Machine Learning in Biomedical Implants: MATLAB Applications and Future Directions

Optimisation and interpretation of machine and deep learning models for improved water quality management in Lake Loktak

ObjectivePostoperative complications remain a major concern in laryngeal cancer surgery, often requiring invasive interventions or intensive care. This study aimed to develop and validate an interpretable machine learning (ML) model to preoperatively predict Clavien-Dindo Grade ≥ III complications and support risk-informed perioperative decision-making.MethodsWe conducted a retrospective study using a temporally split cohort of laryngeal cancer patients. Postoperative complications were graded using the Clavien-Dindo (CD) classification. Eight ML algorithms were trained and evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Model interpretability was assessed using SHapley Additive exPlanations (SHAP). A web-based calculator was deployed for clinical use.ResultThe random forest (RF) model achieved the best performance, with an area under the curve (AUC) of 0.935 in the training set and 0.842 in the test set. The model demonstrated robust sensitivity and specificity for both surgical and medical complications. Calibration curves indicated strong agreement between predicted and actual outcomes. SHAP analysis identified eight key predictors—such as vocal cord mobility, tumor subsite, and nutritional status—that contributed most to risk estimation. A user-friendly web calculator was developed and is accessible at: https://qilushiny.shinyapps.io/qilupredicate/.ConclusionWe developed a clinically interpretable ML model that accurately predicts major postoperative complications in patients undergoing laryngeal cancer surgery. This tool provides individualized risk assessments that can guide surgical planning, optimize perioperative strategies, and enhance shared decision-making. Prospective multicenter validation is needed to confirm its utility in routine practice.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12893-025-03213-z.

Developing Machine Learning (ML) algorithms for heterogeneous/mixed data is a longstanding problem. Many ML algorithms are not applicable to mixed data, which include numeric and non-numeric data, text, graphs and so on to generate interpretable models. Another longstanding problem is developing algorithms for lossless visualization of multidimensional mixed data. The further progress in ML heavily depends on success interpretable ML algorithms for mixed data and lossless interpretable visualization of multidimensional data. The later allows developing interpretable ML models using visual knowledge discovery by end-users, who can bring valuable domain knowledge which is absent in the training data. The challenges for mixed data include: (1) generating numeric coding schemes for non-numeric attributes for numeric ML algorithms to provide accurate and interpretable ML models, (2) generating methods for lossless visualization of n-D non-numeric data and visual rule discovery in these visualizations. This paper presents a classification of mixed data types, analyzes their importance for ML and present the developed experimental toolkit to deal with mixed data. It combines the Data Types Editor, VisCanvas data visualization and rule discovery system which is available on GitHub.

The integration of machine learning (ML) algorithms into audit processes represents a significant advancement in the field of auditing, offering substantial benefits in terms of efficiency, accuracy, and risk management. This review examines the transformative potential of ML in auditing, highlighting its key benefits and the challenges that must be addressed to fully leverage its capabilities. Machine learning algorithms, with their ability to analyze large datasets and identify patterns, enhance the accuracy and thoroughness of audits. Traditional auditing methods often rely on sampling and manual checks, which can miss anomalies and fraudulent activities. In contrast, ML algorithms can process entire datasets, uncovering subtle patterns and irregularities that may indicate fraud or errors. This comprehensive analysis reduces the risk of oversight and improves the reliability of audit findings. One of the primary benefits of ML in auditing is its capacity for anomaly detection. ML models can be trained on historical data to understand normal financial behavior and flag deviations that might signify irregularities. This ability to detect anomalies in real-time enables auditors to identify potential issues promptly, reducing the time lag between occurrence and detection of fraud. Predictive analytics, powered by ML, further enhances audit processes by forecasting future risks based on historical data. This proactive approach allows auditors to anticipate and mitigate risks before they materialize, contributing to more robust risk management strategies. Despite these advantages, integrating ML into audit processes presents several challenges. Ensuring data quality and integrity is crucial, as ML algorithms are only as good as the data they analyze. Poor-quality data can lead to inaccurate predictions and conclusions. Additionally, the "black box" nature of some ML algorithms can pose transparency issues, making it difficult for auditors to explain how specific conclusions were reached, which is critical for stakeholder trust and regulatory compliance. Another significant challenge is the potential for algorithmic bias. ML models can inadvertently perpetuate existing biases in the data, leading to unfair or skewed audit outcomes. Continuous monitoring and validation of ML algorithms are necessary to detect and mitigate such biases. In conclusion, while integrating machine learning algorithms into audit processes offers substantial benefits in terms of accuracy, efficiency, and risk management, it also necessitates careful attention to data quality, transparency, and bias mitigation. Addressing these challenges is essential to fully realize the potential of ML in enhancing audit practices. Keywords: Benefits, Challenges, Audit Processes, Algorithms, ML.

