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Paper spray ionization has been used as a fast sampling/ionization method for the direct mass spectrometric analysis of biological samples at ambient conditions. Here, we demonstrated that by utilizing paper spray ionization-mass spectrometry (PSI-MS) coupled with field asymmetric waveform ion mobility spectrometry (FAIMS), predictive metabolic and lipidomic profiles of routine breast core needle biopsies could be obtained effectively. By the combination of machine learning algorithms and pathological examination reports, we developed a classification model, which has an overall accuracy of 87.5% for an instantaneous differentiation between cancerous and noncancerous breast tissues utilizing metabolic and lipidomic profiles. Our results suggested that paper spray ionization-ion mobility spectrometry-mass spectrometry (PSI-IMS-MS) is a powerful approach for rapid breast cancer diagnosis based on altered metabolic and lipidomic profiles.

The clinical importance of blood group (BG) antigens is related to their ability to induce immune antibodies that can cause hemolysis. Yet, ABO and D (Rh) are still considered to be the key antigens for healthy blood transfusion and secondary antigens are the next priority. Serological typing is the most widely used typing method. Rapid and accurate blood grouping plays an important role in some clinical conditions, rather than conventional techniques. Hence, developing a simple and economical model for rapid blood grouping would facilitate these tests. In recent decades, paper-based microfluidics such as μPADs has gained much interest in wide application areas such as point-of-care diagnostic. In this study, we evaluated μPADs that are performed for blood grouping and its recent progress. A comprehensive literature search was performed using databases including PUBMED, SCOPUS, Web of Science and Google Scholar. Keywords were blood grouping or typing, paper analytical device, rapid test, etc. After investigation of search results, 16 papers from 2010 to 2020 were included. Further information in detail was classified in Table 1. Generally, two principles for blood typing μPADs are introduced. The lateral chromatographic flow method and the vertical flow-through method that detects BG in a visual-based manner. To detect results with acceptable clarity many factors and challenges like paper, blood sample, buffer, Ab and RBC interaction and also μPADs stability need to be considered, which are discussed. In conclusion, the simplicity, stability, cheapness, portability and biocompatibility of μPADs for blood grouping confirming its utility and also they have the capability to robust, universal blood-grouping platform. Table 1 Summary of blood grouping tests using paper-based analytical devices Antigens Type of diagnosis Validation method Sample No Accuracy Action time Paper type Stability Sample dilution Buffer Ref A, B, Rh Forward volunteers records 5 - - Whatman No. 4 - 1/2 PBS* (Khan et al. 2010) A, B, Rh Forward gel assay test and conventional slide test 100 100% 1 min Whatman No. 4 and Kleeenex paper towel 7 Days in 4 °C 1/1 NSS (Al-Tamimi et al. 2012) A, B, Rh Forward gel card assay 99 100% 20 Sec + Washing Kleeenex paper towel - 1/1 NSS (Li et al. 2012) A, B, Rh Forward - - - - Kleeenex paper towel - 45/100 PSS (Li et al. 2013) A, B, Rh Forward gel card assay 98 100% 1.5 min Kleeenex paper towel - 85/100 PBS (Guan et al. 2014b) C, E, c, e, K, Jka, Jkb, M, N, S, P1, and Lea Forward gel card assay 266 100% - Kleeenex paper towel - 1/1 NSS (Li et al. 2014b) A, B, Rh Forward and Reverse conventional slide test 96 ≈ 91% 10 min Whatman No. 1 21 Days in 4 °C 1/2 NSS (Noiphung et al. 2015) C, c, E, e, K, k, Fya, Fyb, Jka, Jkb, M, N, S and s, P1, Lea and Leb Forward - 478 - - Kleeenex paper towel - 1/1 NSS, PBS (Then et al. 2015) A, B Forward and Reverse conventional slide test 76 100% 5-8 min Whatman No. 4 38 Days in 4 °C 1/4, 1/1 NSS (Songjaroen and Laiwattanapaisal 2016) D, K Forward volunteers records 210 - 7.5 min Kleenex paper towel - 1/1 NSS (Yeow et al. 2016) A, B, c, e, D, C, E, M, N, S, s, P1, Jka, Jkb, Lea, Leb, Fya, and Fyb Forward and Reverse gel card assay 3550 ≈100% 30 s Fiber glass and cotton linter 180 Days in 25 °C 45/100, 1/1 PBS (Zhang et al. 2017) A, B Forward conventional slide test 598 100% 3 min Whatman No. 113 14 Day in 4 °C 1/1 NSS (Songjaroen et al. 2018) A, B, Rh Forward conventional slide test - - 30 Sec + Washing Unrefined sisal paper - 1/2 NSS (Casals-Terré et al. 2019) A, B, Rh Forward - - - - Whatman No.1 - 1/1 NSS (Ansari et al. 2020) ABORh Forward and Reverse conventional slide test - 100% Unrefined Eucalyptus papers - 1/2 NSS, PBS (Casals-Terré et al. 2020) A, B, Rh Forward - - - 30 Sec + Washing Whatman No. 4 modified with chitosan ≥ 100 days in 25 °C 1/1 NSS (Parween et al. 2020)

In daily clinical practice, clinicians integrate available data to ascertain the diagnostic and prognostic probability of a disease or clinical outcome for their patients. For patients with suspected or known cardiovascular disease, several anatomical and functional imaging techniques are commonly performed to aid this endeavor, including coronary computed tomography angiography (CCTA) and nuclear cardiology imaging. Continuous improvement in positron emission tomography (PET), single-photon emission computed tomography (SPECT), and CT hardware and software has resulted in improved diagnostic performance and wide implementation of these imaging techniques in daily clinical practice. However, the human ability to interpret, quantify, and integrate these data sets is limited. The identification of novel markers and application of machine learning (ML) algorithms, including deep learning (DL) to cardiovascular imaging techniques will further improve diagnosis and prognostication for patients with cardiovascular diseases. The goal of this position paper of the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI) is to provide an overview of the general concepts behind modern machine learning-based artificial intelligence, highlights currently prefered methods, practices, and computational models, and proposes new strategies to support the clinical application of ML in the field of cardiovascular imaging using nuclear cardiology (hybrid) and CT techniques.

