Coronary Artery Disease Diagnosis; Ranking the Significant Features Using a Random Trees Model

The value of CCTA combined with machine learning for predicting angina pectoris in the anomalous origin of the right coronary artery

BACKGROUND

Anomalous origin of coronary artery is a common coronary artery anatomy anomaly. The anomalous origin of the coronary artery may lead to problems such as narrowing of the coronary arteries at the beginning of the coronary arteries and abnormal alignment, which may lead to myocardial ischemia due to the compression of the coronary arteries. Clinical symptoms include chest tightness and dyspnea, with angina pectoris as a common symptom that can be life-threatening. Timely and accurate diagnosis of anomalous coronary artery origin is of great importance. Coronary computed tomography angiography (CCTA) can provide detailed information on the characteristics of coronary arteries. Therefore, we combined CCTA and artificial intelligence (AI) technology to analyze the CCTA image features and clinical features of patients with anomalous origin of the right coronary artery to predict angina pectoris and the relevance of different features to angina pectoris.

METHODS

In this retrospective analysis, we compiled data on 15 characteristics from 126 patients diagnosed with anomalous right coronary artery origins. The dataset encompassed both CCTA imaging attributes, such as the positioning of the right coronary artery orifices and the alignment of coronary arteries, and clinical parameters including gender and age. To identify the most salient features, we employed the Chi-square feature selection method, which filters features based on their statistical significance. We then focused on features yielding a Chi-square score exceeding a threshold of 1, thereby narrowing down the selection to seven key variables, including cardiac function and gender. Subsequently, we evaluated seven classifiers known for their efficacy in classification tasks. Through rigorous training and testing, we conducted a comparative analysis to identify the top three classifiers with the highest accuracy rates.

RESULTS

The top three classifiers in this study are Support Vector Machine (SVM), Ensemble Learning (EL), and Kernel Approximation Classifier. Among the SVM, EL and Kernel Approximation Classifier-based classifiers, the best performance is achieved for linear SVM, optimizable Ensembles Learning and SVM kernel, respectively. And the corresponding accuracy is 75.7%, 75.7%, and 73.0%, respectively. The AUC values are 0.77, 0.80, and 0.75, respectively.

CONCLUSIONS

Machine learning (ML) models can predict angina pectoris caused by the origin anomalous of the right coronary artery, providing valuable auxiliary diagnostic information for clinicians and serving as a warning to clinicians. It is hoped that timely intervention and treatment can be realized to avoid serious consequences such as myocardial infarction.

Tongue color parameters in predicting the degree of coronary stenosis: a retrospective cohort study of 282 patients with coronary angiography

Purpose

This retrospective cohort study aimed to analyze the relationship between tongue color and coronary artery stenosis severity in 282 patients after underwent coronary angiography.

Methods

A retrospective cohort study was conducted to collect data from patients who underwent coronary angiography in the Department of Cardiology, Shanghai Jiading District Central Hospital from October 1, 2023 to January 15, 2024. All patients were divided into four various stenosis groups. The tongue images of each patient was normalized captured, tongue body (TC_) and tongue coating (CC_) data were converted into RGB and HSV model parameters using SMX System 2.0. Four supervised machine learning classifiers were used to establish a coronary artery stenosis grading prediction model, including random forest (RF), logistic regression, and support vector machine (SVM). Accuracy, precision, recall, and F1 score were used as classification indicators to evaluate the training and validation performance of the model. SHAP values were furthermore used to explore the impacts of features.

Results

This study finally included 282 patients, including 164 males (58.16%) and 118 females (41.84%). 69 patients without stenosis, 70 patients with mild stenosis, 65 patients with moderate stenosis, and 78 patients with severe stenosis. Significant differences of tongue parameters were observed in the four groups [TC_R (P = 0.000), TC_G (P = 0.003), TC_H (P = 0.001) and TC_S (P = 0.024),CC_R (P = 0.006), CC_B (P = 0.023) and CC_S (P = 0.001)]. The SVM model had the highest predictive ability, with AUC values above 0.9 in different stenosis groups, and was particularly good at identifying mild and severe stenosis (AUC = 0.98). SHAP value showed that high values of TC_RIGHT_R, low values of CC_LEFT_R were the most impact factors to predict no coronary stenosis; high CC_LEFT_R and low TC_ROOT_H for mild coronary stenosis; low TC_ROOT_R and CC_ROOT_B for moderate coronary stenosis; high CC_RIGHT_G and low TC_ROOT_H for severe coronary stenosis.

Conclusion

Tongue color parameters can provide a reference for predicting the degree of coronary artery stenosis. The study provides insights into the potential application of tongue color parameters in predicting coronary artery stenosis severity. Future research can expand on tongue features, optimize prediction models, and explore applications in other cardiovascular diseases.

Light-Activated Virtual Sensor Array with Machine Learning for Non-Invasive Diagnosis of Coronary Heart Disease

Early non-invasive diagnosis of coronary heart disease (CHD) is critical. However, it is challenging to achieve accurate CHD diagnosis via detecting breath. In this work, heterostructured complexes of black phosphorus (BP) and two-dimensional carbide and nitride (MXene) with high gas sensitivity and photo responsiveness were formulated using a self-assembly strategy. A light-activated virtual sensor array (LAVSA) based on BP/Ti3C2Tx was prepared under photomodulation and further assembled into an instant gas sensing platform (IGSP). In addition, a machine learning (ML) algorithm was introduced to help the IGSP detect and recognize the signals of breath samples to diagnose CHD. Due to the synergistic effect of BP and Ti3C2Tx as well as photo excitation, the synthesized heterostructured complexes exhibited higher performance than pristine Ti3C2Tx, with a response value 26% higher than that of pristine Ti3C2Tx. In addition, with the help of a pattern recognition algorithm, LAVSA successfully detected and identified 15 odor molecules affiliated with alcohols, ketones, aldehydes, esters, and acids. Meanwhile, with the assistance of ML, the IGSP achieved 69.2% accuracy in detecting the breath odor of 45 volunteers from healthy people and CHD patients. In conclusion, an immediate, low-cost, and accurate prototype was designed and fabricated for the noninvasive diagnosis of CHD, which provided a generalized solution for diagnosing other diseases and other more complex application scenarios.

Development, evaluation and validation of machine learning models to predict hospitalizations of patients with coronary artery disease within the next 12 months

BACKGROUND

Improved survival of patients after acute coronary syndromes, population growth, and overall life expectancy rise have led to a significant increase in the proportion of patients with stable coronary artery disease (CAD), creating a significant load on the entire healthcare system. The disease often progresses with the development of many complications while significantly increasing the likelihood of hospitalization. Developing and applying a machine learning model for predicting hospitalizations of patients with CAD to an inpatient medical facility will allow for close monitoring of high-risk patients, early preventive interventions, and optimized medical care.

