Search

A crucial bottleneck in medical artificial intelligence (AI) is high-quality labeled medical datasets. In this paper, we test a large variety of wisdom of the crowd algorithms to label medical images that were initially classified by individuals recruited through an app-based platform. Individuals classified skin lesions from the International Skin Lesion Challenge 2018 into 7 different categories. There was a large dispersion in the geographical location, experience, training, and performance of the recruited individuals. We tested several wisdom of the crowd algorithms of varying complexity from a simple unweighted average to more complex Bayesian models that account for individual patterns of errors. Using a switchboard analysis, we observe that the best-performing algorithms rely on selecting top performers, weighting decisions by training accuracy, and take into account the task environment. These algorithms far exceed expert performance. We conclude by discussing the implications of these approaches for the development of medical AI.

Antimicrobial resistance has become a critical global health problem due to the abuse of conventional antibiotics and the rise of multi-drug-resistant microbes. Antimicrobial peptides (AMPs) are a group of natural peptides that show promise as next-generation antibiotics due to their low toxicity to the host, broad spectrum of biological activity, including antibacterial, antifungal, antiviral, and anti-parasitic activities, and great therapeutic potential, such as anticancer, anti-inflammatory, etc. Most importantly, AMPs kill bacteria by damaging cell membranes using multiple mechanisms of action rather than targeting a single molecule or pathway, making it difficult for bacterial drug resistance to develop. However, experimental approaches used to discover and design new AMPs are very expensive and time-consuming. In recent years, there has been considerable interest in using in silico methods, including traditional machine learning (ML) and deep learning (DL) approaches, to drug discovery. While there are a few papers summarizing computational AMP prediction methods, none of them focused on DL methods. In this review, we aim to survey the latest AMP prediction methods achieved by DL approaches. First, the biology background of AMP is introduced, then various feature encoding methods used to represent the features of peptide sequences are presented. We explain the most popular DL techniques and highlight the recent works based on them to classify AMPs and design novel peptide sequences. Finally, we discuss the limitations and challenges of AMP prediction. [ABSTRACT FROM AUTHOR]

The global rise in heart disease necessitates precise prediction tools to assess individual risk levels. This paper introduces a novel Multi-Objective Artificial Bee Colony Optimized Hybrid Deep Belief Network and XGBoost (HDBN-XG) algorithm, enhancing coronary heart disease prediction accuracy. Key physiological data, including Electrocardiogram (ECG) readings and blood volume measurements, are analyzed. The HDBN-XG algorithm assesses data quality, normalizes using z-score values, extracts features via the Computational Rough Set method, and constructs feature subsets using the Multi-Objective Artificial Bee Colony approach. Our findings indicate that the HDBN-XG algorithm achieves an accuracy of 99%, precision of 95%, specificity of 98%, sensitivity of 97%, and F1-measure of 96%, outperforming existing classifiers. This paper contributes to predictive analytics by offering a data-driven approach to healthcare, providing insights to mitigate the global impact of coronary heart disease.

Background: Classifications of AAFD/PCFD have evolved with an increased understanding of the pathology involved. A review of classification systems helps identify deficiencies and respective contributions to the evolution in understanding the classification of AAFD/PCFD. Methods: Using multiple electronic database searches (Medline, PubMed) and Google search, original papers classifying AAFD/PCFD were identified. Nine original papers were identified that met the inclusion criteria. Results: Johnson’s original classification and multiple variants provided a significant leap in understanding and communicating the pathology but remained tibialis posterior tendon-focused. Drawbacks of these classifications include the implication of causality, linearity of progression through stages, an oversimplification of stage 2 deformity, and a failure to understand that multiple tendons react, not just tibialis posterior. Later classifications, such as the PCFD classification, are deformity-centric. Early ligament laxity/instability in normal attitude feet and all stages of cavus feet can present with pain and instability with minor/no deformity. These may not be captured in deformity-based classifications. The authors developed the ‘Triple Classification’ (TC) understanding that primary pathology is a progressive ligament failure/laxity that presents as tendon reactivity, deformity, and painful impingement, variably manifested depending on starting foot morphology. In this classification, starting foot morphology is typed, ligament laxities are staged, and deformity is zoned. Conclusions: This review has used identified deficiencies within classification systems for AAFD/PCFD to delink ligament laxity, deformity, and foot type and develop the ‘Triple classification’. Advantages of the TC may include representing foot types with no deformity, defining complex secondary instabilities, delinking foot types, tendon reactivity/ligament instability, and deformity to represent these independently in a new classification system. Level of Evidence: Level V.

Background: Diabetes mellitus (DM) is a chronic condition that can lead to a variety of consequences. Diabetes is a condition that is caused by factors such as age, lack of exercise, sedentary lifestyle, family history of diabetes, high blood pressure, depression and stress, poor food, and so on. Diabetics are at a higher risk of developing diseases such as heart disease, nerve damage (diabetic neuropathy), eye problems (diabetic retinopathy), kidney disease (diabetic nephropathy), stroke, and so on. According to the International Diabetes Federation, 382 million people worldwide suffer from diabetes. By 2035, this number will have risen to 592 million. Every day, a large number of people become victims, and many are ignorant whether they have it or not. It primarily affects individuals between the ages of 25 and 74 years. If diabetes is left untreated and undiagnosed, it can lead to a slew of complications. The emergence of machine learning approaches, on the other hand, solves this crucial issue. Aims and Objectives: The aim was to study the DM and analyze how machine learning algorithms are used to identify the diabetes mellitus at an early stage, which is one of the most serious metabolic disorders in the world today. Methods and Materials: Data was obtained from databases such as Pubmed, IEEE xplore, and INSPEC,and from other secondary sources and primary sources in which methods based on machine learning approaches used in healthcare to predict diabetes at an early stage are reported. Results: After surveying various research papers, it was found that machine learning classification algorithms like Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and Random Forest (RF) etc shows the best accuracy for predicting diabetes at an early stage. Conclusion: Early detection of diabetes is critical for effective therapy. Many people have no idea whether or not they have it. The full assessment of Machine learning approaches for early diabetes prediction and how to apply a variety of supervised and unsupervised machine learning algorithms to the dataset to achieve the best accuracy are addressed in this paper.. Furthermore, the work will be expanded and refined to create a more precise and general predictive model for diabetes risk prediction at an early stage. Different metrics can be used to assess performance and for accurate diabetic diagnosis.

