Machine Learning Techniques Driven Medicine Analysis

The application of machine learning (ML) techniques stands as a reliable method for aiding in the diagnosis of complex diseases. Recent studies have related the composition of the gut microbiota to the presence of autism spectrum disorder (ASD), but until now, the results have been mostly contradictory. This work proposes using machine learning to study the gut microbiome composition and its role in the early diagnosis of ASD. We applied support vector machines (SVMs), artificial neural networks (ANNs), and random forest (RF) algorithms to classify subjects as neurotypical (NT) or having ASD, using published data on gut microbiome composition. Naive Bayes, k-nearest neighbors, ensemble learning, logistic regression, linear regression, and decision trees were also trained and validated; however, the ones presented showed the best performance and interpretability. All the ML methods were developed using the SAS Viya software platform. The microbiome’s composition was determined using 16S rRNA sequencing technology. The application of ML yielded a classification accuracy as high as 90%, with a sensitivity of 96.97% and specificity reaching 85.29%. In the case of the ANN model, no errors occurred when classifying NT subjects from the first dataset, indicating a significant classification outcome compared to traditional tests and data-based approaches. This approach was repeated with two datasets, one from the USA and the other from China, resulting in similar findings. The main predictors in the obtained models differ between the analyzed datasets. The most important predictors identified from the analyzed datasets are Bacteroides, Lachnospira, Anaerobutyricum, and Ruminococcus torques. Notably, among the predictors in each model, there is the presence of bacteria that are usually considered insignificant in the microbiome’s composition due to their low relative abundance. This outcome reinforces the conventional understanding of the microbiome’s influence on ASD development, where an imbalance in the composition of the microbiota can lead to disrupted host–microbiota homeostasis. Considering that several previous studies focused on the most abundant genera and neglected smaller (and frequently not statistically significant) microbial communities, the impact of such communities has been poorly analyzed. The ML-based models suggest that more research should focus on these less abundant microbes. A novel hypothesis explains the contradictory results in this field and advocates for more in-depth research to be conducted on variables that may not exhibit statistical significance. The obtained results seem to contribute to an explanation of the contradictory findings regarding ASD and its relation with gut microbiota composition. While some research correlates higher ratios of Bacillota/Bacteroidota, others find the opposite. These discrepancies are closely linked to the minority organisms in the microbiome’s composition, which may differ between populations but share similar metabolic functions. Therefore, the ratios of Bacillota/Bacteroidota regarding ASD may not be determinants in the manifestation of ASD. Full article

CT scans are currently the most common imaging modality used for suspected stroke patients due to their short acquisition time and wide availability. However, MRI offers superior tissue contrast and image quality. In this study, eight deep learning models are developed, trained, and tested using a dataset of 181 CT/MR pairs from stroke patients. The resultant synthetic MRIs generated by these models are compared through a variety of qualitative and quantitative methods. The synthetic MRIs generated by a 3D UNet model consistently demonstrated superior performance across all methods of evaluation. Overall, the generation of synthetic MRIs from CT scans using the methods described in this paper produces realistic MRIs that can guide the registration of CT scans to MRI atlases. The synthetic MRIs enable the segmentation of white matter, grey matter, and cerebrospinal fluid by using algorithms designed for MRIs, exhibiting a high degree of similarity to true MRIs. Full article

This study addressed the challenge of training generative adversarial networks (GANs) on small tabular clinical trial datasets for data augmentation, which are known to pose difficulties in training due to limited sample sizes. To overcome this obstacle, a hybrid approach is proposed, combining the synthetic minority oversampling technique (SMOTE) to initially augment the original data to a more substantial size for improving the subsequent GAN training with a Wasserstein conditional generative adversarial network with gradient penalty (WCGAN-GP), proven for its state-of-art performance and enhanced stability. The ultimate objective of this research was to demonstrate that the quality of synthetic tabular data generated by the final WCGAN-GP model maintains the structural integrity and statistical representation of the original small dataset using this hybrid approach. This focus is particularly relevant for clinical trials, where limited data availability due to privacy concerns and restricted accessibility to subject enrollment pose common challenges. Despite the limitation of data, the findings demonstrate that the hybrid approach successfully generates synthetic data that closely preserved the characteristics of the original small dataset. By harnessing the power of this hybrid approach to generate faithful synthetic data, the potential for enhancing data-driven research in drug clinical trials become evident. This includes enabling a robust analysis on small datasets, supplementing the lack of clinical trial data, facilitating its utility in machine learning tasks, even extending to using the model for anomaly detection to ensure better quality control during clinical trial data collection, all while prioritizing data privacy and implementing strict data protection measures. Full article

