIs and gene expression, respectively, which not only shows how the model makes a decision but also provides insights into the association between macroscopic pathological phenotypes and microscopic molecular features. [Display omitted] • GaCaMML outperforms the single-modal learning method across three tasks on accuracy. • Per-Slide strategy enhances prediction results by optimizing WSI-to-patient ratio. • WSI features prevail in gastric cancer outcome prediction for most samples. • Certain genes like MMPs and TP53 significantly impact prediction results. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) agents encounter the problem of catastrophic forgetting when they are trained in sequentially with new data batches. This issue poses a barrier to the implementation of AI-based models in tasks that involve ongoing evolution, such as cancer prediction. Moreover, whole slide images (WSI) play a crucial role in cancer management, and their automated analysis has become increasingly popular in assisting pathologists during the diagnosis process. Incremental learning (IL) techniques aim to develop algorithms capable of retaining previously acquired information while also acquiring new insights to predict future data. Deep IL techniques need to address the challenges posed by the gigapixel scale of WSIs, which often necessitates the use of multiple instance learning (MIL) frameworks. In this paper, we introduce an IL algorithm tailored for analyzing WSIs within a MIL paradigm. The proposed M ultiple I nstance C lass- I ncremental L earning (MICIL) algorithm combines MIL with class-IL for the first time, allowing for the incremental prediction of multiple skin cancer subtypes from WSIs within a class-IL scenario. Our framework incorporates knowledge distillation and data rehearsal, along with a novel embedding-level distillation, aiming to preserve the latent space at the aggregated WSI level. Results demonstrate the algorithm's effectiveness in addressing the challenge of balancing IL-specific metrics, such as intransigence and forgetting, and solving the plasticity-stability dilemma. • An incremental learning algorithm is applied under the MIL paradigm to analyze WSI. • A public dataset featuring patch-level embeddings of multiple spindle-cell neoplasms. • A WSI embedding-level distillation to prevent shift in the aggregated latent space. • Comprehensive experiments address the plasticity-stability dilemma in MIL frameworks. [ABSTRACT FROM AUTHOR]

Predicting the response of tumor cells to anti-tumor drugs is critical to realizing cancer precision medicine. Currently, most existing methods ignore the regulatory relationships between genes and thus have unsatisfactory predictive performance. In this paper, we propose to predict anti-tumor drug efficacy via learning the activity representation of tumor cells based on a priori knowledge of gene regulation networks (GRNs). Specifically, the method simulates the cellular biosystem by synthesizing a cell-gene activity network and then infers a new low-dimensional activity representation for tumor cells from the raw high-dimensional expression profile. The simulated cell-gene network mainly comprises known gene regulatory networks collected from multiple resources and fuses tumor cells by linking them to hotspot genes that are over- or under-expressed in them. The resulting activity representation could not only reflect the shallow expression profile (hotspot genes) but also mines in-depth information of gene regulation activity in tumor cells before treatment. Finally, we build deep learning models on the activity representation for predicting drug efficacy in tumor cells. Experimental results on the benchmark GDSC dataset demonstrate the superior performance of the proposed method over SOTA methods with the highest AUC of 0.954 in the efficacy label prediction and the best R2 of 0.834 in the regression of half maximal inhibitory concentration (IC50) values, suggesting the potential value of the proposed method in practice. • Propose a drug efficacy prediction method based on the cellular activity representation • The activity representation learned from a cell-gene network combining GRNs and expression profiles • The predictive ability of the activity representation depends on simulating the real biosystem. [ABSTRACT FROM AUTHOR]

Reliable large-scale cell detection and segmentation is the fundamental first step to understanding biological processes in the brain. The ability to phenotype cells at scale can accelerate preclinical drug evaluation and system-level brain histology studies. The impressive advances in deep learning offer a practical solution to cell image detection and segmentation. Unfortunately, categorizing cells and delineating their boundaries for training deep networks is an expensive process that requires skilled biologists. This paper presents a novel self-supervised Dual-Loss Adaptive Masked Autoencoder (DAMA) for learning rich features from multiplexed immunofluorescence brain images. DAMA's objective function minimizes the conditional entropy in pixel-level reconstruction and feature-level regression. Unlike existing self-supervised learning methods based on a random image masking strategy, DAMA employs a novel adaptive mask sampling strategy to maximize mutual information and effectively learn brain cell data. To the best of our knowledge, this is the first effort to develop a self-supervised learning method for multiplexed immunofluorescence brain images. Our extensive experiments demonstrate that DAMA features enable superior cell detection, segmentation, and classification performance without requiring many annotations. In addition, to examine the generalizability of DAMA, we also experimented on TissueNet, a multiplexed imaging dataset comprised of two-channel fluorescence images from six distinct tissue types, captured using six different imaging platforms. Our code is publicly available at https://github.com/hula-ai/DAMA. • We present a novel information-theoretic self-supervised method for multiplexed brain image analysis. Our theoretical analysis shows that the proposed objective function maximizes the mutual information between the input image and self-supervised labels. • We design the first adaptive mask sampling strategy for self-supervised learning models. We explain how this adaptive sampling helps the model focus on underrepresented features and improve the representation. • Extensive experiments on cell detection and classification are provided to validate the effectiveness of DAMA. [ABSTRACT FROM AUTHOR]

