Evaluating machine learning algorithms to Predict 30-day Unplanned REadmission (PURE) in Urology patients

INNBC DApp, a decentralized application to permanently store biomedical data on a modern, proof-of-stake (POS), blockchain such as BNB Smart Chain

BACKGROUND

A blockchain can be described as a distributed ledger database where, under a consensus mechanism, data are permanently stored in records, called blocks, linked together with cryptography. Each block contains a cryptographic hash function of the previous block, a timestamp, and transaction data, which are permanently stored in thousands of nodes and never altered. This provides a potential real-world application for generating a permanent, decentralized record of scientific data, taking advantage of blockchain features such as timestamping and immutability.

IMPLEMENTATION

Here, we propose INNBC DApp, a Web3 decentralized application providing a simple front-end user interface connected with a smart contract for recording scientific data on a modern, proof-of-stake (POS) blockchain such as BNB Smart Chain. Unlike previously proposed blockchain tools that only store a hash of the data on-chain, here the data are stored fully on-chain within the transaction itself as "transaction input data", with a true decentralized storage solution. In addition to plain text, the DApp can record various types of files, such as documents, images, audio, and video, by using Base64 encoding. In this study, we describe how to use the DApp and perform real-world transactions storing different kinds of data from previously published research articles, describing the advantages and limitations of using such a technology, analyzing the cost in terms of transaction fees, and discussing possible use cases.

RESULTS

We have been able to store several different types of data on the BNB Smart Chain: raw text, documents, images, audio, and video. Notably, we stored several complete research articles at a reasonable cost. We found a limit of 95KB for each single file upload. Considering that Base64 encoding increases file size by approximately 33%, this provides us with a theoretical limit of 126KB. We successfully overcome this limitation by splitting larger files into smaller chunks and uploading them as multi-volume archives. Additionally, we propose AES encryption to protect sensitive data. Accordingly, we show that it is possible to include enough data to be useful for storing and sharing scientific documents and images on the blockchain at a reasonable cost for the users.

CONCLUSION

INNBC DApp represents a real use case for blockchain technology in decentralizing biomedical data storage and sharing, providing us with features such as immutability, timestamp, and identity that can be used to ensure permanent availability of the data and to provide proof-of-existence as well as to protect authorship, a freely available decentralized science (DeSci) tool aiming to help bring mass adoption of blockchain technology among the scientific community.

Application of machine learning models on predicting the length of hospital stay in fragility fracture patients

BACKGROUND

The rate of geriatric hip fracture in Hong Kong is increasing steadily and associated mortality in fragility fracture is high. Moreover, fragility fracture patients increase the pressure on hospital bed demand. Hence, this study aims to develop a predictive model on the length of hospital stay (LOS) of geriatric fragility fracture patients using machine learning (ML) techniques.

METHODS

In this study, we use the basic information, such as gender, age, residence type, etc., and medical parameters of patients, such as the modified functional ambulation classification score (MFAC), elderly mobility scale (EMS), modified Barthel index (MBI) etc, to predict whether the length of stay would exceed 21 days or not.

RESULTS

Our results are promising despite the relatively small sample size of 8000 data. We develop various models with three approaches, namely (1) regularizing gradient boosting frameworks, (2) custom-built artificial neural network and (3) Google's Wide & Deep Learning technique. Our best results resulted from our Wide & Deep model with an accuracy of 0.79, with a precision of 0.73, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.84. Feature importance analysis indicates (1) the type of hospital the patient is admitted to, (2) the mental state of the patient and (3) the length of stay at the acute hospital all have a relatively strong impact on the length of stay at palliative care.

CONCLUSIONS

Applying ML techniques to improve the quality and efficiency in the healthcare sector is becoming popular in Hong Kong and around the globe, but there has not yet been research related to fragility fracture. The integration of machine learning may be useful for health-care professionals to better identify fragility fracture patients at risk of prolonged hospital stays. These findings underline the usefulness of machine learning techniques in optimizing resource allocation by identifying high risk individuals and providing appropriate management to improve treatment outcome.