Breast cancer is a significant health concern affecting millions of women worldwide. Accurate survival risk stratification plays a crucial role in guiding personalised treatment decisions and improving patient outcomes. Here we present BioFusionNet, a deep learning framework that fuses image-derived features with genetic and clinical data to achieve a holistic patient profile and perform survival risk stratification of ER+ breast cancer patients. We employ multiple self-supervised feature extractors, namely DINO and MoCoV3, pretrained on histopathology patches to capture detailed histopathological image features. We then utilise a variational autoencoder (VAE) to fuse these features, and harness the latent space of the VAE to feed into a self-attention network, generating patient-level features. Next, we develop a co-dual-cross-attention mechanism to combine the histopathological features with genetic data, enabling the model to capture the interplay between them. Additionally, clinical data is incorporated using a feed-forward network (FFN), further enhancing predictive performance and achieving comprehensive multimodal feature integration. Furthermore, we introduce a weighted Cox loss function, specifically designed to handle imbalanced survival data, which is a common challenge in the field. The proposed model achieves a mean concordance index (C-index) of 0.77 and a time-dependent area under the curve (AUC) of 0.84, outperforming state-of-the-art methods. It predicts risk (high versus low) with prognostic significance for overall survival (OS) in univariate analysis (HR=2.99, 95% CI: 1.88--4.78, p<0.005), and maintains independent significance in multivariate analysis incorporating standard clinicopathological variables (HR=2.91, 95% CI: 1.80--4.68, p<0.005). The proposed method not only improves model performance but also addresses a critical gap in handling imbalanced data.

Segmentation is an important task in a wide range of computer vision applications, including medical image analysis. Recent years have seen an increase in the complexity of medical image segmentation approaches based on sophisticated convolutional neural network architectures. This progress has led to incremental enhancements in performance on widely recognised benchmark datasets. However, most of the existing approaches are computationally demanding, which limits their practical applicability. This paper presents an expand-squeeze dual multiscale residual network (ESDMR-Net), which is a fully convolutional network that is particularly well-suited for resource-constrained computing hardware such as mobile devices. ESDMR-Net focuses on extracting multiscale features, enabling the learning of contextual dependencies among semantically distinct features. The ESDMR-Net architecture allows dual-stream information flow within encoder-decoder pairs. The expansion operation (depthwise separable convolution) makes all of the rich features with multiscale information available to the squeeze operation (bottleneck layer), which then extracts the necessary information for the segmentation task. The Expand-Squeeze (ES) block helps the network pay more attention to under-represented classes, which contributes to improved segmentation accuracy. To enhance the flow of information across multiple resolutions or scales, we integrated dual multiscale residual (DMR) blocks into the skip connection. This integration enables the decoder to access features from various levels of abstraction, ultimately resulting in more comprehensive feature representations. We present experiments on seven datasets from five distinct examples of applications. Our model achieved the best results despite having significantly fewer trainable parameters, with a reduction of two or even three orders of magnitude.

Diseases such as diabetic retinopathy and age-related macular degeneration pose a significant risk to vision, highlighting the importance of precise segmentation of retinal vessels for the tracking and diagnosis of progression. However, existing vessel segmentation methods that heavily rely on encoder-decoder structures struggle to capture contextual information about retinal vessel configurations, leading to challenges in reconciling semantic disparities between encoder and decoder features. To address this, we propose a novel feature enhancement segmentation network (FES-Net) that achieves accurate pixel-wise segmentation without requiring additional image enhancement steps. FES-Net directly processes the input image and utilizes four prompt convolutional blocks (PCBs) during downsampling, complemented by a shallow upsampling approach to generate a binary mask for each class. We evaluate the performance of FES-Net on four publicly available state-of-the-art datasets: DRIVE, STARE, CHASE, and HRF. The evaluation results clearly demonstrate the superior performance of FES-Net compared to other competitive approaches documented in the existing literature.

