Artificial intelligence in disease diagnosis: a systematic literature review, synthesizing framework and future research agenda

An intelligent decision-making system for embryo transfer in reproductive technology: a machine learning-based approach

Infertility has emerged as a significant public health concern, with assisted reproductive technology (ART) is a last-resort treatment option. However, ART's efficacy is limited by significant financial cost and physical discomfort. The aim of this study is to build Machine learning (ML) decision-support models to predict the optimal range of embryo numbers to transfer, using data from infertile couples identified through literature reviews. Binary classification models were developed to classify cases into two groups: those transferring two or fewer embryos and those transferring three or four. Four popular ML algorithms were used, including random forest (RF), logistic regression (LR), support vector machine (SVM), and artificial neural network (ANN), considering seven criteria: the woman's age, sperm origin, the developmental qualities of four potential embryos, infertility duration, assessment of the woman, morphological qualities of the four best embryos on the day of transfer, and number of oocytes extracted. The stratified 3-fold cross-validation results show that the SVM model obtained the highest average accuracy (95.83%) and demonstrated the best overall performance, closely followed by the ANN and LR models with an average accuracy equal to 91.67%. The RF model achieved a slightly lower average accuracy (88.89%), which demonstrated the lowest variability. Testing on a new dataset revealed all models performed well, with ANN and SVM models classified all test set instances correctly, while the RF and LR models achieved 91.68% accuracy. These results highlight the superior generalization and effectiveness of the ANN and SVM models in guiding ART decisions.

Developing and validating an artificial intelligence-based application for predicting some pregnancy outcomes: a multi-phase study protocol

Background

Pregnancy complications such as preterm birth, low birth weight, gestational diabetes mellitus, preeclampsia, and intrauterine growth restriction significantly affect both maternal and neonatal health outcomes. Early identification of high-risk pregnancies is essential for timely interventions; however, traditional predictive models often lack accuracy. This study aims to develop and validate an AI-based application to improve risk assessment and clinical decision-making regarding pregnancy outcomes through a multi-phase approach.

Methods

This study comprises three phases. In Phase 1, retrospective case-control data will be collected from medical records, including Mother and Infant System (IMaN), Hospital Information System (HIS), and archived records of women who gave birth at Al-Zahra and Taleghani Educational and Medical Centers in Tabriz between 2022 and 2024. In Phase 2, an artificial intelligence model will be developed using machine learning algorithms such as Random Forest, XGBoost, Support Vector Machines (SVM), and neural networks, followed by model training, validation, and integration into a user-friendly application. Phase 3 will focus on a prospective cohort study of pregnant women attending clinics after 22 weeks of gestation, evaluating the AI model’s predictive performance through metrics like AUROC (area under the receiver operating characteristic curve), sensitivity, specificity, and predictive values, along with real-time data collection. Content validity will be determined through expert reviews.

Discussion

This study protocol presents a multi-phase approach to developing and validating an AI-based application for predicting pregnancy outcomes. By integrating retrospective data analysis, machine learning, and prospective validation, the study aims to improve early risk detection and maternal care. If successful, this application could support personalized obstetric decision-making.

This study aims to develop and validate an artificial intelligence (AI)-based tool to predict pregnancy complications, including preterm birth, low birth weight, gestational diabetes, intrauterine growth restriction, and preeclampsia. The research will be conducted in three phases. First, past medical records from two hospitals will be analysed to identify key risk factors. Next, a machine learning model will be developed and integrated into a user-friendly application. Finally, the tool will be tested on a group of pregnant women to assess its accuracy in predicting adverse pregnancy outcomes.

By leveraging AI, this study seeks to enhance early risk detection, enabling healthcare providers to implement timely preventive measures and improve maternal and neonatal health outcomes. If successful, this AI-based application could serve as a valuable resource in maternity care, assisting midwives and doctors in delivering personalized care and reducing complications. The findings could also advance the use of AI technology in obstetric practice, improving decision-making and optimizing healthcare resources.

ECP-GAN: Generating Endometrial Cancer Pathology Images and Segmentation Labels via Two-Stage Generative Adversarial Networks

BACKGROUND

Endometrial cancer is one of the most common tumors of the female reproductive system and ranks third in the world list of gynecological malignancies that cause death. However, due to the privacy and complexity of pathology images, it is difficult to obtain pathology images and corresponding annotation, which affect the accuracy of pathology image segmentation and analysis.

METHODS

To address this issue, this paper proposes a two-stage endometrial cancer pathology images- and labels-generating network, which can generate pathology images and corresponding segmentation labels. In the images-to-images network, a pathological style feature information fusion normalization module is proposed, which decouples the original style feature into style feature vectors to provide independent style feature information. In the images-to-labels network, a pathological prior features guidance loss block is proposed, which improves the ability of the model in feature extraction, the segmentation label-generation accuracy, and the boundary sensitivity to the target region.

RESULTS

Training ECP-GAN in the solid tumor endometrial cancer pathological dataset, by physician recognition and experiments on the medical image segmentation tasks, shows that the ECP-GAN network generates realistic images and significantly improves the accuracy of segmentation tasks, which improves about 20% of the segmentation evaluation indicators.

CONCLUSIONS

Through comparative analysis, the experimental results show that the proposed method effectively improves the robustness and accuracy of the model in segmentation tasks. Particularly when dealing with the complex morphological features of pathology images, this method enhances the model's ability to adapt to various changes, significantly improving.

Effectiveness of smartphone technology for detection of paediatric ocular diseases-a systematic review

BACKGROUND

Artificial intelligence has become part of healthcare with a multitude of applications being customized to roles required in clinical practice. There has been an expanding growth and development of computer technology with increasing appearance in the ophthalmological universe with roles in detection of most ophthalmic diseases. This article attempts to study the efficacy of smartphones and their applications in detection of paediatric eye diseases.

METHODS

On 24 January 2024, a comprehensive search was performed across five databases-PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and ProQuest-focusing on studies assessing smartphone-based disease detection and diagnostic accuracy compared to validated methods. Keywords and MeSH terms, including "smartphone," "eye diseases," and "children," were combined using Boolean operators and eligible studies were obtained. The inclusion criteria covered studies from 2000 to 2023, involving children under 18 years, and reporting diagnostic outcomes. Exclusions included studies not exclusive to eye disease, purely adult population studies, reviews, studies with non-availability of full text, and studies exploring other uses of smartphone and designs lacking diagnostic efficacy analysis. Article quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

RESULTS

A total of 2054 articles were retrieved. After removing 1112 duplicates, 507 records were excluded through title screening, followed by 333 through abstract screening. A full-text review of 83 articles led to the inclusion of 33 studies, involving 16,015 participants. Most of the studies (28, 84.84%) were of high quality, with five (15.15%) of moderate quality. Twelve smartphone applications assessed refractive errors using visual acuity tests or photorefraction, five detected amblyogenic risk factors, six identified strabismus, and three targeted leukocoria. Additional applications evaluated stereoacuity (two), eyelid position (one), chalazion (one), corneal diameter (one), and retinopathy of prematurity (two). Overall, these applications demonstrated the potential of smartphones in paediatric eye disease detection.

CONCLUSION

Smartphone applications are effective tools for detecting important causes of childhood eye disorders such as strabismus, retinopathy of prematurity, chalazion, and refractive errors. These technologies offer promising opportunities for teleophthalmology and integration into routine clinical practice.

Promises and perils of generative artificial intelligence: a narrative review informing its ethical and practical applications in clinical exercise physiology

Generative Artificial Intelligence (GenAI) is transforming various sectors, including healthcare, offering both promising opportunities and notable risks. The infancy and rapid development of GenAI raises questions regarding its effective, safe, and ethical use by health professionals, including clinical exercise physiologists. This narrative review aims to explore existing interdisciplinary literature and summarise the ethical and practical considerations of integrating GenAI into clinical exercise physiology practice. Specifically, it examines the 'promises' of improved exercise programming and healthcare delivery, as well as the 'perils' related to data privacy, person-centred care, and equitable access. Recommendations for the responsible integration of GenAI in clinical exercise physiology are described, in addition to recommendations for future research to address gaps in knowledge. Future directions, including the roles and responsibilities of specific stakeholder groups are discussed, highlighting the need for clear professional guidelines in facilitating safe and ethical deployment of GenAI into clinical exercise physiology practice. Synthesis of current literature serves as an essential step in guiding strategies to ensure the safe, ethical, and effective integration of GenAI in clinical exercise physiology, providing a foundation for future guidelines, training, and research to enhance service delivery while maintaining high standards of practice.

