Search Results (164)

Objectives: To improve the differentiation of borderline ovarian-adnexal tumours (BOTs) from malignant ovarian-adnexal masses, most of which fall into the indeterminate O-RADS MRI 4 category, by developing a multimodal predictive model that integrates clinical, analytic, and MRI parameters. Methods: This retrospective, single-centre study included 248 women who underwent standardised MRI for ovarian-adnexal mass characterisation between 2019 and 2024. Of these, 201 had true ovarian-adnexal masses (114 benign, 22 borderline, and 65 malignant), confirmed by histopathology or stability after ≥12-month follow-up. Forty-one clinical, laboratory, and imaging variables were initially assessed, and after a bivariate evaluation, 18 final predictors with clinical relevance were selected for model construction with thresholds learned from the data. A classification and regression tree (CART) model (“Full Model”) was applied as a second-stage tool after O-RADS MRI scoring, using 10-fold cross-validation to prevent overfitting. A pruned “Simplified Model” was also derived to enhance interpretability. Results: O-RADS MRI performed well at the extremes (scores 2–3 and 5) but showed limited discrimination between BOTs and malignancies within category 4 (PPV for borderline = 0.50). The decision-tree models significantly improved diagnostic performance, increasing overall accuracy from 0.856 with O-RADS MRI alone to 0.905 (Simplified Model) and 0.955 (Full Model). The PPV for BOTs within the intermediate O-RADS MRI 4 category increased from 0.49 with O-RADS MRI alone to 0.77 and 0.90 with the simplified and full models, respectively, while maintaining high accuracy for benign and malignant lesions. Conclusions: In this retrospective single-centre cohort, the addition of an interpretable rule-based predictive model as a second-line tool within O-RADS MRI category 4 was associated with improved discrimination between borderline and invasive malignant ovarian-adnexal tumours. These findings suggest that multimodal integration of clinical, laboratory, and MRI features may help refine risk stratification in indeterminate cases; however, external validation in prospective multicentre cohorts is required before clinical implementation. Full article

Background/Objectives: Acute mesenteric ischemia (AMI) is a time-dependent condition associated with exceptionally high in-hospital mortality, particularly among elderly and comorbid patients. Early identification of patients at high risk of death remains challenging and has important implications for clinical decision-making. The objective of this study was to derive and internally validate a prognostic score for in-hospital mortality of patients with AMI. Materials and Methods: We conducted a multicenter, observational, retrospective cohort study including patients with AMI from 10 participating hospitals. A descriptive and analytical approach was performed. A Classification and Regression Tree (CART) model was used to determine cut-off points for continuous variables and assess their association with mortality. Based on these thresholds, a univariate analysis was performed, and variables with statistical significance (p < 0.05) were incorporated into a multivariate logistic regression model. A score—the RADIAL score—was then derived from the beta coefficients. The discriminative ability of the score was evaluated using the receiver operating characteristic (ROC) curve. Results: A total of 693 patients were studied. Thee mean age was 81 years (IQR 73–86) and 54.2% were women. A history of cardiovascular disease was present in 75.3% of participants. Overall mortality was 62.4%. Most patients (74%) were managed conservatively. Significant variables in the bivariate analysis included hypotension, age > 65 years, pH < 7.3, creatinine > 1.7 mg/dL, and absence of rectal bleeding. These variables were incorporated into the multivariate model. The resulting score showed an area under the ROC curve of 0.78 (95% CI: 0.74–0.82). Conclusions: The RADIAL score demonstrated robust predictive performance and allowed the identification of three mortality-risk groups: 30–40% (low), 50–60% (intermediate), and 80% (high). This tool may support clinical decision-making in the management of patients with AMI. Full article