Background and Aim: Ultrasound (US) imaging is increasingly preferred over other more invasive modalities in preclinical studies using animal models. However, this technique has some limitations, mainly related to operator dependence. To overcome some of the current drawbacks, sophisticated data processing models are proposed, in particular artificial intelligence models based on deep learning (DL) networks. This systematic review aims to overview the application of DL algorithms in assisting US analysis of images acquired in in vivo preclinical studies on animal models. Methods: A literature search was conducted using the Scopus and PubMed databases. Studies published from January 2012 to November 2022 that developed DL models on US images acquired in preclinical/animal experimental scenarios were eligible for inclusion. This review was conducted according to PRISMA guidelines. Results: Fifty-six studies were enrolled and classified into five groups based on the anatomical district in which the DL models were used. Sixteen studies focused on the cardiovascular system and fourteen on the abdominal organs. Five studies applied DL networks to images of the musculoskeletal system and eight investigations involved the brain. Thirteen papers, grouped under a miscellaneous category, proposed heterogeneous applications adopting DL systems. Our analysis also highlighted that murine models were the most common animals used in in vivo studies applying DL to US imaging. Conclusion: DL techniques show great potential in terms of US images acquired in preclinical studies using animal models. However, in this scenario, these techniques are still in their early stages, and there is room for improvement, such as sample sizes, data preprocessing, and model interpretability. Full article

The knee is an anatomical structure that can provide a great deal of data for research on age estimation. The aim of this study was to evaluate and apply a method for semi-automatic measurements of the area under the growth plate closure of the femur distal epiphysis and the growth plate closure itself on the 2D coronary slices using T2 weighted images (T2WI) generated on magnetic resonance (MRI) devices of different technical and technological characteristics. After the semi-automatic segmentation of the femur distal epiphysis under the growth plate closure and the growth plate closure itself, the areas of the measured closures were calculated using MATLAB version: 9.12. (R2022a), MathWorks Inc., Natick, MA, USA, for each individual coronal slice. The area ratio index (ARI) was calculated as the ratio between the area under the growth plate closure of the femur distal epiphysis and the growth plate closure itself. The study sample consisted of 27 female and 23 male Caucasian participants aged 10 to 26 years. A total of 339 T2WI images were used for ARI calculations. There was a positive correlation between chronological age and the average ARI measured by three independent observers (r = 0.8280, p < 0.001). Multiple regression analysis did not show any significant impact of the technical and technological characteristics of the MRI devices on ARI. The results of this study showed that ARI could serve as a useful tool for age estimation using knee MRI as well as for the further development of artificial intelligence (AI) applications. Full article

Wireless Body Area Network (WBAN) is a trending technology of Wireless Sensor Networks (WSN) to enhance the healthcare system. This system is developed to monitor individuals by observing their physical signals to offer physical activity status as a wearable low-cost system that is considered an unremarkable solution for continuous monitoring of cardiovascular health. Various studies have discussed the uses of WBAN in Personal Health Monitoring systems (PHM) based on real-world health monitoring models. The major goal of WBAN is to offer early and fast analysis of the individuals but it is not able to attain its potential by utilizing conventional expert systems and data mining. Multiple kinds of research are performed in WBAN based on routing, security, energy efficiency, etc. This paper suggests a new heart disease prediction under WBAN. Initially, the standard patient data regarding heart diseases are gathered from benchmark datasets using WBAN. Then, the channel selections for data transmission are carried out through the Improved Dingo Optimizer (IDOX) algorithm using a multi-objective function. Through the selected channel, the data are transmitted for the deep feature extraction process using One Dimensional-Convolutional Neural Networks (ID-CNN) and Autoencoder. Then, the optimal feature selections are done through the IDOX algorithm for getting more suitable features. Finally, the IDOX-based heart disease prediction is done by Modified Bidirectional Long Short-Term Memory (M-BiLSTM), where the hyperparameters of BiLSTM are tuned using the IDOX algorithm. Thus, the empirical outcomes of the given offered method show that it accurately categorizes a patient’s health status founded on abnormal vital signs that is useful for providing the proper medical care to the patients. Full article

