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Computer Methods And Programs In Biomedicine[JOURNAL]

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PPG-basis: A python-based toolbox for fast photoplethysmogram decomposition and reconstruction.

Putcha A, Keyal R, Piasecki L … +5 more , Sharma A, Shmuylovich L, Lou Y, Kosorok M, Bai W

Comput Methods Programs Biomed · 2026 Aug · PMID 42105444 · Full text

BACKGROUND & OBJECTIVE: Photoplethysmogram (PPG) data are commonly used for critical biometric extractions, such as heart rate and blood oxygenation. However, PPG data contains valuable information on other metrics, such... BACKGROUND & OBJECTIVE: Photoplethysmogram (PPG) data are commonly used for critical biometric extractions, such as heart rate and blood oxygenation. However, PPG data contains valuable information on other metrics, such as vascular stiffness, within the morphology of the data itself, rather than individual points. As such, a growing body of literature is focused on reliably decomposing PPG data morphology for subsequent biometric extraction. Separately, the accurate reconstruction of noisy PPG data for downstream model training is necessary for developing noise-resistant models. However, to our knowledge, there is no unified toolbox that enables the testing of multiple decomposition methods and subsequent reconstruction. METHODS: We reformulate the PPG generation problem in the phase, rather than time, domain and use a look-up table to avoid recompilation. We then provide three distinct kernels to represent PPG data and develop a two-stage decomposition pipeline to accurately reconstruct PPG data. RESULTS: We demonstrate an order-of-magnitude decrease in computational time using our phase-domain approach while retaining high accuracy when compared to existing methods. We further demonstrate the utility of this work through the decomposition and reconstruction of experimental data with injected noise, as well as the extraction of complex biometrics in N = 50 subjects from the MIMIC-III clinical database. CONCLUSION: On clean input, ppg-basis recovers morphological features - such as dicrotic notch depth and augmentation index - with substantially lower error than bandpass filtering alone, despite higher global waveform MSE. Under noise injection, the framework maintains stable morphological feature detection across SNR levels, whereas filter-based approaches produce artefactual detections that inflate with increasing noise. Furthermore, we anticipate combining morphologically accurate PPGs with noise-injection frameworks could be used for developing noise-resistant models and testing the robustness of existing models focused on PPG analysis.

IML-UNet: A brain-inspired spatiotemporal collaborative encoding method for medical image sequence registration.

Liu X, Chen X, Wang Z … +1 more , Wei Y

Comput Methods Programs Biomed · 2026 Aug · PMID 42102639 · Publisher ↗

BACKGROUND AND OBJECTIVE: Deformable medical image registration is important for radiotherapy planning, respiratory motion analysis, and organ function assessment. In medical image sequences such as 4D CT, organ motion i... BACKGROUND AND OBJECTIVE: Deformable medical image registration is important for radiotherapy planning, respiratory motion analysis, and organ function assessment. In medical image sequences such as 4D CT, organ motion involves large displacements, local non-rigid deformations, and continuous temporal changes. Registration requires accurate spatial matching together with temporal consistency and deformation stability across the sequence. However, most existing methods either process spatial and temporal information in separate stages or treat 4D registration as independent pairwise tasks, limiting spatiotemporal interaction and long-range temporal dependency modeling. We therefore propose a spatiotemporal joint registration method that models multi-scale spatial information and temporal dependencies within a unified framework to improve accuracy, stability, and sequence consistency under large-displacement conditions. METHODS: We propose IML-UNet, a deep learning-based method centered on a new recurrent cell, Inception MLP-like LSTM (iMLSTM), inspired by spatiotemporal collaborative encoding in partially overlapping neuronal populations. The iMLSTM integrates parallel multi-scale feature extraction with long-range temporal modeling to form fused spatiotemporal representations at each network level and reduce hierarchical feature degradation. A Progressive Frequency Architecture (PFA) flexibly adjusts the contributions of high- and low-frequency features across network levels to strengthen representation capability. During training, an Adaptive Weighted Multi-Scale Structural Similarity Index Measure (AM-SSIM) dynamically optimizes multi-scale similarity assessment. We also design efficient sequence registration strategies to capture dynamic features of 4D sequences and support diverse registration scenarios. RESULTS: On two publicly available 4D CT datasets, our method achieved TREs of 1.09 mm and 0.81 mm, respectively, demonstrating superior registration performance over prior methods. CONCLUSIONS: The proposed method delivers stable and accurate registration for lung 4D CT image sequences, with its main advantage lying in hierarchical intra-level spatiotemporal coupling rather than in the simple stacking of spatial and temporal modules. The observed performance gains are achieved with comparable model size and inference time, which strengthens the practical relevance of the method. It provides a promising framework for modeling complex spatiotemporal deformations in this setting. However, the current evidence is limited to a per-case optimization setting, and broader cohort-level generalizability remains to be further validated.

