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Deep learning (DL) in orthopaedics has gained significant attention in recent years. Previous studies have shown that DL can be applied to a wide variety of orthopaedic tasks, including fracture detection, bone tumour diagnosis, implant recognition, and evaluation of osteoarthritis severity. The utilisation of DL is expected to increase, owing to its ability to present accurate diagnoses more efficiently than traditional methods in many scenarios. This reduces the time and cost of diagnosis for patients and orthopaedic surgeons. To our knowledge, no exclusive study has comprehensively reviewed all aspects of DL currently used in orthopaedic practice. This review addresses this knowledge gap using articles from Science Direct, Scopus, IEEE Xplore, and Web of Science between 2017 and 2023. The authors begin with the motivation for using DL in orthopaedics, including its ability to enhance diagnosis and treatment planning. The review then covers various applications of DL in orthopaedics, including fracture detection, detection of supraspinatus tears using MRI, osteoarthritis, prediction of types of arthroplasty implants, bone age assessment, and detection of joint-specific soft tissue disease. We also examine the challenges for implementing DL in orthopaedics, including the scarcity of data to train DL and the lack of interpretability, as well as possible solutions to these common pitfalls. Our work highlights the requirements to achieve trustworthiness in the outcomes generated by DL, including the need for accuracy, explainability, and fairness in the DL models. We pay particular attention to fusion techniques as one of the ways to increase trustworthiness, which have also been used to address the common multimodality in orthopaedics. Finally, we have reviewed the approval requirements set forth by the US Food and Drug Administration to enable the use of DL applications. As such, we aim to have this review function as a guide for researchers to develop a reliable DL application for orthopaedic tasks from scratch for use in the market., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The enhanced thermal efficiency exhibited by Casson nanofluids offers significant practical applications across various industrial and engineering sectors. This study focuses on the mathematical investigation of the steady magnetohydrodynamic (MHD) boundary layer flow of Casson nanofluid through a stretched/shrinking cylinder, taking into account the effects of suction and thermal radiation. The governing partial differential equations (PDEs) have been subjected to a similarity transformation, resulting in a set of nonlinear ordinary differential equations (ODEs). These ODEs were solved numerically utilizing the code of bvp4c in the software of Matlab which offers high accuracy (4th order). The employed nanofluid model incorporates the effects of Brownian motion and thermophoresis. The present study illustrates the graphical depictions of the impacts of different governing parameters, namely Hartmann ( M ) number, curvature ( γ ) parameter, Brownian motion ( N b ) parameter, mass suction ( S ) parameter, thermal radiation ( R d ) parameter, and thermophoresis ( N t ) parameter, on heat transfer, flow, and mass transfer characteristics. Comprehensive determination and visual presentation of the coefficient of skin friction, local Nusselt number, and local Sherwood number were conducted for a range of estimates of applied parameters. Based on our examination, it has been determined that dual similarity solutions are present within a specific range of mass suction parameters. The relationship between the Casson parameter and various fluid dynamic properties, such as skin friction coefficient, heat transfer rate, and mass transfer rates, has been found to exhibit a decreasing trend. Furthermore, the stability analysis discovered that the first solution exhibits linear stability, whereas the second solution displays linear instability. Additionally, the motivation behind this study is to enhance industrial performance through the optimization of thermal power generation systems, thereby increasing their overall efficiency., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Reinforcement learning (RL) has emerged as a dynamic and transformative paradigm in artificial intelligence, offering the promise of intelligent decision-making in complex and dynamic environments. This unique feature enables RL to address sequential decision-making problems with simultaneous sampling, evaluation, and feedback. As a result, RL techniques have become suitable candidates for developing powerful solutions in various domains. In this study, we present a comprehensive and systematic review of RL algorithms and applications. This review commences with an exploration of the foundations of RL and proceeds to examine each algorithm in detail, concluding with a comparative analysis of RL algorithms based on several criteria. This review then extends to two key applications of RL: robotics and healthcare. In robotics manipulation, RL enhances precision and adaptability in tasks such as object grasping and autonomous learning. In healthcare, this review turns its focus to the realm of cell growth problems, clarifying how RL has provided a data-driven approach for optimizing the growth of cell cultures and the development of therapeutic solutions. This review offers a comprehensive overview, shedding light on the evolving landscape of RL and its potential in two diverse yet interconnected fields., Competing Interests: The authors declare no conflicts of interests. The company was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

The main challenge in adopting deep learning models is limited data for training, which can lead to poor generalization and a high risk of overfitting, particularly when detecting forearm abnormalities in X-ray images. Transfer learning from ImageNet is commonly used to address these issues. However, this technique is ineffective for grayscale medical imaging because of a mismatch between the learned features. To mitigate this issue, we propose a domain adaptation deep TL approach that involves training six pre-trained ImageNet models on a large number of X-ray images from various body parts, then fine-tuning the models on a target dataset of forearm X-ray images. Furthermore, the feature fusion technique combines the extracted features with deep neural models to train machine learning classifiers. Gradient-based class activation heat map (Grad CAM) was used to verify the accuracy of our results. This method allows us to see which parts of an image the model uses to make its classification decisions. The statically results and Grad CAM have shown that the proposed TL approach is able to alleviate the domain mismatch problem and is more accurate in their decision-making compared to models that were trained using the ImageNet TL technique, achieving an accuracy of 90.7%, an F1-score of 90.6%, and a Cohen's kappa of 81.3%. These results indicate that the proposed approach effectively improved the performance of the employed models individually and with the fusion technique. It helped to reduce the domain mismatch between the source of TL and the target task.

