Reliable Prediction Models Based on Enriched Data for Identifying the Mode of Childbirth by Using Machine Learning Methods: Development Study

Fast Healthcare Interoperability Resources-Based Support System for Predicting Delivery Type: Model Development and Evaluation Study

BACKGROUND

The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences.

OBJECTIVE

This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians' decisions.

METHODS

This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model's performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals.

RESULTS

The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries.

CONCLUSIONS

This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.

Development of machine learning-based predictors for early diagnosis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) remains a formidable malignancy that significantly impacts human health, and the early diagnosis of HCC holds paramount importance. Therefore, it is imperative to develop an efficacious signature for the early diagnosis of HCC. In this study, we aimed to develop early HCC predictors (eHCC-pred) using machine learning-based methods and compare their performance with existing methods. The enhancements and advancements of eHCC-pred encompassed the following: (i) utilization of a substantial number of samples, including an increased representation of cirrhosis tissues without HCC (CwoHCC) samples for model training and augmented numbers of HCC and CwoHCC samples for model validation; (ii) incorporation of two feature selection methods, namely minimum redundancy maximum relevance and maximum relevance maximum distance, along with the inclusion of eight machine learning-based methods; (iii) improvement in the accuracy of early HCC identification, elevating it from 78.15 to 97% using identical independent datasets; and (iv) establishment of a user-friendly web server. The eHCC-pred is freely accessible at http://www.dulab.com.cn/eHCC-pred/ . Our approach, eHCC-pred, is anticipated to be robustly employed at the individual level for facilitating early HCC diagnosis in clinical practice, surpassing currently available state-of-the-art techniques.

Identification and verification of characteristic differentially expressed ferroptosis-related genes in osteosarcoma using bioinformatics analysis

BACKGROUND

This study identified and verified the characteristic differentially expressed ferroptosis-related genes (CDEFRGs) in osteosarcoma (OS).

METHODS

We extracted ferroptosis-related genes (FRGs), identified differentially expressed FRGs (DEFRGs) in OS, and conducted correlation analysis between DEFRGs. Next, we conducted GO and KEGG analyses to explore the biological functions and pathways of DEFRGs. Furthermore, we used LASSO and SVM-RFE algorithms to screen CDEFRGs, and evaluated its accuracy in diagnosing OS through ROC curves. Then, we demonstrated the molecular function and pathway enrichment of CDEFRGs through GSEA analysis. In addition, we evaluated the differences in immune cell infiltration between OS and NC groups, as well as the correlation between CDEFRGs expressions and immune cell infiltrations. Finally, the expression of CDEFRGs was verified through qRT-PCR, western blotting, and immunohistochemistry experiments.

RESULTS

We identified 51 DEFRGs and the expression relationship between them. GO and KEGG analysis revealed their key functions and important pathways. Based on four CDEFRGs (PEX3, CPEB1, NOX1, and ALOX5), we built the OS diagnostic model, and verified its accuracy. GSEA analysis further revealed the important functions and pathways of CDEFRGs. In addition, there were differences in immune cell infiltration between OS group and NC group, and CDEFRGs showed significant correlation with certain infiltrating immune cells. Finally, we validated the differential expression levels of four CDEFRGs through external experiments.

CONCLUSIONS

This study has shed light on the molecular pathological mechanism of OS and has offered novel perspectives for the early diagnosis and immune-targeted therapy of OS patients.

Intelligent Framework for Early Detection of Severe Pediatric Diseases from Mild Symptoms

Children's health is one of the most significant fields in medicine. Most diseases that result in children's death or long-term morbidity are caused by preventable and treatable etiologies, and they appear in the child at the early stages as mild symptoms. This research aims to develop a machine learning (ML) framework to detect the severity of disease in children. The proposed framework helps in discriminating children's urgent/severe conditions and notifying parents whether a child needs to visit the emergency room immediately or not. The model considers several variables to detect the severity of cases, which are the symptoms, risk factors (e.g., age), and the child's medical history. The framework is implemented by using nine ML methods. The results achieved show the high performance of the proposed framework in identifying serious pediatric diseases, where decision tree and random forest outperformed the other methods with an accuracy rate of 94%. This shows the reliability of the proposed framework to be used as a pediatric decision-making system for detecting serious pediatric illnesses. The results are promising when compared to recent state-of-the-art studies. The main contribution of this research is to propose a framework that is viable for use by parents when their child suffers from any commonly developed symptoms.

