EMG gesture signal analysis towards diagnosis of upper limb using dual-pathway convolutional neural network.

This research introduces a novel dual-pathway convolutional neural network (DP-CNN) architecture tailored for robust performance in Log-Mel spectrogram image analysis derived from raw multichannel electromyography signals. The primary objective is to assess the effectiveness of the proposed DP-CNN architecture across three datasets (NinaPro DB1, DB2, and DB3), encompassing both able-bodied and amputee subjects. Performance metrics, including accuracy, precision, recall, and F1-score, are employed for comprehensive evaluation. The DP-CNN demonstrates notable mean accuracies of 94.93 ± 1.71% and 94.00 ± 3.65% on NinaPro DB1 and DB2 for healthy subjects, respectively. Additionally, it achieves a robust mean classification accuracy of 85.36 ± 0.82% on amputee subjects in DB3, affirming its efficacy. Comparative analysis with previous methodologies on the same datasets reveals substantial improvements of 28.33%, 26.92%, and 39.09% over the baseline for DB1, DB2, and DB3, respectively. The DP-CNN's superior performance extends to comparisons with transfer learning models for image classification, reaffirming its efficacy. Across diverse datasets involving both able-bodied and amputee subjects, the DP-CNN exhibits enhanced capabilities, holding promise for advancing myoelectric control.

Corrigendum: Analysis of hematological indicators via explainable artificial intelligence in the diagnosis of acute heart failure: a retrospective study.

[This corrects the article DOI: 10.3389/fmed.2024.1285067.].

Gait Impairment Analysis Using Silhouette Sinogram Signals and Assisted Knowledge Learning.

The analysis of body motion is a valuable tool in the assessment and diagnosis of gait impairments, particularly those related to neurological disorders. In this study, we propose a novel automated system leveraging artificial intelligence for efficiently analyzing gait impairment from video-recorded images. The proposed methodology encompasses three key aspects. First, we generate a novel one-dimensional representation of each silhouette image, termed a silhouette sinogram, by computing the distance and angle between the centroid and each detected boundary points. This process enables us to effectively utilize relative variations in motion at different angles to detect gait patterns. Second, a one-dimensional convolutional neural network (1D CNN) model is developed and trained by incorporating the consecutive silhouette sinogram signals of silhouette frames to capture spatiotemporal information via assisted knowledge learning. This process allows the network to capture a broader context and temporal dependencies within the gait cycle, enabling a more accurate diagnosis of gait abnormalities. This study conducts training and an evaluation utilizing the publicly accessible INIT GAIT database. Finally, two evaluation schemes are employed: one leveraging individual silhouette frames and the other operating at the subject level, utilizing a majority voting technique. The outcomes of the proposed method showed superior enhancements in gait impairment recognition, with overall F1-scores of 100%, 90.62%, and 77.32% when evaluated based on sinogram signals, and 100%, 100%, and 83.33% when evaluated based on the subject level, for cases involving two, four, and six gait abnormalities, respectively. In conclusion, by comparing the observed locomotor function to a conventional gait pattern often seen in healthy individuals, the recommended approach allows for a quantitative and non-invasive evaluation of locomotion.

Analysis of hematological indicators via explainable artificial intelligence in the diagnosis of acute heart failure: a retrospective study.

