Final Lifelines: The Implications and Outcomes of Thoracic Damage Control Surgeries.

INTRODUCTION: There is a lack of data on the outcomes of thoracic damage control surgery (TDCS). This study aimed to describe the characteristics and outcomes of patients undergoing TDCS. METHODS: This is a retrospective analysis of the American College of Surgeons-Trauma Quality Improvement Program database (2017-2021). All trauma patients who underwent emergency thoracotomy and packing with temporary closure were included. Patients were stratified based on the age groups (pediatric [<18 y], adults [18-64 y], and older adults [≥65 y]). Our primary outcome measures included 6-h, 24-h, and in-hospital mortality. Secondary outcomes were major complications. RESULTS: We identified 14,192 thoracotomies, out of which 213 underwent TDCS (pediatric [n = 17], adults [n = 175], and older adults [n = 21]). The mean (SD) age was 37 (18), and 86% were male. The mean shock index was 1.1 (0.4) on presentation with a median [IQR] Glasgow Coma Scale of 4 [3-14], and 22.1% had a prehospital cardiac arrest. The study population was profoundly injured with a median injury severity scoreand chest-abbreviated injury scale of 26 [17-38] and 4 [3-5], respectively, with lung (76.5%) being the most injured intrathoracic organs. Overall, the rates of 6-h, 24-h, and in-hospital mortality were 22.5%, 33%, and 53%, respectively, and 51% developed major complications. There was no significant difference in terms of in-hospital mortality (P = 0.800) and major complications (0.416) among pediatrics, adults, and older adults. CONCLUSIONS: One in three patients undergoing TDCS die within the first 24 h, and more than half of them develop major complications and die in the hospital, with no difference among pediatric, adults, and older adults. Future efforts should be directed to improve the survival of these severely injured, metabolically depleted, challenging patients.

Coronary Artery Aneurysms and Acute Coronary Syndrome: An Interventionalist's Dilemma.

We report three cases of coronary artery aneurysm (CAA) in adults who presented with acute coronary syndrome. Two of these patients did not have traditional coronary artery disease risk factors. Management of CAA poses a significant challenge to interventionalists. We discuss the etiologic mechanisms, risk factors, pathophysiology, and diagnosis using angiography, intravascular ultrasound, and coronary computed tomography. We also highlight management options, including medical therapy and catheter-based interventions such as stenting, coil embolization, stent-assisted coil embolization, and surgical exclusion.

Drugs, Delirium, and Trauma: Substance Use and Incidence of Delirium After Traumatic Brain Injury.

INTRODUCTION: There is a paucity of data on the effect of preinjury substance (alcohol, drugs) abuse on the risk of delirium in patients with traumatic brain injury (TBI). This study aimed to assess the incidence of delirium among patients with blunt TBI in association with different substances. METHODS: We analyzed the 2020 American College of Surgeons-Trauma Quality Improvement Program. We included all adult (≥18 y) patients with blunt TBI who had a recorded substance (drugs and alcohol) screening. Our primary outcome was the incidence of delirium. RESULTS: A total of 72,901 blunt TBI patients were identified. The mean (standard deviation) age was 56 (20) years and 68.0% were males. The median (interquartile range) injury severity score was 17 (10-25). Among the study population, 23.1% tested positive for drugs (Stimulants: 3.0%; Depressants: 2.9%, hallucinogens: 5.1%, Cannabinoids: 13.4%, TCAs: 0.1%), and 22.8% tested positive for Alcohol. Overall, 1856 (2.5%) experienced delirium. On univariate analysis, patients who developed delirium were more likely to have positive drug screening results. On multivariable regression analyses, positive screen tests for isolated stimulants (adjusted odds ratio [aOR]: 1.340, P = 0.018), tricyclic antidepressants (aOR: 3.107, P = 0.019), and cannabinoids (aOR: 1.326, P ≤ 0.001) were independently associated with higher odds of developing delirium. CONCLUSIONS: Nearly one-fourth of adult patients with blunt TBI had an initial positive substance screening test. Patients with positive results for isolated stimulants, tricyclic antidepressants, and cannabinoids were at a higher risk of developing delirium, whereas this association was not evident with other drugs and alcohol-positive tests. These findings emphasize the need for early drug screening in TBI patients and close monitoring of patients with positive screening tests.

Finding The Sweet Spot: The Association Between Whole Blood to Red Blood Cells Ratio and Outcomes of Hemorrhaging Civilian Trauma Patients.