Proper insulin management is vital for maintaining stable blood sugar levels and preventing complications associated with diabetes. However, the soaring costs of insulin present significant challenges to ensuring affordable management. This paper conducts a comprehensive review of current literature on the application of machine learning (ML) in insulin management for diabetes patients, particularly focusing on enhancing affordability and accessibility within the United States. The review encompasses various facets of insulin management, including dosage calculation and response, prediction of blood glucose and insulin sensitivity, initial insulin estimation, resistance prediction, treatment adherence, complications, hypoglycemia prediction, and lifestyle modifications. Additionally, the study identifies key limitations in the utilization of ML within the insulin management literature and suggests future research directions aimed at furthering accessible and affordable insulin treatments. These proposed directions include exploring insurance coverage, optimizing insulin type selection, assessing the impact of biosimilar insulin and market competition, considering mental health factors, evaluating insulin delivery options, addressing cost-related issues affecting insulin usage and adherence, and selecting appropriate patient cost-sharing programs. By examining the potential of ML in addressing insulin management affordability and accessibility, this work aims to envision improved and cost-effective insulin management practices. It not only highlights existing research gaps but also offers insights into future directions, guiding the development of innovative solutions that have the potential to revolutionize insulin management and benefit patients reliant on this life-saving treatment. • Reviewing literature on application of machine learning for insulin management • Analyzing insulin affordability and accessibility aspects of insulin treatment • Identifying limitations and highlighting research gaps of existing literature • Proposing future research directions for improved affordable insulin care [ABSTRACT FROM AUTHOR]

Anaesthesia, crucial to surgical practice, is undergoing renewed scrutiny due to the integration of artificial intelligence in its medical use. The precise control over the temporary loss of consciousness is vital to ensure safe, pain-free procedures. Traditional methods of depth of anaesthesia (DoA) assessment, reliant on physical characteristics, have proven inconsistent due to individual variations. In response, electroencephalography (EEG) techniques have emerged, with indices such as the Bispectral Index offering quantifiable assessments. This literature review explores the current scope and frontier of DoA research, emphasising methods utilising EEG signals for effective clinical monitoring. This review offers a critical synthesis of recent advances, specifically focusing on electroencephalography (EEG) techniques and their role in enhancing clinical monitoring. By examining 117 high-impact papers, the review delves into the nuances of feature extraction, model building, and algorithm design in EEG-based DoA analysis. Comparative assessments of these studies highlight their methodological approaches and performance, including clinical correlations with established indices like the Bispectral Index. The review identifies knowledge gaps, particularly the need for improved collaboration for data access, which is essential for developing superior machine learning models and real-time predictive algorithms for patient management. It also calls for refined model evaluation processes to ensure robustness across diverse patient demographics and anaesthetic agents. The review underscores the potential of technological advancements to enhance precision, safety, and patient outcomes in anaesthesia, paving the way for a new standard in anaesthetic care. The findings of this review contribute to the ongoing discourse on the application of EEG in anaesthesia, providing insights into the potential for technological advancement in this critical area of medical practice. • Review of the current depth of anaesthesia analysis methods • Emphasis on machine learning techniques based on EEG signal analysis • Trends and future direction of EEG-based depth of anaesthesia analysis methods [ABSTRACT FROM AUTHOR]