The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 2 of this article will inform CAR members on the practical aspects of medical imaging de-identification, strengths and limitations of de-identification approaches, list of de-identification software and tools available, and perspectives on future directions.

We report a multiplexed paper-based assay powered by mobile imaging and machine learning for point-of-care diagnosis of Lyme Disease. Blind testing of 96 serum samples showed a sensitivity and specificity of 85.7% and 96.3%, respectively.

Fast and simultaneous identification of multiple viable pathogens on food is critical to public health. Here we report a pathogen identification system using a paper chromogenic array (PCA) enabled by machine learning. The PCA consists of a paper substrate impregnated with 23 chromogenic dyes and dye combinations, which undergo colour changes on exposure to volatile organic compounds emitted by pathogens of interest. These colour changes are digitized and used to train a multi-layer neural network (NN), endowing it with high-accuracy (91–95%) strain-specific pathogen identification and quantification capabilities. The trained PCA–NN system can distinguish between viable Escherichia coli, E. coli O157:H7 and other viable pathogens, and can simultaneously identify both E. coli O157:H7 and Listeria monocytogenes on fresh-cut romaine lettuce, which represents a realistic and complex environment. This approach has the potential to advance non-destructive pathogen detection and identification on food, without enrichment, culturing, incubation or other sample preparation steps. Fast and simultaneous identification of multiple viable pathogens on food is critical to public health. By integrating paper chromogenic arrays (PCAs) and machine learning, a system was developed to automatically recognize PCA patterns on multiplexed viable pathogens with strain-level specificity.

Machine learning, a branch of artificial intelligence, is increasingly used in health research, including nursing and maternal outcomes research. Machine learning algorithms are complex and involve statistics and terminology that are not common in health research. The purpose of this methods paper is to describe three machine learning algorithms in detail and provide an example of their use in maternal outcomes research. The three algorithms, classification and regression trees, least absolute shrinkage and selection operator, and random forest, may be used to understand risk groups, select variables for a model, and rank variables’ contribution to an outcome, respectively. While machine learning has plenty to contribute to health research, it also has some drawbacks, and these are discussed as well. In order to provide an example of the different algorithms’ function, they were used on a completed cross-sectional study examining the association of oxytocin total dose exposure with primary cesarean section. The results of the algorithms are compared to what was done or found using more traditional methods.

Heart disease has been one of the ruling causes for death for quite some time now. About 31% of all deaths every year in the world take place as a result of cardiovascular diseases [1]. A majority of the patients remain uninformed of their symptoms until quite late while others find it difficult to minimise the effects of risk factors that cause heart diseases. Machine Learning Algorithms have been quite efficacious in producing results with a high level of correctness thereby preventing the onset of heart diseases in many patients and reducing the impact in the ones that are already affected by such diseases. It has helped medical researchers and doctors all over the world in recognising patterns in the patients resulting in early detections of heart diseases.

The development of microfluidic devices for point-of-care (POC) testing has been widely applied for food quality control, environmental monitoring, and clinical diagnoses. Regarding the latter, microfluidic paper-based analytical devices (µPADs) have a great potential in developing portable and disposable platforms for fast disease-relevant biomarker detection in remote areas. In this work, k-nearest neighbors (k-NN) classifiers were applied to demonstrate the reliability of using chemical data obtained from µPADs for diagnosis of diseases like diabetes mellitus and hyperuricemia. Predictors based on glucose, lactate, and uric acid biomarkers were evaluated to reach this goal. Healthy adults were differentiated from the diagnosed patients with a perfect success rate. Metabolic disorders were suitably predicted with 95.0% overall accuracy. This model also showed sensitivities and specificities in the ranges 75–100% and 93–100%, respectively, indicating that the classification protocol is robust. The k-NN modeling proved the potential of the µPADs to be applied in telemedicine for reliable off-site diagnoses.

Attention to the environment and its problems has undergone unprecedented growth in recent years [...]

Drowsiness can be dangerous when performing tasks that require constant attention, such as driving a vehicle. Sleepiness is correlated with a variety of physiological variables, such as eye closing, head movements, pulse rate, eye twitch rate, etc. Also, the yawn can be considered as an accurate indicator of drowsiness and fatigue. Yawning detection is very important for the safety purpose of drivers as it will let the driver know if he/she is getting drowsy. Driving at that moment may not be safe. Several automatic yawning detection techniques have been developed for driver's drowsiness monitoring system. Nevertheless, correctly detecting the yawning of the driver and predicting exhaustion in real-time situations is still a crucial challenge. In this paper, we will be reviewing various existing machine learning approaches for driver's yawning detection. In previous approaches, various classical machine learning algorithms such as viola-Jones, contour activation algorithm and SVM have been used for yawning detection, but these approaches failed to predict yawning in realtime situations. Using Deep learning techniques, we can make a real-time yawn detection system with high accuracy. We find that some precious Deep learning algorithms like CNN, RNN, LSTM, Bi-LSTM can detect the patterns with high accuracy. After the comparison of various algorithms and techniques, we find that with the help of Deep learning algorithms the yawning can be detected in real time with high accuracy.

