Predicting Nurse Turnover for Highly Imbalanced Data Using the Synthetic Minority Over-Sampling Technique and Machine Learning Algorithms.

This study investigates the use of machine learning (ML) models combined with a Synthetic Minority Over-sampling Technique (SMOTE) and its variants to predict perioperative pressure injuries (PIs) in an imbalanced dataset. PIs are a significant healthcare problem, often leading to prolonged hospitalization and increased medical costs. Conventional risk assessment scales are limited in their ability to predict PIs accurately, prompting the exploration of ML techniques to address this challenge.We utilized data from 7,292 patients admitted to a tertiary care hospital in Shanghai between May 2017 and July 2023, with a final dataset of 2,972 patients, including 158 with PIs. Seven ML algorithms-Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost), Extra Trees (ET), K-Nearest Neighbors (KNN), and Decision Trees (DT)-were used in conjunction with SMOTE, SMOTE+ENN, Borderline-SMOTE, ADASYN, and GAN to balance the dataset and improve model performance.Results revealed significant improvements in model performance when SMOTE and its variants were used. For instance, the XGBoost model hadan AUC of 0.996 with SMOTE, compared to 0.800 on raw data. SMOTE+ENN and Borderline-SMOTE further enhanced the models' ability to identify minority classes. External validation indicatedthat XGBoost, RF, and ET exhibited the highest stability and accuracy, with XGBoost having an AUC of 0.977. SHAP analysis revealed that factors such as anesthesia grade, age, and serum albumin levels significantly influenced model predictions.In conclusion, integrating SMOTE with ML algorithms effectively addressed a data imbalance and improved the prediction of perioperative PIs. Future work should focus on refining SMOTE techniques and exploring their application to larger, multi-center datasets to enhance the generalizability of these findings, and especially for diseaseswith a lowincidence.

Outage duration prediction under typhoon disaster with stacking ensemble learning

ObjectiveAnalyze the psychological and clinical factors of clinically significant tinnitus (THI score ≥38) in patients with hearing loss, construct predictive models based on four machine learning (ML) algorithms, and compare the predictive performance of different models.MethodsPatients with hearing loss who visited the Department of Otolaryngology at Qinghai University between August 2024 and May 2025 were enrolled in this study. Clinical data were retrieved from the hospital’s electronic medical record system. The study outcome was the occurrence of clinically significant tinnitus. Predictive variables were screened using univariate analysis, the least absolute shrinkage and selection operator (LASSO) regression, and the Boruta algorithm. Four ML algorithms—logistic regression (LR), random forest (RF), extreme gradient boosting (XGBoost), and support vector machine (SVM)—were applied to construct and validate predictive models. The area under the receiver operating characteristic curve (AUC) of each model in the validation set was compared using the DeLong test. Additionally, model performance metrics in the validation set were compared to identify the optimal model. Finally, the Shapley additive explanations (SHAP) algorithm was employed to interpret the best-performing model.ResultsNine key variables—age, hypertension, sleep disorder, anxiety, hearing loss severity, depression, noise exposure history, hearing side, and ototoxic drug use—were retained after LASSO and Boruta feature selection. Among the four ML models, the RF algorithm achieved the best predictive performance, with an AUC of 0.973 in the training set and 0.977 in the validation set, followed by XGBoost (AUC = 0.962 and 0.961, respectively). DeLong tests confirmed that RF significantly outperformed LR and SVM models (p < 0.001), while its difference from XGBoost was not significant. In the validation set, the RF model yielded the highest accuracy (0.923), sensitivity (0.929), specificity (0.914), precision (0.945), and F1-score (0.937). SHAP analysis indicated that hearing loss severity, age, and sleep disorder were the most influential predictors, suggesting that both auditory and non-auditory factors contribute substantially to the risk of clinically significant tinnitus.ConclusionThe RF model showed the best performance in predicting clinically significant tinnitus, with hearing loss severity, age, and sleep disorder identified as major predictors. Integrating auditory and psychological factors can improve early risk identification in patients with hearing loss.

