Nat Med. 2024 Jul 19. doi: 10.1038/s41591-024-03139-8. Online ahead of print.

ABSTRACT

Primary diabetes care and diabetic retinopathy (DR) screening persist as major public health challenges due to a shortage of trained primary care physicians (PCPs), particularly in low-resource settings. Here, to bridge the gaps, we developed an integrated image-language system (DeepDR-LLM), combining a large language model (LLM module) and image-based deep learning (DeepDR-Transformer), to provide individualized diabetes management recommendations to PCPs. In a retrospective evaluation, the LLM module demonstrated comparable performance to PCPs and endocrinology residents when tested in English and outperformed PCPs and had comparable performance to endocrinology residents in Chinese. For identifying referable DR, the average PCP's accuracy was 81.0% unassisted and 92.3% assisted by DeepDR-Transformer. Furthermore, we performed a single-center real-world prospective study, deploying DeepDR-LLM. We compared diabetes management adherence of patients under the unassisted PCP arm (n = 397) with those under the PCP+DeepDR-LLM arm (n = 372). Patients with newly diagnosed diabetes in the PCP+DeepDR-LLM arm showed better self-management behaviors throughout follow-up (P < 0.05). For patients with referral DR, those in the PCP+DeepDR-LLM arm were more likely to adhere to DR referrals (P < 0.01). Additionally, DeepDR-LLM deployment improved the quality and empathy level of management recommendations. Given its multifaceted performance, DeepDR-LLM holds promise as a digital solution for enhancing primary diabetes care and DR screening.

PMID:39030266 | DOI:10.1038/s41591-024-03139-8

Sci Rep. 2024 Jul 19;14(1):16672. doi: 10.1038/s41598-024-65926-0.

ABSTRACT

Breast cancer (BC) significantly contributes to cancer-related mortality in women, underscoring the criticality of early detection for optimal patient outcomes. Mammography is a key tool for identifying and diagnosing breast abnormalities; however, accurately distinguishing malignant mass lesions remains challenging. To address this issue, we propose a novel deep learning approach for BC screening utilizing mammography images. Our proposed model comprises three distinct stages: data collection from established benchmark sources, image segmentation employing an Atrous Convolution-based Attentive and Adaptive Trans-Res-UNet (ACA-ATRUNet) architecture, and BC identification via an Atrous Convolution-based Attentive and Adaptive Multi-scale DenseNet (ACA-AMDN) model. The hyperparameters within the ACA-ATRUNet and ACA-AMDN models are optimized using the Modified Mussel Length-based Eurasian Oystercatcher Optimization (MML-EOO) algorithm. The performance is evaluated using a variety of metrics, and a comparative analysis against conventional methods is presented. Our experimental results reveal that the proposed BC detection framework attains superior precision rates in early disease detection, demonstrating its potential to enhance mammography-based screening methodologies.

PMID:39030248 | DOI:10.1038/s41598-024-65926-0

Sci Rep. 2024 Jul 19;14(1):16720. doi: 10.1038/s41598-024-66487-y.

ABSTRACT

Programmed death-ligand 1 (PD-L1) expressions play a crucial role in guiding therapeutic interventions such as the use of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in lung cancer. Conventional determination of PD-L1 status includes careful surgical or biopsied tumor specimens. These specimens are gathered through invasive procedures, representing a risk of difficulties and potential challenges in getting reliable and representative tissue samples. Using a single center cohort of 189 patients, our objective was to evaluate various fusion methods that used non-invasive computed tomography (CT) and 18 F-FDG positron emission tomography (PET) images as inputs to various deep learning models to automatically predict PD-L1 in non-small cell lung cancer (NSCLC). We compared three different architectures (ResNet, DenseNet, and EfficientNet) and considered different input data (CT only, PET only, PET/CT early fusion, PET/CT late fusion without as well as with partially and fully shared weights to determine the best model performance. Models were assessed utilizing areas under the receiver operating characteristic curves (AUCs) considering their 95% confidence intervals (CI). The fusion of PET and CT images as input yielded better performance for PD-L1 classification. The different data fusion schemes systematically outperformed their individual counterparts when used as input of the various deep models. Furthermore, early fusion consistently outperformed late fusion, probably as a result of its capacity to capture more complicated patterns by merging PET and CT derived content at a lower level. When we looked more closely at the effects of weight sharing in late fusion architectures, we discovered that while it might boost model stability, it did not always result in better results. This suggests that although weight sharing could be beneficial when modality parameters are similar, the anatomical and metabolic information provided by CT and PET scans are too dissimilar to consistently lead to improved PD-L1 status predictions.

