Socioeconomic inequality as a predictor of unmet health needs in the older adult population of Serbia.

Objectives: The aim of this paper is to assess the relationship between demographic and socioeconomic predictors and the unmet health needs of the older adult population in Serbia. Materials and methods: The study is part of the Population Health Survey of Serbia, which was conducted in the period from October to December 2019 by the Institute for Public Health of Serbia "Dr. Milan Jovanovic Batut" and the Ministry of Health of the Republic of Serbia. The research was conducted on a representative sample of Serbian residents in the form of a cross-sectional study. For the purposes of this research study, data on senior citizens, aged 65 and older, were used. Results: Multivariate regression analysis of demographic characteristics that showed statistical significance in the univariate model as a whole explains between 4.2% (Cox & Snell R Square) and 5.9% (Nagelkerke R Square) of the variance of unmet health needs and correctly classifies 66.3% cases. Statistically significant demographic predictors were the region where the respondents live, level of education, and material condition. The results of the research show that the most dominant predictors of the unmet health needs of the older adult population are related to socioeconomic inequalities, financial reasons, and predictors related to the inaccessibility of health care. Conclusion: The results suggest that individual socioeconomic predictors have a great influence on the emergence of unmet health needs of the older adult population in Serbia. Every third older adult resident did not receive the necessary health care, most often due to financial constraints.

Ensemble model for predicting chronic non-communicable diseases using Latin square extraction and fuzzy-artificial neural networks from 2013 to 2019.

Background: The presented study tracks the increase or decrease in the prevalence of seventeen different chronic non-communicable diseases in Serbia. This analysis considers factors such as region, age, and gender and is based on data from two national cross-sectional studies conducted in 2013 and 2019. The research aims to accurately identify the regions with the highest percentage of affected individuals, as well as their respective age and gender groups. The ultimate goal is to facilitate organized, free preventive screenings for these population categories within a very short time-frame in the future. Materials and methods: The study analyzed two cross-sectional studies conducted between 2013 and 2019, using data obtained from the Institute of Public Health of Serbia. Both studies involved a total of 27801 participants. The study compared the performance of Decision Tree and Support Vector Regressor models with artificial neural network (ANN) models that employed two encoding functions. The new methodology for the ANN-L36 model was based on artificial neural networks constructed using a Latin square (L36) design, incorporating Taguchi's robust design optimization. Results: The results of the analysis from three different models have shown that cardiovascular diseases are the most prevalent illnesses among the population in Serbia, with hypertension as the leading condition in all regions, particularly among individuals aged 64 to 75 years, and more prevalent among females. In 2019, there was a decrease in the percentage of the leading disease, hypertension, compared to 2013, with a decrease from 34.0% to 32.2%. The ANN-L36 model with Fuzzy encoding function demonstrated the highest precision, achieving the smallest relative error of 0.1%. Conclusion: To date, no studies have been conducted at the national level in Serbia to comprehensively track and identify chronic diseases in the manner proposed by this study. The model presented in this research will be implemented in practice and is set to significantly contribute to the future healthcare framework in Serbia, shaping and advancing the approach towards addressing these conditions. Furthermore, experimental evidence has shown that Taguchi's optimization approach yields the best results for identifying various chronic non-communicable diseases.

Unveiling the Comorbidities of Chronic Diseases in Serbia Using ML Algorithms and Kohonen Self-Organizing Maps for Personalized Healthcare Frameworks.