The ongoing digital revolution in the healthcare sector, emphasized by bodies like the US Food and Drug Administration (FDA), is paving the way for a shift towards person-centric healthcare models. These models consider individual needs, turning patients from passive recipients to active participants. A key factor in this shift is Artificial Intelligence (AI), which has the capacity to revolutionize healthcare delivery due to its ability to personalize it. With the rise of software in healthcare and the proliferation of the Internet of Things (IoT), a surge of digital data is being produced. This data, alongside improvements in AI's explainability, is facilitating the spread of person-centric healthcare models, aiming at improving health management and patient experience. This paper outlines a human-centered methodology for the development of an AI-as-a-service platform with the goal of broadening access to personalized healthcare. This approach places humans at its core, aiming to augment, not replace, human capabilities and integrate in current processes. The primary research question guiding this study is: "How can Human-Centered AI principles be considered when designing an AI-as-a-service platform that democratizes access to personalized healthcare?" This informed both our research direction and investigation. Our approach involves a design fiction methodology, engaging clinicians from different domains to gather their perspectives on how AI can meet their needs by envisioning potential future scenarios and addressing possible ethical and social challenges. Additionally, we incorporate Meta-Design principles, investigating opportunities for users to modify the AI system based on their experiences. This promotes a platform that evolves with the user and considers many different perspectives. • Design fiction method effectively probes AI healthcare scenarios, illuminating challenges and opportunities. • Meta-design opportunities identified in personalizing AI-based healthcare interventions. • User journey maps reveal potential biases in AI decision-making and underscore ethical considerations. • AI integration in healthcare requires collaborative efforts between HCI researchers and clinicians. • Aggregated findings across case studies underscore the need for an AI-as-a-service platform prioritizing ethics and personalization. [ABSTRACT FROM AUTHOR]

This paper introduces a novel one-stage end-to-end detector specifically designed to detect small lesions in medical images. Precise localization of small lesions presents challenges due to their appearance and the diverse contextual backgrounds in which they are found. To address this, our approach introduces a new type of pixel-based anchor that dynamically moves towards the targeted lesion for detection. We refer to this new architecture as GravityNet, and the novel anchors as gravity points since they appear to be "attracted" by the lesions. We conducted experiments on two well-established medical problems involving small lesions to evaluate the performance of the proposed approach: microcalcifications detection in digital mammograms and microaneurysms detection in digital fundus images. Our method demonstrates promising results in effectively detecting small lesions in these medical imaging tasks. • Localization of small lesions is a challenge in several medical applications. • GravityNet is a one-stage end-to-end detector for small lesion detection. • Gravity points are a new type of pixel-based anchoring technique. • Gravity points are "attracted" by the targeted lesion for detection. • Experiments demonstrate promising results in detecting small lesions. [ABSTRACT FROM AUTHOR]

Medical imaging is an important tool for clinical diagnosis. Nevertheless, it is very time-consuming and error-prone for physicians to prepare imaging diagnosis reports. Therefore, it is necessary to develop some methods to generate medical imaging reports automatically. Currently, the task of medical imaging report generation is challenging in at least two aspects: (1) medical images are very similar to each other. The differences between normal and abnormal images and between different abnormal images are usually trivial; (2) unrelated or incorrect keywords describing abnormal findings in the generated reports lead to mis-communications. In this paper, we propose a medical image report generation framework composed of four modules, including a Transformer encoder, a MIX-MLP multi-label classification network, a co-attention mechanism (CAM) based semantic and visual feature fusion, and a hierarchical LSTM decoder. The Transformer encoder can be used to learn long-range dependencies between images and labels, effectively extract visual and semantic features of images, and establish long-term dependent relationships between visual and semantic information to accurately extract abnormal features from images. The MIX-MLP multi-label classification network, the co-attention mechanism and the hierarchical LSTM network can better identify abnormalities, achieving visual and text alignment fusion and multi-label diagnostic classification to better facilitate report generation. The results of the experiments performed on two widely used radiology report datasets, IU X-RAY and MIMIC-CXR, show that our proposed framework outperforms current report generation models in terms of both natural linguistic generation metrics and clinical efficacy assessment metrics. The code of this work is available online at https://github.com/watersunhznu/LIFMRG. • A label information fused medical image report generation framework. • ViT encoder based low-level feature extraction for medical image report generation. • A MIX-MLP based multi-label classification network for medical image tag classification. • A POS-SCAN based co-attention mechanism that aligns and fuses both visual information and semantic information. • The focal loss function for the multi-label classification network to address the problem of imbalanced and sparse label distribution. [ABSTRACT FROM AUTHOR]