PMID:39030240 | DOI:10.1038/s41598-024-66487-y

Med Image Anal. 2024 Jul 14;97:103273. doi: 10.1016/j.media.2024.103273. Online ahead of print.

ABSTRACT

Fundus image quality serves a crucial asset for medical diagnosis and applications. However, such images often suffer degradation during image acquisition where multiple types of degradation can occur in each image. Although recent deep learning based methods have shown promising results in image enhancement, they tend to focus on restoring one aspect of degradation and lack generalisability to multiple modes of degradation. We propose an adaptive image enhancement network that can simultaneously handle a mixture of different degradations. The main contribution of this work is to introduce our Multi-Degradation-Adaptive module which dynamically generates filters for different types of degradation. Moreover, we explore degradation representation learning and propose the degradation representation network and Multi-Degradation-Adaptive discriminator for our accompanying image enhancement network. Experimental results demonstrate that our method outperforms several existing state-of-the-art methods in fundus image enhancement. Code will be available at https://github.com/RuoyuGuo/MDA-Net.

PMID:39029157 | DOI:10.1016/j.media.2024.103273

Invest Ophthalmol Vis Sci. 2024 Jul 1;65(8):30. doi: 10.1167/iovs.65.8.30.

ABSTRACT

PURPOSE: Investigating the sequence of morphological changes preceding outer plexiform layer (OPL) subsidence, a marker preceding geographic atrophy, in intermediate AMD (iAMD) using high-precision artificial intelligence (AI) quantifications on optical coherence tomography imaging.

METHODS: In this longitudinal observational study, individuals with bilateral iAMD participating in a multicenter clinical trial were screened for OPL subsidence and RPE and outer retinal atrophy. OPL subsidence was segmented on an A-scan basis in optical coherence tomography volumes, obtained 6-monthly with 36 months follow-up. AI-based quantification of photoreceptor (PR) and outer nuclear layer (ONL) thickness, drusen height and choroidal hypertransmission (HT) was performed. Changes were compared between topographic areas of OPL subsidence (AS), drusen (AD), and reference (AR).

RESULTS: Of 280 eyes of 140 individuals, OPL subsidence occurred in 53 eyes from 43 individuals. Thirty-six eyes developed RPE and outer retinal atrophy subsequently. In the cohort of 53 eyes showing OPL subsidence, PR and ONL thicknesses were significantly decreased in AS compared with AD and AR 12 and 18 months before OPL subsidence occurred, respectively (PR: 20 µm vs. 23 µm and 27 µm [P < 0.009]; ONL, 84 µm vs. 94 µm and 98 µm [P < 0.008]). Accelerated thinning of PR (0.6 µm/month; P < 0.001) and ONL (0.8 µm/month; P < 0.001) was observed in AS compared with AD and AR. Concomitant drusen regression and hypertransmission increase at the occurrence of OPL subsidence underline the atrophic progress in areas affected by OPL subsidence.

CONCLUSIONS: PR and ONL thinning are early subclinical features associated with subsequent OPL subsidence, an indicator of progression toward geographic atrophy. AI algorithms are able to predict and quantify morphological precursors of iAMD conversion and allow personalized risk stratification.

