Search Results (382)

Background: This study examined how patients and caregivers perceive and experience AI-based care technologies through text mining analysis. The goal was to identify major themes, sentiments, and value-oriented interpretations embedded in their narratives and to understand how these perceptions align with key dimensions of patient-centered care. Methods: A corpus of publicly available narratives describing experiences with AI-based care was compiled from online communities. Natural language processing techniques were applied, including descriptive term analysis, topic modeling using Latent Dirichlet Allocation, and sentiment profiling based on a Korean lexicon. Emergent topics and emotional patterns were mapped onto domains of patient-centered care such as information quality, emotional support, autonomy, and continuity. Results: The analysis revealed a three-phase evolution of care values over time. In the early phase of AI-mediated care, patient narratives emphasized disruption of relational care, with negative themes such as reduced human connection, privacy concerns, safety uncertainties, and usability challenges, accompanied by emotions of fear and frustration. During the transitional phase, positive themes including convenience, improved access, and reassurance from diagnostic accuracy emerged alongside persistent emotional ambivalence, reflecting uncertainty regarding responsibility and control. In the final phase, care values were restored and strengthened, with sentiment patterns shifting toward trust and relief as AI functions became supportive of clinical care, while concerns related to depersonalization and surveillance diminished. Conclusions: Patients and caregivers experience AI-based care as both beneficial and unsettling. Perceptions improve when AI enhances efficiency and information flow without compromising relational aspects of care. Ensuring transparency, explainability, opportunities for human contact, and strong data protections is essential for aligning AI with principles of patient-centered care. Based on a small-scale qualitative dataset of patient narratives, this study offers an exploratory, value-oriented interpretation of how relational care evolves in AI-mediated healthcare contexts. In this study, care-ethics values are used as an analytical lens to operationalize key principles of patient-centered care within AI-mediated healthcare contexts. Full article

Medical images obtained from advanced imaging devices play a crucial role in supporting disease diagnosis and detection. Nevertheless, acquiring such images is often costly and storage-intensive, and it is time-consuming to diagnose individuals. The use of artificial intelligence (AI)-based automated diagnostic systems provides potential solutions to address the limitations of cost and diagnostic time. In particular, deep learning and explainable AI (XAI) techniques provide a reliable and robust approach to classifying medical images. This paper presents a hybrid model comprising two networks, ResNext101_32x8d and Swin Transformer to differentiate four categories of Alzheimer’s disease: no dementia, very mild dementia, mild dementia, and moderate dementia. The combination of the two networks is applied to imbalanced data, trained on 5120 MRI images, validated on 768 images, and tested on 512 other images. Grad-CAM and LIME techniques with a saliency map are employed to interpret the predictions of the model, providing transparent and clinically interpretable decision support. The proposed combination is realized through a TensorFlow framework, incorporating hyperparameter optimization and various data augmentation methods. The performance evaluation of the proposed model is conducted through several metrics, including the error matrix, precision recall (PR), receiver operating characteristic (ROC), accuracy, and loss curves. Experimental results reveal that the hybrid of ResNext101_32x8d and Swin Transformer achieved a testing accuracy of 98.83% with a corresponding loss rate of 0.1019. Furthermore, for the combination “ResNext101_32x8d + Swin Transformer”, the precision, F1-score, and recall were 99.39%, 99.15%, and 98.91%, respectively, while the area under the ROC curve (AUC) was 1.00, “100%”. The combination of proposed networks with XAI techniques establishes a unique contribution to advance medical AI systems and assist radiologists during Alzheimer’s disease screening of patients. Full article

As artificial intelligence (AI) continues to expand across clinical environments, healthcare is transitioning from static decision-support tools to dynamic, autonomous agents capable of reasoning, coordination, and continuous interaction. In the context of geriatric medicine, a field characterized by multimorbidity, cognitive decline, and the need for long-term personalized care, this evolution opens new frontiers for delivering adaptive, assistive, and trustworthy digital support. However, the autonomy and interconnectivity of these systems introduce heightened cybersecurity and ethical challenges. This paper presents a Secure Agentic AI Architecture (SAAA) tailored to the unique demands of geriatric healthcare. The architecture is designed around seven layers, grouped into five functional domains (cognitive, coordination, security, oversight, governance) to ensure modularity, interoperability, explainability, and robust protection of sensitive health data. A review of current AI agent implementations highlights limitations in security, transparency, and regulatory alignment, especially in multi-agent clinical settings. The proposed framework is illustrated through a practical use case involving home-based care for elderly patients with chronic conditions, where AI agents manage medication adherence, monitor vital signs, and support clinician communication. The architecture’s flexibility is further demonstrated through its application in perioperative care coordination, underscoring its potential across diverse clinical domains. By embedding trust, accountability, and security into the design of agentic systems, this approach aims to advance the safe and ethical integration of AI into aging-focused healthcare environments. Full article

