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Objective Explore the nature and prevalence of long-term conditions in individuals with intellectual disability.Design Retrospective longitudinal population-based study.Setting Primary and secondary care data across the population of Wales with the Secure Anonymised Information Linkage (SAIL) Databank.Participants 14 323 individuals were identified during the study date period 1 January 2000 to 31 December 2021 using the following inclusion criteria: 18 or older, alive at the cohort start date, a resident of Wales, with a primary care registration at a SAIL providing general practice with available records and a recorded diagnosis of intellectual disability. Once individuals were identified, health records were observed from birth.Results 13 069 individuals had a recorded diagnosis of intellectual disability and at least one long-term condition, reflecting 91.25% of the population. Demographic data from the SAIL dataset reveal that the study population is predominantly White, with low levels of representation of non-White ethnic groups. In the cohort, a larger proportion of patients live in the most deprived areas of Wales (22.30%), with fewer individuals in less deprived categories. Mental illness was identified as the most prevalent of the identified long-term conditions, whereby 30.91% of the population had a recorded diagnosis of a mental illness which was chronic. For many common conditions, including epilepsy, thyroid disorders, upper gastrointestinal disorders, chronic kidney disease and diabetes, there was an overall trend of higher prevalence rates in the intellectual disability cohort when compared with the general population. The prevalence of hypertension was lower in individuals with intellectual disability. Chronic constipation, chronic diarrhoea and insomnia were examples of long-term conditions added as relevant to individuals with intellectual disability. Notable differences in the distribution of long-term conditions were observed when comparing across sex and age groups. The number of long-term conditions increases with age. Conditions which may usually be expected to emerge later in life are present in younger age groups, such as diabetes, hypertension and chronic arthritis. When hospital episodes were analysed, epilepsy, diabetes, chronic airway disease and mental illness were commonly treated conditions during hospital admission across both sexes. Conditions which were less prevalent in the intellectual disability cohort, but which were treated during ≥6% of total hospital admissions include cancer, cardiac arrhythmias and cerebral palsy.Conclusions This study establishes a range of 40 relevant long-term conditions for people with intellectual disability through an iterative process, which included a review of the available literature and a series of discussions with a Professional Advisory Panel and Patient and Public Involvement groups of this research project. The findings of the study reinforce the high prevalence and early emergence of long-term conditions in the intellectual disability cohort. It also demonstrates the difference in the range of conditions when compared with the general population. There were differences in long-term conditions when separated by sex and age. Long-term conditions which commonly require treatment in hospitals were also revealed. Further work is required to translate the findings of this study into actionable insights. Clusters of multiple long-term conditions, trajectories, outcomes and risk factors should be explored to optimise the understanding and longitudinal care of individuals with intellectual disabilities and long-term conditions.

Background Maternity care is a complex system involving treatments and interactions between patients, healthcare providers, and the care environment. To enhance patient safety and outcomes, it is crucial to understand the human factors (e.g. individuals' decisions, local facilities) influencing healthcare. However, most current tools for analysing healthcare data focus only on biomedical concepts (e.g. health conditions, procedures and tests), overlooking the importance of human factors. Methods We developed a new approach called I-SIRch, using artificial intelligence to automatically identify and label human factors concepts in maternity investigation reports describing adverse maternity incidents produced by England's Healthcare Safety Investigation Branch (HSIB). These incident investigation reports aim to identify opportunities for learning and improving maternal safety across the entire healthcare system. Unlike existing clinical annotation tools that extract solely biomedical insights, I-SIRch is uniquely designed to capture the socio-technical dimensions of patient safety incidents. This innovation enables a more comprehensive analysis of the complex systemic issues underlying adverse events in maternity care, providing insights that were previously difficult to obtain at scale. Importantly, I-SIRch employs a hybrid approach, incorporating human expertise to validate and refine the AI-generated annotations, ensuring the highest quality of analysis. Findings I-SIRch was trained using real data and tested on both real and synthetic data to evaluate its performance in identifying human factors concepts. When applied to real reports, the model achieved a high level of accuracy, correctly identifying relevant concepts in 90% of the sentences from 97 reports (Balanced Accuracy of 90% ± 18% (Recall 93% ± 18%, Precision 87% ± 34%, F-score 96% ± 10%). Applying I-SIRch to analyse these reports revealed that certain human factors disproportionately affected mothers from different ethnic groups. In particular, gaps in risk assessment were more prevalent for minority mothers, whilst communication issues were common across all groups but potentially more for minorities. Interpretation Our work demonstrates the potential of using automated tools to identify human factors concepts in maternity incident investigation reports, rather than focusing solely on biomedical concepts. This approach opens up new possibilities for understanding the complex interplay between social, technical and organisational factors influencing maternal safety and population health outcomes. By taking a more comprehensive view of maternal healthcare delivery, we can develop targeted interventions to address disparities and improve maternal outcomes. Targeted interventions to address these disparities could include culturally sensitive risk assessment protocols, enhanced language support, and specialised training for healthcare providers on recognising and mitigating biases. These findings highlight the need for tailored approaches to improve equitable care delivery and outcomes in maternity services. The I-SIRch framework thus represents a significant advancement in our ability to extract actionable intelligence from healthcare incident reports, moving beyond traditional clinical factors to encompass the broader systemic issues that impact patient safety.