PMID:39028907 | DOI:10.1167/iovs.65.8.30

Chaos. 2024 Jul 1;34(7):073134. doi: 10.1063/5.0209068.

ABSTRACT

In this paper, we investigate the data-driven rogue waves solutions of the focusing and the variable coefficient nonlinear Schrödinger (NLS) equations by the deep learning method from initial and boundary conditions. Specifically, first- and second-order rogue wave solutions for the focusing NLS equation and three deformed rogue wave solutions for the variable coefficient NLS equation are solved using physics-informed memory networks (PIMNs). The effects of optimization algorithm, network structure, and mesh size on the solution accuracy are discussed. Numerical experiments clearly demonstrate that the PIMNs can capture the nonlinear features of rogue waves solutions very well. This is of great significance for revealing the dynamical behavior of the rogue waves solutions and advancing the application of deep learning in the field of solving partial differential equations.

PMID:39028903 | DOI:10.1063/5.0209068

J Perinat Med. 2024 Jul 22. doi: 10.1515/jpm-2024-0122. Online ahead of print.

ABSTRACT

OBJECTIVES: Fetal cleft lip is a common congenital defect. Considering the delicacy and difficulty of observing fetal lips, we have utilized deep learning technology to develop a new model aimed at quickly and accurately assessing the development of fetal lips during prenatal examinations. This model can detect ultrasound images of the fetal lips and classify them, aiming to provide a more objective prediction for the development of fetal lips.

METHODS: This study included 632 pregnant women in their mid-pregnancy stage, who underwent ultrasound examinations of the fetal lips, collecting both normal and abnormal fetal lip ultrasound images. To improve the accuracy of the detection and classification of fetal lips, we proposed and validated the Yolov5-ECA model.

RESULTS: The experimental results show that, compared with the currently popular 10 models, our model achieved the best results in the detection and classification of fetal lips. In terms of the detection of fetal lips, the mAP@0.5 and mAP@0.5:0.95 were 0.920 and 0.630, respectively. In the classification of fetal lip ultrasound images, the accuracy reached 0.925.

CONCLUSIONS: The deep learning algorithm has accuracy consistent with manual evaluation in the detection and classification process of fetal lips. This automated recognition technology can provide a powerful tool for inexperienced young doctors, helping them to accurately conduct examinations and diagnoses of fetal lips.

PMID:39028804 | DOI:10.1515/jpm-2024-0122

PLoS One. 2024 Jul 19;19(7):e0305733. doi: 10.1371/journal.pone.0305733. eCollection 2024.

ABSTRACT

The surging popularity of virtual reality (VR) technology raises concerns about VR-induced motion sickness, linked to discomfort and nausea in simulated environments. Our method involves in-depth analysis of EEG data and user feedback to train a sophisticated deep learning model, utilizing an enhanced GRU network for identifying motion sickness patterns. Following comprehensive data pre-processing and feature engineering to ensure input accuracy, a deep learning model is trained using supervised and unsupervised techniques for classifying and predicting motion sickness severity. Rigorous training and validation procedures confirm the model's robustness across diverse scenarios. Research results affirm our deep learning model's 84.9% accuracy in classifying and predicting VR-induced motion sickness, surpassing existing models. This information is vital for improving the VR experience and advancing VR technology.

PMID:39028732 | DOI:10.1371/journal.pone.0305733

IEEE Trans Neural Syst Rehabil Eng. 2024 Jul 19;PP. doi: 10.1109/TNSRE.2024.3431208. Online ahead of print.

