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Automatic detection of gait events: a case study using inductive learning techniques.

One of the problems which occurs in the development of a control system for functional electrical stimulation of the lower limbs is to detect accurately specific events within the gait cycle. We present a method for the classification of phases of the gait cycle using the artificial intelligence technique of inductive learning. Both the terminology of inductive learning and the algorithm used for the analyses are fully explained. Given a set of examples of sensor data from the gait events that are to be detected, the inductive learning algorithm is able to produce a decision tree (or set of rules) which classify the data using a minimum number of sensors. The nature of the redundancy of the sensor set is examined by progressively removing combinations of sensors and noting the effect on both the size of the decision trees produced and their classification accuracy on 'unseen' testing data. Since the algorithm is able to calculate which sensors are more important (informative), comparisons with the intuitive appreciation of sensor importance of five researchers in the fields were made, revealing that those sensors which appear intuitively most informative may, in fact, provide the least information. Comparison results with the standard statistical classification technique of linear discriminant analysis are also presented, showing the relative simplicity of the inductively derived rules together with their good classification accuracy. In addition to the control of FES, such techniques are also applicable to automatic gait analysis and the construction of expert systems for diagnosis of gait pathologies.

Algorithms↗

Looking to the Future: How Will Personalised Medicine Impact Facial Plastic Surgery.

AIMS AND BACKGROUNDS: The objectives of this study are to examine the emerging role of personalized medicine in facial plastic surgery and to consider how biologically, anatomically, and psychologically tailored approaches may refine both aesthetic and reconstructive care. HISTORICAL ASPECTS: Facial plastic surgery has traditionally relied on anatomical principles, surgical expertise, and population-based evidence. Personalized medicine represents a shift toward more individualized care by incorporating patient-specific biological and phenotypic variation into clinical decision-making. ANATOMY: Facial plastic surgery is uniquely dependent on subtle anatomical variation, soft tissue characteristics, wound healing behavior, and age-related change. These factors differ considerably between individuals and have a direct impact on both surgical planning and outcomes. TECHNOLOGY: Advances in genomics, pharmacogenomics, artificial intelligence, tissue engineering, and three-dimensional modelling are expanding the scope of personalized care. These technologies may improve prediction of healing, treatment response, complication risk, and reconstructive requirements. PATIENT SELECTION: Personalized medicine may support more accurate patient selection by identifying those at increased risk of adverse scarring, variable response to injectables or pharmacotherapy, or differential reconstructive needs, thereby improving counselling and expectation management. TECHNIQUES: Potential applications include tailored incision planning, individualized facial rejuvenation strategies, personalized perioperative pharmacological regimens, and patient-specific reconstructive scaffolds, grafts, and implants. POSTOPERATIVE CARE: Postoperative management may also become more individualized through better prediction of inflammatory response, scar formation, analgesic requirements, and recovery trajectory, allowing more precise surveillance and adjunctive treatment. CURRENT AND FUTURE DEVELOPMENT: Although many applications remain investigational, continued progress in regenerative medicine, molecular profiling, and predictive analytics is likely to accelerate clinical translation. Ethical challenges relating to privacy, bias, and equitable access must, however, remain central. CONCLUSION AND CLINICAL RELEVANCE: Personalized medicine has the potential to enhance precision, safety, and patient-centered care in facial plastic surgery. Its future value will depend on thoughtful integration into practice as an adjunct to, rather than a replacement for, surgical judgement and aesthetic insight.

Journal Article↗

The evolution of medical technology: lessons from the Burgess Shale.

Many forthcoming medical advances-growth factors, tissue engineering, gene therapy, attachable prosthetic limbs, and implantable computers--are so new that as yet there is no clinical experience with them. Each therapeutic technique will evolve in an environment containing few guideposts to help judge its efficacy and safety. Recent developments in evolution theory (based on an analysis of Cambrian fossils in Canada's Burgess Shale quarry) suggest that evolution passes, at times, through innovative cycles of progress--when diversification of design leads to perfection of form--with the concomitant production of many unsuccessful models. The evolution of the total knee replacement is a perfect example of the process, because many of the early devices have proven to be dismal failures. However, modern knee replacements would not have been developed without them. Because the risk of unforeseen complications associated with new medical products cannot be discerned in advance, each patient-consumer should have the opportunity to intelligently weigh an innovative product's risk potential against its possible benefit. The proposal made here, for a temporary New Product status for new drugs and devices after a product is cleared by the Food and Drug Administration for general marketing, provides a mechanism for making such decisions.