Aims Individuals with intellectual disability (ID) exhibit elevated health needs when compared with the general population. There is a higher vulnerability to long-term conditions. A scoping review identified that individuals with ID exhibit a distinct pattern of multiple long-term conditions (MLTC) that is different to the general population. Findings highlight health challenges faced by individuals with ID, emphasising the need for targeted and early interventions to address their unique healthcare needs. This study utilises a professional advisory panel (PAP) and patient and public involvement (PPI) group to form a consensus on relevant long-term conditions for people with ID. Machine learning algorithms are employed to identify long-term conditions in a large, population-based data repository covering the whole of Wales revealing a comprehensive range and prevalence of long-term conditions in a sample of 13,361 adults with ID. Methods A consensus on relevant long-term conditions for people with ID was formulated through iterative review followed by revision by PAP and PPI group. PAP comprised a multidisciplinary team with relevant expertise including General Practitioners, a Consultant Psychiatrist, nurses, pharmacists, and data analysts. The PAP worked in collaboration with a PPI group, comprising three groups of experts by experience: people with ID, family or informal carers of people with ID, and professional carers of people with ID. This study utilises machine learning algorithms in the Secure Anonymised Information Linkage (SAIL) databank to identify the range and prevalence of long-term conditions in ID. SAIL is an anonymised, population-based data repository, comprising billions of anonymised records across Wales. This study included 13,361 ID adult patients. Results Following iterative review and revision by the PAP and PPI group, a consensus of 40 long-term conditions relevant for people with ID was identified. Prevalence rates for each condition were calculated. Ten most prevalent conditions were recorded as mental illness, reflux disorders, epilepsy, chronic airway diseases, hypertension, thyroid disorders, chronic arthritis, chronic kidney disease, diabetes, and anaemia. Conclusion Consensus on relevant long-term conditions for the general population developed through previous studies is not relevant for the ID population. This is the first effort at creating a full range of long-term conditions for individuals with ID, utilising a population-based data repository. It is possible to do this in partnership with PAP and PPI groups. Along with prevalence, impact of ageing and gender, and hospitalisation as outcome data, this study describes challenges associated with interpreting data captured by Read Codes and ICD–10 codes.

Image retrieval is the process of searching and retrieving images from a datastore based on their visual content and features. Recently, much attention has been directed towards the retrieval of irregular patterns within industrial or healthcare images by extracting features from the images, such as deep features, colour-based features, shape-based features, and local features. This has applications across a spectrum of industries, including fault inspection, disease diagnosis, and maintenance prediction. This paper proposes an image retrieval framework to search for images containing similar irregular patterns by extracting a set of morphological features (DefChars) from images. The datasets employed in this paper contain wind turbine blade images with defects, chest computerised tomography scans with COVID-19 infections, heatsink images with defects, and lake ice images. The proposed framework was evaluated with different feature extraction methods (DefChars, resized raw image, local binary pattern, and scale-invariant feature transforms) and distance metrics to determine the most efficient parameters in terms of retrieval performance across datasets. The retrieval results show that the proposed framework using the DefChars and the Manhattan distance metric achieves a mean average precision of 80% and a low standard deviation of ±0.09 across classes of irregular patterns, outperforming alternative feature–metric combinations across all datasets. Our proposed ImR framework performed better (by 8.71%) than Super Global, a state-of-the-art deep-learning-based image retrieval approach across all datasets.