Maternal exposure to rubella infection elevates risk of congenital rubella syndrome (CRS)

The rise in neurodevelopmental disorders linked to maternal viral infections, particularly during the first and second trimesters of pregnancy, is concerning. Rubella, a contagious viral disease, primarily affects children and young adults, presenting as a rash and mild fever. It can also cause symptoms such as a swollen spleen, blueberry muffin skin spots, small head circumference, meningoencephalitis, developmental delays, and jaundice. When contracted in the first trimester, rubella can lead to severe birth defects or fetal death, with the risk declining after 20 weeks. Congenital rubella syndrome (CRS) caused by rubella's teratogenic effects, remains a major public health challenge, with an estimated 100,000 CRS cases annually. Following the approval of the rubella vaccine in 1969, significant strides have been made to reduce CRS and rubella incidences. This chapter provides disease management, prevention strategies, treatment options, and immunological response, focusing on prognosis and insights from current research on rubella and CRS.

Artificial Intelligence and Assistive Robotics in Healthcare Services: Applications in Silver Care

Artificial intelligence (AI) and assistive robotics can transform older-person care by offering new, personalised solutions for an ageing population. This paper outlines recent advances in AI-driven applications and robotic assistance in silver care, emphasising their role in improved healthcare services, quality of life and ageing-in-place and alleviating pressure on healthcare systems. Advances in machine learning, natural language processing and computer vision have enabled more accurate early diagnosis, targeted treatment plans and robust remote monitoring for elderly patients. These innovations support continuous health tracking and timely interventions to improve patient outcomes and extend home-based care. In addition, AI-powered assistive robots with advanced motion control and adaptive response mechanisms are studied to support physical and cognitive health. Among these, companion robots, often enhanced with emotional AI, have shown potential in reducing loneliness and increasing connectedness. The combined goal of these technologies is to offer holistic patient-centred care, which preserves the autonomy and dignity of our seniors. This paper also touches on the technical and ethical challenges of integrating AI/robotics into eldercare, like privacy and accessibility, and alludes to future directions on optimising AI-human interaction, expanding preventive healthcare applications and creating an effective, ethical framework for eldercare in the digital age.

Machine Learning Model for Predicting Coronary Heart Disease Risk: Development and Validation Using Insights From a Japanese Population-Based Study

Background

Coronary heart disease (CHD) is a major cause of morbidity and mortality worldwide. Identifying key risk factors is essential for effective risk assessment and prevention. A data-driven approach using machine learning (ML) offers advanced techniques to analyze complex, nonlinear, and high-dimensional datasets, uncovering novel predictors of CHD that go beyond the limitations of traditional models, which rely on predefined variables.

Objective

This study aims to evaluate the contribution of various risk factors to CHD, focusing on both established and novel markers using ML techniques.

Methods

The study recruited 7672 participants aged 30-84 years from Suita City, Japan, between 1989 and 1999. Over an average of 15 years, participants were monitored for cardiovascular events. A total of 7260 participants and 28 variables were included in the analysis after excluding individuals with missing outcome data and eliminating unnecessary variables. Five ML models-logistic regression, random forest (RF), support vector machine, Extreme Gradient Boosting, and Light Gradient-Boosting Machine-were applied for predicting CHD incidence. Model performance was evaluated using accuracy, sensitivity, specificity, precision, area under the curve, F1-score, calibration curves, observed-to-expected ratios, and decision curve analysis. Additionally, Shapley Additive Explanations (SHAPs) were used to interpret the prediction models and understand the contribution of various risk factors to CHD.

Results

Among 7260 participants, 305 (4.2%) were diagnosed with CHD. The RF model demonstrated the highest performance, with an accuracy of 0.73 (95% CI 0.64-0.80), sensitivity of 0.74 (95% CI 0.62-0.84), specificity of 0.72 (95% CI 0.61-0.83), and an area under the curve of 0.73 (95% CI 0.65-0.80). RF also showed excellent calibration, with predicted probabilities closely aligning with observed outcomes, and provided substantial net benefit across a range of risk thresholds, as demonstrated by decision curve analysis. SHAP analysis elucidated key predictors of CHD, including the intima-media thickness (IMT_cMax) of the common carotid artery, blood pressure, lipid profiles (non-high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), and estimated glomerular filtration rate. Novel risk factors identified as significant contributors to CHD risk included lower calcium levels, elevated white blood cell counts, and body fat percentage. Furthermore, a protective effect was observed in women, suggesting the potential necessity for gender-specific risk assessment strategies in future cardiovascular health evaluations.

Conclusions

We developed a model to predict CHD using ML and applied SHAP methods for interpretation. This approach highlights the multifactor nature of CHD risk evaluation, aiming to support health care professionals in identifying risk factors and formulating effective prevention strategies.

Circapproved: Digital Pattern Recognition via Artificial Neural Network for the Identification of Normal Penis Parameters for Circumcision Eligibility Using Mobile App

BACKGROUND

Circumcision is a prevalent surgical procedure performed for medical, cultural, and religious reasons, requiring a thorough assessment of penile anatomy to determine eligibility, especially for identifying contraindications such as congenital anomalies. This study focuses on developing an artificial intelligence (AI) based digital pattern recognition system to accurately identify normal penile parameters for circumcision eligibility using a mobile application.

METHODS

Utilizing an Artificial Neural Network (ANN), the AI model was trained on digital images captured by parents or healthcare personnel from dorsal, lateral, and ventral views of the penis. The training employed advanced techniques such as image augmentation and transfer learning to overcome the challenges posed by a limited dataset. Ethical guidelines were strictly adhered to, with informed consent obtained from all participants, ensuring the study's compliance with the Declaration of Helsinki.

RESULTS

The AI model, integrated into the Circapproved mobile app, demonstrated high accuracy in classifying normal and abnormal penile conditions, achieving 88.89 % accuracy for the dorsal view, 90.91 % for the lateral view, and 92.5 % for the ventral view. The development pipeline included data preprocessing, data splitting, and augmentation, with the AI model being deployed on a cloud-based platform to ensure scalability and accessibility. The results indicate significant potential for the AI-driven mobile application to facilitate large-scale screening and streamline the circumcision approval process, particularly in resource-limited settings.

CONCLUSION

This approach highlights the potential of AI integration for enhancing the precision of circumcision approval process. Future research should focus on further addition to the dataset to increase model accuracy.

Exploring the integration of artificial intelligence in radiology education: A scoping review

BACKGROUND

The integration of Artificial Intelligence (AI) into radiology education presents a transformative opportunity to enhance learning and practice within the field. This scoping review aims to systematically explore and map the current landscape of AI integration in radiology education.

METHODS

The review process involved systematically searching four databases, including MEDLINE (Ovid), Embase (Ovid), PsychINFO (Ovid), and Scopus. Inclusion criteria focused on research that addresses the use of AI technologies in radiology education, including but not limited to, AI-assisted learning platforms, simulation tools, and automated assessment systems. This scoping review was registered on Open Science Framework using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review.

RESULTS

Of the 1081 search results, 9 studies met the inclusion criteria. Key findings indicate a diverse range of AI applications in radiology education, from personalized curriculum generation and diagnostic support tools to automated evaluation systems. The review highlights both the potential benefits, such as enhanced diagnostic accuracy, and the challenges, including technical limitations.

CONCLUSION

The integration of AI into radiology education, which has significant potential to enhance outcomes and professional practice, requires overcoming existing challenges and ensuring that AI complements rather than replaces traditional methods, with future research needed on longitudinal studies to evaluate its long-term impact.

Rare Disease Policy in High-Income Countries: An Overview of Achievements, Challenges, and Solutions

OBJECTIVES

To provide an overview of policy initiatives in high-income countries aimed at supporting the development and accessibility of treatments for rare diseases.

METHODS

We examine how legislative, research, and pricing policies in high-income countries address barriers that have historically hindered innovation and access to rare disease treatments. By analyzing examples from the European Union, United Kingdom, United States, Canada, Japan, and Australia, the article identifies ongoing initiatives, outlines current challenges, and explores proposed solutions to foster a sustainable, innovative, and accessible rare disease treatment ecosystem.

RESULTS

The review highlights policies such as legislative incentives in the European Union, United States, and Japan for orphan drug development, public-private partnerships to boost innovation, and patient registries to support research and clinical trials. Despite these efforts, major challenges persist, including high therapy costs, limited access to innovation for ultrarare diseases, and diagnostic delays, with significant disparities across regions.

CONCLUSIONS

Overcoming these challenges will require sustainable pricing and reimbursement frameworks, alongside stronger collaboration between stakeholders, particularly for ultrarare diseases. Advanced technologies, such as artificial intelligence, hold promise for improving diagnostic accuracy and data collection, supported by enhanced coding systems and registries to facilitate more robust research.