Interpretable vs. noninterpretable machine learning models for data-driven hydro-climatological process modeling

Annual burned areas in the United States have increased twofold during the past decades. With more large fires resulting in more emissions of fine particulate matter, an accurate prediction of fire emissions is critical for quantifying the impacts of fires on air quality, human health, and climate. This study aims to construct a machine learning (ML) model with game-theory interpretation to predict monthly fire emissions over the contiguous US and to understand the controlling factors of fire emissions. By comparing the predicted fire PM2.5 emissions from the interpretable ML model with the Global Fire Emissions Database (GFED) observations and predictions from process-based models in the Fire Modeling Intercomparison Project (FireMIP), the ML model is also used to diagnose the process-based models to inform future development. Results show promising performance for the ML model, Community Land Model (CLM), and Joint UK Land Environment Simulator-Interactive Fire And Emission Algorithm For Natural Environments (JULES-INFERNO) in reproducing the spatial distributions, seasonality, and interannual variability of fire emissions over CONUS. Regional analysis shows that only the ML model and CLM simulate the realistic interannual variability of fire emissions for most of the subregions (r > 0.95 for ML and r = 0.14 ~ 0.70 for CLM), except for Mediterranean California, where all the models perform poorly (r = 0.74 for ML and r < 0.30 for the FireMIP models). Regarding seasonality, most models capture the peak emission in July over western US. However, all models except for the ML model fail to reproduce the bimodal peaks in July and October over Mediterranean California, which may be explained by the coarse spatial resolutions of the processed-based models or atmospheric forcing data or limitations in model parameterizations for capturing the effects of Santa Ana winds on fire activity. Furthermore, most models struggle to capture the spring peak in emissions in southeastern US, probably due to underrepresentation of human effects and the influences of winter dryness on fires in the models. As for extreme events, both the ML model and CLM successfully reproduce the frequency map of extreme emission occurrence but overestimate the number of months with extremely large fire emissions. Comparing the fire PM2.5 emissions from the interpretable ML model with process-based fire models highlights their strengths and uncertainties for regional analysis and prediction and provides useful insights on future directions for model improvements.

In recent years, a significant amount of research has focused on analyzing the effectiveness of machine learning (ML) models for malware detection. These approaches have ranged from methods such as decision trees and clustering to more complex approaches like support vector machine (SVM) and deep neural networks. In particular, neural networks have proven to be very effective in detecting complex and advanced malware. This, however, comes with a caveat. Neural networks are notoriously complex. Therefore, the decisions that they make are often just accepted without questioning why the model made that specific decision. The black box characteristic of neural networks has challenged researchers to explore methods to explain black-box models such as SVM and neural networks and their decision-making process. Transparency and explainability give the experts and malware analysts assurance and trustworthiness about the ML models’ decisions. In addition, it helps in generating comprehensive reports that can be used to enhance cyber threat intelligence sharing. As such, this much needed analysis drives our work in this paper to explore the explainability and interpretability of ML models in the field of online malware detection. In this paper, we used the Shapley Additive exPlanations (SHAP) explainability technique to achieve efficient performance in interpreting the outcome of different ML models such as SVM Linear, SVM-RBF (Radial Basis Function), Random Forest (RF), Feed-Forward Neural Net (FFNN), and Convolutional Neural Network (CNN) models trained on an online malware dataset. To explain the output of these models, explainability techniques such as KernalSHAP, TreeSHAP, and DeepSHAP are applied to the obtained results.