Background: The COVID-19 pandemic has put other infectious diseases, especially in children, into a new perspective. Our study focuses on two important viral infections: COVID-19 and influenza, which often present with similar clinical symptoms. Taking into consideration that the pathophysiology and systemic impact of the two viruses are distinct, which can lead to measurable differences in laboratory values, this study aimed to analyze laboratory features that differentiate between COVID-19 and influenza virus infections in pediatric patients. Methods: We statistically analyzed the routinely available laboratory data of 98 patients with influenza virus and 78 patients with COVID-19. Afterwards, the classification and regression tree (CART) method was performed to identify specific clinical scenarios, based on multilevel interactions of different features that could assist clinicians in evidence-based differentiation. Results: Significant differences between the two groups were observed in ALT, eosinophils, hemoglobin, and creatinine. Influenza-infected infants presented significantly higher leukocyte, neutrophil, and basophil counts compared to infants infected with COVID-19. Regarding children (over 12 months), significantly lower levels of ALT and eosinophil counts were observed in those with influenza compared to those with COVID-19. Furthermore, the CART decision tree model identified distinct profiles based on a combination of features such as age, leukocytes, lymphocytes, platelets, and neutrophils. Conclusions: After further refinement and application, such machine learning-based, evidence-driven models, considering the large scale of clinical and laboratory variables, might help to improve, support, and sustain healthcare practices. The differential decision tree may contribute to enhanced clinical risk assessment and decision making. Full article

Background: Eye-tracking technology enables the objective quantification of oculomotor behavior, providing key insights into visuocognitive performance. This study presents a comparative analysis of visual attention patterns between rhythmic gymnasts and school-aged students using an optical eye-tracking system combined with machine learning algorithms. Methods: Eye movement data were recorded during controlled visual tasks using the DIVE system (sampling rate: 120 Hz). Spatiotemporal metrics—including fixation duration, saccadic amplitude, and gaze entropy—were extracted and used as input features for supervised models: Support Vector Machine (SVM), k-Nearest Neighbors (k-NN), Decision Tree (CART), Random Forest, XGBoost, and a one-dimensional Convolutional Neural Network (1D-CNN). Data were divided according to a hold-out scheme (70/30) and evaluated using accuracy, F1-macro score, and Receiver Operating Characteristic (ROC) curves. Results: XGBoost achieved the best performance (accuracy = 94.6%; F1-macro = 0.945), followed by Random Forest (accuracy = 94.0%; F1-macro = 0.937). The neural network showed intermediate performance (accuracy = 89.3%; F1-macro = 0.888), whereas SVM and k-NN exhibited lower values. Gymnasts demonstrated more stable and goal-directed gaze patterns than students, reflecting greater efficiency in visuomotor control. Conclusions: Integrating eye-tracking with artificial intelligence provides a robust framework for the quantitative assessment of visuocognitive performance. Ensemble algorithms demonstrated high discriminative power, while neural networks require further optimization. This approach shows promising applications in sports science, cognitive diagnostics, and the development of adaptive human–machine interfaces. Full article

Background: University students often display unhealthy eating habits shaped by economic, cultural, and psychosocial factors. These behaviors increase risks of chronic and mental disorders. The COVID-19 pandemic further changed their diet and physical activity (PA) habits, highlighting the need to identify determinants of diet quality (DQ). Objective: The objective of this study is to identify risk profiles of poor DQ among university students from Chile, Mexico, Spain, and Italy through multivariate segmentation analysis. Methods: A cross-sectional predictive study was conducted among 686 university students (60.8% women; mean age = 22.4 ± 5.1 years) using an online questionnaire on sociodemographic, academic, health, and lifestyle factors, including PA (IPAQ-SF^®) and DQ (HEI). Analyses included descriptive, inferential, and decision tree (CHAID and CART) models. Results: Significant differences in HEI scores (p < 0.001) were observed by country, field of study, academic year, and PA level. Chilean and Mexican students had the lowest DQ. Both models achieved high overall accuracy (≈91%), but balanced accuracy was around 50%, reflecting limited discrimination of healthy diet profiles and underscoring their exploratory value for identifying at-risk subgroups rather than precise prediction. CART identified country of residence and socioeconomic status as the primary determinants of poor diet quality (DQ), while CHAID highlighted field of study and socioeconomic status, with PA and BMI contributing at secondary levels. Conclusions: The results emphasize adapting public health strategies to local contexts—promoting Mediterranean-style diets in European universities and improving access to affordable healthy foods in Latin American campuses, complemented by campus initiatives integrating nutrition education, physical activity, and psychosocial support. Full article

