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Pompe disease (OMIM #232300), a rare genetic disorder, leads to glycogen buildup in the body due to an enzyme deficiency, particularly harming the heart and muscles. Infantile-onset Pompe disease (IOPD) requires urgent treatment to prevent mortality, but the unavailability of these methods often delays diagnosis. Our study aims to streamline IOPD diagnosis in the UAE using electronic health records (EHRs) for faster, more accurate detection and timely treatment initiation. This study utilized electronic health records from the Abu Dhabi Healthcare Company (SEHA) healthcare network in the UAE to develop an expert rule-based screening approach operationalized through a dashboard. The study encompassed six diagnosed IOPD patients and screened 93,365 subjects. Expert rules were formulated to identify potential high-risk IOPD patients based on their age, particular symptoms, and creatine kinase levels. The proposed approach was evaluated using accuracy, sensitivity, and specificity. The proposed approach accurately identified five true positives, one false negative, and four false positive IOPD cases. The false negative case involved a patient with both Pompe disease and congenital heart disease. The focus on CHD led to the overlooking of Pompe disease, exacerbated by no measurement of creatine kinase. The false positive cases were diagnosed with Mitochondrial DNA depletion syndrome 12-A (SLC25A4 gene), Immunodeficiency-71 (ARPC1B mutation), Niemann-Pick disease type C (NPC1 gene mutation leading to frameshift), and Group B Streptococcus meningitis. The proposed approach of integrating expert rules with a dashboard facilitated efficient data visualization and automated patient screening, which aids in the early detection of Pompe disease. Future studies are encouraged to investigate the application of machine learning methodologies to enhance further the precision and efficiency of identifying patients with IOPD.

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The COVID-19 pandemic has highlighted the need to take advantage of specific and effective patient telemonitoring platforms, with specific reference to the constant monitoring of vital parameters of patients most at risk. Among the various applications developed in Italy, certainly there is reCOVeryaID, a web application aimed at remotely monitoring patients potentially, currently or no longer infected with COVID-19. Therefore, in this paper we present a system model, consisting of a multi-platform intelligent telemonitoring application, that enables remote monitoring and provision of integrated home care to both patients symptomatic, asymptomatic and pre-symptomatic with severe acute respiratory infectious disease or syndrome caused by viruses belonging to the Coronavirus family, as well as simply to people with respiratory problems and/or related diseases (chronic obstructive pulmonary disease or asthma). In fact, in this paper we focus on exposing the technologies and various functionalities offered by the system, which constitute the practical implementation of the theoretical framework described in detail in another paper. Specifically, the reCOVeryaID telemonitoring application is a stand-alone, knowledge base-supported application that can promptly react and inform physicians if dangerous trends in a patient's short- and long-term vital signs are detected, thus enabling them to be monitored continuously, both in the hospital and at home. The paper also reports an evaluation of user satisfaction, carried out by actual patients and medical doctors.

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PURPOSE: Bleeding is an important health outcome of interest in epidemiological studies. We aimed to develop and validate rule-based algorithms to identify (1) major bleeding and (2) all clinically relevant bleeding (CRB) (composite of major and all clinically relevant nonmajor bleeding) within real-world electronic healthcare data. METHODS: We took a random sample (n = 1630) of inpatient admissions to Singapore public healthcare institutions in 2019 and 2020, stratifying by hospital and year. We included patients of all age groups, sex, and ethnicities. Presence of major bleeding and CRB were ascertained by two annotators through chart review. A total of 630 and 1000 records were used for algorithm development and validation, respectively. We formulated two algorithms: sensitivity- and positive predictive value (PPV)-optimized algorithms. A combination of hemoglobin test patterns and diagnosis codes were used in the final algorithms. RESULTS: During validation, diagnosis codes alone yielded low sensitivities for major bleeding (0.16) and CRB (0.24), although specificities and PPV were high (>0.97). For major bleeding, the sensitivity-optimized algorithm had much higher sensitivity and negative predictive values (NPVs) (sensitivity = 0.94, NPV = 1.00), however false positive rates were also relatively high (specificity = 0.90, PPV = 0.34). PPV-optimized algorithm had improved specificity and PPV (specificity = 0.96, PPV = 0.52), with little reduction in sensitivity and NPV (sensitivity = 0.88, NPV = 0.99). For CRB events, our algorithms had lower sensitivities (0.50-0.56). CONCLUSIONS: The use of diagnosis codes alone misses many genuine major bleeding events. We have developed major bleeding algorithms with high sensitivities, which can ascertain events within populations of interest.

