The integration of artificial intelligence in healthcare has opened new horizons for improving medical diagnostics and patient care. However, challenges persist in developing systems capable of generating accurate and contextually relevant radiology reports, particularly in low-resource languages. In this study, we present a comprehensive benchmark to evaluate the performance of instruction-tuned Vision-Language Models (VLMs) in the specialized task of radiology report generation across three low-resource languages: Italian, German, and Spanish. Employing the LLaVA architectural framework, we conducted a systematic evaluation of pre-trained models utilizing general datasets, domain-specific datasets, and low-resource language-specific datasets. In light of the unavailability of models that possess prior knowledge of both the medical domain and low-resource languages, we analyzed various adaptations to determine the most effective approach for these contexts. The results revealed that language-specific models substantially outperformed both general and domain-specific models in generating radiology reports, emphasizing the critical role of linguistic adaptation. Additionally, models fine-tuned with medical terminology exhibited enhanced performance across all languages compared to models with generic knowledge, highlighting the importance of domain-specific training. We also explored the influence of the temperature parameter on the coherence of report generation, providing insights for optimal model settings. Our findings highlight the importance of tailored language and domain-specific training for improving the quality and accuracy of radiological reports in multilingual settings. This research not only advances our understanding of VLMs adaptability in healthcare but also points to significant avenues for future investigations into model tuning and language-specific adaptations.

Heart failure exacerbations (HFE) represent a critical challenge in healthcare due to their significant role in global mortality. The rise of home and wearable devices capable of monitoring cardiac conditions provides valuable opportunities for data-driven analysis and HFE detection. However, these devices frequently generate low-quality measurements with irregular sampling frequencies and high rates of missing data. Our paper presents a methodology that processes these measurements as a three-dimensional tensor, applying a low-rank tensor completion scheme to manage missing data effectively, thus facilitating anomaly detection without necessitating data imputation. We validate our method on a dataset from 4 patients with chronic HF in the compensation phase, collected at the Hospital Fondazione Policlinico Universitario Campus Bio-Medico in Rome, Italy. Our results demonstrate the tensor-based method’s superiority over traditional techniques, highlighting its potential for detecting anomalies within complex multivariate time series data. This research emphasizes the critical role of advanced data analysis in enhancing HFE identification, which could lead to improved patient care and reduced hospitalization rates.

In our fast-paced world, timely access to information is essential. This urgency is highlighted in stress detection, where swift actions can mitigate harmful psycho-physiological effects. We introduce an early stress detection method using Deep Reinforcement Learning (DRL). This method utilizes DRL to efficiently analyze time series data segments, aiming for accurate and quick stress classification. We employ a dynamic observation window strategy, allowing the DRL agent to adjust based on data complexity. Our evaluations, performed on a public dataset using a Leave-One-Subject-Out (LOSO) method, emphasize DRL’s potential in stress detection. The related code is available at https://github.com/cosbidev/DRL-4-Early-Stress-Detection.

The widespread adoption of electronic health records (EHRs) offers a valuable opportunity to support clinical research by containing crucial patient information, including diagnoses, symptoms, medications, lab tests, and more. Despite the success of deep learning for biomedical Named Entity Recognition (NER), the literature in this field still presents a gap regarding applications focused on lung cancer for the Italian language. Hence, this paper presents a transformer-based approach to extract named entities from Italian clinical notes related to Non-Small Cell Lung Cancer (NSCLC). We introduce a novel set of 25 clinical entities related to NSCLC building a corpus annotated for NER. We apply a state-of the-art model pre-trained on Italian biomedical texts to the manually annotated clinical reports of a cohort of 257 patients suffering from NSCLC, successfully dealing with class-imbalance problems and obtaining promising performance (average F1-score of 84.3%). We also compared our method with two other pre-trained state-of-the-art models showing that the domain specific knowledge offered by the proposed approach is necessary to achieve higher performance. These findings also showcase the feasibility of using transformers to extract biomedical information in the Italian language.

Nowadays diabetes still remains one of the leading causes of death worldwide and it has serious consequences if not properly treated. The advent of hybrid closed-loop systems, connection with consumer electronics and cloud-based data systems have hastened the advancement of diabetes technology. In the wake of this progress, we exploit information technology to make insulin pens smart so as to promote adherence to injection therapy and improve the socio-economic impact for the patient. In this respect, this work focuses on two main open issues, namely injection site rotation and lipodystrophies detection while the patient is taking the insulin. The first one is addressed collecting data with IMU sensor which are processed by a machine learning classifier to detect the injection site. The second one is tackled through a sensor equipped with two leds: features computed from such signals fed a one-class Support Vector Machine trained to recognise healthy tissue, so that samples different from those in the training set can be considered as lipodystrophies. The results obtained for the injection site recognition show an average accuracy larger than 0.957, whilst in the case of lipodystrophies detection we reach an accuracy greater than 0.95 using the IR led.