Epilepsy is one of the most prevalent neurological disorders, affecting over 50 million people worldwide. Accurate detection and characterization of epileptic activity are clinically critical, as seizures are associated with substantial morbidity, mortality, and impaired quality of life. Electroencephalography (EEG) remains the gold standard for epilepsy assessment; however, its manual interpretation is time-consuming, subjective, and prone to inter-rater variability, emphasizing the need for automated analytical approaches. This study proposes an automated ensemble classification framework for outlier detection in EEG signals. Three interpretable baseline models—Support Vector Machine (SVM), k-Nearest Neighbors (k-NN), and decision tree (DT-CART)—were screened. Ensembles were formed only from base models that had a pre-registered meta-selection rule ($F_1$ on the outlier-class $>0.60$). Under this criterion, DT-CART did not qualify and was excluded from all ensembles; final ensembles combined SVM and k-NN. The framework was evaluated on two publicly available datasets with distinct acquisition conditions. The Bonn EEG dataset comprises 500 artifact-free single-channel recordings from healthy subjects and epilepsy patients under controlled laboratory settings. In contrast, the Guinea-Bissau and Nigeria Epilepsy (GBNE) dataset contains multi-channel EEG recordings from 97 participants acquired in field conditions using low-cost equipment, reflecting real-world diagnostic challenges such as motion artifacts and signal variability. The ensemble framework substantially improved outlier detection performance, with stacking achieving up to a 95.0% $F_1$-score (accuracy 95.0%) on the Bonn dataset and 85.5% $F_1$-score (accuracy 85.5%) on the GBNE dataset. These findings demonstrate that the proposed approach provides a robust, interpretable, and generalizable solution for EEG analysis, with strong potential to enhance reliable, efficient, and scalable epilepsy detection in both laboratory and resource-limited clinical environments. Full article

Campaigns significantly impact overall company performance, making the measurement and prediction of campaign efficiency essential. This study proposes an integrated methodology that combines efficiency measurement with efficiency prediction for airline email campaigns. In the first part of the methodology, Data Envelopment Analysis (DEA) was applied to real airline campaign data to evaluate efficiency; this is the first study to analyze email campaign efficiency in this context. In the second part of the methodology, decision tree algorithms were employed to classify historical campaign data based on DEA scores, with the aim of predicting the efficiency of future campaigns—a novel approach in this context. A core dataset of 76 airline email campaigns with six inputs and two outputs was analyzed using output-oriented CCR (Charnes, Cooper, Rhodes) and BCC (Banker, Charnes, Cooper) models; 26 and 46 campaigns were identified as efficient, respectively. The analysis was further segmented by group size, seasonality, and route type. Efficient campaigns were then ranked via super-efficiency, and sensitivity analysis assessed variable and campaign effects. For prediction, decision tree algorithms (J48 (C4.5), C5.0, and CART (Classification and Regression Trees)) were employed to classify campaigns as efficient or inefficient, using DEA efficiency scores as the target variable and DEA inputs as attributes, with classification performed for both BCC and CCR core models. Class imbalance was addressed with SMOTE, and models were evaluated under stratified 10-fold cross-validation. After balancing, the BCC core model (BCC_C) yielded the most reliable predictions (overall accuracy 76.3%), with J48 providing the most balanced results, whereas the CCR core model (CCR_C) remained weak across algorithms. Full article

We consider a dynamic pricing problem in a double-lane system consisting of one general purpose lane and one wireless charging lane (WCL). The electricity price is dynamically adjusted to affect the lane-choice behaviors of incoming electric vehicles (EVs), thereby regulating the traffic assignment between the two lanes with both traffic operation efficiency and charging service efficiency considered in the control objective. We first establish an agent-based dynamic double-lane traffic system model, whereby each EV acts as an agent with distinct behavioral and operational characteristics. Then, a deep Q-learning algorithm is proposed to derive the optimal pricing decisions. A regression tree (CART) algorithm is also designed for benchmarking. The simulation results reveal that the deep Q-learning algorithm demonstrates superior capability in optimizing dynamic pricing strategies compared to CART by more effectively leveraging system dynamics and future traffic demand information, and both outperform the static pricing strategy. This study serves as a pioneering work to explore dynamic pricing issues for WCLs. Full article

Efficient public transportation systems are fundamental to achieving sustainable urban development. As the backbone of urban mobility, the coordinated development of rail transit and bus systems is crucial. The opening of a new rail transit line inevitably reshapes urban travel patterns, posing significant challenges to the existing bus network. Understanding passenger switch behavior is key to optimizing the competition and cooperation between these two modes. However, existing methods on the switch behavior of bus passengers along the newly opened rail transit line cannot balance the predictive accuracy and model interpretability. To bridge this gap, we propose a CART (classification and regression tree) decision tree-based switch behavior model that incorporates both predictive and interpretive abilities. This paper uses the massive passenger swiping-card data before and after the opening of the rail transit to construct the switch dataset of bus passengers. Subsequently, a data-driven predictive model of passenger switch behavior was established based on a CART decision tree. The experimental findings demonstrate the superiority of the proposed method, with the CART model achieving an overall prediction accuracy of 85%, outperforming traditional logit and other machine learning benchmarks. Moreover, the analysis of factor significance reveals that ‘Transfer times needed after switch’ is the dominant feature (importance: 0.52), and the extracted decision rules provide clear insights into the decision-making mechanisms of bus passengers. Full article