Although the goal of rectal cancer treatment is to restore gastrointestinal continuity, some patients with rectal cancer develop a permanent stoma (PS) after sphincter-saving operations. Although many studies have identified the risk factors and causes of PS, few have precisely predicted the probability of PS formation before surgery. To validate whether an artificial intelligence model can accurately predict PS formation in patients with rectal cancer after sphincter-saving operations. Patients with rectal cancer who underwent a sphincter-saving operation at Taipei Medical University Hospital between January 1, 2012, and December 31, 2021, were retrospectively included in this study. A machine learning technique was used to predict whether a PS would form after a sphincter-saving operation. We included 19 routinely available preoperative variables in the artificial intelligence analysis. To evaluate the efficiency of the model, 6 performance metrics were utilized: accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiving operating characteristic curve. In our classification pipeline, the data were randomly divided into a training set (80% of the data) and a validation set (20% of the data). The artificial intelligence models were trained using the training dataset, and their performance was evaluated using the validation dataset. Synthetic minority oversampling was used to solve the data imbalance. A total of 428 patients were included, and the PS rate was 13.6% (58/428) in the training set. The logistic regression (LR), Gaussian Naïve Bayes (GNB), Extreme Gradient Boosting (XGB), Gradient Boosting (GB), random forest, decision tree and light gradient boosting machine (LightGBM) algorithms were employed. The accuracies of the logistic regression (LR), Gaussian Naïve Bayes (GNB), Extreme Gradient Boosting (XGB), Gradient Boosting (GB), random forest (RF), decision tree (DT) and light gradient boosting machine (LightGBM) models were 70%, 76%, 89%, 93%, 95%, 79% and 93%, respectively. The area under the receiving operating characteristic curve values were 0.79 for the LR model, 0.84 for the GNB, 0.95 for the XGB, 0.95 for the GB, 0.99 for the RF model, 0.79 for the DT model and 0.98 for the LightGBM model. The key predictors that were identified were the distance of the lesion from the anal verge, clinical N stage, age, sex, American Society of Anesthesiologists score, and preoperative albumin and carcinoembryonic antigen levels. Integration of artificial intelligence with available preoperative data can potentially predict stoma outcomes after sphincter-saving operations. Our model exhibited excellent predictive ability and can improve the process of obtaining informed consent.