AIMS

Development and external validation of personalized models for predicting the preventable hospitalizations of patients with stable CAD and its complications using ML algorithms and data of real-world clinical practice.

METHODS

135,873 depersonalized electronic health records of 49,103 patients with stable CAD were included in the study. Anthropometric measurements, physical examination results, laboratory, instrumental, anamnestic, and socio-demographic data, widely used in routine medical practice, were considered as potential predictors, a total of 73 features. Logistic regression, decision tree-based methods including gradient boosting (AdaBoost, LightGBM, XGBoost, CatBoost) and bagging (RandomForest and ExtraTrees), discriminant analysis (LinearDiscriminant, QuadraticDiscriminant), and naive Bayes classifier were compared. External validation was performed on the data of a separate region.

RESULTS

The best results and stability to external validation data were shown by the CatBoost model with an AUC of 0.875 (95% CI 0.865-0.885) for the internal testing and 0.872 (95% CI 0.856-0.886) for the external validation. The best model showed good performance evaluated through AUROC, Brier score and standardized net benefit (for the target NPV threshold) for the validation dataset that was only slightly similar to the train data.

CONCLUSION

The metrics of the best model were superior to previously published studies. The results of external validation demonstrated the relative stability of the model to new data from another region that confirms the possibility of the model's application in real clinical practice.

Empirical models for compressive and tensile strength of basalt fiber reinforced concrete

When molten magma solidifies, basalt fiber (BF) is produced as a byproduct. Due to its remaining pollutants that could affect the environment, it is regarded as a waste product. To determine the compressive strength (CS) and tensile strength (TS) of basalt fiber reinforced concrete (BFRC), this study will develop empirical models using gene expression programming (GEP), Artificial Neural Network (ANN) and Extreme Gradient Boosting (XG Boost). A thorough search of the literature was done to compile a variety of information on the CS and TS of BFRC. 153 CS findings and 127 TS outcomes were included in the review. The water-to-cement, BF, fiber length (FL), and coarse aggregates ratios were the influential characteristics found. The outcomes showed that GEP can accurately forecast the CS and TS of BFRC as compared to ANN and XG Boost. Efficiency of GEP was validated by comparing Regression (R2) value of all three models. It was shown that the CS and TS of BFRC increased initially up to a certain limit and then started decreasing as the BF % and FL increased. The ideal BF content for industrial-scale BF reinforcement of concrete was investigated in this study which could be an economical solution for production of BFRC on industrial scale.

Developing a Deep Neural Network model for COVID-19 diagnosis based on CT scan images

COVID-19 is most commonly diagnosed using a testing kit but chest X-rays and computed tomography (CT) scan images have a potential role in COVID-19 diagnosis. Currently, CT diagnosis systems based on Artificial intelligence (AI) models have been used in some countries. Previous research studies used complex neural networks, which led to difficulty in network training and high computation rates. Hence, in this study, we developed the 6-layer Deep Neural Network (DNN) model for COVID-19 diagnosis based on CT scan images. The proposed DNN model is generated to improve accurate diagnostics for classifying sick and healthy persons. Also, other classification models, such as decision trees, random forests and standard neural networks, have been investigated. One of the main contributions of this study is the use of the global feature extractor operator for feature extraction from the images. Furthermore, the 10-fold cross-validation technique is utilized for partitioning the data into training, testing and validation. During the DNN training, the model is generated without dropping out of neurons in the layers. The experimental results of the lightweight DNN model demonstrated that this model has the best accuracy of 96.71% compared to the previous classification models for COVID-19 diagnosis.

Descriptive forest: experiments on a novel tree-structure-generalization method for describing cardiovascular diseases

BACKGROUND

A decision tree is a crucial tool for describing the factors related to cardiovascular disease (CVD) risk and for predicting and explaining it for patients. Notably, the decision tree must be simplified because patients may have different primary topics or factors related to the CVD risk. Many decision trees can describe the data collected from multiple environmental heart disease risk datasets or a forest, where each tree describes the CVD risk for each primary topic.

METHODS

We demonstrate the presence of trees, or a forest, using an integrated CVD dataset obtained from multiple datasets. Moreover, we apply a novel method to an association-rule tree to discover each primary topic hidden within a dataset. To generalize the tree structure for descriptive tasks, each primary topic is a boundary node acting as a root node of a C4.5 tree with the least prodigality for the tree structure (PTS). All trees are assigned to a descriptive forest describing the CVD risks in a dataset. A descriptive forest is used to describe each CVD patient's primary risk topics and related factors. We describe eight primary topics in a descriptive forest acquired from 918 records of a heart failure-prediction dataset with 11 features obtained from five datasets. We apply the proposed method to 253,680 records with 22 features from imbalanced classes of a heart disease health-indicators dataset.

RESULTS

The usability of the descriptive forest is demonstrated by a comparative study (on qualitative and quantitative tasks of the CVD-risk explanation) with a C4.5 tree generated from the same dataset but with the least PTS. The qualitative descriptive task confirms that compared to a single C4.5 tree, the descriptive forest is more flexible and can better describe the CVD risk, whereas the quantitative descriptive task confirms that it achieved higher coverage (recall) and correctness (accuracy and precision) and provided more detailed explanations. Additionally, for these tasks, the descriptive forest still outperforms the C4.5 tree. To reduce the problem of imbalanced classes, the ratio of classes in each subdataset generating each tree is investigated.

CONCLUSION

The results provide confidence for using the descriptive forest.

Diagnosis of Coronary Artery Disease based on Machine Learning algorithms Support Vector Machine, Artificial Neural Network, and Random Forest

Background

Coronary artery disease (CAD) is known as the most common cardiovascular disease. The development of CAD is influenced by several risk factors. Diagnostic and therapeutic methods of this disease have many and costly side effects. Therefore, researchers are looking for cost-effective and accurate methods to diagnose this disease. Machine learning algorithms can help specialists diagnose the disease early. The aim of this study is to detect CAD using machine learning algorithms.

Materials and Methods

In this study, three data mining algorithms support vector machine (SVM), artificial neural network (ANN), and random forest were used to predict CAD using the Isfahan Cohort Study dataset of Isfahan Cardiovascular Research Center. 19 features with 11495 records from this dataset were used for this research.

Results

All three algorithms achieved relatively close results. However, the SVM had the highest accuracy compared to the other techniques. The accuracy was calculated as 89.73% for SVM. The ANN algorithm also obtained the high area under the curve, sensitivity and accuracy and provided acceptable performance. Age, sex, Sleep satisfaction, history of stroke, history of palpitations, and history of heart disease were most correlated with target class. Eleven rules were also extracted from this dataset with high confidence and support.

Conclusion

In this study, it was shown that machine learning algorithms can be used with high accuracy to detect CAD. Thus, it allows physicians to perform timely preventive treatment in patients with CAD.