Background: During the process of the treatment of COVID-19 hospitalized patients, physicians still face a lot of unknowns and problems. Despite the application of the treatment protocol, it is still unknown why the medical status of a certain number of patients worsens and ends with death. Many factors were analyzed for the prediction of the clinical outcome of the patients using different methods. The aim of this paper was to develop a prediction model based on initial laboratory blood test results, accompanying comorbidities, and demographics to help physicians to better understand the medical state of patients with respect to possible clinical outcomes using neural networks, hypothesis testing, and confidence intervals. Methods: The research had retrospective-prospective, descriptive, and analytical character. As inputs for this research, 12 components of laboratory blood test results, six accompanying comorbidities, and demographics (age and gender) data were collected from hospital information system in Sarajevo for each patient from a sample of 634 hospitalized patients. Clinical outcome of the hospitalized patients, survival or death, was recorded 30 days after admission to the hospital. The prediction model was designed using a neural network. In addition, formal hypothesis tests were performed to investigate whether there were significant differences in laboratory blood test results and age between patients who died and those who survived, including the construction of 95% confidence intervals. Results: In this paper, 11 neural networks were developed with different threshold values to determine the optimal neural network with the highest prediction performance. The performances of the neural networks were evaluated by accuracy, precision, sensitivity, and specificity. Optimal neural network model evaluation metrics are: accuracy = 87.78%, precision = 96.37%, sensitivity = 90.07%, and specificity = 62.16%. Significantly higher values (P < 0.05) of blood laboratory result components and age were detected in patients who died. Conclusion: Optimal neural network model, results of hypothesis tests, and confidence intervals could help to predict, analyze, and better understand the medical state of COVID-19 hospitalized patients and thus reduce the mortality rate.

Abstract The COVID-19 pandemic has had a significant impact on students’ academic performance. The effects of the pandemic have varied among students, but some general trends have emerged. One of the primary challenges for students during the pandemic has been the disruption of their study habits. Students getting used to online learning routines might find it even more challenging to perform well in face to face learning. Therefore, assessing various potential risk factors associated with students low performance and its prediction is important for early intervention. As students’ performance data encompass diverse behaviors, standard machine learning methods find it hard to get useful insights for beneficial practical decision making and early interventions. Therefore, this research explores regularized ensemble learning methods for effectively analyzing students’ performance data and reaching valid conclusions. To this end, three pruning strategies are implemented for the random forest method. These methods are based on out-of-bag sampling, sub-sampling and sub-bagging. The pruning strategies discard trees that are adversely affected by the unusual patterns in the students data forming forests of accurate and diverse trees. The methods are illustrated on an example data collected from university students currently studying on campus in a face-to-face modality, who studied during the COVID-19 pandemic through online learning. The suggested methods outperform all the other methods considered in this paper for predicting students at the risk of academic failure. Moreover, various factors such as class attendance, students interaction, internet connectivity, pre-requisite course(s) during the restrictions, etc., are identified as the most significant features.

Abstract Alzheimer’s disease (AD), the predominant form of dementia, is a growing global challenge, emphasizing the urgent need for accurate and early diagnosis. Current clinical diagnoses rely on radiologist expert interpretation, which is prone to human error. Deep learning has thus far shown promise for early AD diagnosis. However, existing methods often overlook focal structural atrophy critical for enhanced understanding of the cerebral cortex neurodegeneration. This paper proposes a deep learning framework that includes a novel structure-focused neurodegeneration CNN architecture named SNeurodCNN and an image brightness enhancement preprocessor using gamma correction. The SNeurodCNN architecture takes as input the focal structural atrophy features resulting from segmentation of brain structures captured through magnetic resonance imaging (MRI). As a result, the architecture considers only necessary CNN components, which comprises of two downsampling convolutional blocks and two fully connected layers, for achieving the desired classification task, and utilises regularisation techniques to regularise learnable parameters. Leveraging mid-sagittal and para-sagittal brain image viewpoints from the Alzheimer’s disease neuroimaging initiative (ADNI) dataset, our framework demonstrated exceptional performance. The para-sagittal viewpoint achieved 97.8% accuracy, 97.0% specificity, and 98.5% sensitivity, while the mid-sagittal viewpoint offered deeper insights with 98.1% accuracy, 97.2% specificity, and 99.0% sensitivity. Model analysis revealed the ability of SNeurodCNN to capture the structural dynamics of mild cognitive impairment (MCI) and AD in the frontal lobe, occipital lobe, cerebellum, temporal, and parietal lobe, suggesting its potential as a brain structural change digi-biomarker for early AD diagnosis. This work can be reproduced using code we made available on GitHub.

