Treatment Algorithm for the Resorption of Calcific Tendinitis Using Extracorporeal Shockwave Therapy: A Data Mining Study.

Background: Although evidence indicates that extracorporeal shockwave therapy (ESWT) is effective in treating calcifying shoulder tendinitis, incomplete resorption and dissatisfactory results are still reported in many cases. Data mining techniques have been applied in health care in the past decade to predict outcomes of disease and treatment. Purpose: To identify the ideal data mining technique for the prediction of ESWT-induced shoulder calcification resorption and the most accurate algorithm for use in the clinical setting. Study Design: Case-control study. Methods: Patients with painful calcified shoulder tendinitis treated by ESWT were enrolled. Seven clinical factors related to shoulder calcification were adopted as the input attributes: sex, age, side affected, symptom duration, pretreatment Constant-Murley score, and calcification size and type. The 5 data mining techniques assessed were multilayer perceptron (neural network), naïve Bayes, sequential minimal optimization, logistic regression, and the J48 decision tree classifier. Results: A total of 248 patients with calcified shoulder tendinitis were enrolled in this study. Shorter symptom duration yielded the highest gain ratio (0.374), followed by smaller calcification size (0.336) and calcification type (0.253). With the J48 decision tree method, the accuracy of 3 input attributes was 89.5% by 10-fold cross-validation, indicating satisfactory accuracy. A treatment algorithm using the J48 decision tree indicated that a symptom duration of ≤10 months was the most positive indicator of calcification resorption, followed by a calcification size of ≤10.82 mm. Conclusion: The J48 decision tree method demonstrated the highest precision and accuracy in the prediction of shoulder calcification resorption by ESWT. A symptom duration of ≤10 months or calcification size of ≤10.82 mm represented the clinical scenarios most likely to show resorption after ESWT.

Prediction of vancomycin initial dosage using artificial intelligence models applying ensemble strategy.

BACKGROUND: Antibiotic resistance has become a global concern. Vancomycin is known as the last line of antibiotics, but its treatment index is narrow. Therefore, clinical dosing decisions must be made with the utmost care; such decisions are said to be "suitable" only when both "efficacy" and "safety" are considered. This study presents a model, namely the "ensemble strategy model," to predict the suitability of vancomycin regimens. The experimental data consisted of 2141 "suitable" and "unsuitable" patients tagged with a vancomycin regimen, including six diagnostic input attributes (sex, age, weight, serum creatinine, dosing interval, and total daily dose), and the dataset was normalized into a training dataset, a validation dataset, and a test dataset. AdaBoost.M1, Bagging, fastAdaboost, Neyman-Pearson, and Stacking were used for model training. The "ensemble strategy concept" was then used to arrive at the final decision by voting to build a model for predicting the suitability of vancomycin treatment regimens. RESULTS: The results of the tenfold cross-validation showed that the average accuracy of the proposed "ensemble strategy model" was 86.51% with a standard deviation of 0.006, and it was robust. In addition, the experimental results of the test dataset revealed that the accuracy, sensitivity, and specificity of the proposed method were 87.54%, 89.25%, and 85.19%, respectively. The accuracy of the five algorithms ranged from 81 to 86%, the sensitivity from 81 to 92%, and the specificity from 77 to 88%. Thus, the experimental results suggest that the model proposed in this study has high accuracy, high sensitivity, and high specificity. CONCLUSIONS: The "ensemble strategy model" can be used as a reference for the determination of vancomycin doses in clinical treatment.

Automatic identifying and counting blood cells in smear images by using single shot detector and Taguchi method.

BACKGROUND: Researchers have tried to identify and count different blood cells in microscopic smear images by using deep learning methods of artificial intelligence to solve the highly time-consuming problem. RESULTS: The three types of blood cells are platelets, red blood cells, and white blood cells. This study used the Resnet50 network as a backbone network of the single shot detector (SSD) for automatically identifying and counting different blood cells and, meanwhile, proposed a systematic method to find a better combination of algorithm hyperparameters of the Resnet50 network for promoting accuracy for identifying and counting blood cells. The Resnet50 backbone network of the SSD with its optimized algorithm hyperparameters, which is called the Resnet50-SSD model, was developed to enhance the feature extraction ability for identifying and counting blood cells. Furthermore, the algorithm hyperparameters of Resnet50 backbone networks of the SSD were optimized by the Taguchi experimental method for promoting detection accuracy of the Resnet50-SSD model. The experimental result shows that the detection accuracy of the Resnet50-SSD model with 512 × 512 × 3 input images was better than that of the Resnet50-SSD model with 300 × 300 × 3 input images on the test set of blood cells images. Additionally, the detection accuracy of the Resnet50-SSD model using the combination of algorithm hyperparameters got by the Taguchi method was better than that of the Resnet50-SSD model using the combination of algorithm hyperparameters given by the Matlab example. CONCLUSION: In blood cell images acquired from the BCCD dataset, the proposed Resnet50-SSD model had higher accuracy in identifying and counting blood cells, especially white blood cells and red blood cells.

