U. Rajendra Acharya

H M Dipu Kabir, Subrota Kumar Mondal, Sadia Khanam et al.

Researchers have proposed several approaches for neural network (NN) based uncertainty quantification (UQ). However, most of the approaches are developed considering strong assumptions. Uncertainty quantification algorithms often perform poorly in an input domain and the reason for poor performance remains unknown. Therefore, we present a neural network training method that considers similar samples with sensitivity awareness in this paper. In the proposed NN training method for UQ, first, we train a shallow NN for the point prediction. Then, we compute the absolute differences between prediction and targets and train another NN for predicting those absolute differences or absolute errors. Domains with high average absolute errors represent a high uncertainty. In the next step, we select each sample in the training set one by one and compute both prediction and error sensitivities. Then we select similar samples with sensitivity consideration and save indexes of similar samples. The ranges of an input parameter become narrower when the output is highly sensitive to that parameter. After that, we construct initial uncertainty bounds (UB) by considering the distribution of sensitivity aware similar samples. Prediction intervals (PIs) from initial uncertainty bounds are larger and cover more samples than required. Therefore, we train bound correction NN. As following all the steps for finding UB for each sample requires a lot of computation and memory access, we train a UB computation NN. The UB computation NN takes an input sample and provides an uncertainty bound. The UB computation NN is the final product of the proposed approach. Scripts of the proposed method are available in the following GitHub repository: github.com/dipuk0506/UQ

Parisa Moridian, Navid Ghassemi, Mahboobeh Jafari et al.

Autism spectrum disorder (ASD) is a brain condition characterized by diverse signs and symptoms that appear in early childhood. ASD is also associated with communication deficits and repetitive behavior in affected individuals. Various ASD detection methods have been developed, including neuroimaging modalities and psychological tests. Among these methods, magnetic resonance imaging (MRI) imaging modalities are of paramount importance to physicians. Clinicians rely on MRI modalities to diagnose ASD accurately. The MRI modalities are non-invasive methods that include functional (fMRI) and structural (sMRI) neuroimaging methods. However, diagnosing ASD with fMRI and sMRI for specialists is often laborious and time-consuming; therefore, several computer-aided design systems (CADS) based on artificial intelligence (AI) have been developed to assist specialist physicians. Conventional machine learning (ML) and deep learning (DL) are the most popular schemes of AI used for diagnosing ASD. This study aims to review the automated detection of ASD using AI. We review several CADS that have been developed using ML techniques for the automated diagnosis of ASD using MRI modalities. There has been very limited work on the use of DL techniques to develop automated diagnostic models for ASD. A summary of the studies developed using DL is provided in the Supplementary Appendix. Then, the challenges encountered during the automated diagnosis of ASD using MRI and AI techniques are described in detail. Additionally, a graphical comparison of studies using ML and DL to diagnose ASD automatically is discussed. We suggest future approaches to detecting ASDs using AI techniques and MRI neuroimaging.

Thanveer Shaik, Xiaohui Tao, Niall Higgins et al.

Recent advances in remote patient monitoring (RPM) systems can recognize various human activities to measure vital signs, including subtle motions from superficial vessels. There is a growing interest in applying artificial intelligence (AI) to this area of healthcare by addressing known limitations and challenges such as predicting and classifying vital signs and physical movements, which are considered crucial tasks. Federated learning is a relatively new AI technique designed to enhance data privacy by decentralizing traditional machine learning modeling. However, traditional federated learning requires identical architectural models to be trained across the local clients and global servers. This limits global model architecture due to the lack of local models heterogeneity. To overcome this, a novel federated learning architecture, FedStack, which supports ensembling heterogeneous architectural client models was proposed in this study. This work offers a protected privacy system for hospitalized in-patients in a decentralized approach and identifies optimum sensor placement. The proposed architecture was applied to a mobile health sensor benchmark dataset from 10 different subjects to classify 12 routine activities. Three AI models, ANN, CNN, and Bi-LSTM were trained on individual subject data. The federated learning architecture was applied to these models to build local and global models capable of state of the art performances. The local CNN model outperformed ANN and Bi-LSTM models on each subject data. Our proposed work has demonstrated better performance for heterogeneous stacking of the local models compared to homogeneous stacking. This work sets the stage to build an enhanced RPM system that incorporates client privacy to assist with clinical observations for patients in an acute mental health facility and ultimately help to prevent unexpected death.

Afshin Shoeibi, Navid Ghassemi, Marjane Khodatars et al.

Nowadays, many people worldwide suffer from brain disorders, and their health is in danger. So far, numerous methods have been proposed for the diagnosis of Schizophrenia (SZ) and attention deficit hyperactivity disorder (ADHD), among which functional magnetic resonance imaging (fMRI) modalities are known as a popular method among physicians. This paper presents an SZ and ADHD intelligent detection method of resting-state fMRI (rs-fMRI) modality using a new deep learning method. The University of California Los Angeles dataset, which contains the rs-fMRI modalities of SZ and ADHD patients, has been used for experiments. The FMRIB software library toolbox first performed preprocessing on rs-fMRI data. Then, a convolutional Autoencoder model with the proposed number of layers is used to extract features from rs-fMRI data. In the classification step, a new fuzzy method called interval type-2 fuzzy regression (IT2FR) is introduced and then optimized by genetic algorithm, particle swarm optimization, and gray wolf optimization (GWO) techniques. Also, the results of IT2FR methods are compared with multilayer perceptron, k-nearest neighbors, support vector machine, random forest, and decision tree, and adaptive neuro-fuzzy inference system methods. The experiment results show that the IT2FR method with the GWO optimization algorithm has achieved satisfactory results compared to other classifier methods. Finally, the proposed classification technique was able to provide 72.71% accuracy.

Thanveer Shaik, Xiaohui Tao, Niall Higgins et al.

The adoption of artificial intelligence (AI) in healthcare is growing rapidly. Remote patient monitoring (RPM) is one of the common healthcare applications that assist doctors to monitor patients with chronic or acute illness at remote locations, elderly people in-home care, and even hospitalized patients. The reliability of manual patient monitoring systems depends on staff time management which is dependent on their workload. Conventional patient monitoring involves invasive approaches which require skin contact to monitor health status. This study aims to do a comprehensive review of RPM systems including adopted advanced technologies, AI impact on RPM, challenges and trends in AI-enabled RPM. This review explores the benefits and challenges of patient-centric RPM architectures enabled with Internet of Things wearable devices and sensors using the cloud, fog, edge, and blockchain technologies. The role of AI in RPM ranges from physical activity classification to chronic disease monitoring and vital signs monitoring in emergency settings. This review results show that AI-enabled RPM architectures have transformed healthcare monitoring applications because of their ability to detect early deterioration in patients' health, personalize individual patient health parameter monitoring using federated learning, and learn human behavior patterns using techniques such as reinforcement learning. This review discusses the challenges and trends to adopt AI to RPM systems and implementation issues. The future directions of AI in RPM applications are analyzed based on the challenges and trends

Mahboobeh Jafari, Delaram Sadeghi, Afshin Shoeibi et al.

