Artificial intelligence in medicine and cardiac imaging: harnessing big data and advanced computing to provide personalized medical diagnosis and treatment

Applications of Machine Learning (ML) and Mathematical Modeling (MM) in Healthcare with Special Focus on Cancer Prognosis and Anticancer Therapy: Current Status and Challenges

The use of data-driven high-throughput analytical techniques, which has given rise to computational oncology, is undisputed. The widespread use of machine learning (ML) and mathematical modeling (MM)-based techniques is widely acknowledged. These two approaches have fueled the advancement in cancer research and eventually led to the uptake of telemedicine in cancer care. For diagnostic, prognostic, and treatment purposes concerning different types of cancer research, vast databases of varied information with manifold dimensions are required, and indeed, all this information can only be managed by an automated system developed utilizing ML and MM. In addition, MM is being used to probe the relationship between the pharmacokinetics and pharmacodynamics (PK/PD interactions) of anti-cancer substances to improve cancer treatment, and also to refine the quality of existing treatment models by being incorporated at all steps of research and development related to cancer and in routine patient care. This review will serve as a consolidation of the advancement and benefits of ML and MM techniques with a special focus on the area of cancer prognosis and anticancer therapy, leading to the identification of challenges (data quantity, ethical consideration, and data privacy) which are yet to be fully addressed in current studies.

The use of artificial intelligence in the treatment of rare diseases: A scoping review

With the increasing application of artificial intelligence (AI) in medicine and healthcare, AI technologies have the potential to improve the diagnosis, treatment, and prognosis of rare diseases. Presently, existing research predominantly focuses on the areas of diagnosis and prognosis, with relatively fewer studies dedicated to the domain of treatment. The purpose of this review is to systematically analyze the existing literature on the application of AI in the treatment of rare diseases. We searched three databases for related studies, and established criteria for the selection of retrieved articles. From the 407 unique articles identified across the three databases, 13 articles from 8 countries were selected, which investigated 10 different rare diseases. The most frequently studied rare disease group was rare neurologic diseases (n = 5/13, 38.46%). Among the four identified therapeutic domains, 7 articles (53.85%) focused on drug research, with 5 specifically focused on drug discovery (drug repurposing, the discovery of drug targets and small-molecule inhibitors), 1 on pre-clinical studies (drug interactions), and 1 on clinical studies (information strength assessment of clinical parameters). Across the selected 13 articles, we identified total 32 different algorithms, with random forest (RF) being the most commonly used (n = 4/32, 12.50%). The predominant purpose of AI in the treatment of rare diseases in these articles was to enhance the performance of analytical tasks (53.33%). The most common data source was database data (35.29%), with 5 of these studies being in the field of drug research, utilizing classic databases such as RCSB, PDB and NCBI. Additionally, 47.37% of the articles highlighted the existing challenge of data scarcity or small sample sizes.

Fuzzy Cognitive Map Applications in Medicine over the Last Two Decades: A Review Study

Fuzzy Cognitive Maps (FCMs) have become an invaluable tool for healthcare providers because they can capture intricate associations among variables and generate precise predictions. FCMs have demonstrated their utility in diverse medical applications, from disease diagnosis to treatment planning and prognosis prediction. Their ability to model complex relationships between symptoms, biomarkers, risk factors, and treatments has enabled healthcare providers to make informed decisions, leading to better patient outcomes. This review article provides a thorough synopsis of using FCMs within the medical domain. A systematic examination of pertinent literature spanning the last two decades forms the basis of this overview, specifically delineating the diverse applications of FCMs in medical realms, including decision-making, diagnosis, prognosis, treatment optimisation, risk assessment, and pharmacovigilance. The limitations inherent in FCMs are also scrutinised, and avenues for potential future research and application are explored.

Protocol for metadata and image collection at diabetic foot ulcer clinics: enabling research in wound analytics and deep learning

BACKGROUND

The escalating impact of diabetes and its complications, including diabetic foot ulcers (DFUs), presents global challenges in quality of life, economics, and resources, affecting around half a billion people. DFU healing is hindered by hyperglycemia-related issues and diverse diabetes-related physiological changes, necessitating ongoing personalized care. Artificial intelligence and clinical research strive to address these challenges by facilitating early detection and efficient treatments despite resource constraints. This study establishes a standardized framework for DFU data collection, introducing a dedicated case report form, a comprehensive dataset named Zivot with patient population clinical feature breakdowns and a baseline for DFU detection using this dataset and a UNet architecture.

RESULTS

Following this protocol, we created the Zivot dataset consisting of 269 patients with active DFUs, and about 3700 RGB images and corresponding thermal and depth maps for the DFUs. The effectiveness of collecting a consistent and clean dataset was demonstrated using a bounding box prediction deep learning network that was constructed with EfficientNet as the feature extractor and UNet architecture. The network was trained on the Zivot dataset, and the evaluation metrics showed promising values of 0.79 and 0.86 for F1-score and mAP segmentation metrics.

CONCLUSIONS

This work and the Zivot database offer a foundation for further exploration of holistic and multimodal approaches to DFU research.

Design and evaluation of an intelligent physical examination system in improving the satisfaction of patients with chronic disease

Background

and Purpose: Enhancing patient satisfaction remains crucial for healthcare quality. The utilization of artificial intelligence (AI) in the Internet of Health Things (loHT) can streamline the medical examination process. Most Traditional Chinese Medicine (TCM) examinations are non-invasive and contribute significantly to patient satisfaction. Our aim was to establish an intelligent physical examination system that amalgamates TCM and Western medicine and to conduct a preliminary investigation into its effectiveness in enhancing the satisfaction of patients with chronic diseases.

Materials and methods

Experts from clinical departments, the equipment department, and the software development department were invited to participate in group discussions to determine the design principles and organizational structure of the intelligent physical examination system. This system integrates TCM and Western medicine. We compared the satisfaction levels of patients examined using the intelligent physical examination system with those examined using the traditional medical examination system.

Results

An intelligent physical examination system, combining TCM and Western medicine, was developed. A total of 106 patients were finally enrolled (intelligent group vs. control group) to evaluate satisfaction. There were no statistically significant differences between the intelligent group and the control group in age, gender, education, or income level. We identified significant differences in five aspects of satisfaction: 1) the physical examination environment; 2) the attitude and responsiveness of doctors; 3) the attitude and responsiveness of nurses; 4) the effectiveness of obtaining results; and 5) the information regarding physical examination and medical advice (p < 0.05). Furthermore, these differences remained statistically significant even after adjusting for age, gender, education, and income level.

Conclusions

The intelligent physical examination system effectively capitalized on the advantages of combining AI with the integration of TCM and Western medicine, substantially optimizing the medical examination process. In comparison to the traditional physical examination system, the intelligent system significantly enhanced patient satisfaction. Future improvements could involve integrating chronic disease follow-up technology into the system.

Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment

Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.