Introduction: Acute heart failure (AHF) is a serious medical problem that necessitates hospitalization and often results in death. Patients hospitalized in the emergency department (ED) should therefore receive an immediate diagnosis and treatment. Unfortunately, there is not yet a fast and accurate laboratory test for identifying AHF. The purpose of this research is to apply the principles of explainable artificial intelligence (XAI) to the analysis of hematological indicators for the diagnosis of AHF. Methods: In this retrospective analysis, 425 patients with AHF and 430 healthy individuals served as assessments. Patients' demographic and hematological information was analyzed to diagnose AHF. Important risk variables for AHF diagnosis were identified using the Least Absolute Shrinkage and Selection Operator (LASSO) feature selection. To test the efficacy of the suggested prediction model, Extreme Gradient Boosting (XGBoost), a 10-fold cross-validation procedure was implemented. The area under the receiver operating characteristic curve (AUC), F1 score, Brier score, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were all computed to evaluate the model's efficacy. Permutation-based analysis and SHAP were used to assess the importance and influence of the model's incorporated risk factors. Results: White blood cell (WBC), monocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), red cell distribution width-standard deviation (RDW-SD), RDW-coefficient of variation (RDW-CV), and platelet distribution width (PDW) values were significantly higher than the healthy group (p < 0.05). On the other hand, erythrocyte, hemoglobin, basophil, lymphocyte, mean platelet volume (MPV), platelet, hematocrit, mean erythrocyte hemoglobin (MCH), and procalcitonin (PCT) values were found to be significantly lower in AHF patients compared to healthy controls (p < 0.05). When XGBoost was used in conjunction with LASSO to diagnose AHF, the resulting model had an AUC of 87.9%, an F1 score of 87.4%, a Brier score of 0.036, and an F1 score of 87.4%. PDW, age, RDW-SD, and PLT were identified as the most crucial risk factors in differentiating AHF. Conclusion: The results of this study showed that XAI combined with ML could successfully diagnose AHF. SHAP descriptions show that advanced age, low platelet count, high RDW-SD, and PDW are the primary hematological parameters for the diagnosis of AHF.

Automated wound care by employing a reliable U-Net architecture combined with ResNet feature encoders for monitoring chronic wounds.

Quality of life is greatly affected by chronic wounds. It requires more intensive care than acute wounds. Schedule follow-up appointments with their doctor to track healing. Good wound treatment promotes healing and fewer problems. Wound care requires precise and reliable wound measurement to optimize patient treatment and outcomes according to evidence-based best practices. Images are used to objectively assess wound state by quantifying key healing parameters. Nevertheless, the robust segmentation of wound images is complex because of the high diversity of wound types and imaging conditions. This study proposes and evaluates a novel hybrid model developed for wound segmentation in medical images. The model combines advanced deep learning techniques with traditional image processing methods to improve the accuracy and reliability of wound segmentation. The main objective is to overcome the limitations of existing segmentation methods (UNet) by leveraging the combined advantages of both paradigms. In our investigation, we introduced a hybrid model architecture, wherein a ResNet34 is utilized as the encoder, and a UNet is employed as the decoder. The combination of ResNet34's deep representation learning and UNet's efficient feature extraction yields notable benefits. The architectural design successfully integrated high-level and low-level features, enabling the generation of segmentation maps with high precision and accuracy. Following the implementation of our model to the actual data, we were able to determine the following values for the Intersection over Union (IOU), Dice score, and accuracy: 0.973, 0.986, and 0.9736, respectively. According to the achieved results, the proposed method is more precise and accurate than the current state-of-the-art.

An Explainable Artificial Intelligence Model Proposed for the Prediction of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the Identification of Distinctive Metabolites.

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex and debilitating illness with a significant global prevalence, affecting over 65 million individuals. It affects various systems, including the immune, neurological, gastrointestinal, and circulatory systems. Studies have shown abnormalities in immune cell types, increased inflammatory cytokines, and brain abnormalities. Further research is needed to identify consistent biomarkers and develop targeted therapies. This study uses explainable artificial intelligence and machine learning techniques to identify discriminative metabolites for ME/CFS. MATERIAL AND METHODS: The model investigates a metabolomics dataset of CFS patients and healthy controls, including 26 healthy controls and 26 ME/CFS patients aged 22-72. The dataset encapsulated 768 metabolites into nine metabolic super-pathways: amino acids, carbohydrates, cofactors, vitamins, energy, lipids, nucleotides, peptides, and xenobiotics. Random forest methods together with other classifiers were applied to the data to classify individuals as ME/CFS patients and healthy individuals. The classification learning algorithms' performance in the validation step was evaluated using a variety of methods, including the traditional hold-out validation method, as well as the more modern cross-validation and bootstrap methods. Explainable artificial intelligence approaches were applied to clinically explain the optimum model's prediction decisions. RESULTS: The metabolomics of C-glycosyltryptophan, oleoylcholine, cortisone, and 3-hydroxydecanoate were determined to be crucial for ME/CFS diagnosis. The random forest model outperformed the other classifiers in ME/CFS prediction using the 1000-iteration bootstrapping method, achieving 98% accuracy, precision, recall, F1 score, 0.01 Brier score, and 99% AUC. According to the obtained results, the bootstrap validation approach demonstrated the highest classification outcomes. CONCLUSION: The proposed model accurately classifies ME/CFS patients based on the selected biomarker candidate metabolites. It offers a clear interpretation of risk estimation for ME/CFS, aiding physicians in comprehending the significance of key metabolomic features within the model.