Interactive Digital Game for Improving Visual-Perceptual Defects in Children With a Developmental Disability: Randomized Controlled Trial.

BACKGROUND: Visual-perceptual defects in children can negatively affect their ability to perform activities of daily living. Conventional rehabilitation training for correcting visual-perceptual defects has limited training patterns and limited interactivity, which makes motivation difficult to sustain. OBJECTIVE: We aimed to develop and evaluate an interactive digital game system for correcting visual-perceptual defects and evaluate its effectiveness. METHODS: Participants were children aged 5 to 10 years with a diagnosis of visual-perceptual defect associated with a developmental disability. The children were randomized into a digital game group who received the traditional course of rehabilitation combined with an interactive digital game intervention (n=12) and a standard rehabilitation group (n=11) who only received the traditional course of rehabilitation. Each group underwent rehabilitation once a week for 4 weeks. Overall improvement in Test of Visual Perceptual Skills 3rd edition (TVPS-3) score and overall improvement in performance in the interactive digital game were evaluated. Parents and therapists were asked to complete a satisfaction questionnaire. RESULTS: After 4 weeks, the TVPS-3 score had significantly increased (P=.002) in the digital game group (pre: mean 41.67, SD 13.88; post: 61.50, SD 21.64). In the standard rehabilitation group, the TVPS-3 score also increased, but the increase was not statistically significant (P=.58). Additionally, TVPS-3 score increases were significantly larger for the digital game group compared with those for the standard rehabilitation group (P=.005). Moreover, both parents and therapists were highly satisfied with the system. All 5 themes of satisfaction had mean scores higher than 4 in a 5-point scale questionnaire (mean 4.30, SD 0.56). CONCLUSIONS: The system has potential applications for improving visual-perceptual function in children undergoing medical rehabilitation for developmental disability. TRIAL REGISTRATION: ClinicalTrials.gov NCT05016492; http://clinicaltrials.gov/ct2/show/NCT05016492.

Integrating Taguchi Method and Gray Relational Analysis for Auto Locks by Using Multiobjective Design in Computer-Aided Engineering.

In automobiles, lock parts are matched with inserts, and this is a crucial quality standard for the dimensional accuracy of the molding. This study employed moldflow analysis to explore the influence of various injection molding process parameters on the warpage deformation. Deformation of the plastic part is caused by the nonuniform product temperature distribution in the manufacturing process. Furthermore, improper parameter design leads to substantial warpage and deformation. The Taguchi robust design method and gray correlation analysis were used to optimize the process parameters. Multiobjective quality analysis was performed for achieving a uniform temperature distribution and reducing the warpage deformation to obtain the optimal injection molding process parameters. Subsequently, three water cooling system designs-original cooling, U-shaped cooling, and conformal cooling-were tested to modify the temperature distribution and reduce the warpage. Taguchi gray correlation analysis revealed that the main influencing parameter was the mold temperature followed by the holding pressure. Moreover, the results indicated that the conformal cooling system improved the average temperature distribution.

Classifying microscopic images as acute lymphoblastic leukemia by Resnet ensemble model and Taguchi method.