Will it run?-A proof of concept for smoke testing decentralized data analytics experiments

The growing interest in data-driven medicine, in conjunction with the formation of initiatives such as the European Health Data Space (EHDS) has demonstrated the need for methodologies that are capable of facilitating privacy-preserving data analysis. Distributed Analytics (DA) as an enabler for privacy-preserving analysis across multiple data sources has shown its potential to support data-intensive research. However, the application of DA creates new challenges stemming from its distributed nature, such as identifying single points of failure (SPOFs) in DA tasks before their actual execution. Failing to detect such SPOFs can, for example, result in improper termination of the DA code, necessitating additional efforts from multiple stakeholders to resolve the malfunctions. Moreover, these malfunctions disrupt the seamless conduct of DA and entail several crucial consequences, including technical obstacles to resolve the issues, potential delays in research outcomes, and increased costs. In this study, we address this challenge by introducing a concept based on a method called Smoke Testing, an initial and foundational test run to ensure the operability of the analysis code. We review existing DA platforms and systematically extract six specific Smoke Testing criteria for DA applications. With these criteria in mind, we create an interactive environment called Development Environment for AuTomated and Holistic Smoke Testing of Analysis-Runs (DEATHSTAR), which allows researchers to perform Smoke Tests on their DA experiments. We conduct a user-study with 29 participants to assess our environment and additionally apply it to three real use cases. The results of our evaluation validate its effectiveness, revealing that 96.6% of the analyses created and (Smoke) tested by participants using our approach successfully terminated without any errors. Thus, by incorporating Smoke Testing as a fundamental method, our approach helps identify potential malfunctions early in the development process, ensuring smoother data-driven research within the scope of DA. Through its flexibility and adaptability to diverse real use cases, our solution enables more robust and efficient development of DA experiments, which contributes to their reliability.

Artificial intelligence in cardiovascular medicine: An updated review of the literature

Screening and early detection of cardiovascular disease (CVD) are crucial for managing progress and preventing related morbidity. In recent years, several studies have reported the important role of Artificial intelligence (AI) technology and its integration into various medical sectors. AI applications are able to deal with the massive amounts of data (medical records, ultrasounds, medications, and experimental results) generated in medicine and identify novel details that would otherwise be forgotten in the mass of healthcare data sets. Nowadays, AI algorithms are currently used to improve diagnosis of some CVDs including heart failure, atrial fibrillation, hypertrophic cardiomyopathy and pulmonary hypertension. This review summarized some AI concepts, critical execution requirements, obstacles, and new applications for CVDs.

ChatGPT and large language models in orthopedics: from education and surgery to research

ChatGPT has quickly popularized since its release in November 2022. Currently, large language models (LLMs) and ChatGPT have been applied in various domains of medical science, including in cardiology, nephrology, orthopedics, ophthalmology, gastroenterology, and radiology. Researchers are exploring the potential of LLMs and ChatGPT for clinicians and surgeons in every domain. This study discusses how ChatGPT can help orthopedic clinicians and surgeons perform various medical tasks. LLMs and ChatGPT can help the patient community by providing suggestions and diagnostic guidelines. In this study, the use of LLMs and ChatGPT to enhance and expand the field of orthopedics, including orthopedic education, surgery, and research, is explored. Present LLMs have several shortcomings, which are discussed herein. However, next-generation and future domain-specific LLMs are expected to be more potent and transform patients' quality of life.

First impressions of a financial AI assistant: differences between high trust and low trust users

Calibrating appropriate trust of non-expert users in artificial intelligence (AI) systems is a challenging yet crucial task. To align subjective levels of trust with the objective trustworthiness of a system, users need information about its strengths and weaknesses. The specific explanations that help individuals avoid over- or under-trust may vary depending on their initial perceptions of the system. In an online study, 127 participants watched a video of a financial AI assistant with varying degrees of decision agency. They generated 358 spontaneous text descriptions of the system and completed standard questionnaires from the Trust in Automation and Technology Acceptance literature (including perceived system competence, understandability, human-likeness, uncanniness, intention of developers, intention to use, and trust). Comparisons between a high trust and a low trust user group revealed significant differences in both open-ended and closed-ended answers. While high trust users characterized the AI assistant as more useful, competent, understandable, and humanlike, low trust users highlighted the system's uncanniness and potential dangers. Manipulating the AI assistant's agency had no influence on trust or intention to use. These findings are relevant for effective communication about AI and trust calibration of users who differ in their initial levels of trust.

Mining electronic health records using artificial intelligence: Bibliometric and content analyses for current research status and product conversion

BACKGROUND

The use of Electronic Health Records is the most important milestone in the digitization and intelligence of the entire medical industry. AI can effectively mine the immense medical information contained in EHRs, potentially assist doctors in reducing many medical errors.

OBJECTIVE

This article aims to summarize the research status and trends in using AI to mine medical information from EHRs for the past thirteen years and investigate its information application.

METHODS

A systematic search was carried out in 5 databases, including Web of Science Core Collection and PubMed, to identify research using AI to mine medical information from EHRs for the past thirteen years. Furthermore, bibliometric and content analysis were used to explore the research hotspots and trends, and systematically analyze the conversion rate of research resources in this field.

RESULTS

A total of 631 articles were included and analyzed. The number of published articles has increased rapidly after 2017, with an average annual growth rate of 55.73%. The US (41.68%) and China (19.65%) publish the most articles, but there is a lack of international cooperation. The extraction of disease lesions is a hot topic at present, and the research topic is gradually shifting from disease risk grading to disease risk prediction. Classification (66%), and regress (15%) are the main implemented AI tasks. For AI algorithms, deep learning (31.70%), decision tree algorithms family (26.47%), and regression algorithms family (17.43%) are used most frequently. The funding rate for publications is 69.26%, and the input-output conversion rate is 21.05%.

CONCLUSIONS

Over the past decade, the use of AI to mine medical information from EHRs has been developing rapidly. However, it is necessary to strengthen international cooperation, improve EHRs data availability, focus on interpretable AI algorithms, and improve the resource conversion rate in future research.

Grad-CAM-Based Explainable Artificial Intelligence Related to Medical Text Processing

The opacity of deep learning makes its application challenging in the medical field. Therefore, there is a need to enable explainable artificial intelligence (XAI) in the medical field to ensure that models and their results can be explained in a manner that humans can understand. This study uses a high-accuracy computer vision algorithm model to transfer learning to medical text tasks and uses the explanatory visualization method known as gradient-weighted class activation mapping (Grad-CAM) to generate heat maps to ensure that the basis for decision-making can be provided intuitively or via the model. The system comprises four modules: pre-processing, word embedding, classifier, and visualization. We used Word2Vec and BERT to compare word embeddings and use ResNet and 1Dimension convolutional neural networks (CNN) to compare classifiers. Finally, the Bi-LSTM was used to perform text classification for direct comparison. With 25 epochs, the model that used pre-trained ResNet on the formalized text presented the best performance (recall of 90.9%, precision of 91.1%, and an F1 score of 90.2% weighted). This study uses ResNet to process medical texts through Grad-CAM-based explainable artificial intelligence and obtains a high-accuracy classification effect; at the same time, through Grad-CAM visualization, it intuitively shows the words to which the model pays attention when making predictions.

Identification of microbial markers associated with lung cancer based on multi-cohort 16 s rRNA analyses: A systematic review and meta-analysis

BACKGROUND

The relationship between commensal microbiota and lung cancer (LC) has been studied extensively. However, developing replicable microbiological markers for early LC diagnosis across multiple populations has remained challenging. Current studies are limited to a single region, single LC subtype, and small sample size. Therefore, we aimed to perform the first large-scale meta-analysis for identifying micro biomarkers for LC screening by integrating gut and respiratory samples from multiple studies and building a machine-learning classifier.

METHODS

In total, 712 gut and 393 respiratory samples were assessed via 16 s rRNA amplicon sequencing. After identifying the taxa of differential biomarkers, we established random forest models to distinguish between LC populations and normal controls. We validated the robustness and specificity of the model using external cohorts. Moreover, we also used the KEGG database for the predictive analysis of colony-related functions.