Low energy surface coatings have found wide range of applications for generating hydrophobic and superhydrophobic surfaces. Most of the studies have been related to use of a single coating material over a single substrate or using a single technique. The degree of hydrophobicity is highly dependent on fabrication processes as well as materials being coated and as such warrants a high-level study using experimental optimization leading to the evaluation of the parametric behavior of coatings and their application techniques. Also, a single platform or system which can predict the required set of parameters for generating hydrophobic surface of required nature for given substrate is of requirement. This work applies the powerful machine learning algorithms (Levenberg Marquardt using Gauss Newton and Gradient methods) to evaluate the various processes affecting the anti-wetting behavior of coated printable paper substrates with the capability to predict the most optimized method of coating and materials that may lead to a desirable surface contact angle. The major application techniques used for this study pertain to dip coating, spray coating, spin coating and inkjet printing and silane and sol–gel base coating materials.

Introduction: The electrocardiogram (ECG) plays an important role in the diagnosis of heart diseases. However, most patterns of diseases are based on old datasets and stepwise algorithms that provide limited accuracy. Improving diagnostic accuracy of the ECG can be done by applying machine learning algorithms. This requires taking existing scanned or printed ECGs of old cohorts and transforming the ECG signal to the raw digital (time (milliseconds), voltage (millivolts)) form. Objectives: We present a MATLAB-based tool and algorithm that converts a printed or scanned format of the ECG into a digitized ECG signal. Methods: 30 ECG scanned curves are utilized in our study. An image processing method is first implemented for detecting the ECG regions of interest and extracting the ECG signals. It is followed by serial steps that digitize and validate the results. Results: The validation demonstrates very high correlation values of several standard ECG parameters: PR interval 0.984 +/−0.021 (p-value < 0.001), QRS interval 1+/− SD (p-value < 0.001), QT interval 0.981 +/− 0.023 p-value < 0.001, and RR interval 1 +/− 0.001 p-value < 0.001. Conclusion: Digitized ECG signals from existing paper or scanned ECGs can be obtained with more than 95% of precision. This makes it possible to utilize historic ECG signals in machine learning algorithms to identify patterns of heart diseases and aid in the diagnostic and prognostic evaluation of patients with cardiovascular disease., We present a MATLAB-based tool and algorithm that converts a printed or scanned ECG into a digitized ECG signal. Validation on 30 ECG scanned curves more than 95% precision. This makes it possible to utilize historic ECG signals in machine learning algorithms to identify patterns of heart diseases and aid in the diagnosis and evaluation of patients with cardiovascular disease.

Many complex physical systems exhibit a rich variety of discrete behavioural modes. Often, the system complexity limits the applicability of standard modelling tools. Hence, understanding the underlying physics of different behaviours and distinguishing between them is challenging. Although traditional machine learning techniques could predict and classify behaviour well, typically they do not provide any meaningful insight into the underlying physics of the system. In this paper we present a novel method for extracting physically meaningful clusters of discrete behaviour from limited experimental observations. This method obtains a set of physically plausible functions that both facilitate behavioural clustering and aid in system understanding. We demonstrate the approach on the V-shaped falling paper system, a new falling paper type system that exhibits four distinct behavioural modes depending on a few morphological parameters. Using just 49 experimental observations, the method discovered a set of candidate functions that distinguish behaviours with an error of 2.04%, while also aiding insight into the physical phenomena driving each behaviour. © 2019 Howison et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

In recent years, there has been a dramatic increase in research papers about machine learning (ML) and artificial intelligence in radiology. With so many papers around, it is of paramount importance to make a proper scientific quality assessment as to their validity, reliability, effectiveness, and clinical applicability. Due to methodological complexity, the papers on ML in radiology are often hard to evaluate, requiring a good understanding of key methodological issues. In this review, we aimed to guide the radiology community about key methodological aspects of ML to improve their academic reading and peer-review experience. Key aspects of ML pipeline were presented within four broad categories: study design, data handling, modelling, and reporting. Sixteen key methodological items and related common pitfalls were reviewed with a fresh perspective: database size, robustness of reference standard, information leakage, feature scaling, reliability of features, high dimensionality, perturbations in feature selection, class balance, bias-variance trade-off, hyperparameter tuning, performance metrics, generalisability, clinical utility, comparison with traditional tools, data sharing, and transparent reporting.Key Points• Machine learning is new and rather complex for the radiology community.• Validity, reliability, effectiveness, and clinical applicability of studies on machine learning can be evaluated with a proper understanding of key methodological concepts about study design, data handling, modelling, and reporting.• Understanding key methodological concepts will provide a better academic reading and peer-review experience for the radiology community.

Machine learning (ML), a form of artificial intelligence (AI), is being increasingly employed in neurology. Reported performance metrics often match or exceed the efficiency of average clinicians. The neurologist is easily baffled by the underlying concepts and terminologies associated with ML studies. The superlative performance metrics of ML algorithms often hide the opaque nature of its inner workings. Questions regarding ML model's interpretability and reproducibility of its results in real-world scenarios, need emphasis. Given an abundance of time and information, the expert clinician should be able to deliver comparable predictions to ML models, a useful benchmark while evaluating its performance. Predictive performance metrics of ML models should not be confused with causal inference between its input and output. ML and clinical gestalt should compete in a randomized controlled trial before they can complement each other for screening, triaging, providing second opinions and modifying treatment.

For primary stage breast cancer detection, mammography techniques are being used for a long time. The disadvantage associated with the technology is taking a long time required by the radiologist to diagnose each image pattern. Moreover, this technique is not suitable for the detection of cancer in younger women. At present, the technique has been upgraded by using the technology-based classifiers, which adds the accuracy, specificity, sensitivity, and time requirement by differentiating malignant and benign. Only limited reviews are available, that focuses on features reduction algorithm and artificial neural networks architecture to enhance the detection techniques. The purpose of this paper is to collect the recently used techniques, algorithms, and future scope related to thermography. The author further suggests the technique to divide the features according to different age groups and to find a unique feature for all.