PURPOSE: To evaluate the dose-dependent effect of Whole Blood (WB) on the outcomes of civilian trauma patients with hemorrhagic shock. METHODS: We performed a 2-year (2020-2021) retrospective analysis of the ACS-TQIP dataset. Adult (≥18) trauma patients with a shock index (SI) >1 who received at least 5 units of PRBC and one unit of WB within the first 4 hours of admission were included. Primary outcomes were 6-hr, 24-hr, and in-hospital mortality. Secondary outcomes were major complications and hospital and ICU length of stay (LOS). RESULTS: A total of 830 trauma patients with a mean (SD) age of 38 (16) were identified. The median [IQR] 4-hour WB and PRBC requirements were 2[2-4] U and 10[7-15] U, respectively, with a median WB:RBC ratio of 0.2 [0.1-0.3]. Every 0.1 increase in WB:RBC ratio was associated with decreased odds of 24-hour mortality (aOR:0.916, p = 0.035) and in-hospital mortality (aOR:0.878, p < 0.001). Youden's index identified 0.25 (1 U of WB for every 4 U of PRBC) as the optimal WB:PRBC ratio to reduce 24-hour mortality. High ratio (≥0.25) group had lower adjusted odds of 24-hour mortality (aOR:0.678, p = 0.021) and in-hospital mortality (aOR:0.618, p < 0.001) compared to the Low ratio group. CONCLUSIONS: A higher WB:PRBC ratio was associated with improved early and late mortality in trauma patients with hemorrhagic shock. Given the availability of WB in trauma centers across the United States, at least one unit of WB for every four units of PRBC may be administered to improve the survival of hemorrhaging civilian trauma patients.

Predicting the time of mortality among older adult trauma patients: Is frailty the answer?

INTRODUCTION: This study aims to evaluate the temporal trends of mortality among frail versus non-frail older adult trauma patients during index hospitalization. METHODS: We performed a 3-year (2017-2019) analysis of ACS-TQIP. We included all older adult (age ≥65 years) trauma patients. Patients were stratified into two groups (Frail vs. Non-Frail). Outcomes were acute (<24 â€‹h), early (24-72 â€‹h), intermediate (72 hours-1 week), and late (>1 week) mortality. RESULTS: A total of 1,022,925 older adult trauma patients were identified, of which 19.7 â€‹% were frail. The mean(SD) age was 77(8) years and 57.4 â€‹% were female. Median[IQR] ISS was 9[4-10] and both groups had comparable injury severity (p â€‹= â€‹0.362). On multivariable analysis, frailty was not associated with acute (aOR 1.034; p â€‹= â€‹0.518) and early (aOR 1.190; p â€‹= â€‹0.392) mortality, while frail patients had independently higher odds of intermediate (aOR 1.269; p â€‹= â€‹0.042) and late (aOR 1.835; p â€‹< â€‹0.001) mortality. On sub-analysis, our results remained consistent in mild, moderate, and severely injured patients. CONCLUSION: Frailty is an independent predictor of mortality in older adult trauma patients who survive the initial 3 days of admission, regardless of injury severity.

Survivorship Struggles: Navigating Etiologies and Clinical Parameters of Febrile Neutropenia During Induction Chemotherapy in Acute Leukemia Patients.

Background Acute leukemia, characterized by the uncontrolled proliferation of immature white blood cell precursors, poses significant challenges during induction chemotherapy, including the elevated risk of febrile neutropenia and its associated complications. Our study aims to explain the clinical and etiological parameters of these patients in a resource-limited setting. Methods This retrospective study focused on a total of 102 adult patients with acute leukemia who developed febrile neutropenia during the induction chemotherapy phase. Patients with disease relapse, prior bone marrow transplantation, and cases of acute promyelocytic leukemia were excluded from the study. Demographical characteristics, symptoms at presentation, diagnoses, infectious causes, and outcomes were systematically reported. Infectious etiologies and detailed culture reports were meticulously tabulated, and subsequent data were analyzed. Results Of the 102 patients, 43 (42.2%) were males, with a mean age of 31.9 ± 6.5 years. During the induction chemotherapy, a total of 31 patients died of complicated febrile neutropenia. Severe vomiting was the most common symptom present in 37 (36.2%), followed by cough in 35 (34.3%) and loose stools in 28 (27.5%). Community-acquired pneumonia, neutropenic sepsis, and neutropenic colitis were among the most common etiologies of febrile neutropenia. A total of 72 (70.6%) patients had culture-proven multidrug-resistant Gram-negative bacteremia that contributed to poor outcomes. Conclusions Acute leukemia patients undergoing induction chemotherapy face high infection-associated mortality due to their immunocompromised state. Inadequate infection control measures and antimicrobial resistance contribute to the emergence of multidrug-resistant organisms. Enhanced infection prevention strategies and evidence-based antibiotic prescription guidelines are need of time in resource-limited settings such as Pakistan to address febrile neutropenia complications and bridge the existing care gap in its management.