Exposure time as an influencing factor among rheumatoid arthritis patients subjected to traditional Siwan therapy.

Rheumatoid arthritis (RA) is a long-term autoimmune disease characterized by intra- and extra-articular manifestations. Sand therapy is traditionally indicated for RA, chronic pain, skin diseases, and musculoskeletal disorders. Many places in the world use sand therapy, including Siwa, which is a famous place in Egypt. This study investigated the exposure time to Siwan traditional therapy as a factor influencing central sensitization, pain severity, pain threshold, and kinesiophobia in RA by measuring the central sensory inventory (CSI), visual analogue scale, pressure algometer, and TAMPA kinesiophobia scale, respectively. Twenty-four patients with RA were recruited from 6 traditional healing centers, 24 RA patients were recruited and randomly assigned to 2 equal groups (GI and GII). The first received Siwan traditional therapy for 3 days, while the second received the same program for 5 days. The results revealed a significant difference in CSI between pre- and posttreatment within the GII (P = .038). The Tampa Scale score improved significantly in both groups (P = .004 and P = .014, respectively). Pain severity and pain threshold at all sites showed significant posttreatment improvements in the GII. Significant posttreatment changes were only found for GI in terms of pain severity and the most painful joint (P = .010 and P = .035, respectively). Significant changes were observed in kinesiophobia, pain severity, and pain threshold in the most painful joint 3 and 5 days after Siwan traditional therapy. Despite the nonsignificant differences in all parameters between the 2 groups, all the measured parameters produced favorable results after 5 days of treatment, suggesting the need for a long-term effect investigation.

Liver Cancer Algorithm: A novel bio-inspired optimizer.

This paper introduces a new bio-inspired optimization algorithm named the Liver Cancer Algorithm (LCA), which mimics the liver tumor growth and takeover process. It uses an evolutionary search approach that simulates the behavior of liver tumors when taking over the liver organ. The tumor's ability to replicate and spread to other organs inspires the algorithm. LCA algorithm is developed using genetic operators and a Random Opposition-Based Learning (ROBL) strategy to efficiently balance local and global searches and explore the search space. The algorithm's efficiency is tested on the IEEE Congress of Evolutionary Computation in 2020 (CEC'2020) benchmark functions and compared to seven widely used metaheuristic algorithms, including Genetic Algorithm (GA), particle swarm optimization (PSO), Differential Evolution (DE), Adaptive Guided Differential Evolution Algorithm (AGDE), Improved Multi-Operator Differential Evolution (IMODE), Harris Hawks Optimization (HHO), Runge-Kutta Optimization Algorithm (RUN), weIghted meaN oF vectOrs (INFO), and Coronavirus Herd Immunity Optimizer (CHIO). The statistical results of the convergence curve, boxplot, parameter space, and qualitative metrics show that the LCA algorithm performs competitively compared to well-known algorithms. Moreover, the versatility of the LCA algorithm extends beyond mathematical benchmark problems. It was also successfully applied to tackle the feature selection problem and optimize the support vector machine for various biomedical data classifications, resulting in the creation of the LCA-SVM model. The LCA-SVM model was evaluated in a total of twelve datasets, among which the MonoAmine Oxidase (MAO) dataset stood out, showing the highest performance compared to the other datasets. In particular, the LCA-SVM model achieved an impressive accuracy of 98.704% on the MAO dataset. This outstanding result demonstrates the efficacy and potential of the LCA-SVM approach in handling complex datasets and producing highly accurate predictions. The experimental results indicate that the LCA algorithm surpasses other methods to solve mathematical benchmark problems and feature selection.