Exploring the complex nature of implementation of Artificial intelligence in clinical practice: an interview study with healthcare professionals, researchers and Policy and Governance Experts

Artificial Intelligence (AI)-based tools have shown potential to optimize clinical workflows, enhance patient quality and safety, and facilitate personalized treatment. However, transitioning viable AI solutions to clinical implementation remains limited. To understand the challenges of bringing AI into clinical practice, we explored the experiences of healthcare professionals, researchers, and Policy and Governance Experts in hospitals. We conducted a qualitative study with thirteen semi-structured interviews (mean duration 52.1 ± 5.4 minutes) with healthcare professionals, researchers, and Policy and Governance Experts, with prior experience on AI development in hospitals. The interview guide was based on value, application, technology, governance, and ethics from the Innovation Funnel for Valuable AI in Healthcare, and the discussions were analyzed through thematic analysis. Six themes emerged: (1) demand-pull vs. tech-push: AI development focusing on innovative technologies may face limited success in large-scale clinical implementation. (2) Focus on generating knowledge, not solutions: Current AI initiatives often generate knowledge without a clear path for implementing AI models once proof-of-concept is achieved. (3) Lack of multidisciplinary collaboration: Successful AI initiatives require diverse stakeholder involvement, often hindered by late involvement and challenging communication. (4) Lack of appropriate skills: Stakeholders, including IT departments and healthcare professionals, often lack the required skills and knowledge for effective AI integration in clinical workflows. (5) The role of the hospital: Hospitals need a clear vision for integrating AI, including meeting preconditions in infrastructure and expertise. (6) Evolving laws and regulations: New regulations can hinder AI development due to unclear implications but also enforce standardization, emphasizing quality and safety in healthcare. In conclusion, this study highlights the complexity of AI implementation in clinical settings. Multidisciplinary collaboration is essential and requires facilitation. Balancing divergent perspectives is crucial for successful AI implementation. Hospitals need to assess their readiness for AI, develop clear strategies, standardize development processes, and foster better collaboration among stakeholders.

Voice assistants' influence on loneliness in older adults: a systematic review

Purpose: This review aims to examine how the use of voice assistants influences loneliness in older adults.

Materials and methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as CINAHL, APA PsycINFO, MEDLINE, PubMed, Web of Science, ScienceDirect, Scopus, SciELO, Google Scholar, and IEEE Xplore were used. We implemented search strategies in English to locate studies published between January 2010 and January 2023, including those examining the impact of voice assistant usage on loneliness in older adults. Descriptive information was examined, assessing its quality with the Mixed Methods Appraisal Tool.

Results: A total of 499 studies were yielded from the initial search, with 13 included in the final analysis. Positive outcomes in reducing loneliness were reported in 84.6% of these studies. There was a prevalence of quasi-experimental studies, alongside heterogeneous measurement instruments, scarce use of standardized tests, and small samples predominantly consisting of women. Commercial voice assistants were the most commonly utilized.

Conclusions: Voice assistants show potential in mitigating feelings of loneliness in older adults. Adequate training and adaptation to specific needs seem essential to maximize their effectiveness. In particular, voice assistants available in the consumer market hold significant potential in this area. Further research is necessary to comprehend their impact, encompassing potential risks and ethical considerations.

Neural network properties of hydrophilic polymers as a key for development of the general theory of evolution

The analysis of the existing literature demonstrates that in order to address the fundamental challenges associated with the origin of life, it is essential to consider this problem from a comprehensive perspective, specifically from the vantage point of the general theory of evolution of complex systems. From these positions, life should be regarded as a distinctive instance of an information storage and processing system that emerges naturally. Evolutionary processes should be examined from the vantage point of the coevolution of material and informational components, which has not been sufficiently emphasized hitherto. It is shown that a specific example in this respect is analogues of neural networks spontaneously formed in solutions of some hydrophilic polymers. Such systems lead to the formation of non-trivial information objects. A wide range of other examples is considered, proving that the processes occurring with the participation of hydrophilic polymers should be interpreted, among other things, from the point of view of formation of information objects, which, under certain conditions, influence the processes occurring at the molecular and supramolecular level. It is shown that it is reasonable to use the tools of classical dialectics to solve such fundamental problems as that of the origin of life.

Machine learning models and classification algorithms in the diagnosis of vestibular migraine: A systematic review and meta-analysis

OBJECTIVES

To perform a systematic review and meta-analysis to evaluate the effectiveness of machine learning (ML) algorithms in the diagnosis of vestibular migraine.

BACKGROUND

Due to the absence of defined biomarkers for diagnosing vestibular migraine (VM), it is valuable to determine which clinical, physical, and exploratory information is most crucial to diagnosing this disease. The use of artificial intelligence tools could streamline this process.

METHODS

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched for records from PubMed, Scopus, and Web of Science. Observational (case-control and cohort) studies were included to assess the ability of artificial intelligence (AI) to distinguish VM from other vestibular disorders. Risk of bias and applicability concerns were assessed using the Quality Assessment of Diagnostic Accuracy Studies-AI tool.

RESULTS

A total of 14 articles were included in the systematic review, and 10 were eligible for meta-analysis. The main inputs included for the ML algorithms were anamnesis (medical history), physical examination, results from audiological and vestibular tests, and imaging. The global sensitivity was 0.85 (95% confidence interval [CI] 0.73-0.92, I2 = 96%), while the global specificity was 0.89 (95% CI 0.84-0.93, I2 = 95%). The pooled diagnostic odds ratio was 48.15 (95% CI 17.64-131.43, I2 = 97%). Using the bivariate model, the area under the curve and for the summary receiver operating characteristic curve, using the 10 available studies, was 0.94 (95% CI 0.86-0.96).

CONCLUSION

Machine learning algorithms could be used as effective tools for the diagnosis process in VM. The use of models trained with three to four inputs yield the highest accuracy, compared to other strategies. However, the design and validation of these studies could be improved to ensure the reproducibility and generalizability of results.

Artificial intelligence in cardiovascular procedures: a bibliometric and visual analysis study

Background

The integration of artificial intelligence (AI) into cardiovascular procedures has significantly advanced diagnostic accuracy, outcome prediction, and robotic-assisted surgeries. However, a comprehensive bibliometric analysis of AI's impact in this field is lacking. This study examines research trends, key contributors, and emerging themes in AI-driven cardiovascular interventions.

Methods

We retrieved relevant publications from the Web of Science Core Collection and analyzed them using VOSviewer, CiteSpace, and Biblioshiny to map research trends and collaborations.

Results

AI-related cardiovascular research has grown substantially from 1993 to 2024, with a sharp increase from 2020 to 2023, peaking at 93 publications in 2023. The USA (127 papers), China (79), and England (31) were the top contributors, with Harvard University leading institutional output (17 papers). Frontiers in Cardiovascular Medicine was the most prolific journal. Core research themes included "machine learning," "mortality," and "cardiac surgery," with emerging trends in "association," "implantation," and "aortic stenosis," underscoring AI's expanding role in predictive modeling and surgical outcomes.

Conclusion

AI demonstrates transformative potential in cardiovascular procedures, particularly in diagnostic imaging, predictive modeling, and patient management. This bibliometric analysis highlights the growing interest in AI applications and provides a framework for integrating AI into clinical workflows to enhance diagnostic accuracy, treatment strategies, and patient outcomes.

A hybrid approach with metaheuristic optimization and random forest in improving heart disease prediction

Cardiovascular diseases (CVD)  a major cause of morbidity and mortality among the world's non-communicable disease incidences. Though these practices are in use for diagnostics of different CVDs in clinical settings, need improvement because they are solving the purpose of only 57% of the patients in emergency. Due to this cost of diagnosis for heart disease is increasing which is the reason for analyzing heart disease and predicting it as early as possible. The main motive of this paper is to find an intelligent method for predicting disease effectively by means of machine learning (ML) and metaheuristic algorithms. Optimization techniques have the merit of handling non-linear complex problems. In this paper, an efficient ML model along with metaheuristic optimization techniques is evaluated for heart disease dataset to enhance the accuracy in predicting the disease. This will help to reduce the death rate due to the severity of heart disease. The SelectKBest feature selection is applied to the Cleveland Heart dataset and overall rank is obtained. Accuracy is measured. The optimization techniques namely Genetic Algorithm Optimized Random Forest (GAORF), Particle Swarm Optimized Random Forest (PSORF), and Ant Colony Optimized Random Forest (ACORF) are applied to the Cleveland dataset. Classification algorithms are performed before and after optimization. The output of the experiment explains that the GAORF performed better for the dataset considered. Also, a comparison is made along with the SelectKBest filter methods. The proposed model achieved better accuracy which is the maximum among other optimization and classification techniques.

