Beat-by-beat monitoring of hemodynamic parameters in the left ventricle contributes to the early diagnosis and treatment of heart failure, valvular heart disease, and other cardiovascular diseases. Current accurate measurement methods for ventricular hemodynamic parameters are inconvenient for monitoring hemodynamic indexes in daily life. The objective of this study is to propose a method for estimating intraventricular hemodynamic parameters in a beat-to-beat style based on non-invasive PCG (phonocardiogram) and PPG (photoplethysmography) signals. Three beagle dogs were used as subjects. PCG, PPG, electrocardiogram (ECG), and invasive blood pressure signals in the left ventricle were synchronously collected while epinephrine medicine was injected into the veins to produce hemodynamic variations. Various doses of epinephrine were used to produce hemodynamic variations. A total of 40 records (over 12,000 cardiac cycles) were obtained. A deep neural network was built to simultaneously estimate four hemodynamic parameters of one cardiac cycle by inputting the PCGs and PPGs of the cardiac cycle. The outputs of the network were four hemodynamic parameters: left ventricular systolic blood pressure (SBP), left ventricular diastolic blood pressure (DBP), maximum rate of left ventricular pressure rise (MRR), and maximum rate of left ventricular pressure decline (MRD). The model built in this study consisted of a residual convolutional module and a bidirectional recurrent neural network module which learnt the local features and context relations, respectively. The training mode of the network followed a regression model, and the loss function was set as mean square error. When the network was trained and tested on one subject using a five-fold validation scheme, the performances were very good. The average correlation coefficients (CCs) between the estimated values and measured values were generally greater than 0.90 for SBP, DBP, MRR, and MRD. However, when the network was trained with one subject\'s data and tested with another subject\'s data, the performance degraded somewhat. The average CCs reduced from over 0.9 to 0.7 for SBP, DBP, and MRD; however, MRR had higher consistency, with the average CC reducing from over 0.9 to about 0.85 only. The generalizability across subjects could be improved if individual differences were considered. The performance indicates the possibility that hemodynamic parameters could be estimated by PCG and PPG signals collected on the body surface. With the rapid development of wearable devices, it has up-and-coming applications for self-monitoring in home healthcare environments.

Ovarian cysts pose significant health risks including torsion, infertility, and cancer, necessitating rapid and accurate diagnosis. Ultrasonography is commonly employed for screening, yet its effectiveness is hindered by challenges like weak contrast, speckle noise, and hazy boundaries in images. This study proposes an adaptive deep learning-based segmentation technique using a database of ovarian ultrasound cyst images. A Guided Trilateral Filter (GTF) is applied for noise reduction in pre-processing. Segmentation utilizes an Adaptive Convolutional Neural Network (AdaResU-net) for precise cyst size identification and benign/malignant classification, optimized via the Wild Horse Optimization (WHO) algorithm. Objective functions Dice Loss Coefficient and Weighted Cross-Entropy are optimized to enhance segmentation accuracy. Classification of cyst types is performed using a Pyramidal Dilated Convolutional (PDC) network. The method achieves a segmentation accuracy of 98.87%, surpassing existing techniques, thereby promising improved diagnostic accuracy and patient care outcomes.

UNASSIGNED: To detect foot ulcers in diabetic patients by analysing thermal images of the foot using a deep learning model and estimate the effectiveness of the proposed model by comparing it with some existing studies.
UNASSIGNED: Open-source thermal images were used for the study. The dataset consists of two types of images of the feet of diabetic patients: normal and abnormal foot images. The dataset contains 1055 total images; among these, 543 are normal foot images, and the others are images of abnormal feet of the patient. The study\'s dataset was converted into a new and pre-processed dataset by applying canny edge detection and watershed segmentation. This pre-processed dataset was then balanced and enlarged using data augmentation, and after that, for prediction, a deep learning model was applied for the diagnosis of an ulcer in the foot. After applying canny edge detection and segmentation, the pre-processed dataset can enhance the model\'s performance for correct predictions and reduce the computational cost.
UNASSIGNED: Our proposed model, utilizing ResNet50 and EfficientNetB0, was tested on both the original dataset and the pre-processed dataset after applying edge detection and segmentation. The results were highly promising, with ResNet50 achieving 89% and 89.1% accuracy for the two datasets, respectively, and EfficientNetB0 surpassing this with 96.1% and 99.4% accuracy for the two datasets, respectively.
UNASSIGNED: Our study offers a practical solution for foot ulcer detection, particularly in situations where expert analysis is not readily available. The efficacy of our models was tested using real images, and they outperformed other available models, demonstrating their potential for real-world application.