Using deep DenseNet with cyclical learning rate to classify leukocytes for leukemia identification.

Background: The examination, counting, and classification of white blood cells (WBCs), also known as leukocytes, are essential processes in the diagnosis of many disorders, including leukemia, a kind of blood cancer characterized by the uncontrolled proliferation of carcinogenic leukocytes in the marrow of the bone. Blood smears can be chemically or microscopically studied to better understand hematological diseases and blood disorders. Detecting, identifying, and categorizing the many blood cell types are essential for disease diagnosis and therapy planning. A theoretical and practical issue. However, methods based on deep learning (DL) have greatly helped blood cell classification. Materials and Methods: Images of blood cells in a microscopic smear were collected from GitHub, a public source that uses the MIT license. An end-to-end computer-aided diagnosis (CAD) system for leukocytes has been created and implemented as part of this study. The introduced system comprises image preprocessing and enhancement, image segmentation, feature extraction and selection, and WBC classification. By combining the DenseNet-161 and the cyclical learning rate (CLR), we contribute an approach that speeds up hyperparameter optimization. We also offer the one-cycle technique to rapidly optimize all hyperparameters of DL models to boost training performance. Results: The dataset has been split into two sets: approximately 80% of the data (9,966 images) for the training set and 20% (2,487 images) for the validation set. The validation set has 623, 620, 620, and 624 eosinophil, lymphocyte, monocyte, and neutrophil images, whereas the training set has 2,497, 2,483, 2,487, and 2,499, respectively. The suggested method has 100% accuracy on the training set of images and 99.8% accuracy on the testing set. Conclusion: Using a combination of the recently developed pretrained convolutional neural network (CNN), DenseNet, and the one fit cycle policy, this study describes a technique of training for the classification of WBCs for leukemia detection. The proposed method is more accurate compared to the state of the art.

Combining docking, molecular dynamics simulations, AD-MET pharmacokinetics properties, and MMGBSA calculations to create specialized protocols for running effective virtual screening campaigns on the autoimmune disorder and SARS-CoV-2 main protease.

The development of novel medicines to treat autoimmune diseases and SARS-CoV-2 main protease (Mpro), a virus that can cause both acute and chronic illnesses, is an ongoing necessity for the global community. The primary objective of this research is to use CoMFA methods to evaluate the quantitative structure-activity relationship (QSAR) of a select group of chemicals concerning autoimmune illnesses. By performing a molecular docking analysis, we may verify previously observed tendencies and gain insight into how receptors and ligands interact. The results of the 3D QSAR models are quite satisfactory and give significant statistical results: Q_loo∧2 = 0.5548, Q_lto∧2 = 0.5278, R∧2 = 0.9990, F-test = 3,101.141, SDEC = 0.017 for the CoMFA FFDSEL, and Q_loo∧2 = 0.7033, Q_lto∧2 = 0.6827, Q_lmo∧2 = 0.6305, R∧2 = 0.9984, F-test = 1994.0374, SDEC = 0.0216 for CoMFA UVEPLS. The success of these two models in exceeding the external validation criteria used and adhering to the Tropsha and Glorbaikh criteria's upper and lower bounds can be noted. We report the docking simulation of the compounds as an inhibitor of the SARS-CoV-2 Mpro and an autoimmune disorder in this context. For a few chosen autoimmune disorder receptors (protein tyrosine phosphatase, nonreceptor type 22 (lymphoid) isoform 1 (PTPN22), type 1 diabetes, rheumatoid arthritis, and SARS-CoV-2 Mpro, the optimal binding characteristics of the compounds were described. According to their potential for effectiveness, the studied compounds were ranked, and those that demonstrated higher molecular docking scores than the reference drugs were suggested as potential new drug candidates for the treatment of autoimmune disease and SARS-CoV-2 Mpro. Additionally, the results of analyses of drug similarity, ADME (Absorption, Distribution, Metabolism, and Excretion), and toxicity were used to screen the best-docked compounds in which compound 4 scaled through. Finally, molecular dynamics (MD) simulation was used to verify compound 4's stability in the complex with the chosen autoimmune diseases and SARS-CoV-2 Mpro protein. This compound showed a steady trajectory and molecular characteristics with a predictable pattern of interactions. These findings suggest that compound 4 may hold potential as a therapy for autoimmune diseases and SARS-CoV-2 Mpro.