BACKGROUND: Researchers have attempted to apply deep learning methods of artificial intelligence for rapidly and accurately detecting acute lymphoblastic leukemia (ALL) in microscopic images. RESULTS: A Resnet101-9 ensemble model was developed for classifying ALL in microscopic images. The proposed Resnet101-9 ensemble model combined the use of the nine trained Resnet-101 models with a majority voting strategy. Each trained Resnet-101 model integrated the well-known pre-trained Resnet-101 model and its algorithm hyperparameters by using transfer learning method to classify ALL in microscopic images. The best combination of algorithm hyperparameters for the pre-trained Resnet-101 model was determined by Taguchi experimental method. The microscopic images used for training of the pre-trained Resnet-101 model and for performance tests of the trained Resnet-101 model were obtained from the C-NMC dataset. In experimental tests of performance, the Resnet101-9 ensemble model achieved an accuracy of 85.11% and an F1-score of 88.94 in classifying ALL in microscopic images. The accuracy of the Resnet101-9 ensemble model was superior to that of the nine trained Resnet-101 individual models. All other performance measures (i.e., precision, recall, and specificity) for the Resnet101-9 ensemble model exceeded those for the nine trained Resnet-101 individual models. CONCLUSION: Compared to the nine trained Resnet-101 individual models, the Resnet101-9 ensemble model had superior accuracy in classifying ALL in microscopic images obtained from the C-NMC dataset.

Epidemic prediction of dengue fever based on vector compartment model and Markov chain Monte Carlo method.

BACKGROUND: Dengue epidemics is affected by vector-human interactive dynamics. Infectious disease prevention and control emphasize the timing intervention at the right diffusion phase. In such a way, control measures can be cost-effective, and epidemic incidents can be controlled before devastated consequence occurs. However, timing relations between a measurable signal and the onset of the pandemic are complex to be discovered, and the typical lag period regression is difficult to capture in these complex relations. This study investigates the dynamic diffusion pattern of the disease in terms of a probability distribution. We estimate the parameters of an epidemic compartment model with the cross-infection of patients and mosquitoes in various infection cycles. We comprehensively study the incorporated meteorological and mosquito factors that may affect the epidemic of dengue fever to predict dengue fever epidemics. RESULTS: We develop a dual-parameter estimation algorithm for a composite model of the partial differential equations for vector-susceptible-infectious-recovered with exogeneity compartment model, Markov chain Montel Carlo method, and boundary element method to evaluate the epidemic periodicity under the effect of environmental factors of dengue fever, given the time series data of 2000-2016 from three cities with a population of 4.7 million. The established computer model of "energy accumulation-delayed diffusion-epidemics" is proven to be effective to predict the future trend of reported and unreported infected incidents. Our artificial intelligent algorithm can inform the authority to cease the larvae at the highest vector infection time. We find that the estimated dengue report rate is about 20%, which is close to the number of official announcements, and the percentage of infected vectors increases exponentially yearly. We suggest that the executive authorities should seriously consider the accumulated effect among infected populations. This established epidemic prediction model of dengue fever can be used to simulate and evaluate the best time to prevent and control dengue fever. CONCLUSIONS: Given our developed model, government epidemic prevention teams can apply this platform before they physically carry out the prevention work. The optimal suggestions from these models can be promptly accommodated when real-time data have been continuously corrected from clinics and related agents.

Classifying chest CT images as COVID-19 positive/negative using a convolutional neural network ensemble model and uniform experimental design method.

BACKGROUND: To classify chest computed tomography (CT) images as positive or negative for coronavirus disease 2019 (COVID-19) quickly and accurately, researchers attempted to develop effective models by using medical images. RESULTS: A convolutional neural network (CNN) ensemble model was developed for classifying chest CT images as positive or negative for COVID-19. To classify chest CT images acquired from COVID-19 patients, the proposed COVID19-CNN ensemble model combines the use of multiple trained CNN models with a majority voting strategy. The CNN models were trained to classify chest CT images by transfer learning from well-known pre-trained CNN models and by applying their algorithm hyperparameters as appropriate. The combination of algorithm hyperparameters for a pre-trained CNN model was determined by uniform experimental design. The chest CT images (405 from COVID-19 patients and 397 from healthy patients) used for training and performance testing of the COVID19-CNN ensemble model were obtained from an earlier study by Hu in 2020. Experiments showed that, the COVID19-CNN ensemble model achieved 96.7% accuracy in classifying CT images as COVID-19 positive or negative, which was superior to the accuracies obtained by the individual trained CNN models. Other performance measures (i.e., precision, recall, specificity, and F1-score) obtained bythe COVID19-CNN ensemble model were higher than those obtained by individual trained CNN models. CONCLUSIONS: The COVID19-CNN ensemble model had superior accuracy and excellent capability in classifying chest CT images as COVID-19 positive or negative.

