Background - Pulmonary vein isolation (PVI) is an effective treatment strategy for patients with atrial fibrillation (AF), but many experience AF recurrence and require repeat ablation procedures. The goal of this study was to develop and evaluate a methodology which combines machine learning (ML) and personalized computational modeling to predict, prior to PVI, which patients are most likely to experience AF recurrence after PVI. Methods - This single-center retrospective proof-of-concept study included 32 patients with documented paroxysmal AF who underwent PVI and had pre-procedural late gadolinium enhanced magnetic resonance imaging (LGE-MRI). For each patient, a personalized computational model of the left atrium simulated AF induction via rapid pacing. Features were derived from pre-PVI LGE-MRI images and from results of simulations (SimAF). The most predictive features were used as input to a quadratic discriminant analysis ML classifier, which was trained, optimized, and evaluated with 10-fold nested cross validation to predict the probability of AF recurrence post-PVI. Results - In our cohort, the ML classifier predicted probability of AF recurrence with an average validation sensitivity and specificity of 82% and 89%, respectively, and a validation AUC of 0.82. Dissecting the relative contributions of SimAF and raw images to the predictive capability of the ML classifier, we found that when only features from SimAF were used to train the ML classifier, its performance remained similar (validation AUC=0.81). However, when only features extracted from raw images were used for training, the validation AUC significantly decreased (0.47). Conclusions - ML and personalized computational modeling can be used together to accurately predict, using only pre-PVI LGE-MRI scans as input, whether a patient is likely to experience AF recurrence following PVI, even when the patient cohort is small.

The main purpose of the study was to develop a high accuracy system able to diagnose skin lesions using deep learning–based methods. We propose a new decision system based on multiple classifiers like neural networks and feature–based methods. Each classifier (method) gives the final decision system a certain weight, depending on the calculated accuracy, helping the system make a better decision. First, we created a neural network (NN) that can differentiate melanoma from benign nevus. The NN architecture is analyzed by evaluating it during the training process. Some biostatistic parameters, such as accuracy, specificity, sensitivity, and Dice coefficient are calculated. Then, we developed three other methods based on convolutional neural networks (CNNs). The CNNs were pre-trained using large ImageNet and Places365 databases. GoogleNet, ResNet-101, and NasNet-Large, were used in the enumeration order. CNN architectures were fine-tuned in order to distinguish the different types of skin lesions using transfer learning. The accuracies of the classifications were determined. The last proposed method uses the classical method of image object detection, more precisely, the one in which some features are extracted from the images, followed by the classification step. In this case, the classification was done by using a support vector machine. Just as in the first method, the sensitivity, specificity, Dice similarity coefficient and accuracy are determined. A comparison of the obtained results from all the methods is then done. As mentioned above, the novelty of this paper is the integration of these methods in a global fusion-based decision system that uses the results obtained by each individual method to establish the fusion weights. The results obtained by carrying out the experiments on two different free databases shows that the proposed system offers higher accuracy results.

Machine learning (ML), a branch of artificial intelligence, where machines learn from big data, is at the crest of a technological wave of change sweeping society. Cardiovascular medicine is at the forefront of many ML applications, and there is a significant effort to bring them into mainstream clinical practice. In the field of cardiac electrophysiology, ML applications have also seen a rapid growth and popularity, particularly the use of ML in the automatic interpretation of ECGs, which has been extensively covered in the literature. Much lesser known are the other aspects of ML application in cardiac electrophysiology and arrhythmias, such as those in basic science research on arrhythmia mechanisms, both experimental and computational; in the development of better techniques for mapping of cardiac electrical function; and in translational research related to arrhythmia management. In the current review, we examine comprehensively such ML applications as they match the scope of this journal. The current review is organized in 3 parts. The first provides an overview of general ML principles and methodologies that will afford readers of the necessary information on the subject, serving as the foundation for inviting further ML applications in arrhythmia research. The basic information we provide can serve as a guide on how one might design and conduct an ML study. The second part is a review of arrhythmia and electrophysiology studies in which ML has been utilized, highlighting the broad potential of ML approaches. For each subject, we outline comprehensively the general topics, while reviewing some of the research advances utilizing ML under the subject. Finally, we discuss the main challenges and the perspectives for ML-driven cardiac electrophysiology and arrhythmia research.

