BACKGROUND: The development of emergency department (ED) triage systems remains challenging in accurately differentiating patients with acute abdominal pain (AAP) who are critical and urgent for surgery due to subjectivity and limitations. We use machine learning models to predict emergency surgical abdominal pain patients in triage, and then compare their performance with conventional Logistic regression models.
METHODS: Using 38 214 patients presenting with acute abdominal pain at Zhongnan Hospital of Wuhan University between March 1, 2014, and March 1, 2022, we identified all adult patients (aged ≥18 years). We utilized routinely available triage data in electronic medical records as predictors, including structured data (eg, triage vital signs, gender, and age) and unstructured data (chief complaints and physical examinations in free-text format). The primary outcome measure was whether emergency surgery was performed. The dataset was randomly sampled, with 80% assigned to the training set and 20% to the test set. We developed 5 machine learning models: Light Gradient Boosting Machine (Light GBM), eXtreme Gradient Boosting (XGBoost), Deep Neural Network (DNN), and Random Forest (RF). Logistic regression (LR) served as the reference model. Model performance was calculated for each model, including the area under the receiver-work characteristic curve (AUC) and net benefit (decision curve), as well as the confusion matrix.
RESULTS: Of all the 38 214 acute abdominal pain patients, 4208 underwent emergency abdominal surgery while 34 006 received non-surgical treatment. In the surgery outcome prediction, all 4 machine learning models outperformed the reference model (eg, AUC, 0.899 [95%CI 0.891-0.903] in the Light GBM vs. 0.885 [95%CI 0.876-0.891] in the reference model), Similarly, most machine learning models exhibited significant improvements in net reclassification compared to the reference model (eg, NRIs of 0.0812[95%CI, 0.055-0.1105] in the XGBoost), with the exception of the RF model. Decision curve analysis shows that across the entire range of thresholds, the net benefits of the XGBoost and the Light GBM models were higher than the reference model. In particular, the Light GBM model performed well in predicting the need for emergency abdominal surgery with higher sensitivity, specificity, and accuracy.
CONCLUSIONS: Machine learning models have demonstrated superior performance in predicting emergency abdominal pain surgery compared to traditional models. Modern machine learning improves clinical triage decisions and ensures that critically needy patients receive priority for emergency resources and timely, effective treatment.

Evaluation of water quality is crucial for managing surface water effectively, ensuring its suitability for human use, and sustaining the environment. In the lower Danube River basin, various methods were employed to assess surface water quality for irrigation, drinking, human health risk purposes and the main mechanism control the surface water chemistry. These methods included water quality indicators (WQIs), complex statistical analyses, geographic information systems (GIS), Monte Carlo simulation, and geochemical modeling. Physicochemical analyses of surface water samples revealed primarily Ca-Mg-HCO3- is the dominant water types. Principal component analysis (PCA), ionic ratios and piper, chloro alkaline index, Chadha, and Gibbs diagrams identified three distinct water characteristics influenced by water-rocks interaction, evaporation, ions exchange, and human activities. The geochemical modeling showed Danube River water\'s strong ability to dissolve gypsum, halite, and anhydrite (SI < 0) and precipitate aragonite, dolomite, and calcite with saturation index (SI) value greater than 0 along its flow path. The irrigation water quality index (IWQI = 99.6-107.6), sodium adsorption ratio (SAR = 0.37-0.68), sodium percentage (Na% = 13.7-18.7), soluble sodium percentage (SSP = 12.5-17.5), Potential Salinity (PS = 0.73-1.6), and Residual Sodium Carbonate (RSC = - 1.27-0.58) values were used, mainly indicating acceptable quality with some limitations. Danube River water was unsuitable for drinking based on WQI value (WQI = 81-104). Oral exposure of children to specific components showed a higher hazard index (HI > 1) compared to adults, indicating a 2.1 times higher overall non-carcinogenic risk hazard index. However, Monte Carlo simulation demonstrated negligible iron, manganese, and nitrate health hazards for both age groups. These findings are valuable for water quality management decisions, contributing to long-term resource sustainability.