ABSTRACT

Freezing of gait (FOG) is an episodic and highly disabling symptom of Parkinson's disease (PD). Although described as a single phenomenon, FOG is heterogeneous and can express as different manifestations, such as trembling in place or complete akinesia. We aimed to analyze the efficacy of deep learning (DL) trained on inertial measurement unit data to classify FOG into both manifestations. We adapted and compared four state-of-the-art FOG detection algorithms for this task and investigated the advantages of incorporating a refinement model to address oversegmentation errors. We evaluated the model's performance in distinguishing between trembling and akinesia, as well as other forms of movement cessation (e.g., stopping and sitting), against gold-standard video annotations. Experiments were conducted on a dataset of eighteen PD patients completing a FOG-provoking protocol in a gait laboratory. Results showed our model achieved an F1 score of 0.78 and segment F1@50 of 0.75 in detecting FOG manifestations. Assessment of FOG severity was strong for trembling (ICC=0.86, [0.66,0.95]) and moderately strong for akinesia (ICC=0.78, [0.51,0.91]). Importantly, our model successfully differentiated FOG from other forms of movement cessation during 360-degree turning-in-place tasks. In conclusion, our study demonstrates that DL can accurately assess different types of FOG manifestations, warranting further investigation in larger and more diverse verification cohorts.

PMID:39028610 | DOI:10.1109/TNSRE.2024.3431208

IEEE Trans Neural Syst Rehabil Eng. 2024 Jul 19;PP. doi: 10.1109/TNSRE.2024.3431024. Online ahead of print.

ABSTRACT

Myoelectric indices forecasting is important for muscle fatigue monitoring in wearable technologies, adaptive control of assistive devices like exoskeletons and prostheses, functional electrical stimulation (FES)-based Neuroprostheses, and more. Non-stationary temporal development of these indices in dynamic contractions makes forecasting difficult. This study aims at incorporating transfer learning into a deep learning model, Myoelectric Fatigue Forecasting Network (MEFFNet), to forecast myoelectric indices of fatigue (both time and frequency domain) obtained during voluntary and FES-induced dynamic contractions in healthy and post-stroke subjects respectively. Different state-of-the-art deep learning models along with the novel MEFFNet architecture were tested on myoelectric indices of fatigue obtained during a) voluntary elbow flexion and extension with four different weights (1 kg, 2 kg, 3 kg, and 4 kg) in sixteen healthy subjects, and b) FES-induced elbow flexion in sixteen healthy and seventeen post-stroke subjects under three different stimulation patterns (customized rectangular, trapezoidal, and muscle synergy-based). A version of MEFFNet, named as pretrained MEFFNet, was trained on a dataset of sixty thousand synthetic time series to transfer its learning on real time series of myoelectric indices of fatigue. The pretrained MEFFNet could forecast up to 22.62 seconds, 60 timesteps, in future with a mean absolute percentage error of 15.99 ± 6.48% in voluntary and 11.93 ± 4.77% in FES-induced contractions, outperforming the MEFFNet and other models under consideration. The results suggest combining the proposed model with wearable technology, prosthetics, robotics, stimulation devices, etc. to improve performance. Transfer learning in time series forecasting has potential to improve wearable sensor predictions.

PMID:39028608 | DOI:10.1109/TNSRE.2024.3431024

IEEE Trans Med Imaging. 2024 Jul 19;PP. doi: 10.1109/TMI.2024.3431192. Online ahead of print.

ABSTRACT

Electron microscopy (EM) image denoising is critical for visualization and subsequent analysis. Despite the remarkable achievements of deep learning-based non-blind denoising methods, their performance drops significantly when domain shifts exist between the training and testing data. To address this issue, unpaired blind denoising methods have been proposed. However, these methods heavily rely on image-to-image translation and neglect the inherent characteristics of EM images, limiting their overall denoising performance. In this paper, we propose the first unsupervised domain adaptive EM image denoising method, which is grounded in the observation that EM images from similar samples share common content characteristics. Specifically, we first disentangle the content representations and the noise components from noisy images and establish a shared domain-agnostic content space via domain alignment to bridge the synthetic images (source domain) and the real images (target domain). To ensure precise domain alignment, we further incorporate domain regularization by enforcing that: the pseudo-noisy images, reconstructed using both content representations and noise components, accurately capture the characteristics of the noisy images from which the noise components originate, all while maintaining semantic consistency with the noisy images from which the content representations originate. To guarantee lossless representation decomposition and image reconstruction, we introduce disentanglement-reconstruction invertible networks. Finally, the reconstructed pseudo-noisy images, paired with their corresponding clean counterparts, serve as valuable training data for the denoising network. Extensive experiments on synthetic and real EM datasets demonstrate the superiority of our method in terms of image restoration quality and downstream neuron segmentation accuracy. Our code is publicly available at https://github.com/sydeng99/DADn.