Abstract As a preprocessing for machine learning and data mining, Feature Selection plays an important role. Feature selection aims to streamline high-dimensional data by eliminating irrelevant and redundant features, which reduces the potential curse of dimensionality of a given large dataset. When working with datasets containing many features, algorithms that aim to identify the most valuable features to improve dataset accuracy may encounter difficulties because of local optima. Many studies have been conducted to solve this problem. One of the solutions is to use meta-heuristic techniques. This paper presents a combination of the Differential evolution and the sailfish optimizer algorithms (DESFO) to tackle the feature selection problem. To assess the effectiveness of the proposed algorithm, a comparison between Differential Evolution, sailfish optimizer, and nine other modern algorithms, including different optimization algorithms, is presented. The evaluation used Random forest and key nearest neighbors as quality measures. The experimental results show that the proposed algorithm is a superior algorithm compared to others. It significantly impacts high classification accuracy, achieving 85.7% with the Random Forest classifier and 100% with the Key Nearest Neighbors classifier across 14 multi-scale benchmarks. According to fitness values, it gained 71% with the Random forest and 85.7% with the Key Nearest Neighbors classifiers.

Machine learning (ML) can enhance a dermatologist’s work, from diagnosis to customized care. The development of ML algorithms in dermatology has been supported lately regarding links to digital data processing (e.g., electronic medical records, Image Archives, omics), quicker computing and cheaper data storage. This article describes the fundamentals of ML-based implementations, as well as future limits and concerns for the production of skin cancer detection and classification systems. We also explored five fields of dermatology using deep learning applications: (1) the classification of diseases by clinical photos, (2) der moto pathology visual classification of cancer, and (3) the measurement of skin diseases by smartphone applications and personal tracking systems. This analysis aims to provide dermatologists with a guide that helps demystify the basics of ML and its different applications to identify their possible challenges correctly. This paper surveyed studies on skin cancer detection using deep learning to assess the features and advantages of other techniques. Moreover, this paper also defined the basic requirements for creating a skin cancer detection application, which revolves around two main issues: the full segmentation image and the tracking of the lesion on the skin using deep learning. Most of the techniques found in this survey address these two problems. Some of the methods also categorize the type of cancer too.

Abstract A paper published in Orphanet Journal of Rare Diseases proposes a new classification of osteogenesis imperfecta (OI) based upon underlying pathological mechanisms. The proposed numbering of OI types conflicts with the currently used numbering and is likely to lead to confusion. In addition, classification of OI according to underlying pathogenic mechanisms is not novel.

Abstract Though COVID-19 is no longer a pandemic but rather an endemic, the epidemiological situation related to the SARS-CoV-2 virus is developing at an alarming rate, impacting every corner of the world. The rapid escalation of the coronavirus has led to the scientific community engagement, continually seeking solutions to ensure the comfort and safety of society. Understanding the joint impact of medical and non-medical interventions on COVID-19 spread is essential for making public health decisions that control the pandemic. This paper introduces two novel hybrid machine-learning ensembles that combine supervised and unsupervised learning for COVID-19 data classification and regression. The study utilizes publicly available COVID-19 outbreak and potential predictive features in the USA dataset, which provides information related to the outbreak of COVID-19 disease in the US, including data from each of 3142 US counties from the beginning of the epidemic (January 2020) until June 2021. The developed hybrid hierarchical classifiers outperform single classification algorithms. The best-achieved performance metrics for the classification task were Accuracy = 0.912, ROC-AUC = 0.916, and F1-score = 0.916. The proposed hybrid hierarchical ensemble combining both supervised and unsupervised learning allows us to increase the accuracy of the regression task by 11% in terms of MSE, 29% in terms of the area under the ROC, and 43% in terms of the MPP metric. Thus, using the proposed approach, it is possible to predict the number of COVID-19 cases and deaths based on demographic, geographic, climatic, traffic, public health, social-distancing-policy adherence, and political characteristics with sufficiently high accuracy. The study reveals that virus pressure is the most important feature in COVID-19 spread for classification and regression analysis. Five other significant features were identified to have the most influence on COVID-19 spread. The combined ensembling approach introduced in this study can help policymakers design prevention and control measures to avoid or minimize public health threats in the future.

Abstract Artificial Neural Networks (ANNs) have been used in a multitude of real-world applications given their predictive capabilities, and algorithms based on gradient descent, such as Backpropagation (BP) and variants, are usually considered for their optimisation. However, these algorithms have been shown to get stuck at local optima, and they require a cautious design of the architecture of the model. This paper proposes a novel memetic training method for simultaneously learning the ANNs structure and weights based on the Coral Reef Optimisation algorithms (CROs), a global-search metaheuristic based on corals’ biology and coral reef formation. Three versions based on the original CRO combined with a Local Search procedure are developed: (1) the basic one, called Memetic CRO; (2) a statistically guided version called Memetic SCRO (M-SCRO) that adjusts the algorithm parameters based on the population fitness; (3) and, finally, an improved Dynamic Statistically-driven version called Memetic Dynamic SCRO (M-DSCRO). M-DSCRO is designed with the idea of improving the M-SCRO version in the evolutionary process, evaluating whether the fitness distribution of the population of ANNs is normal to automatically decide the statistic to be used for assigning the algorithm parameters. Furthermore, all algorithms are adapted to the design of ANNs by means of the most suitable operators. The performance of the different algorithms is evaluated with 40 classification datasets, showing that the proposed M-DSCRO algorithm outperforms the other two versions on most of the datasets. In the final analysis, M-DSCRO is compared against four state-of-the-art methods, demonstrating its superior efficacy in terms of overall accuracy and minority class performance.