Long-Term Coronary Artery Disease Risk Prediction with Machine Learning Models

The heart is the most vital organ of the human body; thus, its improper functioning has a significant impact on human life. Coronary artery disease (CAD) is a disease of the coronary arteries through which the heart is nourished and oxygenated. It is due to the formation of atherosclerotic plaques on the wall of the epicardial coronary arteries, resulting in the narrowing of their lumen and the obstruction of blood flow through them. Coronary artery disease can be delayed or even prevented with lifestyle changes and medical intervention. Long-term risk prediction of coronary artery disease will be the area of interest in this work. In this specific research paper, we experimented with various machine learning (ML) models after the use or non-use of the synthetic minority oversampling technique (SMOTE), evaluating and comparing them in terms of accuracy, precision, recall and an area under the curve (AUC). The results showed that the stacking ensemble model after the SMOTE with 10-fold cross-validation prevailed over the other models, achieving an accuracy of 90.9 %, a precision of 96.7%, a recall of 87.6% and an AUC equal to 96.1%.

Is it the Time to Move Towards Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve Guided Percutaneous Coronary Intervention? The Pros and Cons

Coronary artery disease is the leading cause of mortality worldwide. Diagnosis is conventionally performed by direct visualization of the arteries by invasive coronary angiography (ICA), which has inherent limitations and risks. Measurement of fractional flow reserve (FFR) has been suggested for a more accurate assessment of ischemia in the coronary artery with high accuracy for determining the severity and decision on the necessity of intervention. Nevertheless, invasive coronary angiography-derived fractional flow reserve (ICA-FFR) is currently used in less than one-third of clinical practices because of the invasive nature of ICA and the need for additional equipment and experience, as well as the cost and extra time needed for the procedure. Recent technical advances have moved towards non-invasive high-quality imaging modalities, such as magnetic resonance, single-photon emission computed tomography, and coronary computed tomography (CT) scan; however, none had a definitive modality to confirm hemodynamically significant coronary artery stenosis. Coronary computed tomography angiography (CCTA) can provide accurate anatomic and hemodynamic data about the coronary lesion, especially calculating fractional flow reserve derived from CCTA (CCTA-FFR). Although growing evidence has been published regarding CCTA-FFR results being comparable to ICA-FFR, CCTA-FFR has not yet replaced the invasive conventional angiography, pending additional studies to validate the advantages and disadvantages of each diagnostic method. Furthermore, it has to be identified whether revascularization of a stenotic lesion is plausible based on CCTA-FFR and if the therapeutic plan can be determined safely and accurately without confirmation from invasive methods. Therefore, in the present review, we will outline the pros and cons of using CCTA-FFR vs. ICA-FFR regarding diagnostic accuracy and treatment decision-making.

A Machine Learning Model for Detection of Coronary Artery Disease Using Noninvasive Clinical Parameters

Background and Objective: Coronary artery disease (CAD) is one of the most prevalent causes of death worldwide. The early diagnosis and timely medical care of cardiovascular patients can greatly prevent death and reduce the cost of treatments associated with CAD. In this study, we attempt to prepare a new model for early CAD diagnosis. The proposed model can diagnose CAD based on clinical data and without the use of an invasive procedure. Methods: In this paper, machine-learning (ML) techniques were used for the early detection of CAD, which were applied to a CAD dataset known as Z-Alizadeh Sani. Since this dataset has 54 features, the Pearson correlation feature selection method was conducted to identify the most effective features. Then, six machine learning techniques including decision tree, deep learning, logistic regression, random forest, support vector machine (SVM), and Xgboost were employed based on a semi-random-partitioning framework. Result: Applying Pearson feature selection to the dataset demonstrated that only eight features were the most effective for CAD diagnosis. The results of running the six machine-learning models on the selected features showed that logistic regression and SVM had the same performance with 95.45% accuracy, 95.91% sensitivity, 91.66% specificity, and a 96.90% F1 score. In addition, the ROC curve indicates a similar result regarding the AUC (0.98). Conclusions: Prediction is an important component of medical decision support systems. The results of the present study showed that feature selection has a high impact on machine-learning performance and, regardless of the evaluation metrics of the machine-learning models, determining the effective features is very important. However, SVM and Logistic Regression were designated as the best models according to our selected features.

Efficient Model for Coronary Artery Disease Diagnosis: A Comparative Study of Several Machine Learning Algorithms

Background

In today's industrialized world, coronary artery disease (CAD) is one of the leading causes of death, and early detection and timely intervention can prevent many of its complications and eliminate or reduce the resulting mortality. Machine learning (ML) methods as one of the cutting-edge technologies can be used as a suitable solution in diagnosing this disease.

Methods

In this study, different ML algorithms' performances were compared for their effectiveness in developing a model for early CAD diagnosis based on clinical examination features. This applied descriptive study was conducted on 303 records and overall 26 features, of which 26 were selected as the target features with the advice of several clinical experts. In order to provide a diagnostic model for CAD, we ran most of the most critical classification algorithms, including Multilayer Perceptron (MLP), Support Vector Machine (SVM), Logistic Regression (LR), J48, Random Forest (RF), K-Nearest Neighborhood (KNN), and Naive Bayes (NB). Seven different classification algorithms with 26 predictive features were tested to cover all feature space and reduce model error, and the most efficient algorithms were identified by comparison of the results.

Results

Based on the compared performance metrics, SVM (AUC = 0.88, F-measure = 0.88, ROC = 0.85), and RF (AUC = 0.87, F-measure = 0.87, ROC = 0.91) were the most effective ML algorithms. Among the algorithms, the KNN algorithm had the lowest efficiency (AUC = 0.81, F-measure = 0.81, ROC = 0.77). In the diagnosis of coronary artery disease, machine learning algorithms have played an important role. Proposed ML models can provide practical, cost-effective, and valuable support to doctors in making decisions according to a good prediction. Discussion. It can become the basis for developing clinical decision support systems. SVM and RF algorithms had the highest efficiency and could diagnose CAD based on patient examination data. It is suggested that further studies be performed using these algorithms to diagnose coronary artery disease to obtain more accurate results.

The role of traditional obesity parameters in predicting the number of stenosed coronary arteries (≥ 60%) among patients undergoing cardiac catheterization

The correlation between obesity and coronary artery disease (CAD) has been well-documented in the literature. Body mass index, waist–height ratio, waist–hip ratio, body adiposity index, body shape index, waist circumference, and hip circumference are traditional obesity parameters used to measure obesity. This study aimed to investigate the role of these traditional obesity parameters in the prediction of the number of stenosed coronary arteries (≥ 60%) among patients undergoing cardiac catheterization. A descriptive cross-sectional study was conducted among 220 hospitalized patients undergoing cardiac catheterization in two hospitals in Jordan. Bivariate Pearson’s correlation and forward linear regression analysis were used in the current study. Hip circumference was identified as being the best predictor of CAD (r = 0.5), with the best cut-off value of 103 cm (sensitivity = 0.92, specificity = 0.58). Hip circumference had significant regression levels with the number of stented coronary arteries (P = 0.002) and the number of severe stenosed coronary arteries (P = 0.04). The second-best obesity parameter in predicting CAD was waist circumference (r = 0.4), with a cut-off value of 0.95 m (sensitivity = 0.76, specificity = 0.68). High-sensitivity C-reactive protein (HS-CRP), triglycerides, and smoking had significant positive correlations with the number of stented coronary arteries (P < 0.05). Hip circumference of ≥ 103 cm, increased serum level of triglycerides, HS-CRP, and being a smoker are all factors which can predict CAD or the risk of developing it.