Analytical methods in studying cell force sensing: principles, current technologies and perspectives

Mechanical stimulation plays a crucial role in numerous biological activities, including tissue development, regeneration and remodeling. Understanding how cells respond to their mechanical microenvironment is vital for investigating mechanotransduction with adequate spatial and temporal resolution. Cell force sensing-also known as mechanosensation or mechanotransduction-involves force transmission through the cytoskeleton and mechanochemical signaling. Insights into cell-extracellular matrix interactions and mechanotransduction are particularly relevant for guiding biomaterial design in tissue engineering. To establish a foundation for mechanical biomedicine, this review will provide a comprehensive overview of cell mechanotransduction mechanisms, including the structural components essential for effective mechanical responses, such as cytoskeletal elements, force-sensitive ion channels, membrane receptors and key signaling pathways. It will also discuss the clutch model in force transmission, the role of mechanotransduction in both physiology and pathological contexts, and biomechanics and biomaterial design. Additionally, we outline analytical approaches for characterizing forces at cellular and subcellular levels, discussing the advantages and limitations of each method to aid researchers in selecting appropriate techniques. Finally, we summarize recent advancements in cell force sensing and identify key challenges for future research. Overall, this review should contribute to biomedical engineering by supporting the design of biomaterials that integrate precise mechanical information.

Operationalizing Team Science at the Academic Cancer Center Network to Unveil the Structure and Function of the Gut Microbiome

Oncologists increasingly recognize the microbiome as an important facilitator of health as well as a contributor to disease, including, specifically, cancer. Our knowledge of the etiologies, mechanisms, and modulation of microbiome states that ameliorate or promote cancer continues to evolve. The progressive refinement and adoption of "omic" technologies (genomics, transcriptomics, proteomics, and metabolomics) and utilization of advanced computational methods accelerate this evolution. The academic cancer center network, with its immediate access to extensive, multidisciplinary expertise and scientific resources, has the potential to catalyze microbiome research. Here, we review our current understanding of the role of the gut microbiome in cancer prevention, predisposition, and response to therapy. We underscore the promise of operationalizing the academic cancer center network to uncover the structure and function of the gut microbiome; we highlight the unique microbiome-related expert resources available at the City of Hope of Comprehensive Cancer Center as an example of the potential of team science to achieve novel scientific and clinical discovery.

Emerging applications of gene editing technologies for the development of climate-resilient crops

Climate change threatens global crop yield and food security due to rising temperatures, erratic rainfall, and increased abiotic stresses like drought, heat, and salinity. Gene editing technologies, including CRISPR/Cas9, base editors, and prime editors, offer precise tools for enhancing crop resilience. This review explores the mechanisms of these technologies and their applications in developing climate-resilient crops to address future challenges. While CRISPR/enables targeted modifications of plant DNA, the base editors allow for direct base conversion without inducing double-stranded breaks, and the prime editors enable precise insertions, deletions, and substitutions. By understanding and manipulating key regulator genes involved in stress responses, such as DREB, HSP, SOS, ERECTA, HsfA1, and NHX; crop tolerance can be enhanced against drought, heat, and salt stress. Gene editing can improve traits related to root development, water use efficiency, stress response pathways, heat shock response, photosynthesis, membrane stability, ion homeostasis, osmotic adjustment, and oxidative stress response. Advancements in gene editing technologies, integration with genomics, phenomics, artificial intelligence (AI)/machine learning (ML) hold great promise. However, challenges such as off-target effects, delivery methods, and regulatory barriers must be addressed. This review highlights the potential of gene editing to develop climate-resilient crops, contributing to food security and sustainable agriculture.

Use of artificial intelligence with retinal imaging in screening for diabetes-associated complications: systematic review

Background

Artificial Intelligence (AI) has been used to automate detection of retinal diseases from retinal images with great success, in particular for screening for diabetic retinopathy, a major complication of diabetes. Since persons with diabetes routinely receive retinal imaging to evaluate their diabetic retinopathy status, AI-based retinal imaging may have potential to be used as an opportunistic comprehensive screening for multiple systemic micro- and macro-vascular complications of diabetes.

Methods

We conducted a qualitative systematic review on published literature using AI on retina images to detect systemic diabetes complications. We searched three main databases: PubMed, Google Scholar, and Web of Science (January 1, 2000, to October 1, 2024). Research that used AI to evaluate the associations between retinal images and diabetes-associated complications, or research involving diabetes patients with retinal imaging and AI systems were included. Our primary focus was on articles related to AI, retinal images, and diabetes-associated complications. We evaluated each study for the robustness of the studies by development of the AI algorithm, size and quality of the training dataset, internal validation and external testing, and the performance. Quality assessments were employed to ensure the inclusion of high-quality studies, and data extraction was conducted systematically to gather pertinent information for analysis. This study has been registered on PROSPERO under the registration ID CRD42023493512.

Findings

From a total of 337 abstracts, 38 studies were included. These studies covered a range of topics related to prediction of diabetes from pre-diabetes or non-diabeticindividuals (n = 4), diabetes related systemic risk factors (n = 10), detection of microvascular complications (n = 8) and detection of macrovascular complications (n = 17). Most studies (n = 32) utilized color fundus photographs (CFP) as retinal image modality, while others employed optical coherence tomography (OCT) (n = 6). The performance of the AI systems varied, with an AUC ranging from 0.676 to 0.971 in prediction or identification of different complications. Study designs included cross-sectional and cohort studies with sample sizes ranging from 100 to over 100,000 participants. Risk of bias was evaluated by using the Newcastle-Ottawa Scale and AXIS, with most studies scoring as low to moderate risk.

Interpretation

Our review highlights the potential for the use of AI algorithms applied to retina images, particularly CFP, to screen, predict, or diagnose the various microvascular and macrovascular complications of diabetes. However, we identified few studies with longitudinal data and a paucity of randomized control trials, reflecting a gap between the development of AI algorithms and real-world implementation and translational studies.

Funding

Dr. Gavin Siew Wei TAN is supported by: 1. DYNAMO: Diabetes studY on Nephropathy And other Microvascular cOmplications II supported by National Medical Research Council (MOH-001327-03): data collection, analysis, trial design 2. Prognositc significance of novel multimodal imaging markers for diabetic retinopathy: towards improving the staging for diabetic retinopathy supported by NMRC Clinician Scientist Award (CSA)-Investigator (INV) (MOH-001047-00).

GPT-4/4V's performance on the Japanese National Medical Licensing Examination

BACKGROUND

Recent advances in Artificial Intelligence (AI) are changing the medical world, and AI will likely replace many of the actions performed by medical professionals. The overall clinical ability of the AI has been evaluated by its ability to answer a text-based national medical examination. This study uniquely assesses the performance of Open AI's ChatGPT against all Japanese National Medical Licensing Examination (NMLE), including images, illustrations, and pictures.

METHODS

We obtained the questions of the past six years of the NMLE (112th to 117th) from the Japanese Ministry of Health, Labour and Welfare website. We converted them to JavaScript Object Notation (JSON) format. We created an application programming interface (API) to output correct answers using GPT-4 for questions without images and GPT4-V(ision) or GPT4 console for questions with images.

RESULTS

The percentage of image questions was 723/2400 (30.1%) over the past six years. In all years, GPT-4/4V exceeded the minimum score the examinee should score. In total, over the six years, the percentage of correct answers for basic medical knowledge questions was 665/905 (73.5%); for clinical knowledge questions, 1143/1531 (74.7%); and for image questions 497/723 (68.7%), respectively.

CONCLUSIONS

Regarding medical knowledge, GPT-4/4V met the minimum criteria regardless of whether the questions included images, illustrations, and pictures. Our study sheds light on the potential utility of AI in medical education.

Integration of Multi-Source Medical Data for Medical Diagnosis Question Answering

Medical question answering aims to enhance diagnostic support, improve patient education, and assist in clinical decision-making by automatically answering medical-related queries, which is an important foundation for realizing intelligent healthcare. Existing methods predominantly focus on extracting key information from a single data source, e.g., CT image, for answering. However, these methods are not enough to promote the development of intelligent healthcare, because they lack comprehensive medical diagnosis capabilities, which usually require the integration of multi-source data (e.g., laboratory tests, radiology images, pathology images, etc.) for processing. To address these limitations, our paper introduces the extended task of medical question answering, named medical diagnosis question answering MedDQA. MedDQA task aims to answer questions related to medical diagnosis based on multi-source data. Specifically, we introduce a corresponding dataset that incorporates multi-source diagnostic information from 250,917 patients in clinical data from hospital records, and utilize a large-scale model for constructing Q&A pairs. We propose a novel system based on large language models, named medical multi-agent (MMA) system, which includes a mechanism of multiple agents to handle different medical tasks. Each agent is specifically tailored to process various modalities of data and provide outputs in a uniform textual modality. Experimental results demonstrate that the MMA system's architecture significantly enhances the handling of multi-source data, thereby improving medical diagnosis, establishing a robust baseline for future research.

