BACKGROUND: Clinical notes contain contextualized information beyond structured data related to patients\' past and current health status.
OBJECTIVE: This study aimed to design a multimodal deep learning approach to improve the evaluation precision of hospital outcomes for heart failure (HF) using admission clinical notes and easily collected tabular data.
METHODS: Data for the development and validation of the multimodal model were retrospectively derived from 3 open-access US databases, including the Medical Information Mart for Intensive Care III v1.4 (MIMIC-III) and MIMIC-IV v1.0, collected from a teaching hospital from 2001 to 2019, and the eICU Collaborative Research Database v1.2, collected from 208 hospitals from 2014 to 2015. The study cohorts consisted of all patients with critical HF. The clinical notes, including chief complaint, history of present illness, physical examination, medical history, and admission medication, as well as clinical variables recorded in electronic health records, were analyzed. We developed a deep learning mortality prediction model for in-hospital patients, which underwent complete internal, prospective, and external evaluation. The Integrated Gradients and SHapley Additive exPlanations (SHAP) methods were used to analyze the importance of risk factors.
RESULTS: The study included 9989 (16.4%) patients in the development set, 2497 (14.1%) patients in the internal validation set, 1896 (18.3%) in the prospective validation set, and 7432 (15%) patients in the external validation set. The area under the receiver operating characteristic curve of the models was 0.838 (95% CI 0.827-0.851), 0.849 (95% CI 0.841-0.856), and 0.767 (95% CI 0.762-0.772), for the internal, prospective, and external validation sets, respectively. The area under the receiver operating characteristic curve of the multimodal model outperformed that of the unimodal models in all test sets, and tabular data contributed to higher discrimination. The medical history and physical examination were more useful than other factors in early assessments.
CONCLUSIONS: The multimodal deep learning model for combining admission notes and clinical tabular data showed promising efficacy as a potentially novel method in evaluating the risk of mortality in patients with HF, providing more accurate and timely decision support.

Breast cancer, a highly formidable and diverse malignancy predominantly affecting women globally, poses a significant threat due to its intricate genetic variability, rendering it challenging to diagnose accurately. Various therapies such as immunotherapy, radiotherapy, and diverse chemotherapy approaches like drug repurposing and combination therapy are widely used depending on cancer subtype and metastasis severity. Our study revolves around an innovative drug discovery strategy targeting potential drug candidates specific to RTK signalling, a prominently targeted receptor class in cancer. To accomplish this, we have developed a multimodal deep neural network (MM-DNN) based QSAR model integrating omics datasets to elucidate genomic, proteomic expression data, and drug responses, validated rigorously. The results showcase an R2 value of 0.917 and an RMSE value of 0.312, affirming the model\'s commendable predictive capabilities. Structural analogs of drug molecules specific to RTK signalling were sourced from the PubChem database, followed by meticulous screening to eliminate dissimilar compounds. Leveraging the MM-DNN-based QSAR model, we predicted the biological activity of these molecules, subsequently clustering them into three distinct groups. Feature importance analysis was performed. Consequently, we successfully identified prime drug candidates tailored for each potential downstream regulatory protein within the RTK signalling pathway. This method makes the early stages of drug development faster by removing inactive compounds, providing a hopeful path in combating breast cancer.

Bipolar disorder (BD) is characterized by recurrent episodes of depression and mild mania. In this paper, to address the common issue of insufficient accuracy in existing methods and meet the requirements of clinical diagnosis, we propose a framework called Spatio-temporal Feature Fusion Transformer (STF2Former). It improves on our previous work - MFFormer by introducing a Spatio-temporal Feature Aggregation Module (STFAM) to learn the temporal and spatial features of rs-fMRI data. It promotes intra-modality attention and information fusion across different modalities. Specifically, this method decouples the temporal and spatial dimensions and designs two feature extraction modules for extracting temporal and spatial information separately. Extensive experiments demonstrate the effectiveness of our proposed STFAM in extracting features from rs-fMRI, and prove that our STF2Former can significantly outperform MFFormer and achieve much better results among other state-of-the-art methods.