RESULTS

The α and β diversity indices indicated that LC patients' gut microbiota (GM) and lung microbiota (LM) differed significantly from those of the healthy population. Linear discriminant analysis (LDA) of effect size (LEfSe) helped us identify the top-ranked biomarkers, Enterococcus, Lactobacillus, and Escherichia, in two microbial niches. The area under the curve values of the diagnostic model for the two sites were 0.81 and 0.90, respectively. KEGG enrichment analysis also revealed significant differences in microbiota-associated functions between cancer-affected and healthy individuals that were primarily associated with metabolic disturbances.

CONCLUSIONS

GM and LM profiles were significantly altered in LC patients, compared to healthy individuals. We identified the taxa of biomarkers at the two loci and constructed accurate diagnostic models. This study demonstrates the effectiveness of LC-specific microbiological markers in multiple populations and contributes to the early diagnosis and screening of LC.

Perspective of Artificial Intelligence in Disease Diagnosis: A Review of Current and Future Endeavours in the Medical Field

Artificial intelligence (AI) has demonstrated significant promise for the present and future diagnosis of diseases. At the moment, AI-powered diagnostic technologies can help physicians decipher medical pictures like X-rays, magnetic resonance imaging, and computed tomography scans, resulting in quicker and more precise diagnoses. In order to make a prospective diagnosis, AI algorithms may also examine patient information, symptoms, and medical background. The application of AI in disease diagnosis is anticipated to grow as the field develops. In the future, AI may be used to find patterns in enormous volumes of medical data, aiding in disease prediction and prevention before symptoms appear. Additionally, by combining genetic data, lifestyle data, and environmental variables, AI may help in the diagnosis of complicated diseases. It is crucial to remember that while AI can be a powerful tool, it cannot take the place of qualified medical personnel. Instead, AI ought to support and improve diagnostic procedures, enhancing patient care and healthcare results. Future research and the use of AI for disease diagnosis must take ethical issues, data protection, and ongoing model validation into account.

Biomedical Ethical Aspects Towards the Implementation of Artificial Intelligence in Medical Education

The increasing use of artificial intelligence (AI) in medicine is associated with new ethical challenges and responsibilities. However, special considerations and concerns should be addressed when integrating AI applications into medical education, where healthcare, AI, and education ethics collide. This commentary explores the biomedical ethical responsibilities of medical institutions in incorporating AI applications into medical education by identifying potential concerns and limitations, with the goal of implementing applicable recommendations. The recommendations presented are intended to assist in developing institutional guidelines for the ethical use of AI for medical educators and students.

Individual health-disease phase diagrams for disease prevention based on machine learning

Early disease detection and prevention methods based on effective interventions are gaining attention worldwide. Progress in precision medicine has revealed that substantial heterogeneity exists in health data at the individual level and that complex health factors are involved in chronic disease development. Machine-learning techniques have enabled precise personal-level disease prediction by capturing individual differences in multivariate data. However, it is challenging to identify what aspects should be improved for disease prevention based on future disease-onset prediction because of the complex relationships among multiple biomarkers. Here, we present a health-disease phase diagram (HDPD) that represents an individual's health state by visualizing the future-onset boundary values of multiple biomarkers that fluctuate early in the disease progression process. In HDPDs, future-onset predictions are represented by perturbing multiple biomarker values while accounting for dependencies among variables. We constructed HDPDs for 11 diseases using longitudinal health checkup cohort data of 3,238 individuals, comprising 3,215 measurement items and genetic data. The improvement of biomarker values to the non-onset region in HDPD remarkably prevented future disease onset in 7 out of 11 diseases. HDPDs can represent individual physiological states in the onset process and be used as intervention goals for disease prevention.

Exploring Differential Perceptions of Artificial Intelligence in Health Care Among Younger Versus Older Canadians: Results From the 2021 Canadian Digital Health Survey

BACKGROUND

The changing landscape of health care has led to the incorporation of powerful new technologies like artificial intelligence (AI) to assist with various services across a hospital. However, despite the potential outcomes that this tool may provide, little work has examined public opinion regarding their use.

OBJECTIVE

In this study, we aim to explore differences between younger versus older Canadians with regard to the level of comfort and perceptions around the adoption and use of AI in health care settings.

METHODS

Using data from the 2021 Canadian Digital Health Survey (n=12,052), items related to perceptions about the use of AI as well as previous experience and satisfaction with health care were identified. We conducted Mann-Whitney U tests to compare the level of comfort of younger versus older Canadians regarding the use of AI in health care for a variety of purposes. Multinomial logistic regression was used to predict the comfort ratings based on categorical indicators.

RESULTS

Younger Canadians had greater knowledge of AI, but older Canadians were more comfortable with AI applied to monitoring and predicting health conditions, decision support, diagnostic imaging, precision medicine, drug and vaccine development, disease monitoring at home, tracking epidemics, and optimizing workflow to save time. Additionally, for older respondents, higher satisfaction led to higher comfort ratings. Only 1 interaction effect was identified between previous experience, satisfaction, and comfort with AI for drug and vaccine development.

CONCLUSIONS

Older Canadians may be more open to various applications of AI within health care than younger Canadians. High satisfaction may be a critical criterion for comfort with AI, especially for older Canadians. Additionally, in the case of drug and vaccine development, previous experience may be an important moderating factor. We conclude that gaining a greater understanding of the perceptions of all health care users is integral to the implementation and sustainability of new and cutting-edge technologies in health care settings.

Topological data analysis in medical imaging: current state of the art

Machine learning, and especially deep learning, is rapidly gaining acceptance and clinical usage in a wide range of image analysis applications and is regarded as providing high performance in detecting anatomical structures and identification and classification of patterns of disease in medical images. However, there are many roadblocks to the widespread implementation of machine learning in clinical image analysis, including differences in data capture leading to different measurements, high dimensionality of imaging and other medical data, and the black-box nature of machine learning, with a lack of insight into relevant features. Techniques such as radiomics have been used in traditional machine learning approaches to model the mathematical relationships between adjacent pixels in an image and provide an explainable framework for clinicians and researchers. Newer paradigms, such as topological data analysis (TDA), have recently been adopted to design and develop innovative image analysis schemes that go beyond the abilities of pixel-to-pixel comparisons. TDA can automatically construct filtrations of topological shapes of image texture through a technique known as persistent homology (PH); these features can then be fed into machine learning models that provide explainable outputs and can distinguish different image classes in a computationally more efficient way, when compared to other currently used methods. The aim of this review is to introduce PH and its variants and to review TDA's recent successes in medical imaging studies.

Early Triage of Critically Ill Adult Patients With Mushroom Poisoning: Machine Learning Approach

BACKGROUND

Early triage of patients with mushroom poisoning is essential for administering precise treatment and reducing mortality. To our knowledge, there has been no established method to triage patients with mushroom poisoning based on clinical data.

OBJECTIVE

The purpose of this work was to construct a triage system to identify patients with mushroom poisoning based on clinical indicators using several machine learning approaches and to assess the prediction accuracy of these strategies.

METHODS

In all, 567 patients were collected from 5 primary care hospitals and facilities in Enshi, Hubei Province, China, and divided into 2 groups; 322 patients from 2 hospitals were used as the training cohort, and 245 patients from 3 hospitals were used as the test cohort. Four machine learning algorithms were used to construct the triage model for patients with mushroom poisoning. Performance was assessed using the area under the receiver operating characteristic curve (AUC), decision curve, sensitivity, specificity, and other representative statistics. Feature contributions were evaluated using Shapley additive explanations.

RESULTS

Among several machine learning algorithms, extreme gradient boosting (XGBoost) showed the best discriminative ability in 5-fold cross-validation (AUC=0.83, 95% CI 0.77-0.90) and the test set (AUC=0.90, 95% CI 0.83-0.96). In the test set, the XGBoost model had a sensitivity of 0.93 (95% CI 0.81-0.99) and a specificity of 0.79 (95% CI 0.73-0.85), whereas the physicians' assessment had a sensitivity of 0.86 (95% CI 0.72-0.95) and a specificity of 0.66 (95% CI 0.59-0.73).