Neurokinin B Administration Induces Dose Dependent Proliferation of Seminal Vesicles in Adult Rats.

BACKGROUND: Neurokinin B; an endogenous decapeptide, mediates its reproductive physiological actions through gonadotropin releasing hormone. Despite the potential role of Neurokinin B on seminal vesicles, its effects on seminal vesicles in adult male mammals remain elusive. We aimed to investigate the potentials of variable doses of Neurokinin B, its agonist and antagonist on histomorphology and expression of NK3R on seminal vesicles, and secretory activity of seminal vesicles in adult male rats. METHODS: Adult male Sprague Dawley rats (n=10 in each group) were administered intraperitoneally with Neurokinin B in three variable doses: 1 µg, 1 ηg and 10 ρg while, Senktide (Neurokinin B agonist) and SB222200 (Neurokinin B antagonist) in 1 µg doses consecutively for 12 days. After 12 days of peptide treatment, half of the animals (n=05) in each group were sacrificed while remaining half (n=05) were kept for another 12 days without any treatment to investigate treatment reversal. Seminal vesicles were dissected and excised tissue was processed for light microscopy, immunohistochemistry and estimation of seminal fructose levels. RESULTS: Treatment with Neurokinin B and Senktide significantly increased while SB222200 slightly decrease the seminal vesicles weight, epithelial height and seminal fructose levels as compared to control. Light microscopy revealed increased epithelial height and epithelial folding as compared to control in all Neurokinin B and Senktide treated groups while decreased in SB222200. Effects of various doses of Neurokinin B, Senktide and SB222200 on seminal vesicles weight, epithelial height, seminal fructose levels and histomorphology were reversed when rats were maintained without treatments. Immuno-expression of Neurokinin B shows no change in treatment and reversal groups. CONCLUSION: Continuous administration of Neurokinin B and Senktide effect positively while SB222200 have detrimental effects on cellular morphology, epithelial height and seminal fructose levels in seminal vesicles. Effects of peptide treatments depicted a reversal towards control group when rats were kept without any treatment.

A High-Performance, Low-Cost, and Integrated Hairpin Topology RF Switched Filter Bank for Radar Applications.

Switched filter banks find widespread application in frequency-hopping radar systems and communication networks with multiple operating frequencies, especially in situations demanding elevated filter element isolation. In this paper, the design and implementation of a highly isolated switchable narrow-bandpass filter bank architecture using hairpin microstrip topology is presented. The filter bank has four discrete bandpass filters with passbands of 2.0-2.2 GHz, 2.3-2.5 GHz, 3.1-3.3 GHz, and 3.9-4.1 GHz. These filters span the radar S-frequency band (2.0-4.0 GHz). In order to switch between channels with a switching speed of nanoseconds, low-loss and highly isolated SP4T switches are implemented. Advanced design system (ADS) software is used to design the various filter functionalities, and the entire system is tested on a vector network analyzer (VNA). The proposed architecture makes it much easier to put the filter bank into practice and switch it to the desired frequency, which is useful for radar receiver applications.

Effect of the oxygen vacancy electronic state on Ni migration in Li0.5(Ni0.8Mn0.1Co0.1)O2 cathode material.

Cation migration coupled with oxygen vacancy formation is known to drive the layered to disordered spinel/rock-salt phase transformation in the high-Ni layered oxide cathodes of Li-ion batteries. However, the effect of different electronic states of oxygen vacancies on the cation migration still remains elusive. Here, we investigate Ni migration in delithiated Ni-rich Li0.5Ni0.8Mn0.1Co0.1O2 (hence Li0.5NMC811) in the presence of neutral and charged oxygen vacancies by means of first-principles density functional theory (DFT) calculations coupled with the nudged elastic band (NEB) method. We find that oxygen vacancies with neutral or +2 charge favor the Ni migration to Li tetrahedral and/or octahedral sites, both thermodynamically and kinetically. As for the case of +1 charged oxygen vacancies, while they thermodynamicaly favor the Ni migration to the Li site, the relatively high migration barrier suggests that they kinetically prohibit the Ni migration. Our results suggest that controlling the formation of oxygen vacancies is the key to enhancing the Ni-rich NMC structural stability in particular in their charged states.