Hypertension has been traditionally known to be highlighted by mean blood pressure; however, emerging evidence exhibits that blood pressure variability (BPV), including short-term, day-to-day, and visit-to-visit fluctuations can have an implication across multiple body systems. Elevated BPV reflects repetitive hemodynamic stress, affecting the physiologic hemostasis contributing to vascular injury and end organ damage. This narrative review is a compilation of recent evidence on the prognostic value of BPV, explained by pathophysiology, various devices with its measurement approaches, and, essentially, the clinical implication of BPV and the use of such devices utilizing artificial intelligence. A comprehensive literature search across PubMed, Cochrane Library, Scopus, and Web of Science were conducted, focusing on observational studies, cohorts, randomized trials, and meta-analyses. Higher BPV has been associated with an increased risk of cardiovascular mortality, stroke, coronary events, and heart failure, the progression of chronic kidney disease, cognitive decline, and preeclampsia, among other end organ damage, despite mean blood pressure. The various pathophysiologic mechanisms include autonomic dysregulation, arterial stiffness, endothelial dysfunction, circadian rhythm alteration, and systemic inflammation, which result in vascular remodeling and multisystem damage. Antihypertensive medications such as calcium channel blockers and renin–angiotensin–aldosterone system inhibitors seem to reduce BPV; randomized trials have not specifically investigated their BPV-reducing effects. The aim of this review is to highlight that BPV is a dynamic marker of multisystem risk, and question how various AI-based devices can aid continuous BPV monitoring and patient specific risk stratification. Full article

Cardiac rehabilitation (CR) improves functional capacity and reduces cardiovascular morbidity, yet clinical response remains highly heterogeneous and difficult to stratify using conventional assessment. This study presents a machine-learning framework for the early stratification of CR patients into responders and non-responders based exclusively on pre-intervention baseline characteristics. A total of 122 patients undergoing an 8-week CR program were evaluated using 56 clinical, physiological and metabolic predictors. Multiple classification models were trained under a stratified 10-fold cross-validation scheme. Among them, an SVM-RBF classifier achieved the best performance and retained high discriminative capacity after dimensionality reduction. The final reduced model, based on the ten most informative features identified through convergence between Random Forest and SHAP analyses, preserved >95% of the full-feature performance. The predictors were physiologically coherent, reflecting muscular strength, ventilatory efficiency, chronotropic modulation and metabolic burden. SHAP-based explainability enabled patient-level attribution of improvement likelihood, identifying modifiable variables associated with favorable or limited training response. In parallel, we developed a web-based clinical decision-support prototype that estimates improvement probability and highlights the most influential determinants for each patient, illustrating translational applicability for precision rehabilitation planning. These findings support a transition toward personalized CR strategies guided by explainable AI and baseline phenotyping. Full article

Background: Accurate staging of bladder cancer is critical for guiding clinical management, particularly the distinction between non–muscle-invasive (T1) and muscle-invasive (T2–T4) disease. Although MRI offers superior soft-tissue contrast, image interpretation remains opera-tor-dependent and subject to inter-observer variability. This study proposes an automated deep learning framework for MRI-based bladder cancer staging to support standardized radio-logical interpretation. Methods: A sequential AI-based pipeline was developed, integrating hybrid tumor segmentation using YOLOv11 for lesion detection and DeepLabV3 for boundary refinement, followed by three deep learning classifiers (VGG19, ResNet50, and Vision Transformer) for MRI-based stage prediction. A total of 416 T2-weighted MRI images with radiology-derived stage labels (T1–T4) were included, with data augmentation applied during training. Model performance was evaluated using accuracy, precision, recall, F1-score, and multi-class AUC. Performance un-certainty was characterized using patient-level bootstrap confidence intervals under a fixed training and evaluation pipeline. Results: All evaluated models demonstrated high and broadly comparable discriminative performance for MRI-based bladder cancer staging within the present dataset, with high point estimates of accuracy and AUC, particularly for differentiating non–muscle-invasive from muscle-invasive disease. Calibration analysis characterized the probabilistic behavior of predicted stage probabilities under the current experimental setting. Conclusions: The proposed framework demonstrates the feasibility of automated MRI-based bladder cancer staging derived from radiological reference labels and supports the potential of deep learning for stand-ardizing and reproducing MRI-based staging procedures. Rather than serving as an independent clinical decision-support system, the framework is intended as a methodological and work-flow-oriented tool for automated staging consistency. Further validation using multi-center datasets, patient-level data splitting prior to augmentation, pathology-confirmed reference stand-ards, and explainable AI techniques is required to establish generalizability and clinical relevance. Full article