Schizophrenia (SZ) is a prevalent mental disorder characterized by cognitive, emotional, and behavioral changes. Symptoms of SZ include hallucinations, illusions, delusions, lack of motivation, and difficulties in concentration. Diagnosing SZ involves employing various tools, including clinical interviews, physical examinations, psychological evaluations, the Diagnostic and Statistical Manual of Mental Disorders (DSM), and neuroimaging techniques. Electroencephalography (EEG) recording is a significant functional neuroimaging modality that provides valuable insights into brain function during SZ. However, EEG signal analysis poses challenges for neurologists and scientists due to the presence of artifacts, long-term recordings, and the utilization of multiple channels. To address these challenges, researchers have introduced artificial intelligence (AI) techniques, encompassing conventional machine learning (ML) and deep learning (DL) methods, to aid in SZ diagnosis. This study reviews papers focused on SZ diagnosis utilizing EEG signals and AI methods. The introduction section provides a comprehensive explanation of SZ diagnosis methods and intervention techniques. Subsequently, review papers in this field are discussed, followed by an introduction to the AI methods employed for SZ diagnosis and a summary of relevant papers presented in tabular form. Additionally, this study reports on the most significant challenges encountered in SZ diagnosis, as identified through a review of papers in this field. Future directions to overcome these challenges are also addressed. The discussion section examines the specific details of each paper, culminating in the presentation of conclusions and findings.

Mahboobeh Jafari, Afshin Shoeibi, Navid Ghassemi et al.

Myocarditis is a significant cardiovascular disease (CVD) that poses a threat to the health of many individuals by causing damage to the myocardium. The occurrence of microbes and viruses, including the likes of HIV, plays a crucial role in the development of myocarditis disease (MCD). The images produced during cardiac magnetic resonance imaging (CMRI) scans are low contrast, which can make it challenging to diagnose cardiovascular diseases. In other hand, checking numerous CMRI slices for each CVD patient can be a challenging task for medical doctors. To overcome the existing challenges, researchers have suggested the use of artificial intelligence (AI)-based computer-aided diagnosis systems (CADS). The presented paper outlines a CADS for the detection of MCD from CMR images, utilizing deep learning (DL) methods. The proposed CADS consists of several steps, including dataset, preprocessing, feature extraction, classification, and post-processing. First, the Z-Alizadeh dataset was selected for the experiments. Subsequently, the CMR images underwent various preprocessing steps, including denoising, resizing, as well as data augmentation (DA) via CutMix and MixUp techniques. In the following, the most current deep pre-trained and transformer models are used for feature extraction and classification on the CMR images. The findings of our study reveal that transformer models exhibit superior performance in detecting MCD as opposed to pre-trained architectures. In terms of DL architectures, the Turbulence Neural Transformer (TNT) model exhibited impressive accuracy, reaching 99.73% utilizing a 10-fold cross-validation approach. Additionally, to pinpoint areas of suspicion for MCD in CMRI images, the Explainable-based Grad Cam method was employed.

Niloufar Delfan, Mohammadreza Shahsavari, Sadiq Hussain et al.

Parkinson's disease (PD), a severe and progressive neurological illness, affects millions of individuals worldwide. For effective treatment and management of PD, an accurate and early diagnosis is crucial. This study presents a deep learning-based model for the diagnosis of PD using resting state electroencephalogram (EEG) signal. The objective of the study is to develop an automated model that can extract complex hidden nonlinear features from EEG and demonstrate its generalizability on unseen data. The model is designed using a hybrid model, consists of convolutional neural network (CNN), bidirectional gated recurrent unit (Bi-GRU), and attention mechanism. The proposed method is evaluated on three public datasets (Uc San Diego Dataset, PRED-CT, and University of Iowa (UI) dataset), with one dataset used for training and the other two for evaluation. The results show that the proposed model can accurately diagnose PD with high performance on both the training and hold-out datasets. The model also performs well even when some part of the input information is missing. The results of this work have significant implications for patient treatment and for ongoing investigations into the early detection of Parkinson's disease. The suggested model holds promise as a non-invasive and reliable technique for PD early detection utilizing resting state EEG.

Mirsaeed Abdollahi, Ali Jafarizadeh, Amirhosein Ghafouri Asbagh et al.

Background: Cardiovascular diseases (CVDs) are the leading cause of death globally. The use of artificial intelligence (AI) methods - in particular, deep learning (DL) - has been on the rise lately for the analysis of different CVD-related topics. The use of fundus images and optical coherence tomography angiography (OCTA) in the diagnosis of retinal diseases has also been extensively studied. To better understand heart function and anticipate changes based on microvascular characteristics and function, researchers are currently exploring the integration of AI with non-invasive retinal scanning. There is great potential to reduce the number of cardiovascular events and the financial strain on healthcare systems by utilizing AI-assisted early detection and prediction of cardiovascular diseases on a large scale. Method: A comprehensive search was conducted across various databases, including PubMed, Medline, Google Scholar, Scopus, Web of Sciences, IEEE Xplore, and ACM Digital Library, using specific keywords related to cardiovascular diseases and artificial intelligence. Results: The study included 87 English-language publications selected for relevance, and additional references were considered. This paper provides an overview of the recent developments and difficulties in using artificial intelligence and retinal imaging to diagnose cardiovascular diseases. It provides insights for further exploration in this field. Conclusion: Researchers are trying to develop precise disease prognosis patterns in response to the aging population and the growing global burden of CVD. AI and deep learning are revolutionizing healthcare by potentially diagnosing multiple CVDs from a single retinal image. However, swifter adoption of these technologies in healthcare systems is required.

Javad Hassannataj Joloudari, Sanaz Mojrian, Hamid Saadatfar et al.