In most machine learning (ML) applications, data that arrive from heterogeneous views (i.e., multiple heterogeneous sources of data) are more likely to provide complementary information than does a single view. Hence, these are known as multi-view data. In real-world applications, such as web clustering, data arrive from diverse groups (i.e., sets of features) and therefore have heterogeneous properties. Each feature group is referred to as a particular view. Although multi-view learning provides complementary information for machine learning algorithms, it results in high dimensionality. However, to reduce the dimensionality, feature selection is an efficient method that can be used to select only the representative features of the views so to reduce the dimensionality. In this paper, an unsupervised feature selection for online dynamic multi-views (UFODMV) is developed, which is a novel and efficient mechanism for the dynamic selection of features from multi-views in an unsupervised stream. UFODMV consists of a clustering-based feature selection mechanism enabling the dynamic selection of representative features and a merging process whereby both features and views are received incrementally in a streamed fashion over time. The experimental evaluation demonstrates that the UFODMV model has the best classification accuracy with values of 20% and 50% compared with well-known single-view and multi-view unsupervised feature selection methods, namely OMVFS, USSSF, and SPEC. Full article

Background: Before integrating new machine learning (ML) into clinical practice, algorithms must undergo validation. Validation studies require sample size estimates. Unlike hypothesis testing studies seeking a p-value, the goal of validating predictive models is obtaining estimates of model performance. There is no standard tool for determining sample size estimates for clinical validation studies for machine learning models. Methods: Our open-source method, Sample Size Analysis for Machine Learning (SSAML) was described and was tested in three previously published models: brain age to predict mortality (Cox Proportional Hazard), COVID hospitalization risk prediction (ordinal regression), and seizure risk forecasting (deep learning). Results: Minimum sample sizes were obtained in each dataset using standardized criteria. Discussion: SSAML provides a formal expectation of precision and accuracy at a desired confidence level. SSAML is open-source and agnostic to data type and ML model. It can be used for clinical validation studies of ML models. Full article

There has been a sharp increase in liver disease globally, and many people are dying without even knowing that they have it. As a result of its limited symptoms, it is extremely difficult to detect liver disease until the very last stage. In the event of early detection, patients can begin treatment earlier, thereby saving their lives. It has become increasingly popular to use ensemble learning algorithms since they perform better than traditional machine learning algorithms. In this context, this paper proposes a novel architecture based on ensemble learning and enhanced preprocessing to predict liver disease using the Indian Liver Patient Dataset (ILPD). Six ensemble learning algorithms are applied to the ILPD, and their results are compared to those obtained with existing studies. The proposed model uses several data preprocessing methods, such as data balancing, feature scaling, and feature selection, to improve the accuracy with appropriate imputations. Multivariate imputation is applied to fill in missing values. On skewed columns, log1p transformation was applied, along with standardization, min–max scaling, maximum absolute scaling, and robust scaling techniques. The selection of features is carried out based on several methods including univariate selection, feature importance, and correlation matrix. These enhanced preprocessed data are trained on Gradient boosting, XGBoost, Bagging, Random Forest, Extra Tree, and Stacking ensemble learning algorithms. The results of the six models were compared with each other, as well as with the models used in other research works. The proposed model using extra tree classifier and random forest, outperformed the other methods with the highest testing accuracy of 91.82% and 86.06%, respectively, portraying our method as a real-world solution for detecting liver disease. Full article

