Informatics in Medicine Unlocked

Despite the remarkable progress of artificial intelligence represented by large language models, how AI technologies can contribute to the construction of evidence in evidence-based medicine (EBM) remains an overlooked issue. Now, we need an AI that can be compatible with EBM. In the present paper, we aim to propose an example analysis that may contribute to this approach using variable Vision Transformer.

Melanocytes become cancerous, forming tumors that may invade and destroy the surrounding tissues. When melanocytes acquire invasive characteristics, the anchored melanoma begins to damage the normal cells. Therefore, early intervention and diagnosis are essential to avoid high morbidity and mortality in malignant melanoma. However, It is challenging to distinguish the difference between malignant melanoma and benign clump of melanocytes. Based on a data set of 10,000 melanocyte tumors, this paper develops a new model system to improve the accuracy of distinguishing between benign and malignant melanocytes. In the first stage, the original CNN architectures are used, such as ResNet18, ResNet50, VGG11, and VGG16. Synthetic medical images, generated via a Diffusion Model to extract informative features from the original dataset, are used to train the CNN architectures. This approach improves classification accuracy from 91.1% to 92.9%. In the second stage, the fully connected layer of each neural network is replaced with a high-level classifier, XGBoost, to perform secondary classification. This hybrid strategy further enhances performance, achieving up to 93.3% accuracy by using the synthetic images.

Skin cancer requires early detection for improved survival rates. Most existing methods rely on deep learning based image classification, which is affected by visual similarity among lesions. Fewer studies use Gene Expression (GE) analysis, which captures molecular characteristics but lacks structural and visual details. To overcome limitations of individual modalities, this paper proposes a multimodal framework integrating dermoscopic images and GE profiles for skin cancer classification. EfficientNet and logistic regression are used for image based analysis and genomic skin lesion profiling, respectively, followed by fuzzy rule based decision systems to reduce uncertainty within individual modalities. Finally, fuzzy fusion combines predictions from both modalities using uncertainty based weighting of classifier outputs. The experimental findings show that both the image based and GE based classification models individually achieved accuracies of nearly 92%. However, the integration of prediction results through the proposed fuzzy fusion strategy further enhanced the classification performance, achieving an overall accuracy of 94.25%. The results obtained outperform contemporary methods, highlighting the effectiveness of combining complementary multimodal information compared with single modality approaches.

Fraud in the health landscape is an aggravating issue, with far-reaching consequences burdening the financial stability of the health industry and threatening the quality of medical care. It results from vulnerabilities within the current healthcare framework that are exploited by the fraudsters in their favor. In spite of many developed models that aim to detect fraudulent patterns in insurance claims, the accuracy of such models frequently suffers as a result of the imbalance issue of the Medicare dataset and irrelevant features. This study ventures to improve detection performance and accuracy by employing a deep learning model along with data sampling and feature selection techniques. Comparative analysis among different combinations is conducted to determine their efficacy to enhance the accuracy of the fraud detection model. Hence, the suggested model clearly demonstrates that a combination of myriad data sampling and feature selection techniques is helping to improve accuracy and performance. The accuracy was thus 95.4%, with negligible evidence of overfitting detected using both Chi-square and Synthetic Minority Over-sampling (SMOTE) techniques. Ultimately, the study findings underscore the significance of employing combined techniques instead of using only the baseline deep learning model for better performance in detecting Medicare insurance fraud.