PMID:39028599 | DOI:10.1109/TMI.2024.3431192

IEEE J Biomed Health Inform. 2024 Jul 19;PP. doi: 10.1109/JBHI.2024.3429169. Online ahead of print.

ABSTRACT

Brain functional connectivity has been routinely explored to reveal the functional interaction dynamics between the brain regions. However, conventional functional connectivity measures rely on deterministic models fixed for all participants, usually demanding application-specific empirical analysis, while deep learning approaches focus on finding discriminative features for state classification, thus having limited capability to capture the interpretable functional connectivity characteristics. To address the challenges, this study proposes a self-supervised triplet network with depth-wise attention (TripletNet-DA) to generate the functional connectivity: 1) TripletNet-DA firstly utilizes channel-wise transformations for temporal data augmentation, where the correlated & uncorrelated sample pairs are constructed for self-supervised training, 2) Channel encoder is designed with a convolution network to extract the deep features, while similarity estimator is employed to generate the similarity pairs and the functional connectivity representations with prominent patterns emphasized via depth-wise attention mechanism, 3) TripletNet-DA applies Triplet loss with anchor-negative similarity penalty for model training, where the similarities of uncorrelated sample pairs are minimized to enhance model's learning capability. Experimental results on pathological EEG datasets (Autism Spectrum Disorder, Major Depressive Disorder) indicate that 1) TripletNet-DA demonstrates superiority in both ASD discrimination and MDD classification than the state-of-the-art counterparts in various frequency bands, where the connectivity features in beta & gamma bands have respectively achieved the accuracy of 97.05%,98.32% for ASD discrimination, 89.88%,91.80% for MDD classification in the eyes-closed condition, and 90.90%,92.26% for MDD classification in the eyes-open condition, 2) TripletNet-DA enables to uncover significant differences of functional connectivity between the ASD EEG and the TD ones, and the prominent connectivity links are in accordance with the empirical findings that frontal lobe demonstrates more connectivity links and significant frontal-temporal connectivity occurs in the beta band, thus providing potential biomarkers for clinical ASD analysis.

PMID:39028590 | DOI:10.1109/JBHI.2024.3429169

Med Biol Eng Comput. 2024 Jul 19. doi: 10.1007/s11517-024-03147-3. Online ahead of print.

ABSTRACT

Stroke is a neurological condition that usually results in the loss of voluntary control of body movements, making it difficult for individuals to perform activities of daily living (ADLs). Brain-computer interfaces (BCIs) integrated into robotic systems, such as motorized mini exercise bikes (MMEBs), have been demonstrated to be suitable for restoring gait-related functions. However, kinematic estimation of continuous motion in BCI systems based on electroencephalography (EEG) remains a challenge for the scientific community. This study proposes a comparative analysis to evaluate two artificial neural network (ANN)-based decoders to estimate three lower-limb kinematic parameters: x- and y-axis position of the ankle and knee joint angle during pedaling tasks. Long short-term memory (LSTM) was used as a recurrent neural network (RNN), which reached Pearson correlation coefficient (PCC) scores close to 0.58 by reconstructing kinematic parameters from the EEG features on the delta band using a time window of 250 ms. These estimates were evaluated through kinematic variance analysis, where our proposed algorithm showed promising results for identifying pedaling and rest periods, which could increase the usability of classification tasks. Additionally, negative linear correlations were found between pedaling speed and decoder performance, thereby indicating that kinematic parameters between slower speeds may be easier to estimate. The results allow concluding that the use of deep learning (DL)-based methods is feasible for the estimation of lower-limb kinematic parameters during pedaling tasks using EEG signals. This study opens new possibilities for implementing controllers most robust for MMEBs and BCIs based on continuous decoding, which may allow for maximizing the degrees of freedom and personalized rehabilitation.