Dynamic Coati Optimization Algorithm for Biomedical Classification Tasks.

Medical datasets are primarily made up of numerous pointless and redundant elements in a collection of patient records. None of these characteristics are necessary for a medical decision-making process. Conversely, a large amount of data leads to increased dimensionality and decreased classifier performance in terms of machine learning. Numerous approaches have recently been put out to address this issue, and the results indicate that feature selection can be a successful remedy. To meet the various needs of input patterns, medical diagnostic tasks typically involve learning a suitable categorization model. The k-Nearest Neighbors algorithm (kNN) classifier's classification performance is typically decreased by the input variables' abundance of irrelevant features. To simplify the kNN classifier, essential attributes of the input variables have been searched using the feature selection approach. This paper presents the Coati Optimization Algorithm (DCOA) in a dynamic form as a feature selection technique where each iteration of the optimization process involves the introduction of a different feature. We enhance the exploration and exploitation capability of DCOA by employing dynamic opposing candidate solutions. The most impressive feature of DCOA is that it does not require any preparatory parameter fine-tuning to the most popular metaheuristic algorithms. The CEC'22 test suite and nine medical datasets with various dimension sizes were used to evaluate the performance of the original COA and the proposed dynamic version. The statistical results were validated using the Bonferroni-Dunn test and Kendall's W test and showed the superiority of DCOA over seven well-known metaheuristic algorithms with an overall accuracy of 89.7%, a feature selection of 24%, a sensitivity of 93.35% a specificity of 96.81%, and a precision of 93.90%.

Clinical Decision Support Framework for Segmentation and Classification of Brain Tumor MRIs Using a U-Net and DCNN Cascaded Learning Algorithm.

Brain tumors (BTs) are an uncommon but fatal kind of cancer. Therefore, the development of computer-aided diagnosis (CAD) systems for classifying brain tumors in magnetic resonance imaging (MRI) has been the subject of many research papers so far. However, research in this sector is still in its early stage. The ultimate goal of this research is to develop a lightweight effective implementation of the U-Net deep network for use in performing exact real-time segmentation. Moreover, a simplified deep convolutional neural network (DCNN) architecture for the BT classification is presented for automatic feature extraction and classification of the segmented regions of interest (ROIs). Five convolutional layers, rectified linear unit, normalization, and max-pooling layers make up the DCNN's proposed simplified architecture. The introduced method was verified on multimodal brain tumor segmentation (BRATS 2015) datasets. Our experimental results on BRATS 2015 acquired Dice similarity coefficient (DSC) scores, sensitivity, and classification accuracy of 88.8%, 89.4%, and 88.6% for high-grade gliomas. When it comes to segmenting BRATS 2015 BT images, the performance of our proposed CAD framework is on par with existing state-of-the-art methods. However, the accuracy achieved in this study for the classification of BT images has improved upon the accuracy reported in prior studies. Image classification accuracy for BRATS 2015 BT has been improved from 88% to 88.6%.

RNN and BiLSTM Fusion for Accurate Automatic Epileptic Seizure Diagnosis Using EEG Signals.