CONCLUSIONS

The 14-factor XGBoost model for the early triage of mushroom poisoning can rapidly and accurately identify critically ill patients and will possibly serve as an important basis for the selection of treatment options and referral of patients, potentially reducing patient mortality and improving clinical outcomes.

Deep Learning for Head and Neck CT Angiography: Stenosis and Plaque Classification

Background Studies have rarely investigated stenosis detection from head and neck CT angiography scans because accurate interpretation is time consuming and labor intensive. Purpose To develop an automated convolutional neural network-based method for accurate stenosis detection and plaque classification in head and neck CT angiography images and compare its performance with that of radiologists. Materials and Methods A deep learning (DL) algorithm was constructed and trained with use of head and neck CT angiography images that were collected retrospectively from four tertiary hospitals between March 2020 and July 2021. CT scans were partitioned into training, validation, and independent test sets at a ratio of 7:2:1. An independent test set of CT angiography scans was collected prospectively between October 2021 and December 2021 in one of the four tertiary centers. Stenosis grade categories were as follows: mild stenosis (<50%), moderate stenosis (50%-69%), severe stenosis (70%-99%), and occlusion (100%). The stenosis diagnosis and plaque classification of the algorithm were compared with the ground truth of consensus by two radiologists (with more than 10 years of experience). The performance of the models was analyzed in terms of accuracy, sensitivity, specificity, and areas under the receiver operating characteristic curve. Results There were 3266 patients (mean age ± SD, 62 years ± 12; 2096 men) evaluated. The consistency between radiologists and the DL-assisted algorithm on plaque classification was 85.6% (320 of 374 cases [95% CI: 83.2, 88.6]) on a per-vessel basis. Moreover, the artificial intelligence model assisted in visual assessment, such as increasing confidence in the degree of stenosis. This reduced the time needed for diagnosis and report writing of radiologists from 28.8 minutes ± 5.6 to 12.4 minutes ± 2.0 (P < .001). Conclusion A deep learning algorithm for head and neck CT angiography interpretation accurately determined vessel stenosis and plaque classification and had equivalent diagnostic performance when compared with experienced radiologists. © RSNA, 2023 Supplemental material is available for this article.

Diabetes Monitoring System in Smart Health Cities Based on Big Data Intelligence

Diabetes is a metabolic disorder in which the body is unable to properly regulate blood sugar levels. It can occur when the body does not produce enough insulin or when cells become resistant to insulin’s effects. There are two main types of diabetes, Type 1 and Type 2, which have different causes and risk factors. Early detection of diabetes allows for early intervention and management of the condition. This can help prevent or delay the development of serious complications associated with diabetes. Early diagnosis also allows for individuals to make lifestyle changes to prevent the progression of the disease. Healthcare systems play a vital role in the management and treatment of diabetes. They provide access to diabetes education, regular check-ups, and necessary medications for individuals with diabetes. They also provide monitoring and management of diabetes-related complications, such as heart disease, kidney failure, and neuropathy. Through early detection, prevention and management programs, healthcare systems can help improve the quality of life and outcomes for people with diabetes. Current initiatives in healthcare systems for diabetes may fail due to lack of access to education and resources for individuals with diabetes. There may also be inadequate follow-up and monitoring for those who have been diagnosed, leading to poor management of the disease and lack of prevention of complications. Additionally, current initiatives may not be tailored to specific cultural or demographic groups, resulting in a lack of effectiveness for certain populations. In this study, we developed a diabetes prediction system using a healthcare framework. The system employs various machine learning methods, such as K-nearest neighbors, decision tree, deep learning, SVM, random forest, AdaBoost and logistic regression. The performance of the system was evaluated using the PIMA Indians Diabetes dataset and achieved a training accuracy of 82% and validation accuracy of 80%.

Exploring Stakeholder Requirements to Enable the Research and Development of Artificial Intelligence Algorithms in a Hospital-Based Generic Infrastructure: Protocol for a Multistep Mixed Methods Study

BACKGROUND

In recent years, research and developments in advancing artificial intelligence (AI) in health care and medicine have increased. High expectations surround the use of AI technologies, such as improvements for diagnosis and increases in the quality of care with reductions in health care costs. The successful development and testing of new AI algorithms require large amounts of high-quality data. Academic hospitals could provide the data needed for AI development, but granting legal, controlled, and regulated access to these data for developers and researchers is difficult. Therefore, the German Federal Ministry of Health supports the Protected Artificial Intelligence Innovation Environment for Patient-Oriented Digital Health Solutions for Developing, Testing, and Evidence-Based Evaluation of Clinical Value (pAItient) project, aiming to install the AI Innovation Environment at the Heidelberg University Hospital in Germany. The AI Innovation Environment was designed as a proof-of-concept extension of the already existing Medical Data Integration Center. It will establish a process to support every step of developing and testing AI-based technologies.

OBJECTIVE

The first part of the pAItient project, as presented in this research protocol, aims to explore stakeholders' requirements for developing AI in partnership with an academic hospital and granting AI experts access to anonymized personal health data.

METHODS

We planned a multistep mixed methods approach. In the first step, researchers and employees from stakeholder organizations were invited to participate in semistructured interviews. In the following step, questionnaires were developed based on the participants' answers and distributed among the stakeholders' organizations to quantify qualitative findings and discover important aspects that were not mentioned by the interviewees. The questionnaires will be analyzed descriptively. In addition, patients and physicians were interviewed as well. No survey questionnaires were developed for this second group of participants. The study was approved by the Ethics Committee of the Heidelberg University Hospital (approval number: S-241/2021).

RESULTS

Data collection concluded in summer 2022. Data analysis is planned to start in fall 2022. We plan to publish the results in winter 2022 to 2023.

CONCLUSIONS

The results of our study will help in shaping the AI Innovation Environment at our academic hospital according to stakeholder requirements. With this approach, in turn, we aim to shape an AI environment that is effective and is deemed acceptable by all parties.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/42208.

Characterizing fall risk factors in Belgian older adults through machine learning: a data-driven approach

BACKGROUND

Falls are a major problem associated with ageing. Yet, fall-risk classification models identifying older adults at risk are lacking. Current screening tools show limited predictive validity to differentiate between a low- and high-risk of falling.

OBJECTIVE

This study aims at identifying risk factors associated with higher risk of falling by means of a quality-of-life questionnaire incorporating biological, behavioural, environmental and socio-economic factors. These insights can aid the development of a fall-risk classification algorithm identifying community-dwelling older adults at risk of falling.

METHODS

The questionnaire was developed by the Belgian Ageing Studies research group of the Vrije Universiteit Brussel and administered to 82,580 older adults for a detailed analysis of risk factors linked to the fall incidence data. Based on previously known risk factors, 139 questions were selected from the questionnaire to include in this study. Included questions were encoded, missing values were dropped, and multicollinearity was assessed. A random forest classifier that learns to predict falls was trained to investigate the importance of each individual feature.

RESULTS

Twenty-four questions were included in the classification-model. Based on the output of the model all factors were associated with the risk of falling of which two were biological risk factors, eight behavioural, 11 socioeconomic and three environmental risk factors. Each of these variables contributed between 4.5 and 6.5% to explaining the risk of falling.

CONCLUSION

The present study identified 24 fall risk factors using machine learning techniques to identify older adults at high risk of falling. Maintaining a mental, physical and socially active lifestyle, reducing vulnerability and feeling satisfied with the living situation contributes to reducing the risk of falling. Further research is warranted to establish an easy-to-use screening tool to be applied in daily practice.