Robust optimization of convolutional neural networks with a uniform experiment design method: a case of phonocardiogram testing in patients with heart diseases.

BACKGROUND: Heart sound measurement is crucial for analyzing and diagnosing patients with heart diseases. This study employed phonocardiogram signals as the input signal for heart disease analysis due to the accessibility of the respective method. This study referenced preprocessing techniques proposed by other researchers for the conversion of phonocardiogram signals into characteristic images composed using frequency subband. Image recognition was then conducted through the use of convolutional neural networks (CNNs), in order to classify the predicted of phonocardiogram signals as normal or abnormal. However, CNN requires the tuning of multiple hyperparameters, which entails an optimization problem for the hyperparameters in the model. To maximize CNN robustness, the uniform experiment design method and a science-based methodical experiment design were used to optimize CNN hyperparameters in this study. RESULTS: An artificial intelligence prediction model was constructed using CNN, and the uniform experiment design method was proposed to acquire hyperparameters for optimal CNN robustness. The results indicate Filters ([Formula: see text]), Stride ([Formula: see text]), Activation functions ([Formula: see text]), and Dropout ([Formula: see text]) to be significant factors considerably influencing the ability of CNN to distinguish among heart sound states. Finally, the confirmation experiment was conducted, and the hyperparameter combination for optimal model robustness was Filters ([Formula: see text]) = 32, Kernel Size ([Formula: see text] = 3 × 3, Stride ([Formula: see text]) = (1,1), Padding ([Formula: see text] as same, Optimizer ([Formula: see text] as the stochastic gradient descent, Activation functions ([Formula: see text]) as relu, and Dropout ([Formula: see text]) = 0.544. With this combination of parameters, the model had an average prediction accuracy rate of 0.787 and standard deviation of 0. CONCLUSION: In this study, phonocardiogram signals were used for the early prediction of heart diseases. The science-based and methodical uniform experiment design was used for the optimization of CNN hyperparameters to construct a CNN with optimal robustness. The results revealed that the constructed model exhibited robustness and an acceptable accuracy rate. Other literature has failed to address hyperparameter optimization problems in CNN; a method is subsequently proposed for robust CNN optimization, thereby solving this problem.

Application of artificial intelligence ensemble learning model in early prediction of atrial fibrillation.

BACKGROUND: Atrial fibrillation is a paroxysmal heart disease without any obvious symptoms for most people during the onset. The electrocardiogram (ECG) at the time other than the onset of this disease is not significantly different from that of normal people, which makes it difficult to detect and diagnose. However, if atrial fibrillation is not detected and treated early, it tends to worsen the condition and increase the possibility of stroke. In this paper, P-wave morphology parameters and heart rate variability feature parameters were simultaneously extracted from the ECG. A total of 31 parameters were used as input variables to perform the modeling of artificial intelligence ensemble learning model. RESULTS: This paper applied three artificial intelligence ensemble learning methods, namely Bagging ensemble learning method, AdaBoost ensemble learning method, and Stacking ensemble learning method. The prediction results of these three artificial intelligence ensemble learning methods were compared. As a result of the comparison, the Stacking ensemble learning method combined with various models finally obtained the best prediction effect with the accuracy of 92%, sensitivity of 88%, specificity of 96%, positive predictive value of 95.7%, negative predictive value of 88.9%, F1 score of 0.9231 and area under receiver operating characteristic curve value of 0.911. CONCLUSION: In feature extraction, this paper combined P-wave morphology parameters and heart rate variability parameters as input parameters for model training, and validated the value of the proposed parameters combination for the improvement of the model's predicting effect. In the calculation of the P-wave morphology parameters, the hybrid Taguchi-genetic algorithm was used to obtain more accurate Gaussian function fitting parameters. The prediction model was trained using the Stacking ensemble learning method, so that the model accuracy had better results, which can further improve the early prediction of atrial fibrillation.

Artificial intelligence classification model for macular degeneration images: a robust optimization framework for residual neural networks.