Epilepsy affects over 50 million people worldwide, yet automated seizure detection systems either achieve moderate sensitivity with excessive false alarms or rely on uninterpretable deep networks. This study presents a patient-independent EEG-based seizure detection framework that achieved zero false alarms in 24 h with 95% sensitivity in a retrospective evaluation on a CHB–MIT pediatric cohort (n = 6 seizure-positive patients). The pipeline extracts 27 time-, frequency-, and nonlinear-domain features from 5 s windows and trains five ensemble classifiers (XGBoost, CatBoost, LightGBM, Extra Trees, Random Forest) using strict leave-one-subject-out cross-validation. All models achieved segment-level AUC ≥ 0.99. Under zero-false-alarm constraints, XGBoost attained perfect specificity with 0.922 sensitivity. SHAP and LIME analyses suggested candidate EEG biomarkers that appear consistent with known ictal signatures, including temporo-parietal theta-band power, amplitude variability (IQR, RMS), and Hjorth activity. External validation on the Siena Scalp EEG Database (12 adult patients, 37 seizures) demonstrated cross-dataset generalization with 95% event-level sensitivity (Extra Trees) and AUC of 0.86 (Random Forest). Temporal lobe channels dominated feature importance in both datasets, confirming consistent biomarker identification across pediatric and adult populations. These findings demonstrate that calibrated gradient-boosted ensembles using interpretable EEG features achieve clinically safe seizure detection with cross-dataset generalizability. Full article

Background: Whole-slide imaging and algorithmic advances have moved computational pathology from research to routine consideration. Despite notable successes, real-world deployment remains limited by generalization, validation gaps, and human-factor risks, which can be amplified in resource-constrained settings. Content/Scope: This narrative review and implementation perspective summarizes clinically proximate AI capabilities in cancer pathology, including lesion detection, metastasis triage, mitosis counting, immunomarker quantification, and prediction of selected molecular alterations from routine histology. We also summarize recurring failure modes, dataset leakage, stain/batch/site shifts, misleading explanation overlays, calibration errors, and automation bias, and distinguish applications supported by external retrospective validation, prospective reader-assistance or real-world studies, and regulatory-cleared use. We translate these evidence patterns into a practical checklist covering dataset design, external and temporal validation, robustness testing, calibration and uncertainty handling, explainability sanity checks, and workflow-safety design. Equity Focus: We propose a stepwise adoption pathway for low- and middle-income countries: prioritize narrow, high-impact use cases; match compute and storage requirements to local infrastructure; standardize pre-analytics; pool validation cohorts; and embed quality management, privacy protections, and audit trails. Conclusions: AI can already serve as a reliable second reader for selected tasks, reducing variance and freeing expert time. Safe, equitable deployment requires disciplined validation, calibrated uncertainty, and guardrails against human-factor failure. With pragmatic scoping and shared infrastructure, pathology programs can realize benefits while preserving trust and accountability. Full article

Radiographic imaging remains a cornerstone of diagnostic practice. However, accurate interpretation faces challenges from subtle visual signatures, anatomical variability, and inter-observer inconsistency. Conventional deep learning approaches, such as convolutional neural networks and vision transformers, deliver strong predictive performance but often lack anatomical grounding and interpretability, limiting their trustworthiness in imaging applications. To address these challenges, we present SpineNeuroSym, a neuro-geometric imaging framework that unifies geometry-aware learning and symbolic reasoning for explainable medical image analysis. The framework integrates weakly supervised keypoint and region-of-interest discovery, a dual-stream graph–transformer backbone, and a Differentiable Radiographic Geometry Module (dRGM) that computes clinically relevant indices (e.g., slip ratio, disc asymmetry, sacroiliac spacing, and curvature measures). A Neuro-Symbolic Constraint Layer (NSCL) enforces monotonic logic in image-derived predictions, while a Counterfactual Geometry Diffusion (CGD) module generates rare imaging phenotypes and provides diagnostic auditing through counterfactual validation. Evaluated on a comprehensive dataset of 1613 spinal radiographs from Sunpasitthiprasong Hospital encompassing six diagnostic categories—spondylolisthesis (n = 496), infection (n = 322), spondyloarthropathy (n = 275), normal cervical (n = 192), normal thoracic (n = 70), and normal lumbar spine (n = 258)—SpineNeuroSym achieved 89.4% classification accuracy, a macro-F1 of 0.872, and an AUROC of 0.941, outperforming eight state-of-the-art imaging baselines. These results highlight how integrating neuro-geometric modeling, symbolic constraints, and counterfactual validation advances explainable, trustworthy, and reproducible medical imaging AI, establishing a pathway toward transparent image analysis systems. Full article