With the increasing growth of information through smart devices, increasing the quality level of human life requires various computational paradigms presentation including the Internet of Things, fog, and cloud. Between these three paradigms, the cloud computing paradigm as an emerging technology adds cloud layer services to the edge of the network so that resource allocation operations occur close to the end-user to reduce resource processing time and network traffic overhead. Hence, the resource allocation problem for its providers in terms of presenting a suitable platform, by using computational paradigms is considered a challenge. In general, resource allocation approaches are divided into two methods, including auction-based methods(goal, increase profits for service providers-increase user satisfaction and usability) and optimization-based methods(energy, cost, network exploitation, Runtime, reduction of time delay). In this paper, according to the latest scientific achievements, a comprehensive literature study (CLS) on artificial intelligence methods based on resource allocation optimization without considering auction-based methods in various computing environments are provided such as cloud computing, Vehicular Fog Computing, wireless, IoT, vehicular networks, 5G networks, vehicular cloud architecture,machine-to-machine communication(M2M),Train-to-Train(T2T) communication network, Peer-to-Peer(P2P) network. Since deep learning methods based on artificial intelligence are used as the most important methods in resource allocation problems; Therefore, in this paper, resource allocation approaches based on deep learning are also used in the mentioned computational environments such as deep reinforcement learning, Q-learning technique, reinforcement learning, online learning, and also Classical learning methods such as Bayesian learning, Cummins clustering, Markov decision process.

Michael James Horry, Subrata Chakraborty, Biswajeet Pradhan et al.

Lung cancer is the leading cause of cancer death and early diagnosis is associated with a positive prognosis. Chest X-ray (CXR) provides an inexpensive imaging mode for lung cancer diagnosis. Suspicious nodules are difficult to distinguish from vascular and bone structures using CXR. Computer vision has previously been proposed to assist human radiologists in this task, however, leading studies use down-sampled images and computationally expensive methods with unproven generalization. Instead, this study localizes lung nodules using efficient encoder-decoder neural networks that process full resolution images to avoid any signal loss resulting from down-sampling. Encoder-decoder networks are trained and tested using the JSRT lung nodule dataset. The networks are used to localize lung nodules from an independent external CXR dataset. Sensitivity and false positive rates are measured using an automated framework to eliminate any observer subjectivity. These experiments allow for the determination of the optimal network depth, image resolution and pre-processing pipeline for generalized lung nodule localization. We find that nodule localization is influenced by subtlety, with more subtle nodules being detected in earlier training epochs. Therefore, we propose a novel self-ensemble model from three consecutive epochs centered on the validation optimum. This ensemble achieved a sensitivity of 85% in 10-fold internal testing with false positives of 8 per image. A sensitivity of 81% is achieved at a false positive rate of 6 following morphological false positive reduction. This result is comparable to more computationally complex systems based on linear and spatial filtering, but with a sub-second inference time that is faster than other methods. The proposed algorithm achieved excellent generalization results against an external dataset with sensitivity of 77% at a false positive rate of 7.6.

Bartosz Grabowski, Przemysław Głomb, Wojciech Masarczyk et al.

Interpretation of electrocardiography (ECG) signals is required for diagnosing cardiac arrhythmia. Recently, machine learning techniques have been applied for automated computer-aided diagnosis. Machine learning tasks can be divided into regression and classification. Regression can be used for noise and artifacts removal as well as resolve issues of missing data from low sampling frequency. Classification task concerns the prediction of output diagnostic classes according to expert-labeled input classes. In this work, we propose a deep neural network model capable of solving regression and classification tasks. Moreover, we combined the two approaches, using unlabeled and labeled data, to train the model. We tested the model on the MIT-BIH Arrhythmia database. Our method showed high effectiveness in detecting cardiac arrhythmia based on modified Lead II ECG records, as well as achieved high quality of ECG signal approximation. For the former, our method attained overall accuracy of 87:33% and balanced accuracy of 80:54%, on par with reference approaches. For the latter, application of self-supervised learning allowed for training without the need for expert labels. The regression model yielded satisfactory performance with fairly accurate prediction of QRS complexes. Transferring knowledge from regression to the classification task, our method attained higher overall accuracy of 87:78%.

Thanveer Shaik, Xiaohui Tao, Lin Li et al.

Reinforcement learning has been increasingly applied in monitoring applications because of its ability to learn from previous experiences and can make adaptive decisions. However, existing machine learning-based health monitoring applications are mostly supervised learning algorithms, trained on labels and they cannot make adaptive decisions in an uncertain complex environment. This study proposes a novel and generic system, predictive deep reinforcement learning (PDRL) with multiple RL agents in a time series forecasting environment. The proposed generic framework accommodates virtual Deep Q Network (DQN) agents to monitor predicted future states of a complex environment with a well-defined reward policy so that the agent learns existing knowledge while maximizing their rewards. In the evaluation process of the proposed framework, three DRL agents were deployed to monitor a subject's future heart rate, respiration, and temperature predicted using a BiLSTM model. With each iteration, the three agents were able to learn the associated patterns and their cumulative rewards gradually increased. It outperformed the baseline models for all three monitoring agents. The proposed PDRL framework is able to achieve state-of-the-art performance in the time series forecasting process. The proposed DRL agents and deep learning model in the PDRL framework are customized to implement the transfer learning in other forecasting applications like traffic and weather and monitor their states. The PDRL framework is able to learn the future states of the traffic and weather forecasting and the cumulative rewards are gradually increasing over each episode.

Danial Sharifrazi, Nouman Javed, Javad Hassannataj Joloudari et al.

Human brain neuron activities are incredibly significant nowadays. Neuronal behavior is assessed by analyzing signal data such as electroencephalography (EEG), which can offer scientists valuable information about diseases and human-computer interaction. One of the difficulties researchers confront while evaluating these signals is the existence of large volumes of spike data. Spikes are some considerable parts of signal data that can happen as a consequence of vital biomarkers or physical issues such as electrode movements. Hence, distinguishing types of spikes is important. From this spot, the spike classification concept commences. Previously, researchers classified spikes manually. The manual classification was not precise enough as it involves extensive analysis. Consequently, Artificial Intelligence (AI) was introduced into neuroscience to assist clinicians in classifying spikes correctly. This review discusses the importance and use of AI in spike classification, focusing on the recognition of neural activity noises. The task is divided into three main components: preprocessing, classification, and evaluation. Existing methods are introduced and their importance is determined. The review also highlights the need for more efficient algorithms. The primary goal is to provide a perspective on spike classification for future research and provide a comprehensive understanding of the methodologies and issues involved. The review organizes materials in the spike classification field for future studies. In this work, numerous studies were extracted from different databases. The PRISMA-related research guidelines were then used to choose papers. Then, research studies based on spike classification using machine learning and deep learning approaches with effective preprocessing were selected.