The impact analysis of deep learning models for COVID-19-infected X-ray images is an extremely challenging task. Every model has unique capabilities that can provide suitable solutions for some given problem. The prescribed work analyzes various deep learning models that are used for capturing the chest X-ray images. Their performance-defining factors, such as accuracy, f1-score, training and the validation loss, are tested with the support of the training dataset. These deep learning models are multi-layered architectures. These parameters fluctuate based on the behavior of these layers, learning rate, training efficiency, or over-fitting of models. This may in turn introduce sudden changes in the values of training accuracy, testing accuracy, loss or validation loss, f1-score, etc. Some models produce linear responses with respect to the training and testing data, such as Xception, but most of the models provide a variation of these parameters either in the accuracy or the loss functions. The prescribed work performs detailed experimental analysis of deep learning image neural network models and compares them with the above said parameters with detailed analysis of these parameters with their responses regarding accuracy and loss functions. This work also analyses the suitability of these model based on the various parameters, such as the accuracy and loss functions to various applications. This prescribed work also lists out various challenges on the implementation and experimentation of these models. Solutions are provided for enhancing the performance of these deep learning models. The deep learning models that are used in the prescribed work are Resnet, VGG16, Resnet with VGG, Inception V3, Xception with transfer learning, and CNN. The model is trained with more than 1500 images of the chest-X-ray data and tested with around 132 samples of the X-ray image dataset. The prescribed work analyzes the accuracy, f1-score, recall, and precision of these models and analyzes these parameters. It also measures parameters such as training accuracy, testing accuracy, loss, and validation loss. Each epoch of every model is recorded to measure the changes in these parameters during the experimental analysis. The prescribed work provides insight for future research through various challenges and research findings with future directions. Full article

A smart device carries a great amount of sensitive patient data as it offers innovative and enhanced functionalities in the smart healthcare system. Moreover, the components of healthcare systems are interconnected via the Internet, bringing significant changes to the delivery of healthcare services to individuals. However, easy access to healthcare services and applications has given rise to severe risks and vulnerabilities that hamper the performance of a smart healthcare system. Moreover, a large number of heterogeneous devices accumulate data that vary in terms of size and formats, making it challenging to manage the data in the healthcare repository and secure it from attackers who seek to profit from the data. Thus, smart healthcare systems are susceptible to numerous security threats and risks, such as hardware and software-based attacks, system-level attacks, and network attacks that have the potential to place patients’ lives at risk. An analysis of the literature revealed a research gap in that most security surveys on the healthcare ecosystem examined only the security challenges and did not explore the possibility of integrating modern technologies to alleviate security issues in the smart healthcare system. Therefore, in this article, we conduct a comprehensive review of the various most recent security challenges and their countermeasures in the smart healthcare environment. In addition, an artificial intelligence (AI) and blockchain-based secure architecture is proposed as a case study to analyse malware and network attacks on wearable devices. The proposed architecture is evaluated using various performance metrics such as blockchain scalability, accuracy, and dynamic malware analysis. Lastly, we highlight different open issues and research challenges facing smart healthcare systems. Full article

Medical records generated in hospitals are treasures for academic research and future references. Medical Image Retrieval (MIR) Systems contribute significantly to locating the relevant records required for a particular diagnosis, analysis, and treatment. An efficient classifier and effective indexing technique are required for the storage and retrieval of medical images. In this paper, a retrieval framework is formulated by adopting a modified Local Binary Pattern feature (AvN-LBP) for indexing and an optimized Fuzzy Art Map (FAM) for classifying and searching medical images. The proposed indexing method extracts LBP considering information from neighborhood pixels and is robust to background noise. The FAM network is optimized using the Differential Evaluation (DE) algorithm (DEFAMNet) with a modified mutation operation to minimize the size of the network without compromising the classification accuracy. The performance of the proposed DEFAMNet is compared with that of other classifiers and descriptors; the classification accuracy of the proposed AvN-LBP operator with DEFAMNet is higher. The experimental results on three benchmark medical image datasets provide evidence that the proposed framework classifies the medical images faster and more efficiently with lesser computational cost. Full article

Cerebrospinal fluid (CSF) hypovolemia is the core of spontaneous intracranial hypotension (SIH). More than 1000 magnetic resonance myelography (MRM) images are required to evaluate each subject. An effective spinal CSF quantification method is needed. In this study, we proposed a cascade artificial intelligence (AI) model to automatically segment spinal CSF. From January 2014 to December 2019, patients with SIH and 12 healthy volunteers (HVs) were recruited. We evaluated the performance of AI models which combined object detection (YOLO v3) and semantic segmentation (U-net or U-net++). The network of performance was evaluated using intersection over union (IoU). The best AI model was used to quantify spinal CSF in patients. We obtained 25,603 slices of MRM images from 13 patients and 12 HVs. We divided the images into training, validation, and test datasets with a ratio of 4:1:5. The IoU of Cascade YOLO v3 plus U-net++ (0.9374) was the highest. Applying YOLO v3 plus U-net++ to another 13 SIH patients showed a significant decrease in the volume of spinal CSF measured (59.32 ± 10.94 mL) at disease onset compared to during their recovery stage (70.61 ± 15.31 mL). The cascade AI model provided a satisfactory performance with regard to the fully automatic segmentation of spinal CSF from MRM images. The spinal CSF volume obtained through its measurements could reflect a patient’s clinical status. Full article