Improving Clinical Decisions in IR: Interpretable Machine Learning Models for Predicting Ascites Improvement after Transjugular Intrahepatic Portosystemic Shunt Procedures

The cybersecurity concerns get increasingly intricate as the digital world progresses. In light of the increasing complexity of cyber threats, it is imperative to develop and implement advanced and flexible security strategies. Machine Learning (ML) has become a potent tool in strengthening cybersecurity, providing the capacity to scrutinise extensive information, recognise trends, and improve threat detection and defence methods. This paper examines the significance of ML in the field of cybersecurity, with a special emphasis on the identification of threats and the implementation of protective measures. By incorporating ML algorithms into cybersecurity frameworks, organisations may automate decision-making processes, facilitating prompt responses to ever-changing threats. The initial segment explores the terrain of cyber threats, highlighting the necessity for dynamic and aggressive security methods. Conventional solutions that rely on signatures are frequently inadequate when it comes to handling sophisticated, shape-shifting attacks. ML algorithms, in contrast, have exceptional proficiency in identifying nuanced patterns and irregularities within extensive datasets, therefore offering a more efficient method of detecting potential threats. The second section delves into several ML methodologies utilised in cybersecurity, including supervised and unsupervised learning, deep learning, and reinforcement learning. Every approach is assessed based on its suitability for threat detection, demonstrating its advantages and constraints. Furthermore, the relevance of feature engineering and data pretreatment in improving machine learning models for cybersecurity applications. The versatility of ML algorithms allows them to grow with emerging threats, making them a useful tool in the ever-changing arena of cyber warfare. The final segment focuses on real-world applications of machine learning in cybersecurity, presenting successful use cases across sectors. From anomaly detection to behavior analysis, ML algorithms contribute to the discovery of dangerous activity, lowering false positives and strengthening the overall security posture. Lastly, the paper covers the obstacles and ethical issues related to the adoption of ML in cybersecurity. Issues like as adversarial assaults, skewed datasets, and the interpretability of ML models are examined, highlighting the necessity for a holistic strategy that integrates modern technology with ethical considerations. The fusion of human expertise and machine intelligence offers a formidable defense against evolving cyber threats, paving the way for a more resilient and secure digital future.

To develop an interpretable machine learning (ML) model for predicting surgical outcomes in renal hilar tumors and propose a hilar-specific anatomical nephrometry scoring system. A total of 414 patients with renal hilar tumors who underwent robot-assisted partial nephrectomy (RAPN) were included in this study, comprising 304 patients from the First Affiliated Hospital of Nanchang University and 110 patients from the Second Affiliated Hospital of Nanchang University, which served as the external validation cohort. To identify predictors of trifecta achievement, we used least absolute shrinkage and selection operator regression and the Boruta algorithm, followed by multivariate logistic regression to identify independent factors. Five ML models were developed and evaluated using receiver operating characteristic curves, calibration plots, decision curve analysis, and precision-recall curves. The generalizability of the model was further validated in external cohort. Finally, we used SHapley Additive exPlanations (SHAP) to interpret the contribution of each predictor and enhance the model's explainability. Furthermore, based on anatomical features identified through logistic regression, we developed a modified nephrometry scoring system and compared its risk stratification performance with the traditional R.E.N.A.L. (i.e., Radius, Exophytic or endophytic, Nearness, Anterior or posterior, and Location) scoring system. Among the 304 patients in the primary cohort, 168 achieved trifecta outcomes. Eight variables were incorporated into the predictive model, with logistic regression model ultimately being selected as the optimal predictive model. It showed robust predictive performance in internal and external validation. SHAP methods identified surgeon, classification of hilar tumor, and radius as the three most significant predictive variables. Compared with the traditional R.E.N.A.L. score, the modified R.E.N.A.L. score demonstrated superior stratification ability for operation time, change in serum creatinine, change in estimated glomerular filtration rate, and trifecta achievement. The interpretable ML model accurately predicts trifecta in RAPN for hilar tumors. The modified R.E.N.A.L. score provides refined anatomical stratification and facilitates individualized surgical planning.