BACKGROUND: The prevalence of chronic disease is growing in aging societies, and artificial-intelligence-assisted interpretation of macular degeneration images is a topic that merits research. This study proposes a residual neural network (ResNet) model constructed using uniform design. The ResNet model is an artificial intelligence model that classifies macular degeneration images and can assist medical professionals in related tests and classification tasks, enhance confidence in making diagnoses, and reassure patients. However, the various hyperparameters in a ResNet lead to the problem of hyperparameter optimization in the model. This study employed uniform design-a systematic, scientific experimental design-to optimize the hyperparameters of the ResNet and establish a ResNet with optimal robustness. RESULTS: An open dataset of macular degeneration images ( https://data.mendeley.com/datasets/rscbjbr9sj/3 ) was divided into training, validation, and test datasets. According to accuracy, false negative rate, and signal-to-noise ratio, this study used uniform design to determine the optimal combination of ResNet hyperparameters. The ResNet model was tested and the results compared with results obtained in a previous study using the same dataset. The ResNet model achieved higher optimal accuracy (0.9907), higher mean accuracy (0.9848), and a lower mean false negative rate (0.015) than did the model previously reported. The optimal ResNet hyperparameter combination identified using the uniform design method exhibited excellent performance. CONCLUSION: The high stability of the ResNet model established using uniform design is attributable to the study's strict focus on achieving both high accuracy and low standard deviation. This study optimized the hyperparameters of the ResNet model by using uniform design because the design features uniform distribution of experimental points and facilitates effective determination of the representative parameter combination, reducing the time required for parameter design and fulfilling the requirements of a systematic parameter design process.

Classification of age-related macular degeneration using convolutional-neural-network-based transfer learning.

BACKGROUND: To diagnose key pathologies of age-related macular degeneration (AMD) and diabetic macular edema (DME) quickly and accurately, researchers attempted to develop effective artificial intelligence methods by using medical images. RESULTS: A convolutional neural network (CNN) with transfer learning capability is proposed and appropriate hyperparameters are selected for classifying optical coherence tomography (OCT) images of AMD and DME. To perform transfer learning, a pre-trained CNN model is used as the starting point for a new CNN model for solving related problems. The hyperparameters (parameters that have set values before the learning process begins) in this study were algorithm hyperparameters that affect learning speed and quality. During training, different CNN-based models require different algorithm hyperparameters (e.g., optimizer, learning rate, and mini-batch size). Experiments showed that, after transfer learning, the CNN models (8-layer Alexnet, 22-layer Googlenet, 16-layer VGG, 19-layer VGG, 18-layer Resnet, 50-layer Resnet, and a 101-layer Resnet) successfully classified OCT images of AMD and DME. CONCLUSIONS: The experimental results further showed that, after transfer learning, the VGG19, Resnet101, and Resnet50 models with appropriate algorithm hyperparameters had excellent capability and performance in classifying OCT images of AMD and DME.

Application of Intelligent Modeling Method to Optimize the Multiple Quality Characteristics of the Injection Molding Process of Automobile Lock Parts.

This study focuses on applying intelligent modeling methods to different injection molding process parameters, to analyze the influence of temperature distribution and warpage on the actual development of auto locks. It explores the auto locks using computer-aided engineering (CAE) simulation performance analysis and the optimization of process parameters by combining multiple quality characteristics (warpage and average temperature). In this experimental design, combinations were explored for each single objective optimization process parameter, using the Taguchi robust design process, with the L18 (21 × 37) orthogonal table. The control factors were injection time, material temperature, mold temperature, injection pressure, packing pressure, packing time, cooling liquid, and cooling temperature. The warpage and temperature distribution were analysed as performance indices. Then, signal-to-noise ratios (S/N ratios) were calculated. Gray correlation analysis, with normalization of the S/N ratio, was used to obtain the gray correlation coefficient, which was substituted into the fuzzy theory to obtain the multiple performance characteristic index. The maximum multiple performance characteristic index was used to find multiple quality characteristic-optimized process parameters. The optimal injection molding process parameters with single objective are a warpage of 0.783 mm and an average temperature of 235.23 °C. The optimal parameters with multi-objective are a warpage of 0.753 mm and an average temperature of 238.71 °C. The optimal parameters were then used to explore the different cooling designs (original cooling, square cooling, and conformal cooling), considering the effect of the plastics temperature distribution and warpage. The results showed that, based on the design of the different cooling systems, conformal cooling obtained an optimal warpage of 0.661 mm and a temperature of 237.62 °C. Furthermore, the conformal cooling system is smaller than the original cooling system; it reduces the warpage by 12.2%, and the average temperature by 0.46%.

Non-destructive acoustic screening of pineapple ripeness by unsupervised machine learning and Wavelet Kernel methods.