Humans↗

[Developments in vaccines for prophylactic use (author's transl)].

The epidemiologic background on which the efficacy of vaccines has to be considered shows that the mortality of infectious diseases in the first seventy years of our century was reduced to an extent which goes far beyond all other diseases. This trend is similar in all countries of comparable status of zivilization. Trends in morbidity may be different, but no sufficient documentation is available for morbidity of infectious diseases in this country. Developments of new vaccines for industrialized countries will show a change compared with the present vaccines. After introduction of vaccines against the big killers until 1950 disabling diseases were the more recent target of immunoprophylaxis such as poliomyelitis, measles, rubella, mumps. Vaccine efficiency was greatly increased by vaccination campaigns for which strategies and tactics were developed in an almost military fashion. Analysis of the future vaccines reveals a further change not only by additional antigens but by new target groups of the population to be protected. Not only will more vaccines be developed for adults but also for certain risk groups. More knowledge of immune-defence mechanisms in such groups will be needed for the final success of such vaccines. Moreover immunoprophylaxis may even enable immunotherapy in future. The most dramatic effect of immunoprophylaxis is to be expected in the coming decades in the non-industrialized world. This will be effectuated not by the newer vaccines, but by products which we know already. It is the decision of WHO to include an "Expanded program of vaccination" into their help for developing countries. Here new technologies are under investigation which will procure a new round in vaccination tactics. Vaccination is planned by WHO not only to help to develop countries but to play a decisive role in the problem of over-population. Such expectations are based on the fact that in the industrialized world the birthrate fell while the infant survival rates rose. Vaccination then would be more than immunoprophylaxis; vaccination would have a place then among man's many intelligent answers to mankind's many natural problems.

Adolescent↗

The use of knowledge-based systems in medicine in developing countries: a luxury or a necessity?

Knowledge-based systems (KBSs) in medicine have received much attention over the past two decades, mainly because of the potential benefits that can be gained from using them. They may facilitate in increasing productivity in a medical environment, support the making of diagnoses and other types of medical decisions, assist in the training of medical professionals, and can even handle some routine tasks in a medical environment. However, some critical problems in this field have also been identified. For example, research indicated that some problems can be solved partially, but not completely, with existing artificial intelligence techniques. Another problem is that many of the existing medical information systems do not support the integration of KBSs in a natural way. Furthermore, the routine use of a medical KBS is complicated by legal issues. These and other problems contribute to what we experience today: a large proportion of the medical KB applications that are developed is never actually used in practice. This justifies questions such as: Should developing countries, having limited infrastructure and research resources, invest in medical KBSs research and development, or should this field be regarded as a luxury that only belongs to developed countries?, and: Can developing countries really benefit from the use of these systems? These questions are discussed in this paper. We highlight the main problems surrounding the development and use of medical KBSs. With the focus on developing countries we discuss potential benefits that could be obtained by investing in these systems and we offer guidelines for focusing research and development of medical KBSs.

Artificial Intelligence↗

The future of pediatric vesicoureteral reflux management.

BACKGROUND AND OBJECTIVE: Vesicoureteral reflux (VUR) is a common condition in pediatric urology, yet important uncertainties persist regarding risk stratification, imaging strategies, and prevention of long-term renal damage. Emerging technologies may help address these challenges. This review provides a forward-looking overview of recent advances in artificial intelligence (AI) and immunomodulation that may influence future management of pediatric VUR. METHODS: A forward-looking literature review was performed using the PubMed database (January 2000-March 2025), focusing on studies addressing AI, immunomodulation, or vaccination in the context of VUR and urinary tract infections. Criteria of inclusion were the relevance to pediatric VUR, the novelty of the proposed concept, the potential clinical implications and, for the AI literature, the existence of a clinical evaluation of the algorithm on a dataset from patients. KEY FINDINGS AND LIMITATIONS: AI-based models show promising performance in supporting clinical decision-making, including prediction of the need for voiding cystourethrography, automated grading of VUR, estimation of recurrent urinary tract infection risk and prediction of chemoprophylaxis. These tools may facilitate more individualized diagnostic and therapeutic strategies, although current evidence is largely retrospective and requires prospective validation. Immunization and immunomodulatory approaches aim to reduce infection burden and modulate inflammatory pathways associated with renal scarring. While early experimental and adult clinical data are encouraging, pediatric-specific evidence remains limited, and clinical applicability in children with VUR is not yet established. CONCLUSION: Artificial intelligence and immunologically targeted strategies represent complementary, emerging approaches that may contribute to more personalized management of pediatric VUR. At present, both should be regarded as exploratory tools whose clinical impact will depend on further validation and appropriately designed pediatric studies.