Sudden cardiac death from arrhythmia is a major cause of mortality worldwide. In this study, we developed a novel deep learning (DL) approach that blends neural networks and survival analysis to predict patient-specific survival curves from contrast-enhanced cardiac magnetic resonance images and clinical covariates for patients with ischemic heart disease. The DL-predicted survival curves offer accurate predictions at times up to 10 years and allow for estimation of uncertainty in predictions. The performance of this learning architecture was evaluated on multi-center internal validation data and tested on an independent test set, achieving concordance indexes of 0.83 and 0.74 and 10-year integrated Brier scores of 0.12 and 0.14. We demonstrate that our DL approach, with only raw cardiac images as input, outperforms standard survival models constructed using clinical covariates. This technology has the potential to transform clinical decision-making by offering accurate and generalizable predictions of patient-specific survival probabilities of arrhythmic death over time.

Cardiac sarcoidosis (CS), an inflammatory disease characterized by formation of granulomas in the heart, is associated with high risk of sudden cardiac death (SCD) from ventricular arrhythmias. Current “one-size-fits-all” guidelines for SCD risk assessment in CS result in insufficient appropriate primary prevention. Here, we present a two-step precision risk prediction technology for patients with CS. First, a patient’s arrhythmogenic propensity arising from heterogeneous CS-induced ventricular remodeling is assessed using a novel personalized magnetic-resonance imaging and positron-emission tomography fusion mechanistic model. The resulting simulations of arrhythmogenesis are fed, together with a set of imaging and clinical biomarkers, into a supervised classifier. In a retrospective study of 45 patients, the technology achieved testing results of 60% sensitivity [95% confidence interval (CI): 57-63%], 72% specificity [95% CI: 70-74%], and 0.754 area under the receiver operating characteristic curve [95% CI: 0.710-0.797]. It outperformed clinical metrics, highlighting its potential to transform CS risk stratification.

The detection of human emotions has applicability in various domains such as assisted living, health monitoring, domestic appliance control, crowd behavior tracking real time, and emotional security. The paper proposes a new system for emotion classification based on a generative adversarial network (GAN) classifier. The generative adversarial networks have been widely used for generating realistic images, but the classification capabilities have been vaguely exploited. One of the main advantages is that by using the generator, we can extend our testing dataset and add more variety to each of the seven emotion classes we try to identify. Thus, the novelty of our study consists in increasing the number of classes from N to 2N (in the learning phase) by considering real and fake emotions. Facial key points are obtained from real and generated facial images, and vectors connecting them with the facial center of gravity are used by the discriminator to classify the image as one of the 14 classes of interest (real and fake for seven emotions). As another contribution, real images from different emotional classes are used in the generation process unlike the classical GAN approach which generates images from simple noise arrays. By using the proposed method, our system can classify emotions in facial images regardless of gender, race, ethnicity, age and face rotation. An accuracy of 75.2% was obtained on 7000 real images (14,000, also considering the generated images) from multiple combined facial datasets.

Many single-cell observables are highly heterogeneous. A part of this heterogeneity stems from age-related phenomena: the fact that there is a nonuniform distribution of cells with different ages. This has led to a renewed interest in analytic methodologies including use of the 'von Foerster equation' for predicting population growth and cell age distributions. Here we discuss how some of the most popular implementations of this machinery assume a strong condition on the ergodicity of the cell cycle duration ensemble. We show that one common definition for the term ergodicity, 'a single individual observed over many generations recapitulates the behavior of the entire ensemble' is implied by the other, 'the probability of observing any state is conserved across time and over all individuals' in an ensemble with a fixed number of individuals but that this is not true when the ensemble is growing. We further explore the impact of generational correlations between cell cycle durations on the population growth rate. Finally, we explore the 'growth rate gain'-the phenomenon that variations in the cell cycle duration leads to an improved population-level growth rate-in this context. We highlight that, fundamentally, this effect is due to asymmetric division.

The detection and evaluation of flood damage in rural zones are of great importance for farmers, local authorities, and insurance companies. To this end, the paper proposes an efficient system based on five neural networks to assess the degree of flooding and the remaining vegetation. After a previous analysis the following neural networks were selected as primary classifiers: you only look once network (YOLO), generative adversarial network (GAN), AlexNet, LeNet, and residual network (ResNet). Their outputs were connected in a decision fusion scheme, as a new convolutional layer, considering two sets of components: (a) the weights, corresponding to the proven accuracy of the primary neural networks in the validation phase, and (b) the probabilities generated by the neural networks as primary classification results in the operational (testing) phase. Thus, a subjective behavior (individual interpretation of single neural networks) was transformed into a more objective behavior (interpretation based on fusion of information). The images, difficult to be segmented, were obtained from an unmanned aerial vehicle photogrammetry flight after a moderate flood in a rural region of Romania and make up our database. For segmentation and evaluation of the flooded zones and vegetation, the images were first decomposed in patches and, after classification the resulting marked patches were re-composed in segmented images. From the performance analysis point of view, better results were obtained with the proposed system than the neural networks taken separately and with respect to some works from the references.