To construct and validate the best predictive model for 28-day death risk in patients with septic shock based on different supervised machine learning algorithms. The patients with septic shock meeting the Sepsis-3 criteria were selected from Medical Information Mart for Intensive Care-IV v2.0 (MIMIC-IV v2.0). According to the principle of random allocation, 70% of these patients were used as the training set, and 30% as the validation set. Relevant predictive variables were extracted from three aspects: demographic characteristics and basic vital signs, serum indicators within 24 hours of intensive care unit (ICU) admission and complications possibly affecting indicators, functional scoring and advanced life support. The predictive efficacy of models constructed using five mainstream machine learning algorithms including decision tree classification and regression tree (CART), random forest (RF), support vector machine (SVM), linear regression (LR), and super learner [SL; combined CART, RF and extreme gradient boosting (XGBoost)] for 28-day death in patients with septic shock was compared, and the best algorithm model was selected. The optimal predictive variables were determined by intersecting the results from LASSO regression, RF, and XGBoost algorithms, and a predictive model was constructed. The predictive efficacy of the model was validated by drawing receiver operator characteristic curve (ROC curve), the accuracy of the model was assessed using calibration curves, and the practicality of the model was verified through decision curve analysis (DCA). A total of 3 295 patients with septic shock were included, with 2 164 surviving and 1 131 dying within 28 days, resulting in a mortality of 34.32%. Of these, 2 307 were in the training set (with 792 deaths within 28 days, a mortality of 34.33%), and 988 in the validation set (with 339 deaths within 28 days, a mortality of 34.31%). Five machine learning models were established based on the training set data. After including variables at three aspects, the area under the ROC curve (AUC) of RF, SVM, and LR machine learning algorithm models for predicting 28-day death in septic shock patients in the validation set was 0.823 [95% confidence interval (95%CI) was 0.795-0.849], 0.823 (95%CI was 0.796-0.849), and 0.810 (95%CI was 0.782-0.838), respectively, which were higher than that of the CART algorithm model (AUC = 0.750, 95%CI was 0.717-0.782) and SL algorithm model (AUC = 0.756, 95%CI was 0.724-0.789). Thus above three algorithm models were determined to be the best algorithm models. After integrating variables from three aspects, 16 optimal predictive variables were identified through intersection by LASSO regression, RF, and XGBoost algorithms, including the highest pH value, the highest albumin (Alb), the highest body temperature, the lowest lactic acid (Lac), the highest Lac, the highest serum creatinine (SCr), the highest Ca2+, the lowest hemoglobin (Hb), the lowest white blood cell count (WBC), age, simplified acute physiology score III (SAPS III), the highest WBC, acute physiology score III (APS III), the lowest Na+, body mass index (BMI), and the shortest activated partial thromboplastin time (APTT) within 24 hours of ICU admission. ROC curve analysis showed that the Logistic regression model constructed with above 16 optimal predictive variables was the best predictive model, with an AUC of 0.806 (95%CI was 0.778-0.835) in the validation set. The calibration curve and DCA curve showed that this model had high accuracy and the highest net benefit could reach 0.3, which was significantly outperforming traditional models based on single functional score [APS III score, SAPS III score, and sequential organ failure assessment (SOFA) score] with AUC (95%CI) of 0.746 (0.715-0.778), 0.765 (0.734-0.796), and 0.625 (0.589-0.661), respectively. The Logistic regression model, constructed using 16 optimal predictive variables including pH value, Alb, body temperature, Lac, SCr, Ca2+, Hb, WBC, SAPS III score, APS III score, Na+, BMI, and APTT, is identified as the best predictive model for the 28-day death risk in patients with septic shock. Its performance is stable, with high discriminative ability and accuracy.

Diabetes Mellitus (DM) is caused due to the elevated levels of blood sugar i.e., said to be hyperglycemia. The DM is a metabolic chronic disease; therefore, early diagnosis and treatment is necessary to avoid life-threatening risks. According to the World Health Organization (WHO), the diabetes cause high mortality rate with 1.5 million deaths in a year. With the remarkable improvisations in the technology, the disease can be diagnosed earlier. In this paper, we have developed a decision-making support with the machine learning algorithms for DM diagnosis. The Pima Indians Diabetes dataset was chosen to train with Machine Learning algorithms. Our approach begins with Exploratory data analysis, and later the data is sent for data pre-processing and perform the feature Selection techniques. The important features are selected and finally, the data is trained with six various Machine learning (ML) algorithms such as Naïve Bayes, KNN, Random Forest, Logistic Regression, Decision Tree, and eXtreme gradient boosting. The Experimental results of the ML algorithms are calculated by the performance metrics in which that the eXtreme Gradient Boosting has scored highest with 88.2% accuracy than other machine learning algorithms.