This paper examines a kind of explainable AI, centered around what we term pro-hoc explanations , that is a form of support that consists of offering alternative explanations (one for each possible outcome) instead of a specific post-hoc explanation following specific advice. Specifically, our support mechanism utilizes explanations by examples , featuring analogous cases for each category in a binary setting. Pro-hoc explanations are an instance of what we called frictional AI , a general class of decision support aimed at achieving a useful compromise between the increase of decision effectiveness and the mitigation of cognitive risks, such as over-reliance, automation bias and deskilling. To illustrate an instance of frictional AI, we conducted an empirical user study to investigate its impact on the task of radiological detection of vertebral fractures in x-rays. Our study engaged 16 orthopedists in a 'human-first, second-opinion' interaction protocol. In this protocol, clinicians first made initial assessments of the x-rays without AI assistance and then provided their final diagnosis after considering the pro-hoc explanations. Our findings indicate that physicians, particularly those with less experience, perceived pro-hoc XAI support as significantly beneficial, even though it did not notably enhance their diagnostic accuracy. However, their increased confidence in final diagnoses suggests a positive overall impact. Given the promisingly high effect size observed, our results advocate for further research into pro-hoc explanations specifically, and into the broader concept of frictional AI. • Pro-hoc AI explanations aim to reduce over-reliance, not just give advice. • Study: 16 orthopedists assess pro-hoc explanations in fracture detection. • Introducing Frictional AI: Systems embedding cognitive friction for better decisions. • Pro-hoc XAI aids doctors, enhancing decision-making for novices without accuracy loss. • Research needed on pro-hoc explanations, Frictional AI for decision-making balance. [ABSTRACT FROM AUTHOR]

In the context of dementia care, Artificial Intelligence (AI) powered clinical decision support systems have the potential to enhance diagnosis and management. However, the scope and challenges of applying these technologies remain unclear. This scoping review aims to investigate the current state of AI applications in the development of intelligent decision support systems for dementia care. We conducted a comprehensive scoping review of empirical studies that utilised AI-powered clinical decision support systems in dementia care. The results indicate that AI applications in dementia care primarily focus on diagnosis, with limited attention to other aspects outlined in the World Health Organization (WHO) Global Action Plan on the Public Health Response to Dementia 2017–2025 (GAPD). A trifecta of challenges, encompassing data availability, cost considerations, and AI algorithm performance, emerges as noteworthy barriers in adoption of AI applications in dementia care. To address these challenges and enhance AI reliability, we propose a novel approach: a digital twin-based patient journey model. Future research should address identified gaps in GAPD action areas, navigate data-related obstacles, and explore the implementation of digital twins. Additionally, it is imperative to emphasize that addressing trust and combating the stigma associated with AI in healthcare should be a central focus of future research directions. • This paper examines the trajectory of AI-based CDSS application in dementia care. • It focuses on GAPD's seven action areas, highlighting AI's role in improving diagnosis and care. • It identifies limitations in data volume and cost as barriers to their development and usage in practice. • A model utilising digital twin technology is presented as a potential approach to addressing these identified limitations. [ABSTRACT FROM AUTHOR]

Named entity recognition (NER) is an important task for the natural language processing of biomedical text. Currently, most NER studies standardized biomedical text, but NER for unstandardized biomedical text draws less attention from researchers. Named entities in online biomedical text exist with errors and polymorphisms, which negatively impact NER models' performance and impede support from knowledge representation methods. In this paper, we propose a neural network method that can effectively recognize entities in unstandardized online medical/health text. We introduce a new pre-training scheme that uses large-scale online question-answering pairs to enhance transformers' model capacity on online biomedical text. Moreover, we supply models with knowledge representations from a knowledge base called multi-channel knowledge labels, and this method overcomes the restriction from languages, like Chinese, that require word segmentation tools to represent knowledge. Our model outperforms other baseline methods significantly in experiments on a dataset for Chinese online medical entity recognition and achieves state-of-the-art results. [Display omitted] [ABSTRACT FROM AUTHOR]

Sepsis is the third leading cause of death worldwide. Antibiotics are an important component in the treatment of sepsis. The use of antibiotics is currently facing the challenge of increasing antibiotic resistance (Evans et al., 2021). Sepsis medication prediction can be modeled as a Markov decision process, but existing methods fail to integrate with medical knowledge, making the decision process potentially deviate from medical common sense and leading to underperformance. (Wang et al., 2021). In this paper, we use Deep Q-Network (DQN) to construct a Sepsis Anti-infection DQN (SAI-DQN) model to address the challenge of determining the optimal combination and duration of antibiotics in sepsis treatment. By setting sepsis clinical knowledge as reward functions to guide DQN complying with medical guidelines, we formed personalized treatment recommendations for antibiotic combinations. The results showed that our model had a higher average value for decision-making than clinical decisions. For the test set of patients, our model predicts that 79.07% of patients will achieve a favorable prognosis with the recommended combination of antibiotics. By statistically analyzing decision trajectories and drug action selection, our model was able to provide reasonable medication recommendations that comply with clinical practices. Our model was able to improve patient outcomes by recommending appropriate antibiotic combinations in line with certain clinical knowledge. [Display omitted] • Using deep reinforcement learning to provide antibiotic treatment recommendations for sepsis. • Integrated with clinical data to formulate highly targeted antibiotic combination recommendations. • Guided by clinical expert knowledge and relevant medical guidelines. • Improving patient prognosis and reducing duration of antibiotic use. [ABSTRACT FROM AUTHOR]