The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 1 of this article will inform CAR members on principles of de-identification, pseudonymization, encryption, direct and indirect identifiers, k-anonymization, risks of reidentification, implementations, data set release models, and validation of AI algorithms, with a view to developing appropriate standards to safeguard patient information effectively.

Bacteria identification has predominantly been conducted using specific bioreceptors such as antibodies or nucleic acid sequences. This approach may be inappropriate for environmental monitoring when the user does not know the target bacterial species and for screening complex water samples with many unknown bacterial species. In this work, we investigate the supervised machine learning of the bacteria-particle aggregation pattern induced by the peptide sets identified from the biofilm-bacteria interface. Each peptide is covalently conjugated to polystyrene particles and loaded together with bacterial suspensions onto paper microfluidic chips. Each peptide interacts with bacterial species to a different extent, leading to varying sizes of particle aggregation. This aggregation changes the surface tension and viscosity of the liquid flowing through the paper pores, altering the flow velocity at different extents. A smartphone camera captures this flow velocity without being affected by ambient and environmental conditions, towards a low-cost, rapid, and field-ready assay. A collection of such flow velocity data generates a unique fingerprinting profile for each bacterial species. Support vector machine is utilized to classify the species. At optimized conditions, the training model can predict the species at 93.3% accuracy out of five bacteria: Escherichia coli, Staphylococcus aureus, Salmonella Typhimurium, Enterococcus faecium, and Pseudomonas aeruginosa. Flow rates are monitored for less than 6 s and the sample-to-answer assay time is less than 10 min. The demonstrated method can open a new way of analyzing complex biological and environmental samples in a biomimetic manner with machine learning classification.

The regularly expanding measures of patient’s information as medicinal image, forces new difficulties to clinical routine, for example, diagnosis, treatment and checking. Image mining is the way toward seeking and finding profitable data learning of information. It is connected on image preparing and machine learning. Picture handling is having essentially for ailment recognition on restorative pictures. These sickness acknowledgment and arrangement are particular to human organ and image nature. With help of image processing and machine learning strategies it is conceivable to computerize as well as help doctors in clinical analysis. In this paper depicts the utilization of different image processing and machine learning methods for identification of eye diseases.

The paper presents a method to classify electromyographic (EMG) signals according to the postures of rock-paper-scissors by using multi-layer perceptrons (MLPs). The EMGs are first applied to He-Zajac-Levine bilinear activation model and then the output of model is utilized to be inputs of the MLPs. Cross validation method is used to evaluate the classification performance of MLPs and its outcome also shows that accuracy of the proposed method is over 97%.

This work aimed to review different Computer-Aided Detection (CAD) systems that were proposed as alternative means to replace the tedious and erroneous double reading procedure via radiologists. These CAD systems include the use of different signal processing techniques such as Wavelet Transform and Curvelet Transform, image processing technique, pattern recognition, artificial intelligence technologies namely the Artificial Neural Network and Fuzzy Logic system, and different algorithms of computer sciences. Among the developed algorithms proposed for this purpose include k-nn algorithm, fuzzy C-means (FCM), swarm algorithm, genetic algorithm and multi-resolution techniques. It was found from this study that multiscale curvelet transform has the highest classification accuracy with the reported value up to 98.59 %, followed by the Swarm Optimization which produced a percentage error of 1.7 %. Meanwhile it was observed that multi-resolution technique along with genetic algorithm produced the highest error of 20.8 ± 8 % in its diagnosis. This work concluded that curvelet transform and swarm algorithm is, thus far, the most suitable CAD techniques to be used before clinical investigation of malignant breast tissues. In the future, these techniques may be improved further to detect different stages of breast cancer.

Objective To evaluate the design characteristics of studies that evaluated the performance of artificial intelligence (AI) algorithms for the diagnostic analysis of medical images. Materials and methods PubMed MEDLINE and Embase databases were searched to identify original research articles published between January 1, 2018 and August 17, 2018 that investigated the performance of AI algorithms that analyze medical images to provide diagnostic decisions. Eligible articles were evaluated to determine 1) whether the study used external validation rather than internal validation, and in case of external validation, whether the data for validation were collected, 2) with diagnostic cohort design instead of diagnostic case-control design, 3) from multiple institutions, and 4) in a prospective manner. These are fundamental methodologic features recommended for clinical validation of AI performance in real-world practice. The studies that fulfilled the above criteria were identified. We classified the publishing journals into medical vs. non-medical journal groups. Then, the results were compared between medical and non-medical journals. Results Of 516 eligible published studies, only 6% (31 studies) performed external validation. None of the 31 studies adopted all three design features: diagnostic cohort design, the inclusion of multiple institutions, and prospective data collection for external validation. No significant difference was found between medical and non-medical journals. Conclusion Nearly all of the studies published in the study period that evaluated the performance of AI algorithms for diagnostic analysis of medical images were designed as proof-of-concept technical feasibility studies and did not have the design features that are recommended for robust validation of the real-world clinical performance of AI algorithms.

A number of illnesses that affect people’s daily life are caused by numerous sleep disorders which usually have common symptoms. In order for a physician to determine the correct diagnosis and its proper treatment, an overnight sleep analysis is usually performed. The scope of this paper is to design and implement a portable system that will assist Narcoleptic patients, in real-time, to aid them into leading a more productive life. The Feature Extraction Unit of the system is implemented on a Xilinx FPGA chip with a maximum error rate of 0.1618%. The classification method used is based on Support Vector Machine (SVM) algorithm. The kernel function used in this design is the Radial Basis Function (RBF) Kernel as it provides the highest classification rates, achieving an accuracy rate greater than 90%.

