Level Fusion Research Articles

The Effects of Sensor and Feature Level Fusion Methods in Multimodal Emotion Analysis

Fusion-based multimodal emotion recognition (MER) studies are very popular nowadays. In this study, EEG signals and face images are fused with sensor level fusion (SLF) and feature level fusion (FLF) methods for multimodal emotion recognition. The general flow of the study is as follows. Firstly, EEG signals are converted into angle amplitude graph (AAG) images. Secondly, the most unique ones are automatically identified from all face images obtained from video recordings. Then, these modalities are fused separately using SLF and FLF methods. The fusion approaches were used to combine the obtained data and perform classification on the integrated data. The experiments were performed with the publicly available DEAP dataset. The highest accuracy was 82.14% with 5.26 standard deviations for SLF and 87.62% with 6.74 standard deviations for FLF. These results show that this study makes a significant contribution to the field of emotion recognition by providing an effective method.

Clinical prediction model for red cell blood transfusion in elective primary posterior lumbar spine fusion

Overestimated the cross-match of preoperative PRC preparation for elective primary lumbar spinal fusion needs revision for cost-effectiveness. We aimed to develop a novel preoperative predictive model for appropriate PRC preparation. This clinical prediction model in a retrospective cohort was studied between January 2015 and September 2022. Multivariate logistic regression models were used to assess predictive variables. The logistic coefficient of each predictor generated scores to establish a predictive model. The area under the receiver operating characteristic curve (AuROC) was used to evaluate the model. The predictive performance was validated using bootstrapping techniques and externally validated in 102 independent cases. Among 416 patients, 178 (43%) required transfusion. Four final predictors: preoperative hematocrit level, laminectomy level, transforaminal lumbar interbody fusion level, and sacral fusion. When categorized into two risk groups, the positive predictive values for the low-risk score (≤ 4) were 18.4 (95% Cl 13.9, 23.6) and 83.9 (95% CI 77.1, 89.3) for the high-risk score (> 4). AuROC was 0.90. Internal validation (bootstrap shrinkage = 0.993) and external validation (AuROC: 0.91). A new model demonstrated exemplary performance and discrimination in predicting the appropriate preparation for PRC. This study should be corroborated by rigorous external validation in other hospitals and by prospective assessments.

Defining Age-Adjusted PI-LL Targets for Surgical Realignment in Adult Degenerative Scoliosis: A Retrospective Cohort Study.

Objectives: The purpose of this study was to investigate postoperative pelvic incidence minus lumbar lordosis mismatch (PI-LL) and health-related quality of life (HRQOL) outcomes to determine age-adjusted PI-LL targets. Method: The dataset encompassed a range of variables, including age, sex, body mass index, Charlson comorbidity index, presence of osteopenia, hospital stay, operative duration, blood loss, American Society of Anesthesiologists score, number of fusion levels, lumbar lordosis, sagittal vertical axis, pelvic incidence, and PI-LL. The non-linear relationship between PI-LL and clinical outcomes was examined using a curve analysis, with adjustments made for potential confounding variables. Upon identification of a non-linear relationship, a two-piecewise regression model was employed to determine the threshold effect. Results: A total of 280 patients were enrolled. In the fully adjusted model, the optimal PI-LL target for patients aged 45-54 years old was PI-LL < 10°, the optimal target for patients aged 55-74 was 10-20°, and the optimal target for patients older than 75 years was more suitable for PI-LL > 20°. In the curve-fitting graph, it could be seen that the relationship between PI-LL and HRQOL outcomes was not linear in each age group. The peaks of the curves within each group occurred at different locations. Higher and lower thresholds for optimal surgical goals were determined using the two-piecewise regression model from the SRS-22 score and the ODI score. Conclusions: This study showed that the optimal PI-LL after corrective surgery in adult degenerative scoliosis patients should be adjusted according to age.

Distal Lumbar Lordosis is Associated With Reoperation for Adjacent Segment Disease After Lumbar Fusion for Degenerative Conditions.