BackgroundDengue has been a major health threat globally in recent years. In particular, dengue incidences continue to increase annually and the epidemic area has expanded primarily due to global warming. Therefore, effective case detection and surveillance strategies are crucial to tackle this global health challenge. In clinical practice, the rapid test kit detecting dengue non-structural protein 1 antigen and commonly referred as NS1, is widely employed for early diagnosis. However, real-world studies revealed that the sensitivity of the NS1 test kit ranged from approximately 61% to 95%. Since early diagnosis is really critical for disease surveillance in the early stage of a dengue epidemic, scientists have been working hard to develop novel diagnosis methods that can provide higher sensitivity levels. Methodology/Principal FindingsIn response to this challenge, in this study, we have developed a novel diagnosis procedure that integrates machine learning technologies with the NS1 test kit. Our experimental results revealed that we would be able to raise the sensitivity of the dengue diagnosis procedure to higher than 99% by incorporating machine learning based prediction models to screen the suspected patients with a negative NS1 result. Furthermore, the relative risks between the suspected patients who were predicted to be positive and those who were predicted to be negative exceeded 4.8. Conclusions/SignificanceThese results illustrate that the proposed approach provides an effective and efficient diagnosis procedure to address the global health challenge caused by spread of dengue. Author SummaryThis study has aimed to enhance surveillance of the dengue disease by integrating machine learning technologies with the rapid test kit commonly employed in early diagnosis. In clinical practice, the NS1 rapid test kit is widely employed for early diagnosis. However, real-world studies revealed that a certain percentage of the patients with a negative NS1 test result, ranging from 5% to 39%, were actually infected by dengue. Since early diagnosis is critical for disease control in the early stage of a dengue epidemic, scientists have been working hard to tackle this challenge. Based on this observation, this study was launched to investigate the effects of incorporating machine learning based prediction models to further screen those patients with a negative NS1 test result. The experimental results revealed that the proposed approach was able to identify over 99% of the patients who were infected by the dengue disease. Furthermore, the risk of the suspected patients who were predicted to be positive was 4.8 times higher than the risk of those who were predicted to be negative. The experimental results illustrate that the proposed approach provides an effective and efficient diagnosis procedure to enhance surveillance of the dengue disease.

Predicting response to induction chemotherapy (IC) and overall survival (OS) is critical for optimizing treatment in patients with locally advanced nasopharyngeal carcinoma (LANPC). This study aimed to develop and validate a multi-task deep learning model integrating pretreatment MRI and whole slide images (WSIs) to predict IC response and OS in LANPC. Pretreatment MRI and WSIs from 404 patients with LANPC were retrospectively collected to construct a multi-task model (MoEMIL) for the simultaneous prediction of early IC response and OS. MoEMIL employed multi-instance learning to process WSIs, PyRadiomics and a convolutional neural network (ResNet50) to extract MRI features, and fused multimodal features through a multi-gate mixture-of-experts architecture. Clustering-constrained attention multiple instance learning and gradient-weighted class activation mapping were applied for visualization and interpretation. MoEMIL effectively stratified patients into good and poor IC response groups, achieving areas under the curve of 0.917, 0.869, and 0.801 in the train, validation, and test sets, respectively, and outperformed the deep learning radiomics model, the pathomics model and TNM staging. The model also stratified patients into high- and low-risk OS groups (P < 0.05). MoEMIL shows promise as a decision-support tool for early IC response prediction and prognostication in LANPC. Author SummaryWe have developed a deep learning model that integrates two types of medical images, including magnetic resonance imaging (MRI) and digital pathological slices, to simultaneously predict response to induction chemotherapy and prognosis in patients with locally advanced nasopharyngeal carcinoma. Current treatment decisions primarily rely on traditional tumor staging (TNM), which often fails to comprehensively reflect the complexity of the disease. Our model, named MoEMIL, was trained and tested on data from 404 patients across two hospitals and consistently outperformed both single-model approaches and TNM staging methods. By identifying patients who exhibit poor response to induction chemotherapy or higher prognostic risk, our tool can assist clinicians in achieving personalized treatment, enabling intensified management for high-risk patients and avoiding unnecessary side effects for low-risk patients. Additionally, we visualize the models reasoning process through heat map generation, which highlights the image regions exerting the greatest influence on prediction outcomes. This work represents a step toward more precise treatment for nasopharyngeal carcinoma; however, larger-scale prospective studies are required before the model can be integrated into routine clinical practice.