Time-resolved aortic 3D shape reconstruction from a limited number of cine 2D MRI slices.

Wolkerstorfer G, Buoso S, Schlenker R … +3 more , von Spiczak J, Manka R, Kozerke S

Comput Methods Programs Biomed · 2026 Aug · PMID 42096748 · Publisher ↗

BACKGROUND AND OBJECTIVE: To assess the feasibility and accuracy of reconstructing time-resolved, three-dimensional, subject-specific aortic geometries from a limited number of standard cine 2D magnetic resonance imaging... BACKGROUND AND OBJECTIVE: To assess the feasibility and accuracy of reconstructing time-resolved, three-dimensional, subject-specific aortic geometries from a limited number of standard cine 2D magnetic resonance imaging (MRI) acquisitions. This is achieved by coupling a statistical shape model with a differentiable volumetric mesh optimization algorithm. METHODS: Cine 2D MRI slices were manually segmented and used to reconstruct subject-specific aortic geometries via a differentiable mesh optimization algorithm, constrained by a statistical shape model. Optimal slice positioning was first evaluated on synthetic data, followed by in-vivo acquisition in 30 subjects (19 volunteers and 11 aortic stenosis patients). Time-resolved aortic geometries were reconstructed, from which geometric descriptors and radial strain were derived. In a subset of 10 subjects, 4D flow MRI data was acquired to provide volumetric reference for peak-systolic shape comparison. RESULTS: Accurate reconstruction was achieved using as few as six cine 2D MRI slices. Agreement with 4D flow MRI reference data yielded a Dice score of (89.9 ± 1.6) %, Intersection over Union of (81.7 ± 2.7) %, Hausdorff distance of (7.3 ± 3.3) mm, and Chamfer distance of (3.7 ± 0.6) mm. The mean absolute radius error along the aortic arch was (0.8 ± 0.6) mm. Secondary analysis demonstrated significant differences in geometric features and radial strain across age groups, with strain decreasing progressively with age at values of (11.00 ± 3.11) × 10 vs. (3.74 ± 1.25) × 10 vs. (2.89 ± 0.87) × 10 for the young, mid-age, and elderly groups, respectively. CONCLUSION: The proposed framework enables reconstruction of time-resolved, subject-specific aortic geometries from a limited number of standard cine 2D MRI acquisitions, providing a practical basis for downstream computational analysis.

Radiomic feature-based classification of BI-RADS 4/5 breast lesions on contrast-enhanced mammography.