In a pineapple exporting factory, manual lines are usually built to screen fruits of non-ripen hitting sounds from millions of undecided fruits for long-haul transportation. However, human workers cannot concentratedly listen and make consistent judgments over long hours. Pineapple screening becomes arbitrary after approximately an hour. We developed a non-destructive screening device aside from the conveyor sorter to classify pineapples automatically. The device makes intelligent judgments by tapping a sound source to the skin of pineapples and analyzing the penetrated sounds by wavelet kernel decomposition and unsupervised machine learning (ML). The sound tapping relies on the well-touch of the skin. We also design several acoustic couplers to adapt the vibrator to the skin and pick high-quality penetrated sounds. A Taguchi experiment design was used to determine the most suitable coupler. We found that our unsupervised ML method achieves 98.56% accuracy and 0.93 F1-score by using a specially designed thorn-board for assisting tapping sound to fruit skin.

Data assimilation and multisource decision-making in systems biology based on unobtrusive Internet-of-Things devices.

Biological and medical diagnoses depend on high-quality measurements. A wearable device based on Internet of Things (IoT) must be unobtrusive to the human body to encourage users to accept continuous monitoring. However, unobtrusive IoT devices are usually of low quality and unreliable because of the limitation of technology progress that has slowed down at high peak. Therefore, advanced inference techniques must be developed to address the limitations of IoT devices. This review proposes that IoT technology in biological and medical applications should be based on a new data assimilation process that fuses multiple data scales from several sources to provide diagnoses. Moreover, the required technologies are ready to support the desired disease diagnosis levels, such as hypothesis test, multiple evidence fusion, machine learning, data assimilation, and systems biology. Furthermore, cross-disciplinary integration has emerged with advancements in IoT. For example, the multiscale modeling of systems biology from proteins and cells to organs integrates current developments in biology, medicine, mathematics, engineering, artificial intelligence, and semiconductor technologies. Based on the monitoring objectives of IoT devices, researchers have gradually developed ambulant, wearable, noninvasive, unobtrusive, low-cost, and pervasive monitoring devices with data assimilation methods that can overcome the limitations of devices in terms of quality measurement. In the future, the novel features of data assimilation in systems biology and ubiquitous sensory development can describe patients' physical conditions based on few but long-term measurements.

Retrieving hidden atrial repolarization waves from standard surface ECGs.

BACKGROUND: This study estimates atrial repolarization activities (Ta waves), which are typically hidden most of the time from body surface electrocardiography when diagnosing cardiovascular diseases. The morphology of Ta waves has been proven to be an important marker for the early sign of inferior injury, such as acute atrial infarction, or arrhythmia, such as atrial fibrillation. However, Ta waves are usually unseen except during conduction system malfunction, such as long QT interval or atrioventricular block. Therefore, justifying heart diseases based on atrial repolarization becomes impossible in sinus rhythm. METHODS: We obtain TMPs in the atrial part of the myocardium which reflects the correct excitation sequence starting from the atrium to the end of the apex. RESULTS: The resulting TMP shows the hidden atrial part of ECG waves. CONCLUSIONS: This extraction makes many diseases, such as acute atrial infarction or arrhythmia, become easily diagnosed.

Fuzzy logic-based mobile computing system for hand rehabilitation after neurological injury.

BACKGROUND: Effective neurological rehabilitation requires long term assessment and treatment. The rapid progress of virtual reality-based assistive technologies and tele-rehabilitation has increased the potential for self-rehabilitation of various neurological injuries under clinical supervision. OBJECTIVE: The objective of this study was to develop a fuzzy inference mechanism for a smart mobile computing system designed to support in-home rehabilitation of patients with neurological injury in the hand by providing an objective means of self-assessment. METHODS: A commercially available tablet computer equipped with a Bluetooth motion sensor was integrated in a splint to obtain a smart assistive device for collecting hand motion data, including writing performance and the corresponding grasp force. A virtual reality game was also embedded in the smart splint to support hand rehabilitation. Quantitative data obtained during the rehabilitation process were modeled by fuzzy logic. Finally, the improvement in hand function was quantified with a fuzzy rule database of expert opinion and experience. RESULTS: Experiments in chronic stroke patients showed that the proposed system is applicable for supporting in-home hand rehabilitation. CONCLUSIONS: The proposed virtual reality system can be customized for specific therapeutic purposes. Commercial development of the system could immediately provide stroke patients with an effective in-home rehabilitation therapy for improving hand problems.