In previous years, significant attempts have been made to enhance computer-aided diagnosis and prediction applications. This paper presents the results obtained using different machine learning (ML) algorithms and a special type of a neural network map to uncover previously unknown comorbidities associated with chronic diseases, allowing for fast, accurate, and precise predictions. Furthermore, we are presenting a comparative study on different artificial intelligence (AI) tools like the Kohonen self-organizing map (SOM) neural network, random forest, and decision tree for predicting 17 different chronic non-communicable diseases such as asthma, chronic lung diseases, myocardial infarction, coronary heart disease, hypertension, stroke, arthrosis, lower back diseases, cervical spine diseases, diabetes mellitus, allergies, liver cirrhosis, urinary tract diseases, kidney diseases, depression, high cholesterol, and cancer. The research was developed as an observational cross-sectional study through the support of the European Union project, with the data collected from the largest Institute of Public Health "Dr. Milan Jovanovic Batut" in Serbia. The study found that hypertension is the most prevalent disease in Sumadija and western Serbia region, affecting 9.8% of the population, and it is particularly prominent in the age group of 65 to 74 years, with a prevalence rate of 33.2%. The use of Random Forest algorithms can also aid in identifying comorbidities associated with hypertension, with the highest number of comorbidities established as 11. These findings highlight the potential for ML algorithms to provide accurate and personalized diagnoses, identify risk factors and interventions, and ultimately improve patient outcomes while reducing healthcare costs. Moreover, they will be utilized to develop targeted public health interventions and policies for future healthcare frameworks to reduce the burden of chronic diseases in Serbia.

Innovation in Hyperinsulinemia Diagnostics with ANN-L(atin square) Models.

Hyperinsulinemia is a condition characterized by excessively high levels of insulin in the bloodstream. It can exist for many years without any symptomatology. The research presented in this paper was conducted from 2019 to 2022 in cooperation with a health center in Serbia as a large cross-sectional observational study of adolescents of both genders using datasets collected from the field. Previously used analytical approaches of integrated and relevant clinical, hematological, biochemical, and other variables could not identify potential risk factors for developing hyperinsulinemia. This paper aims to present several different models using machine learning (ML) algorithms such as naive Bayes, decision tree, and random forest and compare them with a new methodology constructed based on artificial neural networks using Taguchi's orthogonal vector plans (ANN-L), a special extraction of Latin squares. Furthermore, the experimental part of this study showed that ANN-L models achieved an accuracy of 99.5% with less than seven iterations performed. Furthermore, the study provides valuable insights into the share of each risk factor contributing to the occurrence of hyperinsulinemia in adolescents, which is crucial for more precise and straightforward medical diagnoses. Preventing the risk of hyperinsulinemia in this age group is crucial for the well-being of the adolescents and society as a whole.

FDG PET-CT as an important diagnostic tool and prognostic marker in suspected recurrent cervical carcinoma after radiotherapy: comparison with MRI.

BACKGROUND: Recurrent disease in post-irradiation patients with cervical cancer is often difficult to delineate on magnetic resonance imaging (MRI), because posttreatment changes can have a similar appearance, and further evaluation is often required. The aims of the study were to evaluate positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG PET-CT) diagnostic role in suspected recurrent cervical cancer after radiotherapy, compare it to MRI, and assess their prognostic impact in these patients. PATIENTS AND METHODS: This cohort retrospective study included patients previously treated with radiotherapy for carcinoma of uterine cervix with suspected recurrence, who had undergone MRI of abdomen and pelvis, and were subsequently evaluated on FDG PET-CT, with minimum follow-up period of 12 months. RESULTS: In the total of 84 patients included in analysis, MRI vs. FDG PET-CT showed sensitivity, specificity and accuracy of 80.1%, 52.4% and 66.7%, vs. 97.6%, 61.9% and 79.8%, respectively. Patients with positive findings on MRI (Log Rank, p = 0.003) and PET-CT (Log Rank, p < 0.001) had shorter progression-free survival (PFS) than those with negative results. In univariate Cox regression models, MRI and FDG PET-CT results were found to be related to PFS (p = 0.005 and p < 0.001, respectively). However, multivariate analysis proved only FDG PET-CT to be independent prognostic factor, where patients with positive FDG PET-CT results had almost nine times higher risk of progression (p < 0.001). CONCLUSION: FDG PET-CT represents useful diagnostic tool in suspected recurrent cervical cancer after radiotherapy, showing high sensitivity in its detection. In addition, it is an independent factor in predicting progression-free survival in these patients.

A Novel Approach of Determining the Risks for the Development of Hyperinsulinemia in the Children and Adolescent Population Using Radial Basis Function and Support Vector Machine Learning Algorithm.