to predict vestibular schwannoma (VS) response to radiosurgery by applying machine learning (ML) algorithms on radiomic features extracted from pre-treatment magnetic resonance (MR) images. patients with VS treated with radiosurgery in two Centers from 2004 to 2016 were retrospectively evaluated. Brain T1-weighted contrast-enhanced MR images were acquired before and at 24 and 36 months after treatment. Clinical and treatment data were collected contextually. Treatment responses were assessed considering the VS volume variation based on pre- and post-radiosurgery MR images at both time points. Tumors were semi-automatically segmented and radiomic features were extracted. Four ML algorithms (Random Forest, Support Vector Machine, Neural Network, and extreme Gradient Boosting) were trained and tested for treatment response (i.e., increased or non-increased tumor volume) using nested cross-validation. For training, feature selection was performed using the Least Absolute Shrinkage and Selection Operator, and the selected features were used as input to separately build the four ML classification algorithms. To overcome class imbalance during training, Synthetic Minority Oversampling Technique was used. Finally, trained models were tested on the corresponding held out set of patients to evaluate balanced accuracy, sensitivity, and specificity. 108 patients treated with Cyberknife® were retrieved; an increased tumor volume was observed at 24 months in 12 patients, and at 36 months in another group of 12 patients. The Neural Network was the best predictive algorithm for response at 24 (balanced accuracy 73% ± 18%, specificity 85% ± 12%, sensitivity 60% ± 42%) and 36 months (balanced accuracy 65% ± 12%, specificity 83% ± 9%, sensitivity 47% ± 27%). radiomics may predict VS response to radiosurgery avoiding long-term follow-up as well as unnecessary treatment.

Any company's human resources department faces the challenge of predicting whether an applicant will search for a new job or stay with the company. In this paper, we discuss how machine learning (ML) is used to predict who will move to a new job. First, the data is pre-processed into a suitable format for ML models. To deal with categorical features, data encoding is applied and several MLA (ML Algorithms) are performed including Random Forest (RF), Logistic Regression (LR), Decision Tree (DT), and eXtreme Gradient Boosting (XGBoost). To improve the performance of ML models, the synthetic minority oversampling technique (SMOTE) is used to retain them. Models are assessed using decision support metrics such as precision, recall, F1-Score, and accuracy.

Depression and anxiety are significant global public health, their comorbidity share similar clinical symptoms with heterogeneous progression patterns for patients. The early and accurate prediction of anxiety, depression, and comorbidity of anxiety and depression is essential for timely discrimination of high-risk patients, individual treatment strategies, and hierarchical management. This study aimed to develop and validate an interpretable, multi-task prediction model using heart rate variability (HRV) for discriminating anxiety alone, depression alone, and comorbid patients with psychiatric disorders. Patients diagnosed with anxiety or depression by trained psychiatrists were retrospectively enrolled from the Department of Psychiatry, the Affiliated Hospital of Southwest Medical University, between March 2024 and April 2025. The Synthetic Minority Over-sampling Technique (SMOTE) was applied to address class imbalance, and the Recursive feature elimination (RFE) was used for feature selection. Six machine-learning algorithms, including logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGBoost), k-nearest neighbor (KNN), and naïve Bayes (NB), were adopt to develop multi-task prediction models for discriminating psychiatric comorbidities. Model performances were evaluated by receiver operating characteristic (ROC) curves, accuracy, sensitivity, specificity, F1 score, and Matthews correlation coefficient (MCC). The SHapley Additive exPlanation (SHAP) method was used to visualize the feature contributions and interpret the best model. A total of 546 patients, 114 with anxiety group(20.88%), 100 with depression group (18.32%), and 332 with comorbidity of anxiety and depression (60.81%), were included in this study. The ML-based models were developed for each task using the eleven contributing features. Among the six ML models, the XGBoost achieved the best performance across all tasks. In the validation set, this model achieved the AUCs of 0.8341 (95% confidence interval [CI]:0.761–0.907) for the task of anxiety versus comorbidity of anxiety and depression, and 0.8458(95% CI:0.775–0.917) for the task of depression versus comorbidity of anxiety and depression, respectively. The clinical utility was evaluated using Decision curve analysis (DCA) and calibration curves. The proposed model has potential clinical application prospects and may assist clinicians to improve the accuracy and efficiency of diagnosis, and thereby facilitating timely appropriate intervention measures for patients with psychiatric disorders. Not applicable.