Analysis of long-term multichannel EEG signals for automatic seizure detection is an active area of research that has seen application of methods from different domains of signal processing and machine learning. The majority of approaches developed in this context consist of extraction of hand-crafted features that are used to train a classifier for eventual seizure detection. Approaches that are data-driven, do not use hand-crafted features, and use small amounts of patients' historical EEG data for classifier training are few in number. The approach presented in this paper falls in the latter category, and is based on a signal-derived empirical dictionary approach, which utilizes empirical mode decomposition (EMD) and discrete wavelet transform (DWT) based dictionaries learned using a framework inspired by traditional methods of dictionary learning. Three features associated with traditional dictionary learning approaches, namely projection coefficients, coefficient vector and reconstruction error, are extracted from both EMD and DWT based dictionaries for automated seizure detection. This is the first time these features have been applied for automatic seizure detection using an empirical dictionary approach. Small amounts of patients' historical multi-channel EEG data are used for classifier training, and multiple classifiers are used for seizure detection using newer data. In addition, the seizure detection results are validated using 5-fold cross-validation to rule out any bias in the results. The CHB-MIT benchmark database containing long-term EEG recordings of pediatric patients is used for validation of the approach, and seizure detection performance comparable to the state-of-the-art is obtained. Seizure detection is performed using five classifiers, thereby allowing a comparison of the dictionary approaches, features extracted, and classifiers used. The best seizure detection performance is obtained using EMD based dictionary and reconstruction error feature and support vector machine classifier, with accuracy, sensitivity and specificity values of 88.2, 90.3, and 88.1%, respectively. Comparison is also made with other recent studies using the same database. The methodology presented in this paper is shown to be computationally efficient and robust for patient-specific automatic seizure detection. A data-driven methodology utilizing a small amount of patients' historical data is hence demonstrated as a practical solution for automatic seizure detection.

We propose a new pruning constraint when mining frequent temporal patterns to be used as classification and prediction features, the Semantic Adjacency Criterion [SAC], which filters out temporal patterns that contain potentially semantically contradictory components, exploiting each medical domain's knowledge. We have defined three SAC versions and tested them within three medical domains (oncology, hepatitis, diabetes) and a frequent-temporal-pattern discovery framework. Previously, we had shown that using SAC enhances the repeatability of discovering the same temporal patterns in similar proportions in different patient groups within the same clinical domain. Here, we focused on SAC's computational implications for pattern discovery, and for classification and prediction, using the discovered patterns as features, by four different machine-learning methods: Random Forests, Naïve Bayes, SVM, and Logistic Regression. Using SAC resulted in a significant reduction, across all medical domains and classification methods, of up to 97% in the number of discovered temporal patterns, and in the runtime of the discovery process, of up to 98%. Nevertheless, the highly reduced set of only semantically transparent patterns, when used as features, resulted in classification and prediction models whose performance was at least as good as the models resulting from using the complete temporal-pattern set. [ABSTRACT FROM AUTHOR]

Background Glaucoma and diabetic retinopathy (DR) are the leading causes of irreversible retinal damage leading to blindness. Early detection of these diseases through regular screening is especially important to prevent progression. Retinal fundus imaging serves as the principal method for diagnosing glaucoma and DR. Consequently, automated detection of eye diseases represents a significant application of retinal image analysis. Compared with classical diagnostic techniques, image classification by convolutional neural networks (CNN) exhibits potential for effective eye disease detection. Methods This paper proposes the use of MATLAB – retrained AlexNet CNN for computerized eye diseases identification, particularly glaucoma and diabetic retinopathy, by employing retinal fundus images. The acquisition of the database was carried out through free access databases and access upon request. A transfer learning technique was employed to retrain the AlexNet CNN for non-disease (Non_D), glaucoma (Sus_G) and diabetic retinopathy (Sus_R) classification. Moreover, model benchmarking was conducted using ResNet50 and GoogLeNet architectures. A Grad-CAM analysis is also incorporated for each eye condition examined. Results Metrics for validation accuracy, false positives, false negatives, precision, and recall were reported. Validation accuracies for the NetTransfer (I-V) and netAlexNet ranged from 89.7% to 94.3%, demonstrating varied effectiveness in identifying Non_D, Sus_G, and Sus_R categories, with netAlexNet achieving a 93.2% accuracy in the benchmarking of models against netResNet50 at 93.8% and netGoogLeNet at 90.4%. Conclusions This study demonstrates the efficacy of using a MATLAB-retrained AlexNet CNN for detecting glaucoma and diabetic retinopathy. It emphasizes the need for automated early detection tools, proposing CNNs as accessible solutions without replacing existing technologies.

Abstract Osteogenesis imperfecta (OI) is a connective tissue disorder affecting the skeleton and other organs, which has multiple genetic patterns, numerous causative genes, and complex pathogenic mechanisms. The previous classifications lack structure and scientific basis and have poor applicability. In this paper, we summarize and sort out the pathogenic mechanisms of OI, and analyze the molecular pathogenic mechanisms of OI from the perspectives of type I collagen defects(synthesis defects, processing defects, post-translational modification defects, folding and cross-linking defects), bone mineralization disorders, osteoblast differentiation and functional defects respectively, and also generalize several new untyped OI-causing genes and their pathogenic mechanisms, intending to provide the evidence of classification and a scientific basis for the precise diagnosis and treatment of OI.

AbstractBackground The endoscopic Hill classification of the gastroesophageal flap valve (GEFV) is of great importance for understanding the functional status of the esophagogastric junction (EGJ). Deep learning (DL) methods have been extensively employed in the area of digestive endoscopy. To improve the efficiency and accuracy of the endoscopist’s Hill classification and assist in incorporating it into routine endoscopy reports and GERD assessment examinations, this study first employed DL to establish a four-category model based on the Hill classification.Materials and Methods A dataset consisting of 3256 GEFV endoscopic images has been constructed for training and evaluation. Furthermore, a new attention mechanism module has been provided to improve the performance of the DL model. Combined with the attention mechanism module, numerous experiments were conducted on the GEFV endoscopic image dataset, and 12 mainstream DL models were tested and evaluated. The classification accuracy of the DL model and endoscopists with different experience levels was compared.Results 12 mainstream backbone networks were trained and tested, and four outstanding feature extraction backbone networks (ResNet-50, VGG-16, VGG-19, and Xception) were selected for further DL model development. The ResNet-50 showed the best Hill classification performance; its area under the curve (AUC) reached 0.989, and the classification accuracy (93.39%) was significantly higher than that of junior (74.83%) and senior (78.00%) endoscopists.Conclusions The DL model combined with the attention mechanism module in this paper demonstrated outstanding classification performance based on the Hill grading and has great potential for improving the accuracy of the Hill classification by endoscopists.