PMID:39028484 | DOI:10.1007/s11517-024-03147-3

J Med Syst. 2024 Jul 19;48(1):68. doi: 10.1007/s10916-024-02087-7.

ABSTRACT

Artificial intelligence (AI) based predictive models for early detection of cardiovascular disease (CVD) risk are increasingly being utilised. However, AI based risk prediction models that account for right-censored data have been overlooked. This systematic review (PROSPERO protocol CRD42023492655) includes 33 studies that utilised machine learning (ML) and deep learning (DL) models for survival outcome in CVD prediction. We provided details on the employed ML and DL models, eXplainable AI (XAI) techniques, and type of included variables, with a focus on social determinants of health (SDoH) and gender-stratification. Approximately half of the studies were published in 2023 with the majority from the United States. Random Survival Forest (RSF), Survival Gradient Boosting models, and Penalised Cox models were the most frequently employed ML models. DeepSurv was the most frequently employed DL model. DL models were better at predicting CVD outcomes than ML models. Permutation-based feature importance and Shapley values were the most utilised XAI methods for explaining AI models. Moreover, only one in five studies performed gender-stratification analysis and very few incorporate the wide range of SDoH factors in their prediction model. In conclusion, the evidence indicates that RSF and DeepSurv models are currently the optimal models for predicting CVD outcomes. This study also highlights the better predictive ability of DL survival models, compared to ML models. Future research should ensure the appropriate interpretation of AI models, accounting for SDoH, and gender stratification, as gender plays a significant role in CVD occurrence.

PMID:39028429 | DOI:10.1007/s10916-024-02087-7

Eur Radiol. 2024 Jul 19. doi: 10.1007/s00330-024-10941-y. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to evaluate the potential of deep learning (DL)-assisted automated three-dimensional quantitative tumor burden at MRI to predict postoperative early recurrence (ER) of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: This was a single-center retrospective study enrolling patients who underwent resection for BCLC A and B HCC and preoperative contrast-enhanced MRI. Quantitative total tumor volume (cm3) and total tumor burden (TTB, %) were obtained using a DL automated segmentation tool. Radiologists' visual assessment was used to ensure the quality control of automated segmentation. The prognostic value of clinicopathological variables and tumor burden-related parameters for ER was determined by Cox regression analyses.

RESULTS: A total of 592 patients were included, with 525 and 67 patients assigned to BCLC A and B, respectively (2-year ER rate: 30.0% vs. 45.3%; hazard ratio (HR) = 1.8; p = 0.007). TTB was the most important predictor of ER (HR = 2.2; p < 0.001). Using 6.84% as the threshold of TTB, two ER risk strata were obtained in overall (p < 0.001), BCLC A (p < 0.001), and BCLC B (p = 0.027) patients, respectively. The BCLC B low-TTB patients had a similar risk for ER to BCLC A patients and thus were reassigned to a BCLC An stage; whilst the BCLC B high-TTB patients remained in a BCLC Bn stage. The 2-year ER rate was 30.5% for BCLC An patients vs. 58.1% for BCLC Bn patients (HR = 2.8; p < 0.001).

CONCLUSIONS: TTB determined by DL-based automated segmentation at MRI was a predictive biomarker for postoperative ER and facilitated refined subcategorization of patients within BCLC stages A and B.