Data-Driven Machine-Learning Methods for Diabetes Risk Prediction

Diabetes mellitus is a chronic condition characterized by a disturbance in the metabolism of carbohydrates, fats and proteins. The most characteristic disorder in all forms of diabetes is hyperglycemia, i.e., elevated blood sugar levels. The modern way of life has significantly increased the incidence of diabetes. Therefore, early diagnosis of the disease is a necessity. Machine Learning (ML) has gained great popularity among healthcare providers and physicians due to its high potential in developing efficient tools for risk prediction, prognosis, treatment and the management of various conditions. In this study, a supervised learning methodology is described that aims to create risk prediction tools with high efficiency for type 2 diabetes occurrence. A features analysis is conducted to evaluate their importance and explore their association with diabetes. These features are the most common symptoms that often develop slowly with diabetes, and they are utilized to train and test several ML models. Various ML models are evaluated in terms of the Precision, Recall, F-Measure, Accuracy and AUC metrics and compared under 10-fold cross-validation and data splitting. Both validation methods highlighted Random Forest and K-NN as the best performing models in comparison to the other models.

FLED-Block: Federated Learning Ensembled Deep Learning Blockchain Model for COVID-19 Prediction

With the SARS-CoV-2's exponential growth, intelligent and constructive practice is required to diagnose the COVID-19. The rapid spread of the virus and the shortage of reliable testing models are considered major issues in detecting COVID-19. This problem remains the peak burden for clinicians. With the advent of artificial intelligence (AI) in image processing, the burden of diagnosing the COVID-19 cases has been reduced to acceptable thresholds. But traditional AI techniques often require centralized data storage and training for the predictive model development which increases the computational complexity. The real-world challenge is to exchange data globally across hospitals while also taking into account of the organizations' privacy concerns. Collaborative model development and privacy protection are critical considerations while training a global deep learning model. To address these challenges, this paper proposes a novel framework based on blockchain and the federated learning model. The federated learning model takes care of reduced complexity, and blockchain helps in distributed data with privacy maintained. More precisely, the proposed federated learning ensembled deep five learning blockchain model (FLED-Block) framework collects the data from the different medical healthcare centers, develops the model with the hybrid capsule learning network, and performs the prediction accurately, while preserving the privacy and shares among authorized persons. Extensive experimentation has been carried out using the lung CT images and compared the performance of the proposed model with the existing VGG-16 and 19, Alexnets, Resnets-50 and 100, Inception V3, Densenets-121, 119, and 150, Mobilenets, SegCaps in terms of accuracy (98.2%), precision (97.3%), recall (96.5%), specificity (33.5%), and F1-score (97%) in predicting the COVID-19 with effectively preserving the privacy of the data among the heterogeneous users.

SperoPredictor: An Integrated Machine Learning and Molecular Docking-Based Drug Repurposing Framework With Use Case of COVID-19

The global spread of the SARS coronavirus 2 (SARS-CoV-2), its manifestation in human hosts as a contagious disease, and its variants have induced a pandemic resulting in the deaths of over 6,000,000 people. Extensive efforts have been devoted to drug research to cure and refrain the spread of COVID-19, but only one drug has received FDA approval yet. Traditional drug discovery is inefficient, costly, and unable to react to pandemic threats. Drug repurposing represents an effective strategy for drug discovery and reduces the time and cost compared to de novo drug discovery. In this study, a generic drug repurposing framework (SperoPredictor) has been developed which systematically integrates the various types of drugs and disease data and takes the advantage of machine learning (Random Forest, Tree Ensemble, and Gradient Boosted Trees) to repurpose potential drug candidates against any disease of interest. Drug and disease data for FDA-approved drugs (n = 2,865), containing four drug features and three disease features, were collected from chemical and biological databases and integrated with the form of drug-disease association tables. The resulting dataset was split into 70% for training, 15% for testing, and the remaining 15% for validation. The testing and validation accuracies of the models were 99.3% for Random Forest and 99.03% for Tree Ensemble. In practice, SperoPredictor identified 25 potential drug candidates against 6 human host-target proteomes identified from a systematic review of journals. Literature-based validation indicated 12 of 25 predicted drugs (48%) have been already used for COVID-19 followed by molecular docking and re-docking which indicated 4 of 13 drugs (30%) as potential candidates against COVID-19 to be pre-clinically and clinically validated. Finally, SperoPredictor results illustrated the ability of the platform to be rapidly deployed to repurpose the drugs as a rapid response to emergent situations (like COVID-19 and other pandemics).

Statistical modelling for a new family of generalized distributions with real data applications

The modern trend in distribution theory is to propose hybrid generators and generalized families using existing algebraic generators along with some trigonometric functions to offer unique, more flexible, more efficient, and highly productive G-distributions to deal with new data sets emerging in different fields of applied research. This article aims to originate an odd sine generator of distributions and construct a new G-family called "The Odd Lomax Trigonometric Generalized Family of Distributions". The new densities, useful functions, and significant characteristics are thoroughly determined. Several specific models are also presented, along with graphical analysis and detailed description. A new distribution, "The Lomax cosecant Weibull" (LocscW), is studied in detail. The versatility, robustness, and competency of the LocscW model are confirmed by applications on hydrological and survival data sets. The skewness and kurtosis present in this model are explained using modern graphical methods, while the estimation and statistical inference are explored using many estimation approaches.

Vector textures derived from higher order derivative domains for classification of colorectal polyps

Textures have become widely adopted as an essential tool for lesion detection and classification through analysis of the lesion heterogeneities. In this study, higher order derivative images are being employed to combat the challenge of the poor contrast across similar tissue types among certain imaging modalities. To make good use of the derivative information, a novel concept of vector texture is firstly introduced to construct and extract several types of polyp descriptors. Two widely used differential operators, i.e., the gradient operator and Hessian operator, are utilized to generate the first and second order derivative images. These derivative volumetric images are used to produce two angle-based and two vector-based (including both angle and magnitude) textures. Next, a vector-based co-occurrence matrix is proposed to extract texture features which are fed to a random forest classifier to perform polyp classifications. To evaluate the performance of our method, experiments are implemented over a private colorectal polyp dataset obtained from computed tomographic colonography. We compare our method with four existing state-of-the-art methods and find that our method can outperform those competing methods over 4%-13% evaluated by the area under the receiver operating characteristics curves.