The detection and classification of traumatic brain injury (TBI) by medical professionals can vary due to subjectivity and differences in experience. Thus, a computational approach for detecting and classifying TBI would be invaluable for an objective diagnosis of this injury. In this review paper, various machine learning algorithms used to detect, classify, and predict the severity and outcomes of TBI in a clinical setting are discussed. The most promising of these algorithms is the convolutional neural network (CNN), which is highlighted in the review.

In the human body, white blood cells (WBCs) are crucial immune cells that help in the early detection of a variety of illnesses. Determination of the number of WBCs can be used to diagnose conditions such as hematological, immunological, and autoimmune diseases, as well as AIDS and leukemia. However, the conventional method of classifying and counting WBCs is time-consuming, laborious, and potentially erroneous. Therefore, this paper presents a computer-assisted automated method for recognizing and detecting WBC categories from blood images. Initially, the blood cell image is preprocessed and then segmented using an effective deep learning architecture called SegNet. Then, the important features are devised and extracted using the EfficientNet architecture. Finally, the WBCs are categorized into four different types using the XGBoost classifier: neutrophils, eosinophils, monocytes, and lymphocytes. The advantages of SegNet, EfficientNet, and XGBoost make the proposed model more robust and achieve a more efficient classification of the WBCs. The BCCD dataset is used to evaluate the performance of the proposed methodology, and the findings are compared to existing state-of-the-art approaches based on accuracy, precision, sensitivity, specificity, and F1-score. Evaluation results show that the proposed approach has a higher rank-1 accuracy of 99.02% and outperformed other existing techniques.

Pressure ulcers carry a significant risk in clinical practice. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve the data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity, and skin moisture. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. Thus, the primary aim of this approach is to provide nursing professionals with valuable insights for assessing the potential risk levels of pressure ulcers, which could support their decision-making and allow, for example, the application of suitable preventive measures tailored to each patient’s requirements. The interpretability of the models proposed and their performance, evaluated through stratified cross-validation, make them a helpful tool for nursing care in estimating the pressure ulcer risk level.

Over the last two decades, augmented reality (AR) has led to the rapid development of new interfaces in various fields of social and technological application domains. One such domain is medicine, and to a higher extent surgery, where these visualization techniques help to improve the effectiveness of preoperative and intraoperative procedures. Following this trend, this paper presents SLIMBRAIN, a real-time acquisition and processing AR system suitable to classify and display brain tumor tissue from hyperspectral (HS) information. This system captures and processes HS images at 14 frames per second (FPS) during the course of a tumor resection operation to detect and delimit cancer tissue at the same time the neurosurgeon operates. The result is represented in an AR visualization where the classification results are overlapped with the RGB point cloud captured by a LiDAR camera. This representation allows natural navigation of the scene at the same time it is captured and processed, improving the visualization and hence effectiveness of the HS technology to delimit tumors. The whole system has been verified in real brain tumor resection operations. [ABSTRACT FROM AUTHOR]

Auscultation methods enable non-invasive diagnosis of diseases, e.g. of the heart, based on heartbeat sounds. Regular, early examinations using machine learning techniques could help to detect diseases at an early stage to prevent serious health conditions and then provide optimal therapy through continuous monitoring. There is already a lot of work on human data using AI algorithms to detect patterns in signals or images. However, there is hardly no work on detecting heart murmurs with digital such as Myxomatous Mitral Valve Disease. In this paper, we present a canine auscultation project that aims to provide a tool to establish a baseline of classification parameters from audio signals that could be used to monitor canine health status by analyzing deviations from this baseline. In the future, data analysis could also lead to prediction and early detection of other diseases.

Despite their relevance in neurorehabilitation, physical therapy (PT) goals and interventions are poorly described, compromising a proper understanding of PT effectiveness in everyday clinical practice. Thus, this paper aims to describe the prevalence of PT goals and interventions in people with neurological disorders, along with the participants’ clinical features, setting characteristics of the clinical units involved, and PT impact on outcome measures. A multicenter longitudinal observational study involving hospitals and rehabilitation centers across Italy has been conducted. We recruited people with stroke (n = 119), multiple sclerosis (n = 48), and Parkinson’s disease (n = 35) who underwent the PT sessions foreseen by the National Healthcare System. Clinical outcomes were administered before and after the intervention, and for each participant the physical therapists completed a semi-structured interview to report the goals and interventions of the PT sessions. Results showed that the most relevant PT goals were related to the ICF activities with “walking” showing the highest prevalence. The most used interventions aimed at improving walking performance, followed by those aimed at improving organ/body system functioning, while interventions targeting the cognitive–affective and educational aspects have been poorly considered. Considering PT effectiveness, 83 participants experienced a clinically significant improvement in the outcome measures assessing gait and balance functions.

This article introduces a novel approach to digitize legislation using rule based-decision trees (RBDTs). As regulation is one of the major barriers to innovation, novel methods for helping stakeholders better understand, and conform to, legislation are becoming increasingly important. Newly introduced medical device regulation has resulted in an increased complexity of regulatory strategy for manufacturers, and the pressure on notified body resources to support this process is making this an increasing concern in industry. This paper explores a real-world classification problem that arises for medical device manufacturers when they want to be certified according to the In Vitro Diagnostic Regulation (IVDR). A modification to an existing RBDT algorithm is introduced (RBDT-1C) and a case study demonstrates how this method can be applied. The RBDT-1C algorithm is used to design a decision tree to classify IVD devices according to their risk-based classes: Class A, Class B, Class C and Class D. The applied RBDT-1C algorithm demonstrated accurate classification in-line with published ground-truth data. This approach should enable users to better understand the legislation, has informed policy makers about potential areas for future guidance, and allowed for the identification of errors in the regulations that have already been recognized and amended by the European Commission.