The purpose of this study is to develop a deep radiomic signature based on an artificial intelligence (AI) model. This radiomic signature identifies oocyte morphological changes corresponding to reproductive aging in bright field images captured by optical light microscopy. Oocytes were collected from three mice groups: young (4- to 5-week-old) C57BL/6J female mice, aged (12-month-old) mice, and aged mice treated with the NAD+ precursor nicotinamide mononucleotide (NMN), a treatment recently shown to rejuvenate aspects of fertility in aged mice. We applied deep learning, swarm intelligence, and discriminative analysis to images of mouse oocytes taken by bright field microscopy to identify a highly informative deep radiomic signature (DRS) of oocyte morphology. Predictive DRS accuracy was determined by evaluating sensitivity, specificity, and cross-validation, and was visualized using scatter plots of the data associated with three groups: Young, old and Old + NMN. DRS could successfully distinguish morphological changes in oocytes associated with maternal age with 92% accuracy (AUC~1), reflecting this decline in oocyte quality. We then employed the DRS to evaluate the impact of the treatment of reproductively aged mice with NMN. The DRS signature classified 60% of oocytes from NMN-treated aged mice as having a ‘young’ morphology. In conclusion, the DRS signature developed in this study was successfully able to detect aging-related oocyte morphological changes. The significance of our approach is that DRS applied to bright field oocyte images will allow us to distinguish and select oocytes originally affected by reproductive aging and whose quality has been successfully restored by the NMN therapy. Full article

The suspected cases of COVID-19 must be detected quickly and accurately to avoid the transmission of COVID-19 on a large scale. Existing COVID-19 diagnostic tests are slow and take several hours to generate the required results. However, on the other hand, most X-rays or chest radiographs only take less than 15 min to complete. Therefore, we can utilize chest radiographs to create a solution for early and accurate COVID-19 detection and diagnosis to reduce COVID-19 patient treatment problems and save time. For this purpose, CovidDetNet is proposed, which comprises ten learnable layers that are nine convolutional layers and one fully-connected layer. The architecture uses two activation functions: the ReLu activation function and the Leaky Relu activation function and two normalization operations that are batch normalization and cross channel normalization, making it a novel COVID-19 detection model. It is a novel deep learning-based approach that automatically and reliably detects COVID-19 using chest radiograph images. Towards this, a fine-grained COVID-19 classification experiment is conducted to identify and classify chest radiograph images into normal, COVID-19 positive, and pneumonia. In addition, the performance of the proposed novel CovidDetNet deep learning model is evaluated on a standard COVID-19 Radiography Database. Moreover, we compared the performance of our approach with hybrid approaches in which we used deep learning models as feature extractors and support vector machines (SVM) as a classifier. Experimental results on the dataset showed the superiority of the proposed CovidDetNet model over the existing methods. The proposed CovidDetNet outperformed the baseline hybrid deep learning-based models by achieving a high accuracy of 98.40%. Full article

Angiotensin I-converting enzyme (ACE) is a peptidase widely presented in human tissues and biological fluids. ACE is a glycoprotein containing 17 potential N-glycosylation sites which can be glycosylated in different ways due to post-translational modification of the protein in different cells. For the first time, surface-enhanced Raman scattering (SERS) spectra of human ACE from lungs, mainly produced by endothelial cells, ACE from heart, produced by endothelial heart cells and miofibroblasts, and ACE from seminal fluid, produced by epithelial cells, have been compared with full assignment. The ability to separate ACEs’ SERS spectra was demonstrated using the linear discriminant analysis (LDA) method with high accuracy. The intervals in the spectra with maximum contributions of the spectral features were determined and their contribution to the spectrum of each separate ACE was evaluated. Near 25 spectral features forming three intervals were enough for successful separation of the spectra of different ACEs. However, more spectral information could be obtained from analysis of 50 spectral features. Band assignment showed that several features did not correlate with band assignments to amino acids or peptides, which indicated the carbohydrate contribution to the final spectra. Analysis of SERS spectra could be beneficial for the detection of tissue-specific ACEs. Full article