A single centre retrospective review. Recent studies have suggested that distal lordosis (L4-S1, DL) remains constant across all pelvic incidence (PI) subgroups, whilst proximal lordosis (L1-L4, PL) varies. We sought to investigate the impact of post-operative DL on adjacent segment disease (ASD) requiring reoperation in patients undergoing lumbar fusion for degenerative conditions. Patients undergoing 1-3 level lumbar fusion with the two senior authors between 2007-16 were included. Demographic and radiographic data were recorded. Univariate, multivariate binary logistic regression, and Kaplan Meier survivorship analyses were performed. 335 patients were included in the final analysis. Most had single (67%) or two (31%) level fusions. The mean follow-up was 64-month. Fifty-seven patients (17%) underwent reoperation for ASD at an average of 78-month post-operatively (R group). The R group had a significantly lower mean post-operative DL (27.3 vs 31.1 deg, P < .001) and mean PI (55.5 vs 59.2 deg, P < .05). On univariate analysis, patients with a post-operative DL of <35 deg had higher odds of reoperation for ASD than those with a post-operative DL of ≥35 deg (OR 2.7, P = .016). In the multivariate model, post-operative DL, low/average PI, and spondylolisthesis were all significantly associated with reoperation for ASD. This study provides preliminary support to an association between post-operative distal lumbar lordosis and risk of reoperation for ASD in patients undergoing fusions for degenerative conditions. Further multicentre prospective study is needed to independently confirm this association and identify the impact of restoration of physiological distal lumbar lordosis on long term patient outcomes.

Return to sporting activities following long fusions to the pelvis in adult spinal deformity

Returning to recreational sporting activities after adult spinal deformity (ASD) correction may significantly impact the patient's perceived quality of life. This study sought to characterize participation in sporting activities before and after ASD surgery, and to identify factors associated with impaired return to sports. Cross-sectional survey and retrospective review of prospectively collected data. Patients who underwent posterior-only thoracolumbar ASD surgery between 2016 and 2021 with ≥1 year follow-up and ≥3 levels of fusion to the pelvis were included. Preoperative and postoperative participation in sports, timing of return to these activities, and reasons for limited sports participation postoperatively were assessed. A survey was used to evaluate outcome measures. Differences in demographic, surgical, and perioperative variables between patients who reported improved, unchanged, or worsened activity tolerance were evaluated. Ninety-five patients were included (mean age: 64.3±10.1 years; BMI: 27.3±6.1 kg/m2; median levels fused: 7). The survey was completed at an average of 43.5±15.9 months after surgery. Sixty-eight (72%) patients participated in sports preoperatively. The most common sports were swimming (n=33, 34.7%), yoga (n=23, 24.2%), weightlifting (n=20, 21.1%), elliptical (n=19, 20.0%), and golf (n=11, 11.6%). Fifty-seven (83.8%) returned to at least one sport postoperatively, most commonly 6-12 months after surgery (45%). Elliptical had the highest rate of equal or improved participation (53%). Patients generally returned below their preoperative level to all other sports. Reasons for reduced sporting activities included physical limitation (51.4%), fear (20.0%), pain (17.1%), and surgeon advice (8.6%). There were no differences in the demographic, surgical, or perioperative characteristics between those who returned to sports at the same or better level compared with those who returned at a lower level. About 84% of patients successfully resumed sporting activities after undergoing fusion to the sacrum/pelvis for ASD. However, this return is typically at a lower level of participation than their preoperative participation, particularly in higher demand sports. Understanding trends in sporting activity may be valuable for counseling patients and setting expectations.

Bigdata clustering and classification with improved fuzzy based deep architecture under MapReduce framework

The current state of economic, social ideas, and the advancement of cutting-edge technology are determined by the primary subjects of the contemporary information era, big data. People are immersed in a world of information, guided by the abundance of data that penetrates every element of their surroundings. Smart gadgets, the IoT, and other technologies are responsible for the data’s explosive expansion. Organisations have struggled to store data effectively throughout the past few decades. This disadvantage is related to outdated, expensive, and inadequately large storage technology. In the meanwhile, large data demands innovative storage techniques supported by strong technology. This paper proposes the bigdata clustering and classification model with improved fuzzy-based Deep Architecture under the Map Reduce framework. At first, the pre-processing phase involves data partitioning from the big dataset utilizing an improved C-Means clustering procedure. The pre-processed big data is then handled by the Map Reduce framework, which involves the mapper and reducer phases. In the mapper phase. Data normalization takes place, followed by the feature fusion approach that combines the extracted features like entropy-based features and correlation-based features. In the reduction phase, all the mappers are combined to produce an acceptable feature. Finally, a deep hybrid model, which is the combination of a DCNN and Bi-GRU is used for the classification process. The Improved score level fusion procedure is used in this case to obtain the final classification result. Moreover, the analysis of the proposed work has proved to be efficient in terms of classification accuracy, precision, recall, FNR, FPR, and other performance metrics.