Target association rule mining to explore novel paediatric illness patterns in emergency settings

BACKGROUND AND AIMS

To assess the hospitalized sick children admitted to the pediatric emergency department (ED) and to find new patterns of clinical and laboratory attributes using association rule mining (ARM).

METHODS

In this observational study, 158 children with median (IQR) age 11 months and a PRISM III score of 5 (2-9) were enrolled. Hotspot data mining method was applied to assess clinical attributes, lab investigations and pre-defined outcome parameters of children and their association in sick hospitalized children aged 1 month to 12 years.

RESULTS

We obtained 30 rules with value for outcome as discharge is given attributes as follows: duration of hospitalization > 4 days, lactate > 1.2 mmol/L, platelet = 3.67/μL, dur_ventil = 0 h, serum K = 5.2 mmol/L, SBP = 120 mmHg, pCO₂ = 41.9 mmHg, PaO₂ = 163 mmHg, age = 92 months, heart rate > 114-159 per minute, temperature > 98 °F, GCS (Glasgow Coma Scale) > 7-14, gas K = 4.14 mmol/L, gas Na = 138.1 mmol/L, BUN (Blood Urea Nitrogen) = 18.69 mg/dL, Diagnosis > 1-718, Creatinine = 1.2 mg/dL, serum Na = 148 mmol/L, shock = 2, Glucose = 144 mg/dL, Mg(i) > 0.23 meq/L, BUN > 6.54 mg/dL.

CONCLUSION

ARM is an effective data analysis technique to find meaningful patterns using clinical features with actual numbers in pediatric critical illness. It can prove to be important while analysing the association of clinical attributes with disease pattern, its features, and therapeutic or intervention success patterns.

Artificial intelligence and robot nurses: From nurse managers' perspective: A descriptive cross-sectional study

AIM

This research was planned to identify nurse managers' opinions on artificial intelligence and robot nurses.

BACKGROUND

As the concepts of artificial intelligence and robot nurses are becoming widespread in Turkey, nurse managers are expected to guide and cooperate with nurses in the future in regard to these technologies.

METHODS

The sample of the study consisted of 326 manager nurses, who were reached via the online questionnaire during the period of September to November 2021. A Nurse Managers Information Form and a Question Form on Artificial Intelligence and Robot Nurses were used to collect data. Data in this cross-sectional descriptive study were collected between September 2021 and November 2021 by the online survey method. The descriptive statistics of the data were analysed with numbers and percentages. The difference between the knowledge of artificial intelligence and robot nurses and demographic characteristics was analysed with the chi-square test.

RESULTS

According to the findings, 66.9% of the nurse managers reported having heard the concepts of artificial intelligence and robot nurses previously. 67.2% stated that they thought that robot nurses would benefit the nursing profession, but 86.2% voiced disbelief that robots would replace nurses.

CONCLUSIONS

The majority of the participating nurse managers reported that artificial intelligence and robot nurses would not replace nurses but would be beneficial for nurses and would reduce their workload.

IMPLICATIONS FOR NURSING MANAGEMENT

It should be ensured that the nurse managers plan the areas in the hospital where artificial intelligence and robot nurses will be used and determine the possible risks. Awareness should be increased with in-service trainings, and patient safety and ethical problems regarding the use of artificial intelligence and robot nurses should be identified.

Association of artificial intelligence use and the retention of elderly caregivers: A cross-sectional study based on empowerment theory

AIM

The purpose of this study is to investigate how the use of artificial intelligence is associated with the retention of elderly caregivers.

BACKGROUND

The turnover of elderly caregivers is high and increasing. Elderly care institutions are beginning to use artificial intelligence to support caregivers in their work, and the use of technology is critical to staff retention. Empowerment of elderly caregivers has been neglected by managers and researchers.

METHODS

This cross-sectional study involved 511 elderly caregivers in 25 elderly institutions. Six validated standardized scales were used for data collection, and the software SPSS and SmartPLS were used for data analysis.

RESULTS

The quality of artificial intelligence has a significant positive effect on empowerment. Artificial intelligence psychological empowerment (β = .355, p < .001) and artificial intelligence structural empowerment (β = .375, p < .001) both had positive effects on retention intention, and the jointly explained variance (R² ) was 42.6%.

CONCLUSIONS

The results show that a significant relationship exists between artificial intelligence empowerment and retention intention. Elderly caregivers with more structural empowerment have higher retention intention.

IMPLICATIONS FOR NURSING MANAGEMENT

Artificial intelligence suppliers need to pay attention to the role of product quality in elderly care services, continuously improve artificial intelligence quality, and strengthen the application and routine maintenance of artificial intelligence technologies. Elderly care institution managers should pay special attention to artificial intelligence structural empowerment (such as artificial intelligence-related education and training, learning and development opportunities, and resource support).

Clinician Adoption of an Artificial Intelligence Algorithm to Detect Left Ventricular Systolic Dysfunction in Primary Care

OBJECTIVE

To compare the clinicians' characteristics of "high adopters" and "low adopters" of an artificial intelligence (AI)-enabled electrocardiogram (ECG) algorithm that alerted for possible low left ventricular ejection fraction (EF) and the subsequent effectiveness of detecting patients with low EF.

METHODS

Clinicians in 48 practice sites of a US Midwest health system were cluster-randomized by the care team to usual care or to receive a notification that suggested ordering an echocardiogram in patients flagged as potentially having low EF based on an AI-ECG algorithm. Enrollment was between June 26, 2019, and July 30, 2019; participation concluded on March 31, 2020. This report is focused on those clinicians randomized to receive the notification of the AI-ECG algorithm. At the patient level, data were analyzed for the proportion of patients with positive AI-ECG results. Adoption was defined as the clinician order of an echocardiogram after prompted by the alert.

RESULTS

A total of 165 clinicians and 11,573 patients were included in this analysis. Among patients with positive AI-ECG, high adopters (n=41) were twice as likely to diagnose patients with low EF (33.9%) vs low adopters, n=124, (16.9%); odds ratio, 1.62; 95% CI, 1.21 to 2.17). High adopters were more often advanced practice providers (eg, nurse practitioners and physician assistants) vs physicians, Family Medicine vs Internal Medicine specialty, and tended to have less complex patients.

CONCLUSION

Clinicians who most frequently followed the recommendations of an AI tool were twice as likely to diagnose low EF. Those clinicians with less complex patients were more likely to be high adopters.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT04000087.

The Merits, Limitations, and Future Directions of Cost-Effectiveness Analysis in Cardiac MRI with a Focus on Coronary Artery Disease: A Literature Review

Cardiac magnetic resonance (CMR) imaging has a wide range of clinical applications with a high degree of accuracy for many myocardial pathologies. Recent literature has shown great utility of CMR in diagnosing many diseases, often changing the course of treatment. Despite this, it is often underutilized possibly due to perceived costs, limiting patient factors and comfort, and longer examination periods compared to other imaging modalities. In this regard, we conducted a literature review using keywords “Cost-Effectiveness” and “Cardiac MRI” and selected articles from the PubMed MEDLINE database that met our inclusion and exclusion criteria to examine the cost-effectiveness of CMR. Our search result yielded 17 articles included in our review. We found that CMR can be cost-effective in quality-adjusted life years (QALYs) in select patient populations with various cardiac pathologies. Specifically, the use of CMR in coronary artery disease (CAD) patients with a pretest probability below a certain threshold may be more cost-effective compared to patients with a higher pretest probability, although its use can be limited based on geographic location, professional society guidelines, and differing reimbursement patterns. In addition, a stepwise combination of different imaging modalities, with conjunction of AHA/ACC guidelines can further enhance the cost-effectiveness of CMR.