An idiosyncratic MIMBO-NBRF based automated system for child birth mode prediction

Predicting the mode of child birth is still remains one of the most complex and challenging tasks in ancient times. Also, there is no such strong methodologies are developed in the conventional works for birth mode prediction. Therefore, the proposed work objects to develop a novel and distinct optimization based machine learning technique for creating the child birth mode prediction system. This framework includes the modules of data imputation, feature selection, classification, and prediction. Initially, the data imputation process is performed to improve the quality of dataset by normalizing the attributes and filling the missed fields. Then, the Multivariate Intensified Mine Blast Optimization (MIMBO) technique is implemented to choose the best set of features by estimating the optimal function. After that, an integrated Naïve Bayes - Random Forest (NBRF) technique is developed by incorporating the functions of conventional NB and RF techniques. The novel contribution of this technique, a Bird Mating (BM) optimization technique is used in NBRF classifier for estimating the likelihood parameter to generate the Bayesian rules. The main idea of this paper is to develop a simple as well as efficient automated system with the use of hybrid machine learning model for predicting the mode of child birth. For this purpose, advanced algorithms such as MIMBO based feature selection, and NBRF based classification are implemented in this work. Due to the inclusion of MIMBO and BM optimization techniques, the performance of classifier is greatly improved with low computational burden and increased prediction accuracy. Moreover, the combination of proposed MIMBO-NBRF technique outperforms the existing child birth prediction methods with superior results in terms of average accuracy up to 99 %. In addition, some other parameters are also estimated and compared with the existing techniques for proving the overall superiority of the proposed framework.

A smart secured framework for detecting and averting online recruitment fraud using ensemble machine learning techniques

With the rise of the Internet and social media, information has become available at our fingertips. However, on the dark side, these advancements have opened doors for fraudsters. Online recruitment fraud (ORF) is one of the problems created by these modern technologies, as hundreds of thousands of applicants are victimized every year globally. Fraudsters advertise bogus jobs on online platforms and target job hunters with fake offerings such as huge salaries and desirable geographical locations. The objective of these fraudsters is to collect personal information to be misused in the future, leading to the loss of applicants' privacy. To prevent such situations, there is a need for an automatic detecting system that can distinguish between real and fake job advertisements and preserve the applicants' privacy. This study attempts to build a smart secured framework for detecting and preventing ORF using ensemble machine learning (ML) techniques. In this regard, four ensemble methods-AdaBoost (AB), Xtreme Gradient Boost (XGB), Voting, and Random Forest (RF)-are used to build a detection framework. The dataset used was pre-processed using several methods for cleaning and denoising in order to achieve better outcomes. The performance evaluation measures of the applied methods were accuracy, precision, sensitivity, F-measure, and ROC curves. According to these measures, AB performed best, followed by XGB, voting, and RF. In the proposed framework, AB achieved a high accuracy of 98.374%, showing its reliability for detecting and preventing ORF. The results of AB were compared to existing methods in the literature validating the reliability of the model to be significantly used for detecting ORF.

Machine learning based efficient prediction of positive cases of waterborne diseases

BACKGROUND

Water quality has been compromised and endangered by different contaminants due to Pakistan's rapid population development, which has resulted in a dramatic rise in waterborne infections and afflicted many regions of Pakistan. Because of this, modeling and predicting waterborne diseases has become a hot topic for researchers and is very important for controlling waterborne disease pollution.