Humans↗

Artificial intelligence in kidney cancer: a review of clinical applications across the disease spectrum.

PURPOSE OF REVIEW: This review examines recent advances (2024-2025) in the application of artificial intelligence (AI) to kidney cancer diagnosis, prognosis, and treatment planning. It categorizes studies across 13 clinical scenarios to assess where AI offers the most clinical utility. RECENT FINDINGS: AI models have demonstrated strong performance in a range of tasks including tumor grading, subtype classification, survival prediction, and risk stratification. Integration of radiomics, genomics, and histopathology has enabled personalized, noninvasive, and timely decision-making. The highest-performing models used CT-based radiomics, particularly for predicting progression-free and recurrence-free survival. However, performance varies across tasks and tumor subtypes, with lower accuracy in detecting oncocytomas or benign vs. malignant differentiation. AI applications in metastatic and nonresected cases remain underexplored, and ultrasound remains a largely under researched modality. While some models improve diagnostic accuracy and workflow efficiency, broader validation across diverse populations is still needed. SUMMARY: AI is transforming kidney cancer care across multiple clinical stages. Although promising, real-world implementation demands ongoing validation and postdeployment monitoring to prevent performance degradation due to distributional drift. AI's integration with multimodal data offers substantial potential to improve outcomes and reduce overtreatment.

Humans↗

Low-level lead exposure and intelligence in children.

Numerous prospective and cross-sectional studies of the relation between low-level lead exposure and cognitive functioning in children have suggested that intellectual and academic performance declines as lead burdens increase. Kaufman [Arch. Clin. Neuropsychol. (2001)] raises questions regarding interpretive issues along these lines, and therein challenges the wisdom of using the available lead/IQ data complex as an essential element of the decision-making process that leads to policy statements. In this article, we address some of the concerns expressed by Kaufman, and conclude that each of his five points are logically or statistically flawed, as is his overall strategy of critiquing individual studies after methodologically sound meta-analyses have been performed. Kaufman is perhaps correct that the findings from correlational research on low lead levels and IQ loss should be interpreted with caution, but the caution extends equally if not more greatly in the direction of previous research having underestimated the relationship between the two variables in question.

Comment↗

A Web-based system for the intelligent management of diabetic patients.

We describe the design and implementation of a distributed computer-based system for the management of insulin-dependent diabetes mellitus. The goal of the system is to support the normal activities of the physicians and patients involved in the care of diabetes by providing them with a set of automated services ranging from data collection and transmission to data analysis and decision support. The system is highly integrated with current practices in the management of diabetes, and it uses Internet technology to achieve high availability and ease of use. In particular, the user interaction takes place through dynamically generated World Wide Web pages, so that all the system's functions share an intuitive graphic user interface.

Blood Glucose Self-Monitoring↗

On the definition of the concepts thinking, consciousness, and conscience.

A complex system (CS) is defined as a set of elements, with connections between them, singled out of the environment, capable of getting information from the environment, capable of making decisions (i.e., of choosing between alternatives), and having purposefulness (i.e., an urge towards preferable states or other goals). Thinking is a process that takes place (or which can take place) in some of the CS and consists of (i) receiving information from the environment (and from itself), (ii) memorizing the information, (iii) the subconscious, and (iv) consciousness. Life is a process that takes place in some CS and consists of functions i and ii, as well as (v) reproduction with passing of hereditary information to progeny, and (vi) oriented energy and matter exchange with the environment sufficient for the maintenance of all life processes. Memory is a complex of processes of placing information in memory banks, keeping it there, and producing it according to prescriptions available in the system or to inquiries arising in it. Consciousness is a process of realization by the thinking CS of some set of algorithms consisting of the comparison of its knowledge, intentions, decisions, and actions with reality--i.e., with accumulated and continuously received internal and external information. Conscience is a realization of an algorithm of good and evil pattern recognition.