Malaria is one of the deadliest diseases in sub-Saharan Africa and Southeast Asia. The majority of the fatalities occur mostly in children under 5 years and pregnant women and this is due to infection by Plasmodium spp, of which Plasmodium falciparum is the most virulent and is responsible for most of the morbidity and mortality. Despite various public health interventions such as use of insecticide-treated bed nets, spraying of homes with insecticides and use of WHO recommended artemisinin-based combination therapies (ACT), malaria prevention still faces major setback due to drug and insecticide resistance by P. falciparum and mosquitoes respectively. The study uses molecular docking and immunoinformatics to screen various Plasmodium spp antigens and evaluate their antigenicity and suitability as vaccine candidates. The P. falciparum antigens and T-cell receptor (TCR) structures were obtained from Protein Data Bank (PDB) based on a range of factors related to their role in the lifecycle of the parasite and their status as vaccine targets. Protein structures not available in the PDB were predicted using AlphaFold. The 3D structures of selected P. falciparum antigens and TCR structures were downloaded in PDB format then all water molecules, Hetatm, and bound ligands were deleted from the protein structures using BIOVIA Discovery Studio Visualizer. Subsequently, molecular docking was done using ClusPro v2.0 server and docked complexes were compared. The findings of this study gave valuable insights into the interaction of human immune response with P. falciparum antigens. The best three ranked antigen complexes are PfCyRPA, PfMSP10 and PfCSP and this confirm their use as potential candidates for vaccine development. This study highlights the usefulness of computational docking in identifying P. falciparum antigens of excellent immunogenic potential as vaccine candidates.

BackgroundPa4ediatric pneumonia is a major cause of childhood morbidity and mortality. Chest X-rays (CXR) are central to diagnosis, but shortages of specialist radiologists can delay reporting. Multimodal large language models (MLLMs) may assist clinical workflows by analysing images and communicating findings, although their diagnostic performance remains below state-of-the-art classifiers. ObjectiveTo evaluate whether ensemble strategies improve MLLM diagnostic performance for paediatric radiological pneumonia detection on CXRs. MethodsIn this retrospective study, paediatric CXRs from two datasets (balanced and real-world) at KK Womens and Childrens Hospital were analysed. Images were independently reviewed by two board-certified radiologists, with pneumonia severity assigned to three classes using a predefined consensus algorithm. Fifteen MedGemma-4B-it agents classified each CXR into five likelihood categories, which were mapped to the three severity classes for evaluation. Majority voting, soft voting and GPTOSS-20B aggregation were compared with baseline average agent performance. The primary outcome was One-vs-Rest (OvR) AUROC. Secondary metrics included accuracy, sensitivity, specificity, F1-score, Cohens {kappa} and One-vs-One (OvO) AUROC. ResultsThe balanced dataset contained 900 CXRs and the real-world dataset 1300 CXRs. Soft voting significantly improved OvR-AUROC compared with baseline in both datasets (Balanced: 0.829>0.764; 95%CI=0.752-0.779; P=0.0002. Real-world: 0.728>0.655; 95%CI=0.638-0.679; P=0.0003). Soft voting also improved accuracy, Cohens {kappa}, OvO-AUROC in both datasets and F1-score in the balanced dataset. ConclusionSoft voting enhances MedGemmas diagnostic discriminatory performance for paediatric radiological pneumonia detection. Our system enables privacy-preserving, near real-time clinical decision support with explainable outputs, having potential for integration into emergency departments. Our systems high specificity supports triage by flagging high-risk radiological pneumonia cases. Clinical ImpactO_LIPaediatric CXRs often face reporting delays exceeding 24 hours due to radiologist shortages. C_LIO_LIOur proposed MLLM ensemble framework achieves better than average MLLM diagnostic discrimination for radiological pneumonia without requiring cloud-based systems. C_LIO_LISoft-voting aggregation enhances diagnostic discriminatory effectiveness for paediatric pneumonia severity, while preserving explainable outputs. C_LIO_LIOur system acts as a decision support tool that identifies higher-risk pneumonia cases for urgent review, supporting safer triage. C_LI