Forecasting Compressive Strength of RHA Based Concrete Using Multi-Expression Programming

Rice husk ash (RHA) is a significant pollutant produced by agricultural sectors that cause a malignant outcome to the environment. To encourage the re-use of RHA, this work used multi expression programming (MEP) to construct an empirical model for forecasting the compressive nature of concrete made with RHA (CRHA) as a cement substitute. Thus, the compressive strength of CRHA was developed comprising of 192 findings from the broad and trustworthy database obtained from literature review. The most significant characteristics, namely the specimen’s age, the percentage of RHA, the amount of cement, superplasticizer, aggregates, and the amount of water, were used as input for the modeling of CRHA. External validation, sensitivity analysis, statistical checks, and Shapley Additive Explanations (SHAP) analysis were used to evaluate the models’ performance. It was discovered that the most significant factors impacting the compressive strength of CRHA are the age of the concrete sample (AS), the amount of cement (C) and the amount of aggregate (A). The findings of this study have the potential to increase the re-use of RHA in the production of green concrete, hence promoting environmental protection and financial gain.

Research Progress of Machine Learning and Deep Learning in Intelligent Diagnosis of the Coronary Atherosclerotic Heart Disease

The coronary atherosclerotic heart disease is a common cardiovascular disease with high morbidity, disability, and societal burden. Early, precise, and comprehensive diagnosis of the coronary atherosclerotic heart disease is of great significance. The rise of artificial intelligence technologies, represented by machine learning and deep learning, provides new methods to address the above issues. In recent years, artificial intelligence has achieved an extraordinary progress in multiple aspects of coronary atherosclerotic heart disease diagnosis, including the construction of intelligent diagnostic models based on artificial intelligence algorithms, applications of artificial intelligence algorithms in coronary angiography, coronary CT angiography, intravascular imaging, cardiac magnetic resonance, and functional parameters. This paper presents a comprehensive review of the technical background and current state of research on the application of artificial intelligence in the diagnosis of the coronary atherosclerotic heart disease and analyzes recent challenges and perspectives in this field.

Solving the class imbalance problem using ensemble algorithm: application of screening for aortic dissection

Background

Imbalance between positive and negative outcomes, a so-called class imbalance, is a problem generally found in medical data. Despite various studies, class imbalance has always been a difficult issue. The main objective of this study was to find an effective integrated approach to address the problems posed by class imbalance and to validate the method in an early screening model for a rare cardiovascular disease aortic dissection (AD).

Methods

Different data-level methods, cost-sensitive learning, and the bagging method were combined to solve the problem of low sensitivity caused by the imbalance of two classes of data. First, feature selection was applied to select the most relevant features using statistical analysis, including significance test and logistic regression. Then, we assigned two different misclassification cost values for two classes, constructed weak classifiers based on the support vector machine (SVM) model, and integrated the weak classifiers with undersampling and bagging methods to build the final strong classifier. Due to the rarity of AD, the data imbalance was particularly prominent. Therefore, we applied our method to the construction of an early screening model for AD disease. Clinical data of 523,213 patients from the Institute of Hypertension, Xiangya Hospital, Central South University were used to verify the validity of this method. In these data, the sample ratio of AD patients to non-AD patients was 1:65, and each sample contained 71 features.

Results

The proposed ensemble model achieved the highest sensitivity of 82.8%, with training time and specificity reaching 56.4 s and 71.9% respectively. Additionally, it obtained a small variance of sensitivity of 19.58 × 10^–3 in the seven-fold cross validation experiment. The results outperformed the common ensemble algorithms of AdaBoost, EasyEnsemble, and Random Forest (RF) as well as the single machine learning (ML) methods of logistic regression, decision tree, k nearest neighbors (KNN), back propagation neural network (BP) and SVM. Among the five single ML algorithms, the SVM model after cost-sensitive learning method performed best with a sensitivity of 79.5% and a specificity of 73.4%.

Conclusions

In this study, we demonstrate that the integration of feature selection, undersampling, cost-sensitive learning and bagging methods can overcome the challenge of class imbalance in a medical dataset and develop a practical screening model for AD, which could lead to a decision support for screening for AD at an early stage.

Significance of Visible Non-Invasive Risk Attributes for the Initial Prediction of Heart Disease Using Different Machine Learning Techniques

INTRODUCTION

Heart disease is emerging as the single most critical cause of death worldwide and is one of the costliest chronic conditions.

PURPOSE

Stimulated by the increasing heart disease mortality rate incidents, an effective, low-cost, and reliable heart disease risk evaluation model is developed using significant non-invasive risk attributes. The significant non-invasive risk attributes like (age, systolic BP, diastolic BP, BMI, hereditary factor, smoking, alcohol, and physical inactivity) are identified by the help of medical domain experts, and their reliability in heart disease prediction is investigated through different feature selection techniques. Methodology. The enhancements of applying specific investigated techniques like random forest, Naïve Bayes, decision tree, support vector machine, and K nearest neighbor to the risk factors are tested. The heart disease risk assessment model is developed using the Jupyter Notebook web application, and its performance is tested not only through medical domain measures but also through the model performance measures. Findings. To evaluate heart disease risk evaluation model, we calculated measures of discrimination like error rate, AUROC, sensitivity, specificity, accuracy, precision, and so on. Experimental results show that the random forest heart disease risk evaluation model outperforms other existing risk models with admirable predictive accuracy and minimum misclassification rate. Originality. The heart disease risk evaluation model is developed based on novel non-invasive heart disease dataset, which consists of 5776 records. This dataset is collected from different heterogeneous data sources of Kashmir (India) through quantitative data collection methods. Research Implications. The risk model is applicable where people lack the facilities of integrated primary medical care technologies for untimely heart disease risk prediction. Future Work. To investigate deep learning and study the significance of other controlled attributes on different age and sex groups in the risk estimation of heart disease.

Diabetes mellitus risk prediction in the presence of class imbalance using flexible machine learning methods

Background

Early detection and prediction of type two diabetes mellitus incidence by baseline measurements could reduce associated complications in the future. The low incidence rate of diabetes in comparison with non-diabetes makes accurate prediction of minority diabetes class more challenging.

Methods

Deep neural network (DNN), extremely gradient boosting (XGBoost), and random forest (RF) performance is compared in predicting minority diabetes class in Tehran Lipid and Glucose Study (TLGS) cohort data. The impact of changing threshold, cost-sensitive learning, over and under-sampling strategies as solutions to class imbalance have been compared in improving algorithms performance.