Covert tobacco advertisements often raise regulatory measures. This paper presents that artificial intelligence, particularly deep learning, has great potential for detecting hidden advertising and allows unbiased, reproducible, and fair quantification of tobacco-related media content. We propose an integrated text and image processing model based on deep learning, generative methods, and human reinforcement, which can detect smoking cases in both textual and visual formats, even with little available training data. Our model can achieve 74% accuracy for images and 98% for text. Furthermore, our system integrates the possibility of expert intervention in the form of human reinforcement. Using the pre-trained multimodal, image, and text processing models available through deep learning makes it possible to detect smoking in different media even with few training data.

Alzheimer\'s Disease is the most common cause of dementia, whose progression spans in different stages, from very mild cognitive impairment to mild and severe conditions. In clinical trials, Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) are mostly used for the early diagnosis of neurodegenerative disorders since they provide volumetric and metabolic function information of the brain, respectively. In recent years, Deep Learning (DL) has been employed in medical imaging with promising results. Moreover, the use of the deep neural networks, especially Convolutional Neural Networks (CNNs), has also enabled the development of DL-based solutions in domains characterized by the need of leveraging information coming from multiple data sources, raising the Multimodal Deep Learning (MDL). In this paper, we conduct a systematic analysis of MDL approaches for dementia severity assessment exploiting MRI and PET scans. We propose a Multi Input-Multi Output 3D CNN whose training iterations change according to the characteristic of the input as it is able to handle incomplete acquisitions, in which one image modality is missed. Experiments performed on OASIS-3 dataset show the satisfactory results of the implemented network, which outperforms approaches exploiting both single image modality and different MDL fusion techniques.

The broad adoption of electronic health record (EHR) systems brings us a tremendous amount of clinical data and thus provides opportunities to conduct data-based healthcare research to solve various clinical problems in the medical domain. Machine learning and deep learning methods are widely used in the medical informatics and healthcare domain due to their power to mine insights from raw data. When adapting deep learning models for EHR data, it is essential to consider its heterogeneous nature: EHR contains patient records from various sources including medical tests (e.g. blood test, microbiology test), medical imaging, diagnosis, medications, procedures, clinical notes, etc. Those modalities together provide a holistic view of patient health status and complement each other. Therefore, combining data from multiple modalities that are intrinsically different is challenging but intuitively promising in deep learning for EHR. To assess the expectations of multimodal data, we introduce a comprehensive fusion framework designed to integrate temporal variables, medical images, and clinical notes in EHR for enhanced performance in clinical risk prediction. Early, joint, and late fusion strategies are employed to combine data from various modalities effectively. We test the model with three predictive tasks: in-hospital mortality, long length of stay, and 30-day readmission. Experimental results show that multimodal models outperform uni-modal models in the tasks involved. Additionally, by training models with different input modality combinations, we calculate the Shapley value for each modality to quantify their contribution to multimodal performance. It is shown that temporal variables tend to be more helpful than CXR images and clinical notes in the three explored predictive tasks.

BACKGROUND: The Drug-Target Interaction (DTI) prediction uses a drug molecule and a protein sequence as inputs to predict the binding affinity value. In recent years, deep learning-based models have gotten more attention. These methods have two modules: the feature extraction module and the task prediction module. In most deep learning-based approaches, a simple task prediction loss (i.e., categorical cross entropy for the classification task and mean squared error for the regression task) is used to learn the model. In machine learning, contrastive-based loss functions are developed to learn more discriminative feature space. In a deep learning-based model, extracting more discriminative feature space leads to performance improvement for the task prediction module.
RESULTS: In this paper, we have used multimodal knowledge as input and proposed an attention-based fusion technique to combine this knowledge. Also, we investigate how utilizing contrastive loss function along the task prediction loss could help the approach to learn a more powerful model. Four contrastive loss functions are considered: (1) max-margin contrastive loss function, (2) triplet loss function, (3) Multi-class N-pair Loss Objective, and (4) NT-Xent loss function. The proposed model is evaluated using four well-known datasets: Wang et al. dataset, Luo\'s dataset, Davis, and KIBA datasets.
CONCLUSIONS: Accordingly, after reviewing the state-of-the-art methods, we developed a multimodal feature extraction network by combining protein sequences and drug molecules, along with protein-protein interaction networks and drug-drug interaction networks. The results show it performs significantly better than the comparable state-of-the-art approaches.