Background. Lung metastases in osteosarcoma (OS) are the main cause of the death. The accuracy of the diagnosis of nodules by computed tomography (CT) of the lungs is critically important for determining the disseminated stage of the disease and planning surgical treatment. The use of artificial intelligence (AI) in the search for lung nodules increases the accuracy of diagnosis and reduces the chance of missing metastases. Objective: to evaluate the accuracy of lung nodules diagnosis in adolescents with OS using AI. Methods. A retrospective assessment of CT scans of adolescents with OS was performed. A pathological nodule with an average size of [&ge;]4 mm was considered a target finding. The diagnostic accuracy of an AI algorithm previously trained on an adult dataset was evaluated, and the number of false positives (FP) and false negatives (FN) was determined. Sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value, negative predictive value, and F1-measure were calculated. Based on the obtained results, the effectiveness of the algorithm was assessed. Results. 248 CT scans of adolescents with OS were evaluated. The following results were obtained: in 5 cases, the AI algorithm showed a FP result (2.02%), in 34 cases, it showed a FN result (13.71%), and in 209 cases, a correct result (both true positive and true negative) (84.27%). The diagnostic accuracy of the algorithm was 0.843 (95% CI 0.794-0.887). The application of the AI algorithm in the practice of an X-ray doctor in a specific clinical task would allow to increase the sensitivity from 0.805 to 0.891, while ensuring an absolute decrease in the number of FN results by 8.59% and a relative decrease by 44%. Conclusion. The obtained results confirm the practical value of the application of the AI algorithm and justify the implementation of AI-assisted systems in the diagnostic protocols for lung metastases in adolescents with OS.

IntroductionTo propose an improved U-Net-based segmentation model for colorectal polyp segmentation, aiming to address the challenges of variable lesion morphology, ambiguous boundaries, complex background interference, and insufficient cross-level feature fusion in endoscopic images [5,12]. MethodsAn improved network termed MCA-UNet was developed based on U-Net [5]. The model incorporates a multi-scale context convolution block (MCCB) to enhance multi-scale feature extraction and an attention-guided feature fusion module (AGFF) to optimize skip-feature selection and fusion in the decoder. Experiments were conducted on publicly available colorectal polyp image datasets, including Kvasir-SEG and CVC-ClinicDB [13-15]. Four models, including U-Net, U-Net+MCCB, U-Net+AGFF, and MCA-UNet, were compared, and all models were trained for 100 epochs. Dice, intersection over union (IoU), and mean absolute error (MAE) were used as the main evaluation metrics [20]. ResultsOn the mixed validation set, the Dice scores of U-Net, U-Net+MCCB, U-Net+AGFF, and MCA-UNet were 0.742, 0.771, 0.754, and 0.783, respectively; the corresponding IoU values were 0.603, 0.635, 0.618, and 0.649; and the MAE values were 0.102, 0.090, 0.097, and 0.086. Compared with the baseline U-Net, MCA-UNet improved Dice and IoU by 5.53% and 7.63%, respectively, while reducing MAE by 15.69%. Comparisons on the Kvasir-SEG and CVC-ClinicDB validation subsets further demonstrated the more stable performance of the proposed model. ConclusionBy jointly integrating multi-scale contextual modeling and attention-guided feature fusion, MCA-UNet effectively improves the accuracy and robustness of colorectal polyp segmentation and may provide useful support for intelligent endoscopic image analysis [12,17,18].

Predicting protein-ligand interactions in the modern drug discovery has revolved from the involvement of artificial intelligence and structural bioinformatics using Graph Neural Networks (GNNs). The limited explainability of GNN models presents an important encumbrance in biomedical research, but it has achieved a high degree of accuracy in determining and identifying binding affinity and active compounds, as evidenced by [1] [2] [3] [4]. Here this research focuses on the interpretation of protein-ligand interactions at a molecular level, a rapidly developing area within Graph Neural Networks (GNNs). Now days modern study handling techniques such as visualization techniques, attention mechanism and model-based feature ascription by model to boost, and make robust and decrease false predictions on binding. Along with some approaches include like graph pooling strategies, message-passing optimization, self-supervised learning, transfer learning and contrastive learning are rapidly utilized to enhance the representative learnings. Furthermore, integration of molecular docking simulations, hybrid deep learning architectures and protein language model gives more reliable & biological predictions of protein-ligand interactions. That focuses on given process that identifies key ligand atoms and binding residues, as well as physicochemical factors influencing affinity, through chemical thought processes. Here this research work identified the challenges of developing biologically significant explanations, transparency, and the corollary dataset biases on interpretability. The research work conducted an in-depth investigation into the consolidation of protein language models to establish more reliable pathways for future research, examining hybrid architectures, transparent and energy-efficient GNNs, and scientifically grounded AI models for drug discovery. My research work highlights that XGNNs establishes a connection between Deep Learning and Biochemical expertise with increased confidence, which will enhance the accuracy of predictive models and computational models.