Inquiring the impact of rural-urban migration, construction sector, and agriculture irrigated land on environmental degradation: insights from urbanized Asian countries.

The present study investigates the influence of rural-urban migration, construction sector share, and agriculture-irrigated land on environmental quality in urbanized Asian nations. For analysis, panel data from seven highly urbanized economies from 1996 to 2020 is utilized. The study employed an augmented mean group (AMG) estimator to find short and long-run results. The empirical discoveries depict that rural-urban migration increases energy demand in urbanized areas and significantly contributes to deteriorating environmental quality. The findings also reveal that the expansion of construction sectors is a significant source of high cement production, which also increases carbon emissions and environmental pollution by increasing the concentration of particulate matter in the atmosphere. The findings also exposed the role of agriculture-irrigated land, contributing to carbon emissions in urbanized Asian economies. The study also investigated the impact of the square term of irrigated agricultural land on environmental deterioration, revealing that adding agricultural land will further intensify environmental degradation by increasing carbon emissions in the atmosphere. A policy framework to reduce environmental damage in Asian economies caused by rural-to-urban migration, the building industry, and irrigated agricultural land was recommended based on the study's findings.

Anti-inflammatory and analgesic properties of Polyphyllin VI revealed by network pharmacology and RNA sequencing.

Inflammatory pain, sustained by a complex network of inflammatory mediators, is a severe and persistent illness affecting many of the general population. We explore possible anti-inflammatory pathways of Polyphyllin VI (PPVI) based on our prior study, which showed that PPVI reduces inflammation in mice to reduce pain. Network pharmacology and RNA-Seq identified the contribution of the MAPK signaling pathway to inflammatory pain. In the LPS/ATP-induced RAW264.7 cell model, pretreatment with PPVI for 1 h inhibited the release of IL-6 and IL-8, down-regulated expression of the P2X7 receptor(P2X7R), and decreased phosphorylation of p38 and ERK1/2 components of the MAPK pathway. Moreover, PPVI decreased expression of IL-6 and IL-8 was observed in the serum of the inflammatory pain mice model and reduced phosphorylation of p38 and ERK1/2 in the dorsal root ganglia while the reductions of expression of IL-6 and phosphorylation of ERK1/2 were not observed after the pre-treatment with A740003 (an antagonist of the P2X7R). These results suggest that PPVI may inhibit the release of IL-8 by regulating P2X7R to reduce the phosphorylation of p38. However, the modulation of PPVI on the release of IL-6 and phosphorylation of ERK1/2 may mediated by other P2X7R-independent signals.

Bipolar picture fuzzy hypersoft set-based performance analysis of abrasive textiles for enhanced quality control.

Abrasive textiles have widespread industrial applications in the fields of polishing, finishing, deburring, and cleaning of various surfaces. Effective decision making and performance analysis are crucial in the development and manufacturing of abrasive textiles, as it enables manufacturers to evaluate and optimize the performance of these materials for specific applications and to make informed decisions about their production processes. For that purpose, this work aims to introduce an innovative bipolar picture fuzzy hypersoft set (BPFHSS) which is composed of two picture fuzzy hyper soft sets; one of them gives us the positive information, and the other gives us the negative information, for each membership degree, neutral membership, and non-membership degree. The properties of the designed structure and discussed alongside a thorough discussion on the De-Morgan's laws. Also, the bipolar picture fuzzy hypersoft weighted geometric (BPFHSWG) operator is defined for the BPFHSS framework to aggregate bipolar picture fuzzy hypersoft numbers (BPFHSN) information. This research highlights the importance of considering inconsistent, bipolar, and multiple sub-attribute information in decision-making processes by using the defined operators to develop an algorithm for a multi-attribute analysis for quality control of manufacture of abrasive textiles.

How flare-up of small and medium enterprises intensifies carbon emissions in Asian and European regions: a panel analysis.

SMEs (small and medium enterprises) contribute substantially to the global and national economies. So, their activities can significantly affect the ecosystem; however, environmental performance is primarily targeted at larger corporations. Therefore, this study measures the SMEs' impact on environmental quality through CO2 emissions. For this purpose, data on twenty-five Asian and European economies from 2005 to 2020 is utilized, and the effect of SMEs on the environment is measured in the light of the EKC hypothesis. In order to validate and test the influence of SMEs on the environment, the pooled mean group (PMG) model with cointegration approaches is utilized. The results show that the flare-up of small and medium enterprises increases environmental pollution through high carbon emissions at micro levels. Thus, the study suggests that governments, SMEs, and other stakeholders have to create strategies and regulations targeted at SMEs to minimize their negative environmental impact.