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The DR.BEAT project aims to develop an accelerometer-based, wearable sensor system for measuring ballistocardiographic (BCG) signals, coupled with signal processing and visualization, to support cardiac health monitoring. A rule-based heartbeat detection was developed to enable the derivation of health parameters independent of an existing reference. This paper outlines the algorithm's methodology and provides an initial evaluation of its performance based on seismocardiographic (SCG) measurements obtained from an initial study involving twelve heart-healthy adults. On average, 87.6% of the heartbeats over all measurements, 97.6% of the heartbeats at rest and 71.9% of the heartbeats during physical stress could be detected.

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The effectiveness of government policies and environmental initiatives to mitigate global warming relies heavily on public support, which is closely tied to public perception and awareness. Despite the scientific evidence communicated, the public remains reluctant to take preventive measures against global warming. The aim of the paper is to investigate the communicative actions of publics proposed as in the situational theory of problem solving to understand publics' communicative actions towards global warming. The paper utilizes a fuzzy rule-based system approach to analyze the communicative actions of publics to reveal non-linear relationships; whereas previous studies mostly used linear statistical analysis. The paper provides a deeper understanding into the interplay between problem recognition, constraint recognition, and involvement in shaping information behavior. The results show that the communicative actions of the publics are at a low-to-moderate level. The paper's interesting finding is the nonlinear effects of constraint recognition on communicative action about global warming. Contrary to the current literature, it was found out that the dominant factor that may convince public to start taking action towards global warming seems to be recognizing being constrained at a moderate level. Based on the results, it is suggested for policy makers and communication strategists to mitigate the negative outcomes of global warming by integrating environmental issues into education at all levels and collaborating with non-governmental organizations for national awareness campaigns which focus on increasing public problem recognition and involvement.

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BACKGROUND: Pregnancy and gestation information is routinely recorded in electronic medical record (EMR) systems across China in various data sets. The combination of data on the number of pregnancies and gestations can imply occurrences of abortions and other pregnancy-related issues, which is important for clinical decision-making and personal privacy protection. However, the distribution of this information inside EMR is variable due to inconsistent IT structures across different EMR systems. A large-scale quantitative evaluation of the potential exposure of this sensitive information has not been previously performed, ensuring the protection of personal information is a priority, as emphasized in Chinese laws and regulations. OBJECTIVE: This study aims to perform the first nationwide quantitative analysis of the identification sites and exposure frequency of sensitive pregnancy and gestation information. The goal is to propose strategies for effective information extraction and privacy protection related to women's health. METHODS: This study was conducted in a national health care data network. Rule-based protocols for extracting pregnancy and gestation information were developed by a committee of experts. A total of 6 different sub-data sets of EMRs were used as schemas for data analysis and strategy proposal. The identification sites and frequencies of identification in different sub-data sets were calculated. Manual quality inspections of the extraction process were performed by 2 independent groups of reviewers on 1000 randomly selected records. Based on these statistics, strategies for effective information extraction and privacy protection were proposed. RESULTS: The data network covered hospitalized patients from 19 hospitals in 10 provinces of China, encompassing 15,245,055 patients over an 11-year period (January 1, 2010-December 12, 2020). Among women aged 14-50 years, 70% were randomly selected from each hospital, resulting in a total of 1,110,053 patients. Of these, 688,268 female patients with sensitive reproductive information were identified. The frequencies of identification were variable, with the marriage history in admission medical records being the most frequent at 63.24%. Notably, more than 50% of female patients were identified with pregnancy and gestation history in nursing records, which is not generally considered a sub-data set rich in reproductive information. During the manual curation and review process, 1000 cases were randomly selected, and the precision and recall rates of the information extraction method both exceeded 99.5%. The privacy-protection strategies were designed with clear technical directions. CONCLUSIONS: Significant amounts of critical information related to women's health are recorded in Chinese routine EMR systems and are distributed in various parts of the records with different frequencies. This requires a comprehensive protocol for extracting and protecting the information, which has been demonstrated to be technically feasible. Implementing a data-based strategy will enhance the protection of women's privacy and improve the accessibility of health care services.