The year 2020 was characterized by the COVID-19 pandemic that has caused, by the end of March 2021, more than 2.5 million deaths worldwide. Since the beginning, besides the laboratory test, used as the gold standard, many applications have been applying deep learning algorithms to chest X-ray images to recognize COVID-19 infected patients. In this context, we found out that convolutional neural networks perform well on a single dataset but struggle to generalize to other data sources. To overcome this limitation, we propose a late fusion approach where we combine the outputs of several state-of-the-art CNNs, introducing a novel method that allows us to construct an optimum ensemble determining which and how many base learners should be aggregated. This choice is driven by a two-objective function that maximizes, on a validation set, the accuracy and the diversity of the ensemble itself. A wide set of experiments on several publicly available datasets, accounting for more than 92,000 images, shows that the proposed approach provides average recognition rates up to 93.54% when tested on external datasets.

The year 2020 was marked by the worldwide COVID-19 pandemic, which caused over 2.5 million deaths by the end of February 2021. Different methods have been established since the beginning to identify infected patients and restrict the spread of the virus. In addition to laboratory analysis, used as the gold standard, several applications have been developed to apply deep learning algorithms to chest X-ray (CXR) images to diagnose patients affected by COVID-19. The literature shows that convolutional neural networks (CNNs) perform well on a single image dataset, but fail to generalize to other sources of data. To overcome this limitation, we present a late fusion approach in which multiple CNNs collaborate to diagnose the CXR scan of a patient, improving the generalizability. Experiments on three datasets publicly available show that the ensemble of CNNs outperforms stand-alone networks, achieving promising performance not only in cross-validation, but also when external validation is used, with an average accuracy of 95.18%.

Recent years have witnessed the rise of pathomics as a mean to describe histopathological images with quantitative biomarkers for predictive and prognostic ends, combining digital pathology, omic science and artificial intelligence. This novel research branch is the counterpart of radiomics which pursues the same aims extracting knowledge from radiological images. In this paper, we present the design of a pathomic deep learning-based system to predict the treatment outcome in non-small cell lung cancer patients. We describe the system design and optimization under the condition of limited data and limited training, with corresponding tests. The experimental results show the feasibility of the proposed scalable architecture providing also a comparison between different transfer learning strategies.

The breakthrough of social media has boosted to an increase in the spread of misleading information, with a serious impact on society especially when related to health knowledge. Recently, researchers have been developing AI-based automatic systems to detect rumours in social microblogs. Nevertheless rumours detection at the level of single post, also referred to as micro-level, is still a major challenge since most of the efforts have been directed toward the macro-level, which means that the system considers as rumours news carried by a set of aggregated microblog posts. In this work, we provide two contributions: first, we compare two state-of-the-art representations to figure out which one better catches hidden information in the data. Second, we explore whether it is possible to exploit knowledge extracted on a topic to automatically recognise micro-level rumour in a different one. To this end, we experimentally investigate three transfer learning methods on two health-related datasets. The comparison with a baseline that does not use any knowledge transfer from the source and target domains reveals that negative transfer occurs.

Recent epidemiological data report that worldwide more than 53 million people have been infected by SARS-CoV-2, resulting in 1.3 million deaths. The disease has been spreading very rapidly and few months after the identification of the first infected, shortage of hospital resources quickly became a problem. In this work we investigate whether artificial intelligence working with chest X-ray (CXR) scans and clinical data can be used as a possible tool for the early identification of patients at risk of severe outcome, like intensive care or death. Indeed, further to induce lower radiation dose than computed tomography (CT), CXR is a simpler and faster radiological technique, being also more widespread. In this respect, we present three approaches that use features extracted from CXR images, either handcrafted or automatically learnt by convolutional neuronal networks, which are then integrated with the clinical data. As a further contribution, this work introduces a repository that collects data from 820 patients enrolled in six Italian hospitals in spring 2020 during the first COVID-19 emergency. The dataset includes CXR images, several clinical attributes and clinical outcomes. Exhaustive evaluation shows promising performance both in 10-fold and leave-one-centre-out cross-validation, suggesting that clinical data and images have the potential to provide useful information for the management of patients and hospital resources.

The rising capabilities of storing and registering data has increased the number of temporal datasets, boosting the attention on time series classification and forecasting. In case of multivariate time series, symbolic methods that try to predict phenomena transform the data into a more compact format to produce a representation of the time series easy to be handled in a machine learning framework. However, up to now these representations do not grasp information on both inter-attribute variability and temporal variability. In this work we present an approach that, taking into account the relationships between attributes and their periodicity, reduces the multivariate time series to a collection of symbols, whose distribution is represented by histograms. The approach has been successfully tested on a publicly available dataset, the Telecom Italia Big Data Challenge 2014 dataset, reporting also the results attained by other methods available in the literature.