CLINICAL RELEVANCE STATEMENT: Total tumor burden derived by deep learning-based automated segmentation at MRI may serve as an imaging biomarker for predicting early recurrence, thereby improving subclassification of Barcelona Clinic Liver Cancer A and B hepatocellular carcinoma patients after hepatectomy.

KEY POINTS: Total tumor burden (TTB) is important for Barcelona Clinic Liver Cancer (BCLC) staging, but is heterogenous. TTB derived by deep learning-based automated segmentation was predictive of postoperative early recurrence. Incorporating TTB into the BCLC algorithm resulted in successful subcategorization of BCLC A and B patients.

PMID:39028376 | DOI:10.1007/s00330-024-10941-y

J Imaging Inform Med. 2024 Jul 19. doi: 10.1007/s10278-024-01189-5. Online ahead of print.

ABSTRACT

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a reduced attention span, hyperactivity, and impulsive behaviors, which typically manifest during childhood. This study employs functional magnetic resonance imaging (fMRI) to use spontaneous brain activity for classifying individuals with ADHD, focusing on a 3D convolutional neural network (CNN) architecture to facilitate the design of decision support systems. We developed a novel deep learning model based on 3D CNNs using the ADHD-200 database, which comprises datasets from NeuroImage (NI), New York University (NYU), and Peking University (PU). We used fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo) data in three dimensions and performed a fivefold cross-validation to address the dataset imbalance. We aimed to verify the efficacy of our proposed 3D CNN by contrasting it with a fully connected neural network (FCNN) architecture. The 3D CNN achieved accuracy rates of 76.19% (NI), 69.92% (NYU), and 70.77% (PU) for fALFF data. The FCNN model yielded lower accuracy rates across all datasets. For generalizability, we trained on NI and NYU datasets and tested on PU. The 3D CNN achieved 69.48% accuracy on fALFF outperforming the FCNN. Our results demonstrate that using 3D CNNs for classifying fALFF data is an effective approach for diagnosing ADHD. Also, FCNN confirmed the efficiency of the designed model.

PMID:39028358 | DOI:10.1007/s10278-024-01189-5

J Med Syst. 2024 Jul 19;48(1):67. doi: 10.1007/s10916-024-02088-6.

ABSTRACT

Medical advances prolonging life have led to more permanent pacemaker implants. When pacemaker implantation (PMI) is commonly caused by sick sinus syndrome or conduction disorders, predicting PMI is challenging, as patients often experience related symptoms. This study was designed to create a deep learning model (DLM) for predicting future PMI from ECG data and assess its ability to predict future cardiovascular events. In this study, a DLM was trained on a dataset of 158,471 ECGs from 42,903 academic medical center patients, with additional validation involving 25,640 medical center patients and 26,538 community hospital patients. Primary analysis focused on predicting PMI within 90 days, while all-cause mortality, cardiovascular disease (CVD) mortality, and the development of various cardiovascular conditions were addressed with secondary analysis. The study's raw ECG DLM achieved area under the curve (AUC) values of 0.870, 0.878, and 0.883 for PMI prediction within 30, 60, and 90 days, respectively, along with sensitivities exceeding 82.0% and specificities over 81.9% in the internal validation. Significant ECG features included the PR interval, corrected QT interval, heart rate, QRS duration, P-wave axis, T-wave axis, and QRS complex axis. The AI-predicted PMI group had higher risks of PMI after 90 days (hazard ratio [HR]: 7.49, 95% CI: 5.40-10.39), all-cause mortality (HR: 1.91, 95% CI: 1.74-2.10), CVD mortality (HR: 3.53, 95% CI: 2.73-4.57), and new-onset adverse cardiovascular events. External validation confirmed the model's accuracy. Through ECG analyses, our AI DLM can alert clinicians and patients to the possibility of future PMI and related mortality and cardiovascular risks, aiding in timely patient intervention.

PMID:39028354 | DOI:10.1007/s10916-024-02088-6

Mil Med. 2024 Jul 19:usae359. doi: 10.1093/milmed/usae359. Online ahead of print.