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BACKGROUND AND OBJECTIVE: Patient-ventilator asynchrony (PVA) is associated with poor clinical outcomes and remains under-monitored. Automated PVA detection would enable complete monitoring standard observational methods do not allow. While model-based and machine learning PVA approaches exist, they have variable performance and can miss specific PVA events. This study compares a model and rule-based algorithm with a machine learning PVA method by retrospectively validating both methods using an independent patient cohort. METHODS: Hysteresis loop analysis (HLA) which is a rule-based method (RBM) and a tri-input convolutional neural network (TCNN) machine learning model are used to classify 7 different types of PVA, including: 1) flow asynchrony; 2) reverse triggering; 3) premature cycling; 4) double triggering; 5) delayed cycling; 6) ineffective efforts; and 7) auto triggering. Class activation mapping (CAM) heatmaps visualise sections of respiratory waveforms the TCNN model uses for decision making, improving result interpretability. Both PVA classification methods were used to classify incidence in an independent retrospective clinical cohort of 11 mechanically ventilated patients for validation and performance comparison. RESULTS: Self-validation with the training dataset shows overall better HLA performance (accuracy, sensitivity, specificity: 97.5 %, 96.6 %, 98.1 %) compared to the TCNN model (accuracy, sensitivity, specificity: 89.5 %, 98.3 %, 83.9 %). In this study, the TCNN model demonstrates higher sensitivity in detecting PVA, but HLA was better at identifying non-PVA breathing cycles due to its rule-based nature. While the overall AI identified by both classification methods are very similar, the intra-patient distribution of each PVA type varies between HLA and TCNN. CONCLUSION: The collective findings underscore the efficacy of both HLA and TCNN in PVA detection, indicating the potential for real-time continuous monitoring of PVA. While ML methods such as TCNN demonstrate good PVA identification performance, it is essential to ensure optimal model architecture and diversity in training data before widespread uptake as standard care. Moving forward, further validation and adoption of RBM methods, such as HLA, offers an effective approach to PVA detection while providing clear distinction into the underlying patterns of PVA, better aligning with clinical needs for transparency, explicability, adaptability and reliability of these emerging tools for clinical care.

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Models of human categorization predict the prefrontal cortex (PFC) serves a central role in category learning. The dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) have been implicated in categorization; however, it is unclear whether both are critical for categorization and whether they support unique functions. We administered three categorization tasks to patients with PFC lesions (mean age, 69.6 years; 5 men, 5 women) to examine how the prefrontal subregions contribute to categorization. These included a rule-based (RB) task that was solved via a unidimensional rule, an information integration (II) task that was solved by combining information from two stimulus dimensions, and a deterministic/probabilistic (DP) task with stimulus features that had varying amounts of category-predictive information. Compared with healthy comparison participants, both patient groups had impaired performance. Impairments in the dlPFC patients were largest during the RB task, whereas impairments in the vmPFC patients were largest during the DP task. A hierarchical model was fit to the participants' data to assess learning deficits in the patient groups. PFC damage was correlated with a regularization term that limited updates to attention after each trial. Our results suggest that the PFC, as a whole, is important for learning to orient attention to relevant stimulus information. The dlPFC may be especially important for rule-based learning, whereas the vmPFC may be important for focusing attention on deterministic (highly diagnostic) features and ignoring less predictive features. These results support overarching functions of the dlPFC in executive functioning and the vmPFC in value-based decision-making.