Detecting Alzheimer's disease (AD) and disease progression based on the patient's speech not the patient's speech data can aid non-invasive, cost-effective, real-time early diagnostic and repetitive monitoring in minimum time and effort using machine learning (ML) classification approaches. This paper aims to predict early AD diagnosis and evaluate stages of AD through exploratory analysis of acoustic features, non-stationarity, and non-linearity testing, and applying data augmentation techniques on spontaneous speech signals collected from AD and cognitively normal (CN) subjects. Evaluation of the proposed AD prediction and AD stages classification models using Random Forest classifier yielded accuracy rates of 82.2% and 71.5%. This will enrich the Alzheimer's research community with further understanding of methods to improve models for AD classification and addressing non-stationarity and non-linearity properties on audio features to determine the best-suited acoustic features for AD monitoring.

Chiari malformations are a group of craniovertebral junction anomalies characterized by the herniation of cerebellar tonsils below the foramen magnum, often accompanied by brainstem descent. The existing classification systems for Chiari malformations have expanded from the original four categories to nine, leading to debates about the need for a more descriptive and etiopathogenic terminology. This review aims to examine the various classification approaches employed and proposes a simplified scheme to differentiate between different types of tonsillar herniations. Furthermore, it explores the most appropriate terminology for acquired herniation of cerebellar tonsils and other secondary Chiari-like malformations. Recent advances in magnetic resonance imaging (MRI) have revealed a higher prevalence and incidence of Chiari malformation Type 1 (CM1) and identified similar cerebellar herniations in individuals unrelated to the classic phenotypes described by Chiari. As we reassess the existing classifications, it becomes crucial to establish a terminology that accurately reflects the diverse presentations and underlying causes of these conditions. This paper contributes to the ongoing discussion by offering insights into the evolving understanding of Chiari malformations and proposing a simplified classification and terminology system to enhance diagnosis and management.

Access to digital health data collections such as clinical notes, discharge summaries, or medical charts has increased in the last few years due to the increased use of electronic health records, which provide instant access to patients’ clinical information. The volume and the unstructured nature of these datasets present great challenges in analyses and subsequent applications to healthcare. The growing volume of clinical data generated and stored in electronic health records creates challenges for physicians when reviewing patients’ records with the aim of understanding individual patients’ health histories. Electronic healthcare records contain large volumes of unstructured data, which require one to read through to get the required information. This is a challenging task due to lack of suitable techniques to quickly extract the needed information. Information processing tools in the clinical domain that provide support to users in seeking needed information are lacking. The use of data visualization has been introduced in an attempt to solve this problem; however, no single approach has been widely adopted. In this paper, we propose a unique approach for modeling clinical notes using the semantics of various units of a clinical text document to aid doctors in reviewing electronic clinical notes. This is achieved by applying the supervised machine learning technique to identify and present semantically similar information together, facilitating the identification of relevant information to users.

Medical cyber-physical systems (MCPS) represent a platform through which patient health data are acquired by emergent Internet of Things (IoT) sensors, preprocessed locally, and managed through improved machine intelligence algorithms. Wireless medical cyber-physical systems are extensively adopted in the daily practices of medicine, where vast amounts of data are sampled using wireless medical devices and sensors and passed to decision support systems (DSSs). With the development of physical systems incorporating cyber frameworks, cyber threats have far more acute effects, as they are reproduced in the physical environment. Patients’ personal information must be shielded against intrusions to preserve their privacy and confidentiality. Therefore, every bit of information stored in the database needs to be kept safe from intrusion attempts. The IWMCPS proposed in this work takes into account all relevant security concerns. This paper summarizes three years of fieldwork by presenting an IWMCPS framework consisting of several components and subsystems. The IWMCPS architecture is developed, as evidenced by a scenario including applications in the medical sector. Cyber-physical systems are essential to the healthcare sector, and life-critical and context-aware health data are vulnerable to information theft and cyber-okayattacks. Reliability, confidence, security, and transparency are some of the issues that must be addressed in the growing field of MCPS research. To overcome the abovementioned problems, we present an improved wireless medical cyber-physical system (IWMCPS) based on machine learning techniques. The heterogeneity of devices included in these systems (such as mobile devices and body sensor nodes) makes them prone to many attacks. This necessitates effective security solutions for these environments based on deep neural networks for attack detection and classification. The three core elements in the proposed IWMCPS are the communication and monitoring core, the computational and safety core, and the real-time planning and administration of resources. In this study, we evaluated our design with actual patient data against various security attacks, including data modification, denial of service (DoS), and data injection. The IWMCPS method is based on a patient-centric architecture that preserves the end-user’s smartphone device to control data exchange accessibility. The patient health data used in WMCPSs must be well protected and secure in order to overcome cyber-physical threats. Our experimental findings showed that our model attained a high detection accuracy of 92% and a lower computational time of 13 sec with fewer error analyses.