Mapping the literature on the application of artificial intelligence in libraries (AAIL): a scientometric analysis

Purpose

Artificial Intelligence (AI) is an emerging technology and turned into a field of knowledge that has been consistently displacing technologies for a change in human life. It is applied in all spheres of life as reflected in the review of the literature section here. As applicable in the field of libraries too, this study scientifically mapped the papers on AAIL and analyze its growth, collaboration network, trending topics, or research hot spots to highlight the challenges and opportunities in adopting AI-based advancements in library systems and processes.

Design/methodology/approach

The study was developed with a bibliometric approach, considering a decade, 2012 to 2021 for data extraction from a premier database, Scopus. The steps followed are (1) identification, selection of keywords, and forming the search strategy with the approval of a panel of computer scientists and librarians and (2) design and development of a perfect algorithm to verify these selected keywords in title-abstract-keywords of Scopus (3) Performing data processing in some state-of-the-art bibliometric visualization tools, Biblioshiny R and VOSviewer (4) discussing the findings for practical implications of the study and limitations.

Findings

As evident from several papers, not much research has been conducted on AI applications in libraries in comparison to topics like AI applications in cancer, health, medicine, education, and agriculture. As per the Price law, the growth pattern is exponential. The total number of papers relevant to the subject is 1462 (single and multi-authored) contributed by 5400 authors with 0.271 documents per author and around 4 authors per document. Papers occurred mostly in open-access journals. The productive journal is the Journal of Chemical Information and Modelling (NP = 63) while the highly consistent and impactful is the Journal of Machine Learning Research (z-index=63.58 and CPP = 56.17). In the case of authors, J Chen (z-index=28.86 and CPP = 43.75) is the most consistent and impactful author. At the country level, the USA has recorded the highest number of papers positioned at the center of the co-authorship network but at the institutional level, China takes the 1st position. The trending topics of research are machine learning, large dataset, deep learning, high-level languages, etc. The present information system has a high potential to improve if integrated with AI technologies.

Practical implications

The number of scientific papers has increased over time. The evolution of themes like machine learning implicates AI as a broad field of knowledge that converges with other disciplines. The themes like large datasets imply that AI may be applied to analyze and interpret these data and support decision-making in public sector enterprises. Theme named high-level language emerged as a research hotspot which indicated that extensive research has been going on in this area to improve computer systems for facilitating the processing of data with high momentum. These implications are of high strategic worth for policymakers, library stakeholders, researchers and the government as a whole for decision-making.

Originality/value

The analysis of collaboration, prolific authors/journals using consistency factor and CPP, testing the relationship between consistency (z-index) and impact (h-index), using state-of-the-art network visualization and cluster analysis techniques make this study novel and differentiates it from the traditional bibliometric analysis. To the best of the author's knowledge, this work is the first attempt to comprehend the research streams and provide a holistic view of research on the application of AI in libraries. The insights obtained from this analysis are instrumental for both academics and practitioners.

Analysis of Diabetes Disease Risk Prediction and Diabetes Medication Pattern Based on Data Mining

Diabetes mellitus is the second most common disease after cardiovascular diseases and malignant tumors. With the continuous acceleration of people's living standards and life rhythm, the number of diabetic patients is rapidly increasing and showing a trend of youthfulness. A recent study found that 114 million adults in China have diabetes and have a high prevalence rate, but the awareness rate, treatment rate, and compliance rate are low. If diabetes is not treated and controlled in time, various complications will occur, such as cardiovascular, cerebrovascular, and diabetic foot, which will not only have a great impact on the survival of the patient, but also cause a lot of pressure on the family and society. Therefore, prevention and control of diabetes is an important strategy to save medical resources and reduce medical costs. In this paper, we mainly read a lot of literature and accumulate some important theoretical knowledge to clarify the basic principles and methods of data mining and refer to the research results of other scholars to select a new combined algorithm model combining K-means algorithm and logistic regression algorithm to construct a prediction model of diabetes and explore the law of medication for diabetic patients based on this analysis.

Recent Advances of Utilizing Artificial Intelligence in Lab on a Chip for Diagnosis and Treatment

Nowadays, artificial intelligence (AI) creates numerous promising opportunities in the life sciences. AI methods can be significantly advantageous for analyzing the massive datasets provided by biotechnology systems for biological and biomedical applications. Microfluidics, with the developments in controlled reaction chambers, high-throughput arrays, and positioning systems, generate big data that is not necessarily analyzed successfully. Integrating AI and microfluidics can pave the way for both experimental and analytical throughputs in biotechnology research. Microfluidics enhances the experimental methods and reduces the cost and scale, while AI methods significantly improve the analysis of huge datasets obtained from high-throughput and multiplexed microfluidics. This review briefly presents a survey of the role of AI and microfluidics in biotechnology. Also, the incorporation of AI with microfluidics is comprehensively investigated. Specifically, recent studies that perform flow cytometry cell classification, cell isolation, and a combination of them by gaining from both AI methods and microfluidic techniques are covered. Despite all current challenges, various fields of biotechnology can be remarkably affected by the combination of AI and microfluidic technologies. Some of these fields include point-of-care systems, precision, personalized medicine, regenerative medicine, prognostics, diagnostics, and treatment of oncology and non-oncology-related diseases.

"AI for all" is a matter of social justice

Artificial intelligence (AI) is a radically transformative technology (or system of technologies) that created new existential possibilities and new standards of well-being in human societies. In this article, I argue that to properly understand the increasingly important role AI plays in our society, we must consider its impacts on social justice. For this reason, I propose to conceptualize AI's transformative role and its socio-political implications through the lens of the theory of social justice known as the Capability Approach. According to the approach, a just society must put its members in a position to acquire and exercise a series of basic capabilities and provide them with the necessary means for these capabilities to be actively realized. Because AI is re-shaping the very definition of some of these basic capabilities, I conclude that AI itself should be considered among the conditions of possession and realization of the capabilities it transforms. In other words, access to AI-in the many forms this access can take-is necessary for social justice.

SARS-CoV-2: Has artificial intelligence stood the test of time

ABSTRACT

Artificial intelligence (AI) has proven time and time again to be a game-changer innovation in every walk of life, including medicine. Introduced by Dr. Gunn in 1976 to accurately diagnose acute abdominal pain and list potential differentials, AI has since come a long way. In particular, AI has been aiding in radiological diagnoses with good sensitivity and specificity by using machine learning algorithms. With the coronavirus disease 2019 pandemic, AI has proven to be more than just a tool to facilitate healthcare workers in decision making and limiting physician-patient contact during the pandemic. It has guided governments and key policymakers in formulating and implementing laws, such as lockdowns and travel restrictions, to curb the spread of this viral disease. This has been made possible by the use of social media to map severe acute respiratory syndrome coronavirus 2 hotspots, laying the basis of the "smart lockdown" strategy that has been adopted globally. However, these benefits might be accompanied with concerns regarding privacy and unconsented surveillance, necessitating authorities to develop sincere and ethical government-public relations.