Hyperinsulinemia is a condition with extremely high levels of insulin in the blood. Various factors can lead to hyperinsulinemia in children and adolescents. Puberty is a period of significant change in children and adolescents. They do not have to have explicit symptoms for prediabetes, and certain health indicators may indicate a risk of developing this problem. The scientific study is designed as a cross-sectional study. In total, 674 children and adolescents of school age from 12 to 17 years old participated in the research. They received a recommendation from a pediatrician to do an OGTT (Oral Glucose Tolerance test) with insulinemia at a regular systematic examination. In addition to factor analysis, the study of the influence of individual factors was tested using RBF (Radial Basis Function) and SVM (Support Vector Machine) algorithm. The obtained results indicated statistically significant differences in the values of the monitored variables between the experimental and control groups. The obtained results showed that the number of adolescents at risk is increasing, and, in the presented research, it was 17.4%. Factor analysis and verification of the SVM algorithm changed the percentage of each risk factor. In addition, unlike previous research, three groups of children and adolescents at low, medium, and high risk were identified. The degree of risk can be of great diagnostic value for adopting corrective measures to prevent this problem and developing potential complications, primarily type 2 diabetes mellitus, cardiovascular disease, and other mass non-communicable diseases. The SVM algorithm is expected to determine the most accurate and reliable influence of risk factors. Using factor analysis and verification using the SVM algorithm, they significantly indicate an accurate, precise, and timely identification of children and adolescents at risk of hyperinsulinemia, which is of great importance for improving their health potential, and the health of society as a whole.

Improved Effort and Cost Estimation Model Using Artificial Neural Networks and Taguchi Method with Different Activation Functions.

Software estimation involves meeting a huge number of different requirements, such as resource allocation, cost estimation, effort estimation, time estimation, and the changing demands of software product customers. Numerous estimation models try to solve these problems. In our experiment, a clustering method of input values to mitigate the heterogeneous nature of selected projects was used. Additionally, homogeneity of the data was achieved with the fuzzification method, and we proposed two different activation functions inside a hidden layer, during the construction of artificial neural networks (ANNs). In this research, we present an experiment that uses two different architectures of ANNs, based on Taguchi's orthogonal vector plans, to satisfy the set conditions, with additional methods and criteria for validation of the proposed model, in this approach. The aim of this paper is the comparative analysis of the obtained results of mean magnitude relative error (MMRE) values. At the same time, our goal is also to find a relatively simple architecture that minimizes the error value while covering a wide range of different software projects. For this purpose, six different datasets are divided into four chosen clusters. The obtained results show that the estimation of diverse projects by dividing them into clusters can contribute to an efficient, reliable, and accurate software product assessment. The contribution of this paper is in the discovered solution that enables the execution of a small number of iterations, which reduces the execution time and achieves the minimum error.

Risk Assessment and Determination of Factors That Cause the Development of Hyperinsulinemia in School-Age Adolescents.

Background and Objectives: Hyperinsulinemia and insulin resistance are not synonymous; if the risk of developing insulin resistance in adolescents is monitored, they do not necessarily have hyperinsulinemia. It is considered a condition of pre-diabetes and represents a condition of increased risk of developing DM (diabetes mellitus); it can exist for many years without people having the appropriate symptoms. This study aims to determine the risk of developing hyperinsulinemia at an early age in adolescents by examining which factors are crucial for its occurrence. Materials and Methods: The cross-sectional study lasting from 2019 to 2021 (2 years) was realized at the school children's department in the Valjevo Health Center, which included a total of 822 respondents (392 male and 430 female) children and adolescents aged 12 to 17. All respondents underwent a regular, systematic examination scheduled for school children. BMI is a criterion according to which respondents are divided into three groups. Results: After summary analyzes of OGTT test respondents and calculated values of HOMA-IR (homeostatic model assessment for insulin resistance), the study showed that a large percentage of respondents, a total of 12.7%, are at risk for hyperinsulinemia. The research described in this paper aimed to use the most popular AI (artificial intelligence) model, ANN (artificial neural network), to show that 13.1% of adolescents are at risk, i.e., the risk is higher by 0.4%, which was shown by statistical tests as a significant difference. Conclusions: It is estimated that a model using three different ANN architectures, based on Taguchi's orthogonal vector plans, gives more precise and accurate results with much less error. In addition to monitoring changes in each individual's risk, the risk assessment of the entire monitored group is updated without having to analyze all data.