Pre-trained machine learning models have recently been widely used to detect COVID-19 automatically from X-ray images. Although these models can selectively retrain their layers for the desired task, the output remains biased due to the massive number of pre-trained weights and parameters. This paper proposes a novel batch normalized convolutional neural network (BNCNN) model to identify COVID-19 cases from chest X-ray images in binary and multi-class frameworks with a dual aim to extract salient features that improve model performance over pre-trained image analysis networks while reducing computational complexity. The BNCNN model has three phases: Data pre-processing to normalize and resize X-ray images, Feature extraction to generate feature maps, and Classification to predict labels based on the feature maps. Feature extraction uses four repetitions of a block comprising a convolution layer to learn suitable kernel weights for the features map, a batch normalization layer to solve the internal covariance shift of feature maps, and a max-pooling layer to find the highest-level patterns by increasing the convolution span. The classifier section uses two repetitions of a block comprising a dense layer to learn complex feature maps, a batch normalization layer to standardize internal feature maps, and a dropout layer to avoid overfitting while aiding the model generalization. Comparative analysis shows that when applied to an open-access dataset, the proposed BNCNN model performs better than four other comparative pre-trained models for three-way and two-way class datasets. Moreover, the BNCNN requires fewer parameters than the pre-trained models, suggesting better deployment suitability on low-resource devices.

Brain tumors (BTs) are an uncommon but fatal kind of cancer. Therefore, the development of computer-aided diagnosis (CAD) systems for classifying brain tumors in magnetic resonance imaging (MRI) has been the subject of many research papers so far. However, research in this sector is still in its early stage. The ultimate goal of this research is to develop a lightweight effective implementation of the U-Net deep network for use in performing exact real-time segmentation. Moreover, a simplified deep convolutional neural network (DCNN) architecture for the BT classification is presented for automatic feature extraction and classification of the segmented regions of interest (ROIs). Five convolutional layers, rectified linear unit, normalization, and max-pooling layers make up the DCNN’s proposed simplified architecture. The introduced method was verified on multimodal brain tumor segmentation (BRATS 2015) datasets. Our experimental results on BRATS 2015 acquired Dice similarity coefficient (DSC) scores, sensitivity, and classification accuracy of 88.8%, 89.4%, and 88.6% for high-grade gliomas. When it comes to segmenting BRATS 2015 BT images, the performance of our proposed CAD framework is on par with existing state-of-the-art methods. However, the accuracy achieved in this study for the classification of BT images has improved upon the accuracy reported in prior studies. Image classification accuracy for BRATS 2015 BT has been improved from 88% to 88.6%.

Early prenatal screening with an ultrasound (US) can significantly lower newborn mortality caused by congenital heart diseases (CHDs). However, the need for expertise in fetal cardiologists and the high volume of screening cases limit the practically achievable detection rates. Hence, automated prenatal screening to support clinicians is desirable. This paper presents and analyses potential deep learning (DL) techniques to diagnose CHDs in fetal USs. Four convolutional neural network architectures were compared to select the best classifier with satisfactory results. Hence, dense convolutional network (DenseNet) 201 architecture was selected for the classification of seven CHDs, such as ventricular septal defect, atrial septal defect, atrioventricular septal defect, Ebstein’s anomaly, tetralogy of Fallot, transposition of great arteries, hypoplastic left heart syndrome, and a normal control. The sensitivity, specificity, and accuracy of the DenseNet201 model were 100%, 100%, and 100%, respectively, for the intra-patient scenario and 99%, 97%, and 98%, respectively, for the inter-patient scenario. We used the intra-patient DL prediction model to validate our proposed model against the prediction results of three expert fetal cardiologists. The proposed model produces a satisfactory result, which means that our model can support expert fetal cardiologists to interpret the decision to improve CHD diagnostics. This work represents a step toward the goal of assisting front-line sonographers with CHD diagnoses at the population level.

A timely diagnosis of coronavirus is critical in order to control the spread of the virus. To aid in this, we propose in this paper a deep learning-based approach for detecting coronavirus patients using ultrasound imagery. We propose to exploit the transfer learning of a EfficientNet model pre-trained on the ImageNet dataset for the classification of ultrasound images of suspected patients. In particular, we contrast the results of EfficentNet-B2 with the results of ViT and gMLP. Then, we show the results of the three models by learning from scratch, i.e., without transfer learning. We view the detection problem from a multiclass classification perspective by classifying images as COVID-19, pneumonia, and normal. In the experiments, we evaluated the models on a publically available ultrasound dataset. This dataset consists of 261 recordings (202 videos + 59 images) belonging to 216 distinct patients. The best results were obtained using EfficientNet-B2 with transfer learning. In particular, we obtained precision, recall, and F1 scores of 95.84%, 99.88%, and 24 97.41%, respectively, for detecting the COVID-19 class. EfficientNet-B2 with transfer learning presented an overall accuracy of 96.79%, outperforming gMLP and ViT, which achieved accuracies of 93.03% and 92.82%, respectively.

Early detection of high fall risk is an important process of fall prevention in hospitalized elderly patients. Hospitalized elderly patients can face several falling risks. Monitoring systems can be utilized to protect health and lives, and monitoring models can be less effective if the alarm is not invoked in real time. Therefore, in this paper we propose a monitoring prediction system that incorporates artificial intelligence. The proposed system utilizes a scalable clustering technique, namely the Catboost method, for binary classification. These techniques are executed on the Snowflake platform to rapidly predict safe and risky incidence for hospitalized elderly patients. A later stage employs a deep learning model (DNN) that is based on a convolutional neural network (CNN). Risky incidences are further classified into various monitoring alert types (falls, falls with broken bones, falls that lead to death). At this phase, the model employs adaptive sampling techniques to elucidate the unbalanced overfitting in the datasets. A performance study utilizes the benchmarks datasets, namely SERV-112 and SV-S2017 of the image sequences for assessing accuracy. The simulation depicts that the system has higher true positive counts in case of all health-related risk incidences. The proposed system depicts real-time classification speed with lower training time. The performance of the proposed multi-risk prediction is high at 87.4% in the SERV-112 dataset and 98.71% in the SV-S2017 dataset.