The authors recognize these shortcomings and propose several adjustments for enhancing the per- formance and practicality of the method. They are right in underlining the potential power of SVM algorithms for future studies in enabling prediction of treatment effects on the individual level. L eon Plaghki Institute of Neuroscience (IoNS), Faculty of Medicine, Universit e catholique de Louvain, Brussels, Belgium

Bioterrorism is no longer a hypothetical construct but a reality. Nevertheless, disease detection and intervention currently remain largely reliant on clinical assessment. Technology providing early detection of disease could impact the care of individual patients and the evolution of epidemic spread. Hyperspectral Imaging (HSI) is a remote sensing technology developed originally by the Department of Defense that combines high-resolution imaging with chemical spectroscopy. In other medical applications HSI is emerging as a new means of early or more sensitive detection of changes in tissue that can be used to define pathology, predict clinical outcomes and adapt therapy. As a small, robust, camera based, non-invasive device, HSI may be well suited to aid in defense against biological warfare or epidemic disease by providing early detection or confirmation of disease and by monitoring the efficacy of vaccination or therapy. Crossover applications exist in the evaluation and treatment of emerging diseases. HSI is well suited to be a screening tool to provide earlier or more accurate detection of disease in an at risk population to better treat and contain disease.

In spite of machine learning has been successfully used in a wide range of healthcare applications, there are several parameters that could influence the performance of a machine learning system. One of the big issues for a machine learning algorithm is related to imbalanced dataset. An imbalanced dataset occurs when the distribution of data is not uniform. This makes harder the implementation of accurate models. In this paper, intelligent models are implemented to predict the hematocrit level of blood starting from visible spectral data. The aim of this work is to show the effects of two balancing techniques (SMOTE and SMOTE+ENN) on the imbalanced dataset of blood spectra. Four different machine learning systems are fitted with imbalanced and balanced datasets and their performances are compared showing an improvement, in terms of accuracy, due to the use of balancing.

Real-time execution of machine learning (ML) pipelines on radiology images is difficult due to limited computing resources in clinical environments, whereas running them in research clusters requires efficient data transfer capabilities. We developed Niffler, an open-source Digital Imaging and Communications in Medicine (DICOM) framework that enables ML and processing pipelines in research clusters by efficiently retrieving images from the hospitals’ PACS and extracting the metadata from the images. We deployed Niffler at our institution (Emory Healthcare, the largest healthcare network in the state of Georgia) and retrieved data from 715 scanners spanning 12 sites, up to 350 GB/day continuously in real-time as a DICOM data stream over the past 2 years. We also used Niffler to retrieve images bulk on-demand based on user-provided filters to facilitate several research projects. This paper presents the architecture and three such use cases of Niffler. First, we executed an IVC filter detection and segmentation pipeline on abdominal radiographs in real-time, which was able to classify 989 test images with an accuracy of 96.0%. Second, we applied the Niffler Metadata Extractor to understand the operational efficiency of individual MRI systems based on calculated metrics. We benchmarked the accuracy of the calculated exam time windows by comparing Niffler against the Clinical Data Warehouse (CDW). Niffler accurately identified the scanners’ examination timeframes and idling times, whereas CDW falsely depicted several exam overlaps due to human errors. Third, with metadata extracted from the images by Niffler, we identified scanners with misconfigured time and reconfigured five scanners. Our evaluations highlight how Niffler enables real-time ML and processing pipelines in a research cluster.

Nowadays, humanity is facing one of the most dangerous pandemics known as COVID-19. Due to its high inter-person contagiousness, COVID-19 is rapidly spreading across the world. Positive patients are often suffering from different symptoms that can vary from mild to severe including cough, fever, sore throat, and body aches. In more dire cases, infected patients can experience severe symptoms that can cause breathing difficulties which lead to stern organ failure and die. The medical corps all over the world are overloaded because of the exponentially myriad number of contagions. Therefore, screening for the disease becomes overwrought with the limited tools of test. Additionally, test results may take a long time to acquire, leaving behind a higher potential for the prevalence of the virus among other individuals by the patients. To reduce the chances of infection, we suggest a prediction model that distinguishes the infected COVID-19 cases based on clinical symptoms and features. This model can be helpful for citizens to catch their infection without the need for visiting the hospital. Also, it helps the medical staff in triaging patients in case of a deficiency of medical amenities. In this paper, we use the non-dominated sorting genetic algorithm (NSGA-II) to select the interesting features by finding the best trade-offs between two conflicting objectives: minimizing the number of features and maximizing the weights of selected features. Then, a classification phase is conducted using an AdaBoost classifier. The proposed model is evaluated using two different datasets. To maximize results, we performed a natural selection of hyper-parameters of the classifier using the genetic algorithm. The obtained results prove the efficiency of NSGA-II as a feature selection algorithm combined with AdaBoost classifier. It exhibits higher classification results that outperformed the existing methods.

The paper delves into the plausibility of applying fractal, spectral, and nonlinear time series analyses for lung auscultation. The thirty-five sound signals of bronchial (BB) and pulmonary crackle (PC) analysed by fast Fourier transform and wavelet not only give the details of number, nature, and time of occurrence of the frequency components but also throw light onto the embedded air flow during breathing. Fractal dimension, phase portrait, and sample entropy help in divulging the greater randomness, antipersistent nature, and complexity of airflow dynamics in BB than PC. The potential of principal component analysis through the spectral feature extraction categorises BB, fine crackles, and coarse crackles. The phase portrait feature-based supervised classification proves to be better compared to the unsupervised machine learning technique. The present work elucidates phase portrait features as a better choice of classification, as it takes into consideration the temporal correlation between the data points of the time series signal, and thereby suggesting a novel surrogate method for the diagnosis in pulmonology. The study suggests the possible application of the techniques in the auscultation of coronavirus disease 2019 seriously affecting the respiratory system.