Application in medicine: Has artificial intelligence stood the test of time

ABSTRACT

Artificial intelligence (AI) has proven time and time again to be a game-changer innovation in every walk of life, including medicine. Introduced by Dr. Gunn in 1976 to accurately diagnose acute abdominal pain and list potential differentials, AI has since come a long way. In particular, AI has been aiding in radiological diagnoses with good sensitivity and specificity by using machine learning algorithms. With the coronavirus disease 2019 pandemic, AI has proven to be more than just a tool to facilitate healthcare workers in decision making and limiting physician-patient contact during the pandemic. It has guided governments and key policymakers in formulating and implementing laws, such as lockdowns and travel restrictions, to curb the spread of this viral disease. This has been made possible by the use of social media to map severe acute respiratory syndrome coronavirus 2 hotspots, laying the basis of the "smart lockdown" strategy that has been adopted globally. However, these benefits might be accompanied with concerns regarding privacy and unconsented surveillance, necessitating authorities to develop sincere and ethical government-public relations.

SinGAN-Seg: Synthetic training data generation for medical image segmentation

Analyzing medical data to find abnormalities is a time-consuming and costly task, particularly for rare abnormalities, requiring tremendous efforts from medical experts. Therefore, artificial intelligence has become a popular tool for the automatic processing of medical data, acting as a supportive tool for doctors. However, the machine learning models used to build these tools are highly dependent on the data used to train them. Large amounts of data can be difficult to obtain in medicine due to privacy reasons, expensive and time-consuming annotations, and a general lack of data samples for infrequent lesions. In this study, we present a novel synthetic data generation pipeline, called SinGAN-Seg, to produce synthetic medical images with corresponding masks using a single training image. Our method is different from the traditional generative adversarial networks (GANs) because our model needs only a single image and the corresponding ground truth to train. We also show that the synthetic data generation pipeline can be used to produce alternative artificial segmentation datasets with corresponding ground truth masks when real datasets are not allowed to share. The pipeline is evaluated using qualitative and quantitative comparisons between real data and synthetic data to show that the style transfer technique used in our pipeline significantly improves the quality of the generated data and our method is better than other state-of-the-art GANs to prepare synthetic images when the size of training datasets are limited. By training UNet++ using both real data and the synthetic data generated from the SinGAN-Seg pipeline, we show that the models trained on synthetic data have very close performances to those trained on real data when both datasets have a considerable amount of training data. In contrast, we show that synthetic data generated from the SinGAN-Seg pipeline improves the performance of segmentation models when training datasets do not have a considerable amount of data. All experiments were performed using an open dataset and the code is publicly available on GitHub.

Interdisciplinary Collaboration Opportunities, Challenges and Solutions for Artificial Intelligence in Ultrasound

Ultrasound is one of the most widely utilized imaging tools in clinical practice with the advantages of noninvasive nature and ease of use. However, ultrasound examinations have low reproducibility and considerable heterogeneity due to the variability of operators, scanners, and patients. In recent years, Artificial Intelligence (AI) -assisted ultrasound has matured and moved closer to routine clinical uses. The combination of AI with ultrasound has opened up a world of possibilities for increasing work productivity and precision diagnostics. In this article, we describe AI strategies in ultrasound, from current opportunities, constraints to potential options for AI-assisted ultrasound.

Potential and role of artificial intelligence in current medical healthcare

Artificial intelligence (AI) is defined as the digital computer or computer-controlled robot's ability to mimic intelligent conduct and crucial thinking commonly associated with intelligent beings. The application of AI technology and machine learning in medicine have allowed medical practitioners to provide patients with better quality of services; and current advancements have led to a dramatic change in the healthcare system. However, many efficient applications are still in their initial stages, which need further evaluations to improve and develop these applications. Clinicians must recognize and acclimate themselves with the developments in AI technology to improve their delivery of healthcare services; but for this to be possible, a significant revision of medical education is needed to provide future leaders with the required competencies. This article reviews the potential and limitations of AI in healthcare, as well as the current medical application trends including healthcare administration, clinical decision assistance, patient health monitoring, healthcare resource allocation, medical research, and public health policy development. Also, future possibilities for further clinical and scientific practice were also summarized.

Localization and Edge-Based Segmentation of Lumbar Spine Vertebrae to Identify the Deformities Using Deep Learning Models

The lumbar spine plays a very important role in our load transfer and mobility. Vertebrae localization and segmentation are useful in detecting spinal deformities and fractures. Understanding of automated medical imagery is of main importance to help doctors in handling the time-consuming manual or semi-manual diagnosis. Our paper presents the methods that will help clinicians to grade the severity of the disease with confidence, as the current manual diagnosis by different doctors has dissimilarity and variations in the analysis of diseases. In this paper we discuss the lumbar spine localization and segmentation which help for the analysis of lumbar spine deformities. The lumber spine is localized using YOLOv5 which is the fifth variant of the YOLO family. It is the fastest and the lightest object detector. Mean average precision (mAP) of 0.975 is achieved by YOLOv5. To diagnose the lumbar lordosis, we correlated the angles with region area that is computed from the YOLOv5 centroids and obtained 74.5% accuracy. Cropped images from YOLOv5 bounding boxes are passed through HED U-Net, which is a combination of segmentation and edge detection frameworks, to obtain the segmented vertebrae and its edges. Lumbar lordortic angles (LLAs) and lumbosacral angles (LSAs) are found after detecting the corners of vertebrae using a Harris corner detector with very small mean errors of 0.29° and 0.38°, respectively. This paper compares the different object detectors used to localize the vertebrae, the results of two methods used to diagnose the lumbar deformity, and the results with other researchers.

The Impact of Artificial Intelligence on Waiting Time for Medical Care in an Urgent Care Service for COVID-19: Single-Center Prospective Study

Background

To demonstrate the value of implementation of an artificial intelligence solution in health care service, a winning project of the Massachusetts Institute of Technology Hacking Medicine Brazil competition was implemented in an urgent care service for health care professionals at Hospital das Clínicas of the Faculdade de Medicina da Universidade de São Paulo during the COVID-19 pandemic.

Objective

The aim of this study was to determine the impact of implementation of the digital solution in the urgent care service, assessing the reduction of nonvalue-added activities and its effect on the nurses’ time required for screening and the waiting time for patients to receive medical care.

Methods

This was a single-center, comparative, prospective study designed according to the Public Health England guide “Evaluating Digital Products for Health.” A total of 38,042 visits were analyzed over 18 months to determine the impact of implementing the digital solution. Medical care registration, health screening, and waiting time for medical care were compared before and after implementation of the digital solution.

Results

The digital solution automated 92% of medical care registrations. The time for health screening increased by approximately 16% during the implementation and in the first 3 months after the implementation. The waiting time for medical care after automation with the digital solution was reduced by approximately 12 minutes compared with that required for visits without automation. The total time savings in the 12 months after implementation was estimated to be 2508 hours.

Conclusions

The digital solution was able to reduce nonvalue-added activities, without a substantial impact on health screening, and further saved waiting time for medical care in an urgent care service in Brazil during the COVID-19 pandemic.

Perceptions and Needs of Artificial Intelligence in Health Care to Increase Adoption: Scoping Review

BACKGROUND

Artificial intelligence (AI) has the potential to improve the efficiency and effectiveness of health care service delivery. However, the perceptions and needs of such systems remain elusive, hindering efforts to promote AI adoption in health care.

OBJECTIVE

This study aims to provide an overview of the perceptions and needs of AI to increase its adoption in health care.

METHODS

A systematic scoping review was conducted according to the 5-stage framework by Arksey and O'Malley. Articles that described the perceptions and needs of AI in health care were searched across nine databases: ACM Library, CINAHL, Cochrane Central, Embase, IEEE Xplore, PsycINFO, PubMed, Scopus, and Web of Science for studies that were published from inception until June 21, 2021. Articles that were not specific to AI, not research studies, and not written in English were omitted.

