This study proposes a hierarchical network architecture, named EAGLE-Net, for identifying anatomical landmarks in the upper gastrointestinal (GI) tract endoscopic videos. Unlike conventional techniques, which label anatomical landmarks for static endoscopic images, the proposed method aims to classify landmarks from videos of the upper GI tract. Video streams often suffer from many noises and contaminated objects, which requires a new approach to tackle this issue. The proposed technique utilizes hierarchical network architecture, which consists of two stages: endoscopic image quality assessment and anatomical landmark classification. In the first stage, high-quality frames are preserved from GI tract videos. These frames are then used to identify a specific location among ten anatomical landmarks. The proposed method increases the coherence between the hierarchical data levels. It integrates an attention module to strengthen feature connections and utilizes a new hierarchical cross-entropy loss function to optimize model performance. The experimental results demonstrated that the proposed system achieves a high accuracy of 93% on average in both classification stages. In clinical experiments, anatomical landmarks are automatically denoted to help physicians monitor the endoscopy process. In addition, the proposed method demonstrates a potential solution for the deployment of a computer-aided diagnostic application for the detection and treatment of upper GI tract lesions. • Develop a hierarchical neural network to classify images from endoscopic procedures. • Enhance the detection of anatomical landmarks using an attention-based mechanism. • Achieve 93 percent accuracy in identifying clinically informative frames from endoscopic videos. • Improve classification performance for difficult-to-detect landmarks within the digestive tract. • Enable real-time decision support for clinical use in upper gastrointestinal endoscopy.

This study investigates the impact of 19 external factors, related to weather, road traffic conditions, air quality, and time, on the hourly occurrence of emergencies. The analysis relies on six years of dispatch records (2015–2021) from the Centre Hospitalier Universitaire Vaudois (CHUV), which oversees 18 ambulance stations across the French-speaking region of Switzerland. First, classical statistical methods, including Chi-squared test, Student’s t-test, and information value, are employed to identify dependencies between the occurrence of emergencies and the considered parameters. Additionally, SHapley Additive exPlanations (SHAP) values and permutation importance are computed using eXtreme Gradient Boosting (XGBoost) and Multilayer Perceptron (MLP) models. Training and hyperparameter optimization were performed on data from 2015–2020, while the 2021 data were held out for evaluation and for computing model interpretation metrics. Results indicate that temporal features – particularly the hour of the day – are the dominant drivers of emergency occurrences, whereas other external factors contribute minimally once temporal effects are accounted for. Subsequently, performance comparisons with a simplified model that considers only the hour of the day suggest that more complex machine learning approaches offer limited added value in this context. Operationally, this result supports the use of simple time-dependent demand curves for EMS planning. Such models can effectively guide staffing schedules and relocations without the overhead of integrating external data or maintaining complex pipelines. By highlighting the limited utility of external predictors, this study provides practical guidance for EMS organizations seeking efficient, data-driven resource allocation methods.

Medical imaging (MI) plays a vital role in healthcare by providing detailed insights into anatomical structures and pathological conditions, supporting accurate diagnosis and treatment planning. Noninvasive modalities, such as X-ray, magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US), produce high-resolution images of internal organs and tissues. The effective interpretation of these images relies on the precise segmentation of the regions of interest (ROI), including organs and lesions. Traditional methods based on manual feature extraction are time-consuming, inconsistent, and not scalable. This review explores recent advances in artificial intelligence (AI)-driven segmentation, focusing on Convolutional Neural Network (CNN) architectures, particularly the U-Net family and its variants—U-Net++, and U-Net 3+. These models enable automated, pixel-wise classification across modalities and have improved segmentation accuracy and efficiency. The review outlines the evolution of U-Net architectures, their clinical integration, and offers a modality-wise comparison. It also addresses challenges such as data heterogeneity, limited generalizability, and model interpretability, proposing solutions including attention mechanisms and Transformer-based designs. Emphasizing clinical applicability, this work bridges the gap between algorithmic development and real-world implementation. • Review U-Net applications in medical image segmentation across modalities. • Analyze deep learning advancements in healthcare imaging techniques. • Identify key challenges in data quality and model generalization. • Explore strategies to enhance segmentation efficiency and accuracy. • Provide insights for selecting models and datasets in healthcare.