Estimating the lifetime of enameled wires using the conventional/standard test method requires a significant amount of time that can endure up to thousands of testing hours, which could considerably delay the time-to-market of a new product. This paper presents a new approach that estimates the insulation lifetime of enameled wire, employed in electrical machines, using curve fitting models whose computation is rapid and accurate. Three curve fit models are adopted to predict the insulation resistance of double-coated enameled magnet wire samples, with respect to their aging time. The samples' mean time-to-failure is estimated, and performance of the models is apprised through a comparison against the conventional `standard method' of lifetime estimation of the enameled wires. The best prediction accuracy is achieved by a logarithmic curve fit approach, which gives an error of 0.95% and 1.62% when its thermal index is compared with the conventional method and manufacturer claim respectively. The proposed approach provides a time-saving of 67% (83 days) when its computation time is compared with respect to the `standard method' of lifetime estimation.

Detecting the presence of prostate cancer (PCa) and distinguishing low- or intermediate-risk disease from high-risk disease early, and without the need for potentially unnecessary invasive biopsies remains a significant clinical challenge. The aim of this study is to determine whether the T and B cell phenotypic features which we have previously identified as being able to distinguish between benign prostate disease and PCa in asymptomatic men having Prostate-Specific Antigen (PSA) levels < 20 ng/ml can also be used to detect the presence and clinical risk of PCa in a larger cohort of patients whose PSA levels ranged between 3 and 2617 ng/ml. The peripheral blood of 130 asymptomatic men having elevated Prostate-Specific Antigen (PSA) levels was immune profiled using multiparametric whole blood flow cytometry. Of these men, 42 were subsequently diagnosed as having benign prostate disease and 88 as having PCa on biopsy-based evidence. We built a bidirectional Long Short-Term Memory Deep Neural Network (biLSTM) model for detecting the presence of PCa in men which combined the previously-identified phenotypic features (CD8+CD45RA-CD27-CD28- (CD8+ Effector Memory cells), CD4+CD45RA-CD27-CD28- (CD4+ Effector Memory cells), CD4+CD45RA+CD27-CD28- (CD4+ Terminally Differentiated Effector Memory Cells re-expressing CD45RA), CD3-CD19+ (B cells), CD3+CD56+CD8+CD4+ (NKT cells) with Age. The performance of the PCa presence ‘detection’ model was: Acc: 86.79 ( ± 0.10), Sensitivity: 82.78% (± 0.15); Specificity: 95.83% (± 0.11) on the test set (test set that was not used during training and validation); AUC: 89.31% (± 0.07), ORP-FPR: 7.50% (± 0.20), ORP-TPR: 84.44% (± 0.14). A second biLSTM ‘risk’ model combined the immunophenotypic features with PSA to predict whether a patient with PCa has high-risk disease (defined by the D’Amico Risk Classification) achieved the following: Acc: 94.90% (± 6.29), Sensitivity: 92% (± 21.39); Specificity: 96.11 (± 0.00); AUC: 94.06% (± 10.69), ORP-FPR: 3.89% (± 0.00), ORP-TPR: 92% (± 21.39). The ORP-FPR for predicting the presence of PCa when combining FC+PSA was lower than that of PSA alone. This study demonstrates that AI approaches based on peripheral blood phenotyping profiles can distinguish between benign prostate disease and PCa and predict clinical risk in asymptomatic men having elevated PSA levels.