The Effects of Longer Use of Teriparatide on Clinical and Radiographic Outcomes after Spinal Fusion in Geriatric Patients.

Background: Teriparatide is an anabolic agent for osteoporosis and is believed to improve the bone healing process. Previous studies showed that teriparatide could enhance not only fracture healing but also spine fusion. It has been reported that use of teriparatide could promote the spine fusion process and decrease mechanical complications. However, there was no consensus regarding optimal treatment duration. The purpose of this study was to compare surgical outcomes between short-duration and long-duration teriparatide treatment after lumbar fusion surgery in elderly patients. Materials and Methods: All consecutive patients older than 60 years who underwent 1-level lumbar fusion surgery for degenerative diseases between January 2015 and December 2019 were retrospectively reviewed. Based on the duration of teriparatide treatment (daily subcutaneous injection of 20 µg teriparatide), patients were subdivided into two groups: a short-duration (SD) group (<6 months) and a long-duration (LD) group (≥6 months). Mechanical complications, such as screw loosening, cage subsidence, and adjacent vertebral fractures, were investigated. Postoperative 1-year union rate was also evaluated on computed tomography. Clinical outcomes were recorded using visual analog scale (VAS) and Oswestry Disability Index (ODI). Between-group differences for these radiographic and clinical outcomes were analyzed. Results: Ninety-one patients were reviewed in this study, including sixty patients in the SD group and thirty-one patients in the LD group. Their mean age was 72.3 ± 6.2 years, and 79 patients were female. Mean T-score was -3.3 ± 0.8. Cage subsidence (6.7% vs. 3.2%), screw loosening (28.3% vs. 35.5%), and adjacent vertebral fracture (6.7% vs. 9.7%) were not significantly different between the SD and LD groups. Union rate at 1-year postoperative was 65.0% in the SD group and 87.1% in the LD group (p = 0.028). Both groups showed improvement in VAS and ODI after surgery. However, the differences of VAS from preoperative to 6 months and 1 year postoperative were significantly higher in the LD group. Conclusions: Longer teriparatide treatment after lumbar fusion surgery resulted in a higher union rate at 1-year postoperative than the shorter treatment. Also, it could be more beneficial for clinical outcomes.

Predictive Value of Modified Frailty Index, Sarcopenia, Prognostic Nutritional Index, and Geriatric Nutritional Risk Index for Postoperative Complications in Oblique Lumbar Interbody Fusion Over 60 Years

ObjectiveElderly patients undergoing spinal surgery are at an increased risk of morbidity and mortality. Evaluating frailty and preoperative status is crucial for predicting postoperative outcomes. This study aimed to assess the predictive value of the modified Frailty Index (mFI), sarcopenia, Prognostic Nutritional Index (PNI) and Geriatric Nutritional Risk Index (GNRI) in determining postoperative complications in patients undergoing oblique lumbar interbody fusion (OLIF) over 60 years. MethodsPreoperative risk factors were assessed using 11 variables, including mFI, PNI, GNRI. Complication rates were compared among nonfrail (mFI = 0; n = 50), prefrail (mFI = 0.09–0.18; n = 144), and frail (mFI ≥0.27; n = 80) patients. Demographic and perioperative variables were compared between the complication and noncomplication groups. The incidence of complications was the primary outcome measure. ResultsComplications occurred in 36 of 274 patients (13.1%). The frail group exhibited a significantly higher incidence of pneumonia than the nonfrail and prefrail groups. The complication group displayed significant differences in several variables, including age, fusion level, albumin level, lymphocyte count, platelet count, creatinine level, and estimated blood loss. Moreover, mFI, PNI, and GNRI differed significantly between the complication and noncomplication groups. ConclusionMFI, PNI, and GNRI can be useful for predicting postoperative morbidity and mortality in patients undergoing OLIF. These comprehensive assessment methods enable the identification of high-risk patients and the formulation of tailored strategies to enhance postoperative outcomes. Integrating mFI, PNI, and GNRI into the preoperative evaluation process can help healthcare providers proactively manage high-risk patients, thus improving the overall quality of care for elderly individuals undergoing OLIF.

Anterior cervical hybrid constructs reduce superior adjacent segment burden compared to multilevel anterior cervical discectomy and fusion.

Traditional surgical treatment for symptomatic cervical degenerative disc disease is anterior cervical discectomy and fusion (ACDF), yet the increased risk of adjacent segment degeneration (ASD) requiring additional surgery exists and may result in limiting long-term surgical success when it occurs. Disc arthroplasty can preserve or restore physiologic range of motion (ROM), decreasing adjacent level stress and subsequent surgery. For patients with multilevel pathology requiring at least a 1-level fusion, interest is growing in anterior cervical hybrid (ACH) surgery as a partial motion-preserving procedure to decrease the adjacent level burden. This radiographic study compares postoperative superior adjacent segment motion between ACH and ACDF. Secondarily, total global motion, construct motion, inferior adjacent segment motion, and sagittal alignment parameters were compared. This is a single-center, multi-surgeon, retrospective cohort study of 2- and 3-level ACH and ACDF cases between 2013 and 2021. Degrees of motion were analyzed on flexion/extension views using Cobb angles to measure global (C2-C7) construct and adjacent segment lordosis. Neutral lateral X-rays were analyzed for alignment parameters, including global lordosis, cervical sagittal vertical axis (cSVA), and T1 slope (T1S). Differences were determined by independent t-test and Fisher's exact test. Of 100 patients, 38% were 2-level cases (47% ACH, 53% ACDF) and 62% were 3-level cases: (52% ACH, 48% ACDF). Postoperatively, superior adjacent segment motion increased with ACDF and decreased with ACH (-1.3°±5.3° ACH, 1.6°±4.6° ACDF, P=0.005). Postoperatively, the ACH group had greater ROM across the construct (16.3°±8.7° ACH, 4.7°±3.3° ACDF, P<0.001) and total global ROM (38.0°±12.8° ACH, 28.0°±11.1° ACDF, P<0.001). ACH resulted in a significant reduction of motion loss across the construct (-10.0°±11.7° ACH, -18.1°±10.8° ACDF, P<0.001). Postoperative alignment restoration was similar between both cohorts (-2.61°±8.36° ACH, 0.04°±12.24° ACDF, P=0.21). Compared to ACDF, hybrid constructs partially preserved motion across operative levels and had greater postoperative global ROM without increasing superior adjacent segment mobility or sacrificing alignment restoration. This supports the consideration of ACH in patients with multilevel degenerative cervical pathology requiring at least a 1-level fusion and suggests a propensity for long-term success by reducing the superior adjacent segment burden.

Predictive role of FRAX© for postoperative proximal junctional kyphosis with vertebral fracture after adult spinal deformity surgery.

To identify risk factors, including FRAX (a tool for assessing osteoporosis) scores, for development of proximal junctional kyphosis (PJK), defined as Type 2 in the Yagi-Boachie classification (bone failure), with vertebral fracture (VF) after surgery for symptomatic adult spinal deformity. This was a retrospective, single institution study of 127 adults who had undergone corrective long spinal fusion of six or more spinal segments for spinal deformity and been followed up for at least 2years. The main outcome was postoperative development of PJK with VF. Possible predictors of this outcome studied included age at surgery, BMI, selected radiographic measurements, bone mineral density, and 10-year probability of major osteoporotic fracture (MOF) as determined by FRAX. We also analyzed use of medications for osteoporosis. Associations between the selected variables and PJK with VF were assessed by the Mann-Whitney, Fishers exact, and Wilcoxon signed-rank tests, and Kaplan-Meier analysis, as indicated. Forty patients (31.5%) developed PJK with VF postoperatively,73% of them within 6months of surgery. Statistical analysis of the selected variables found that only a preoperative estimate by FRAX of a > 15% risk of MOF within 10years, pelvic tilt > 30° at first standing postoperatively and lower instrumented level (fusion terminating at the pelvis) were significantly associated with development of PJK with VF. Preoperative assessment of severity of osteoporosis using FRAX provides an accurate estimate of risk of postoperative PJK with VF after surgery for adult spinal deformity.

Longitudinal effects of cognitive fusion in depressive and anxious symptoms of family caregivers of people with dementia.

Family dementia caregiving has been commonly associated with psychological distress for caregivers. Cognitive fusion, that is, the tendency to become too entangled in thoughts, beliefs, or judgments (in the absence of objectivity) that may often lead to rigid thinking and impact psychological distress, is a transdiagnostic and central process of psychological inflexibility. Cross-sectional studies have shown that family caregivers of people with dementia who could present high levels of stress may be vulnerable to experiencing psychological symptoms such as depression and anxiety (even comorbidity) if they present this rigid way of thinking without seeing the objectivity of their thoughts, which could be related to aspects of the family member's dementia or helplessness in being a caregiver, for example. Specifically, studies in the caregiving field, as well as in other populations, suggest that cognitive fusion could play a mediating role in the relationship between stress and psychological symptoms. However, the predictive role of caregivers' cognitive fusion on psychological distress has not been analyzed in longitudinal studies. The objective of this study was to analyze the longitudinal effect of cognitive fusion in depressive and anxious symptoms after controlling for other relevant variables in a sample of Spanish family caregivers. Face to face assessments were conducted with a total of 176 Spanish family dementia caregivers. The study involved three assessments in a two-year period (baseline, 12 and 24 months). Linear mixed model analysis was used to analyze the associations between time-varying values of frequency and reaction to care-recipient behavioral problems, cognitive fusion, and caregivers' depressive and anxiety symptoms. Increases in cognitive fusion significantly predicted depressive and anxious symptoms (p < 0.01). In addition, reaction to care-recipients’ behavioral problems and being a female caregiver predicted increases in anxiety symptoms over time (p < 0.05). These results suggested that cognitive fusion may constitute a core dysfunctional mechanism involved in depressive and anxious symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers' distress.

Clinical Outcome of Lumbar Hybrid Surgery in a Consecutive Series of Patients with Long-term Follow-up.

This was a retrospective study combined with attempted prospective patient contact to collect current data. The purpose of this study was to investigate long-term clinical outcome of patients undergoing lumbar hybrid surgery (total disc replacement (TDR) at one level and fusion at an adjacent level. Many patients with symptomatic lumbar disc degeneration are affected at more than one level. Lumbar TDR was introduced as a fusion alternative; however, some disc levels are not amenable to TDR and fusion is preferable at such levels. Hybrid surgery was introduced as an option to fusing multiple levels. A consecutive series of 305 patients undergoing lumbar hybrid surgery was identified beginning with the first case experience in 2005. Operative and clinical outcome data including visual analog scales (VAS) assessing back and leg pain, Oswestry Disability Index (ODI), and re-operations were collected. The mean follow-up duration was 67.1 months. There were statistically significant improvements (P<0.01) in the mean values of all three clinical outcome measures: VAS back pain scores improved from 6.7 to 3.3; leg pain improved from 4.3 to 2.0; and ODI scores improved from 45.5 to 24.6. There were no significant differences in pain and function scores for patients with minimum 10-year follow-up vs. those with shorter follow-up duration. Re-operation occurred in 16.1% of patients, many of which involved removal of posterior instrumentation at the fusion level (6.2% of study group, 38.8% of re-operations). Re-operation involving the TDR level occurred in 9 patients (2.9%), only 3 of which (1.0%) involved TDR removal/revision. This study supports that for many patients with multilevel symptomatic disc degeneration, hybrid surgery is a viable surgical option. Significant improvements were demonstrated in pain and function scores with no diminished improvement in scores among patients with more than 10-year follow-up.

Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion.

Retrospective Study. To compare subsidence and radiographic fusion rates of titanium-surface polyetheretherketone (PEEK-Ti) and 3D-Titanium (3D-Ti) cages, implanted within the same patient concurrently, during multi-level transforaminal lumbar interbody fusions (TLIF). Forty-eight patients were treated with both PEEK-Ti and 3D-Ti cages during 2- or 3-level TLIF and instrumented posterolateral fusion (108 spinal levels in all). Equivalent bone graft material was implanted within each patient. Radiographic analysis of CT and/or X-ray imaging was performed retrospectively for each spinal level throughout 12-month follow-up period. Fusion was defined as bridging trabecular bone and subsidence was incursion into one/both vertebral bodies >20% cage height. Outcomes were analyzed with Fisher's exact test. At 6-months post-operative follow-up, incidence of subsidence was significantly lower for PEEK-Ti cages, with 4.8% subsidence, compared to a 27.9% subsidence rate for 3D-Ti cages (P = .007). Fusion rates were comparable at 100% for PEEK-Ti and 95.5% for 3D-Ti. Results at 12-months showed similar but not statistically significant trends of less subsidence with PEEK-Ti than 3D-Ti cages (14.3% PEEK-Ti, 37.5% 3D-Ti), and similar fusion rates of 100% for PEEK-Ti and 91.7% for 3D-Ti. Thirty-nine out of 48 total patients were available for follow-up at 6 months and 20 patients at 12 months. CT availability at 6 and 12-months was 100% and 90%, respectively. A significantly lower subsidence rate was associated with a PEEK-Ti cage, compared to 3D-Ti, 6 months after TLIF. Results may not be generalized across technologies due to differences in cage designs; additional research studies are warranted.

The ArgR-Regulated ADI Pathway Facilitates the Survival of Vibrio fluvialis under Acidic Conditions.

Vibrio fluvialis is an emerging foodborne pathogenic bacterium that can cause severe cholera-like diarrhea and various extraintestinal infections, posing challenges to public health and food safety worldwide. The arginine deiminase (ADI) pathway plays an important role in bacterial environmental adaptation and pathogenicity. However, the biological functions and regulatory mechanisms of the pathway in V. fluvialis remain unclear. In this study, we demonstrate that L-arginine upregulates the expression of the ADI gene cluster and promotes the growth of V. fluvialis. The ADI gene cluster, which we proved to be comprised of two operons, arcD and arcACB, significantly enhances the survival of V. fluvialis in acidic environments both in vitro (in culture medium and in macrophage) and in vivo (in mice). The mRNA level and reporter gene fusion analyses revealed that ArgR, a transcriptional factor, is necessary for the activation of both arcD and arcACB transcriptions. Bioinformatic analysis predicted the existence of multiple potential ArgR binding sites at the arcD and arcACB promoter regions that were further confirmed by electrophoretic mobility shift assay, DNase I footprinting, or point mutation analyses. Together, our study provides insights into the important role of the ArgR-ADI pathway in the survival of V. fluvialis under acidic conditions and the detailed molecular mechanism. These findings will deepen our understanding of how environmental changes and gene expression interact to facilitate bacterial adaptations and virulence.

Comparison of health promotion lifestyle, metacognitive beliefs, cognitive fusion, experiential avoidance, and emotion regulation in couples with emotional divorce and normal couplescopules

Introduction: One of the important factors of psychological dysfunction in families is the conflict resulting from emotional divorce. Therefore, the present study aimed to compare the effects of health-promoting lifestyle, metacognitive beliefs, cognitive fusion, experiential avoidance, and emotional regulation on couples with emotional divorce and normal couples. Method: The current comparative causal research was conducted on 88 married students of the Islamic Azad University of Qom, who were selected by the convenience sampling method, (44 subjects with emotional divorce and 44 normal subjects). The research tools were Health Promotion Questionnaire developed by Walker et al. [1987], Emotional Divorce prepared by Gutman et al. [2001], Metacognitive Beliefs made by Wells and Cartwright Hutton [2004], Cognitive Fusion prepared by Gillands et al. [2010], Experiential Avoidance Questionnaire developed by Gams et al. in 2011, and Emotion Regulation Questionnaire made by Gross and John in 2003. Data analysis was performed using analysis of variance in SPSS software (version 27). Results: The results showed that couples with emotional divorce had different levels of health-promoting lifestyle (P=0.000, F=19.74), metacognitive beliefs (P=0.000, F=31.74), cognitive fusion (P=0.000, F=16.28), and experiential avoidance (P=0.000, F=19.31), compared to normal couples. Moreover, couples with emotional divorce used a more non-adaptive strategy (Fronshani, P=0.001, F=12/43) to regulate emotion in comparison with normal couples. Conclusion: The results indicated the difference in research variables between couples with emotional divorce and normal couples. Therefore, psychological health screening is suggested to prevent small levels of psychological problems in the sample group

Artificial intelligence enhances whole-slide interpretation ofPD-L1 CPS in triple-negative breast cancer: Amulti-institutional ring study.

Evaluation of the programmed cell death ligand-1 (PD-L1) combined positive score (CPS) is vital to predict the efficacy of the immunotherapy in triple-negative breast cancer (TNBC), but pathologists show substantial variability in the consistency and accuracy of the interpretation. It is of great importance to establish an objective and effective method which is highly repeatable. We proposed a model in a deep learning-based framework, which at the patch level incorporated cell analysis and tissue region analysis, followed by the whole-slide level fusion of patch results. Three rounds of ring studies (RSs) were conducted. Twenty-one pathologists of different levels from four institutions evaluated the PD-L1 CPS in TNBC specimens as continuous scores by visual assessment and our artificial intelligence (AI)-assisted method. In the visual assessment, the interpretation results of PD-L1 (Dako 22C3) CPS by different levels of pathologists have significant differences and showed weak consistency. Using AI-assisted interpretation, there were no significant differences between all pathologists (P = 0.43), and the intraclass correlation coefficient (ICC) value was increased from 0.618 [95% confidence interval (CI) = 0.524-0.719] to 0.931 (95% CI = 0.902-0.955). The accuracy of interpretation result is further improved to 0.919 (95% CI = 0.886-0.947). Acceptance of AI results by junior pathologists was the highest among all levels, and 80% of the AI results were accepted overall. With the help of the AI-assisted diagnostic method, different levels of pathologists achieved excellent consistency and repeatability in the interpretation of PD-L1 (Dako 22C3) CPS. Our AI-assisted diagnostic approach was proved to strengthen the consistency and repeatability in clinical practice.

RSR-YOLO: a real-time method for small target tomato detection based on improved YOLOv8 network

In tomato producing fields, automated large-area detection method is critical for fruit health monitoring and harvesting. However, due to the limited feature information included in tomatoes, large-area detection across long distances results in more missing or incorrect detections. To address this issue, this research proposes an improved YOLOv8 network, RSR-YOLO, for long-distance identification of tomato fruits. Firstly, this paper designs a partial group convolution (PgConv) and furthermore an innovative FasterNet (IFN) module for feature extraction, taking into account the impact of split operations on the computational complexity of the backbone network. The IFN module is lightweight and efficient, which improves the detection accuracy and real-time detection performance of the model. Secondly, this research combines the Gather and Distribute mechanism (GD) and redesigns the feature fusion module to implement the extraction and fusion of various levels of tomato features, given the critical significance that low-dimensional features play in small target recognition and localization. Finally, Repulsion Loss is used in this paper to examine the impact of fruit overlap and leaf occlusion on detection outcomes. RSR-YOLO achieves precision, recall, F1 score, and mean average precision (mAP@0.5) of 91.6%, 85.9%, 88.7%, and 90.7%, respectively, marking increases of 4.2%, 4%, 4.2%, and 3.6% compared to YOLOv8n. In addition, this paper designs a specialized Graphical User Interface (GUI) for the real-time detection task of tomatoes.

“Image-Spectral” fusion monitoring of small cotton samples nitrogen content based on improved deep forest

Accurate monitoring of nitrogen nutrition is crucial for improving cotton yield and quality, as well as the ecological environment. The mainstream method for monitoring nutrition is to establish traditional machine learning (ML) models using a single data source. However, this approach has limitations such as limited access to feature information, model-fitting problems, and limited generalization. Deep learning (DL), on the other hand, has shown promise in complex nonlinear modeling tasks due to its flexible structure. However, it has its limitations, such as the fact that agronomic sample collection and testing are usually labor- and material-intensive, resulting in sample sizes that are too small to meet its training conditions. Therefore, there is an urgent need for DL models that can effectively integrate features from multiple data sources and accurately monitor crop nitrogen content, especially in scenarios with small samples. In this study, we conducted indoor pot experiments using the cotton variety Xinluzao 53 and subjected it to six nitrogen treatments. The data sources for our analysis included hyperspectral and digital images of the cotton leaves. To enhance representation learning capabilities, we enriched the multi-class base learners within each layer of the deep forest (DF) model and introduced skip connections. These enhancements improved the quality of inversion for both hyperspectral and digital image datasets. We then developed image-spectral fusion models, which combined the DF structure with stacking ensemble learning. Our focus was on three levels of fusion: feature-level fusion, decision-level fusion, and secondary decision-level fusion. This approach aimed to further enhance the accuracy and stability of nitrogen content inversion. The DF model satisfied the training condition for small samples. Compared to traditional ML algorithms and the original DF algorithm, the improved DF model achieved an increase in validation set R2 of 13.4–28.5% and 10.9–14.9%, respectively. These findings highlight the enhanced accuracy and stability of the improved DF model. Additionally, compared to the optimal inversion model using two single data sources, the “Image-Spectral” three-level fusion models exhibited improvements in validation set R2 of 8.6–9.3%, 10.5–11.2%, and 11.8–12.5% for feature-level, decision-level, and secondary decision-level fusion, respectively. The improved DF and three-level fusion model collectively contributed to the increased accuracy of cotton nitrogen content inversion. Among these models, the secondary decision-level fusion model demonstrated the most marked improvement. This methodology provides valuable insights into monitoring crop phenotypic parameters in situations with limited sample sizes.

Feature Level Fusion of Fingerprints and IRIS for the Enhancement of Biometric System

Background:: With the growing need for information safety and security rules in every corner of the globe. The biometric innovation has been used widely all over the world in daily life. In this view, the Multimodal-based biometric technique has gained popularity and interest due to its capability to resolve various problems associated with single-model biometric identification systems Methods:: In this research, an advanced multimodal-based biometric recognition system is introduced, which depends on multilayer perceptron (MLP), and it identifies humans using biometric features of Fingerprints and IRIS. To build an efficient model, the popular model called Rest- Net50 was used, the gradient method was used and the hinge technique was used as a loss function. For the technique of fusion, different techniques are used to show the effect of fusion in our model. The recognition rate of introduced systems was assessed by experimenting with various techniques on SDUMLA-HMT datasets based on the multimodal biometric datasets. The recognition rate showed that merging two biometric features in biometric recognition systems gives the best results compared to a single biometric feature. Results:: The results obtained showed the superiority of our model with other existing techniques by obtaining a recognition rate of 99.79% with a feature-based fusion method. Conclusion:: The introduced system used the MLP deep learning technique. The feature level fusion was applied to recognize the user using IRIS and fingerprints. To the best of our belief, this is the first research to incorporate MLP and multimodal-based biometric systems using IRIS and fingerprints.

Comparison of minimally invasive transforaminal lumbar interbody fusion and midline lumbar interbody fusion in patients with spondylolisthesis

BackgroundThis study aimed to compare surgical outcomes, clinical outcomes, and complications between minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and midline lumbar interbody fusion (MIDLIF) in patients with spondylolisthesis.MethodsThis study retrospectively compared the patients who underwent MIS TLIF (n = 37) or MIDLIF (n = 50) for spinal spondylolisthesis. Data of surgical outcomes (postoperative one-year fusion rate and time to bony fusion), clinical outcomes (visual analog scale [VAS] for pain and Oswestry Disability Index [ODI] for spine function), and complications were collected and analyzed.ResultsThere was more 2-level fusion in MIDLIF (46% vs. 24.3%, p = 0.038). The MIS TLIF and MIDLIF groups had similar one-year fusion rate and time to fusion. The MIDLIF group had significantly lower VAS at postoperative 3-months (2.2 vs. 3.1, p = 0.002) and postoperative 1-year (1.1 vs. 2.1, p = < 0.001). ODI was not significantly different. The operation time was shorter in MIDLIF (166.1 min vs. 196.2 min, p = 0.014). The facet joint violation is higher in MIS TLIF (21.6% vs. 2%, p = 0.009). The other complications were not significantly different including rate of implant removal, revision, and adjacent segment disease.ConclusionIn this study, postoperative VAS, operation time, and the rate of facet joint violation were significantly higher in the MIS TLIF group. Comparable outcomes were observed between MIDLIF and MIS TLIF in terms of fusion rate, time to fusion, and postoperative ODI score.