Turker Tuncer, Sengul Dogan, Mehmet Baygin et al.

The generative pre-trained transformer (GPT)-based chatbot software ChatGPT possesses excellent natural language processing capabilities but is inadequate for solving arithmetic problems, especially multiplication. Its GPT structure uses a computational graph for multiplication, which has limited accuracy beyond simple multiplication operations. We developed a graph-based multiplication algorithm that emulated human-like numerical operations by incorporating a 10k operator, where k represents the maximum power to base 10 of the larger of two input numbers. Our proposed algorithm attained 100% accuracy for 1,000,000 large number multiplication tasks, effectively solving the multiplication challenge of GPT-based and other large language models. Our work highlights the importance of blending simple human insights into the design of artificial intelligence algorithms. Keywords: Graph-based multiplication; ChatGPT; Multiplication problem

Mahboobeh Jafari, Afshin Shoeibi, Marjane Khodatars et al.

In recent years, cardiovascular diseases (CVDs) have become one of the leading causes of mortality globally. CVDs appear with minor symptoms and progressively get worse. The majority of people experience symptoms such as exhaustion, shortness of breath, ankle swelling, fluid retention, and other symptoms when starting CVD. Coronary artery disease (CAD), arrhythmia, cardiomyopathy, congenital heart defect (CHD), mitral regurgitation, and angina are the most common CVDs. Clinical methods such as blood tests, electrocardiography (ECG) signals, and medical imaging are the most effective methods used for the detection of CVDs. Among the diagnostic methods, cardiac magnetic resonance imaging (CMR) is increasingly used to diagnose, monitor the disease, plan treatment and predict CVDs. Coupled with all the advantages of CMR data, CVDs diagnosis is challenging for physicians due to many slices of data, low contrast, etc. To address these issues, deep learning (DL) techniques have been employed to the diagnosis of CVDs using CMR data, and much research is currently being conducted in this field. This review provides an overview of the studies performed in CVDs detection using CMR images and DL techniques. The introduction section examined CVDs types, diagnostic methods, and the most important medical imaging techniques. In the following, investigations to detect CVDs using CMR images and the most significant DL methods are presented. Another section discussed the challenges in diagnosing CVDs from CMR data. Next, the discussion section discusses the results of this review, and future work in CVDs diagnosis from CMR images and DL techniques are outlined. The most important findings of this study are presented in the conclusion section.

Danial Sharifrazi, Nouman Javed, Roohallah Alizadehsani et al.

Mosquito-borne diseases present considerable risks to the health of both animals and humans. Aedes aegypti mosquitoes are the primary vectors for numerous medically important viruses such as dengue, Zika, yellow fever, and chikungunya. To characterize this mosquito neural activity, it is essential to classify the generated electrical spikes. However, no open-source neural spike classification method is currently available for mosquitoes. Our work presented in this paper provides an innovative artificial intelligence-based method to classify the neural spikes in uninfected, dengue-infected, and Zika-infected mosquitoes. Aiming for outstanding performance, the method employs a fusion of normalization, feature importance, and dimension reduction for the preprocessing and combines convolutional neural network and extra gradient boosting (XGBoost) for classification. The method uses the electrical spiking activity data of mosquito neurons recorded by microelectrode array technology. We used data from 0, 1, 2, 3, and 7 days post-infection, containing over 15 million samples, to analyze the method's performance. The performance of the proposed method was evaluated using accuracy, precision, recall, and the F1 scores. The results obtained from the method highlight its remarkable performance in differentiating infected vs uninfected mosquito samples, achieving an average of 98.1%. The performance was also compared with 6 other machine learning algorithms to further assess the method's capability. The method outperformed all other machine learning algorithms' performance. Overall, this research serves as an efficient method to classify the neural spikes of Aedes aegypti mosquitoes and can assist in unraveling the complex interactions between pathogens and mosquitoes.

Moloud Abdar, Soorena Salari, Sina Qahremani et al.

The COVID-19 (Coronavirus disease 2019) pandemic has become a major global threat to human health and well-being. Thus, the development of computer-aided detection (CAD) systems that are capable to accurately distinguish COVID-19 from other diseases using chest computed tomography (CT) and X-ray data is of immediate priority. Such automatic systems are usually based on traditional machine learning or deep learning methods. Differently from most of existing studies, which used either CT scan or X-ray images in COVID-19-case classification, we present a simple but efficient deep learning feature fusion model, called UncertaintyFuseNet, which is able to classify accurately large datasets of both of these types of images. We argue that the uncertainty of the model's predictions should be taken into account in the learning process, even though most of existing studies have overlooked it. We quantify the prediction uncertainty in our feature fusion model using effective Ensemble MC Dropout (EMCD) technique. A comprehensive simulation study has been conducted to compare the results of our new model to the existing approaches, evaluating the performance of competing models in terms of Precision, Recall, F-Measure, Accuracy and ROC curves. The obtained results prove the efficiency of our model which provided the prediction accuracy of 99.08\% and 96.35\% for the considered CT scan and X-ray datasets, respectively. Moreover, our UncertaintyFuseNet model was generally robust to noise and performed well with previously unseen data. The source code of our implementation is freely available at: https://github.com/moloud1987/UncertaintyFuseNet-for-COVID-19-Classification.

Sajad Mousavi, Fatemeh Afghah, U. Rajendra Acharya

Electroencephalogram (EEG) is a common base signal used to monitor brain activity and diagnose sleep disorders. Manual sleep stage scoring is a time-consuming task for sleep experts and is limited by inter-rater reliability. In this paper, we propose an automatic sleep stage annotation method called SleepEEGNet using a single-channel EEG signal. The SleepEEGNet is composed of deep convolutional neural networks (CNNs) to extract time-invariant features, frequency information, and a sequence to sequence model to capture the complex and long short-term context dependencies between sleep epochs and scores. In addition, to reduce the effect of the class imbalance problem presented in the available sleep datasets, we applied novel loss functions to have an equal misclassified error for each sleep stage while training the network. We evaluated the proposed method on different single-EEG channels (i.e., Fpz-Cz and Pz-Oz EEG channels) from the Physionet Sleep-EDF datasets published in 2013 and 2018. The evaluation results demonstrate that the proposed method achieved the best annotation performance compared to current literature, with an overall accuracy of 84.26%, a macro F1-score of 79.66% and Cohen's Kappa coefficient = 0.79. Our developed model is ready to test with more sleep EEG signals and aid the sleep specialists to arrive at an accurate diagnosis. The source code is available at https://github.com/SajadMo/SleepEEGNet.