Employee churn is a significant challenge for organizations, leading to substantial costs associated with recruiting, onboarding, and training new employees. High turnover rates can negatively impact overall productivity, employee morale, and organizational stability. Therefore, accurately predicting employee churn is crucial for companies to implement targeted retention strategies, minimize turnover, and reduce associated expenses. In this study, we leveraged machine learning techniques to predict employee churn using the "HR Analytics" dataset from Kaggle. One of the key challenges in churn prediction is class imbalance, where the number of employees who leave is significantly lower than those who stay. To address this, we applied two data-balancing techniques: Synthetic Minority Over-sampling Technique (SMOTE) and Random Over-Sampling (ROS). We then trained and evaluated four machine learning models Logistic Regression, Random Forest, Decision Tree, and Extreme Gradient Boosting (XGBoost) on the balanced datasets. The F1 scores for the SMOTE-balanced data were: Logistic Regression (0.5990), Random Forest (0.9753), Decision Tree (0.9319), and XGBoost (0.9634). Meanwhile, the ROS-balanced data produced F1 scores of: Logistic Regression (0.5978), Random Forest (0.9760), Decision Tree (0.9475), and XGBoost (0.9703). The results demonstrated that ROS yielded superior performance, particularly for the Random Forest and XGBoost models, leading us to select ROS for further hyperparameter tuning. Using RandomizedSearchCV for optimization, the Random Forest model achieved the highest F1 score of 0.9779. Finally, we deployed the optimized Random Forest model via a Flask API, enabling HR professionals to access a user-friendly web interface for realtime churn prediction. This research highlights the effectiveness of machine learning in HR analytics and underscores the practical benefits of predictive modeling in workforce management, helping organizations proactively address employee retetion challenges.

ABSTRACTThe prediction of pollutants removal efficiency from the generated effluent of a treatment plant is valuable and can reduce the time, sampling and energy required during performance assessment. The present study aims to predict the effect of different input parameters on the treatment efficiency of the developed microbial‐based anaerobic process for textile effluent using machine leaning algorithms. The decolourisation and chemical oxygen demand (COD) reduction of the treated effluent were predicted on the basis of the three different input parameters pH, COD and colour value of the textile wastewater. The effectiveness of different machine learning algorithms, support vector machines (SVM), random forest (RF), gradient boost regressor (GBR), AdaBoost, extreme gradient boosting (XGB) regressor and voting regressor, were evaluated based on the correlation coefficient (R2) value. The results revealed that the RF achieved the highest accuracy for decolourisation (training data R2: ∼0.85 and test data R2: ∼0.84) as well as COD reduction (training data R2: ∼0.87 and test data R2: ∼0.94) compared to the other algorithms. These results were validated experimentally, confirming that RF can be used as a tool to predict the performance efficiency of a microbial‐based treatment system.

Coronary Artery Disease (CAD) is a cardiovascular disease that has the highest mortality rate. The non-invasive method for diagnosing CAD is coronary angiography which is expensive and exposes the patient to radiation. The present scenario for diagnosing CAD has motivated researchers to analyze and diagnose the disease using Machine Learning (ML) algorithms. In this work, the efficacy of various ML algorithms used to diagnose CAD disease is presented and compared. The proposed methodology aims to train the dataset using algorithms namely: K-Nearest Neighbor, Support Vector Machine, Logistic Regression, Naïve Bayes, Decision Tree, Extreme Gradient Boosting, Random Forest, Extra Tree Classifier, and Light Gradient Boosting machine, to achieve accuracy for diagnosing the CAD. The experimental results are validated in the simulation environment, and the conclusions were drawn from the performance indices, i.e., Accuracy, Sensitivity, Specificity, Precision, F1-Score, and Binary cross-entropy cost function. The meta-analysis shows that Light Gradient Machine achieves an accuracy of 93.36%, which is the highest among other ML algorithms.