Objectives: Clinical prediction models estimate the risk of a future outcome in patients. Such models are often externally validated using independent datasets; however, even when a model has been rigorously validated in a new setting and patient population, its performance across other clinical settings remains unclear. Therefore, we systematically evaluated model performance and clinical utility across diverse patient populations to quantify the limits of transportability. Methods: Using liver transplantation as an example, we used the UK donation-after-circulatory-death (DCD) risk score and descriptive statistics from Swiss DCD liver transplant populations to simulate realistic target populations with varying donor and recipient characteristics. The risk score's ability to predict one-year graft failure was evaluated using calibration intercept, calibration slope, area under the receiver operating characteristic (ROC) curve, and net benefit. Results: The UK DCD Risk Score's performance depended heavily on the simulated population characteristics. While the score performed adequately in settings similar to those where it was derived, it was not satisfactory in others. Discussion: The study showed, using a risk score in liver transplantation as an example, that the application of a prediction model can be limited in certain external populations when they differ, and that its transportability in new settings is not guaranteed. Conclusion: This study highlights the importance of external validation of clinical prediction models to determine transportability to various target populations. Their application requires careful consideration and potential model re-estimation.

PurposeIn this study, we aimed to develop and evaluate an artificial intelligence-based diagnostic model for the diagnosis of acute cholecystitis (AC) using non-contrast CT images and clinical data. Materials and MethodsThis retrospective study included 199 patients (100 AC, 99 non-AC) treated between January 2016 and December 2025 at a single center. Patients were randomly divided into training (n=139) and test (n=60) datasets. Three models were constructed: an imaging-based deep learning model, a clinical data-based machine learning model, and a hybrid machine learning model integrating deep learning-derived imaging features with clinical data. CT images were preprocessed, and gallbladder regions were segmented. Clinical variables included white blood cell counts and levels of C-reactive protein and liver function markers. Model performance was evaluated using accuracy, precision, recall, specificity, F1 score, and area under the receiver operating characteristic curve (AUC). Statistical comparisons were performed using Welchs t-test and Chi-square test. ResultsThe imaging-based model achieved accuracy 0.883, precision 0.848, recall 0.933, specificity 0.833, and AUC 0.916. The blood-based model achieved accuracy 0.917, precision 0.931, recall 0.900, specificity 0.933, and AUC 0.949. The hybrid model showed the highest performance, with accuracy 0.950, precision 0.909, recall 1.000, specificity 0.900, F1 score 0.952, and AUC 0.986. ConclusionA hybrid model integrating CT imaging and clinical data improved diagnostic performance for AC compared with single-modality models.

Machine learning (ML) is being considered to help diagnose cardiovascular diseases (CVD). Still, challenges like inconsistent and limited datasets, limited infrastructure, and global inequalities lead to the need for a reliable and practicable ML solution. This paper presents an ML-driven framework for predicting CVD risk scores and classifying status. Several data preprocessing techniques, including multiple imputation by chained equations (MICE), outlier removal, are considered. In addition, hyperparameter tuning is performed with the GridSearchCV tuning technique. Moreover, a consensus-driven five-feature selection method is applied to identify optimal predictors. The dataset used in this study contains healthcare records related to future CVD risk scores, comprising 1,529 patient records with 22 features. The optimized stacked ensemble model is applied to the dataset and achieves a cross-validated coefficient of determination value of 98.13% for CVD risk score regression. Comparative evaluation with other ML models confirmed improved accuracy, efficiency, and interpretability. The explainable AI technique SHAP is applied to interpret predictions and highlight key risk factors. Moreover, a deployment-ready web platform with multi-role access has been developed that demonstrates clinical applicability. The proposed framework offers a reliable and interpretable tool for early detection of CVD and personalized risk assessment. In the future, this work can be extended to integrate longitudinal data, medical imaging, and deep learning to improve generalizability and strengthen real-world impact.