Isfahan Artificial Intelligence Event 2023: Lesion Segmentation and Localization in Magnetic Resonance Images of Patients with Multiple Sclerosis

Background

Multiple sclerosis (MS) is one of the most common reasons of neurological disabilities in young adults. The disease occurs when the immune system attacks the central nervous system and destroys the myelin of nervous cells. This results in appearing several lesions in the magnetic resonance (MR) images of patients. Accurate determination of the amount and the place of lesions can help physicians to determine the severity and progress of the disease.

Method

Due to the importance of this issue, this challenge has been dedicated to the segmentation and localization of lesions in MR images of patients with MS. The goal was to segment and localize the lesions in the flair MR images of patients as close as possible to the ground truth masks.

Results

Several teams sent us their results for the segmentation and localization of lesions in MR images. Most of the teams preferred to use deep learning methods. The methods varied from a simple U-net structure to more complicated networks.

Conclusion

The results show that deep learning methods can be useful for segmentation and localization of lesions in MR images. In this study, we briefly described the dataset and the methods of teams attending the competition.

Physical activity and neuroplasticity in neurodegenerative disorders: a comprehensive review of exercise interventions, cognitive training, and AI applications

This review aimed to elucidate the mechanisms through which (i) physical activity (PA) enhances neuroplasticity and cognitive function in neurodegenerative disorders, and (ii) identify specific PA interventions for improving cognitive rehabilitation programs. We conducted a literature search in PubMed, Medline, Scopus, Web of Science, and PsycINFO, covering publications from January 1990 to August 2024. The search strategy employed key terms related to neuroplasticity, physical exercise, cognitive function, neurodegenerative disorders, and personalized physical activity. Inclusion criteria included original research on the relationship between PA and neuroplasticity in neurodegenerative disorders, while exclusion criteria eliminated studies focusing solely on pharmacological interventions. The review identified multiple pathways through which PA may enhance neuroplasticity, including releasing neurotrophic factors, modulation of neuroinflammation, reduction of oxidative stress, and enhancement of synaptic connectivity and neurogenesis. Aerobic exercise was found to increase hippocampal volume by 1-2% and improve executive function scores by 5-10% in older adults. Resistance training enhanced cognitive control and memory performance by 12-18% in elderly individuals. Mind-body exercises, such as yoga and tai-chi, improved gray matter density in memory-related brain regions by 3-5% and enhanced emotional regulation scores by 15-20%. Dual-task training improved attention and processing speed by 8-14% in individuals with neurodegenerative disorders. We also discuss the potential role of AI-based exercise and AI cognitive training in preventing and rehabilitating neurodegenerative illnesses, highlighting innovative approaches to personalized interventions and improved patient outcomes. PA significantly enhances neuroplasticity and cognitive function in neurodegenerative disorders through various mechanisms. Aerobic exercise, resistance training, mind-body practices, and dual-task exercises each offer unique cognitive benefits. Implementing these activities in clinical settings can improve patient outcomes. Future research should focus on creating personalized interventions tailored to specific conditions, incorporating personalized physical exercise programs to optimize cognitive rehabilitation.

What Are Patients' Perceptions and Attitudes Regarding the Use of Artificial Intelligence in Skin Cancer Screening and Diagnosis? Narrative Review

Artificial intelligence (AI) could enable early diagnosis of skin cancer; however, how AI should be implemented in clinical practice is debated. This narrative literature review (16 studies; 2012-2024) explored patient perceptions of AI in skin cancer screening and diagnosis. Patients were generally positive and perceived AI to increase diagnostic speed and accuracy. Patients preferred AI to augment a dermatologist's diagnosis rather than replace it. Patients were concerned that AI could lead to privacy breaches and clinicians deskilling and threaten doctor-patient relationships. Findings also highlight the complex nature of the impact of demographic, quality, and functional attributes on patients' attitudes toward AI.

Applications of digital health technologies and artificial intelligence algorithms in COPD: systematic review

BACKGROUND

Chronic Obstructive Pulmonary Disease (COPD) represents a significant global health challenge, placing considerable burdens on healthcare systems. The rise of digital health technologies (DHTs) and artificial intelligence (AI) algorithms offers new opportunities to improve COPD predictive capabilities, diagnostic accuracy, and patient management. This systematic review explores the types of data in COPD under DHTs, the AI algorithms employed for data analysis, and identifies key application areas reported in the literature.

METHODS

A systematic search was conducted in PubMed and Web of Science for studies published up to December 2024 that applied AI algorithms in digital health for COPD management. Inclusion criteria focused on original research utilizing AI algorithms and digital health technologies for COPD, while review articles were excluded. Two independent reviewers screened the studies, resolving discrepancies through consensus.

RESULTS

From an initial pool of 265 studies, 41 met the inclusion criteria. Analysis of these studies highlighted a diverse range of data types and modalities collected from DHTs in the COPD context, including clinical data, patient-reported outcomes, and environmental/lifestyle data. Machine learning (ML) algorithms were employed in 34 studies, and deep learning (DL) algorithms in 16. Support vector machines and boosting were the most frequently used ML models, while deep neural networks (DNN) and convolutional neural networks (CNN) were the most commonly used DL models. The review identified three key application domains for AI in COPD: screening and diagnosis (10 studies), exacerbation prediction (22 studies), and patient monitoring (9 studies). Disease progression prediction was a prevalent focus across three domains, with promising accuracy and performance metrics reported.

CONCLUSIONS

Digital health technologies and AI algorithms have a wide range of applications and promise for COPD management. ML models, in particularly, show great potential in improving digital health solutions for COPD. Future research should focus on enhancing global collaboration to explore the cost-effectiveness and data-sharing capabilities of DHTs, enhancing the interpretability of AI models, and validating these algorithms through clinical trials to facilitate their safe integration into the routine COPD management.

An efficient artificial neural network-based optimization techniques for the early prediction of coronary heart disease: comprehensive analysis

Coronary heart disease (CHD) is the world's leading cause of death, contributing to a high mortality rate. This emphasizes the requirement for an advanced decision support system in order to evaluate the risk of CHD. This study presents an Artificial Neural Network (ANN) based intelligent healthcare system to predict the risk of CHD. The proposed ANN model is trained using the Framingham Heart Study (FHS) dataset, which comprises 4240 data instances and 15 potential risk factors. To combat overfitting, the proposed model uses four hidden dense layers with dropout rates ranging from 0.5 to 0.2. Also, two activation functions, ReLU and LeakyReLU, are used in conjunction with four optimizers: Adam, SGD, RMSProp, and AdaDelta to fine-tune the parameters and minimize the loss functions. Moreover, three sophisticated preprocessing methods, SMOTE, SMOTETomek, and SMOTEENN, along with the proposed two-stage sampling approach, are applied to address the target class data imbalance. Experimental results demonstrate that the Adam optimizer coupled with the ReLU activation function and the combined sequential effect of SMOTEENN and SMOTETomek's two-stage sampling approach achieved superior performance. The validation accuracy reached 96.25% with a recall value of 0.98, outperforming existing approaches reported in the literature. The combined effect of approaches will be evidence of the modern healthcare decision-making support system for the risk prediction of CHD.

Combining pelvic floor ultrasonography with deep learning to diagnose anterior compartment organ prolapse

Background

Anterior compartment prolapse is a common pelvic organ prolapse (POP), which occurs frequently among middle-aged and elderly women and can cause urinary incontinence, perineal pain and swelling, and seriously affect their physical and mental health. At present, pelvic floor ultrasound is the primary examination method, but it is not carried out by many primary medical institutions due to the significant shortcomings of training in the early stage and the variable image quality. There has been great progress in the application of deep learning (DL) in image-based diagnosis in various clinical contexts. The main purpose of this study was to improve the speed and reliability of pelvic floor ultrasound diagnosis of POP by training neural networks to interpret ultrasound images, thereby facilitating the diagnosis and treatment of POP in primary care.

Methods

This retrospective study analyzed medical records of women with anterior compartment organ prolapse (n=1,605, mean age 45.1±12.2 years) or without (n=200, mean age 38.1±13.4 years), who were examined at West China Second University Hospital between March 2019 and September 2021. Static ultrasound images of the anterior chamber of the pelvic floor (5,281 abnormal, 535 normal) were captured at rest and at maximal Valsalva motion, and four convolutional neural network (CNN) models, AlexNet, VGG-16, ResNet-18, and ResNet-50, were trained on 80% of the images, then internally validated on the other 20%. Each model was trained in two ways: through a random initialization parameter training method and through a transfer learning method based on ImageNet pre-training. The diagnostic performance of each network was evaluated according to accuracy, precision, recall and F1-score, and the receiver operating characteristic (ROC) curve of each network in the training set and validation set was drawn and the area under the curve (AUC) was obtained.