PurposeIn this study, machine learning (ML) algorithms were employed to predict the shear capacity and behavior of DCSWs.Design/methodology/approachIn this study, ML algorithms were employed to predict the shear capacity and behavior of DCSWs. Various ML techniques, including linear regression (LR), support vector machine (SVM), decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost) and artificial neural network (ANN), were utilized. The ML models were trained using a dataset of 462 numerical and experimental samples. Numerical models were generated and analyzed using the finite element (FE) software Abaqus. These models underwent push-over analysis, subjecting them to pure shear conditions by applying a target displacement solely to the top of the shear walls without interaction from a frame. The input data encompassed eight survey variables: geometric values and material types. The characterization of input FE data was randomly generated within a logical range for each variable. The training and testing phases employed 90 and 10% of the data, respectively. The trained models predicted two output targets: the shear capacity of DCSWs and the likelihood of buckling. Accurate predictions in these areas contribute to the efficient lateral enhancement of structures. An ensemble method was employed to enhance capacity prediction accuracy, incorporating select algorithms.FindingsThe proposed model achieved a remarkable 98% R-score for estimating shear strength and a corresponding 98% accuracy in predicting buckling occurrences. Among all the algorithms tested, XGBoost demonstrated the best performance.Originality/valueIn this study, for the first time, ML algorithms were employed to predict the shear capacity and behavior of DCSWs.

The classification of clinical notes into specific diagnostic categories is critical in healthcare, especially for mental health conditions like anxiety and adjustment disorder. In this study, we compare the performance of various artificial intelligence models, including both traditional machine learning approaches (random forest, support vector machine, K-nearest neighbors, decision tree, and eXtreme Gradient Boost) and deep learning models (DistilBERT and SciBERT), to classify clinical notes into these two diagnoses. Additionally, we implemented three oversampling strategies: No Oversampling, Random Oversampling, and Synthetic Minority Over-sampling Technique (SMOTE), to assess their impact on model performance. Hyperparameter tuning was also applied to optimize model accuracy. Our results indicate that oversampling techniques had minimal impact on model performance overall. The only exception was SMOTE, which showed a positive effect specifically with Bidirectional Encoder Representations from Transformers (BERT)-based models. However, hyperparameter optimization significantly improved accuracy across the models, enhancing their ability to generalize and perform on the dataset. The decision tree and eXtreme Gradient Boost models achieved the highest accuracy among machine learning approaches, both reaching 96%, while the DistilBERT and SciBERT models also attained 96% accuracy in the deep learning category. These findings underscore the importance of hyperparameter tuning in maximizing model performance. This study contributes to the ongoing research on AI-assisted diagnostic tools in mental health by providing insights into the efficacy of different model architectures and data balancing methods.

Objective:The aim of this study was to develop and validate a machine learning model to predict the risk of comorbid depression in asthma patients.Methods:We conducted a retrospective study of 2464 asthma patients with comorbid depression using National Health and Nutrition Examination Survey (NHANES) data. Feature selection was conducted using the Boruta algorithm and the Least Absolute Shrinkage and Selection Operator (LASSO). Eight machine learning algorithms, namely Decision Tree (DT), k-Nearest Neighbors (KNN), Light Gradient Booster Machine (LGBM), Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), eXtreme Gradient Boosting (XGBoost), and Multilayer Perceptron (MLP), were trained using 5-fold cross-validation methodology. Model performance was evaluated through various metrics such as area under the curve (AUC), accuracy, sensitivity, specificity, F1 score, and decision curve analysis (DCA). Interpretation was conducted using SHapley Additive exPlanations (SHAP) analysis, highlighting feature importance.Results:The training set comprised 1724 participants, while the validation set included 740 participants, with a depression prevalence of 14.45%. Significant predictors identified included hypertension, chronic obstructive pulmonary disease (COPD), stroke, sleep questionnaire (SLQ) scores, smoking status, Poverty Index Ratio (PIR), and educational level. The XGBoost model demonstrated superior performance compared with alternative machine learning (ML) algorithms, achieving an AUC of 0.750, an accuracy of 69.1%, a sensitivity of 68.2%, a specificity of 73.8%, and an F1 score of 79%. The SHAP method identified SLQ, PIR, and education level as the primary decision factors influencing the ML model’s predictions.Conclusion:The XGBoost model effectively predicts the risk of depression in asthma patients, serving as a valuable reference for early clinical identification and intervention.