Artificial Intelligence↗

Classification of neck movement patterns related to whiplash-associated disorders using neural networks.

This paper presents a new method for classification of neck movement patterns related to Whiplash-associated disorders (WAD) using a resilient backpropagation neural network (BPNN). WAD are a common diagnosis after neck trauma, typically caused by rear-end car accidents. Since physical injuries seldom are found with present imaging techniques, the diagnosis can be difficult to make. The active range of the neck is often visually inspected in patients with neck pain, but this is a subjective measure, and a more objective decision support system, that gives a reliable and more detailed analysis of neck movement pattern, is needed. The objective of this study was to evaluate the predictive ability of a BPNN, using neck movement variables as input. Three-dimensional (3-D) neck movement data from 59 subjects with WAD and 56 control subjects were collected with a ProReflex system. Rotation angle and angle velocity were calculated using the instantaneous helical axis method and motion variables were extracted. A principal component analysis was performed in order to reduce data and improve the BPNN performance. BPNNs with six hidden nodes had a predictivity of 0.89, a sensitivity of 0.90 and a specificity of 0.88, which are very promising results. This shows that neck movement analysis combined with a neural network could build the basis of a decision support system for classifying suspected WAD, even though further evaluation of the method is needed.

Adult↗

Computer probability estimates of angiographic coronary artery disease: transportability and comparison with cardiologists' estimates.

A computer algorithm for estimating probabilities of any significant coronary obstruction and triple vessel/left main obstructions was derived, validated, and compared with the assessments of cardiac clinician angiographers. The algorithm performed at least as well as the clinicians when the latter knew the identity of the patients whose angiograms they had decided to perform. The clinicians were more accurate when they did not know the identity of the subjects but worked from tabulated objective data. Referral and value induced bias may affect physician judgment in assessing disease probability. Application of computer aids or consultation with cardiologists not directly involved with patient management may assist in more rational assessments and decision making.

Adult↗

Comprehensive vertical sample-based KNN/LSVM classification for gene expression analysis.

Classification analysis of microarray gene expression data has been widely used to uncover biological features and to distinguish closely related cell types that often appear in the diagnosis of cancer. However, the number of dimensions of gene expression data is often very high, e.g., in the hundreds or thousands. Accurate and efficient classification of such high-dimensional data remains a contemporary challenge. In this paper, we propose a comprehensive vertical sample-based KNN/LSVM classification approach with weights optimized by genetic algorithms for high-dimensional data. Experiments on common gene expression datasets demonstrated that our approach can achieve high accuracy and efficiency at the same time. The improvement of speed is mainly related to the vertical data representation, P-tree,Patents are pending on the P-tree technology. This work is partially supported by GSA Grant ACT#:K96130308. and its optimized logical algebra. The high accuracy is due to the combination of a KNN majority voting approach and a local support vector machine approach that makes optimal decisions at the local level. As a result, our approach could be a powerful tool for high-dimensional gene expression data analysis.

Algorithms↗

Challenges in real-life emotion annotation and machine learning based detection.

Since the early studies of human behavior, emotion has attracted the interest of researchers in many disciplines of Neurosciences and Psychology. More recently, it is a growing field of research in computer science and machine learning. We are exploring how the expression of emotion is perceived by listeners and how to represent and automatically detect a subject's emotional state in speech. In contrast with most previous studies, conducted on artificial data with archetypal emotions, this paper addresses some of the challenges faced when studying real-life non-basic emotions. We present a new annotation scheme allowing the annotation of emotion mixtures. Our studies of real-life spoken dialogs from two call center services reveal the presence of many blended emotions, dependent on the dialog context. Several classification methods (SVM, decision trees) are compared to identify relevant emotional states from prosodic, disfluency and lexical cues extracted from the real-life spoken human-human interactions.

Artificial Intelligence↗

Chronic pain patients are impaired on an emotional decision-making task.