Classification is an important task in the field of machine learning. Decision tree algorithms are a popular choice for handling classification tasks due to their high accuracy, simple algorithmic process, and good interpretability. Traditional decision tree algorithms, such as ID3, C4.5, and CART, differ primarily in their criteria for splitting trees. Shannon entropy, Gini index, and mean squared error are all examples of measures that can be used as splitting criteria. However, their performance varies on different datasets, making it difficult to determine the optimal splitting criterion. As a result, the algorithms lack flexibility. In this paper, we introduce the concept of generalized entropy from information theory, which unifies many splitting criteria under one free parameter, as the split criterion for decision trees. We propose a new decision tree algorithm called RSE (RS-Entropy decision tree). Additionally, we improve upon a two-term information measure method by incorporating penalty terms and coefficients into the split criterion, leading to a new decision tree algorithm called RSEIM (RS-Entropy Information Method). In theory, the improved algorithms RSE and RSEIM are more flexible due to the presence of multiple free parameters. In experiments conducted on several datasets, using genetic algorithms to optimize the parameters, our proposed RSE and RSEIM methods significantly outperform traditional decision tree methods in terms of classification accuracy without increasing the complexity of the resulting trees. Full article

The characterization and mapping of urban landscape spatial form are critical for advancing sustainable planning and informed environmental management. From a morphometric perspective, this study introduces a novel, data-driven framework for typo-morphological analysis. First, morphological cells (MCs) are defined as objectively and universally applicable spatial units for morphometric investigation. Second, by integrating a multi-dimensional cognition of full-scale morphological and associated landscape elements, we construct a set of 48 spatial form indicators and attach them to morphological cells, enabling a precise description of each unit. Third, a Gaussian mixture model (GMM) is employed to cluster the metrical information within the spatially lagged context derived from the topological structure of the morphological cells, resulting in the delineation of distinct typo-morphological zones (TMZs). We then adopt Ward’s algorithm to establish a hierarchical relationship among identified urban landscape types. Using Wuxi City, China, as a case study, our results demonstrate the effectiveness of the proposed framework in capturing the heterogeneity and underlying connotation of urban landscape spatial characteristics. Building upon the unsupervised clustering results, we further apply the classification and regression tree (CART) to provide a supervised interpretation of the key spatial form conditions driving typological decisions. It facilitates the systematic identification of the components and formative mechanisms of spatial form. The findings contribute a scalable, reproducible, and interpretable typo-morphometric approach for analyzing urban landscape spatial characteristics, thereby providing a robust quantitative foundation for integrated decision-making in landscape planning, socio-ecological assessment, and urban design practices. More broadly, the study carries both applied and theoretical significance for advancing refined urban governance and fostering interdisciplinary research related to urban sustainable development. Full article

Enhancing green innovation performance is crucial for manufacturing enterprises to achieve sustainable development. This paper employs the strategic tripod framework (organization, industry, institution) using the K-means clustering algorithm to identify types of manufacturing performed by listed companies in China’s Shanghai and Shenzhen markets and adopts the CART decision tree algorithm to analyze influencing factors of green innovation performance across different enterprise types. The study finds that manufacturing enterprises can be divided into three types, with significant differences in influencing factors of green innovation performance. From the perspective of internal drivers, the improvement in green innovation performance mainly relies on organizational resource endowments, among which R&D ability is particularly key. From the perspective of the external institutional environment, the driving logic of mimetic pressure shows differentiated characteristics between different enterprise groups and differentiated response strategies need to be formulated accordingly. In addition, when the overall impact of external factors is weak, the level of industrial structure still has a prominent promoting effect on green innovation performance. Based on the data-driven perspective, this paper identifies the influencing factors of green innovation performance of different types of manufacturing enterprises, which is helpful to improve the green innovation performance of manufacturing enterprises. Full article