Results

All four models, regardless of training method, achieved recognition accuracy of >91%, whereas transfer learning led to more stable and effective feature extraction. Specifically, ResNet-18 and ResNet-50 performed better than AlexNet and VGG-16. However, the four networks learned by transfer all showed fairly high AUCs, with the ResNet-18 network performing the best: it read images in 13.4 msec and provided recognition an accuracy of 93.53% along with an AUC of 0.852.

Conclusions

Combining DL with pelvic floor ultrasonography can substantially accelerate diagnosis of anterior compartment organ prolapse in women while improving accuracy.

A Protocol for AI-Powered Tools to Enhance Mobility and Function in Older Adults: An Evidence and Gap Map

Introduction: Artificial intelligence (AI) is transforming healthcare by enhancing diagnostic accuracy, treatment, and patient monitoring, benefiting older adults by offering personalized care plans. AI-powered tools help manage chronic conditions and maintain independence, making them a valuable asset in addressing aging challenges. Objectives: The objectives are as follows: 1. To identify and describe AI-power-based exercise programs for older adults. 2. To highlight primary evidence gaps in AI interventions for functional improvement and mobility. 3. To evaluate the quality of existing reviews on this topic. Methods: The evidence gap map (EGM) will follow the five-step method, adhering to the Campbell Collaboration guidelines and, if available at the time of reporting, PRISMA-AI standards. Guided by the Metaverse Equitable Rehabilitation Therapy framework, this study will categorize findings across domains like equity, health service integration, interoperability, governance, and humanization. The study will include systematic reviews, randomized controlled trials, and pre-and post-intervention designs. Results will be reported following PRISMA-AI guidelines. We will use AMSTAR-2 Checklist for Analyzing Systematic Reviews on AI Interventions for Improving mobility and function in Older Adults to evaluate the reliability of systematic reviews and focus on internal validity. Conclusions: This comprehensive analysis will act as a critical resource for guiding future research, refining clinical interventions, and influencing policy decisions to enhance AI-driven solutions for aging populations. The EGM aims to bridge existing evidence gaps, fostering a more informed, equitable, and effective approach to AI solutions for older adults.

Leveraging AI to improve disease screening among American Indians: insights from the Strong Heart Study

Screening tests for disease have their performance measured through sensitivity and specificity, which inform how well the test can discriminate between those with and without the condition. Typically, high values for sensitivity and specificity are desired. These two measures of performance are unaffected by the outcome prevalence of the disease in the population. Research projects into the health of the American Indian frequently develop Machine learning algorithms as predictors of conditions in this population. In essence, these models serve as in silico screening tests for disease. A screening test's sensitivity and specificity values, typically determined during the development of the test, inform on the performance at the population level and are not affected by the prevalence of disease. A screening test's positive predictive value (PPV) is susceptible to the prevalence of the outcome. As the number of artificial intelligence and machine learning models flourish to predict disease outcomes, it is crucial to understand if the PPV values for these in silico methods suffer as traditional screening tests in a low prevalence outcome environment. The Strong Heart Study (SHS) is an epidemiological study of the American Indian and has been utilized in predictive models for health outcomes. We used data from the SHS focusing on the samples taken during Phases V and VI. Logistic Regression, Artificial Neural Network, and Random Forest were utilized as in silico screening tests within the SHS group. Their sensitivity, specificity, and PPV performance were assessed with health outcomes of varying prevalence within the SHS subjects. Although sensitivity and specificity remained high in these in silico screening tests, the PPVs' values declined as the outcome's prevalence became rare. Machine learning models used as in silico screening tests are subject to the same drawbacks as traditional screening tests when the outcome to be predicted is of low prevalence.

Application of Generative Artificial Intelligence Models for Accurate Prescription Label Identification and Information Retrieval for the Elderly in Northern East of Thailand

This study introduces a novel AI-driven approach to support elderly patients in Thailand with medication management, focusing on accurate drug label interpretation. Two model architectures were explored: a Two-Stage Optical Character Recognition (OCR) and Large Language Model (LLM) pipeline combining EasyOCR with Qwen2-72b-instruct and a Uni-Stage Visual Question Answering (VQA) model using Qwen2-72b-VL. Both models operated in a zero-shot capacity, utilizing Retrieval-Augmented Generation (RAG) with DrugBank references to ensure contextual relevance and accuracy. Performance was evaluated on a dataset of 100 diverse prescription labels from Thai healthcare facilities, using RAG Assessment (RAGAs) metrics to assess Context Recall, Factual Correctness, Faithfulness, and Semantic Similarity. The Two-Stage model achieved high accuracy (94%) and strong RAGAs scores, particularly in Context Recall (0.88) and Semantic Similarity (0.91), making it well-suited for complex medication instructions. In contrast, the Uni-Stage model delivered faster response times, making it practical for high-volume environments such as pharmacies. This study demonstrates the potential of zero-shot AI models in addressing medication management challenges for the elderly by providing clear, accurate, and contextually relevant label interpretations. The findings underscore the adaptability of AI in healthcare, balancing accuracy and efficiency to meet various real-world needs.

Artificial intelligence-driven intelligent learning models for identification and prediction of cardioneurological disorders: A comprehensive study

The integration of Artificial Intelligence (AI) and Intelligent Learning Models (ILMs) in healthcare has transformed the field, offering precise diagnostics, remote monitoring, personalized treatment, and more. Cardioneurological disorders (CD), affecting the cardiovascular and neurological systems, present significant diagnostic and management challenges. Traditional testing methods often lack sensitivity and specificity, leading to delayed or inaccurate diagnoses. AI-driven ILMs trained on large datasets offer promise for accurate identification and prediction of CD by analyzing complex data patterns. However, there is a lack of comprehensive studies reviewing AI applications for the diagnosis of CD and inter related disorders. This paper comprehensively reviews existing integrated solutions involving AI and ILMs in CD, examining their clinical manifestations, epidemiology, diagnostic challenges, and therapeutic considerations. The study examines recent research on CD, reviews AI-driven models' landscape, evaluates existing models, addresses practical considerations, and outlines future research directions. Through this work, we aim to provide insights into the transformative potential of AI-driven ILMs in improving clinical practice and patient outcomes for CD.

Trends of Artificial Intelligence (AI) Use in Drug Targets, Discovery and Development: Current Status and Future Perspectives

The applications of artificial intelligence (AI) in pharmaceutical sectors have advanced drug discovery and development methods. AI has been applied in virtual drug design, molecule synthesis, advanced research, various screening methods, and decision-making processes. In the fourth industrial revolution, when medical discoveries are happening swiftly, AI technology is essential to reduce the costs, effort, and time in the pharmaceutical industry. Further, it will aid "genome-based medicine" and "drug discovery." AI may prepare proactive databases according to diseases, disorders, and appropriate usage of drugs which will facilitate the required data for the process of drug development. The application of AI has improved clinical trials on patient selection in a population, stratification, and sample assessment such as biomarkers, effectiveness measures, dosage selection, and trial length. Various studies suggest AI could be perform better compared to conventional techniques in drug discovery. The present review focused on the positive impact of AI in drug discovery and development processes in the pharmaceutical industry and beneficial usage in health sectors as well.

Nanotoxicology: developments and new insights

The use of nanoparticles (NPs) in treatment of diseases have increased exponentially recently, giving rise to the science of nanomedicine. The safety of these NPs in humans has also led to the science of nanotoxicology. Due to a dearth of both readily available models and precise bio-dispersion characterization techniques, nanotoxicological research has obviously been constrained. However, the ensuing years were notable for the emergence of improved synthesis methods and characterization tools. Major advances have been made in linking certain physical variables, paralleling improvements in characterization size, shape, or coating factors to the resulting physiological reactions. Although significant progress has been a contribution to the development of nanotoxicology, however, it faces numerous difficulties and technical constraints distinct from those of conventional toxicological assessment as it attempts to improve the therapeutic effects of medicines. Determining thorough characterization standards, standardizing dosimetry, assessing the kinetics of ions dissolving and enhancing the accuracy of in vitro-in vivo correlation efficiency, also defining restrictions on exposure protection are some of the most important and pressing concerns. This article will explore the past advancement and potential prospects of nanotoxicology, standard models, emphasizing significant findings from earlier studies and examining current challenges, giving insight on the way forward.

The Impact of Artificial Intelligence on Healthcare: A Comprehensive Review of Advancements in Diagnostics, Treatment, and Operational Efficiency

Background and Aims

Artificial Intelligence (AI) beginning to integrate in healthcare, is ushering in a transformative era, impacting diagnostics, altering personalized treatment, and significantly improving operational efficiency. The study aims to describe AI in healthcare, including important technologies like robotics, machine learning (ML), deep learning (DL), and natural language processing (NLP), and to investigate how these technologies are used in patient interaction, predictive analytics, and remote monitoring. The goal of this review is to present a thorough analysis of AI's effects on healthcare while providing stakeholders with a road map for navigating this changing environment.