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This paper presents a control strategy synthesis method for dynamical systems with differential constraints, emphasizing the prioritization of specific rules. Special attention is given to scenarios where not all rules can be simultaneously satisfied to complete a given task, necessitating decisions on the extent to which each rule is satisfied, including which rules must be upheld or disregarded. We propose a learning-based Model Predictive Control (MPC) method designed to address these challenges. Our approach integrates a learning method with a traditional control scheme, enabling the controller to emulate human expert behavior. Rules are represented as Signal Temporal Logic (STL) formulas. A robustness margin, quantifying the degree of rule satisfaction, is learned from expert demonstrations using a Conditional Variational Autoencoder (CVAE). This learned margin is then applied in the MPC process to guide the prioritization or exclusion of rules. In a track driving simulation, our method demonstrates the ability to generate behavior resembling that of human experts and effectively manage rule-based dilemmas.

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Drug repurposing aims to find new therapeutic applications for existing drugs in the pharmaceutical market, leading to significant savings in time and cost. The use of artificial intelligence and knowledge graphs to propose repurposing candidates facilitates the process, as large amounts of data can be processed. However, it is important to pay attention to the explainability needed to validate the predictions. We propose a general architecture to understand several explainable methods for graph completion based on knowledge graphs and design our own architecture for drug repurposing. We present XG4Repo (eXplainable Graphs for Repurposing), a framework that takes advantage of the connectivity of any biomedical knowledge graph to link compounds to the diseases they can treat. Our method allows methapaths of different types and lengths, which are automatically generated and optimised based on data. XG4Repo focuses on providing meaningful explanations to the predictions, which are based on paths from compounds to diseases. These paths include nodes such as genes, pathways, side effects, or anatomies, so they provide information about the targets and other characteristics of the biomedical mechanism that link compounds and diseases. Paths make predictions interpretable for experts who can validate them and use them in further research on drug repurposing. We also describe three use cases where we analyse new uses for Epirubicin, Paclitaxel, and Predinisone and present the paths that support the predictions.

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Objective.Vital rules learned from fluorodeoxyglucose positron emission tomography (FDG-PET) radiomics of tumor subregional response can provide clinical decision support for precise treatment adaptation. We combined a rule-based machine learning (ML) model (RuleFit) with a heuristic algorithm (gray wolf optimizer, GWO) for mid-chemoradiation FDG-PET response prediction in patients with locally advanced non-small cell lung cancer.Approach.Tumors subregions were identified using K-means clustering. GWO+RuleFit consists of three main parts: (i) a random forest is constructed based on conventional features or radiomic features extracted from tumor regions or subregions in FDG-PET images, from which the initial rules are generated; (ii) GWO is used for iterative rule selection; (iii) the selected rules are fit to a linear model to make predictions about the target variable. Two target variables were considered: a binary response measure (ΔSUVmean ⩾ 20% decline) for classification and a continuous response measure (ΔSUVmean) for regression. GWO+RuleFit was benchmarked against common ML algorithms and RuleFit, with leave-one-out cross-validated performance evaluated by the area under the receiver operating characteristic curve (AUC) in classification and root-mean-square error (RMSE) in regression.Main results.GWO+RuleFit selected 15 rules from the radiomic feature dataset of 23 patients. For treatment response classification, GWO+RuleFit attained numerically better cross-validated performance than RuleFit across tumor regions and sets of features (AUC: 0.58-0.86 vs. 0.52-0.78,p= 0.170-0.925). GWO+Rulefit also had the best or second-best performance numerically compared to all other algorithms for all conditions. For treatment response regression prediction, GWO+RuleFit (RMSE: 0.162-0.192) performed better numerically for low-dimensional models (p= 0.097-0.614) and significantly better for high-dimensional models across all tumor regions except one (RMSE: 0.189-0.219,p< 0.004).Significance. The GWO+RuleFit selected rules were interpretable, highlighting distinct radiomic phenotypes that modulated treatment response. GWO+Rulefit achieved parsimonious models while maintaining utility for treatment response prediction, which can aid clinical decisions for patient risk stratification, treatment selection, and biologically driven adaptation. Clinical trial: NCT02773238.