Dysphonia is one of the early symptoms of Parkinson's disease (PD). Most existing methods use feature selection methods to find the optimal subset of voice features for all PD patients. Few have considered the heterogeneity between patients, which implies the need to provide specific prediction models for different patients. However, building the specific model faces the challenge of small sample size, which makes it lack generalization ability. Instance transfer is an effective way to solve this problem. Therefore, this paper proposes a patient-specific game-based transfer (PSGT) method for PD severity prediction. First, a selection mechanism is used to select PD patients with similar disease trends to the target patient from the source domain, which reduces the risk of negative transfer. Then, the contribution of the transferred subjects and their instances to the disease estimation of the target subject is fairly evaluated by the Shapley value, which improves the interpretability of the method. Next, the proportion of valid instances in the transferred subjects is determined, and the instances with higher contribution are transferred to further reduce the difference between the transferred instance subset and the target subject. Finally, the selected subset of instances is added to the training set of the target subject, and the extended data is fed into the random forest to improve the performance of the method. Parkinson's telemonitoring dataset is used to evaluate the feasibility and effectiveness. The mean values of mean absolute error, root mean square error, and volatility obtained by predicting motor-UPDRS and total-UPDRS for target patients are 1.59, 1.95, 1.56 and 1.98, 2.54, 1.94, respectively. Experiment results show that the PSGT has better performance in both prediction error and stability over compared methods. • A novel model is proposed to predict the severity of Parkinson's disease. • Subjects similar to target patients are selected by subject transfer mechanism. • Shapley value evaluates the contribution of transferred subjects and their instances. • We achieve better prediction performance compared to the state-of-the-art methods. [ABSTRACT FROM AUTHOR]

Predicting drug–disease associations can contribute to discovering new therapeutic potentials of drugs, and providing important association information for new drug research and development. Many existing drug–disease association prediction methods have not distinguished relevant background information for the same drug targeted to different diseases. Therefore, this paper proposes a drug–disease association prediction model based on graph convolutional network and graph attention network (GCNGAT) to reposition marketed drugs under the distinguishment of background information. Firstly, in order to obtain initial drug–disease information, a drug–disease heterogeneous graph structure is constructed based on all known drug–disease associations. Secondly, based on the heterogeneous graph structure, the corresponding subgraphs of each group of drug–disease association pairs are extracted to distinguish different background information for the same drug from different diseases. Finally, a model combining Graph neural network with global Average pooling (GnnAp) is designed to predict potential drug–disease associations by learning drug–disease interaction feature representations. The experimental results show that adding subgraph extraction can effectively improve the prediction performance of the model, and the graph representation learning module can fully extract the deep features of drug–disease. Using the 5-fold cross-validation, the proposed model (GCNGAT) achieves AUC (Area Under the receiver operating characteristic Curve) values of 0.9182 and 0.9417 on the PREDICT dataset and CDataset dataset, respectively. Compared with other predictors on the same dataset (PREDICT dataset), GCNGAT outperforms the existing best-performing model (PSGCN), with a 1.58% increase in the AUC value. It is anticipated that this model can provide experimental reference for drug repositioning and further promote the drug research and development process. • A drug–disease heterogeneous graph structure is constructed. • Subgraphs of association pairs are extracted to distinguish background information. • A model combining a graph convolution network and a graph attention network is built. [ABSTRACT FROM AUTHOR]