Cross-Modal Hashing (CMH) retrieval methods have garnered increasing attention within the information retrieval research community due to their capability to deal with large amounts of data thanks to the computational efficiency of hash-based methods. To date, the focus of cross-modal hashing methods has been on training with paired data. Paired data refers to samples with one-to-one correspondence across modalities, e.g., image and text pairs where the text sample describes the image. However, real-world applications produce unpaired data that cannot be utilised by most current CMH methods during the training process. Models that can learn from unpaired data are crucial for real-world applications such as cross-modal neural information retrieval where paired data is limited or not available to train the model. This paper provides (1) an overview of the CMH methods when applied to unpaired datasets, (2) proposes a framework that enables pairwise-constrained CMH methods to train with unpaired samples, and (3) evaluates the performance of state-of-the-art CMH methods across different pairing scenarios.

For a continuous mode of operation, insulating material in an electrical machine is subject to constant thermal, electrical, mechanical and environmental stresses where thermal stress is a major cause of gradual insulation deterioration, which leads to ultimate winding failure. To guarantee a satisfactory lifetime, electrical machines are designed to operate winding temperatures well below their thermal class, which results in an oversized design. Standard methods for thermal lifetime evaluation of electrical machines are based on accelerated aging tests that require several months of testing. This paper proposes an alternative approach relying on a supervised neural network that significantly shortens the time demanded by accelerated aging tests for thermal lifetime evaluation of electrical machines. The supervised neural network is based on a feedforward neural network trained with Bayesian Regularisation Backpropagation (BRP) algorithm. The network predicts the wire insulation resistance with respect to its aging time at aging temperatures of 250°C, 270°C and 290°C, which reveals a good match of prediction outcomes against the experimental findings. The mean time-to-failure at each aging temperature is extracted using the Weibull probability plot in order to compare the Arrhenius curves for both conventional and proposed method and a relative error of 0.125% is achieved in terms of their temperature indexes. In addition, the analysis shows a time saving of 1680 hours (57% time saved of experimental test procedure) when the thermal life of the insulating material is predicted using BRP neural network.

We demonstrate that prostate cancer can be identified by flow cytometric profiling of blood immune cell subsets. Herein, we profiled natural killer (NK) cell subsets in the blood of 72 asymptomatic men with Prostate-Specific Antigen (PSA) levels < 20 ng ml-1, of whom 31 had benign disease (no cancer) and 41 had prostate cancer. Statistical and computational methods identified a panel of eight phenotypic features ([Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text]) that, when incorporated into an Ensemble machine learning prediction model, distinguished between the presence of benign prostate disease and prostate cancer. The machine learning model was then adapted to predict the D’Amico Risk Classification using data from 54 patients with prostate cancer and was shown to accurately differentiate between the presence of low-/intermediate-risk disease and high-risk disease without the need for additional clinical data. This simple blood test has the potential to transform prostate cancer diagnostics.

Eigendecomposition is the factorization of a matrix into its canonical form, whereby the matrix is represented in terms of its eigenvalues and eigenvectors. A common step is the reduction of the data to a kernel matrix also known as a Gram matrix which is used for machine learning tasks. A significant drawback of kernel methods is the computational complexity associated with manipulating kernel matrices. This paper demonstrates that leading eigenvectors derived from singular value decomposition (SVD) and Nyström approximation methods can be utilized for classification tasks without the need to construct Gram matrices. Experiments were conducted with 14 biomedical datasets to compare classifier performance when taking as input into a classifier matrices containing: 1) leading eigenvectors which result from each approximation method, and 2) matrices which result from constructing the patient-by-patient Gram matrix. The results provide evidence to support the main hypothesis of this paper that using the leading eigenvectors as input into a classifier significantly (p