Methods

This review analyzes the impact of AI on healthcare using data from the Web of Science (2014-2024), focusing on keywords like AI, ML, and healthcare applications. It examines the uses and effects of AI on healthcare by synthesizing recent literature and real-world case studies, such as Google Health and IBM Watson Health, highlighting AI technologies, their useful applications, and the difficulties in putting them into practice, including problems with data security and resource limitations. The review also discusses new developments in AI, and how they can affect society.

Results

The findings demonstrate how AI is enhancing the skills of medical professionals, enhancing diagnosis, and opening the door to more individualized treatment plans, as reflected in the steady rise of AI-related healthcare publications from 158 articles (3.54%) in 2014 to 731 articles (16.33%) by 2024. Core applications like remote monitoring and predictive analytics improve operational effectiveness and patient involvement. However, there are major obstacles to the mainstream implementation of AI in healthcare, including issues with data security and budget constraints.

Conclusion

Healthcare may be transformed by AI, but its successful use requires ethical and responsible use. To meet the changing demands of the healthcare sector and guarantee the responsible application of AI technologies, the evaluation highlights the necessity of ongoing research, instruction, and multidisciplinary cooperation. In the future, integrating AI responsibly will be essential to optimizing its advantages and reducing related dangers.

Machine Learning Algorithm-Based Prediction of Diabetes Among Female Population Using PIMA Dataset

Background: Diabetes is a metabolic disorder characterized by increased blood sugar levels. Early detection of diabetes could help individuals to manage and delay the progression of this disorder effectively. Machine learning (ML) methods are important in forecasting the progression and diagnosis of different medical problems with better accuracy. Although they cannot substitute the work of physicians in the prediction and diagnosis of disease, they can be of great help in identifying hidden patterns based on the results and outcome of disease. Methods: In this research, we retrieved the PIMA dataset from the Kaggle repository, the retrieved dataset was further processed for applied PCA, heatmap, and scatter plot for exploratory data analysis (EDA), which helps to find out the relationship between various features in the dataset using visual representation. Four different ML algorithms Random Forest (RF), Decision Tree (DT), Naïve Bayes (NB), and Logistic regression (LR) were implemented on Rattle using Python for the prediction of diabetes among the female population. Results: Results of our study showed that RF performs better in terms of accuracy of 80%, precision of 82%, error rate of 20%, and sensitivity of 88% as compared to other developed models DT, NB, and LR. Conclusions: Diabetes is a common problem prevailing across the globe, ML-based prediction models can help in the prediction of diabetes much earlier before the worsening of the condition.

CerviFusionNet: A multi-modal, hybrid CNN-transformer-GRU model for enhanced cervical lesion multi-classification

Cervical lesions pose a significant threat to women's health worldwide. Colposcopy is essential for screening and treating cervical lesions, but its effectiveness depends on the doctor's experience. Artificial intelligence-based solutions via colposcopy images have shown great potential in cervical lesions screening. However, some challenges still need to be addressed, such as low algorithm performance and lack of high-quality multi-modal datasets. Here, we established a multi-modal colposcopy dataset of 2,273 HPV+ patients, comprising original colposcopy images, acetic acid reactions at 60s and 120s, iodine staining, diagnostic reports, and pathological results. Utilizing this dataset, we developed CerviFusionNet, a hybrid architecture that merges convolutional neural networks and vision transformers to learn robust representations. We designed a temporal module to capture dynamic changes in acetic acid sequences, which can boost the model performance without sacrificing inference speed. Compared with several existing methods, CerviFusionNet demonstrated excellent accuracy and efficiency.

AI frontiers in emergency care: the next evolution of nursing interventions

This scoping review explores the utilization of artificial intelligence in emergency nursing, assessing its impact, potential benefits, and the obstacles faced in its adoption. It covers the scope of AI from advanced triage protocols to continuous monitoring of patients, assistance in diagnosis, and providing support for clinical decisions. The review notes that AI in emergency healthcare can lead to more efficient care and timely, data-driven actions, but also highlights significant issues such as safeguarding patient data, the necessity for dependable infrastructure, and concerns over discriminatory algorithms. The promise of AI in improving emergency healthcare practices and patient care is clear, yet the identified challenges must be carefully navigated to promote safe and ethical use. Further empirical research is called for to confirm the effectiveness of AI applications in the dynamic environment of emergency care setups.

Prediction of cyanotic and acyanotic congenital heart disease using machine learning models

BACKGROUND

Congenital heart disease is most commonly seen in neonates and it is a major cause of pediatric illness and childhood morbidity and mortality.

AIM

To identify and build the best predictive model for predicting cyanotic and acyanotic congenital heart disease in children during pregnancy and identify their potential risk factors.

METHODS

The data were collected from the Pediatric Cardiology Department at Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan from December 2017 to October 2019. A sample of 3900 mothers whose children were diagnosed with cyanotic or acyanotic congenital heart disease was taken. Multivariate outlier detection methods were used to identify the potential outliers. Different machine learning models were compared, and the best-fitted model was selected using the area under the curve, sensitivity, and specificity of the models.

RESULTS

Out of 3900 patients included, about 69.5% had acyanotic and 30.5% had cyanotic congenital heart disease. Males had more cases of acyanotic (53.6%) and cyanotic (54.5%) congenital heart disease as compared to females. The odds of having cyanotic was 1.28 times higher for children whose mothers used more fast food frequently during pregnancy. The artificial neural network model was selected as the best predictive model with an area under the curve of 0.9012, sensitivity of 65.76%, and specificity of 97.23%.

CONCLUSION

Children having a positive family history are at very high risk of having cyanotic and acyanotic congenital heart disease. Males are more at risk and their mothers need more care, good food, and physical activity during pregnancy. The best-fitted model for predicting cyanotic and acyanotic congenital heart disease is the artificial neural network. The results obtained and the best model identified will be useful for medical practitioners and public health scientists for an informed decision-making process about the earlier diagnosis and improve the health condition of children in Pakistan.

DLLabelsCT: Annotation tool using deep transfer learning to assist in creating new datasets from abdominal computed tomography scans, case study: Pancreas

The utilization of artificial intelligence (AI) is expanding significantly within medical research and, to some extent, in clinical practice. Deep learning (DL) applications, which use large convolutional neural networks (CNN), hold considerable potential, especially in optimizing radiological evaluations. However, training DL algorithms to clinical standards requires extensive datasets, and their processing is labor-intensive. In this study, we developed an annotation tool named DLLabelsCT that utilizes CNN models to accelerate the image analysis process. To validate DLLabelsCT, we trained a CNN model with a ResNet34 encoder and a UNet decoder to segment the pancreas on an open-access dataset and used the DL model to assist in annotating a local dataset, which was further used to refine the model. DLLabelsCT was also tested on two external testing datasets. The tool accelerates annotation by 3.4 times compared to a completely manual annotation method. Out of 3,715 CT scan slices in the testing datasets, 50% did not require editing when reviewing the segmentations made by the ResNet34-UNet model, and the mean and standard deviation of the Dice similarity coefficient was 0.82±0.24. DLLabelsCT is highly accurate and significantly saves time and resources. Furthermore, it can be easily modified to support other deep learning models for other organs, making it an efficient tool for future research involving larger datasets.

Comparison of measurement of integrated relaxation pressure by esophageal manometry with analysis of swallowing sounds with artificial intelligence in patients with achalasia

BACKGROUND

Esophageal motility disorders are mainly evaluated with high-resolution manometry (HRM) which is a time-consuming and uncomfortable procedure with potential adverse events. Acoustic characterization of the swallowing has the potential to be an alternative noninvasive procedure.

METHODS

We compared the findings on HRM and swallowing sounds in 43 patients who were referred for evaluation of dysphagia. The sound analysis was done with empirical mode decomposition method and with artificial intelligence (AI) and the estimated integrated relaxation pressure (IRP) from a two-layer neural network method was compared to measured IRP on HRM. The model then was tested in five patients.

KEY RESULTS

IRP was estimated with high accuracy using the model developed with two-layer neural network method.

CONCLUSIONS & INFERENCES

The analysis of acoustic properties of swallowing has the potential to be used for evaluation of esophageal motility disorders, this needs to be further evaluated in larger studies.