Yasin Sadeghi Bazargani, Majid Mirzaei, Navid Sobhi et al.

Diabetes mellitus (DM) predisposes patients to vascular complications. Retinal images and vasculature reflect the body's micro- and macrovascular health. They can be used to diagnose DM complications, including diabetic retinopathy (DR), neuropathy, nephropathy, and atherosclerotic cardiovascular disease, as well as forecast the risk of cardiovascular events. Artificial intelligence (AI)-enabled systems developed for high-throughput detection of DR using digitized retinal images have become clinically adopted. Beyond DR screening, AI integration also holds immense potential to address challenges associated with the holistic care of the patient with DM. In this work, we aim to comprehensively review the literature for studies on AI applications based on retinal images related to DM diagnosis, prognostication, and management. We will describe the findings of holistic AI-assisted diabetes care, including but not limited to DR screening, and discuss barriers to implementing such systems, including issues concerning ethics, data privacy, equitable access, and explainability. With the ability to evaluate the patient's health status vis a vis DM complication as well as risk prognostication of future cardiovascular complications, AI-assisted retinal image analysis has the potential to become a central tool for modern personalized medicine in patients with DM.

Ali Jafarizadeh, Shadi Farabi Maleki, Parnia Pouya et al.

Retinopathy of prematurity (ROP) is a severe condition affecting premature infants, leading to abnormal retinal blood vessel growth, retinal detachment, and potential blindness. While semi-automated systems have been used in the past to diagnose ROP-related plus disease by quantifying retinal vessel features, traditional machine learning (ML) models face challenges like accuracy and overfitting. Recent advancements in deep learning (DL), especially convolutional neural networks (CNNs), have significantly improved ROP detection and classification. The i-ROP deep learning (i-ROP-DL) system also shows promise in detecting plus disease, offering reliable ROP diagnosis potential. This research comprehensively examines the contemporary progress and challenges associated with using retinal imaging and artificial intelligence (AI) to detect ROP, offering valuable insights that can guide further investigation in this domain. Based on 89 original studies in this field (out of 1487 studies that were comprehensively reviewed), we concluded that traditional methods for ROP diagnosis suffer from subjectivity and manual analysis, leading to inconsistent clinical decisions. AI holds great promise for improving ROP management. This review explores AI's potential in ROP detection, classification, diagnosis, and prognosis.

Ali Abbasian Ardakani, Afshin Mohammadi, Taha Yusuf Kuzan et al.

To develop and externally validate integrated ultrasound nomograms combining BIRADS features and quantitative morphometric characteristics, and to compare their performance with expert radiologists and state of the art large language models in biopsy recommendation and malignancy prediction for breast lesions. In this retrospective multicenter, multinational study, 1747 women with pathologically confirmed breast lesions underwent ultrasound across three centers in Iran and Turkey. A total of 10 BIRADS and 26 morphological features were extracted from each lesion. A BIRADS, morphometric, and fused nomogram integrating both feature sets was constructed via logistic regression. Three radiologists (one senior, two general) and two ChatGPT variants independently interpreted deidentified breast lesion images. Diagnostic performance for biopsy recommendation (BIRADS 4,5) and malignancy prediction was assessed in internal and two external validation cohorts. In pooled analysis, the fused nomogram achieved the highest accuracy for biopsy recommendation (83.0%) and malignancy prediction (83.8%), outperforming the morphometric nomogram, three radiologists and both ChatGPT models. Its AUCs were 0.901 and 0.853 for the two tasks, respectively. In addition, the performance of the BIRADS nomogram was significantly higher than the morphometric nomogram, three radiologists and both ChatGPT models for biopsy recommendation and malignancy prediction. External validation confirmed the robust generalizability across different ultrasound platforms and populations. An integrated BIRADS morphometric nomogram consistently outperforms standalone models, LLMs, and radiologists in guiding biopsy decisions and predicting malignancy. These interpretable, externally validated tools have the potential to reduce unnecessary biopsies and enhance personalized decision making in breast imaging.

Matthew Squires, Xiaohui Tao, Soman Elangovan et al.

Suicide is a prominent issue in society. Unfortunately, many people at risk for suicide do not receive the support required. Barriers to people receiving support include social stigma and lack of access to mental health care. With the popularity of social media, people have turned to online forums, such as Reddit to express their feelings and seek support. This provides the opportunity to support people with the aid of artificial intelligence. Social media posts can be classified, using text classification, to help connect people with professional help. However, these systems fail to account for the inherent uncertainty in classifying mental health conditions. Unlike other areas of healthcare, mental health conditions have no objective measurements of disease often relying on expert opinion. Thus when formulating deep learning problems involving mental health, using hard, binary labels does not accurately represent the true nature of the data. In these settings, where human experts may disagree, fuzzy or soft labels may be more appropriate. The current work introduces a novel label smoothing method which we use to capture any uncertainty within the data. We test our approach on a five-label multi-class classification problem. We show, our semi-supervised deep label smoothing method improves classification accuracy above the existing state of the art. Where existing research reports an accuracy of 43\% on the Reddit C-SSRS dataset, using empirical experiments to evaluate our novel label smoothing method, we improve upon this existing benchmark to 52\%. These improvements in model performance have the potential to better support those experiencing mental distress. Future work should explore the use of probabilistic methods in both natural language processing and quantifying contributions of both epistemic and aleatoric uncertainty in noisy datasets.

Matthew Squires, Xiaohui Tao, Soman Elangovan et al.

Repetitive Transcranial Magnetic Stimulation (rTMS) is a well-supported, evidence-based treatment for depression. However, patterns of response to this treatment are inconsistent. Emerging evidence suggests that artificial intelligence can predict rTMS treatment outcomes for most patients using fMRI connectivity features. While these models can reliably predict treatment outcomes for many patients for some underrepresented fMRI connectivity measures DNN models are unable to reliably predict treatment outcomes. As such we propose a novel method, Diversity Enhancing Conditional General Adversarial Network (DE-CGAN) for oversampling these underrepresented examples. DE-CGAN creates synthetic examples in difficult-to-classify regions by first identifying these data points and then creating conditioned synthetic examples to enhance data diversity. Through empirical experiments we show that a classification model trained using a diversity enhanced training set outperforms traditional data augmentation techniques and existing benchmark results. This work shows that increasing the diversity of a training dataset can improve classification model performance. Furthermore, this work provides evidence for the utility of synthetic patients providing larger more robust datasets for both AI researchers and psychiatrists to explore variable relationships.