Continued use of an interactive computer game-based visual perception learning system in children with developmental delay.

This study developed an interactive computer game-based visual perception learning system for special education children with developmental delay. To investigate whether perceived interactivity affects continued use of the system, this study developed a theoretical model of the process in which learners decide whether to continue using an interactive computer game-based visual perception learning system. The technology acceptance model, which considers perceived ease of use, perceived usefulness, and perceived playfulness, was extended by integrating perceived interaction (i.e., learner-instructor interaction and learner-system interaction) and then analyzing the effects of these perceptions on satisfaction and continued use. Data were collected from 150 participants (rehabilitation therapists, medical paraprofessionals, and parents of children with developmental delay) recruited from a single medical center in Taiwan. Structural equation modeling and partial-least-squares techniques were used to evaluate relationships within the model. The modeling results indicated that both perceived ease of use and perceived usefulness were positively associated with both learner-instructor interaction and learner-system interaction. However, perceived playfulness only had a positive association with learner-system interaction and not with learner-instructor interaction. Moreover, satisfaction was positively affected by perceived ease of use, perceived usefulness, and perceived playfulness. Thus, satisfaction positively affects continued use of the system. The data obtained by this study can be applied by researchers, designers of computer game-based learning systems, special education workers, and medical professionals.

Mortality predicted accuracy for hepatocellular carcinoma patients with hepatic resection using artificial neural network.

The aim of this present study is firstly to compare significant predictors of mortality for hepatocellular carcinoma (HCC) patients undergoing resection between artificial neural network (ANN) and logistic regression (LR) models and secondly to evaluate the predictive accuracy of ANN and LR in different survival year estimation models. We constructed a prognostic model for 434 patients with 21 potential input variables by Cox regression model. Model performance was measured by numbers of significant predictors and predictive accuracy. The results indicated that ANN had double to triple numbers of significant predictors at 1-, 3-, and 5-year survival models as compared with LR models. Scores of accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of 1-, 3-, and 5-year survival estimation models using ANN were superior to those of LR in all the training sets and most of the validation sets. The study demonstrated that ANN not only had a great number of predictors of mortality variables but also provided accurate prediction, as compared with conventional methods. It is suggested that physicians consider using data mining methods as supplemental tools for clinical decision-making and prognostic evaluation.

Leuconostoc mesenteroides growth in food products: prediction and sensitivity analysis by adaptive-network-based fuzzy inference systems.

BACKGROUND: An adaptive-network-based fuzzy inference system (ANFIS) was compared with an artificial neural network (ANN) in terms of accuracy in predicting the combined effects of temperature (10.5 to 24.5°C), pH level (5.5 to 7.5), sodium chloride level (0.25% to 6.25%) and sodium nitrite level (0 to 200 ppm) on the growth rate of Leuconostoc mesenteroides under aerobic and anaerobic conditions. METHODS: THE ANFIS AND ANN MODELS WERE COMPARED IN TERMS OF SIX STATISTICAL INDICES CALCULATED BY COMPARING THEIR PREDICTION RESULTS WITH ACTUAL DATA: mean absolute percentage error (MAPE), root mean square error (RMSE), standard error of prediction percentage (SEP), bias factor (Bf), accuracy factor (Af), and absolute fraction of variance (R (2)). Graphical plots were also used for model comparison. CONCLUSIONS: The learning-based systems obtained encouraging prediction results. Sensitivity analyses of the four environmental factors showed that temperature and, to a lesser extent, NaCl had the most influence on accuracy in predicting the growth rate of Leuconostoc mesenteroides under aerobic and anaerobic conditions. The observed effectiveness of ANFIS for modeling microbial kinetic parameters confirms its potential use as a supplemental tool in predictive mycology. Comparisons between growth rates predicted by ANFIS and actual experimental data also confirmed the high accuracy of the Gaussian membership function in ANFIS. Comparisons of the six statistical indices under both aerobic and anaerobic conditions also showed that the ANFIS model was better than all ANN models in predicting the four kinetic parameters. Therefore, the ANFIS model is a valuable tool for quickly predicting the growth rate of Leuconostoc mesenteroides under aerobic and anaerobic conditions.