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BACKGROUND: A comprehensive collection of data on doses in adult computed tomography procedures in Australia has not been undertaken for some time. This is largely due to the effort involved in collecting the data required for calculating the population dose. This data collection effort can be greatly reduced, and the coverage increased, if the process can be automated without major changes to the workflow of the imaging facilities providing the data. Success would provide a tool to determine a truly national assessment of the dose incurred through diagnostic imaging in Australia. PURPOSE: The aims of this study were to develop an automated tool to categorize electronic records of imaging procedures into a standardized set of broad procedure types, to validate the tool by applying it to data collected from nine facilities, and to assess the feasibility of applying the automated tool to compute population dose and determine the data manipulations required. METHODS: A rule-based classifier was implemented capitalizing on semantic and clinical rules. The keyword list was initially built from 609 unique study descriptions. It was then refined using an additional 414 unique study descriptions. The classifier was then tested on an additional 1198 unique study descriptions. Input from a radiologist provided the ground truth for the refinement of the classifier. RESULTS: From a sample of 238 139 studies containing 2794 unique study descriptions, the classifier correctly classified 2789 study types with only five misclassifications, demonstrating the feasibility of automating the process and the need for data pre-processing. Dose statistics for 21 categories were compiled using the 238 139 studies. CONCLUSION: The classifier achieved excellent classification results using the testing data supplied by the facilities. However, since all data supplied were from public facilities, the performance of the classifier may be biased. The performance of the classifier is yet to be tested on a more representative mix of private and public facilities.

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The expanding computer landscape leads us toward ubiquitous computing, in which smart gadgets seamlessly provide intelligent services anytime, anywhere. Smartphones and other smart devices with multiple sensors are at the vanguard of this paradigm, enabling context-aware computing. Similar setups are also known as smart spaces. Context-aware systems, primarily deployed on mobile and other resource-constrained wearable devices, use a variety of implementation approaches. Rule-based reasoning, noted for its simplicity, is based on a collection of assertions in working memory and a set of rules that regulate decision-making. However, controlling working memory capacity efficiently is a key challenge, particularly in the context of resource-constrained systems. The paper's main focus lies in addressing the dynamic working memory challenge in memory-constrained devices by introducing a systematic method for content removal. The initiative intends to improve the creation of intelligent systems for resource-constrained devices, optimize memory utilization, and enhance context-aware computing.

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Bluetooth sensors in intelligent transportation systems possess extensive coverage and access to a large number of identity (ID) data, but they cannot distinguish between vehicles and persons. This study aims to classify and differentiate raw data collected from Bluetooth sensors positioned between various origin-destination (i-j) points into vehicles and persons and to determine their distribution ratios. To reduce data noise, two different filtering algorithms are proposed. The first algorithm employs time series simplification based on Simple Moving Average (SMA) and threshold models, which are tools of statistical analysis. The second algorithm is rule-based, using speed data of Bluetooth devices derived from sensor data to provide a simplification algorithm. The study area was the Historic Peninsula Traffic Cord Region of Istanbul, utilizing data from 39 sensors in the region. As a result of time-based filtering, the ratio of person ID addresses for Bluetooth devices participating in circulation in the region was found to be 65.57% (397,799 person IDs), while the ratio of vehicle ID addresses was 34.43% (208,941 vehicle IDs). In contrast, the rule-based algorithm based on speed data found that the ratio of vehicle ID addresses was 35.82% (389,392 vehicle IDs), while the ratio of person ID addresses was 64.17% (217,348 person IDs). The Jaccard similarity coefficient was utilized to identify similarities in the data obtained from the applied filtering approaches, yielding a coefficient (J) of 0.628. The identity addresses of the vehicles common throughout the two date sets which are obtained represent the sampling size for traffic measurements.