Development of hamming and hausdorff distance metrics for cubic intuitionistic fuzzy hypersoft set in cement storage quality control: Development and evaluation.

Quality control is paramount in product manufacturing as it ensures consistent production to meet customer expectations, regulatory requirements and maintain a company's reputation and profitability. Distance measures within fuzzy sets serve as powerful tools for quality control, allowing for data comparison and identification of potential defects or outliers within a system. This study aims to develop a hybrid concept by combining a Cubic Intuitionistic Fuzzy Set (CIFS) with Soft Set (SS) and extending it to Cubic Intuitionistic Fuzzy Hypersoft Set (CIFHSS). CIFHSS enables handling multiple distinct attributes at the sub-attribute level within a cubic set environment. The concept includes operations like internal, partial internal, external, complement, direct sum, and product. Additionally, six distance metrics are defined within CIFHSS and applied to establish a quality control management system for industrial applications. The versatility of CIFHSS in quality control management stems from its ability to capture and model uncertainty, vagueness, and imprecision in data. This makes it an effective tool for decision-making, risk analysis, and process optimization across a wide range of industrial applications.

Prevalence and Risk Factors of Dry Eye Disease among Adults in Saudi Arabia.

Background: Environmental and epidemiological factors increase the risk of dry eye in Saudi Arabia, but most studies have limited generalizability. Objective: To determine the prevalence of dry eye disease (DED) among adults across Saudi Arabia and the associated risk factors. The secondary objective was to estimate the economic burden of DED by calculating lubricant usage and its annual costs. Methods: This cross-sectional study invited adults from across Saudi Arabia to complete a questionnaire that collected data regarding demographics, symptoms related to DED, previous diagnosis of DED, use of contact lenses, and use of eye lubricants. Results: A total of 2042 responses were received, of which 784 (38.4%) respondents had previously been diagnosed with DED and 752 (36.8%) were symptomatic but undiagnosed. Between the DED diagnosed and symptomatic-undiagnosed groups, a significant difference was found in terms of age (P < 0.001), gender (P = 0.002), presence of diabetes mellitus (P = 0.004), smoking status (P = 0.007), duration of electronic screen use (P = 0.05), number of ocular complaints (P < 0.001), and frequency of lubricants use (P < 0.001). Between the DED-diagnosed and non-DED groups, significant differences were found in terms of age (P < 0.001), gender (P < 0.001), presence of diabetes mellitus (P = 0.001), allergy (P = 0.001), autoimmune disease (P = 0.005), smoking status (P < 0.001), and history of refractive surgery (P < 0.001). The mean estimated annual cost of using lubricating agents was SAR 328.2 ± 210.3 (USD 87.5 ± 56.1), and this was significantly higher in the diagnosed group (P = 0.01) than the symptomatic-undiagnosed group. Conclusions: The prevalence of DED is high among adults in Saudi Arabia. High-risk population include elderly, female, and using electronic screens for >2 hours/day.

Frequency and Factors of Sleep Paralysis Among Medical Students of Karachi.

INTRODUCTION: Sleep paralysis is a prevalent phenomenon characterized by suffocation, immobility, and hallucinations. Its causes remain unknown, although the neurotransmitter imbalance is suggested as a potential factor. This condition is closely associated with hallucinations and a sense of intrusion, often observed in patients with narcolepsy, hypertension, and seizures. METHODS: A cross-sectional study was conducted in various medical colleges in Karachi, involving 297 participants aged 18 to 30 years. The participants were divided into groups based on gender and year of study. They were surveyed about the frequency of sleep paralysis episodes, their beliefs about the phenomenon, sleep routines, and academic impacts. RESULTS: Among the respondents, a significant number of females (n=209, 70.3%) reported experiencing sleep paralysis. The overall mean age was 20±2.0 years. Correlation analysis revealed an insignificant relationship between depression and mental anxiety (p=0.147). Similarly, no significant association was found when comparing the occurrence of sleep paralysis (p=0.16). However, a notable finding was the significant link between sleep paralysis and its impact on academics (p=0.043). CONCLUSION: This study highlighted the frequency of sleep paralysis among medical students, particularly among females. Furthermore, it emphasizes the diverse beliefs held by individuals regarding these frightening episodes. To address this neglected issue, it is essential to conduct awareness sessions aimed at understanding and alleviating sleep paralysis in individuals' lives.