To simulate the functions of olfaction, gustation, vision, and oral touch, intelligent sensory technologies have been developed. Headspace solid-phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC/MS) with electronic noses (E-noses), electronic tongues (E-tongues), computer vision (CVs), and texture analyzers (TAs) was applied for sensory characterization of lamb shashliks (LSs) with various roasting methods. A total of 56 VOCs in lamb shashliks with five roasting methods were identified by HS-SPME/GC-MS, and 21 VOCs were identified as key compounds based on OAV (>1). Cross-channel sensory Transformer (CCST) was also proposed and used to predict 19 sensory attributes and their lamb shashlik scores with different roasting methods. The model achieved satisfactory results in the prediction set (R2 = 0.964). This study shows that a multimodal deep learning model can be used to simulate assessor, and it is feasible to guide and correct sensory evaluation.

Multiple Sclerosis (MS) is a chronic disease developed in the human brain and spinal cord, which can cause permanent damage or deterioration of the nerves. The severity of MS disease is monitored by the Expanded Disability Status Scale, composed of several functional sub-scores. Early and accurate classification of MS disease severity is critical for slowing down or preventing disease progression via applying early therapeutic intervention strategies. Recent advances in deep learning and the wide use of Electronic Health Records (EHR) create opportunities to apply data-driven and predictive modeling tools for this goal. Previous studies focusing on using single-modal machine learning and deep learning algorithms were limited in terms of prediction accuracy due to data insufficiency or model simplicity. In this paper, we proposed the idea of using patients\' multimodal longitudinal and longitudinal EHR data to predict multiple sclerosis disease severity in the future. Our contribution has two main facets. First, we describe a pioneering effort to integrate structured EHR data, neuroimaging data and clinical notes to build a multi-modal deep learning framework to predict patient\'s MS severity. The proposed pipeline demonstrates up to 19% increase in terms of the area under the Area Under the Receiver Operating Characteristic curve (AUROC) compared to models using single-modal data. Second, the study also provides valuable insights regarding the amount useful signal embedded in each data modality with respect to MS disease prediction, which may improve data collection processes.

With the development of multimedia systems in wireless environments, the rising need for artificial intelligence is to design a system that can properly communicate with humans with a comprehensive understanding of various types of information in a human-like manner. Therefore, this paper addresses an audio-visual scene-aware dialog system that can communicate with users about audio-visual scenes. It is essential to understand not only visual and textual information but also audio information in a comprehensive way. Despite the substantial progress in multimodal representation learning with language and visual modalities, there are still two caveats: ineffective use of auditory information and the lack of interpretability of the deep learning systems\' reasoning. To address these issues, we propose a novel audio-visual scene-aware dialog system that utilizes a set of explicit information from each modality as a form of natural language, which can be fused into a language model in a natural way. It leverages a transformer-based decoder to generate a coherent and correct response based on multimodal knowledge in a multitask learning setting. In addition, we also address the way of interpreting the model with a response-driven temporal moment localization method to verify how the system generates the response. The system itself provides the user with the evidence referred to in the system response process as a form of the timestamp of the scene. We show the superiority of the proposed model in all quantitative and qualitative measurements compared to the baseline. In particular, the proposed model achieved robust performance even in environments using all three modalities, including audio. We also conducted extensive experiments to investigate the proposed model. In addition, we obtained state-of-the-art performance in the system response reasoning task.