This study examines clinician interactions with a Knowledge Graph (KG)-enhanced Large Language Model (LLM) for diagnostic support, with an emphasis on the rare condition pseudohypoparathyroidism (PHP). Ten medical professionals engaged with simulated diagnostic scenarios, using the KG-enhanced LLM to support reasoning and validate differential diagnoses. Evaluation included basic model performance (RAGAS = 0.85; F1 = 0.79) and clinician-centered outcomes, such as diagnostic conclusions, confidence, adherence, and efficiency. Results show the tool was most valuable for rare or uncertain cases, increasing clinician confidence and supporting reasoning, while familiar cases elicited selective adoption with minimal AI engagement. Participant feedback indicated generally high usability, accuracy, and relevance, with most reporting improved efficiency and trust. Statistical analysis confirmed that AI assistance significantly reduced time-to-diagnosis ($t\left(8\right)=4.99$, $p=0.001$, Cohen’s $d_z=1.66$, 95% CI [73.8, 197.2]; Wilcoxon $W=0.0$, $p=0.0039$). These findings suggest that KG-enhanced LLMs can effectively augment clinician judgment in complex cases, serving as reasoning aids or educational tools while preserving clinician control over decision-making. The study emphasizes evaluating AI not only for accuracy, but also for practical utility and integration into real-world clinical workflows. Full article

Artificial intelligence (AI) has shown promising performance in brain tumor diagnosis and prognosis; however, most reported advances remain difficult to translate into clinical practice due to limited interpretability, inconsistent evaluation protocols, and weak generalization across datasets and institutions. In this work, we present a critical synthesis of recent brain tumor AI studies (2020–2025) guided by two novel conceptual tools: a unified diagnostic-prognostic framework and a triadic evaluation model emphasizing interpretability, computational efficiency, and generalizability as core dimensions of clinical readiness. Following PRISMA 2020 guidelines, we screened and analyzed over 100 peer-reviewed studies. A structured analysis of reported metrics reveals systematic trends and trade-offs—for instance, between model accuracy and inference latency—rather than providing a direct performance benchmark. This synthesis exposes critical gaps in current evaluation practices, particularly the under-reporting of interpretability validation, deployment-level efficiency, and external generalization. By integrating conceptual structuring with evidence-driven analysis, this work provides a framework for more clinically grounded development and evaluation of AI systems in neuro-oncology. Full article

Background: The rapid advancement in artificial intelligence (AI) has fundamentally reshaped gut microbiome research by enabling high-resolution analysis of complex, high-dimensional microbial communities and their functional interactions with the human host. Objective: This narrative review aims to synthesize recent methodological advances in AI-driven gut microbiome research and to evaluate their translational relevance for therapeutic optimization, personalized nutrition, and precision medicine. Methods: A narrative literature review was conducted using PubMed, Google Scholar, Web of Science, and IEEE Xplore, focusing on peer-reviewed studies published between approximately 2015 and early 2025. Representative articles were selected based on relevance to AI methodologies applied to gut microbiome analysis, including machine learning, deep learning, transformer-based models, graph neural networks, generative AI, and multi-omics integration frameworks. Additional seminal studies were identified through manual screening of reference lists. Results: The reviewed literature demonstrates that AI enables robust identification of diagnostic microbial signatures, prediction of individual responses to microbiome-targeted therapies, and design of personalized nutritional and pharmacological interventions using in silico simulations and digital twin models. AI-driven multi-omics integration—encompassing metagenomics, metatranscriptomics, metabolomics, proteomics, and clinical data—has improved functional interpretation of host–microbiome interactions and enhanced predictive performance across diverse disease contexts. For example, AI-guided personalized nutrition models have achieved AUC exceeding 0.8 for predicting postprandial glycemic responses, while community-scale metabolic modeling frameworks have accurately forecast individualized short-chain fatty acid production. Conclusions: Despite substantial progress, key challenges remain, including data heterogeneity, limited model interpretability, population bias, and barriers to clinical deployment. Future research should prioritize standardized data pipelines, explainable and privacy-preserving AI frameworks, and broader population representation. Collectively, these advances position AI as a cornerstone technology for translating gut microbiome data into actionable insights for diagnostics, therapeutics, and precision nutrition. Full article