In all developing countries, the application of biomedical signals has been growing, and there is a potential interest to apply it to healthcare management systems. However, with the existing infrastructure, the system will not provide high-end support for the transfer of signals by using a communication medium, as biomedical signals need to be classified at appropriate stages. Therefore, this article addresses the issues of physical infrastructure, using Hadoop-based systems where a four-layer model is created. The four-layer model is integrated with Fuzzy Interface System Algorithm (FISA) with low robustness, and data transfers in these layers are carried out with reference health data that are collected at various treatment centers. The performance of this new flanged system model aims to minimize the loss functionalities that are present in biomedical signals, and an activation function is introduced at the middle stages. The effectiveness of the proposed model is simulated by using MATLAB, using a biomedical signal processing toolbox, where the performance of FISA proves to be better in terms of signal strength, distance, and cost. As a comparative outcome, the proposed method overlooks the conventional methods for an average percentage of 78% in real-time conditions. Full article

Epilepsy is a chronic and recurrent brain dysfunction disease. An acute epileptic attack will interfere with a patient’s normal behavior and consciousness, having a great impact on their life. The purpose of this study was to design a seizure prediction model to improve the quality of patients’ lives and assist doctors in making diagnostic decisions. This paper presents a transformer-based seizure prediction model. Firstly, the time-frequency characteristics of electroencephalogram (EEG) signals were extracted by short-time Fourier transform (STFT). Secondly, a three transformer tower model was used to fuse and classify the features of the EEG signals. Finally, when combined with the attention mechanism of transformer networks, the EEG signal was processed as a whole, which solves the problem of length limitations in deep learning models. Experiments were conducted with a Children’s Hospital Boston and the Massachusetts Institute of Technology database to evaluate the performance of the model. The experimental results show that, compared with previous EEG classification models, our model can enhance the ability to use time, frequency, and channel information from EEG signals to improve the accuracy of seizure prediction. Full article

Motivation, BRCA1 and BRCA2 are genes with tumor suppressor activity. They are involved in a considerable number of biological processes. To help the biologist in tumor classification, we developed a deep learning algorithm. The question when we want to construct a neural network is how many hidden layers and neurons should we use. If the number of inputs and outputs is defined by the problem, the number of hidden layers and neurons is difficult to define. Hidden layers and neurons that make up each layer of the neural network influence the performance of system predictions. There are different methods for finding the optimal architecture. In this paper, we present the two packages that we have developed, the genetic algorithm (GA) and the particle swarm optimization (PSO) to optimize the parameters of the neural network for predicting BRCA1 and BRCA2 pathogenicity; Results, we will compare the results obtained by the two algorithms. We used datasets collected from our NGS analysis of BRCA1 and BRCA2 genes to train deep learning models. It represents a data collection of 11,875 BRCA1 and BRCA2 variants. Our preliminary results show that the PSO provided the most significant architecture of hidden layers and the number of neurons compared to grid search and GA; Conclusions, the optimal architecture found by the PSO algorithm is composed of 6 hidden layers with 275 hidden nodes with an accuracy of 0.98, precision 0.99, recall 0.98, and a specificity of 0.99. Full article

This study was a multicenter retrospective cohort study of term nulliparous women who underwent labor, and was conducted to develop an automated machine learning model for prediction of emergent cesarean section (CS) before onset of labor. Nine machine learning methods of logistic regression, random forest, Support Vector Machine (SVM), gradient boosting, extreme gradient boosting (XGBoost), light gradient boosting machine (LGBM), k-nearest neighbors (KNN), Voting, and Stacking were applied and compared for prediction of emergent CS during active labor. External validation was performed using a nationwide multicenter dataset for Korean fetal growth. A total of 6549 term nulliparous women was included in the analysis, and the emergent CS rate was 16.1%. The C-statistics values for KNN, Voting, XGBoost, Stacking, gradient boosting, random forest, LGBM, logistic regression, and SVM were 0.6, 0.69, 0.64, 0.59, 0.66, 0.68, 0.68, 0.7, and 0.69, respectively. The logistic regression model showed the best predictive performance with an accuracy of 0.78. The machine learning model identified nine significant variables of maternal age, height, weight at pre-pregnancy, pregnancy-associated hypertension, gestational age, and fetal sonographic findings. The C-statistic value for the logistic regression machine learning model in the external validation set (1391 term nulliparous women) was 0.69, with an overall accuracy of 0.68, a specificity of 0.83, and a sensitivity of 0.41. Machine learning algorithms with clinical and sonographic parameters at near term could be useful tools to predict individual risk of emergent CS during active labor in nulliparous women. Full article