Investigating catalytic oxidative desulfurization of model fuel using hollow PW12/TiO2@MgCO3 and performance optimization via box-behnken design.

A facile and eco-friendly synthesis of PW12/TiO2@MgCO3 hollow tubes (PW12·âˆ¼· H3[PW12O40] = polyoxometalate) using a soluble and reusable MgCO3·3H2O micro-rods template was reported for the first time. The resultant hollow tubes were characterized by Fourier transform infrared spectroscopy (FT-IR), UV-visible spectroscopy, powder X-ray diffraction (PXRD), energy-dispersive X-ray spectroscopy (EDX), and scanning electron microscopy (SEM), which indicated that the [PW12O40]3- structure remained intact within the hollow tubes. Furthermore, the specific surface area (88.982 m2/g) and average pore size (2.6 nm) of the PW12/TiO2@MgCO3 hollow tubes were calculated using the Brunauer-Emmett-Teller (BET) analysis. This study explored the catalytic performance of PW12/TiO2@MgCO3 hollow tubes using a three-level Box-Behnken design (BBD), through which optimization curves were designed. The desulfurization of model fuel using hollow tubes was optimally performed when the catalyst dose, time, temperature, and oxidant/sulfur (O/S) were 20-80 gm, 80-120 min, 25-80 °C and 3-8 molar ratio, respectively. These results were further processed, and the experiments were replicated twenty-nine times using a model based on two quadratic polynomials to create a response surface methodology (RSM). This permits a mathematical correlation linking the desulfurization and experimental parameters. The optimal performance of reaction mixture was evaluated to be 80 mg for catalyst concentration, 25 °C of temperature, reaction time of 100 min, and 5.5 for oxidant/sulfur molar ratio from 20 mL of octane simulation oil containing 350 ppm dibenzothiophene (DBT). The predicted desulfurization rate of the model fuel under these optimal conditions was 95.3%. The correspondence between the experimental results and predicted values was verified based on regression analysis, with an R2 value greater than 0.99. These hollow tubes could be used for their desulfurization properties ten times a row without significantly reducing catalytic activity.

Domain Adaptive Object Detection via Balancing Between Self-Training and Adversarial Learning.

Deep learning based object detectors struggle generalizing to a new target domain bearing significant variations in object and background. Most current methods align domains by using image or instance-level adversarial feature alignment. This often suffers due to unwanted background and lacks class-specific alignment. A straightforward approach to promote class-level alignment is to use high confidence predictions on unlabeled domain as pseudo-labels. These predictions are often noisy since model is poorly calibrated under domain shift. In this paper, we propose to leverage model's predictive uncertainty to strike the right balance between adversarial feature alignment and class-level alignment. We develop a technique to quantify predictive uncertainty on class assignments and bounding-box predictions. Model predictions with low uncertainty are used to generate pseudo-labels for self-training, whereas the ones with higher uncertainty are used to generate tiles for adversarial feature alignment. This synergy between tiling around uncertain object regions and generating pseudo-labels from highly certain object regions allows capturing both image and instance-level context during the model adaptation. We report thorough ablation study to reveal the impact of different components in our approach. Results on five diverse and challenging adaptation scenarios show that our approach outperforms existing state-of-the-art methods with noticeable margins.

Multi-modal medical image classification using deep residual network and genetic algorithm.

Artificial intelligence (AI) development across the health sector has recently been the most crucial. Early medical information, identification, diagnosis, classification, then analysis, along with viable remedies, are always beneficial developments. Precise and consistent image classification has critical in diagnosing and tactical decisions for healthcare. The core issue with image classification has become the semantic gap. Conventional machine learning algorithms for classification rely mainly on low-level but rather high-level characteristics, employ some handmade features to close the gap, but force intense feature extraction as well as classification approaches. Deep learning is a powerful tool with considerable advances in recent years, with deep convolution neural networks (CNNs) succeeding in image classification. The main goal is to bridge the semantic gap and enhance the classification performance of multi-modal medical images based on the deep learning-based model ResNet50. The data set included 28378 multi-modal medical images to train and validate the model. Overall accuracy, precision, recall, and F1-score evaluation parameters have been calculated. The proposed model classifies medical images more accurately than other state-of-the-art methods. The intended research experiment attained an accuracy level of 98.61%. The suggested study directly benefits the health service.