Chronic Pseudomonas aeruginosa lung infections in cystic fibrosis (CF) represent one of the most treatment-refractory bacterial diseases, sustained by biofilm formation, metabolic dormancy, and adaptive antibiotic resistance evolution. While bacteriophage (phage) therapy has emerged as a promising alternative for multidrug-resistant (MDR) pathogens, clinical studies in CF have demonstrated transient reductions in bacterial burden without achieving complete eradication. This review integrates molecular, evolutionary, and immunological findings to explain the multifactorial barriers that limit phage therapeutic efficacy in chronic CF infections. We highlight three major obstacles: (i) bacterial dormancy and persistence within biofilms that restrict phage adsorption and replication; (ii) hypermutability and extensive genotypic diversification of CF-adapted P. aeruginosa, which accelerate phage resistance evolution and necessitate broad host-range coverage; and (iii) CF-specific immune constraints—including a dysfunctional innate immune system and phage-neutralizing humoral immunity—that reduce phage bioavailability and undermine sustained bacterial clearance. Emerging strategies to overcome these challenges include the discovery of dormant-targeting phages capable of replicating in metabolically quiescent cells, evolution-informed phage training to delay resistance evolution, and synthetic phage engineering approaches designed to disrupt biofilms and expand host-range coverage. In parallel, computational or artificial intelligence (AI)-guided frameworks for phage cocktail design and cystic fibrosis transmembrane conductance regulator (CFTR) modulator-mediated restoration of host immune function together offer a more integrated therapeutic paradigm that unites phage biology and host immune context. By unifying clinical outcomes with mechanistic, evolutionary, and immunological perspectives, this review outlines a next-generation framework for phage therapy in CF aimed at achieving more durable therapeutic outcomes. Full article

The exponential growth of multimodal orthopedic data, ranging from longitudinal Electronic Health Records to high-resolution musculoskeletal imaging, has rendered manual analysis insufficient. This has established Large Language Models (LLMs) as algorithmically necessary for managing healthcare complexity. However, their deployment in high-stakes surgical environments presents a fundamental algorithmic paradox: while generic foundation models possess vast reasoning capabilities, they often lack the precise, protocol-driven domain knowledge required for safe orthopedic decision support. This review provides a structured synthesis of the emerging algorithmic frameworks required to build modern clinical AI assistants. We deconstruct current methodologies into their core components: large-language-model adaptation, multimodal data fusion, and standardized data interoperability pipelines. Rather than proposing a single proprietary architecture, we analyze how recent literature connects specific algorithmic choices such as the trade-offs between full fine-tuning and Low-Rank Adaptation to their computational costs and factual reliability. Furthermore, we examine the theoretical architectures required for ‘agentic’ capabilities, where AI systems integrate outputs from deep convolutional neural networks and biosensors. The review concludes by outlining the unresolved challenges in algorithmic bias, security, and interoperability that must be addressed to transition these technologies from research prototypes to scalable clinical solutions. Full article

Neuromuscular diseases are biologically diverse, clinically heterogeneous, and often difficult to diagnose and treat, highlighting the need for computational tools that can help resolve overlapping phenotypes and support timely, mechanism-informed interventions. This narrative review synthesizes recent advances in artificial intelligence (AI) and machine learning applied to neuromuscular diseases across diagnosis, outcome modeling, biomarker development, and therapeutics. AI-based approaches may assist clinical and genetic diagnosis from phenotypic data; however, early phenotype-driven tools have seen limited clinician adoption due to modest accuracy, usability challenges, and poor workflow integration. Electrophysiological studies remain central to diagnosing neuromuscular diseases, and AI shows promise for accurate classification of electrophysiological signals. Predictive models for disease outcome and progression—particularly in amyotrophic lateral sclerosis—are under active investigation, but most remain at an early stage of development and are not yet ready for routine clinical use. Digital biomarkers derived from imaging, gait, voice, and wearable sensors are emerging, with MRI-based quantification of muscle fat replacement representing the most mature and widely accepted application to date. Efforts to apply AI to therapeutic discovery, including drug repurposing and optimization of gene-based therapies, are ongoing but have thus far yielded limited clinical translation. Persistent barriers to broader adoption include disease rarity, data scarcity, heterogeneous acquisition protocols, inconsistent terminology, limited external validation, insufficient model explainability, and lack of seamless integration into clinical workflows. Addressing these challenges is essential to moving AI tools from the laboratory into clinical practice. We conclude with a practical checklist of considerations intended to guide the development and adoption of AI tools in neuromuscular disease care. Full article