Results

DNN with the highest accuracy in predicting diabetes, 54.8%, outperformed XGBoost and RF in terms of AUROC, g-mean, and f1-measure in original imbalanced data. Changing threshold based on the maximum of f1-measure improved performance in g-mean, and f1-measure in three algorithms. Repeated edited nearest neighbors (RENN) under-sampling in DNN and cost-sensitive learning in tree-based algorithms were the best solutions to tackle the imbalance issue. RENN increased ROC and Precision-Recall AUCs, g-mean and f1-measure from 0.857, 0.603, 0.713, 0.575 to 0.862, 0.608, 0.773, 0.583, respectively in DNN. Weighing improved g-mean and f1-measure from 0.667, 0.554 to 0.776, 0.588 in XGBoost, and from 0.659, 0.543 to 0.775, 0.566 in RF, respectively. Also, ROC and Precision-Recall AUCs in RF increased from 0.840, 0.578 to 0.846, 0.591, respectively.

Conclusion

G-mean experienced the most increase by all imbalance solutions. Weighing and changing threshold as efficient strategies, in comparison with resampling methods are faster solutions to handle class imbalance. Among sampling strategies, under-sampling methods had better performance than others.

FCM-DNN: diagnosing coronary artery disease by deep accuracy fuzzy C-means clustering model

Cardiovascular disease is one of the most challenging diseases in middle-aged and older people, which causes high mortality. Coronary artery disease (CAD) is known as a common cardiovascular disease. A standard clinical tool for diagnosing CAD is angiography. The main challenges are dangerous side effects and high angiography costs. Today, the development of artificial intelligence-based methods is a valuable achievement for diagnosing disease. Hence, in this paper, artificial intelligence methods such as neural network (NN), deep neural network (DNN), and fuzzy C-means clustering combined with deep neural network (FCM-DNN) are developed for diagnosing CAD on a cardiac magnetic resonance imaging (CMRI) dataset. The original dataset is used in two different approaches. First, the labeled dataset is applied to the NN and DNN to create the NN and DNN models. Second, the labels are removed, and the unlabeled dataset is clustered via the FCM method, and then, the clustered dataset is fed to the DNN to create the FCM-DNN model. By utilizing the second clustering and modeling, the training process is improved, and consequently, the accuracy is increased. As a result, the proposed FCM-DNN model achieves the best performance with a 99.91% accuracy specifying 10 clusters, i.e., 5 clusters for healthy subjects and 5 clusters for sick subjects, through the 10-fold cross-validation technique compared to the NN and DNN models reaching the accuracies of 92.18% and 99.63%, respectively. To the best of our knowledge, no study has been conducted for CAD diagnosis on the CMRI dataset using artificial intelligence methods. The results confirm that the proposed FCM-DNN model can be helpful for scientific and research centers.

GSVMA: A Genetic Support Vector Machine ANOVA Method for CAD Diagnosis

Background

Coronary artery disease (CAD) is one of the crucial reasons for cardiovascular mortality in middle-aged people worldwide. The most typical tool is angiography for diagnosing CAD. The challenges of CAD diagnosis using angiography are costly and have side effects. One of the alternative solutions is the use of machine learning-based patterns for CAD diagnosis.

Methods

Hence, this paper provides a new hybrid machine learning model called genetic support vector machine and analysis of variance (GSVMA). The analysis of variance (ANOVA) is known as the kernel function for the SVM algorithm. The proposed model is performed based on the Z-Alizadeh Sani dataset so that a genetic optimization algorithm is used to select crucial features. In addition, SVM with ANOVA, linear SVM (LSVM), and library for support vector machine (LIBSVM) with radial basis function (RBF) methods were applied to classify the dataset.

Results

As a result, the GSVMA hybrid method performs better than other methods. This proposed method has the highest accuracy of 89.45% through a 10-fold crossvalidation technique with 31 selected features on the Z-Alizadeh Sani dataset.

Conclusion

We demonstrated that SVM combined with genetic optimization algorithm could be lead to more accuracy. Therefore, our study confirms that the GSVMA method outperforms other methods so that it can facilitate CAD diagnosis.

Machine Learning-Based Automated Diagnostic Systems Developed for Heart Failure Prediction Using Different Types of Data Modalities: A Systematic Review and Future Directions

One of the leading causes of deaths around the globe is heart disease. Heart is an organ that is responsible for the supply of blood to each part of the body. Coronary artery disease (CAD) and chronic heart failure (CHF) often lead to heart attack. Traditional medical procedures (angiography) for the diagnosis of heart disease have higher cost as well as serious health concerns. Therefore, researchers have developed various automated diagnostic systems based on machine learning (ML) and data mining techniques. ML-based automated diagnostic systems provide an affordable, efficient, and reliable solutions for heart disease detection. Various ML, data mining methods, and data modalities have been utilized in the past. Many previous review papers have presented systematic reviews based on one type of data modality. This study, therefore, targets systematic review of automated diagnosis for heart disease prediction based on different types of modalities, i.e., clinical feature-based data modality, images, and ECG. Moreover, this paper critically evaluates the previous methods and presents the limitations in these methods. Finally, the article provides some future research directions in the domain of automated heart disease detection based on machine learning and multiple of data modalities.

Improvement of the Performance of Models for Predicting Coronary Artery Disease Based on XGBoost Algorithm and Feature Processing Technology

Coronary artery disease (CAD) is one of the diseases with the highest morbidity and mortality in the world. In 2019, the number of deaths caused by CAD reached 9.14 million. The detection and treatment of CAD in the early stage is crucial to save lives and improve prognosis. Therefore, the purpose of this research is to develop a machine-learning system that can be used to help diagnose CAD accurately in the early stage. In this paper, two classical ensemble learning algorithms, namely, XGBoost algorithm and Random Forest algorithm, were used as the classification model. In order to improve the classification accuracy and performance of the model, we applied four feature processing techniques to process features respectively. In addition, synthetic minority oversampling technology (SMOTE) and adaptive synthetic (ADASYN) were used to balance the dataset, which included 71.29% CAD samples and 28.71% normal samples. The four feature processing technologies improved the performance of the classification models in terms of classification accuracy, precision, recall, F1 score and specificity. In particular, the XGBboost algorithm achieved the best prediction performance results on the dataset processed by feature construction and the SMOTE method. The best classification accuracy, recall, specificity, precision, F1 score and AUC were 94.7%, 96.1%, 93.2%, 93.4%, 94.6% and 98.0%, respectively. The experimental results prove that the proposed method can accurately and reliably identify CAD patients from suspicious patients in the early stage and can be used by medical staff for auxiliary diagnosis.