ObjectivesAmong surgically resected non-small cell lung cancer (NSCLC) patients with similar stage and histopathological characteristics, there is variability in patient outcomes which highlights urgency of identifying biomarkers to predict recurrence. The goal of this study was to systematically develop a pre-surgical CT-based habitat-based radiomics classifier to predict recurrence-of-risk in NSCLC. MethodsThis study included 293 NSCLC patients with surgically resected stage IA-IIIA disease that were randomly divided into a training (n = 195) and test cohorts (n = 98). From pre-surgical CT images, tumor habitats were generated using two-level unsupervised clustering and then radiomic features were calculated from the intratumoral region and habitat-defined subregions. Using ridge-regularized logistic regression, separate classifiers were developed to predict 3-year recurrence using intratumoral radiomics, habitat-based radiomics, and a combined model (intratumoral and habitat) which was generated using a stacked learning framework. For each classifier, probability of recurrence was calculated for each patient then numerous statistical and machine learning approaches were utilized to stratify patients for recurrence-free survival. ResultsThe combined radiomics classifier yielded a superior AUC (0.82) compared to the intratumoral (AUC = 0.75) and habitat radiomics (AUC = 0.81) models. When the classifiers were used to stratify high- versus low-risk patients utilizing a cut-point identified by decision tree analysis, high-risk patients were yielded the largest risk estimate (HR = 8.43; 95% CI 2.47 - 28.81) compared to the habitat (HR = 5.41; 95% CI 2.08 - 14.09) and intratumoral radiomics (HR = 3.54; 95% CI 1.45 - 8.66) models. SHAP analyses indicated that habitat-derived information contributed most strongly to recurrence prediction. ConclusionsThis study revealed that habitat-based radiomics provided superior statistical performance than intratumoral radiomics for predicting recurrence in NSCLC.

Purpose: To develop a deep neural network-based, AIF-free, perfusion estimation method (QTMnet) for improved performance on glioma classification. Methods: A globally defined arterial input function (AIF) is needed to recover perfusion parameters in the two-compartment exchange model (2CXM). We have developed Quantitative Transport Mapping (QTM) to create an AIF-independent estimation method. QTM estimation can be formulated using deep neural networks trained on synthetic DCE-MRI data (QTMnet). Here, we provide a fluid mechanics-based DCE-MRI simulation with exchange between the capillaries and extravascular extracellular space. We implemented tumor ROI generation to morphologically characterize tissue perfusion. We compared our QTMnet implementation with 2CXM on 30 glioma human subjects, 15 of which had low-grade gliomas, and 15 with high-grade glioblastomas. Results: QTMnet outperforms (best AUC: 0.973) traditional 2CXM (best AUC: 0.911) in a glioma grading task. Conclusion: The AIF-independent QTMnet estimation provides a quantitative delineation between low-grade and high-grade gliomas.

Computer vision and deep learning techniques, including convolutional neural networks (CNNs) and transformers, have increased the performance of medical image classification systems. However, training deep learning models using medical images is a challenging task that necessitates a substantial amount of annotated data. In this paper, we implement data augmentation strategies to tackle dataset imbalance in the VinDr-SpineXR dataset, which has a lower number of spine abnormality X-ray images compared to normal spine X-ray images. Geometric transformations and synthetic image generation using Generative Adversarial Networks are explored and applied to the abnormal classes of the dataset, and classifier performance is validated using VGG-16 and InceptionNet to identify the most effective augmentation technique. Additionally, we introduce a hybrid augmentation technique that addresses class imbalance, reduces computational overhead relative to a GAN-only approach, and achieves [~]99% validation accuracy with both classifiers across all three case studies.