METHODS

In our study, first, we collected typhoid and malaria patient data for the years 2017-2020 from Ayub Medical Hospital. The collected data set has seven important input features. In the current study, different ML models were first trained and tested on the current study dataset using the tenfold cross-validation method. Second, we investigated the importance of input features in waterborne disease-positive case detection. The experiment results showed that Random Forest correctly predicted malaria-positive cases 60% of the time and typhoid-positive cases 77% of the time, which is better than other machine-learning models. In this research, we have also investigated the input features that are more important in the prediction and will help analyze positive cases of waterborne disease. The random forest feature selection technique has been used, and experimental results have shown that age, history, and test results play an important role in predicting waterborne disease-positive cases. In the end, we concluded that this interesting study could help health departments in different areas reduce the number of people who get sick from the water.

Biological injection therapy with leukocyte-poor platelet-rich plasma induces cellular alterations, enhancement of lubricin, and inflammatory downregulation in vivo in human knees: A controlled, prospective human clinical trial based on mass spectrometry imaging analysis

Objective

To investigate the in vivo biological effects of leukocyte-poor platelet-rich plasma (LpPRP) treatment in human synovial layer to establish the cellular basis for a prolonged clinical improvement.

Methods

Synovial tissues (n = 367) were prospectively collected from patients undergoing arthroscopic surgery. Autologous-conditioned plasma, LpPRP, was injected into the knees of 163 patients 1-7 days before surgery to reduce operative trauma and inflammation, and to induce the onset of regeneration. A total of 204 patients did not receive any injection. All samples were analyzed by mass spectrometry imaging. Data analysis was evaluated by clustering, classification, and investigation of predictive peptides. Peptide identification was done by tandem mass spectrometry and database matching.

Results

Data analysis revealed two major clusters belonging to LpPRP-treated (LpPRP-1) and untreated (LpPRP-0) patients. Classification analysis showed a discrimination accuracy of 82%-90%. We identified discriminating peptides for CD45 and CD29 receptors (receptor-type tyrosine-protein phosphatase C and integrin beta 1), indicating an enhancement of musculoskeletal stem cells, as well as an enhancement of lubricin, collagen alpha-1-(I) chain, and interleukin-receptor-17-E, dampening the inflammatory reaction in the LpPRP-1 group following LpPRP injection.

Conclusions

We could demonstrate for the first time that injection therapy using "autologic-conditioned biologics" may lead to cellular changes in the synovial membrane that might explain the reported prolonged beneficial clinical effects. Here, we show in vivo cellular changes, possibly based on muscular skeletal stem cell alterations, in the synovial layer. The gliding capacities of joints might be improved by enhancing of lubricin, anti-inflammation by activation of interleukin-17 receptor E, and reduction of the inflammatory process by blocking interleukin-17.

Early Detection and Diagnosis of Chronic Kidney Disease Based on Selected Predominant Features

In numerous perilous cases, a quick medical decision is needed for the early detection of chronic diseases to avoid austere consequences that may be fatal. Chronic kidney disease (CKD) is a prevalent disease that presents a variety of challenges, including soaring costs for intervention, urgency, and, more importantly, difficulty in early detection of the disease. The current study carries out a prediction-based method that helps in detecting and diagnosing CKD patients which enables a fast and accurate decision-making process at the early stage. A combination of preprocessing and feature selection methods was developed; additionally, several prediction models, such as K-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), and bagging, were trained based on the processed dataset. The performance evaluation shows higher reliability of all models in terms of accuracy, precision, sensitivity, F-measure, specificity, and area under the curve (AUC) score. Specifically, KNN outperformed with an accuracy of 99.50%, sensitivity of 99.2%, precision of 100%, specificity of 98.7%, and F-measure and AUC score of 99.6%. The experimental results of KNN show the best fitted model compared to the existing state-of-the-art methods. Moreover, the reduced feature set proves that just a few clinical tests are enough to detect CKD, resulting in diagnosis cost reduction.