We propose a fully convolutional neural network based on the attention mechanism for 3D medical image segmentation tasks. It can adaptively learn to highlight the salient features of images that are useful for image segmentation tasks. Some prior methods enhance accuracy using multi-scale feature fusion or dilated convolution, which is basically artificial and lacks the flexibility of the model itself. Therefore, some works proposed the 2D attention gate module, but these works process 2D medical slice images, ignoring the correlation between 3D image sequences. In contrast, the 3D attention gate can comprehensively use the information of three dimensions of medical images. In this paper, we propose the Attention V-Net architecture, which uses the 3D attention gate module, and applied it to the left atrium segmentation framework based on semi-supervised learning. The proposed method is evaluated on the dataset of the 2018 left atrial challenge. The experimental results show that the Attention V-Net obtains improved performance under evaluation indicators, such as Dice, Jaccard, ASD (Average surface distance), and 95HD (Hausdorff distance). The result indicates that the model in this paper can effectively improve the accuracy of left atrial segmentation, therefore laying the foundation for subsequent work such as in atrial reconstruction. Meanwhile, our model is of great significance for assisting doctors in treating cardiovascular diseases. Full article

Previous studies demonstrate the feasibility of predicting obesity using various machine learning techniques; however, these studies do not address the limitations of these methods in real-life settings where available data for children may vary. We investigated the medical history required for machine learning models to accurately predict body mass index (BMI) during early childhood. Within a longitudinal dataset of children ages 0–4 years, we developed predictive models based on long short-term memory (LSTM), a recurrent neural network architecture, using history EHR data from 2 to 8 clinical encounters to estimate child BMI. We developed separate, sex-stratified models using 80% of the data for training and 20% for external validation. We evaluated model performance using K-fold cross-validation, mean average error (MAE), and Pearson’s correlation coefficient (R²). Two history encounters and a 4-month prediction yielded a high prediction error and low correlation between predicted and actual BMI (MAE of 1.60 for girls and 1.49 for boys). Model performance improved with additional history encounters; improvement was not significant beyond five history encounters. The combined model outperformed the sex-stratified models, with a MAE = 0.98 (SD 0.03) and R² = 0.72. Our models show that five history encounters are sufficient to predict BMI prior to age 4 for both boys and girls. Moreover, starting from an initial dataset with more than 269 exposure variables, we were able to identify a limited set of 24 variables that can facilitate BMI prediction in early childhood. Nine of these final variables are collected once, and the remaining 15 need to be updated during each visit. Full article

(1) Background: The role of using artificial intelligence (AI) with electrocardiograms (ECGs) for the diagnosis of significant coronary artery disease (CAD) is unknown. We first tested the hypothesis that using AI to read ECG could identify significant CAD and determine which vessel was obstructed. (2) Methods: We collected ECG data from a multi-center retrospective cohort with patients of significant CAD documented by invasive coronary angiography and control patients in Taiwan from 1 January 2018 to 31 December 2020. (3) Results: We trained convolutional neural networks (CNN) models to identify patients with significant CAD (>70% stenosis), using the 12,954 ECG from 2303 patients with CAD and 2090 ECG from 1053 patients without CAD. The Marco-average area under the ROC curve (AUC) for detecting CAD was 0.869 for image input CNN model. For detecting individual coronary artery obstruction, the AUC was 0.885 for left anterior descending artery, 0.776 for right coronary artery, and 0.816 for left circumflex artery obstruction, and 1.0 for no coronary artery obstruction. Marco-average AUC increased up to 0.973 if ECG had features of myocardial ischemia. (4) Conclusions: We for the first time show that using the AI-enhanced CNN model to read standard 12-lead ECG permits ECG to serve as a powerful screening tool to identify significant CAD and localize the coronary obstruction. It could be easily implemented in health check-ups with asymptomatic patients and identifying high-risk patients for future coronary events. Full article