ABSTRACT

Artificial intelligence (AI) has garnered significant attention for its pivotal role in the national security and health care sectors. However, its utilization in military medicine remains relatively unexplored despite its immense potential. AI operates through evolving algorithms that process extensive datasets, continuously improving accuracy and emulating human learning processes. Generative AI, a type of machine learning, uses algorithms to generate new content, such as images, text, videos, audio, and computer code. These models employ deep learning to encode simplified representations of training data and generate new work resembling the original without being identical. Although many AI applications in military medicine are theoretical, the U.S. Military has implemented several initiatives, often without widespread awareness among its personnel. This article aims to shed light on two resilience initiatives spearheaded by the Joint Artificial Intelligence Center, which is now the Chief Digital and Artificial Intelligence Office. These initiatives aim to enhance commanders' dashboards for predicting troop behaviors and develop models to forecast troop suicidality. Additionally, it outlines 5 key AI applications within military medicine, including (1) clinical efficiency and routine decision-making support, (2) triage and clinical care algorithms for large-scale combat operations, (3) patient and resource movements in the medical common operating picture, (4) health monitoring and biosurveillance, and (5) medical product development. Even with its promising potential, AI brings forth inherent risks and limitations that require careful consideration and discussion. The article also advocates for a forward-thinking approach for the U.S. Military to effectively leverage AI in advancing military health and overall operational readiness.

PMID:39028176 | DOI:10.1093/milmed/usae359

Korean J Radiol. 2024 Jul 10. doi: 10.3348/kjr.2024.0598. Online ahead of print.

NO ABSTRACT

PMID:39028011 | DOI:10.3348/kjr.2024.0598

Front Vet Sci. 2024 Jul 4;11:1383320. doi: 10.3389/fvets.2024.1383320. eCollection 2024.

ABSTRACT

Culex pipiens, an important vector of many vector borne diseases, is a species capable to feeding on a wide variety of hosts and adapting to different environments. To predict the potential distribution of Cx. pipiens in central Italy, this study integrated presence/absence data from a four-year entomological survey (2019-2022) carried out in the Abruzzo and Molise regions, with a datacube of spectral bands acquired by Sentinel-2 satellites, as patches of 224 × 224 pixels of 20 meters spatial resolution around each site and for each satellite revisit time. We investigated three scenarios: the baseline model, which considers the environmental conditions at the time of collection; the multitemporal model, focusing on conditions in the 2 months preceding the collection; and the MultiAdjacency Graph Attention Network (MAGAT) model, which accounts for similarities in temperature and nearby sites using a graph architecture. For the baseline scenario, a deep convolutional neural network (DCNN) analyzed a single multi-band Sentinel-2 image. The DCNN in the multitemporal model extracted temporal patterns from a sequence of 10 multispectral images; the MAGAT model incorporated spatial and climatic relationships among sites through a graph neural network aggregation method. For all models, we also evaluated temporal lags between the multi-band Earth Observation datacube date of acquisition and the mosquito collection, from 0 to 50 days. The study encompassed a total of 2,555 entomological collections, and 108,064 images (patches) at 20 meters spatial resolution. The baseline model achieved an F1 score higher than 75.8% for any temporal lag, which increased up to 81.4% with the multitemporal model. The MAGAT model recorded the highest F1 score of 80.9%. The study confirms the widespread presence of Cx. pipiens throughout the majority of the surveyed area. Utilizing only Sentinel-2 spectral bands, the models effectively capture early in advance the temporal patterns of the mosquito population, offering valuable insights for directing surveillance activities during the vector season. The methodology developed in this study can be scaled up to the national territory and extended to other vectors, in order to support the Ministry of Health in the surveillance and control strategies for the vectors and the diseases they transmit.

PMID:39027906 | PMC:PMC11256216 | DOI:10.3389/fvets.2024.1383320