Image segmentation is one of the vital steps in medical image analysis. A large number of methods based on convolutional neural networks have emerged, which can extract abstract features from multiple-modality medical images, learn valuable information that is difficult to recognize by humans, and obtain more reliable results than traditional image segmentation approaches. U-Net, due to its simple structure and excellent performance, is widely used in medical image segmentation. In this paper, to further improve the performance of U-Net, we propose a channel and space compound attention (CSCA) convolutional neural network, CSCA U-Net in abbreviation, which increases the network depth and employs a double squeeze-and-excitation (DSE) block in the bottleneck layer to enhance feature extraction and obtain more high-level semantic features. Moreover, the characteristics of the proposed method are three-fold: (1) channel and space compound attention (CSCA) block, (2) cross-layer feature fusion (CLFF), and (3) deep supervision (DS). Extensive experiments on several available medical image datasets, including Kvasir-SEG, CVC-ClinicDB, CVC-ColonDB, ETIS, CVC-T, 2018 Data Science Bowl (2018 DSB), ISIC 2018, and JSUAH-Cerebellum, show that CSCA U-Net achieves competitive results and significantly improves generalization performance. The codes and trained models are available at https://github.com/xiaolanshu/CSCA-U-Net. • CSCA U-Net is a six-layer U-shaped network that enhances expressiveness. • CSCA U-Net achieves a greater receptive field at the bottleneck layer. • DSE enhances feature extraction ability and obtains more advanced semantic features. • CSCA block makes the model focus on target regions in the feature map. [ABSTRACT FROM AUTHOR]

Surgical process models support improving healthcare provision by facilitating communication and reasoning about processes in the medical domain. Modelling surgical processes is challenging as it requires integrating information that might be fragmented, scattered, and not process-oriented. These challenges can be faced by involving healthcare domain experts during process modelling. This paper presents ProDeM: a novel Process-Oriented Delphi Method for the systematic, asynchronous, and consensual modelling of surgical processes. ProDeM is an adaptable and flexible method that acknowledges that: (i) domain experts have busy calendars and might be geographically dispersed, and (ii) various elements of the process model need to be assessed to ensure model quality. The contribution of the paper is twofold as it outlines ProDeM, but also demonstrates its operationalisation in the context of a well-known surgical process. Besides showing the method's feasibility in practice, we also present an evaluation of the method by the experts involved in the demonstration. [ABSTRACT FROM AUTHOR]

Mental and physical disorders (MPD) are inextricably linked in many medical cases; psychosomatic diseases can be induced by mental concerns and psychological discomfort can ensue from physiological diseases. However, existing medical informatics studies focus on identifying mental or physical disorders from a unilateral perspective. Consequently, no existing domain knowledge base, corpus, or detection modeling approach considers mental as well as physical aspects concurrently. This paper proposes a joint modeling approach to detect MPD. First, we crawl through online medical consultation records of patients from websites and build an MPD knowledge ontology by extracting the core conceptual features of the text. Based on the ontology, an MPD knowledge graph containing 12,673 nodes and 82,195 relations is obtained using term matching with a domain thesaurus of each concept. Subsequently, an MPD corpus with fine-grained severities (None , Mild , Moderate , Severe , Dangerous) and 8909 records is constructed by formulating MPD classification criteria and a data annotation process under the guidance of domain experts. Taking the knowledge graph and corpus as the dataset, we design a multi-task learning model to detect the MPD severity, in which a knowledge graph attention network (KGAT) is embedded to better extract knowledge features. Experiments are performed to demonstrate the effectiveness of our model. Furthermore, we employ ontology-based and centrality-based methods to discover additional potential inferred knowledge, which can be captured by KGAT so as to improve the prediction performance and interpretability of our model. Our dataset has been made publicly available, so it can be further used as a medical informatics reference in the fields of psychosomatic medicine, psychiatrics, physical co-morbidity, and so on. • We construct the first corpus combining the fine-grained severity of mental disorders and physical disorders. • We are the first to construct a large-scale mental and physical disorder knowledge graph. • We present a multi-task learning model to automatically detect the mental and physical disorder severity of patients. [ABSTRACT FROM AUTHOR]