OBJECTIVE: Early diagnosis of laryngeal cancer (LC) is crucial, particularly in rural areas. Despite existing studies on deep learning models for LC identification, challenges remain in selecting suitable models for rural areas with shortages of laryngologists and limited computer resources. We present the intelligent laryngeal cancer detection system (ILCDS), a deep learning-based solution tailored for effective LC screening in resource-constrained rural areas.
METHODS: We compiled a dataset comprised of 2023 laryngoscopic images and applied data augmentation techniques for dataset expansion. Subsequently, we utilized eight deep learning models-AlexNet, VGG, ResNet, DenseNet, MobileNet, ShuffleNet, Vision Transformer, and Swin Transformer-for LC identification. A comprehensive evaluation of their performances and efficiencies was conducted, and the most suitable model was selected to assemble the ILCDS.
RESULTS: Regarding performance, all models attained an average accuracy exceeding 90 % on the test set. Particularly noteworthy are VGG, DenseNet, and MobileNet, which exceeded an accuracy of 95 %, with scores of 95.32 %, 95.75 %, and 95.99 %, respectively. Regarding efficiency, MobileNet excels owing to its compact size and fast inference speed, making it an ideal model for integration into ILCDS.
CONCLUSIONS: The ILCDS demonstrated promising accuracy in LC detection while maintaining modest computational resource requirements, indicating its potential to enhance LC screening accuracy and alleviate the workload on otolaryngologists in rural areas.

Treatment-induced ototoxicity and accompanying hearing loss are a great concern associated with chemotherapeutic or antibiotic drug regimens. Thus, prophylactic cure or early treatment is desirable by local delivery to the inner ear. In this study, we examined a novel way of intratympanically delivered sustained nanoformulation by using crosslinked hybrid nanoparticle (cHy-NPs) in a thermoresponsive hydrogel i.e. thermogel that can potentially provide a safe and effective treatment towards the treatment-induced or drug-induced ototoxicity. The prophylactic treatment of the ototoxicity can be achieved by using two therapeutic molecules, Flunarizine (FL: T-type calcium channel blocker) and Honokiol (HK: antioxidant) co-encapsulated in the same delivery system. Here we investigated, FL and HK as cytoprotective molecules against cisplatin-induced toxic effects in the House Ear Institute - Organ of Corti 1 (HEI-OC1) cells and in vivo assessments on the neuromast hair cell protection in the zebrafish lateral line. We observed that cytotoxic protective effect can be enhanced by using FL and HK in combination and developing a robust drug delivery formulation. Therefore, FL-and HK-loaded crosslinked hybrid nanoparticles (FL-cHy-NPs and HK-cHy-NPs) were synthesized using a quality-by-design approach (QbD) in which design of experiment-central composite design (DoE-CCD) following the standard least-square model was used for nanoformulation optimization. The physicochemical characterization of FL and HK loaded-NPs suggested the successful synthesis of spherical NPs with polydispersity index < 0.3, drugs encapsulation (> 75%), drugs loading (~ 10%), stability (> 2 months) in the neutral solution, and appropriate cryoprotectant selection. We assessed caspase 3/7 apopototic pathway in vitro that showed significantly reduced signals of caspase 3/7 activation after the FL-cHy-NPs and HK-cHy-NPs (alone or in combination) compared to the CisPt. The final formulation i.e. crosslinked-hybrid-nanoparticle-embedded-in-thermogel was developed by incorporating drug-loaded cHy-NPs in poloxamer-407, poloxamer-188, and carbomer-940-based hydrogel. A combination of artificial intelligence (AI)-based qualitative and quantitative image analysis determined the particle size and distribution throughout the visible segment. The developed formulation was able to release the FL and HK for at least a month. Overall, a highly stable nanoformulation was successfully developed for combating treatment-induced or drug-induced ototoxicity via local administration to the inner ear.

Proton-exchange membrane fuel cells (PEMFCs) play a crucial role in the transition to sustainable energy systems. Accurately estimating the state of health (SOH) of PEMFCs under dynamic operating conditions is essential for ensuring their reliability and longevity. This study designed dynamic operating conditions for fuel cells and conducted durability tests using both crack-free fuel cells and fuel cells with uniform cracks. Utilizing deep learning methods, we estimated the SOH of PEMFCs under dynamic operating conditions and investigated the performance of long short-term memory networks (LSTM), gated recurrent units (GRU), temporal convolutional networks (TCN), and transformer models for SOH estimation tasks. We also explored the impact of different sampling intervals and training set proportions on the predictive performance of these models. The results indicated that shorter sampling intervals and higher training set proportions significantly improve prediction accuracy. The study also highlighted the challenges posed by the presence of cracks. Cracks cause more frequent and intense voltage fluctuations, making it more difficult for the models to accurately capture the dynamic behavior of PEMFCs, thereby increasing prediction errors. However, under crack-free conditions, due to more stable voltage output, all models showed improved predictive performance. Finally, this study underscores the effectiveness of deep learning models in estimating the SOH of PEMFCs and provides insights into optimizing sampling and training strategies to enhance prediction accuracy. The findings make a significant contribution to the development of more reliable and efficient PEMFC systems for sustainable energy applications.