This study posits that a structured preprocessing and feature selection methodology might substantially improve the classification accuracy and generalizability of machine learning (ML) models in predicting stages of hepatitis C virus (HCV) using clinical and demographic data. The HCV is a chronic liver ailment characterized by many phases, necessitating precise and prompt categorization for optimal therapy. Although ML presents opportunities for stage prediction, issues such as class imbalance, missing data, and feature redundancy limit model efficacy and generalizability. To test this theory, we established an extensive four-phase preparation pipeline: Baseline imputes missing values using class-specific means; Refine mitigates outliers through class-specific medians and normalization; Balanced addresses class imbalance across five stages employing localized random affine shadow-sampling; and Augmented incorporates a clustering-based feature derived from an ensemble of K-means and Gaussian mixture models, combined with principal component analysis. The prediction model was developed by optimizing feature selection with the ReliefF approach and a random forest classifier employing random search. The resultant model exhibited outstanding performance, attaining an accuracy of 0.9983, precision of 0.9984, recall of 0.9983, F1-score of 0.9984, and Matthews correlation coefficient (MCC) of 0.9979 on the training set. It achieved an accuracy of 0.9977, precision of 0.9976, recall of 0.9981, F1-score of 0.9978, and MCC of 0.9973 on the independent test. The ensemble clustering component demonstrated reasonable validity, shown by an adjusted Rand index of 1.0, a moderate silhouette coefficient of 0.4702, and a Davies–Bouldin score of 1.1745, modestly outperforming individual clustering methods. The findings support the hypothesis and demonstrate that thorough preprocessing, stringent feature selection, and model optimization provide a highly accurate and generalizable tool for predicting HCV stages, hence improving clinical diagnosis and treatment strategies. • Propose a hybrid model to classify hepatitis C infection stages with clinical data. • Address class imbalance with a localized sampling technique for reliable diagnosis. • Improve prediction using advanced feature extraction and selection strategies. • Integrate ensemble clustering with dimensionality reduction to reveal patterns. • Deliver high accuracy and strong generalization through robust model optimization.

Digital healthcare relies on accurate, connected data to deliver safe and efficient patient care. Yet, fragmented management systems create data silos, limit interoperability, and delay clinical and administrative decisions. These conditions impede the promise of personalized, coordinated, and efficient care. Smart Product Service Systems (Smart PSS) integrate intelligent products, digital platforms, and value-added services, thereby providing a pathway to enhanced data management and improved patient care. Prior studies seldom identify or link the specific Smart PSS attributes that shape healthcare data management and organizational performance, particularly from a causal perspective. This study fills that gap by developing an analytical framework for improving healthcare data management and organizational performance. A literature review produced 47 candidate attributes. Thirty-three healthcare experts validated 27 attributes through the Fuzzy Delphi Method. Fuzzy Decision-Making Trial and Evaluation Laboratory then mapped the causal structure among the validated attributes and their associated aspects. Intelligent products, stakeholder collaboration, and service realization emerged as core causal aspects that influence data management and organizational performance. Smart repair, monitoring and early warning, synchronized transactions, information integration, data quality, and organizational readiness ranked as the most influential criteria for practice. By prioritizing these criteria, healthcare managers reduce data fragmentation and improve service outcomes. The study provides a hierarchical Smart PSS framework and managerial guidance for institutions advancing digital healthcare.

This study investigates how the determinants of Japanese workers’ well-being shifted before and during the COVID-19 pandemic. We estimate a Bayesian hierarchical panel model and Markov chain Monte Carlo sampling is implemented with the ancillarity–sufficiency interweaving strategy to handle the high parameter-to-sample ratio efficiently. Consequently, we observed that positive drivers include marriage, good health, job satisfaction, and conversion from nonregular to regular employment, whereas male gender, turnover intention, reduced family contact, and pandemic-related financial concerns lower well-being. Age traces a U-shape, and weekday sleep shows an inverse-U pattern. Although the evidence is correlational and confined to self-reported data from one country, the analysis clarifies how socio-economic and workplace factors interact with a major external shock.