Artificial intelligence (AI)‐based systems applied to histopathology whole‐slide images have the potential to improve patient care through mitigation of challenges posed by diagnostic variability, histopathology caseload, and shortage of pathologists. We sought to define the performance of an AI‐based automated prostate cancer detection system, Paige Prostate, when applied to independent real‐world data. The algorithm was employed to classify slides into two categories: benign (no further review needed) or suspicious (additional histologic and/or immunohistochemical analysis required). We assessed the sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) of a local pathologist, two central pathologists, and Paige Prostate in the diagnosis of 600 transrectal ultrasound‐guided prostate needle core biopsy regions (‘part‐specimens’) from 100 consecutive patients, and to ascertain the impact of Paige Prostate on diagnostic accuracy and efficiency. Paige Prostate displayed high sensitivity (0.99; CI 0.96–1.0), NPV (1.0; CI 0.98–1.0), and specificity (0.93; CI 0.90–0.96) at the part‐specimen level. At the patient level, Paige Prostate displayed optimal sensitivity (1.0; CI 0.93–1.0) and NPV (1.0; CI 0.91–1.0) at a specificity of 0.78 (CI 0.64–0.89). The 27 part‐specimens considered by Paige Prostate as suspicious, whose final diagnosis was benign, were found to comprise atrophy (n = 14), atrophy and apical prostate tissue (n = 1), apical/benign prostate tissue (n = 9), adenosis (n = 2), and post‐atrophic hyperplasia (n = 1). Paige Prostate resulted in the identification of four additional patients whose diagnoses were upgraded from benign/suspicious to malignant. Additionally, this AI‐based test provided an estimated 65.5% reduction of the diagnostic time for the material analyzed. Given its optimal sensitivity and NPV, Paige Prostate has the potential to be employed for the automated identification of patients whose histologic slides could forgo full histopathologic review. In addition to providing incremental improvements in diagnostic accuracy and efficiency, this AI‐based system identified patients whose prostate cancers were not initially diagnosed by three experienced histopathologists. © 2021 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.

Diabetic retinopathy (DR) is a significant reason for the global increase in visual loss. Studies show that timely treatment can significantly bring down such incidents. Hence, it is essential to distinguish the stages and severity of DR to recommend needed medical attention. In this view, this paper presents DRISTI (Diabetic Retinopathy classIfication by analySing reTinal Images), where a hybrid deep learning model composed of VGG16 and capsule network is proposed, which yields statistically significant performance improvement over the state of the art. To validate our claim, we have reported detailed experimental and ablation studies. We have also created an augmented dataset to increase the APTOS dataset’s size and check how robust the model is. The five-class training and validation accuracy for the expanded dataset is \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$99.21\%$$\end{document}99.21% and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$75.50\%$$\end{document}75.50%. The two-class training and validation accuracy on augmented APTOS is \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$99.96\%$$\end{document}99.96% and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$97.05\%$$\end{document}97.05%. Extending the two-class model for the mixed dataset, we get a training and validation accuracy of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$99.92\%$$\end{document}99.92% and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$91.43\%$$\end{document}91.43%, respectively. We have also performed cross-dataset and mixed dataset testing to demonstrate the efficiency of DRISTI.

Severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) pneumopathy is characterized by a complex clinical picture and heterogeneous pathological lesions, both involving alveolar and vascular components. The severity and distribution of morphological lesions associated with SARS‐CoV‐2 and how they relate to clinical, laboratory, and radiological data have not yet been studied systematically. The main goals of the present study were to objectively identify pathological phenotypes and factors that, in addition to SARS‐CoV‐2, may influence their occurrence. Lungs from 26 patients who died from SARS‐CoV‐2 acute respiratory failure were comprehensively analysed. Robust machine learning techniques were implemented to obtain a global pathological score to distinguish phenotypes with prevalent vascular or alveolar injury. The score was then analysed to assess its possible correlation with clinical, laboratory, radiological, and tissue viral data. Furthermore, an exploratory random forest algorithm was developed to identify the most discriminative clinical characteristics at hospital admission that might predict pathological phenotypes of SARS‐CoV‐2. Vascular injury phenotype was observed in most cases being consistently present as pure form or in combination with alveolar injury. Phenotypes with more severe alveolar injury showed significantly more frequent tracheal intubation; longer invasive mechanical ventilation, illness duration, intensive care unit or hospital ward stay; and lower tissue viral quantity (p

The exponential spread of COVID‐19 worldwide is evident, with devastating outbreaks primarily in the United States, Spain, Italy, the United Kingdom, France, Germany, Turkey and Russia. As of 1 May 2020, a total of 3,308,386 confirmed cases have been reported worldwide, with an accumulative mortality of 233,093. Due to the complexity and uncertainty of the pathology of COVID‐19, it is not easy for front‐line doctors to categorise severity levels of clinical COVID‐19 that are general and severe/critical cases, with consistency. The more than 300 laboratory features, coupled with underlying disease, all combine to complicate proper and rapid patient diagnosis. However, such screening is necessary for early triage, diagnosis, assignment of appropriate level of care facility, and institution of timely intervention. A machine learning analysis was carried out with confirmed COVID‐19 patient data from 10 January to 18 February 2020, who were admitted to Tongji Hospital, in Wuhan, China. A softmax neural network‐based machine learning model was established to categorise patient severity levels. According to the analysis of 2662 cases using clinical and laboratory data, the present model can be used to reveal the top 30 of more than 300 laboratory features, yielding 86.30% blind test accuracy, 0.8195 F1‐score, and 100% consistency using a two‐way patient classification of severe/critical to general. For severe/critical cases, F1‐score is 0.9081 (i.e. recall is 0.9050, and precision is 0.9113). This model for classification can be accomplished at a mini‐second‐level computational cost (in contrast to minute‐level manual). Based on available COVID‐19 patient diagnosis and therapy, an artificial intelligence model paradigm can help doctors quickly classify patients with a high degree of accuracy and 100% consistency to significantly improve diagnostic and classification efficiency. The discovered top 30 laboratory features can be used for greater differentiation to serve as an essential supplement to current guidelines, thus creating a more comprehensive assessment of COVID‐19 cases during the early stages of infection. Such early differentiation will help the assignment of the appropriate level of care for individual patients.