Normal tissue complication probability (NTCP) models for radiation pneumonitis (RP) in lung cancer patients with stereotactic body radiation therapy (SBRT), which based on dosimetric data from treatment planning, are limited to patients who have already received radiation therapy (RT). This study aims to identify a novel predictive factor for lung dose distribution and RP probability before devising actionable SBRT plans for lung cancer patients. A comprehensive correlation analysis was performed on the clinical and dose parameters of lung cancer patients who underwent SBRT. Linear regression models were utilized to analyze the dosimetric data of lungs. The performance of the regression models was evaluated using mean squared error (MSE) and the coefficient of determination (R2). Correlational analysis revealed that most clinical data exhibited weak correlations with dosimetric data. However, nearly all dosimetric variables showed \"strong\" or \"very strong\" correlations with each other, particularly concerning the mean dose of the ipsilateral lung (MI) and the other dosimetric parameters. Further study verified that the lung tumor ratio (LTR) was a significant predictor for MI, which could predict the incidence of RP. As a result, LTR can predict the probability of RP without the need to design an elaborate treatment plan. This study, as the first to offer a comprehensive correlation analysis of dose parameters, explored the specific relationships among them. Significantly, it identified LTR as a novel predictor for both dose parameters and the incidence of RP, without the need to design an elaborate treatment plan.

From the various perspectives of machine learning (ML) and the multiple models used in this discipline, there is an approach aimed at training models for the early detection (ED) of anomalies. The early detection of anomalies is crucial in multiple areas of knowledge since identifying and classifying them allows for early decision making and provides a better response to mitigate the negative effects caused by late detection in any system. This article presents a literature review to examine which machine learning models (MLMs) operate with a focus on ED in a multidisciplinary manner and, specifically, how these models work in the field of fraud detection. A variety of models were found, including Logistic Regression (LR), Support Vector Machines (SVMs), decision trees (DTs), Random Forests (RFs), naive Bayesian classifier (NB), K-Nearest Neighbors (KNNs), artificial neural networks (ANNs), and Extreme Gradient Boosting (XGB), among others. It was identified that MLMs operate as isolated models, categorized in this article as Single Base Models (SBMs) and Stacking Ensemble Models (SEMs). It was identified that MLMs for ED in multiple areas under SBMs\' and SEMs\' implementation achieved accuracies greater than 80% and 90%, respectively. In fraud detection, accuracies greater than 90% were reported by the authors. The article concludes that MLMs for ED in multiple applications, including fraud, offer a viable way to identify and classify anomalies robustly, with a high degree of accuracy and precision. MLMs for ED in fraud are useful as they can quickly process large amounts of data to detect and classify suspicious transactions or activities, helping to prevent financial losses.

The water quality index (WQI) is a widely used tool for comprehensive assessment of river environments. However, its calculation involves numerous water quality parameters, making sample collection and laboratory analysis time-consuming and costly. This study aimed to identify key water parameters and the most reliable prediction models that could provide maximum accuracy using minimal indicators. Water quality from 2020 to 2023 were collected including nine biophysical and chemical indicators in seventeen rivers in Yancheng and Nantong, two coastal cities in Jiangsu Province, China, adjacent to the Yellow Sea. Linear regression and seven machine learning models (Artificial Neural Network (ANN), Self-Organizing Maps (SOM), K-Nearest Neighbor (KNN), Support Vector Machines (SVM), Random Forest (RF), Extreme Gradient Boosting (XGB) and Stochastic Gradient Boosting (SGB)) were developed to predict WQI using different groups of input variables based on correlation analysis. The results indicated that water quality improved from 2020 to 2022 but deteriorated in 2023, with inland stations exhibiting better conditions than coastal ones, particularly in terms of turbidity and nutrients. The water environment was comparatively better in Nantong than in Yancheng, with mean WQI values of approximately 55.3-72.0 and 56.4-67.3, respectively. The classifications \"Good\" and \"Medium\" accounted for 80 % of the records, with no instances of \"Excellent\" and 2 % classified as \"Bad\". The performance of all prediction models, except for SOM, improved with the addition of input variables, achieving R2 values higher than 0.99 in models such as SVM, RF, XGB, and SGB. The most reliable models were RF and XGB with key parameters of total phosphorus (TP), ammonia nitrogen (AN), and dissolved oxygen (DO) (R2 = 0.98 and 0.91 for training and testing phase) for predicting WQI values, and RF using TP and AN (accuracy higher than 85 %) for WQI grades. The prediction accuracy for \"Medium\" and \"Low\" water quality grades was highest at 90 %, followed by the \"Good\" level at 70 %. The model results could contribute to efficient water quality evaluation by identifying key water parameters and facilitating effective water quality management in river basins.

Esthesioneuroblastomas (ENBs) present unique diagnostic and therapeutic challenges due to their rare and complex clinical presentation. In recent years, artificial intelligence (AI) and machine learning (ML) have emerged as promising tools in various medical specialties, revolutionizing diagnostic accuracy, treatment planning, and patient outcomes. However, their application in ENBs remains relatively unexplored. This comprehensive literature review aims to evaluate the current state of AI and ML technologies in ENB diagnosis, radiological and histopathological imaging, and treatment planning. By synthesizing existing evidence and identifying gaps in knowledge, this review aims to showcase the potential benefits, limitations, and future directions of integrating AI and ML into the multidisciplinary management of ENBs.