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Introduction: Fine-grained, descriptive information on habitats and reproductive conditions of plant species are crucial in forest restoration and rehabilitation efforts. Precise timing of fruit collection and knowledge of species' habitat preferences and reproductive status are necessary especially for tropical plant species that have short-lived recalcitrant seeds, and those that exhibit complex reproductive patterns, e.g., species with supra-annual mass flowering events that may occur in irregular intervals. Understanding plant regeneration in the way of planning for effective reforestation can be aided by providing access to structured information, e.g., in knowledge bases, that spans years if not decades as well as covering a wide range of geographic locations. The content of such a resource can be enriched with literature-derived information on species' time-sensitive reproductive conditions and location-specific habitats. Methods: We sought to develop unsupervised approaches to extract relationships pertaining to habitats and their locations, and reproductive conditions of plant species and corresponding temporal information. Firstly, we handcrafted rules for a traditional rule-based pattern matching approach. We then developed a relation extraction approach building upon transformer models, i.e., the Text-to-Text Transfer Transformer (T5), casting the relation extraction problem as a question answering and natural language inference task. We then propose a novel unsupervised hybrid approach that combines our rule-based and transformer-based approaches. Results: Evaluation of our hybrid approach on an annotated corpus of biodiversity-focused documents demonstrated an improvement of up to 15 percentage points in recall and best performance over solely rule-based and transformer-based methods with F1-scores ranging from 89.61 to 96.75% for reproductive condition - temporal expression relations, and ranging from 85.39% to 89.90% for habitat - geographic location relations. Our work shows that even without training models on any domain-specific labeled dataset, we are able to extract relationships between biodiversity concepts from literature with satisfactory performance.

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Eating behavior is a key factor for nutritional intake and plays a significant role in the development of eating disorders and obesity. The standard methods to detect eating behavior events (i.e., bites and chews) from video recordings rely on manual annotation, which lacks objective assessment and standardization. Yet, video recordings of eating episodes provide a non-invasive and scalable source for automation. Here, we present a rule-based system to count bites automatically from video recordings with 468 3D facial key points. We tested the performance against manual annotation in 164 videos from 15 participants. The system can count bites with 79% accuracy when annotation is available, and 71.4% when annotation is unavailable. The system showed consistent performance across varying food textures. Eating behavior researchers can use this automated and objective system to replace manual bite count annotation, provided the system's error is acceptable for the purpose of their study. Utilizing our approach enables real-time bite counting, thereby promoting interventions for healthy eating behaviors. Future studies in this area should explore rule-based systems and machine learning methods with 3D facial key points to extend the automated analysis to other eating events while providing accuracy, interpretability, generalizability, and low computational requirements.

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Objective: Long COVID, marked by persistent, recurring, or new symptoms post-COVID-19 infection, impacts children's well-being yet lacks a unified clinical definition. This study evaluates the performance of an empirically derived Long COVID case identification algorithm, or computable phenotype, with manual chart review in a pediatric sample. This approach aims to facilitate large-scale research efforts to understand this condition better. Methods: The algorithm, composed of diagnostic codes empirically associated with Long COVID, was applied to a cohort of pediatric patients with SARS-CoV-2 infection in the RECOVER PCORnet EHR database. The algorithm classified 31,781 patients with conclusive, probable, or possible Long COVID and 307,686 patients without evidence of Long COVID. A chart review was performed on a subset of patients (n=651) to determine the overlap between the two methods. Instances of discordance were reviewed to understand the reasons for differences. Results: The sample comprised 651 pediatric patients (339 females, M age = 10.10 years) across 16 hospital systems. Results showed moderate overlap between phenotype and chart review Long COVID identification (accuracy = 0.62, PPV = 0.49, NPV = 0.75); however, there were also numerous cases of disagreement. No notable differences were found when the analyses were stratified by age at infection or era of infection. Further examination of the discordant cases revealed that the most common cause of disagreement was the clinician reviewers' tendency to attribute Long COVID-like symptoms to prior medical conditions. The performance of the phenotype improved when prior medical conditions were considered (accuracy = 0.71, PPV = 0.65, NPV = 0.74). Conclusions: Although there was moderate overlap between the two methods, the discrepancies between the two sources are likely attributed to the lack of consensus on a Long COVID clinical definition. It is essential to consider the strengths and limitations of each method when developing Long COVID classification algorithms.