Epilepsy is a common neurological condition. The effects of epilepsy are not restricted to seizures alone. They comprise a wide spectrum of problems that might impair and reduce quality of life. Even with medication, 30% of epilepsy patients still have recurring seizures. An epileptic seizure is caused by significant neuronal electrical activity, which affects brain activity. EEG shows these changes as high-amplitude spiky and sluggish waves. Recognizing seizures on an electroencephalogram (EEG) manually by a professional neurologist is a time-consuming and labor-intensive process, hence an efficient automated approach is necessary for the identification of epileptic seizure. One technique to increase the speed and accuracy with which a diagnosis of epileptic seizures could be made is by utilizing computer-aided diagnosis systems that are built on deep neural networks, or DNN. This study introduces a fusion of recurrent neural networks (RNNs) and bi-directional long short-term memories (BiLSTMs) for automatic epileptic seizure identification via EEG signal processing in order to tackle the aforementioned informational challenges. An electroencephalogram's (EEG) raw data were first normalized after undergoing pre-processing. A RNN model was fed the normalized EEG sequence data and trained to accurately extract features from the data. Afterwards, the features were passed to the BiLSTM layers for processing so that further temporal information could be retrieved. In addition, the proposed RNN-BiLSTM model was tested in an experimental setting using the freely accessible UCI epileptic seizure dataset. Experimental findings of the suggested model have achieved avg values of 98.90%, 98.50%, 98. 20%, and 98.60%, respectively, for accuracy, sensitivity, precision, and specificity. To further verify the new model's efficacy, it is compared to other models, such as the RNN-LSTM and the RNN-GRU learning models, and is shown to have improved the same metrics by 1.8%, 1.69%, 1.95%, and 2.2% on using 5-fold. Additionally, the proposed method was compared to state-of-the-art approaches and proved to be a more accurate categorization of such techniques.

A Hybrid Workflow of Residual Convolutional Transformer Encoder for Breast Cancer Classification Using Digital X-ray Mammograms.

Breast cancer, which attacks the glandular epithelium of the breast, is the second most common kind of cancer in women after lung cancer, and it affects a significant number of people worldwide. Based on the advantages of Residual Convolutional Network and the Transformer Encoder with Multiple Layer Perceptron (MLP), this study proposes a novel hybrid deep learning Computer-Aided Diagnosis (CAD) system for breast lesions. While the backbone residual deep learning network is employed to create the deep features, the transformer is utilized to classify breast cancer according to the self-attention mechanism. The proposed CAD system has the capability to recognize breast cancer in two scenarios: Scenario A (Binary classification) and Scenario B (Multi-classification). Data collection and preprocessing, patch image creation and splitting, and artificial intelligence-based breast lesion identification are all components of the execution framework that are applied consistently across both cases. The effectiveness of the proposed AI model is compared against three separate deep learning models: a custom CNN, the VGG16, and the ResNet50. Two datasets, CBIS-DDSM and DDSM, are utilized to construct and test the proposed CAD system. Five-fold cross validation of the test data is used to evaluate the accuracy of the performance results. The suggested hybrid CAD system achieves encouraging evaluation results, with overall accuracies of 100% and 95.80% for binary and multiclass prediction challenges, respectively. The experimental results reveal that the proposed hybrid AI model could identify benign and malignant breast tissues significantly, which is important for radiologists to recommend further investigation of abnormal mammograms and provide the optimal treatment plan.

BCNet: A Deep Learning Computer-Aided Diagnosis Framework for Human Peripheral Blood Cell Identification.

Blood cells carry important information that can be used to represent a person's current state of health. The identification of different types of blood cells in a timely and precise manner is essential to cutting the infection risks that people face on a daily basis. The BCNet is an artificial intelligence (AI)-based deep learning (DL) framework that was proposed based on the capability of transfer learning with a convolutional neural network to rapidly and automatically identify the blood cells in an eight-class identification scenario: Basophil, Eosinophil, Erythroblast, Immature Granulocytes, Lymphocyte, Monocyte, Neutrophil, and Platelet. For the purpose of establishing the dependability and viability of BCNet, exhaustive experiments consisting of five-fold cross-validation tests are carried out. Using the transfer learning strategy, we conducted in-depth comprehensive experiments on the proposed BCNet's architecture and test it with three optimizers of ADAM, RMSprop (RMSP), and stochastic gradient descent (SGD). Meanwhile, the performance of the proposed BCNet is directly compared using the same dataset with the state-of-the-art deep learning models of DensNet, ResNet, Inception, and MobileNet. When employing the different optimizers, the BCNet framework demonstrated better classification performance with ADAM and RMSP optimizers. The best evaluation performance was achieved using the RMSP optimizer in terms of 98.51% accuracy and 96.24% F1-score. Compared with the baseline model, the BCNet clearly improved the prediction accuracy performance 1.94%, 3.33%, and 1.65% using the optimizers of ADAM, RMSP, and SGD, respectively. The proposed BCNet model outperformed the AI models of DenseNet, ResNet, Inception, and MobileNet in terms of the testing time of a single blood cell image by 10.98, 4.26, 2.03, and 0.21 msec. In comparison to the most recent deep learning models, the BCNet model could be able to generate encouraging outcomes. It is essential for the advancement of healthcare facilities to have such a recognition rate improving the detection performance of the blood cells.