Transfer learning (TL) has been widely utilized to address the lack of training data for deep learning models. Specifically, one of the most popular uses of TL has been for the pre-trained models of the ImageNet dataset. Nevertheless, although these pre-trained models have shown an effective performance in several domains of application, those models may not offer significant benefits in all instances when dealing with medical imaging scenarios. Such models were designed to classify a thousand classes of natural images. There are fundamental differences between these models and those dealing with medical imaging tasks regarding learned features. Most medical imaging applications range from two to ten different classes, where we suspect that it would not be necessary to employ deeper learning models. This paper investigates such a hypothesis and develops an experimental study to examine the corresponding conclusions about this issue. The lightweight convolutional neural network (CNN) model and the pre-trained models have been evaluated using three different medical imaging datasets. We have trained the lightweight CNN model and the pre-trained models with two scenarios which are with a small number of images once and a large number of images once again. Surprisingly, it has been found that the lightweight model trained from scratch achieved a more competitive performance when compared to the pre-trained model. More importantly, the lightweight CNN model can be successfully trained and tested using basic computational tools and provide high-quality results, specifically when using medical imaging datasets., Competing Interests: The authors declare that they have no competing interests., (© 2021 Alzubaidi et al.)

Deep learning requires a large amount of data to perform well. However, the field of medical image analysis suffers from a lack of sufficient data for training deep learning models. Moreover, medical images require manual labeling, usually provided by human annotators coming from various backgrounds. More importantly, the annotation process is time-consuming, expensive, and prone to errors. Transfer learning was introduced to reduce the need for the annotation process by transferring the deep learning models with knowledge from a previous task and then by fine-tuning them on a relatively small dataset of the current task. Most of the methods of medical image classification employ transfer learning from pretrained models, e.g., ImageNet, which has been proven to be ineffective. This is due to the mismatch in learned features between the natural image, e.g., ImageNet, and medical images. Additionally, it results in the utilization of deeply elaborated models. In this paper, we propose a novel transfer learning approach to overcome the previous drawbacks by means of training the deep learning model on large unlabeled medical image datasets and by next transferring the knowledge to train the deep learning model on the small amount of labeled medical images. Additionally, we propose a new deep convolutional neural network (DCNN) model that combines recent advancements in the field. We conducted several experiments on two challenging medical imaging scenarios dealing with skin and breast cancer classification tasks. According to the reported results, it has been empirically proven that the proposed approach can significantly improve the performance of both classification scenarios. In terms of skin cancer, the proposed model achieved an F1-score value of 89.09% when trained from scratch and 98.53% with the proposed approach. Secondly, it achieved an accuracy value of 85.29% and 97.51%, respectively, when trained from scratch and using the proposed approach in the case of the breast cancer scenario. Finally, we concluded that our method can possibly be applied to many medical imaging problems in which a substantial amount of unlabeled image data is available and the labeled image data is limited. Moreover, it can be utilized to improve the performance of medical imaging tasks in the same domain. To do so, we used the pretrained skin cancer model to train on feet skin to classify them into two classes-either normal or abnormal (diabetic foot ulcer (DFU)). It achieved an F1-score value of 86.0% when trained from scratch, 96.25% using transfer learning, and 99.25% using double-transfer learning.

In the last few years, the deep learning (DL) computing paradigm has been deemed the Gold Standard in the machine learning (ML) community. Moreover, it has gradually become the most widely used computational approach in the field of ML, thus achieving outstanding results on several complex cognitive tasks, matching or even beating those provided by human performance. One of the benefits of DL is the ability to learn massive amounts of data. The DL field has grown fast in the last few years and it has been extensively used to successfully address a wide range of traditional applications. More importantly, DL has outperformed well-known ML techniques in many domains, e.g., cybersecurity, natural language processing, bioinformatics, robotics and control, and medical information processing, among many others. Despite it has been contributed several works reviewing the State-of-the-Art on DL, all of them only tackled one aspect of the DL, which leads to an overall lack of knowledge about it. Therefore, in this contribution, we propose using a more holistic approach in order to provide a more suitable starting point from which to develop a full understanding of DL. Specifically, this review attempts to provide a more comprehensive survey of the most important aspects of DL and including those enhancements recently added to the field. In particular, this paper outlines the importance of DL, presents the types of DL techniques and networks. It then presents convolutional neural networks (CNNs) which the most utilized DL network type and describes the development of CNNs architectures together with their main features, e.g., starting with the AlexNet network and closing with the High-Resolution network (HR.Net). Finally, we further present the challenges and suggested solutions to help researchers understand the existing research gaps. It is followed by a list of the major DL applications. Computational tools including FPGA, GPU, and CPU are summarized along with a description of their influence on DL. The paper ends with the evolution matrix, benchmark datasets, and summary and conclusion., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2021.)