Mohamad Roshanzamir, Roohallah Alizadehsani, Mahdi Roshanzamir et al.

One of the most common problems encountered in human-computer interaction is automatic facial expression recognition. Although it is easy for human observer to recognize facial expressions, automatic recognition remains difficult for machines. One of the methods that machines can recognize facial expression is analyzing the changes in face during facial expression presentation. In this paper, optical flow algorithm was used to extract deformation or motion vectors created in the face because of facial expressions. Then, these extracted motion vectors are used to be analyzed. Their positions and directions were exploited for automatic facial expression recognition using different data mining techniques. It means that by employing motion vector features used as our data, facial expressions were recognized. Some of the most state-of-the-art classification algorithms such as C5.0, CRT, QUEST, CHAID, Deep Learning (DL), SVM and Discriminant algorithms were used to classify the extracted motion vectors. Using 10-fold cross validation, their performances were calculated. To compare their performance more precisely, the test was repeated 50 times. Meanwhile, the deformation of face was also analyzed in this research. For example, what exactly happened in each part of face when a person showed fear? Experimental results on Extended Cohen-Kanade (CK+) facial expression dataset demonstrated that the best methods were DL, SVM and C5.0, with the accuracy of 95.3%, 92.8% and 90.2% respectively.

Afshin Shoeibi, Navid Ghassemi, Marjane Khodatars et al.

Epileptic seizures are one of the most crucial neurological disorders, and their early diagnosis will help the clinicians to provide accurate treatment for the patients. The electroencephalogram (EEG) signals are widely used for epileptic seizures detection, which provides specialists with substantial information about the functioning of the brain. In this paper, a novel diagnostic procedure using fuzzy theory and deep learning techniques is introduced. The proposed method is evaluated on the Bonn University dataset with six classification combinations and also on the Freiburg dataset. The tunable-Q wavelet transform (TQWT) is employed to decompose the EEG signals into different sub-bands. In the feature extraction step, 13 different fuzzy entropies are calculated from different sub-bands of TQWT, and their computational complexities are calculated to help researchers choose the best set for various tasks. In the following, an autoencoder (AE) with six layers is employed for dimensionality reduction. Finally, the standard adaptive neuro-fuzzy inference system (ANFIS), and also its variants with grasshopper optimization algorithm (ANFIS-GOA), particle swarm optimization (ANFIS-PSO), and breeding swarm optimization (ANFIS-BS) methods are used for classification. Using our proposed method, ANFIS-BS method has obtained an accuracy of 99.74% in classifying into two classes and an accuracy of 99.46% in ternary classification on the Bonn dataset and 99.28% on the Freiburg dataset, reaching state-of-the-art performances on both of them.

Zakaria Senousy, Mohammed M. Abdelsamea, Mohamed Medhat Gaber et al.

Breast histology image classification is a crucial step in the early diagnosis of breast cancer. In breast pathological diagnosis, Convolutional Neural Networks (CNNs) have demonstrated great success using digitized histology slides. However, tissue classification is still challenging due to the high visual variability of the large-sized digitized samples and the lack of contextual information. In this paper, we propose a novel CNN, called Multi-level Context and Uncertainty aware (MCUa) dynamic deep learning ensemble model.MCUamodel consists of several multi-level context-aware models to learn the spatial dependency between image patches in a layer-wise fashion. It exploits the high sensitivity to the multi-level contextual information using an uncertainty quantification component to accomplish a novel dynamic ensemble model.MCUamodelhas achieved a high accuracy of 98.11% on a breast cancer histology image dataset. Experimental results show the superior effectiveness of the proposed solution compared to the state-of-the-art histology classification models.

Javad Hassannataj Joloudari, Sanaz Mojrian, Issa Nodehi et al.

Myocardial infarction (MI) results in heart muscle injury due to receiving insufficient blood flow. MI is the most common cause of mortality in middle-aged and elderly individuals around the world. To diagnose MI, clinicians need to interpret electrocardiography (ECG) signals, which requires expertise and is subject to observer bias. Artificial intelligence-based methods can be utilized to screen for or diagnose MI automatically using ECG signals. In this work, we conducted a comprehensive assessment of artificial intelligence-based approaches for MI detection based on ECG as well as other biophysical signals, including machine learning (ML) and deep learning (DL) models. The performance of traditional ML methods relies on handcrafted features and manual selection of ECG signals, whereas DL models can automate these tasks. The review observed that deep convolutional neural networks (DCNNs) yielded excellent classification performance for MI diagnosis, which explains why they have become prevalent in recent years. To our knowledge, this is the first comprehensive survey of artificial intelligence techniques employed for MI diagnosis using ECG and other biophysical signals.

Afshin Shoeibi, Parisa Moridian, Marjane Khodatars et al.

Epilepsy is a disorder of the brain denoted by frequent seizures. The symptoms of seizure include confusion, abnormal staring, and rapid, sudden, and uncontrollable hand movements. Epileptic seizure detection methods involve neurological exams, blood tests, neuropsychological tests, and neuroimaging modalities. Among these, neuroimaging modalities have received considerable attention from specialist physicians. One method to facilitate the accurate and fast diagnosis of epileptic seizures is to employ computer-aided diagnosis systems (CADS) based on deep learning (DL) and neuroimaging modalities. This paper has studied a comprehensive overview of DL methods employed for epileptic seizures detection and prediction using neuroimaging modalities. First, DL-based CADS for epileptic seizures detection and prediction using neuroimaging modalities are discussed. Also, descriptions of various datasets, preprocessing algorithms, and DL models which have been used for epileptic seizures detection and prediction have been included. Then, research on rehabilitation tools has been presented, which contains brain-computer interface (BCI), cloud computing, internet of things (IoT), hardware implementation of DL techniques on field-programmable gate array (FPGA), etc. In the discussion section, a comparison has been carried out between research on epileptic seizure detection and prediction. The challenges in epileptic seizures detection and prediction using neuroimaging modalities and DL models have been described. In addition, possible directions for future works in this field, specifically for solving challenges in datasets, DL, rehabilitation, and hardware models, have been proposed. The final section is dedicated to the conclusion which summarizes the significant findings of the paper.