Despite endovascular coiling as a valid modality in treatment of aneurysmal subarachnoid hemorrhage (aSAH), there is a risk of poor prognosis. However, the clinical utility of previously proposed early prediction tools remains limited. We aimed to develop a clinically generalizable machine learning (ML) models for accurately predicting unfavorable outcomes in aSAH patients after endovascular coiling. Functional outcomes at 6 months after endovascular coiling were assessed via the modified Rankin Scale (mRS) and unfavorable outcomes were defined as mRS 3-6. Five ML algorithms (logistic regression, random forest, support vector machine, deep neural network, and extreme gradient boosting) were used for model development. The area under precision-recall curve (AUPRC) and receiver operating characteristic curve (AUROC) was used as main indices of model evaluation. SHapley Additive exPlanations (SHAP) method was applied to interpret the best-performing ML model. A total of 371 patients were eventually included into this study, and 85.4% of them had favorable outcomes. Among the five models, the DNN model had a better performance with AUPRC of 0.645 (AUROC of 0.905). Postoperative GCS score, size of aneurysm, and age were the top three powerful predictors. The further analysis of five random cases presented the good interpretability of the DNN model. Interpretable clinical prediction models based on different ML algorithms have been successfully constructed and validated, which would serve as reliable tools in optimizing the treatment decision-making of aSAH. Our DNN model had better performance to predict the unfavorable outcomes at 6 months in aSAH patients compared with Yan's nomogram model.

Ovarian cancer (OC) is a deadly disease that affects a large number of women worldwide. Machine Learning (ML) models can help in the early detection of this disease, however, the use of these models may be limited by their lack of interpretability and the difficulty to evaluate their performance. In this work, five types of datasets were used, employing clinical features, different types of coding genomic features, and combining both. The use of interpretable ML (IML) models (one linear and one nonlinear model) provided us with better interpretability of the five feature sets. Following this study, nine binary classification models were compared, and the Accuracy, Recall, and Area Under the Curve were analyzed. The results showed that ML models employed the combination of clinical features and genomes with the coding of the position of genes in patients significantly improves the prediction. We demonstrated that the inclusion of different preprocessed patient data and especially through the information provided by IML models, can help clinicians to understand the disease better and make informed treatment decisions.

Undernutrition among children under the age of five is a major public health concern, especially in developing countries. This study aimed to use machine learning (ML) algorithms to predict undernutrition and identify its associated factors. Secondary data analysis of the 2017 Multiple Indicator Cluster Survey (MICS) was performed using R and Python. The main outcomes of interest were undernutrition (stunting: height-for-age (HAZ) < -2 SD; wasting: weight-for-height (WHZ) < -2 SD; and underweight: weight-for-age (WAZ) < -2 SD). Seven ML algorithms were trained and tested: linear discriminant analysis (LDA), logistic model, support vector machine (SVM), random forest (RF), least absolute shrinkage and selection operator (LASSO), ridge regression, and extreme gradient boosting (XGBoost). The ML models were evaluated using the accuracy, confusion matrix, and area under the curve (AUC) receiver operating characteristics (ROC). In total, 8564 children were included in the final analysis. The average age of the children was 926 days, and the majority were females. The weighted prevalence rates of stunting, wasting, and underweight were 17%, 7%, and 12%, respectively. The accuracies of all the ML models for wasting were (LDA: 84%; Logistic: 95%; SVM: 92%; RF: 94%; LASSO: 96%; Ridge: 84%, XGBoost: 98%), stunting (LDA: 86%; Logistic: 86%; SVM: 98%; RF: 88%; LASSO: 86%; Ridge: 86%, XGBoost: 98%), and for underweight were (LDA: 90%; Logistic: 92%; SVM: 98%; RF: 89%; LASSO: 92%; Ridge: 88%, XGBoost: 98%). The AUC values of the wasting models were (LDA: 99%; Logistic: 100%; SVM: 72%; RF: 94%; LASSO: 99%; Ridge: 59%, XGBoost: 100%), for stunting were (LDA: 89%; Logistic: 90%; SVM: 100%; RF: 92%; LASSO: 90%; Ridge: 89%, XGBoost: 100%), and for underweight were (LDA: 95%; Logistic: 96%; SVM: 100%; RF: 94%; LASSO: 96%; Ridge: 82%, XGBoost: 82%). Age, weight, length/height, sex, region of residence and ethnicity were important predictors of wasting, stunting and underweight. The XGBoost model was the best model for predicting wasting, stunting, and underweight. The findings showed that different ML algorithms could be useful for predicting undernutrition and identifying important predictors for targeted interventions among children under five years in Ghana.