Despite major advances in artificial intelligence (AI) for medicine and healthcare, the deployment and adoption of AI technologies remain limited in real-world clinical practice. In recent years, concerns have been raised about the technical, clinical, ethical and legal risks associated with medical AI. To increase real world adoption, it is essential that medical AI tools are trusted and accepted by patients, clinicians, health organisations and authorities. This work describes the FUTURE-AI guideline as the first international consensus framework for guiding the development and deployment of trustworthy AI tools in healthcare. The FUTURE-AI consortium was founded in 2021 and currently comprises 118 inter-disciplinary experts from 51 countries representing all continents, including AI scientists, clinicians, ethicists, and social scientists. Over a two-year period, the consortium defined guiding principles and best practices for trustworthy AI through an iterative process comprising an in-depth literature review, a modified Delphi survey, and online consensus meetings. The FUTURE-AI framework was established based on 6 guiding principles for trustworthy AI in healthcare, i.e. Fairness, Universality, Traceability, Usability, Robustness and Explainability. Through consensus, a set of 28 best practices were defined, addressing technical, clinical, legal and socio-ethical dimensions. The recommendations cover the entire lifecycle of medical AI, from design, development and validation to regulation, deployment, and monitoring. FUTURE-AI is a risk-informed, assumption-free guideline which provides a structured approach for constructing medical AI tools that will be trusted, deployed and adopted in real-world practice. Researchers are encouraged to take the recommendations into account in proof-of-concept stages to facilitate future translation towards clinical practice of medical AI.

Deep neural network (DNN) models for retinopathy have estimated predictive accuracies in the mid-to-high 90%. However, the following aspects remain unaddressed: State-of-the-art models are complex and require substantial computational infrastructure to train and deploy; The reliability of predictions can vary widely. In this paper, we focus on these aspects and propose a form of iterative knowledge distillation(IKD), called IKD+ that incorporates a tradeoff between size, accuracy and reliability. We investigate the functioning of IKD+ using two widely used techniques for estimating model calibration (Platt-scaling and temperature-scaling), using the best-performing model available, which is an ensemble of EfficientNets with approximately 100M parameters. We demonstrate that IKD+ equipped with temperature-scaling results in models that show up to approximately 500-fold decreases in the number of parameters than the original ensemble without a significant loss in accuracy. In addition, calibration scores (reliability) for the IKD+ models are as good as or better than the base mode

Heart failure (HF) is one of the most prevalent life-threatening cardiovascular diseases in which 6.5 million people are suffering in the USA and more than 23 million worldwide. Mechanical circulatory support of HF patients can be achieved by implanting a left ventricular assist device (LVAD) into HF patients as a bridge to transplant, recovery or destination therapy and can be controlled by measurement of normal and abnormal pulmonary arterial wedge pressure (PAWP). While there are no commercial long-term implantable pressure sensors to measure PAWP, real-time non-invasive estimation of abnormal and normal PAWP becomes vital. In this work, first an improved Harris Hawks optimizer algorithm called HHO+ is presented and tested on 24 unimodal and multimodal benchmark functions. Second, a novel fully Elman neural network (FENN) is proposed to improve the classification performance. Finally, four novel 18-layer deep learning methods of convolutional neural networks (CNNs) with multi-layer perceptron (CNN-MLP), CNN with Elman neural networks (CNN-ENN), CNN with fully Elman neural networks (CNN-FENN), and CNN with fully Elman neural networks optimized by HHO+ algorithm (CNN-FENN-HHO+) for classification of abnormal and normal PAWP using estimated HVAD pump flow were developed and compared. The estimated pump flow was derived by a non-invasive method embedded into the commercial HVAD controller. The proposed methods are evaluated on an imbalanced clinical dataset using 5-fold cross-validation. The proposed CNN-FENN-HHO+ method outperforms the proposed CNN-MLP, CNN-ENN and CNN-FENN methods and improved the classification performance metrics across 5-fold cross-validation. The proposed methods can reduce the likelihood of hazardous events like pulmonary congestion and ventricular suction for HF patients and notify identified abnormal cases to the hospital, clinician and cardiologist.