Chronic pain can result in anxiety, depression and reduced quality of life. However, its effects on cognitive abilities have remained unclear although many studies attempted to psychologically profile chronic pain. We hypothesized that performance on an emotional decision-making task may be impaired in chronic pain since human brain imaging studies show that brain regions critical for this ability are also involved in chronic pain. Chronic back pain (CBP) patients, chronic complex regional pain syndrome (CRPS) patients, and normal volunteers (matched for age, sex, and education) were studied on the Iowa Gambling Task, a card game developed to study emotional decision-making. Outcomes on the gambling task were contrasted to performance on other cognitive tasks. The net number of choices made from advantageous decks after subtracting choices made from disadvantageous decks on average was 22.6 in normal subjects (n = 26), 13.4 in CBP patients (n = 26), and -9.5 in CRPS patients (n = 12), indicating poor performance in the patient groups as compared to the normal controls (P < 0.004). Only pain intensity assessed during the gambling task was correlated with task outcome and only in CBP patients (r = -0.75, P < 0.003). Other cognitive abilities, such as attention, short-term memory, and general intelligence tested normal in the chronic pain patients. Our evidence indicates that chronic pain is associated with a specific cognitive deficit, which may impact everyday behavior especially in risky, emotionally laden, situations.

Adult↗

Metabolic convergence of diabetes and prostate cancer: from dysglycemia to tumor microenvironment reprogramming.

The relationship between diabetes mellitus and prostate cancer (PC) represents one of the most intriguing paradoxes in cancer epidemiology, with diabetic individuals exhibiting a reduced incidence of PC yet poorer prognosis following diagnosis. This apparent contradiction underscores the need for an integrated understanding of how systemic metabolic dysfunction influences prostate carcinogenesis and disease progression. The present review critically synthesizes contemporary epidemiological, mechanistic, and translational evidence to establish metabolic convergence as a unifying framework linking diabetes-associated metabolic abnormalities with PC biology. Current evidence indicates that chronic dysglycemia, hyperinsulinemia, insulin resistance, and endocrine perturbations orchestrate interconnected intracellular signaling networks involving PI3K-AKT-mTOR, AMPK, AGE-RAGE signaling, oxidative stress, mitochondrial dysfunction, and epigenetic reprogramming, collectively driving metabolic adaptation and tumor evolution. Beyond tumor-intrinsic mechanisms, diabetes profoundly remodels the prostate tumor microenvironment through alterations in stromal metabolism, cancer-associated fibroblast activation, adipocyte-tumor crosstalk, extracellular matrix (ECM) remodeling, hypoxic adaptation, and vascular dysfunction, while simultaneously promoting immunometabolic reprogramming characterized by macrophage polarization, T-cell dysfunction, immune checkpoint activation, and immune evasion. The review further examines the bidirectional interactions between antidiabetic therapies and PC treatment, critically evaluating the translational potential of metformin and emerging glucose-lowering agents within the context of precision metabolic therapeutics. Finally, future directions encompassing biomarker-guided patient stratification, longitudinal metabolic profiling, multi-omics integration, artificial intelligence, and clinically relevant mechanistic validation are discussed as essential components of next-generation precision oncology. Collectively, this review reframes diabetes as an active metabolic determinant of PC rather than a coincidental comorbidity and highlights metabolism-centered precision strategies as promising avenues for improving risk stratification, therapeutic decision-making, and clinical outcomes in diabetes-associated PC.

Humans↗

Functionality of gray-scale display workstation hardware and software in clinical radiology.

This article examines the functional factors crucial for the successful conversion from film-based radiography to radiologic gray-scale display systems, including hardware architecture and software requirements, radiologic workstation operations, and a multilayered intelligent user interface. Radiologic workstation operations are logically decomposed into case preparation, case selection, case presentation, case interpretation, and documentation and presentation of the diagnosis. A multilayered software architecture for an adaptive, intelligent user interface is proposed: a hardware interface layer, an object-oriented layer, and a knowledge-based layer. The knowledge-based layer is composed of three elements: image presentation based on context-dependent models of diagnostic requirements, knowledge-based expert systems for assistance in diagnostic decision making, and computer-assisted diagnosis to alert the radiologist to potential lesions or abnormalities.

Diagnosis, Computer-Assisted↗