Diabetic Retinopathy (DR), an ocular complication of diabetes, is a leading cause of blindness worldwide. Traditionally, DR is monitored using Color Fundus Photography (CFP), a widespread 2-D imaging modality. However, DR classifications based on CFP have poor predictive power, resulting in suboptimal DR management. Optical Coherence Tomography Angiography (OCTA) is a recent 3-D imaging modality offering enhanced structural and functional information (blood flow) with a wider field of view. This paper investigates automatic DR severity assessment using 3-D OCTA. A straightforward solution to this task is a 3-D neural network classifier. However, 3-D architectures have numerous parameters and typically require many training samples. A lighter solution consists in using 2-D neural network classifiers processing 2-D en-face (or frontal) projections and/or 2-D cross-sectional slices. Such an approach mimics the way ophthalmologists analyze OCTA acquisitions: (1) en-face flow maps are often used to detect avascular zones and neovascularization, and (2) cross-sectional slices are commonly analyzed to detect macular edemas, for instance. However, arbitrary data reduction or selection might result in information loss. Two complementary strategies are thus proposed to optimally summarize OCTA volumes with 2-D images: (1) a parametric en-face projection optimized through deep learning and (2) a cross-sectional slice selection process controlled through gradient-based attribution. The full summarization and DR classification pipeline is trained from end to end. The automatic 2-D summary can be displayed in a viewer or printed in a report to support the decision. We show that the proposed 2-D summarization and classification pipeline outperforms direct 3-D classification with the advantage of improved interpretability. • An algorithm to quickly and efficiently classify 3-D images is presented. • 3-D images are summarized by one or a few 2-D images as an intermediate step. • The pipeline is trained from end to end: the 2-D summary is thus problem-specific. • This multiview 2-D summarization allows interpretability and knowledge discovery. • It is applied to diabetic retinopathy severity assessment using OCT angiography. [ABSTRACT FROM AUTHOR]

Since different disease grades require different treatments from physicians, i.e., the low-grade patients may recover with follow-up observations whereas the high-grade may need immediate surgery, the accuracy of disease grading is pivotal in clinical practice. In this paper, we propose a Triplet-Branch Network with ContRastive priOr-knoWledge embeddiNg (TBN-CROWN) for the accurate disease grading, which enables physicians to accordingly take appropriate treatments. Specifically, our TBN-CROWN has three branches, which are implemented for representation learning, classifier learning and grade-related prior-knowledge learning, respectively. The former two branches deal with the issue of class-imbalanced training samples, while the latter one embeds the grade-related prior-knowledge via a novel auxiliary module, termed contrastive embedding module. The proposed auxiliary module takes the features embedded by different branches as input, and accordingly constructs positive and negative embeddings for the model to deploy grade-related prior-knowledge via contrastive learning. Extensive experiments on our private and two publicly available disease grading datasets show that our TBN-CROWN can effectively tackle the class-imbalance problem and yield a satisfactory grading accuracy for various diseases, such as fatigue fracture, ulcerative colitis, and diabetic retinopathy. [Display omitted] • The auxiliary ranking task in previous TBN is improved to a novel contrastive embedding module. • The proposed TBN-CROWN is validated on the publicly available ulcerative colitis grading dataset. • This is the first work trying to develop an automated system for fatigue fracture diagnosis. [ABSTRACT FROM AUTHOR]

Deep learning methods have shown great potential in processing multi-modal Magnetic Resonance Imaging (MRI) data, enabling improved accuracy in brain tumor segmentation. However, the performance of these methods can suffer when dealing with incomplete modalities, which is a common issue in clinical practice. Existing solutions, such as missing modality synthesis, knowledge distillation, and architecture-based methods, suffer from drawbacks such as long training times, high model complexity, and poor scalability. This paper proposes IMS2Trans, a novel lightweight scalable Swin Transformer network by utilizing a single encoder to extract latent feature maps from all available modalities. This unified feature extraction process enables efficient information sharing and fusion among the modalities, resulting in efficiency without compromising segmentation performance even in the presence of missing modalities. Two datasets, BraTS 2018 and BraTS 2020, containing incomplete modalities for brain tumor segmentation are evaluated against popular benchmarks. On the BraTS 2018 dataset, our model achieved higher average Dice similarity coefficient (DSC) scores for the whole tumor, tumor core, and enhancing tumor regions (86.57, 75.67, and 58.28, respectively), in comparison with a state-of-the-art model, i.e. mmFormer (86.45, 75.51, and 57.79, respectively). Similarly, on the BraTS 2020 dataset, our model scored higher DSC scores in these three brain tumor regions (87.33, 79.09, and 62.11, respectively) compared to mmFormer (86.17, 78.34, and 60.36, respectively). We also conducted a Wilcoxon test on the experimental results, and the generated p -value confirmed that our model's performance was statistically significant. Moreover, our model exhibits significantly reduced complexity with only 4.47 M parameters, 121.89G FLOPs, and a model size of 77.13 MB, whereas mmFormer comprises 34.96 M parameters, 265.79 G FLOPs, and a model size of 559.74 MB. These indicate our model, being light-weighted with significantly reduced parameters, is still able to achieve better performance than a state-of-the-art model. By leveraging a single encoder for processing the available modalities, IMS2Trans offers notable scalability advantages over methods that rely on multiple encoders. This streamlined approach eliminates the need for maintaining separate encoders for each modality, resulting in a lightweight and scalable network architecture. The source code of IMS2Trans and the associated weights are both publicly available at https://github.com/hudscomdz/IMS2Trans. • We propose a scalable Swin Transformer for the incomplete MRI modalities brain tumor segmentation. • We introduce a lightweight MLP bottleneck that not only reduces model parameters but also obtains better feature maps. • We introduce a feature distillation to improve consistency across different modalities. • We propose a 3D multimodal CutMix specifically for multi-modal MRI to enhance the robustness. [ABSTRACT FROM AUTHOR]