Afshin Shoeibi, Marjane Khodatars, Mahboobeh Jafari et al.

Multiple Sclerosis (MS) is a type of brain disease which causes visual, sensory, and motor problems for people with a detrimental effect on the functioning of the nervous system. In order to diagnose MS, multiple screening methods have been proposed so far; among them, magnetic resonance imaging (MRI) has received considerable attention among physicians. MRI modalities provide physicians with fundamental information about the structure and function of the brain, which is crucial for the rapid diagnosis of MS lesions. Diagnosing MS using MRI is time-consuming, tedious, and prone to manual errors. Hence, computer aided diagnosis systems (CADS) based on artificial intelligence (AI) methods have been proposed in recent years for accurate diagnosis of MS using MRI neuroimaging modalities. In the AI field, automated MS diagnosis is being conducted using (i) conventional machine learning and (ii) deep learning (DL) techniques. The conventional machine learning approach is based on feature extraction and selection by trial and error. In DL, these steps are performed by the DL model itself. In this paper, a complete review of automated MS diagnosis methods performed using DL techniques with MRI neuroimaging modalities are discussed. Also, each work is thoroughly reviewed and discussed. Finally, the most important challenges and future directions in the automated MS diagnosis using DL techniques coupled with MRI modalities are presented in detail.

Delaram Sadeghi, Afshin Shoeibi, Navid Ghassemi et al.

Schizophrenia (SZ) is a mental disorder that typically emerges in late adolescence or early adulthood. It reduces the life expectancy of patients by 15 years. Abnormal behavior, perception of emotions, social relationships, and reality perception are among its most significant symptoms. Past studies have revealed that SZ affects the temporal and anterior lobes of hippocampus regions of the brain. Also, increased volume of cerebrospinal fluid (CSF) and decreased volume of white and gray matter can be observed due to this disease. Magnetic resonance imaging (MRI) is the popular neuroimaging technique used to explore structural/functional brain abnormalities in SZ disorder, owing to its high spatial resolution. Various artificial intelligence (AI) techniques have been employed with advanced image/signal processing methods to accurately diagnose SZ. This paper presents a comprehensive overview of studies conducted on the automated diagnosis of SZ using MRI modalities. First, an AI-based computer aided-diagnosis system (CADS) for SZ diagnosis and its relevant sections are presented. Then, this section introduces the most important conventional machine learning (ML) and deep learning (DL) techniques in the diagnosis of diagnosing SZ. A comprehensive comparison is also made between ML and DL studies in the discussion section. In the following, the most important challenges in diagnosing SZ are addressed. Future works in diagnosing SZ using AI techniques and MRI modalities are recommended in another section. Results, conclusion, and research findings are also presented at the end.

Roohallah Alizadehsani, Danial Sharifrazi, Navid Hoseini Izadi et al.

The new coronavirus has caused more than one million deaths and continues to spread rapidly. This virus targets the lungs, causing respiratory distress which can be mild or severe. The X-ray or computed tomography (CT) images of lungs can reveal whether the patient is infected with COVID-19 or not. Many researchers are trying to improve COVID-19 detection using artificial intelligence. Our motivation is to develop an automatic method that can cope with scenarios in which preparing labeled data is time consuming or expensive. In this article, we propose a Semi-supervised Classification using Limited Labeled Data (SCLLD) relying on Sobel edge detection and Generative Adversarial Networks (GANs) to automate the COVID-19 diagnosis. The GAN discriminator output is a probabilistic value which is used for classification in this work. The proposed system is trained using 10,000 CT scans collected from Omid Hospital, whereas a public dataset is also used for validating our system. The proposed method is compared with other state-of-the-art supervised methods such as Gaussian processes. To the best of our knowledge, this is the first time a semi-supervised method for COVID-19 detection is presented. Our system is capable of learning from a mixture of limited labeled and unlabeled data where supervised learners fail due to a lack of sufficient amount of labeled data. Thus, our semi-supervised training method significantly outperforms the supervised training of Convolutional Neural Network (CNN) when labeled training data is scarce. The 95% confidence intervals for our method in terms of accuracy, sensitivity, and specificity are 99.56 +- 0.20%, 99.88 +- 0.24%, and 99.40 +- 0.18%, respectively, whereas intervals for the CNN (trained supervised) are 68.34 +- 4.11%, 91.2 +- 6.15%, and 46.40 +- 5.21%.

Moloud Abdar, Farhad Pourpanah, Sadiq Hussain et al.

Uncertainty quantification (UQ) plays a pivotal role in reduction of uncertainties during both optimization and decision making processes. It can be applied to solve a variety of real-world applications in science and engineering. Bayesian approximation and ensemble learning techniques are two most widely-used UQ methods in the literature. In this regard, researchers have proposed different UQ methods and examined their performance in a variety of applications such as computer vision (e.g., self-driving cars and object detection), image processing (e.g., image restoration), medical image analysis (e.g., medical image classification and segmentation), natural language processing (e.g., text classification, social media texts and recidivism risk-scoring), bioinformatics, etc. This study reviews recent advances in UQ methods used in deep learning. Moreover, we also investigate the application of these methods in reinforcement learning (RL). Then, we outline a few important applications of UQ methods. Finally, we briefly highlight the fundamental research challenges faced by UQ methods and discuss the future research directions in this field.

Roohallah Alizadehsani, Mohamad Roshanzamir, Sadiq Hussain et al.

Understanding data and reaching valid conclusions are of paramount importance in the present era of big data. Machine learning and probability theory methods have widespread application for this purpose in different fields. One critically important yet less explored aspect is how data and model uncertainties are captured and analyzed. Proper quantification of uncertainty provides valuable information for optimal decision making. This paper reviewed related studies conducted in the last 30 years (from 1991 to 2020) in handling uncertainties in medical data using probability theory and machine learning techniques. Medical data is more prone to uncertainty due to the presence of noise in the data. So, it is very important to have clean medical data without any noise to get accurate diagnosis. The sources of noise in the medical data need to be known to address this issue. Based on the medical data obtained by the physician, diagnosis of disease, and treatment plan are prescribed. Hence, the uncertainty is growing in healthcare and there is limited knowledge to address these problems. We have little knowledge about the optimal treatment methods as there are many sources of uncertainty in medical science. Our findings indicate that there are few challenges to be addressed in handling the uncertainty in medical raw data and new models. In this work, we have summarized various methods employed to overcome this problem. Nowadays, application of novel deep learning techniques to deal such uncertainties have significantly increased.