BACKGROUND Acute kidney injury (AKI) is a common adverse outcome following nephrectomy. The progression from AKI to acute kidney disease (AKD) and subsequently to chronic kidney disease (CKD) remains a concern; yet, the predictive mechanisms for these transitions are not fully understood. Interpretable machine learning (ML) models offer insights into how clinical features influence long-term renal function outcomes after nephrectomy, providing a more precise framework for identifying patients at risk and supporting improved clinical decision-making processes. OBJECTIVE This study aimed to (1) evaluate postnephrectomy rates of AKI, AKD, and CKD, analyzing long-term renal outcomes along different trajectories; (2) interpret AKD and CKD models using Shapley Additive Explanations values and Local Interpretable Model-Agnostic Explanations algorithm; and (3) develop a web-based tool for estimating AKD or CKD risk after nephrectomy. METHODS We conducted a retrospective cohort study involving patients who underwent nephrectomy between July 2012 and June 2019. Patient data were randomly split into training, validation, and test sets, maintaining a ratio of 76.5:8.5:15. Eight ML algorithms were used to construct predictive models for postoperative AKD and CKD. The performance of the best-performing models was assessed using various metrics. We used various Shapley Additive Explanations plots and Local Interpretable Model-Agnostic Explanations bar plots to interpret the model and generated directed acyclic graphs to explore the potential causal relationships between features. Additionally, we developed a web-based prediction tool using the top 10 features for AKD prediction and the top 5 features for CKD prediction. RESULTS The study cohort comprised 1559 patients. Incidence rates for AKI, AKD, and CKD were 21.7% (n=330), 15.3% (n=238), and 10.6% (n=165), respectively. Among the evaluated ML models, the Light Gradient-Boosting Machine (LightGBM) model demonstrated superior performance, with an area under the receiver operating characteristic curve of 0.97 for AKD prediction and 0.96 for CKD prediction. Performance metrics and plots highlighted the model’s competence in discrimination, calibration, and clinical applicability. Operative duration, hemoglobin, blood loss, urine protein, and hematocrit were identified as the top 5 features associated with predicted AKD. Baseline estimated glomerular filtration rate, pathology, trajectories of renal function, age, and total bilirubin were the top 5 features associated with predicted CKD. Additionally, we developed a web application using the LightGBM model to estimate AKD and CKD risks. CONCLUSIONS An interpretable ML model effectively elucidated its decision-making process in identifying patients at risk of AKD and CKD following nephrectomy by enumerating critical features. The web-based calculator, found on the LightGBM model, can assist in formulating more personalized and evidence-based clinical strategies.

This study presents a comparative analysis of the classification performance of facial and emotion recognition systems using Machine Learning (ML) and Deep Learning (DL) algorithms. The primary objective of this work is to evaluate the applicability of emotion recognition in fields such as psychotherapy and crime analysis, using the FER-2013 dataset.The study was conducted with ML algorithms such as Support Vector Machines (SVM), Random Forest (RF), K-Nearest Neighbor (KNN), Decision Trees, and Gradient Boosting, as well as the DL algorithm, Convolutional Neural Network (CNN). Supported by the application of feature selection, preprocessing, and feature extraction techniques, the model’s performance was measured using standard metrics such as accuracy, precision, F1-score, and AUC-ROC.The experimental results showed that the highest classification accuracy (46.61%) was achieved with the CNN model. While the ML models generally offered lower accuracy, they provided advantages in terms of computational efficiency in specific scenarios.This study aims to contribute to the literature by providing a comparative analysis of ML and DL algorithms and by highlighting the effect of data preprocessing on performance. The findings set targets for future work, such as real-time system integration and hybrid model development.