Since pig vocalization is an important indicator of monitoring pig conditions, pig vocalization detection and recognition using deep learning play a crucial role in the management and welfare of modern pig livestock farming. However, collecting pig sound data for deep learning model training takes time and effort. Acknowledging the challenges of collecting pig sound data for model training, this study introduces a deep convolutional neural network (DCNN) architecture for pig vocalization and non-vocalization classification with a real pig farm dataset. Various audio feature extraction methods were evaluated individually to compare the performance differences, including Mel-frequency cepstral coefficients (MFCC), Mel-spectrogram, Chroma, and Tonnetz. This study proposes a novel feature extraction method called Mixed-MMCT to improve the classification accuracy by integrating MFCC, Mel-spectrogram, Chroma, and Tonnetz features. These feature extraction methods were applied to extract relevant features from the pig sound dataset for input into a deep learning network. For the experiment, three datasets were collected from three actual pig farms: Nias, Gimje, and Jeongeup. Each dataset consists of 4000 WAV files (2000 pig vocalization and 2000 pig non-vocalization) with a duration of three seconds. Various audio data augmentation techniques are utilized in the training set to improve the model performance and generalization, including pitch-shifting, time-shifting, time-stretching, and background-noising. In this study, the performance of the predictive deep learning model was assessed using the k-fold cross-validation (k = 5) technique on each dataset. By conducting rigorous experiments, Mixed-MMCT showed superior accuracy on Nias, Gimje, and Jeongeup, with rates of 99.50%, 99.56%, and 99.67%, respectively. Robustness experiments were performed to prove the effectiveness of the model by using two farm datasets as a training set and a farm as a testing set. The average performance of the Mixed-MMCT in terms of accuracy, precision, recall, and F1-score reached rates of 95.67%, 96.25%, 95.68%, and 95.96%, respectively. All results demonstrate that the proposed Mixed-MMCT feature extraction method outperforms other methods regarding pig vocalization and non-vocalization classification in real pig livestock farming.

OBJECTIVE: We aimed to construct an artificial intelligence-enabled electrocardiogram (ECG) algorithm that can accurately predict the presence of left atrial low-voltage areas (LVAs) in patients with persistent atrial fibrillation.
METHODS: The study included 587 patients with persistent atrial fibrillation who underwent catheter ablation procedures between March 2012 and December 2023 and 942 scanned images of 12-lead ECGs obtained before the ablation procedures were performed. Artificial intelligence-based algorithms were used to construct models for predicting the presence of LVAs. The DR-FLASH and APPLE clinical scores for LVA prediction were calculated. We used a receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis to evaluate model performance.
RESULTS: The data obtained from the participants were split into training (n = 469), validation (n = 58), and test sets (n = 60). LVAs were detected in 53.7% of all participants. Using ECG alone, the deep learning algorithm achieved an area under the ROC curve (AUROC) of 0.752, outperforming both the DR-FLASH score (AUROC = 0.610) and the APPLE score (AUROC = 0.510). The random forest classification model, which integrated a probabilistic deep learning model and clinical features, showed a maximum AUROC of 0.759. Moreover, the ECG-based deep learning algorithm for predicting extensive LVAs achieved an AUROC of 0.775, with a sensitivity of 0.816 and a specificity of 0.896. The random forest classification model for predicting extensive LVAs achieved an AUROC of 0.897, with a sensitivity of 0.862, and a specificity of 0.935.
CONCLUSIONS: The deep learning model based exclusively on ECG data and the machine learning model that combined a probabilistic deep learning model and clinical features both predicted the presence of LVAs with a higher degree of accuracy than the DR-FLASH and the APPLE risk scores.

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

Background: Chest radiography is the standard method for detecting rib fractures. Our study aims to develop an artificial intelligence (AI) model that, with only a relatively small amount of training data, can identify rib fractures on chest radiographs and accurately mark their precise locations, thereby achieving a diagnostic accuracy comparable to that of medical professionals. Methods: For this retrospective study, we developed an AI model using 540 chest radiographs (270 normal and 270 with rib fractures) labeled for use with Detectron2 which incorporates a faster region-based convolutional neural network (R-CNN) enhanced with a feature pyramid network (FPN). The model\'s ability to classify radiographs and detect rib fractures was assessed. Furthermore, we compared the model\'s performance to that of 12 physicians, including six board-certified anesthesiologists and six residents, through an observer performance test. Results: Regarding the radiographic classification performance of the AI model, the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were 0.87, 0.83, and 0.89, respectively. In terms of rib fracture detection performance, the sensitivity, false-positive rate, and free-response receiver operating characteristic (JAFROC) figure of merit (FOM) were 0.62, 0.3, and 0.76, respectively. The AI model showed no statistically significant difference in the observer performance test compared to 11 of 12 and 10 of 12 physicians, respectively. Conclusions: We developed an AI model trained on a limited dataset that demonstrated a rib fracture classification and detection performance comparable to that of an experienced physician.