Effect of compressive therapy on sensorimotor function of the more affected upper extremity in chronic stroke patients: A randomized clinical trial.

BACKGROUND: Common upper extremity (UE) physical impairments after stroke include paresis, abnormal muscle tone, and somatosensory affection. This study evaluated the effect of passive somatosensory stimulation using compressive therapy on sensorimotor function of the more affected UE in chronic stroke patients. METHODS: Forty chronic stroke patients were enrolled in this study. They were randomized into 2 groups: Gr1 and Gr2. Three patients dropped out leaving us with a total of 37 patients completing the study. Gr1 received UE motor program for the more affected UE along with sham electrical stimulation while Gr2 had the same UE motor program along with passive somatosensory stimulation. The session duration in both groups was 85 min. Gr1 and Gr2 received a total of 36 sessions for 6 successive weeks. UE function in Gr1 and Gr2 was examined, before and after treatment using Box and Block test (BBT) and Perdue Pegboard test (PPBT) as measures of motor of both the more affected and less affected UE while the Nottingham sensory assessment (NSA) scale was used as a measure of sensory function of the more affected UE. RESULTS: There were significant improvements in motor and sensory function of the more affected UE compared to the less affected UE in both groups, measured by the BBT, PPBT, and NSA scales post-treatment (P < .05). However, the comparison between both groups regarding improvement revealed no significant change (P > .05). CONCLUSION: Upper extremity motor and passive somatosensory stimulation techniques are effective in improving sensorimotor function of the more affected UE, but none of them had the advantage over the other, in terms of improving motor and sensory function in chronic stroke patients.

Classification Framework for Medical Diagnosis of Brain Tumor with an Effective Hybrid Transfer Learning Model.

Brain tumors (BTs) are deadly diseases that can strike people of every age, all over the world. Every year, thousands of people die of brain tumors. Brain-related diagnoses require caution, and even the smallest error in diagnosis can have negative repercussions. Medical errors in brain tumor diagnosis are common and frequently result in higher patient mortality rates. Magnetic resonance imaging (MRI) is widely used for tumor evaluation and detection. However, MRI generates large amounts of data, making manual segmentation difficult and laborious work, limiting the use of accurate measurements in clinical practice. As a result, automated and dependable segmentation methods are required. Automatic segmentation and early detection of brain tumors are difficult tasks in computer vision due to their high spatial and structural variability. Therefore, early diagnosis or detection and treatment are critical. Various traditional Machine learning (ML) techniques have been used to detect various types of brain tumors. The main issue with these models is that the features were manually extracted. To address the aforementioned insightful issues, this paper presents a hybrid deep transfer learning (GN-AlexNet) model of BT tri-classification (pituitary, meningioma, and glioma). The proposed model combines GoogleNet architecture with the AlexNet model by removing the five layers of GoogleNet and adding ten layers of the AlexNet model, which extracts features and classifies them automatically. On the same CE-MRI dataset, the proposed model was compared to transfer learning techniques (VGG-16, AlexNet, SqeezNet, ResNet, and MobileNet-V2) and ML/DL. The proposed model outperformed the current methods in terms of accuracy and sensitivity (accuracy of 99.51% and sensitivity of 98.90%).

A Healthcare Paradigm for Deriving Knowledge Using Online Consumers' Feedback.