ChatGPT-Assisted Machine Learning for Chronic Disease Classification and Prediction: A Developmental and Validation Study

Background Chronic diseases such as chronic kidney disease (CKD), chronic liver disease (CLD), tuberculosis (TB), dementia, and heart disease are global health concerns of significant importance, representing major causes of morbidity and mortality worldwide. Early diagnosis and interventions are critical to improve patient outcomes and reduce healthcare costs. Methods This prospective observational study analyzed clinical data from 270 patients (calculated using G*Power 3.1.9.7 analysis (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany), α = 0.05, power = 0.80), with 260 (96.3%) completing the protocol. The cohort comprised 149 (55.2%) males and 121 (44.8%) females, distributed across CKD (n=55, 21.2%), CLD (n=52, 20.0%), TB (n=51, 19.6%), dementia (n=50, 19.2%), and heart disease (n=52, 20.0%). Three ML models were employed with ChatGPT version 3.5 assistance (OpenAI, San Francisco, CA, USA) in feature selection and hyperparameter optimization: logistic regression, random forest, and support vector machines. Model performance was evaluated using accuracy, sensitivity, specificity, precision, recall, F1-score, and AUC-ROC metrics. Ten-fold cross-validation was applied to ensure robustness. Results The random forest model demonstrated superior performance, achieving the highest accuracy in predicting CKD (47/55, 85.3%, p < 0.001, sensitivity 45/55, 82.5%, specificity 48/55, 87.2%) and heart disease (46/52, 88.2%, p < 0.001, sensitivity 45/52, 85.7%, specificity 47/52, 90.1%). Logistic regression effectively predicted TB (41/51, 80.1%, p < 0.01) and dementia (41/50, 82.4%, p < 0.01). Key predictive parameters included hemoglobin (median 10.2 g/dL, IQR 8.4-12.6) and erythrocyte sedimentation rate (median 42.0 mm/hr, IQR 20.0-65.0). Model validation showed high consistency, with positive acid-fast bacilli in 40/51 (78.4%) TB cases and characteristic radiological findings in 43/51 (84.3%) cases. Conclusion ML algorithms, particularly random forest, show promising potential in chronic disease classification and prediction. The integration of ChatGPT enhanced model development through optimized feature selection and hyperparameter tuning. Future research should focus on external validation through multi-center studies and prospective clinical trials.

Artificial intelligence and omics in malignant gliomas

Glioblastoma multiforme (GBM) is one of the most common and aggressive type of malignant glioma with an average survival time of 12-18 mo. Despite the utilization of extensive surgical resections using cutting-edge neuroimaging, and advanced chemotherapy and radiotherapy, the prognosis remains unfavorable. The heterogeneity of GBM and the presence of the blood-brain barrier further complicate the therapeutic process. It is crucial to adopt a multifaceted approach in GBM research to understand its biology and advance toward effective treatments. In particular, omics research, which primarily includes genomics, transcriptomics, proteomics, and epigenomics, helps us understand how GBM develops, finds biomarkers, and discovers new therapeutic targets. The availability of large-scale multiomics data requires the development of computational models to infer valuable biological insights for the implementation of precision medicine. Artificial intelligence (AI) refers to a host of computational algorithms that is becoming a major tool capable of integrating large omics databases. Although the application of AI tools in GBM-omics is currently in its early stages, a thorough exploration of AI utilization to uncover different aspects of GBM (subtype classification, prognosis, and survival) would have a significant impact on both researchers and clinicians. Here, we aim to review and provide database resources of different AI-based techniques that have been used to study GBM pathogenesis using multiomics data over the past decade. We summarize different types of GBM-related omics resources that can be used to develop AI models. Furthermore, we explore various AI tools that have been developed using either individual or integrated multiomics data, highlighting their applications and limitations in the context of advancing GBM research and treatment.

Highly-Cited Papers on Fracture Non-union - A Bibliometric Analysis of the Global Literature (1990-2023)

Objective

The growing interest in this field of fracture nonunion has been informally acknowledged through published studies. A bibliometric analysis was conducted to objectively outline the patterns in published clinical research concerning nonunion fractures by utilizing highly cited papers (HCPs).

Methods

Through a predetermined search strategy, we gathered literature on the clinical management of nonunion fractures from the Scopus database and utilized bibliometrics to examine the publication dates, countries, institutions, journals, authors, HCPs, and research focal points. Statistical analysis and visualization were conducted using MS Excel and VOSviewer software.

Results

From 1990 to 2023, a total of 168 HCPs in the field of fracture nonunion were identified. They received an average of 167.68 citations per paper (CPP). Among them, 4.08% received external funding, while 17.26% were involved in international collaboration. The United States (49.4% share) was the most productive country and France had the highest citation impact. P.V. Gianoudis had the highest productivity with 13 publications and P. Hernigou had the highest citation impact. The Mayo Clinic was the most productive organization and Hopital Henri Mondor achieved the highest citation impact. The most productive journal was Clinical Orthopedics & Related Research, and the Journal of Bone & Joint Surgery, American Volume had the highest average citation impact.

Conclusion

This contemporary bibliometric study illustrates the research features and developments of nonunion fractures. Through the use of VOSviewer, key countries, organizations, and authors could be identified, providing researchers with essential information to pinpoint current and future areas of interest in fracture nonunion.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43465-024-01176-6.

Artificial intelligence applications for immunology laboratory: image analysis and classification study of IIF photos

Artificial intelligence (AI) is increasingly being used in medicine to enhance the speed and accuracy of disease diagnosis and treatment. AI-based image analysis is expected to play a crucial role in future healthcare facilities and laboratories, offering improved precision and cost-effectiveness. As technology advances, the requirement for specialized software knowledge to utilize AI applications is diminishing. Our study will examine the advantages and challenges of employing AI-based image analysis in the field of immunology and will investigate whether physicians without software expertise can use MS Azure Portal for ANA IIF test classification and image analysis. This is the first study to perform Hep-2 image analysis using MS Azure Portal. We will also assess the potential for AI applications to aid physicians in interpreting ANA IIF results in immunology laboratories. The study was designed in four stages by two specialists. Stage 1: creation of an image library, Stage 2: finding an artificial intelligence application, Stage 3: uploading images and training artificial intelligence, Stage 4: performance analysis of the artificial intelligence application. In the first training, the average pattern identification accuracy for 72 testing images was 81.94%. After the second training, this accuracy increased to 87.5%. Patterns Precision improved from 71.42 to 79.96% after the second training. As a result, the number of correctly identified patterns and their accuracy increased with the second training process. Artificial intelligence-based image analysis shows promising potential. This technology is expected to become essential in healthcare facility laboratories, offering higher accuracy rates and lower costs.

Managing Dyslipidemia in Children: Current Approaches and the Potential of Artificial Intelligence

Dyslipidemia is abnormal lipid and lipoprotein levels in the blood, influenced mainly by genetics, lifestyle, and environmental factors. The management of lipid levels in children involves early screening, nonpharmacological interventions such as lifestyle modifications and dietary changes, nutraceuticals, and pharmacological treatments, including drug therapy. However, the prevalence of dyslipidemia in the pediatric population is increasing, particularly among obese children, which is a significant risk factor for cardiovascular complications. This narrative review analyzes current literature on the management of dyslipidemia in children and explores the potential of artificial intelligence (AI) to improve screening, diagnosis, and treatment outcomes. A comprehensive literature search was conducted using Google Scholar and PubMed databases, focusing primarily on the application of AI in managing dyslipidemia. AI has been beneficial in managing lipid disorders, including lipid profile analysis, obesity assessments, and familial hypercholesterolemia screening. Deep learning models, machine learning algorithms, and artificial neural networks have improved diagnostic accuracy and treatment efficacy. While most studies are done in the adult population, the promising results suggest further exploring AI management of dyslipidemia in children.

Artificial Intelligence Diagnosing of Oral Lichen Planus: A Comparative Study

Early diagnosis of oral lichen planus (OLP) is challenging, which traditionally is dependent on clinical experience and subjective interpretation. Artificial intelligence (AI) technology has been widely applied in objective and rapid diagnoses. In this study, we aim to investigate the potential of AI diagnosis in OLP and evaluate its effectiveness in improving diagnostic accuracy and accelerating clinical decision making. A total of 128 confirmed OLP patients were included, and lesion images from various anatomical sites were collected. The diagnosis was performed using AI platforms, including ChatGPT-4O, ChatGPT (Diagram-Date extension), and Claude Opus, for AI directly identification and AI pre-training identification. After OLP feature training, the diagnostic accuracy of the AI platforms significantly improved, with the overall recognition rates of ChatGPT-4O, ChatGPT (Diagram-Date extension), and Claude Opus increasing from 59%, 68%, and 15% to 77%, 80%, and 50%, respectively. Additionally, the pre-training recognition rates for buccal mucosa reached 94%, 93%, and 56%, respectively. However, the AI platforms performed less effectively when recognizing lesions in less common sites and complex cases; for instance, the pre-training recognition rates for the gums were only 60%, 60%, and 20%, demonstrating significant limitations. The study highlights the strengths and limitations of different AI technologies and provides a reference for future AI applications in oral medicine.