RESULTS

Of the 3666 articles retrieved, 26 (0.71%) were eligible and included in this review. The mean age of the participants ranged from 30 to 72.6 years, the proportion of men ranged from 0% to 73.4%, and the sample sizes for primary studies ranged from 11 to 2780. The perceptions and needs of various populations in the use of AI were identified for general, primary, and community health care; chronic diseases self-management and self-diagnosis; mental health; and diagnostic procedures. The use of AI was perceived to be positive because of its availability, ease of use, and potential to improve efficiency and reduce the cost of health care service delivery. However, concerns were raised regarding the lack of trust in data privacy, patient safety, technological maturity, and the possibility of full automation. Suggestions for improving the adoption of AI in health care were highlighted: enhancing personalization and customizability; enhancing empathy and personification of AI-enabled chatbots and avatars; enhancing user experience, design, and interconnectedness with other devices; and educating the public on AI capabilities. Several corresponding mitigation strategies were also identified in this study.

CONCLUSIONS

The perceptions and needs of AI in its use in health care are crucial in improving its adoption by various stakeholders. Future studies and implementations should consider the points highlighted in this study to enhance the acceptability and adoption of AI in health care. This would facilitate an increase in the effectiveness and efficiency of health care service delivery to improve patient outcomes and satisfaction.

Precision Medicine for Hypertension Patients with Type 2 Diabetes via Reinforcement Learning

Precision medicine is a new approach to understanding health and disease based on patient-specific data such as medical diagnoses; clinical phenotype; biologic investigations such as laboratory studies and imaging; and environmental, demographic, and lifestyle factors. The importance of machine learning techniques in healthcare has expanded quickly in the last decade owing to the rising availability of vast multi-modality data and developed computational models and algorithms. Reinforcement learning is an appealing method for developing efficient policies in various healthcare areas where the decision-making process is typically defined by a long period or a sequential process. In our research, we leverage the power of reinforcement learning and electronic health records of South Koreans to dynamically recommend treatment prescriptions, which are personalized based on patient information of hypertension. Our proposed reinforcement learning-based treatment recommendation system decides whether to use mono, dual, or triple therapy according to the state of the hypertension patients. We evaluated the performance of our personalized treatment recommendation model by lowering the occurrence of hypertension-related complications and blood pressure levels of patients who followed our model’s recommendation. With our findings, we believe that our proposed hypertension treatment recommendation model could assist doctors in prescribing appropriate antihypertensive medications.

The Emergence of Artificial Intelligence in Cardiology: Current and Future Applications

Artificial intelligence technology is emerging as a promising entity in cardiovascular medicine, potentially improving diagnosis and patient care. In this article, we review the literature on artificial intelligence and its utility in cardiology. We provide a detailed description of concepts of artificial intelligence tools like machine learning, deep learning, and cognitive computing. This review discusses the current evidence, application, prospects, and limitations of artificial intelligence in cardiology.

Unbox the black-box for the medical explainable AI via multi-modal and multi-centre data fusion: A mini-review, two showcases and beyond

Explainable Artificial Intelligence (XAI) is an emerging research topic of machine learning aimed at unboxing how AI systems' black-box choices are made. This research field inspects the measures and models involved in decision-making and seeks solutions to explain them explicitly. Many of the machine learning algorithms cannot manifest how and why a decision has been cast. This is particularly true of the most popular deep neural network approaches currently in use. Consequently, our confidence in AI systems can be hindered by the lack of explainability in these black-box models. The XAI becomes more and more crucial for deep learning powered applications, especially for medical and healthcare studies, although in general these deep neural networks can return an arresting dividend in performance. The insufficient explainability and transparency in most existing AI systems can be one of the major reasons that successful implementation and integration of AI tools into routine clinical practice are uncommon. In this study, we first surveyed the current progress of XAI and in particular its advances in healthcare applications. We then introduced our solutions for XAI leveraging multi-modal and multi-centre data fusion, and subsequently validated in two showcases following real clinical scenarios. Comprehensive quantitative and qualitative analyses can prove the efficacy of our proposed XAI solutions, from which we can envisage successful applications in a broader range of clinical questions.

Intelligent retrieval method of mobile learning resources in the intelligent higher education system

Mobile learning has become more important for the new generation. It helps students think better, pushes them to study more deeply, and leads them to significant knowledge production. Mobile learning (mobile learning) is a learning paradigm that enables students to get resources from mobile technology and the Internet everywhere and anytime. The mobile learning components should be appropriately arranged. The interactions between the different components should be combined effectively and optimally for m-learning to be successful and effective. It is important to arrange the features of mobile learning and how they are applied to mobile learning activities, the application procedures, and the duration of the application time well in advance. In this paper, Human-interaction machine-based intelligent retrieved (HIM-IR) method has been suggested to improve student performance using mobile education. In mobile learning, students would find information through the network. Thus, the retrieval of quality information in support services is quite crucial. Mobile intelligent recovery would help the intelligence engine for mobile learning. The existing web server has technology on the server that doesn't have great precision and intelligence. The input string format is necessary for the retrieval process. The proposed methods aim to define the fundamental aspects and features of mobile learning in new trends in technological development. HIM-IR can be beneficial for anyone engaged in mobile learning design, preparation, and implementation.

Home monitoring of physiology and symptoms to detect interstitial lung disease exacerbations and progression: a systematic review

Background

Acute exacerbations (AEs) and disease progression in interstitial lung disease (ILD) pose important challenges to clinicians and patients. AEs of ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AEs of ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data. The aim of this review was to systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD.

Method

We searched Ovid-EMBASE, MEDLINE and CINAHL using Medical Subject Headings (MeSH) terms in accordance with the PRISMA guidelines (PROSPERO registration number CRD42020215166).

Results

13 studies involving 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was >75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p<0.001) between home and hospital-based readings. Two studies suggested that home monitoring of forced vital capacity might facilitate detection of progression in idiopathic pulmonary fibrosis.

Conclusion

Despite the fact that individual studies in this systematic review provide supportive evidence suggesting the feasibility and utility of home monitoring in ILD, further studies are necessary to quantify the potential of home monitoring to detect disease progression and/or AEs.

First systematic review that provides supportive evidence for the feasibility and utility of home monitoring in ILD; further studies are necessary to evaluate approaches to detect exacerbation and/or progressionhttps://bit.ly/2Y8OCJL

Potential of Internet of Medical Things (IoMT) applications in building a smart healthcare system: A systematic review

Sudden spurting of Corona virus disease (COVID-19) has put the whole healthcare system on high alert. Internet of Medical Things (IoMT) has eased the situation to a great extent, also COVID-19 has motivated scientists to make new ‘Smart’ healthcare system focusing towards early diagnosis, prevention of spread, education and treatment and facilitate living in the new normal. This review aims to identify the role of IoMT applications in improving healthcare system and to analyze the status of research demonstrating effectiveness of IoMT benefits to the patient and healthcare system along with a brief insight into technologies supplementing IoMT and challenges faced in developing a smart healthcare system.

An internet-based search in PUBMED, Google Scholar and IEEE Library for english language publications using relevant terms resulted in 987 articles. After screening title, abstract, and content related to IoMT in healthcare and excluding duplicate articles, 135 articles published in journal with impact factor ≥1 were eligible for inclusion. Also relevant articles from the references of the selected articles were considered.

The habituation of IoMT and related technology has resolved several difficulties using remote monitoring, telemedicine, robotics, sensors etc. However mass adoption seems challenging due to factors like privacy and security of data, management of large amount of data, scalability and upgradation etc. Although ample knowledge has been compiled and exchanged, this structured systematic review will help the healthcare practitioners, policymakers/decision makers, scientists and researchers to gauge the applicability of IoMT in healthcare more efficiently.