Home healthcare agencies (HHCAs) provide clinical care and rehabilitation services to patients in their own homes. The organization's rules regulate several connected practitioners, doctors, and licensed skilled nurses. Frequently, it monitors a physician or licensed nurse for the facilities and keeps track of the health histories of all clients. HHCAs' quality of care is evaluated using Medicare's star ratings for in-home healthcare agencies. The advent of technology has extensively evolved our living style. Online businesses' ratings and reviews are the best representatives of organizations' trust, services, quality, and ethics. Using data mining techniques to analyze HHCAs' data can help to develop an effective framework for evaluating the finest home healthcare facilities. As a result, we developed an automated predictive framework for obtaining knowledge from patients' feedback using a combination of statistical and machine learning techniques. HHCAs' data contain twelve performance characteristics that we are the first to analyze and depict. After adequate pattern recognition, we applied binary and multi-class approaches on similar data with variations in the target class. Four prominent machine learning models were considered: SVM, Decision Tree, Random Forest, and Deep Neural Networks. In the binary class, the Deep Neural Network model presented promising performance with an accuracy of 97.37%. However, in the case of multiple class, the random forest model showed a significant outcome with an accuracy of 91.87%. Additionally, variable significance is derived from investigating each attribute's importance in predictive model building. The implications of this study can support various stakeholders, including public agencies, quality measurement, healthcare inspectors, and HHCAs, to boost their performance. Thus, the proposed framework is not only useful for putting valuable insights into action, but it can also help with decision-making.

Efficacy of Siwan Traditional Therapy on Erythrocyte Sedimentation Rate, Lipid Profile, and Atherogenic Index as Cardiac Risk Factors Related to Rheumatoid Arthritis.

Background and Objectives: The most frequent cause of mortality in rheumatoid arthritis (RA) patients is cardiovascular disease (CVD). Inflammation, dyslipidemia, and decreased physical activity are some of the main risk factors for CVD. Siwan sand therapy is a type of traditional therapy used in Egypt to treat RA. The approach of this therapy depends on the experience of the healers. The aim of the current study was to compare the effects of three sessions of Siwan traditional therapy to five sessions on common CVD risk factors and physical function in rheumatoid arthritis patients. Materials and Methods: Thirty patients (9 male and 21 female) were assigned into two groups of equal size: group (A) received three sessions of Siwan traditional therapy in the form of a sand bath. Group (B) received the same form of therapy for five days. Erythrocyte sedimentation rate (ESR), lipid profile, atherogenic index of plasma (AIP), and a health assessment questionnaire (HAQ) were measured before and after treatment. Results: There was a significant increase above normal within group (A) for ESR (p = 0.001), triglycerides (TG; p = 0.015), total cholesterol (Tot-Chol; p = 0.0001), and low-density lipoprotein (LDL; p = 0.0001). However, there were no considerable differences in high-density lipoprotein (HDL; p = 0.106), very low-density lipoprotein (VLDL; p = 0.213), AIP (p = 0.648), and HAQ (p = 0.875). For the second group, there were significant changes within group B only in Tot-Chol (p = 0.0001), HDL (p = 0.0001), VLDL (p = 0.0001), AIP (p = 0.008), and HAQ (p = 0.014). There was a significant difference between both groups regarding HDL (p = 0.027), LDL (p = 0.005), AIP (p = 0.029), ESR (p = 0.016), and HAQ (p = 0.036). Conclusions: For RA patients, five days of Siwan traditional therapy caused significant changes regarding inflammation, Tot-Chol, LDL, HDL, AIP, and functional activity when compared to three days of Siwan hot sand therapy.

Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial.

Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the treatment program. Outcome measures used were the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the box and block test (BBT) as measures of the motor function of the affected UE. Brain activity of the motor area (C3) in the ipsilesional hemisphere was measured using a quantitative electroencephalogram (QEEG). The measured parameter was peak frequency. It was noted that the motor function of the affected UE improved significantly post-treatment in both groups, while no significant change was reported in the FMA-UE and BBT scores post-treatment in either G1 or G2. On the other hand, the activity of the motor area C3 improved significantly in G2 only, post-treatment, while G1 showed no significant improvement. There was also significant improvement in the activity of the motor area (C3) in G2 compared to G1 post-treatment. The results of the current study indicate that TST only or combined with TENS acupoints can be considered an effective method for improving motor function of the affected UE in chronic stroke patients, both being equally effective. However, TST combined with TENS acupoints proved better in improving brain plasticity in chronic stroke patients.