Visual-semantic embedding (VSE) networks create joint image–text representations to map images and texts in a shared embedding space to enable various information retrieval-related tasks, such as image–text retrieval, image captioning, and visual question answering. The most recent state-of-the-art VSE-based networks are: VSE++, SCAN, VSRN, and UNITER. This study evaluates the performance of those VSE networks for the task of image-to-text retrieval and identifies and analyses their strengths and limitations to guide future research on the topic. The experimental results on Flickr30K revealed that the pre-trained network, UNITER, achieved 61.5% on average Recall@5 for the task of retrieving all relevant descriptions. The traditional networks, VSRN, SCAN, and VSE++, achieved 50.3%, 47.1%, and 29.4% on average Recall@5, respectively, for the same task. An additional analysis was performed on image–text pairs from the top 25 worst-performing classes using a subset of the Flickr30K-based dataset to identify the limitations of the performance of the best-performing models, VSRN and UNITER. These limitations are discussed from the perspective of image scenes, image objects, image semantics, and basic functions of neural networks. This paper discusses the strengths and limitations of VSE networks to guide further research into the topic of using VSE networks for cross-modal information retrieval tasks.

Demand for wind power has grown, and this has increased wind turbine blade (WTB) inspections and defect repairs. This paper empirically investigates the performance of state-of-the-art deep learning algorithms, namely, YOLOv3, YOLOv4, and Mask R-CNN for detecting and classifying defects by type. The paper proposes new performance evaluation measures suitable for defect detection tasks, and these are: Prediction Box Accuracy, Recognition Rate, and False Label Rate. Experiments were carried out using a dataset, provided by the industrial partner, that contains images from WTB inspections. Three variations of the dataset were constructed using different image augmentation settings. Results of the experiments revealed that on average, across all proposed evaluation measures, Mask R-CNN outperformed all other algorithms when transformation-based augmentations (i.e., rotation and flipping) were applied. In particular, when using the best dataset, the mean Weighted Average (mWA) values (i.e., mWA is the average of the proposed measures) achieved were: Mask R-CNN: 86.74%, YOLOv3: 70.08%, and YOLOv4: 78.28%. The paper also proposes a new defect detection pipeline, called Image Enhanced Mask R-CNN (IE Mask R-CNN), that includes the best combination of image enhancement and augmentation techniques for pre-processing the dataset, and a Mask R-CNN model tuned for the task of WTB defect detection and classification.

Determining whether an asymptomatic individual with Prostate-Specific Antigen (PSA) levels below 20 ng ml−1 has prostate cancer in the absence of definitive, biopsy-based evidence continues to present a significant challenge to clinicians who must decide whether such individuals with low PSA values have prostate cancer. Herein, we present an advanced computational data extraction approach which can identify the presence of prostate cancer in men with PSA levels

The prediction of cancer staging in prostate cancer is a process for estimating the likelihood that the cancer has spread before treatment is given to the patient. Although important for determining the most suitable treatment and optimal management strategy for patients, staging continues to present significant challenges to clinicians. Clinical test results such as the pre-treatment Prostate-Specific Antigen (PSA) level, the biopsy most common tumor pattern (Primary Gleason pattern) and the second most common tumor pattern (Secondary Gleason pattern) in tissue biopsies, and the clinical T stage can be used by clinicians to predict the pathological stage of cancer. However, not every patient will return abnormal results in all tests. This significantly influences the capacity to effectively predict the stage of prostate cancer. Herein we have developed a neuro-fuzzy computational intelligence model for classifying and predicting the likelihood of a patient having Organ-Confined Disease (OCD) or Extra-Prostatic Disease (ED) using a prostate cancer patient dataset obtained from The Cancer Genome Atlas (TCGA) Research Network. The system input consisted of the following variables: Primary and Secondary Gleason biopsy patterns, PSA levels, age at diagnosis, and clinical T stage. The performance of the neuro-fuzzy system was compared to other computational intelligence based approaches, namely the Artificial Neural Network, Fuzzy C-Means, Support Vector Machine, the Naive Bayes classifiers, and also the AJCC pTNM Staging Nomogram which is commonly used by clinicians. A comparison of the optimal Receiver Operating Characteristic (ROC) points that were identified using these approaches, revealed that the neuro-fuzzy system, at its optimal point, returns the largest Area Under the ROC Curve (AUC), with a low number of false positives (FPR = 0.274, TPR = 0.789, AUC = 0.812). The proposed approach is also an improvement over the AJCC pTNM Staging Nomogram (FPR = 0.032, TPR = 0.197, AUC = 0.582).