Artificial intelligence (AI) models can play a more effective role in managing patients with the explosion of digital health records available in the healthcare industry. Machine-learning (ML) and deep-learning (DL) techniques are two methods used to develop predictive models that serve to improve the clinical processes in the healthcare industry. These models are also implemented in medical imaging machines to empower them with an intelligent decision system to aid physicians in their decisions and increase the efficiency of their routine clinical practices. The physicians who are going to work with these machines need to have an insight into what happens in the background of the implemented models and how they work. More importantly, they need to be able to interpret their predictions, assess their performance, and compare them to find the one with the best performance and fewer errors. This review aims to provide an accessible overview of key evaluation metrics for physicians without AI expertise. In this review, we developed four real-world diagnostic AI models (two ML and two DL models) for breast cancer diagnosis using ultrasound images. Then, 23 of the most commonly used evaluation metrics were reviewed uncomplicatedly for physicians. Finally, all metrics were calculated and used practically to interpret and evaluate the outputs of the models. Accessible explanations and practical applications empower physicians to effectively interpret, evaluate, and optimize AI models to ensure safety and efficacy when integrated into clinical practice.

In river research, forecasting flow velocity accurately in vegetated channels is a significant challenge. The forecasting performance of various independent and hybrid machine learning (ML) models are thus quantified for the first time in this work. Utilizing flow velocity measurements in both natural and laboratory flume experiments, we assess the efficacy of four distinct standalone machine learning techniques-Kstar, M5P, reduced error pruning tree (REPT) and random forest (RF) models. In addition, we also test for eight types of hybrid ML algorithms trained with an Additive Regression (AR) and Bagging (BA) (AR-Kstar, AR-M5P, AR-REPT, AR-RF, BA-Kstar, BA-M5P, BA-REPT and BA-RF). Findings from a comparison of their predictive capabilities, along with a sensitivity analysis of the influencing factors, indicated: (1) Vegetation height emerged as the most sensitive parameter for determining the flow velocity; (2) all ML models displayed outperforming empirical equations; (3) nearly all ML algorithms worked optimal when the model was built using all of the input parameters. Overall, the findings showed that hybrid ML algorithms outperform regular ML algorithms and empirical equations at forecasting flow velocity. AR-M5P (R2 = 0.954, R = 0.977, NSE = 0.954, MAE = 0.042, MSE = 0.003, and PBias = 1.466) turned out to be the optimal model for forecasting of flow velocity in vegetated-rivers.

The paper \"Using Absorption Models for Insulin and Carbohydrates and Deep Leaning to Improve Glucose Level Predictions\" (Sensors2021, 21, 5273) proposes a novel approach to predicting blood glucose levels for people with type 1 diabetes mellitus (T1DM). By building exponential models from raw carbohydrate and insulin data to simulate the absorption in the body, the authors reported a reduction in their model\'s root-mean-square error (RMSE) from 15.5 mg/dL (raw) to 9.2 mg/dL (exponential) when predicting blood glucose levels one hour into the future. In this comment, we demonstrate that the experimental techniques used in that paper are flawed, which invalidates its results and conclusions. Specifically, after reviewing the authors\' code, we found that the model validation scheme was malformed, namely, the training and test data from the same time intervals were mixed. This means that the reported RMSE numbers in the referenced paper did not accurately measure the predictive capabilities of the approaches that were presented. We repaired the measurement technique by appropriately isolating the training and test data, and we discovered that their models actually performed dramatically worse than was reported in the paper. In fact, the models presented in the that paper do not appear to perform any better than a naive model that predicts future glucose levels to be the same as the current ones.

Increased interest in the development and integration of navigation and positioning services into a wide range of receivers makes them susceptible to a variety of security attacks such as Global Navigation Satellite Systems (GNSS) jamming and spoofing attacks. The availability of low-cost devices including software-defined radios (SDRs) provides a wide accessibility of affordable platforms that can be used to perform these attacks. Early detection of jamming and spoofing interferences is essential for mitigation and avoidance of service degradation. For these reasons, the development of efficient detection methods has become an important research topic and a number of effective methods has been reported in the literature. This survey offers the reader a comprehensive and systematic review of methods for detection of GNSS jamming and spoofing interferences. The categorization and classification of selected methods according to specific parameters and features is provided with a focus on recent advances in the field. Although many different detection methods have been reported, significant research efforts toward developing new and more efficient methods remain ongoing. These efforts are driven by the rapid development and increased number of attacks that pose high-security risks. The presented review of GNSS jamming and spoofing detection methods may be used for the selection of the most appropriate solution for specific purposes and constraints and also to provide a reference for future research.