Breast cancer is the most common tumour in women and it is characterized by a huge variety of clinical and histological scenarios and imaging pattern. The axillary lymph node metastases presence or absence is one of the most important prognostic factors affecting the loco-regional recurrence and the overall survival. The lymph node status is usually determined by an histological exam, an invasive procedure that could result in complications. This work aims to provide a safer and non-invasive prognostic approach by introducing a radiomics-based method that predicts axillary lymph node metastasis. It combines primary tumor histological features and patients clinical data with quantitative measures extracted from the MR images. To compute these latter quantities we determine the convex hull of the ROIs and we introduce the Three Orthogonal Planes-Local Binary Pattern (TOP-LBP). On 99 samples the approach achieves a promising AUC equal to 85.6%.

The COVID-19 disease caused by the coronavirus SARS-nCoV2 is currently a global public health threat and Italy is one of the countries mostly suffering from this epidemic. It is therefore important to analyze epidemic data, considering also that the government deployed laws limiting the societal activities. We model COVID-19 dynamics with a SIQR (susceptible - infectious - quarantined - recovered) model, where we take into account the temporal variability of its parameters. Particle Swarm Optimization is used to find out the best parameters in the case of Italy and of Italian regions where the epidemic has the greatest impact. The basic reproductive number is estimated by a novel approach that averages out different PSO fits computed considering different temporal time-windows and reducing possible noise in the data. The results on data collected from February 24 to April 24 show that our approach is able to fit the data with low errors and that the basic reproductive number is characterized by a descending trend in time from 3.5 to a value below 1.

In many real world medical datasets learning under class imbalance can limit the performance of most supervised algorithms, resulting in a low recognition rate for samples belonging to the minority class. Within the wide literature on this issue the class of techniques that goes under the name of ensemble methods have been less investigated, despite their effectiveness. In this panorama, we present here an original strategy to construct the training set of each base classifier in the ensemble: it exploits information in the feature space that can give rise to unreliable classifications, which are determined by a novel algorithm here introduced. Our proposal is compared against multiple standard ensemble approaches on 18 publicly available biological datasets, showing promising results.

Class imbalance limits the performance of most learning algorithms, resulting in a low recognition rate for samples belonging to the minority class. Although there are different strategies to address this problem, methods that generate ensemble of classifiers have proven to be effective in several applications. This paper presents a new strategy to construct the training set of each classifier in the ensemble by exploiting information in the feature space that can give rise to unreliable classifications, which are determined by a novel algorithm here introduced. The performance of our proposal is compared against multiple standard ensemble approaches on 25 publicly available datasets, showing promising results.

Prostate cancer is the most common form of cancer in Western countries and there is the need to develop clinical decision support systems able to support physicians in the diagnosis of clinical relevant prostate cancer and avoid useless invasive prostate biopsies. In this respect, this paper introduces a radiomic approach that classifies the prostate cancer aggressiveness by combining Three Orthogonal Planes-Local Binary Pattern (TOP - LBP) with other texture measures. Furthermore, to combat the skewed nature of class priors, our proposal employs a data augmentation technique. The results achieved on 99 samples are up-and-coming, they favorably compare against conventional PI-RADS-based approach, and they show also the benefit given by the introduction of TOP-LBP in the radiomic signature.

The possibility of planning a therapy minimizing side effects and optimizing efficacy of cancer treatments is one of the main challenges tackled by precision medicine research in oncology. In this context, radiomics is revealing itself as a promising path for better understanding the correct approach to personalized cures. Its primary aim is to go beyond basic medical images analysis, which only leverages on direct measurements on the tumor mass, i.e. dimension and shape. On the contrary, radiomics approach is oriented to the extraction of heterogeneous and quantitative data from the images to characterize the disease from a wider perspective, in order to provide the physician a valid support for the therapy decision and survival prediction. This manuscript presents an application of radiomics to Non-Small Cell Lung Cancer, dealing with the novel task of predicting the possibility to carry out an adaptive therapy. We achieved promising performance, reporting a radiomics signature for predicting tumor reduction during therapy.

In the last years social networks have emerged as a critical mean for information spreading. In spite of all the positive consequences this phenomenon brings, unverified and instrumentally relevant information statements in circulation, named as rumours, are becoming a potential threat to the society. Recently, there have been several studies on topic-independent rumour detection on Twitter. In this paper we present a novel rumour detection system which focuses on a specific topic, that is health-related rumours on Twitter. To this aim, we constructed a new subset of features including influence potential and network characteristics features. We tested our approach on a real dataset observing promising results, as it is able to correctly detect about 89% of rumours, with acceptable levels of precision.