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BACKGROUND: Clinical medicine offers a promising arena for applying Machine Learning (ML) models. However, despite numerous studies employing ML in medical data analysis, only a fraction have impacted clinical care. This article underscores the importance of utilising ML in medical data analysis, recognising that ML alone may not adequately capture the full complexity of clinical data, thereby advocating for the integration of medical domain knowledge in ML. METHODS: The study conducts a comprehensive review of prior efforts in integrating medical knowledge into ML and maps these integration strategies onto the phases of the ML pipeline, encompassing data pre-processing, feature engineering, model training, and output evaluation. The study further explores the significance and impact of such integration through a case study on diabetes prediction. Here, clinical knowledge, encompassing rules, causal networks, intervals, and formulas, is integrated at each stage of the ML pipeline, resulting in a spectrum of integrated models. RESULTS: The findings highlight the benefits of integration in terms of accuracy, interpretability, data efficiency, and adherence to clinical guidelines. In several cases, integrated models outperformed purely data-driven approaches, underscoring the potential for domain knowledge to enhance ML models through improved generalisation. In other cases, the integration was instrumental in enhancing model interpretability and ensuring conformity with established clinical guidelines. Notably, knowledge integration also proved effective in maintaining performance under limited data scenarios. CONCLUSIONS: By illustrating various integration strategies through a clinical case study, this work provides guidance to inspire and facilitate future integration efforts. Furthermore, the study identifies the need to refine domain knowledge representation and fine-tune its contribution to the ML model as the two main challenges to integration and aims to stimulate further research in this direction.

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DNA-based data storage is a new technology in computational and synthetic biology, that offers a solution for long-term, high-density data archiving. Given the critical importance of medical data in advancing human health, there is a growing interest in developing an effective medical data storage system based on DNA. Data integrity, accuracy, reliability, and efficient retrieval are all significant concerns. Therefore, this study proposes an Effective DNA Storage (EDS) approach for archiving medical MRI data. The EDS approach incorporates three key components (i) a novel fraction strategy to address the critical issue of rotating encoding, which often leads to data loss due to single base error propagation; (ii) a novel rule-based quaternary transcoding method that satisfies bio-constraints and ensure reliable mapping; and (iii) an indexing technique designed to simplify random search and access. The effectiveness of this approach is validated through computer simulations and biological experiments, confirming its practicality. The EDS approach outperforms existing methods, providing superior control over bio-constraints and reducing computational time. The results and code provided in this study open new avenues for practical DNA storage of medical MRI data, offering promising prospects for the future of medical data archiving and retrieval.

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The rehabilitation robot can assist hemiplegic patients to complete the training program effectively, but it only focuses on helping the patient's training process and requires the rehabilitation therapists to manually adjust the training parameters according to the patient's condition. Therefore, there is an urgent need for intelligent training prescription research of rehabilitation robots to promote the clinical applications. This study proposed a decision support system for the training of upper limb rehabilitation robot based on hybrid reasoning with rule-based reasoning (RBR) and case-based reasoning (CBR). The expert knowledge base of this system is established base on 10 professional rehabilitation therapists from three different rehabilitation departments in Shanghai who are enriched with experiences in using desktop-based upper limb rehabilitation robot. The rule-based reasoning is chosen to construct the cycle plan inference model, which develops a 21-day training plan for the patients. The case base consists of historical case data from 54 stroke patients who underwent rehabilitation training with a desktop-based upper limb rehabilitation robot. The case-based reasoning, combined with a Random Forest optimized algorithm, was constructed to adjust the training parameters for the patients in real-time. The system recommended a rehabilitation training program with an average accuracy of 91.5%, an average AUC value of 0.924, an average recall rate of 88.7%, and an average F1 score of 90.1%. The application of this system in rehabilitation robot would be useful for therapists.