Purpose Low-dose-rate brachytherapy is a key treatment for low-risk or favorable intermediate-risk prostate cancer. The number of radioactive seeds inserted during the procedure depends on prostate volume, and is not easy to predict without pre-planning. Consequently, a large number of unused seeds may be left after treatment. The objective of the present study was to predict the exact number of seeds for future patients using machine learning and a database of 409 treatments. Material and methods Database consisted of 18 dosimetric and efficiency parameters for each of 409 cases. Nine predictive algorithms based on machine-learning were compared in this database, which was divided into training group (80%) and test group (20%). Ten-fold cross-validation was applied to obtain robust statistics. The best algorithm was then used to build an abacus able to predict number of implanted seeds from expected prostate volume only. As an evaluation, the abacus was also applied on an independent series of 38 consecutive patients. Results The best coefficients of determination R2 were given by support vector regression, with values attaining 0.928, 0.948, and 0.968 for training set, test set, and whole set, respectively. In terms of predicted seeds in test group, mean square error, median absolute error, mean absolute error, and maximum error were 2.55, 0.92, 1.21, and 7.29, respectively. The use of obtained abacus in 38 additional patients resulted in saving of 493 seeds (393 vs. 886 remaining seeds). Conclusions Machine-learning-based abacus proposed in this study aims at estimating the necessary number of seeds for future patients according to past experience. This new abacus, based on 409 treatments and successfully tested in 38 new patients, is a good alternative to non-specific recommendations.

Machine learning has been widely used in the characterization of tumors recently. This article aims to explore the feasibility of the whole tumor fat-suppressed (FS) T2WI and ADC features-based least absolute shrinkage and selection operator (LASSO)-logistic predictive models in the differentiation of soft tissue neoplasms (STN). The clinical and MR findings of 160 cases with 161 histologically proven STN were reviewed, retrospectively, 75 with diffusion-weighted imaging (DWI with b values of 50, 400, and 800 s/mm2). They were divided into benign and malignant groups and further divided into training (70%) and validation (30%) cohorts. The MR FS T2WI and ADC features-based LASSO-logistic models were built and compared. The AUC of the FS T2WI features-based LASSO-logistic regression model for benign and malignant prediction was 0.65 and 0.75 for the training and validation cohorts. The model’s sensitivity, specificity, and accuracy of the validation cohort were 55%, 96%, and 76.6%. While the AUC of the ADC features-based model was 0.932 and 0.955 for the training and validation cohorts. The model’s sensitivity, specificity, and accuracy were 83.3%, 100%, and 91.7%. The performances of these models were also validated by decision curve analysis (DCA). The AUC of the whole tumor ADC features-based LASSO-logistic regression predictive model was larger than that of FS T2WI features (p = 0.017). The whole tumor fat-suppressed T2WI and ADC features-based LASSO-logistic predictive models both can serve as useful tools in the differentiation of STN. ADC features-based LASSO-logistic regression predictive model did better than that of FS T2WI features.

Classification of benign and malignant in lung nodules using chest CT images is a key step in the diagnosis of early-stage lung cancer, as well as an effective way to improve the patients’ survival rate. However, due to the diversity of lung nodules and the visual similarity of lung nodules to their surrounding tissues, it is difficult to construct a robust classification model with conventional deep learning–based diagnostic methods. To address this problem, we propose a multi-model ensemble learning architecture based on 3D convolutional neural network (MMEL-3DCNN). This approach incorporates three key ideas: (1) Constructed multi-model network architecture can be well adapted to the heterogeneity of lung nodules. (2) The input that concatenated of the intensity image corresponding to the nodule mask, the original image, and the enhanced image corresponding to which can help training model to extract advanced feature with more discriminative capacity. (3) Select the corresponding model to different nodule size dynamically for prediction, which can improve the generalization ability of the model effectively. In addition, ensemble learning is applied in this paper to further improve the robustness of the nodule classification model. The proposed method has been experimentally verified on the public dataset, LIDC-IDRI. The experimental results show that the proposed MMEL-3DCNN architecture can obtain satisfactory classification results.

Introduction: Dementia is a progressive disorder associated with age, which is characterized by deterioration of individuals’ cognitive functions such as the ability to perform routine tasks. With the increase of human life expectancy, the prevalence of dementia patients will reach 152 million in 2050. Unfortunately, there is no treatment available to cure dementia or alter the course of its progression. However, there is an area of support for patients and caregivers to assist daily living. Technological devices and applications are increasingly advancing, exploiting sensory data for dementia patients and homecare using smartphones to permit monitoring of their activities. Aim: This paper uses the labeled dataset besides comparing the 3-classification algorithm to evaluate whether or not the algorithms deployed can classify the activities with high accuracy. Results: A public data is used to classify human activities into one of the six activities, BigML platform is used to build machine learning models. Results show that machine learning algorithms can achieve high accuracy. The activity recognition algorithms are highly accurate using ridged regression and deep neural networks, with almost all activities being recognized correctly over 98% of the time. Conclusion: An application of smartphones can be utilized for human activities monitoring by proposing a high level for dementia patients and homecare monitoring services. Using this service, the patients only need to carry the smartphone, and their caregivers simply need to use the application that monitors their patients’ activities.