CNN-KCL: Automatic myocarditis diagnosis using convolutional neural network combined with k-means clustering

Myocarditis is the form of an inflammation of the middle layer of the heart wall which is caused by a viral infection and can affect the heart muscle and its electrical system. It has remained one of the most challenging diagnoses in cardiology. Myocardial is the prime cause of unexpected death in approximately 20% of adults less than 40 years of age. Cardiac MRI (CMR) has been considered a noninvasive and golden standard diagnostic tool for suspected myocarditis and plays an indispensable role in diagnosing various cardiac diseases. However, the performance of CMR depends heavily on the clinical presentation and features such as chest pain, arrhythmia, and heart failure. Besides, other imaging factors like artifacts, technical errors, pulse sequence, acquisition parameters, contrast agent dose, and more importantly qualitatively visual interpretation can affect the result of the diagnosis. This paper introduces a new deep learning-based model called Convolutional Neural Network-Clustering (CNN-KCL) to diagnose Myocarditis. In this study, we used 47 subjects with a total number of 98,898 images to diagnose myocarditis disease. Our results demonstrate that the proposed method achieves an accuracy of 97.41% based on 10 fold-cross validation technique with 4 clusters for diagnosis of Myocarditis. To the best of our knowledge, this research is the first to use deep learning algorithms for the diagnosis of myocarditis.

Machine learning risk prediction model for acute coronary syndrome and death from use of non-steroidal anti-inflammatory drugs in administrative data

Our aim was to investigate the usefulness of machine learning approaches on linked administrative health data at the population level in predicting older patients’ one-year risk of acute coronary syndrome and death following the use of non-steroidal anti-inflammatory drugs (NSAIDs). Patients from a Western Australian cardiovascular population who were supplied with NSAIDs between 1 Jan 2003 and 31 Dec 2004 were identified from Pharmaceutical Benefits Scheme data. Comorbidities from linked hospital admissions data and medication history were inputs. Admissions for acute coronary syndrome or death within one year from the first supply date were outputs. Machine learning classification methods were used to build models to predict ACS and death. Model performance was measured by the area under the receiver operating characteristic curve (AUC-ROC), sensitivity and specificity. There were 68,889 patients in the NSAIDs cohort with mean age 76 years and 54% were female. 1882 patients were admitted for acute coronary syndrome and 5405 patients died within one year after their first supply of NSAIDs. The multi-layer neural network, gradient boosting machine and support vector machine were applied to build various classification models. The gradient boosting machine achieved the best performance with an average AUC-ROC of 0.72 predicting ACS and 0.84 predicting death. Machine learning models applied to linked administrative data can potentially improve adverse outcome risk prediction. Further investigation of additional data and approaches are required to improve the performance for adverse outcome risk prediction.

The Effect of an Educational Intervention based on Pender's Health Promotion Model on Treatment Adherence in the Patients with Coronary Artery Disease

Background:

Increasing of hospitalization rates of Coronary Artery Disease (CAD) management have created major challenge for the health system. Poor adherence to treatment is one of the main reasons for treatment failure, prolongation of treatment, and increase care costs. The aim of this research was to determine the effect of educational intervention based on Pender's Health Promotion Model (HPM) on adherence in patients with CAD.

Materials and Methods:

This randomized controlled clinical trial was held in an educational hospital in Isfahan, Iran, February 2018–May 2019. Data were collected from 64 patients with CAD, before, 1 and 3 months after the intervention. The instrument used included treatment adherence questionnaire and a checklist Pender's HPM. The study group received dietary, exercise, and medication education based on Pender's HPM in four sessions which were held in 4 weeks. The control group received the routine educational program of the hospital. The data was analyzed using descriptive statistics, repeated measures ANOVA, independent t, Chi-square, and Mann–Whitney tests via SPSS software.

Results:

The mean score of treatment adherence was significantly different between two groups in one (z = 5.28, df = 2, p < 0.001) and three (z = 4.51, df = 2, p < 0.001) months after the intervention. The mean (SD) of treatment adherence in the study group was 139.82 (27.44) 3 months after the intervention.

Conclusions:

Educational intervention based on Pender's HPM is more effective on treatment adherence than the routine method in the patients with CAD. It is recommended to integrate the Pender's HPM as a nursing care program for these patients.

Dietary protein is the strong predictor of coronary artery disease; a data mining approach

BACKGROUNDS

Coronary artery disease (CAD) is the major cause of mortality and morbidity globally. Diet is known to contribute to CAD risk, and the dietary intake of specific macro- or micro-nutrients might be potential predictors of CAD risk. Machine learning methods may be helpful in the analysis of the contribution of several parameters in dietary including macro- and micro-nutrients to CAD risk. Here we aimed to determine the most important dietary factors for predicting CAD.

METHODS

A total of 273 cases with more than 50% obstruction in at least one coronary artery and 443 healthy controls who completed a food frequency questionnaire (FFQ) were entered into the study. All dietary intakes were adjusted for energy intake. The QUEST method was applied to determine the diagnosis pattern of CAD.

RESULTS

A total of 34 dietary variables obtained from the FFQ were entered into the initial study analysis, of these variables 23 were significantly associated with CAD according to t-tests. Of these 23 dietary input variables, adjusted protein, manganese, biotin, zinc and cholesterol remained in the model. According to our tree, only protein intake could identify the patients with coronary artery stenosis according to angiography from healthy participant up to 80%. The dietary intake of manganese was the second most important variable. The accuracy of the tree was 84.36% for the training dataset and 82.94% for the testing dataset.

CONCLUSION

Among several dietary macro- and micro-nutrients, a combination of protein, manganese, biotin, zinc and cholesterol could predict the presence of CAD in individuals undergoing angiography.

Classification of Biodegradable Substances Using Balanced Random Trees and Boosted C5.0 Decision Trees

Substances that do not degrade over time have proven to be harmful to the environment and are dangerous to living organisms. Being able to predict the biodegradability of substances without costly experiments is useful. Recently, the quantitative structure-activity relationship (QSAR) models have proposed effective solutions to this problem. However, the molecular descriptor datasets usually suffer from the problems of unbalanced class distribution, which adversely affects the efficiency and generalization of the derived models. Accordingly, this study aims at validating the performances of balanced random trees (RTs) and boosted C5.0 decision trees (DTs) to construct QSAR models to classify the ready biodegradation of substances and their abilities to deal with unbalanced data. The balanced RTs model algorithm builds individual trees using balanced bootstrap samples, while the boosted C5.0 DT is modeled using cost-sensitive learning. We employed the two-dimensional molecular descriptor dataset, which is publicly available through the University of California, Irvine (UCI) machine learning repository. The molecular descriptors were ranked according to their contributions to the balanced RTs classification process. The performance of the proposed models was compared with previously reported results. Based on the statistical measures, the experimental results showed that the proposed models outperform the classification results of the support vector machine (SVM), K-nearest neighbors (KNN), and discrimination analysis (DA). Classification measures were analyzed in terms of accuracy, sensitivity, specificity, precision, false positive rate, false negative rate, F1 score, receiver operating characteristic (ROC) curve, and area under the ROC curve (AUROC).