Afshin Shoeibi, Marjane Khodatars, Mahboobeh Jafari et al.

Coronavirus, or COVID-19, is a hazardous disease that has endangered the health of many people around the world by directly affecting the lungs. COVID-19 is a medium-sized, coated virus with a single-stranded RNA, and also has one of the largest RNA genomes and is approximately 120 nm. The X-Ray and computed tomography (CT) imaging modalities are widely used to obtain a fast and accurate medical diagnosis. Identifying COVID-19 from these medical images is extremely challenging as it is time-consuming and prone to human errors. Hence, artificial intelligence (AI) methodologies can be used to obtain consistent high performance. Among the AI methods, deep learning (DL) networks have gained popularity recently compared to conventional machine learning (ML). Unlike ML, all stages of feature extraction, feature selection, and classification are accomplished automatically in DL models. In this paper, a complete survey of studies on the application of DL techniques for COVID-19 diagnostic and segmentation of lungs is discussed, concentrating on works that used X-Ray and CT images. Additionally, a review of papers on the forecasting of coronavirus prevalence in different parts of the world with DL is presented. Lastly, the challenges faced in the detection of COVID-19 using DL techniques and directions for future research are discussed.

Marjane Khodatars, Afshin Shoeibi, Delaram Sadeghi et al.

Accurate diagnosis of Autism Spectrum Disorder (ASD) followed by effective rehabilitation is essential for the management of this disorder. Artificial intelligence (AI) techniques can aid physicians to apply automatic diagnosis and rehabilitation procedures. AI techniques comprise traditional machine learning (ML) approaches and deep learning (DL) techniques. Conventional ML methods employ various feature extraction and classification techniques, but in DL, the process of feature extraction and classification is accomplished intelligently and integrally. DL methods for diagnosis of ASD have been focused on neuroimaging-based approaches. Neuroimaging techniques are non-invasive disease markers potentially useful for ASD diagnosis. Structural and functional neuroimaging techniques provide physicians substantial information about the structure (anatomy and structural connectivity) and function (activity and functional connectivity) of the brain. Due to the intricate structure and function of the brain, proposing optimum procedures for ASD diagnosis with neuroimaging data without exploiting powerful AI techniques like DL may be challenging. In this paper, studies conducted with the aid of DL networks to distinguish ASD are investigated. Rehabilitation tools provided for supporting ASD patients utilizing DL networks are also assessed. Finally, we will present important challenges in the automated detection and rehabilitation of ASD and propose some future works.

Afshin Shoeibi, Marjane Khodatars, Navid Ghassemi et al.

A variety of screening approaches have been proposed to diagnose epileptic seizures, using electroencephalography (EEG) and magnetic resonance imaging (MRI) modalities. Artificial intelligence encompasses a variety of areas, and one of its branches is deep learning (DL). Before the rise of DL, conventional machine learning algorithms involving feature extraction were performed. This limited their performance to the ability of those handcrafting the features. However, in DL, the extraction of features and classification are entirely automated. The advent of these techniques in many areas of medicine, such as in the diagnosis of epileptic seizures, has made significant advances. In this study, a comprehensive overview of works focused on automated epileptic seizure detection using DL techniques and neuroimaging modalities is presented. Various methods proposed to diagnose epileptic seizures automatically using EEG and MRI modalities are described. In addition, rehabilitation systems developed for epileptic seizures using DL have been analyzed, and a summary is provided. The rehabilitation tools include cloud computing techniques and hardware required for implementation of DL algorithms. The important challenges in accurate detection of automated epileptic seizures using DL with EEG and MRI modalities are discussed. The advantages and limitations in employing DL-based techniques for epileptic seizures diagnosis are presented. Finally, the most promising DL models proposed and possible future works on automated epileptic seizure detection are delineated.

Sajad Mousavi, Fatemeh Afghah, U. Rajendra Acharya

Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias that affects the lives of more than 3 million people in the U.S. and over 33 million people around the world and is associated with a five-fold increased risk of stroke and mortality. like other problems in healthcare domain, artificial intelligence (AI)-based algorithms have been used to reliably detect AF from patients' physiological signals. The cardiologist level performance in detecting this arrhythmia is often achieved by deep learning-based methods, however, they suffer from the lack of interpretability. In other words, these approaches are unable to explain the reasons behind their decisions. The lack of interpretability is a common challenge toward a wide application of machine learning-based approaches in the healthcare which limits the trust of clinicians in such methods. To address this challenge, we propose HAN-ECG, an interpretable bidirectional-recurrent-neural-network-based approach for the AF detection task. The HAN-ECG employs three attention mechanism levels to provide a multi-resolution analysis of the patterns in ECG leading to AF. The first level, wave level, computes the wave weights, the second level, heartbeat level, calculates the heartbeat weights, and third level, window (i.e., multiple heartbeats) level, produces the window weights in triggering a class of interest. The detected patterns by this hierarchical attention model facilitate the interpretation of the neural network decision process in identifying the patterns in the signal which contributed the most to the final prediction. Experimental results on two AF databases demonstrate that our proposed model performs significantly better than the existing algorithms. Visualization of these attention layers illustrates that our model decides upon the important waves and heartbeats which are clinically meaningful in the detection task.

Jen Hong Tan, U. Rajendra Acharya, Sulatha V. Bhandary et al.

We have developed and trained a convolutional neural network to automatically and simultaneously segment optic disc, fovea and blood vessels. Fundus images were normalised before segmentation was performed to enforce consistency in background lighting and contrast. For every effective point in the fundus image, our algorithm extracted three channels of input from the neighbourhood of the point and forward the response across the 7 layer network. In average, our segmentation achieved an accuracy of 92.68 percent on the testing set from Drive database.

Jen Hong Tan, U. Rajendra Acharya

Rarely in literature a method of segmentation cares for the edit after the algorithm delivers. They provide no solution when segmentation goes wrong. We propose to formulate point distribution model in terms of centripetal-parameterized Catmull-Rom spline. Such fusion brings interactivity to model-based segmentation, so that edit is better handled. When the delivered segment is unsatisfactory, user simply shifts points to vary the curve. We ran the method on three disparate imaging modalities and achieved an average overlap of 0.879 for automated lung segmentation on chest radiographs. The edit afterward improved the average overlap to 0.945, with a minimum of 0.925. The source code and the demo video are available at http://wp.me/p3vCKy-2S