Detecting High-Risk Factors and Early Diagnosis of Diabetes Using Machine Learning Methods

Diabetes is a chronic disease that can cause several forms of chronic damage to the human body, including heart problems, kidney failure, depression, eye damage, and nerve damage. There are several risk factors involved in causing this disease, with some of the most common being obesity, age, insulin resistance, and hypertension. Therefore, early detection of these risk factors is vital in helping patients reverse diabetes from the early stage to live healthy lives. Machine learning (ML) is a useful tool that can easily detect diabetes from several risk factors and, based on the findings, provide a decision-based model that can help in diagnosing the disease. This study aims to detect the risk factors of diabetes using ML methods and to provide a decision support system for medical practitioners that can help them in diagnosing diabetes. Moreover, besides various other preprocessing steps, this study has used the synthetic minority over-sampling technique integrated with the edited nearest neighbor (SMOTE-ENN) method for balancing the BRFSS dataset. The SMOTE-ENN is a more powerful method than the individual SMOTE method. Several ML methods were applied to the processed BRFSS dataset and built prediction models for detecting the risk factors that can help in diagnosing diabetes patients in the early stage. The prediction models were evaluated using various measures that show the high performance of the models. The experimental results show the reliability of the proposed models, demonstrating that k-nearest neighbor (KNN) outperformed other methods with an accuracy of 98.38%, sensitivity, specificity, and ROC/AUC score of 98%. Moreover, compared with the existing state-of-the-art methods, the results confirm the efficacy of the proposed models in terms of accuracy and other evaluation measures. The use of SMOTE-ENN is more beneficial for balancing the dataset to build more accurate prediction models. This was the main reason it was possible to achieve models more accurate than the existing ones.

An intelligent approach for Arabic handwritten letter recognition using convolutional neural network

Currently, digital transformation has occurred in most countries in the world to varying degrees, but digitizing business processes are complex in terms of understanding the various aspects of manual documentation. The use of digital devices and intelligent systems is vital in the digital transformation of manual documentation from hardcopy to digital formats. The transformation of handwritten documents into electronic files is one of the principal aspects of digitization and represents a common need shared by today's businesses. Generally, handwriting recognition poses a complex digitization challenge, and Arabic handwriting recognition, specifically, proves inordinately challenging due to the nature of Arabic scripts and the excessive diversity in human handwriting. This study presents an intelligent approach for recognizing handwritten Arabic letters. In this approach, a convolution neural network (CNN) model is proposed to recognize handwritten Arabic letters. The model is regularized using batch normalization and dropout operations. Moreover, the model was tested with and without dropout, resulting in a significant difference in the performance. Hence, the model overfitting has been prevented using dropout regularization. The proposed model was applied to the prominent, publicly-available Arabic handwritten characters (AHCD) dataset with 16,800 letters, and the performance was measured using several evaluation measures. The experimental results show the best fit of the proposed model in terms of higher accuracy results that reached 96.78%; additionally, other evaluation measures compared to popular domain-relevant approaches in the literature.

Identification of data elements for blood gas analysis dataset: a base for developing registries and artificial intelligence-based systems

Background

One of the challenging decision-making tasks in healthcare centers is the interpretation of blood gas tests. One of the most effective assisting approaches for the interpretation of blood gas analysis (BGA) can be artificial intelligence (AI)-based decision support systems. A primary step to develop intelligent systems is to determine information requirements and automated data input for the secondary analyses. Datasets can help the automated data input from dispersed information systems. Therefore, the current study aimed to identify the data elements required for supporting BGA as a dataset.

Materials and methods

This cross-sectional descriptive study was conducted in Nemazee Hospital, Shiraz, Iran. A combination of literature review, experts’ consensus, and the Delphi technique was used to develop the dataset. A review of the literature was performed on electronic databases to find the dataset for BGA. An expert panel was formed to discuss on, add, or remove the data elements extracted through searching the literature. Delphi technique was used to reach consensus and validate the draft dataset.

Results

The data elements of the BGA dataset were categorized into ten categories, namely personal information, admission details, present illnesses, past medical history, social status, physical examination, paraclinical investigation, blood gas parameter, sequential organ failure assessment (SOFA) score, and sampling technique errors. Overall, 313 data elements, including 172 mandatory and 141 optional data elements were confirmed by the experts for being included in the dataset.

Conclusions

We proposed a dataset as a base for registries and AI-based systems to assist BGA. It helps the storage of accurate and comprehensive data, as well as integrating them with other information systems. As a result, high-quality care is provided and clinical decision-making is improved.