The healthcare sector, characterized by vast datasets and many diseases, is pivotal in shaping community health and overall quality of life. Traditional healthcare methods, often characterized by limitations in disease prevention, predominantly react to illnesses after their onset rather than proactively averting them. The advent of Artificial Intelligence (AI) has ushered in a wave of transformative applications designed to enhance healthcare services, with Machine Learning (ML) as a noteworthy subset of AI. ML empowers computers to analyze extensive datasets, while Deep Learning (DL), a specific ML methodology, excels at extracting meaningful patterns from these data troves. Despite notable technological advancements in recent years, the full potential of these applications within medical contexts remains largely untapped, primarily due to the medical community's cautious stance toward novel technologies. The motivation of this paper lies in recognizing the pivotal role of the healthcare sector in community well-being and the necessity for a shift toward proactive healthcare approaches. To our knowledge, there is a notable absence of a comprehensive published review that delves into ML, DL and distributed systems, all aimed at elevating the Quality of Service (QoS) in healthcare. This study seeks to bridge this gap by presenting a systematic and organized review of prevailing ML, DL, and distributed system algorithms as applied in healthcare settings. Within our work, we outline key challenges that both current and future developers may encounter, with a particular focus on aspects such as approach, data utilization, strategy, and development processes. Our study findings reveal that the Internet of Things (IoT) stands out as the most frequently utilized platform (44.3 %), with disease diagnosis emerging as the predominant healthcare application (47.8 %). Notably, discussions center significantly on the prevention and identification of cardiovascular diseases (29.2 %). The studies under examination employ a diverse range of ML and DL methods, along with distributed systems, with Convolutional Neural Networks (CNNs) being the most commonly used (16.7 %), followed by Long Short-Term Memory (LSTM) networks (14.6 %) and shallow learning networks (12.5 %). In evaluating QoS, the predominant emphasis revolves around the accuracy parameter (80 %). This study highlights how ML, DL, and distributed systems reshape healthcare. It contributes to advancing healthcare quality, bridging the gap between technology and medical adoption, and benefiting practitioners and patients. • Conducting a systematic review of available technologies for enhancing healthcare QoS; • Performing a thorough analysis of current challenges related to DL methods in the healthcare sector; • Exploring novel applications of AI in healthcare; • Investigating the impact of regulatory changes on healthcare technology adoption; • Evaluating each platform of distributed systems by highlighting various attributes, including advantages, challenges, datasets and dataset size, usages, privacy, and security; • Describing vital aspects where the preceding strategies may be improved shortly;•Investigating emerging trends in healthcare technology; • Assessing the scalability of distributed systems in healthcare applications. [ABSTRACT FROM AUTHOR]

Alzheimer's Disease is the most common cause of dementia, whose progression spans in different stages, from very mild cognitive impairment to mild and severe conditions. In clinical trials, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) are mostly used for the early diagnosis of neurodegenerative disorders since they provide volumetric and metabolic function information of the brain, respectively. In recent years, Deep Learning (DL) has been employed in medical imaging with promising results. Moreover, the use of the deep neural networks, especially Convolutional Neural Networks (CNNs), has also enabled the development of DL-based solutions in domains characterized by the need of leveraging information coming from multiple data sources, raising the Multimodal Deep Learning (MDL). In this paper, we conduct a systematic analysis of MDL approaches for dementia severity assessment exploiting MRI and PET scans. We propose a Multi Input–Multi Output 3D CNN whose training iterations change according to the characteristic of the input as it is able to handle incomplete acquisitions, in which one image modality is missed. Experiments performed on OASIS-3 dataset show the satisfactory results of the implemented network, which outperforms approaches exploiting both single image modality and different MDL fusion techniques. [Display omitted] • Evaluation of multimodal deep learning approaches for dementia severity assessment. • Training strategy to manage incomplete dataset in multimodal deep learning. • Multi input-multi output 3D CNN to process brain MRI and PET acquisitions. [ABSTRACT FROM AUTHOR]