Using Fuzzy Mathematical Model in the Differential Diagnosis of Pancreatic Lesions Using Ultrasonography and Echographic Texture Analysis.

Malignant tumors of the pancreas are the fourth leading cause of cancer-related deaths. This is mainly because they are often diagnosed at a late stage. One of the challenges in diagnosing focal lesions in the pancreas is the difficulty in distinguishing them from other conditions due to the unique location and anatomy of the organ, as well as the similarity in their ultrasound characteristics. One of the most sensitive imaging modalities of the pancreas is endoscopic ultrasonography. However, clinicians recognize that EUS is a difficult and highly operator-dependent method, while its results are highly dependent on the experience of the investigator. Hybrid technologies based on artificial intelligence methods can improve the accuracy and objectify the results of endosonographic diagnostics. Endoscopic ultrasonography was performed on 272 patients with focal lesions of the pancreatobiliary zone, who had been treated in the surgical section of the Kursk Regional Clinical Hospital in 2014-2023. The study utilized an Olympus EVIS EXERA II video information endoscopic system, along with an EU-ME1 ultrasound unit equipped with GF UM160 and GF UC140P-AL5 echo endoscopes. Out of the focal formations in the pancreatobiliary zone, pancreatic cancer was detected in 109 patients, accounting for 40.1% of the cases. Additionally, 40 patients (14.7%) were diagnosed with local forms of chronic pancreatitis. The reference sonograms displayed distinguishable focal pancreatic pathologies, leading to the development of hybrid fuzzy mathematical decision-making rules at the South-West State University in Kursk, Russian Federation. This research resulted in the creation of a fuzzy hybrid model for the differential diagnosis of chronic focal pancreatitis and pancreatic cancer. Endoscopic ultrasonography, combined with hybrid fuzzy logic methodology, has made it possible to create a model for differentiating between chronic focal pancreatitis and pancreatic ductal adenocarcinoma. Statistical testing on control samples has shown that the diagnostic model, based on reference endosonograms of the echographic texture of pancreatic focal pathology, has a confidence level of 0.6 for the desired diagnosis. By incorporating additional information about the contours of focal formations obtained through endosonography, the reliability of the diagnosis can be increased to 0.9. This level of reliability is considered acceptable in clinical practice and allows for the use of the developed model, even with data that is not well-structured.

Differential Diagnosis of Pancreatic Cancer and Chronic Pancreatitis According to Endoscopic Ultrasonography Based on the Analysis of the Nature of the Contours of Focal Formations Based on Fuzzy Mathematical Models.

One of the key echographic signs of focal pathology of the pancreas is the presence of formation contours and their nature. Endoscopic ultrasonography has a unique ability to visualize the echographic texture of the pancreatic parenchyma, and also allows you to assess in detail the boundaries and nature of the contours of the tumor formations of the organ due to the proximity of the ultrasound sensor. However, the differential diagnosis of focal pancreatic lesions remains a difficult clinical task due to the similarity of their echosemiotics. One of the ways to objectify and improve the accuracy of ultrasound data is the use of artificial intelligence methods for interpreting images. Improving the quality of differential diagnosis of focal pathology of the pancreas according to endoscopic ultrasonography based on the analysis of the nature of the contours of focal formations using fuzzy mathematical models.

Method for Determining the Body's Level of Protection According to Oxidant Status in Assessing the Influence of Industrial Risk Factors on Health.

This work aims at improving the quality of health assessments, specifically under the influence of occupational risk factors. For this purpose, additional informative indicators are utilized in prognostic and diagnostic models. The models are used to characterize the level of body protection based on oxidative status. A quantitative method is proposed to assess the body's level of protection by means of the levels of lipid peroxidation and antioxidant activity, which characterize the body's oxidative status. A mechanism is developed for integrating the proposed method into prognostic and diagnostic decision rules. The developed rules are in the form of mathematical models used to synthesize hybrid fuzzy decision rules, which are then used to quantify the level of body protection (LBP) against external risk factors, based on the use of protection level functions in terms of lipid peroxidation and antioxidant activity. A mechanism for embedding LBP into predictive and diagnostic decision rules has been proposed. The proposed method is used to predict the occurrence and development of coronary heart disease in railroad locomotive drivers. It was found that to improve the predicting and diagnosing of diseases caused by external pathogenic factors, quantitative assessments of LBP, determined by oxidative status, can be implemented. It has been established that the use of the protection level indicator in predictive decision rules makes it possible to increase the efficiency of the prediction while simultaneously increasing its accuracy.

Development of a Fuzzy Diagnostic Model of Ischemic Disease of the Lower Limbs for Different Stages of Patient Management.

Ischemic disease has severe impact on patients which makes accurate diagnosis vital for health protection. Improving the quality of prediction of patients with ischemic extremity disease by using hybrid fuzzy model allows for early and accurate prognosis of the development of the disease at various stages. The prediction of critical ischemia of lower extremity (CLI) at various disease stages is complex problem due to inter-related factors. We developed hybrid fuzzy decision rules to classify ischemic severity using clinical thinking (natural intelligence) with artificial intelligence, which allows achieving a new quality in solving complex systemic problems and is innovative. In this study mathematical model was developed to classify the risk level of CLI into: subcritical ischemia, favorable outcome, questionable outcome, and unfavorable outcome. The prognosis is made using such complex indicators as confidence that the patient will develop gangrene of the lower extremity (unfavorable outcome), complex coefficient of variability, and reversibility of the ischemic process. Model accuracy was calculated using representative control samples that showed high diagnostic accuracy and specificity characterizing the quality of prediction are 0.9 and higher, which makes it possible to recommend their use in medical practice.

Fuzzy Models of Choice of Prevention Schemes for the Occurrence and Development of Gangrene of the Lower Extremities.

The study focuses on the choice of prevention schemes of the appearance and recurrence of gangrene of the lower extremities, depending on any of the degrees of confidence that the patient will have gangrene or will experience its relapse. The degree of confidence is determined using the fuzzy logic of decision making on the relevant membership functions. For each of the selected classes, an appropriate prevention scheme has been developed, the effectiveness of which was tested using the theory of measuring latent variables and the synthesis of mathematical models of their choice depending on the degree of risk of the occurrence and recurrence of lower extremities gangrene. Model statistical tests showed that compared with traditional prevention schemes the use of the proposed models can increase the rate of positive results in the absence of lower extremities gangrene and reduce the possibility of relapse (recurrent changes by 42%, risk of amputation by 35%).