Background/Objectives: Myopia is a growing global health concern, especially among school-aged children in East Asia. Topical atropine is a key treatment for pediatric myopia control, but individual responses vary, with some children showing rapid progression despite higher doses. This retrospective observational study aims to develop an interpretable machine learning model to predict individualized treatment responses and support personalized clinical decisions, based on data collected over a 3-year period without a control group. Methods: A total of 1545 pediatric eyes treated with topical atropine for myopia control at a single tertiary medical center are analyzed. Classification and regression tree (CART) is constructed to predict changes in spherical equivalent (SE) and identify influencing risk factors. These factors are mainly received treatments for myopia including atropine dosage records, treatment duration, and ophthalmic examinations. Furthermore, decision rules that closely resemble the clinical diagnosis process are provided to assist clinicians with more interpretable insights into personalized treatment decisions. The performance of CART is evaluated by comparing with the benchmark model of least absolute shrinkage and selection operator regression (Lasso) to confirm the practicality of CART usage. Results: Both the CART and Lasso models demonstrated comparable predictive performance. The CART model identified baseline SE as the primary determinant of myopia progression. Children with a baseline SE more negative than −3.125 D exhibited greater myopic progression, particularly those with prolonged treatment duration and higher cumulative atropine dosage. Conclusions: Baseline SE has been identified as the key factor affecting SE difference. The generated decision rules from CART demonstrate the use of explainable machine learning in precision myopia management. Full article

Accurate assessment of terrestrial ecosystem carbon storage is essential for understanding the global carbon cycle and informing climate change mitigation strategies. However, traditional estimation models face significant challenges in complex mountainous regions due to difficulties in data acquisition and high ecosystem heterogeneity. This study focuses on the Nanling Mountains in Guangdong Province, China, utilizing the Google Earth Engine (GEE) platform to integrate multi-source remote sensing data (Sentinel-1/2, ALOS, GEDI, MODIS), topographic/climatic variables, and field-collected samples. We employed machine learning models to achieve high-precision prediction and high-resolution mapping of ecosystem carbon storage while also analyzing spatial differentiation patterns. The results indicate that the Random Forest algorithm outperformed Gradient Boosting Decision Tree and Classification and Regression Tree (CART) algorithms by suppressing overfitting through dual randomization. The integration of multi-source data significantly enhanced model performance, achieving a coefficient of determination (R²) of 0.87 for aboveground biomass (AGB) and 0.65 for soil organic carbon (SOC). Integrating precipitation, temperature, and topographic variables improved SOC prediction accuracy by 96.77% compared to using optical data alone. The total carbon storage reached 404 million tons, with forest ecosystems contributing 96.7% of the total and soil carbon pools accounting for 60%. High carbon density zones (>160 Mg C/ha) were mainly concentrated in mid-elevation gentle slopes (300–700 m). The proposed integrated “optical-radar-topography-climate” framework offers a scalable and transferable solution for monitoring carbon storage in complex terrains and provides robust scientific support for carbon sequestration planning in subtropical mountain ecosystems. Full article

Groundwater plays a crucial role in sustaining agriculture and livelihoods in the arid Middle Draa Valley (MDV) of southeastern Morocco. However, increasing groundwater extraction, declining rainfall, and the absence of effective floodwater harvesting systems have led to severe aquifer depletion. This study applies and compares six machine learning (ML) algorithms—decision trees (CART), ensemble methods (random forest, LightGBM, XGBoost), distance-based learning (k-nearest neighbors), and support vector machines—integrating GIS, satellite data, and field observations to delineate zones suitable for groundwater recharge. The results indicate that ensemble tree-based methods yielded the highest predictive accuracy, with LightGBM outperforming the others by achieving an overall accuracy of 0.90. Random forest and XGBoost also demonstrated strong performance, effectively identifying priority areas for artificial recharge, particularly near ephemeral streams. A feature importance analysis revealed that soil permeability, elevation, and stream proximity were the most influential variables in recharge zone delineation. The generated maps provide valuable support for irrigation planning, aquifer conservation, and floodwater management. Overall, the proposed machine learning–geospatial framework offers a robust and transferable approach for mapping groundwater recharge zones (GWRZ) in arid and semi-arid regions, contributing to the achievement of Sustainable Development Goals (SDGs))—notably SDG 6 (Clean Water and Sanitation), by enhancing water-use efficiency and groundwater recharge (Target 6.4), and SDG 13 (Climate Action), by supporting climate-resilient aquifer management. Full article