Wavelet Transform-Statistical Time Features-Based Methodology for Epileptic Seizure Prediction Using Electrocardiogram Signals

Epilepsy is a brain disorder that affects about 50 million persons around the world and is characterized by generating recurrent seizures, which can put patients in permanent because of falls, drowning, burns, and prolonged seizures that they can suffer. Hence, it is of vital importance to propose a methodology with the capability of predicting a seizure with several minutes before the onset, allowing that the patients take their precautions against injuries. In this regard, a methodology based on the wavelet packet transform (WPT), statistical time features (STFs), and a decision tree classifier (DTC) for predicting an epileptic seizure using electrocardiogram (ECG) signals is presented. Seventeen STFs were analyzed to measure changes in the properties of ECG signals and find characteristics capable of differentiating between healthy and 15 min prior to seizure signals. The effectiveness of the proposed methodology for predicting an epileptic event is demonstrated using a database of seven patients with 10 epileptic seizures, which was provided by the Massachusetts Institute of Technology–Beth Israel Hospital (MIT–BIH). The results show that the proposed methodology is capable of predicting an epileptic seizure 15 min before with an accuracy of 100%. Our results suggest that the use of STFs at frequency bands related to heart activity to find parameters for the prediction of epileptic seizures is suitable.

Coronary artery disease detection using artificial intelligence techniques: A survey of trends, geographical differences and diagnostic features 1991-2020

While coronary angiography is the gold standard diagnostic tool for coronary artery disease (CAD), but it is associated with procedural risk, it is an invasive technique requiring arterial puncture, and it subjects the patient to radiation and iodinated contrast exposure. Artificial intelligence (AI) can provide a pretest probability of disease that can be used to triage patients for angiography. This review comprehensively investigates published papers in the domain of CAD detection using different AI techniques from 1991 to 2020, in order to discern broad trends and geographical differences. Moreover, key decision factors affecting CAD diagnosis are identified for different parts of the world by aggregating the results from different studies. In this study, all datasets that have been used for the studies for CAD detection, their properties, and achieved performances using various AI techniques, are presented, compared, and analyzed. In particular, the effectiveness of machine learning (ML) and deep learning (DL) techniques to diagnose and predict CAD are reviewed. From PubMed, Scopus, Ovid MEDLINE, and Google Scholar search, 500 papers were selected to be investigated. Among these selected papers, 256 papers met our criteria and hence were included in this study. Our findings demonstrate that AI-based techniques have been increasingly applied for the detection of CAD since 2008. AI-based techniques that utilized electrocardiography (ECG), demographic characteristics, symptoms, physical examination findings, and heart rate signals, reported high accuracy for the detection of CAD. In these papers, the authors ranked the features based on their assessed clinical importance with ML techniques. The results demonstrate that the attribution of the relative importance of ML features for CAD diagnosis is different among countries. More recently, DL methods have yielded high CAD detection performance using ECG signals, which drives its burgeoning adoption.

Evaluating Machine Learning Methods for Predicting Diabetes among Female Patients in Bangladesh

Machine Learning has a significant impact on different aspects of science and technology including that of medical researches and life sciences. Diabetes Mellitus, more commonly known as diabetes, is a chronic disease that involves abnormally high levels of glucose sugar in blood cells and the usage of insulin in the human body. This article has focused on analyzing diabetes patients as well as detection of diabetes using different Machine Learning techniques to build up a model with a few dependencies based on the PIMA dataset. The model has been tested on an unseen portion of PIMA and also on the dataset collected from Kurmitola General Hospital, Dhaka, Bangladesh. The research is conducted to demonstrate the performance of several classifiers trained on a particular country’s diabetes dataset and tested on patients from a different country. We have evaluated decision tree, K-nearest neighbor, random forest, and Naïve Bayes in this research and the results show that both random forest and Naïve Bayes classifier performed well on both datasets.

Patient Privacy Violation Detection in Healthcare Critical Infrastructures: An Investigation Using Density-Based Benchmarking

Hospital critical infrastructures have a distinct threat vector, due to (i) a dependence on legacy software; (ii) the vast levels of interconnected medical devices; (iii) the use of multiple bespoke software and that (iv) electronic devices (e.g., laptops and PCs) are often shared by multiple users. In the UK, hospitals are currently upgrading towards the use of electronic patient record (EPR) systems. EPR systems and their data are replacing traditional paper records, providing access to patients’ test results and details of their overall care more efficiently. Paper records are no-longer stored at patients’ bedsides, but instead are accessible via electronic devices for the direct insertion of data. With over 83% of hospitals in the UK moving towards EPRs, access to this healthcare data needs to be monitored proactively for malicious activity. It is paramount that hospitals maintain patient trust and ensure that the information security principles of integrity, availability and confidentiality are upheld when deploying EPR systems. In this paper, an investigation methodology is presented towards the identification of anomalous behaviours within EPR datasets. Many security solutions focus on a perimeter-based approach; however, this approach alone is not enough to guarantee security, as can be seen from the many examples of breaches. Our proposed system can be complementary to existing security perimeter solutions. The system outlined in this research employs an internal-focused methodology for anomaly detection by using the Local Outlier Factor (LOF) and Density-Based Spatial Clustering of Applications with Noise (DBSCAN) algorithms for benchmarking behaviour, for assisting healthcare data analysts. Out of 90,385 unique IDs, DBSCAN finds 102 anomalies, whereas 358 are detected using LOF.

Is the Random Forest Algorithm Suitable for Predicting Parkinson's Disease with Mild Cognitive Impairment out of Parkinson's Disease with Normal Cognition?

Because it is possible to delay the progression of dementia if it is detected and treated in an early stage, identifying mild cognitive impairment (MCI) is an important primary goal of dementia treatment. The objectives of this study were to develop a random forest-based Parkinson's disease with mild cognitive impairment (PD-MCI) prediction model considering health behaviors, environmental factors, medical history, physical functions, depression, and cognitive functions using the Parkinson's Dementia Clinical Epidemiology Data (a national survey conducted by the Korea Centers for Disease Control and Prevention) and to compare the prediction accuracy of our model with those of decision tree and multiple logistic regression models. We analyzed 96 subjects (PD-MCI = 45; Parkinson's disease with normal cognition (PD-NC) = 51 subjects). The prediction accuracy of the model was calculated using the overall accuracy, sensitivity, and specificity. Based on the random forest analysis, the major risk factors of PD-MCI were, in descending order of magnitude, Clinical Dementia Rating (CDR) sum of boxes, Untitled Parkinson's Disease Rating (UPDRS) motor score, the Korean Mini Mental State Examination (K-MMSE) total score, and the K- Korean Montreal Cognitive Assessment (K-MoCA) total score. The random forest method achieved a higher sensitivity than the decision tree model. Thus, it is advisable to develop a protocol to easily identify early stage PDD based on the PD-MCI prediction model developed in this study, in order to establish individualized monitoring to track high-risk groups.

The Role of Urban Morphology Design on Enhancing Physical Activity and Public Health

Along with environmental pollution, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural-social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces, based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture.