Zubair Shah

Usama Tariq, Rizwan Qureshi, Anas Zafar et al.

Generative models have been very successful over the years and have received significant attention for synthetic data generation. As deep learning models are getting more and more complex, they require large amounts of data to perform accurately. In medical image analysis, such generative models play a crucial role as the available data is limited due to challenges related to data privacy, lack of data diversity, or uneven data distributions. In this paper, we present a method to generate brain tumor MRI images using generative adversarial networks. We have utilized StyleGAN2 with ADA methodology to generate high-quality brain MRI with tumors while using a significantly smaller amount of training data when compared to the existing approaches. We use three pre-trained models for transfer learning. Results demonstrate that the proposed method can learn the distributions of brain tumors. Furthermore, the model can generate high-quality synthetic brain MRI with a tumor that can limit the small sample size issues. The approach can addresses the limited data availability by generating realistic-looking brain MRI with tumors. The code is available at: ~\url{https://github.com/rizwanqureshi123/Brain-Tumor-Synthetic-Data}.

Farida Mohsen, Hazrat Ali, Nady El Hajj et al.

Healthcare data are inherently multimodal, including electronic health records (EHR), medical images, and multi-omics data. Combining these multimodal data sources contributes to a better understanding of human health and provides optimal personalized healthcare. Advances in artificial intelligence (AI) technologies, particularly machine learning (ML), enable the fusion of these different data modalities to provide multimodal insights. To this end, in this scoping review, we focus on synthesizing and analyzing the literature that uses AI techniques to fuse multimodal medical data for different clinical applications. More specifically, we focus on studies that only fused EHR with medical imaging data to develop various AI methods for clinical applications. We present a comprehensive analysis of the various fusion strategies, the diseases and clinical outcomes for which multimodal fusion was used, the ML algorithms used to perform multimodal fusion for each clinical application, and the available multimodal medical datasets. We followed the PRISMA-ScR guidelines. We searched Embase, PubMed, Scopus, and Google Scholar to retrieve relevant studies. We extracted data from 34 studies that fulfilled the inclusion criteria. In our analysis, a typical workflow was observed: feeding raw data, fusing different data modalities by applying conventional machine learning (ML) or deep learning (DL) algorithms, and finally, evaluating the multimodal fusion through clinical outcome predictions. Specifically, early fusion was the most used technique in most applications for multimodal learning (22 out of 34 studies). We found that multimodality fusion models outperformed traditional single-modality models for the same task. Disease diagnosis and prediction were the most common clinical outcomes (reported in 20 and 10 studies, respectively) from a clinical outcome perspective.

Hazrat Ali, Shafaq Murad, Zubair Shah

Generative models are becoming popular for the synthesis of medical images. Recently, neural diffusion models have demonstrated the potential to generate photo-realistic images of objects. However, their potential to generate medical images is not explored yet. In this work, we explore the possibilities of synthesis of medical images using neural diffusion models. First, we use a pre-trained DALLE2 model to generate lungs X-Ray and CT images from an input text prompt. Second, we train a stable diffusion model with 3165 X-Ray images and generate synthetic images. We evaluate the synthetic image data through a qualitative analysis where two independent radiologists label randomly chosen samples from the generated data as real, fake, or unsure. Results demonstrate that images generated with the diffusion model can translate characteristics that are otherwise very specific to certain medical conditions in chest X-Ray or CT images. Careful tuning of the model can be very promising. To the best of our knowledge, this is the first attempt to generate lungs X-Ray and CT images using neural diffusion models. This work aims to introduce a new dimension in artificial intelligence for medical imaging. Given that this is a new topic, the paper will serve as an introduction and motivation for the research community to explore the potential of diffusion models for medical image synthesis. We have released the synthetic images on https://www.kaggle.com/datasets/hazrat/awesomelungs.

Hazrat Ali, Farida Mohsen, Zubair Shah

Vision transformer-based methods are advancing the field of medical artificial intelligence and cancer imaging, including lung cancer applications. Recently, many researchers have developed vision transformer-based AI methods for lung cancer diagnosis and prognosis. This scoping review aims to identify the recent developments on vision transformer-based AI methods for lung cancer imaging applications. It provides key insights into how vision transformers complemented the performance of AI and deep learning methods for lung cancer. Furthermore, the review also identifies the datasets that contributed to advancing the field. Of the 314 retrieved studies, this review included 34 studies published from 2020 to 2022. The most commonly addressed task in these studies was the classification of lung cancer types, such as lung squamous cell carcinoma versus lung adenocarcinoma, and identifying benign versus malignant pulmonary nodules. Other applications included survival prediction of lung cancer patients and segmentation of lungs. The studies lacked clear strategies for clinical transformation. SWIN transformer was a popular choice of the researchers; however, many other architectures were also reported where vision transformer was combined with convolutional neural networks or UNet model. It can be concluded that vision transformer-based models are increasingly in popularity for developing AI methods for lung cancer applications. However, their computational complexity and clinical relevance are important factors to be considered for future research work. This review provides valuable insights for researchers in the field of AI and healthcare to advance the state-of-the-art in lung cancer diagnosis and prognosis. We provide an interactive dashboard on lung-cancer.onrender.com/.

Hazrat Ali, Zubair Shah

This review presents a comprehensive study on the role of GANs in addressing the challenges related to COVID-19 data scarcity and diagnosis. It is the first review that summarizes the different GANs methods and the lungs images datasets for COVID-19. It attempts to answer the questions related to applications of GANs, popular GAN architectures, frequently used image modalities, and the availability of source code. This review included 57 full-text studies that reported the use of GANs for different applications in COVID-19 lungs images data. Most of the studies (n=42) used GANs for data augmentation to enhance the performance of AI techniques for COVID-19 diagnosis. Other popular applications of GANs were segmentation of lungs and super-resolution of the lungs images. The cycleGAN and the conditional GAN were the most commonly used architectures used in nine studies each. 29 studies used chest X-Ray images while 21 studies used CT images for the training of GANs. For majority of the studies (n=47), the experiments were done and results were reported using publicly available data. A secondary evaluation of the results by radiologists/clinicians was reported by only two studies. Conclusion: Studies have shown that GANs have great potential to address the data scarcity challenge for lungs images of COVID-19. Data synthesized with GANs have been helpful to improve the training of the Convolutional Neural Network (CNN) models trained for the diagnosis of COVID-19. Besides, GANs have also contributed to enhancing the CNNs performance through the super-resolution of the images and segmentation. This review also identified key limitations of the potential transformation of GANs based methods in clinical applications.

Hazrat Ali, Christer Gronlund, Zubair Shah

Artificial Intelligence (AI)-based models can help in diagnosing COVID-19 from lung CT scans and X-ray images; however, these models require large amounts of data for training and validation. Many researchers studied Generative Adversarial Networks (GANs) for producing synthetic lung CT scans and X-Ray images to improve the performance of AI-based models. It is not well explored how good GAN-based methods performed to generate reliable synthetic data. This work analyzes 43 published studies that reported GANs for synthetic data generation. Many of these studies suffered data bias, lack of reproducibility, and lack of feedback from the radiologists or other domain experts. A common issue in these studies is the unavailability of the source code, hindering reproducibility. The included studies reported rescaling of the input images to train the existing GANs architecture without providing clinical insights on how the rescaling was motivated. Finally, even though GAN-based methods have the potential for data augmentation and improving the training of AI-based models, these methods fall short in terms of their use in clinical practice. This paper highlights research hotspots in countering the data scarcity problem, identifies various issues as well as potentials, and provides recommendations to guide future research. These recommendations might be useful to improve acceptability for the GAN-based approaches for data augmentation as GANs for data augmentation are increasingly becoming popular in the AI and medical imaging research community.

Md Rafiul Biswas, Zubair Shah, Wajdi Zaghouani

This paper focuses on detecting propagandistic spans and persuasion techniques in Arabic text from tweets and news paragraphs. Each entry in the dataset contains a text sample and corresponding labels that indicate the start and end positions of propaganda techniques within the text. Tokens falling within a labeled span were assigned "B" (Begin) or "I" (Inside), "O", corresponding to the specific propaganda technique. Using attention masks, we created uniform lengths for each span and assigned BIO tags to each token based on the provided labels. Then, we used AraBERT-base pre-trained model for Arabic text tokenization and embeddings with a token classification layer to identify propaganda techniques. Our training process involves a two-phase fine-tuning approach. First, we train only the classification layer for a few epochs, followed by full model fine-tuning, updating all parameters. This methodology allows the model to adapt to the specific characteristics of the propaganda detection task while leveraging the knowledge captured by the pre-trained AraBERT model. Our approach achieved an F1 score of 0.2774, securing the 3rd position in the leaderboard of Task 1.

Farida Mohsen, Hamada R. H. Al-Absi, Noha A. Yousri et al.

The rising prevalence of type 2 diabetes mellitus (T2DM) necessitates the development of predictive models for T2DM risk assessment. Artificial intelligence (AI) models are being extensively used for this purpose, but a comprehensive review of their advancements and challenges is lacking. This scoping review analyzes existing literature on AI-based models for T2DM risk prediction. Forty studies were included, mainly published in the past four years. Traditional machine learning models were more prevalent than deep learning models. Electronic health records were the most commonly used data source. Unimodal AI models relying on EHR data were prominent, while only a few utilized multimodal models. Both unimodal and multimodal models showed promising performance, with the latter outperforming the former. Internal validation was common, while external validation was limited. Interpretability methods were reported in half of the studies. Few studies reported novel biomarkers, and open-source code availability was limited. This review provides insights into the current state and limitations of AI-based T2DM risk prediction models and highlights challenges for their development and clinical implementation.

Md. Rafiul Biswas, Ashhadul Islam, Zubair Shah et al.

The advanced large language model (LLM) ChatGPT has shown its potential in different domains and remains unbeaten due to its characteristics compared to other LLMs. This study aims to evaluate the potential of using a fine-tuned ChatGPT model as a personal medical assistant in the Arabic language. To do so, this study uses publicly available online questions and answering datasets in Arabic language. There are almost 430K questions and answers for 20 disease-specific categories. GPT-3.5-turbo model was fine-tuned with a portion of this dataset. The performance of this fine-tuned model was evaluated through automated and human evaluation. The automated evaluations include perplexity, coherence, similarity, and token count. Native Arabic speakers with medical knowledge evaluated the generated text by calculating relevance, accuracy, precision, logic, and originality. The overall result shows that ChatGPT has a bright future in medical assistance.

Ashhadul Islam, Md. Rafiul Biswas, Wajdi Zaghouani et al.

$ $The synergy of language and vision models has given rise to Large Language and Vision Assistant models (LLVAs), designed to engage users in rich conversational experiences intertwined with image-based queries. These comprehensive multimodal models seamlessly integrate vision encoders with Large Language Models (LLMs), expanding their applications in general-purpose language and visual comprehension. The advent of Large Multimodal Models (LMMs) heralds a new era in Artificial Intelligence (AI) assistance, extending the horizons of AI utilization. This paper takes a unique perspective on LMMs, exploring their efficacy in performing image classification tasks using tailored prompts designed for specific datasets. We also investigate the LLVAs zero-shot learning capabilities. Our study includes a benchmarking analysis across four diverse datasets: MNIST, Cats Vs. Dogs, Hymnoptera (Ants Vs. Bees), and an unconventional dataset comprising Pox Vs. Non-Pox skin images. The results of our experiments demonstrate the model's remarkable performance, achieving classification accuracies of 85\%, 100\%, 77\%, and 79\% for the respective datasets without any fine-tuning. To bolster our analysis, we assess the model's performance post fine-tuning for specific tasks. In one instance, fine-tuning is conducted over a dataset comprising images of faces of children with and without autism. Prior to fine-tuning, the model demonstrated a test accuracy of 55\%, which significantly improved to 83\% post fine-tuning. These results, coupled with our prior findings, underscore the transformative potential of LLVAs and their versatile applications in real-world scenarios.

Farida Mohsen, Zubair Shah

Type 2 Diabetes Mellitus (T2DM) remains a global health challenge, underscoring the need for early and accurate risk prediction. This study presents ECG-DiaNet, a multimodal deep learning model that integrates electrocardiogram (ECG) features with clinical risk factors (CRFs) to enhance T2DM onset prediction. Using data from Qatar Biobank (QBB), we trained and validated models on a development cohort (n=2043) and evaluated performance on a longitudinal test set (n=395) with five-year follow-up. ECG-DiaNet outperformed unimodal ECG-only and CRF-only models, achieving a higher AUROC (0.845 vs 0.8217) than the CRF-only model, with statistical significance (DeLong p<0.001). Reclassification metrics further confirmed improvements: Net Reclassification Improvement (NRI=0.0153) and Integrated Discrimination Improvement (IDI=0.0482). Risk stratification into low-, medium-, and high-risk groups showed ECG-DiaNet achieved superior positive predictive value (PPV) in high-risk individuals. The model's reliance on non-invasive and widely available ECG signals supports its feasibility in clinical and community health settings. By combining cardiac electrophysiology and systemic risk profiles, ECG-DiaNet addresses the multifactorial nature of T2DM and supports precision prevention. These findings highlight the value of multimodal AI in advancing early detection and prevention strategies for T2DM, particularly in underrepresented Middle Eastern populations.

Muhammad Rafiq, Hazrat Ali, Ghulam Mujtaba et al.

Deep learning-based computer-aided diagnosis (CAD) of medical images requires large datasets. However, the lack of large publicly available labeled datasets limits the development of deep learning-based CAD systems. Generative Adversarial Networks (GANs), in particular, CycleGAN, can be used to generate new cross-domain images without paired training data. However, most CycleGAN-based synthesis methods lack the potential to overcome alignment and asymmetry between the input and generated data. We propose a two-stage technique for the synthesis of abdominal MRI using cross-modality translation of abdominal CT. We show that the synthetic data can help improve the performance of the liver segmentation network. We increase the number of abdominal MRI images through cross-modality image transformation of unpaired CT images using a CycleGAN inspired deformation invariant network called EssNet. Subsequently, we combine the synthetic MRI images with the original MRI images and use them to improve the accuracy of the U-Net on a liver segmentation task. We train the U-Net on real MRI images and then on real and synthetic MRI images. Consequently, by comparing both scenarios, we achieve an improvement in the performance of U-Net. In summary, the improvement achieved in the Intersection over Union (IoU) is 1.17%. The results show potential to address the data scarcity challenge in medical imaging.

Sulaiman Khan, Md. Rafiul Biswas, Zubair Shah

This study introduces a novel approach for early Type 2 Diabetes Mellitus (T2DM) risk prediction using a tabular transformer (TabTrans) architecture to analyze longitudinal patient data. By processing patients` longitudinal health records and bone-related tabular data, our model captures complex, long-range dependencies in disease progression that conventional methods often overlook. We validated our TabTrans model on a retrospective Qatar BioBank (QBB) cohort of 1,382 subjects, comprising 725 men (146 diabetic, 579 healthy) and 657 women (133 diabetic, 524 healthy). The study integrated electronic health records (EHR) with dual-energy X-ray absorptiometry (DXA) data. To address class imbalance, we employed SMOTE and SMOTE-ENN resampling techniques. The proposed model`s performance is evaluated against conventional machine learning (ML) and generative AI models, including Claude 3.5 Sonnet (Anthropic`s constitutional AI), GPT-4 (OpenAI`s generative pre-trained transformer), and Gemini Pro (Google`s multimodal language model). Our TabTrans model demonstrated superior predictive performance, achieving ROC AUC $\geq$ 79.7 % for T2DM prediction compared to both generative AI models and conventional ML approaches. Feature interpretation analysis identified key risk indicators, with visceral adipose tissue (VAT) mass and volume, ward bone mineral density (BMD) and bone mineral content (BMC), T and Z-scores, and L1-L4 scores emerging as the most important predictors associated with diabetes development in Qatari adults. These findings demonstrate the significant potential of TabTrans for analyzing complex tabular healthcare data, providing a powerful tool for proactive T2DM management and personalized clinical interventions in the Qatari population. Index Terms: tabular transformers, multimodal data, DXA data, diabetes, T2DM, feature interpretation, tabular data

Zubair Shah, Noaman Khan

Neural network pruning is widely used to reduce model size and computational cost. Yet, most existing methods treat sparsity as an externally imposed constraint, enforced through heuristic importance scores or training-time regularization. In this work, we propose a fundamentally different perspective: pruning as an equilibrium outcome of strategic interaction among model components. We model parameter groups such as weights, neurons, or filters as players in a continuous non-cooperative game, where each player selects its level of participation in the network to balance contribution against redundancy and competition. Within this formulation, sparsity emerges naturally when continued participation becomes a dominated strategy at equilibrium. We analyze the resulting game and show that dominated players collapse to zero participation under mild conditions, providing a principled explanation for pruning behavior. Building on this insight, we derive a simple equilibrium-driven pruning algorithm that jointly updates network parameters and participation variables without relying on explicit importance scores. This work focuses on establishing a principled formulation and empirical validation of pruning as an equilibrium phenomenon, rather than exhaustive architectural or large-scale benchmarking. Experiments on standard benchmarks demonstrate that the proposed approach achieves competitive sparsity-accuracy trade-offs while offering an interpretable, theory-grounded alternative to existing pruning methods.

Atifa Kalsoom, M. A. Iftikhar, Amjad Ali et al.

Retinal fundus images provide valuable insights into the human eye's interior structure and crucial features, such as blood vessels, optic disk, macula, and fovea. However, accurate segmentation of retinal blood vessels can be challenging due to imbalanced data distribution and varying vessel thickness. In this paper, we propose BLCB-CNN, a novel pipeline based on deep learning and bi-level class balancing scheme to achieve vessel segmentation in retinal fundus images. The BLCB-CNN scheme uses a Convolutional Neural Network (CNN) architecture and an empirical approach to balance the distribution of pixels across vessel and non-vessel classes and within thin and thick vessels. Level-I is used for vessel/non-vessel balancing and Level-II is used for thick/thin vessel balancing. Additionally, pre-processing of the input retinal fundus image is performed by Global Contrast Normalization (GCN), Contrast Limited Adaptive Histogram Equalization (CLAHE), and gamma corrections to increase intensity uniformity as well as to enhance the contrast between vessels and background pixels. The resulting balanced dataset is used for classification-based segmentation of the retinal vascular tree. We evaluate the proposed scheme on standard retinal fundus images and achieve superior performance measures, including an area under the ROC curve of 98.23%, Accuracy of 96.22%, Sensitivity of 81.57%, and Specificity of 97.65%. We also demonstrate the method's efficacy through external cross-validation on STARE images, confirming its generalization ability.

Abdul Hannaan, Zubair Shah, Aiman Erbad et al.

This paper introduces a novel federated learning framework termed LoRa-FL designed for training low-rank one-shot image detection models deployed on edge devices. By incorporating low-rank adaptation techniques into one-shot detection architectures, our method significantly reduces both computational and communication overhead while maintaining scalable accuracy. The proposed framework leverages federated learning to collaboratively train lightweight image recognition models, enabling rapid adaptation and efficient deployment across heterogeneous, resource-constrained devices. Experimental evaluations on the MNIST and CIFAR10 benchmark datasets, both in an independent-and-identically-distributed (IID) and non-IID setting, demonstrate that our approach achieves competitive detection performance while significantly reducing communication bandwidth and compute complexity. This makes it a promising solution for adaptively reducing the communication and compute power overheads, while not sacrificing model accuracy.

Farida Mohsen, Samir Belhaouari, Zubair Shah

Diabetic retinopathy is a serious ocular complication that poses a significant threat to patients' vision and overall health. Early detection and accurate grading are essential to prevent vision loss. Current automatic grading methods rely heavily on deep learning applied to retinal fundus images, but the complex, irregular patterns of lesions in these images, which vary in shape and distribution, make it difficult to capture subtle changes. This study introduces RadFuse, a multi-representation deep learning framework that integrates non-linear RadEx-transformed sinogram images with traditional fundus images to enhance diabetic retinopathy detection and grading. Our RadEx transformation, an optimized non-linear extension of the Radon transform, generates sinogram representations to capture complex retinal lesion patterns. By leveraging both spatial and transformed domain information, RadFuse enriches the feature set available to deep learning models, improving the differentiation of severity levels. We conducted extensive experiments on two benchmark datasets, APTOS-2019 and DDR, using three convolutional neural networks (CNNs): ResNeXt-50, MobileNetV2, and VGG19. RadFuse showed significant improvements over fundus-image-only models across all three CNN architectures and outperformed state-of-the-art methods on both datasets. For severity grading across five stages, RadFuse achieved a quadratic weighted kappa of 93.24%, an accuracy of 87.07%, and an F1-score of 87.17%. In binary classification between healthy and diabetic retinopathy cases, the method reached an accuracy of 99.09%, precision of 98.58%, and recall of 99.6%, surpassing previously established models. These results demonstrate RadFuse's capacity to capture complex non-linear features, advancing diabetic retinopathy classification and promoting the integration of advanced mathematical transforms in medical image analysis.

Sulaiman Khan, Md. Rafiul Biswas, Alina Murad et al.

Recent developments in multimodal large language models (MLLMs) have spurred significant interest in their potential applications across various medical imaging domains. On the one hand, there is a temptation to use these generative models to synthesize realistic-looking medical image data, while on the other hand, the ability to identify synthetic image data in a pool of data is also significantly important. In this study, we explore the potential of the Gemini (\textit{gemini-1.0-pro-vision-latest}) and GPT-4V (gpt-4-vision-preview) models for medical image analysis using two modalities of medical image data. Utilizing synthetic and real imaging data, both Gemini AI and GPT-4V are first used to classify real versus synthetic images, followed by an interpretation and analysis of the input images. Experimental results demonstrate that both Gemini and GPT-4 could perform some interpretation of the input images. In this specific experiment, Gemini was able to perform slightly better than the GPT-4V on the classification task. In contrast, responses associated with GPT-4V were mostly generic in nature. Our early investigation presented in this work provides insights into the potential of MLLMs to assist with the classification and interpretation of retinal fundoscopy and lung X-ray images. We also identify key limitations associated with the early investigation study on MLLMs for specialized tasks in medical image analysis.

Amal Awadalla Ali, Asma Hamid ElFadl, Maha Fawzy Abujazar et al.

Contact tracing apps are powerful software tools that can help control the spread of COVID-19. In this article, we evaluated 53 COVID-19 contact tracing apps found on the Google Play Store in terms of their usage, rating, access permission, and user privacy. For each app included in the study, we identified the country of origin, number of downloads, and access permissions to further understand the attributes and ratings of the apps. Our results show that contact tracing apps had low overall ratings and nearly 40% of the included apps were requesting dangerous access permission including access to storage, media files, and camera permissions. We also found that user adoption rates were inversely correlated to access permission requirements. To the best of our knowledge, our article summarizes the most extensive collection of contact tracing apps for COVID-19. We recommend that future contact tracing apps should be more transparent in permission requirements and should provide justification for permissions requested to preserve the app users privacy.

Zubair Shah, Paige Martin, Enrico Coiera et al.

Background: Studies examining how sentiment on social media varies depending on timing and location appear to produce inconsistent results, making it hard to design systems that use sentiment to detect localized events for public health applications. Objective: The aim of this study was to measure how common timing and location confounders explain variation in sentiment on Twitter. Methods: Using a dataset of 16.54 million English-language tweets from 100 cities posted between July 13 and November 30, 2017, we estimated the positive and negative sentiment for each of the cities using a dictionary-based sentiment analysis and constructed models to explain the differences in sentiment using time of day, day of week, weather, city, and interaction type (conversations or broadcasting) as factors and found that all factors were independently associated with sentiment. Results: In the full multivariable model of positive (Pearson r in test data 0.236; 95\% CI 0.231-0.241) and negative (Pearson r in test data 0.306; 95\% CI 0.301-0.310) sentiment, the city and time of day explained more of the variance than weather and day of week. Models that account for these confounders produce a different distribution and ranking of important events compared with models that do not account for these confounders. Conclusions: In public health applications that aim to detect localized events by aggregating sentiment across populations of Twitter users, it is worthwhile accounting for baseline differences before looking for unexpected changes.