BackgroundA critical radiologist shortage exists in India, leading to delayed chest radiograph (CXR) interpretation. This leads to disease progression, higher morbidity, and mortality. Artificial intelligence-based CXR interpretation by Lenek Intelligent Radiology Assistant (LIRA) is a promising solution. This study aims to establish the screening and triaging capabilities of LIRA by assessing its accuracy in detecting abnormalities and pathologies in CXRs from geographically diverse institutions. MethodsWe conducted a retrospective multi-source validation of the diagnostic accuracy of LIRA for the detection of general abnormalities, tuberculosis, consolidation, pleural effusion, pneumothorax, and cardiomegaly. De-identified chest radiographs were input into LIRA models. The obtained interpretations were compared to the established ground truth reporting for the calculation of sensitivity, specificity, and AUROC with 95% CI for individual pathologies across varying probability thresholds. ResultsLIRA demonstrated high sensitivity for general abnormality detection (AUROC 0.93-0.986, 84.4-97.1% sensitivity, 88.9-92.4% specificity) and tuberculosis triaging (Shenzhen & Montgomery: 88.5-89.7% sensitivity, 89.9-90.5% specificity; Jaypee: 98.7% sensitivity, 63.6% specificity). For consolidation (AUROC 0.884-0.895, 96.4-96.9% sensitivity, 70.8-77.1% specificity), pleural effusion (AUROC 0.942-0.967, 79.7-99.1% sensitivity, 81.2-87.7% specificity), pneumothorax (AUROC 0.87, 90.6-94.8% sensitivity, 79.5-82.7% specificity) and cardiomegaly (AUROC 0.883, 95.1% sensitivity, 81.6% specificity), the model exhibited commendable accuracy as well. ConclusionsThe diagnostic performance of LIRA was consistent across various pathologies and chest radiographs from diverse geographic locations, with particular strengths in abnormality detection and tuberculosis screening. The risk-stratified triaging and high sensitivity of LIRA make it a reliable adjunct solution to address radiologist shortages, reduce turnaround times, and support Indias tuberculosis elimination goals.

Purpose: Modified Barium Swallow (MBS) studies utilize videofluoroscopy, a dynamic X-ray technique for evaluating swallowing anatomy and physiology. Each MBS exam typically includes multiple bolus trials, often involving different bolus consistencies. Accurate classification of bolus types is essential, as swallowing dynamics, aspiration risks, and residue levels vary with bolus consistency. In this preliminary study, we propose a deep learning-based approach for automated bolus type classification in MBS, aiming to provide a standardized and efficient framework for automated processing of swallowing assessments. Methods: A total of 206 patients (Mean +/- SD age: 60.24 +/- 9.02 years; 89.32% men) underwent MBS examinations, comprising 277 individual MBS studies. The dataset included 2,752 bolus-level video segments, categorized by bolus type as follows: 1,711 liquid (IDDSI 0-3, 62.17%), 521 pudding (IDDSI 4, 18.93%), and 520 solid boluses (IDDSI 7, cookie or cracker, 18.89%). To standardize variable video lengths for the data pipeline, each MBS video was temporally segmented into a fixed-length frame sequence, with shorter videos padded using static frames and longer videos randomly cropped to the target length. We employed an Inflated 3D convolutional neural network to develop the deep learning model. Results: Each video segment contained an average of 273.03 +/- 195.81 frames. On the independent test set, the deep learning model achieved an overall accuracy of 96.13%, and the macro F1-score was 95.05% in classifying food bolus types within MBS videos. Conclusions: The developed AI-based system demonstrated effective automated classification of food bolus types in MBS videos, representing an important step toward fully automated MBS analysis for swallowing efficiency assessment. The AI model reduces the reliance on manual labels, thereby promising to streamline clinical and research workflows.

Vitiligo is an acquired pigmentary disorder of the skin and mucus membranes. Previous study has demonstrated that autologous cultured epithelial grafts (ACEG) is an effective treatment for stable vitiligo. However, extraction of full-thickness skin might result in scar formation at donor site, which have hindered the wider application of this technology, especially for patients requiring large-area transplantation. Hair follicle as a source of keratinocyte and melanocyte, could be potential source of cells for preparation of autologous cultured sheet. Through culture system optimization, we have demonstrated maintenance of undifferentiated hair follicle-derived cells in feeder-independent culture system. After expansion, the hair follicle cells were directed to differentiate into a multi-layered, epidermis-like sheet. Cell identity, viability, purity, genomic stability, and antiseptic testing for hair follicle-derived epithelial sheet (HFES) were evaluated to ensure its safety. Immunofluorescence staining showed that basal keratinocytes were the main cell type of the autologous HFES. Optimization of culture conditions leads to increased melanocyte proliferation and functionality. Transcriptomic analysis confirmed upregulation of melanosome maturation genes. The proportions of cells are also similar to composition of cells under physiological conditions. Transplantation of HFES to depigmented areas in patients with stable vitiligo results in skin repigmentation. This technology provides a novel therapeutic option for vitiligo management.