Magnetic resonance imaging (MRI) offers visual representations of the interior of a body for clinical analysis and medical intervention. The MRI process is subjected to a variety of image processing and machine learning approaches to identify, diagnose, and classify brain diseases as well as detect abnormalities. In this paper, we propose an improved classification method for distinguishing cancerous and noncancerous tumors from brain MRI images by using Log Polar Transformation (LPT) and convolutional neural networks (CNN). The LPT has been applied for feature extraction of rotation and scaling of distorted images, while the integration of CNN introduces a machine learning approach for the tumor classification of distorted images. The dataset was formed with images of seven different brain diseases, and the training set was formed by applying CNN with the extracted features. The proposed method is then evaluated in comparison to state-of-the-art algorithms, showing a definite improvement of the former. The obtained results show that the machine learning approach offers better classification with a success rate of about 96% in both plain brain MR images and rotation- and scale-invariant brain MR images. This work also successfully classified T-1 and T-2 weighted images of neoplastic and degenerative brain diseases. The obtained accuracy is perfected by several kernel procedures, while the combined performance of the two wavelet transformations and a strong dataset make our method robust and efficient. Since no earlier study on machine learning approaches with rotated and scaled brain MRI has come to our attention, it is expected that our proposed method introduces a new paradigm in this research field.

There has been a rapid increase in the number of artificial intelligence (AI)/machine learning (ML)-based biomarker diagnostic classifiers in recent years. However, relatively little work has focused on assessing the robustness of these biomarkers, i.e., investigating the uncertainty of the AI/ML models that these biomarkers are based upon. This paper addresses this issue by proposing a framework to evaluate the already-developed classifiers with regard to their robustness by focusing on the variability of the classifiers’ performance and changes in the classifiers’ parameter values using factor analysis and Monte Carlo simulations. Specifically, this work evaluates (1) the importance of a classifier’s input features and (2) the variability of a classifier’s output and model parameter values in response to data perturbations. Additionally, it was found that one can estimate a priori how much replacement noise a classifier can tolerate while still meeting accuracy goals. To illustrate the evaluation framework, six different AI/ML-based biomarkers are developed using commonly used techniques (linear discriminant analysis, support vector machines, random forest, partial-least squares discriminant analysis, logistic regression, and multilayer perceptron) for a metabolomics dataset involving 24 measured metabolites taken from 159 study participants. The framework was able to correctly predict which of the classifiers should be less robust than others without recomputing the classifiers itself, and this prediction was then validated in a detailed analysis.

Multidirectional instability (MDI) of the glenohumeral joint refers to symptomatic subluxations or dislocations in more than one direction. The aetiology of MDI is multifactorial, which makes the classification of this condition challenging. A shoulder rehabilitation program is the initial recommended treatment for MDI, however available rehabilitation programs have varying levels of evidence to support their effectiveness. In 2016, we published the details of an evidence-based program for MDI that has been evaluated for efficacy in two single-group studies and a randomised controlled trial. In 2017, we published a clinical commentary on the aetiology, classification, and treatment of this condition. The aim of this paper is to provide an update on the components of these publications with a particular focus on new advances in the non-operative management of this condition.

Pneumonia is a common disease that occurs in many countries, more specifically, in poor countries. This disease is an obstructive pneumonia which has the same impression on pulmonary radiographs as other pulmonary diseases, which makes it hard to distinguish even for medical radiologists. Lately, image processing and deep learning models are established to rapidly and precisely diagnose pneumonia disease. In this research, we have predicted pneumonia diseases dependably from the X-ray images, employing image segmentation and machine learning models. A public labelled database is utilized with 4000 pneumonia disease X-rays and 4000 healthy X-rays. ImgNet and SqueezeNet are utilized for transfer learning from their previous computed weights. The proposed deep learning models are trained for classifying pneumonia and non-pneumonia cases. The following processes are presented in this paper: X-ray segmentation utilizing BoxENet architecture, X-ray classification utilizing the segmented chest images. We propose the improved BoxENet model by incorporating transfer learning from both ImgNet and SqueezeNet using a majority fusion model. Performance metrics such as accuracy, specificity, sensitivity and Dice are evaluated. The proposed Improved BoxENet model outperforms the other models in binary and multi-classification models. Additionally, the Improved BoxENet has higher speed compared to other models in both training and classification.

Recently, the COVID-19 epidemic has had a major impact on day-to-day life of people all over the globe, and it demands various kinds of screening tests to detect the coronavirus. Conversely, the development of deep learning (DL) models combined with radiological images is useful for accurate detection and classification. DL models are full of hyperparameters, and identifying the optimal parameter configuration in such a high dimensional space is not a trivial challenge. Since the procedure of setting the hyperparameters requires expertise and extensive trial and error, metaheuristic algorithms can be employed. With this motivation, this paper presents an automated glowworm swarm optimization (GSO) with an inception-based deep convolutional neural network (IDCNN) for COVID-19 diagnosis and classification, called the GSO-IDCNN model. The presented model involves a Gaussian smoothening filter (GSF) to eradicate the noise that exists from the radiological images. Additionally, the IDCNN-based feature extractor is utilized, which makes use of the Inception v4 model. To further enhance the performance of the IDCNN technique, the hyperparameters are optimally tuned using the GSO algorithm. Lastly, an adaptive neuro-fuzzy classifier (ANFC) is used for classifying the existence of COVID-19. The design of the GSO algorithm with the ANFC model for COVID-19 diagnosis shows the novelty of the work. For experimental validation, a series of simulations were performed on benchmark radiological imaging databases to highlight the superior outcome of the GSO-IDCNN technique. The experimental values pointed out that the GSO-IDCNN methodology has demonstrated a proficient outcome by offering a maximal sensy of 0.9422, specy of 0.9466, precn of 0.9494, accy of 0.9429, and F1score of 0.9394.