Background Decision curve analysis is a method to evaluate prediction models and diagnostic tests that was introduced in a 2006 publication. Decision curves are now commonly reported in the literature, but there remains widespread misunderstanding of and confusion about what they mean. Summary of commentary In this paper, we present a didactic, step-by-step introduction to interpreting a decision curve analysis and answer some common questions about the method. We argue that many of the difficulties with interpreting decision curves can be solved by relabeling the y-axis as “benefit” and the x-axis as “preference.” A model or test can be recommended for clinical use if it has the highest level of benefit across a range of clinically reasonable preferences. Conclusion Decision curves are readily interpretable if readers and authors follow a few simple guidelines.

Introduction Minimally invasive surgery has been widely used in gynecology. The laparoendoscopic single-site surgery (LESS) risk prediction model can provide evidence-based references for preoperative surgical procedure selection. Aim To determine whether the patients are suitable for LESS and to provide guidance for the clinical operation plan, we aimed to compare the clinical outcomes of LESS and conventional laparoscopic surgery (CLS) in gynecology. We constructed a LESS risk prediction model and predicted surgical conditions for the preoperative evaluation system. Material and methods A retrospective analysis was carried out among patients undergoing LESS (n = 1019) and CLS (n = 1055). Various clinical indicators were compared. Multiple machine model algorithms were evaluated. The optimal results were chosen as the model to form the risk prediction model. Results The LESS group showed advantages in the postoperative 12/24 h visual analog scale and Vancouver scar score compared with the CLS group (p < 0.05). The comparisons in other clinical indicators between the two groups showed that each group had advantages and the difference was statistically significant (p < 0.05), including operative time, estimated blood loss, and hospital stay. We evaluated the predictive value for various models using AUC values of 0.77, 0.77, 0.76, and 0.67 for XGBoost, random forest, GBDT, and logistic regression, respectively. The decision tree model was shown to be the optimal model. Conclusions LESS can reduce postoperative pain, shorten hospital stay and make scars acceptable. The risk prediction model based on a machine learning algorithm has manifested a high degree of accuracy and can satisfy the doctors’ demand for individualized preoperative evaluation and surgical safety in LESS.

Motivation Cancer dependencies provide potential drug targets. Unfortunately, dependencies differ among cancers and even individuals. To this end, visible neural networks (VNNs) are promising due to robust performance and the interpretability required for the biomedical field. Results We design Biological visible neural network (BioVNN) using pathway knowledge to predict cancer dependencies. Despite having fewer parameters, BioVNN marginally outperforms traditional neural networks (NNs) and converges faster. BioVNN also outperforms an NN based on randomized pathways. More importantly, dependency predictions can be explained by correlating with the neuron output states of relevant pathways, which suggest dependency mechanisms. In feature importance analysis, BioVNN recapitulates known reaction partners and proposes new ones. Such robust and interpretable VNNs may facilitate the understanding of cancer dependency and the development of targeted therapies. Availability and implementation Code and data are available at https://github.com/LichtargeLab/BioVNN Supplementary information Supplementary data are available at Bioinformatics online.

Purpose Injuries are common in sports and can have significant physical, psychological and financial consequences. Machine learning (ML) methods could be used to improve injury prediction and allow proper approaches to injury prevention. The aim of our study was therefore to perform a systematic review of ML methods in sport injury prediction and prevention. Methods A search of the PubMed database was performed on March 24th 2020. Eligible articles included original studies investigating the role of ML for sport injury prediction and prevention. Two independent reviewers screened articles, assessed eligibility, risk of bias and extracted data. Methodological quality and risk of bias were determined by the Newcastle–Ottawa Scale. Study quality was evaluated using the GRADE working group methodology. Results Eleven out of 249 studies met inclusion/exclusion criteria. Different ML methods were used (tree-based ensemble methods (n = 9), Support Vector Machines (n = 4), Artificial Neural Networks (n = 2)). The classification methods were facilitated by preprocessing steps (n = 5) and optimized using over- and undersampling methods (n = 6), hyperparameter tuning (n = 4), feature selection (n = 3) and dimensionality reduction (n = 1). Injury predictive performance ranged from poor (Accuracy = 52%, AUC = 0.52) to strong (AUC = 0.87, f1-score = 85%). Conclusions Current ML methods can be used to identify athletes at high injury risk and be helpful to detect the most important injury risk factors. Methodological quality of the analyses was sufficient in general, but could be further improved. More effort should be put in the interpretation of the ML models.

Background The early diagnosis of autism spectrum disorder (ASD) is highly desirable but remains a challenging task, which requires a set of cognitive tests and hours of clinical examinations. In addition, variations of such symptoms exist, which can make the identification of ASD even more difficult. Although diagnosis tests are largely developed by experts, they are still subject to human bias. In this respect, computer-assisted technologies can play a key role in supporting the screening process. Objective This paper follows on the path of using eye tracking as an integrated part of screening assessment in ASD based on the characteristic elements of the eye gaze. This study adds to the mounting efforts in using eye tracking technology to support the process of ASD screening Methods The proposed approach basically aims to integrate eye tracking with visualization and machine learning. A group of 59 school-aged participants took part in the study. The participants were invited to watch a set of age-appropriate photographs and videos related to social cognition. Initially, eye-tracking scanpaths were transformed into a visual representation as a set of images. Subsequently, a convolutional neural network was trained to perform the image classification task. Results The experimental results demonstrated that the visual representation could simplify the diagnostic task and also attained high accuracy. Specifically, the convolutional neural network model could achieve a promising classification accuracy. This largely suggests that visualizations could successfully encode the information of gaze motion and its underlying dynamics. Further, we explored possible correlations between the autism severity and the dynamics of eye movement based on the maximal information coefficient. The findings primarily show that the combination of eye tracking, visualization, and machine learning have strong potential in developing an objective tool to assist in the screening of ASD. Conclusions Broadly speaking, the approach we propose could be transferable to screening for other disorders, particularly neurodevelopmental disorders.