Błędzińska W, Pałachniak J, Winder M … +2 more , Grażyńska A, Czajkowska J

Comput Methods Programs Biomed · 2026 Aug · PMID 42092369 · Publisher ↗

BACKGROUND AND OBJECTIVE: Differentiating benign from malignant BI-RADS 4/5 lesions, particularly architectural distortions, remains challenging. We investigated whether radiomics from contrast-enhanced mammography (low-... BACKGROUND AND OBJECTIVE: Differentiating benign from malignant BI-RADS 4/5 lesions, particularly architectural distortions, remains challenging. We investigated whether radiomics from contrast-enhanced mammography (low-energy, LE, and recombined, RI) improve lesion classification and how performance depends on LE-RI matching, projection, feature selection and classifier choice. METHODS: We analysed 333 patients with enhancing BI-RADS 4/5 findings (842 focal masses, 184 architectural distortions). Radiomic features were extracted from LE-only and three LE-RI matching strategies. Analyses were performed separately for CC, MLO and combined projections, including projection-specific feature selection. Images were z-score normalised and biopsy markers were removed using patch-based inpainting. Multiple feature selectors and classifiers were evaluated in patient-stratified fivefold cross-validation, and F1, ROC AUC and average precision were compared using linear mixed-effects models. RESULTS: For focal masses, incorporating RI information improved average precision and ROC AUC by 0.03-0.08 versus LE-only. For architectural distortions, best-match and merged LE-RI strategies yielded larger improvements up to 0.28-0.33 in optimal CC configurations. The impact of RI was strongly projection-dependent, with consistent improvements in the CC view, while effects in MLO were smaller and often not statistically significant. In combined CC+MLO analyses, performing feature selection separately for each projection improved performance, particularly for architectural distortions (up to 0.062 AP, 0.094 F1 and 0.063 ROC AUC). Performance depended on interactions between matching strategy, feature selection method and classifier. GLMM was the most consistent selector for focal masses, whereas merged LASSO-LARS performed best for distortions. The best-performing configurations achieved average precision values of up to approximately 0.86 for architectural distortions and 0.84 for focal masses. YOLOv8-based detection was insufficiently accurate for fully automated radiomics. CONCLUSIONS: Radiomics from paired LE and RI images improve classification of BI-RADS 4/5 lesions, with performance critically influenced by LE-RI matching and projection-specific feature selection. LE+RI radiomics show promise as a decision-support tool for biopsy-level assessment.

Hybrid learning/numerical framework for fast and robust electric field simulation in irreversible electroporation.

Desier K, Sutter O, Lafitte L … +4 more , Facq L, Seror O, Poignard C, Denis de Senneville B

Comput Methods Programs Biomed · 2026 Aug · PMID 42092368 · Publisher ↗

OBJECTIVE: Irreversible electroporation (IRE) represents a promising non-thermal ablation modality for the treatment of deep-seated tumors. However, its clinical efficacy is critically dependent on the accurate, patient-... OBJECTIVE: Irreversible electroporation (IRE) represents a promising non-thermal ablation modality for the treatment of deep-seated tumors. However, its clinical efficacy is critically dependent on the accurate, patient-specific distribution of the electric field. While advanced numerical solvers offer physically rigorous simulations, their computational demands render them impractical for intraoperative use, thereby limiting real-time treatment adaptation. This study seeks to develop a clinically oriented workflow designed to enable rapid and reliable electric dose mapping during IRE procedures, thereby enhancing treatment precision and patient outcomes. APPROACH: We propose a hybrid learning/numerical framework that combines the speed of neural networks with the precision of classical solvers. A convolutional neural network generates rapid approximations of electric potential fields based on electrode configurations and tissue properties, which are then refined through a lightweight iterative numerical correction to enforce physical consistency. The framework is designed to integrate seamlessly into clinical workflows, accommodating intraoperative imaging and segmentation updates. MAIN RESULTS: Evaluations conducted on both synthetic and clinical datasets, including 15 patient cases, using high-resolution domains (100×100×100 voxels at 1 mm resolution), demonstrate the model's robustness to variations in electrode configurations and heterogeneous tissue conductivities, two critical factors for personalized IRE treatment planning. Under homogeneous tissue conductivity assumptions, the hybrid solver achieves a 15-fold acceleration in computation time while preserving dosimetric accuracy. In non-homogeneous settings, the method not only surpasses conventional solvers in accuracy but also maintains a computational speedup exceeding twofold. SIGNIFICANCE: This work addresses a key barrier to the clinical adoption of numerical simulation in IRE by enabling near-real-time, patient-specific dosimetry. The proposed framework not only accelerates computation but also ensures the reliability required for clinical deployment, supporting more adaptive and precise tumor ablation.

Calibrated ROI-gated conditional computation for high-throughput and backbone-agnostic brain tumor MRI classification.

Nirob AA, Apon TS, Tahsin A … +5 more , Alam MGR, Costanzo S, Fortino G, Aliverti A, Hassan MM

Comput Methods Programs Biomed · 2026 Aug · PMID 42092367 · Publisher ↗

BACKGROUND AND OBJECTIVE: Multi-class brain tumor classification from magnetic resonance imaging must achieve high diagnostic accuracy while maintaining low inference latency and reliable confidence for real-time clinica... BACKGROUND AND OBJECTIVE: Multi-class brain tumor classification from magnetic resonance imaging must achieve high diagnostic accuracy while maintaining low inference latency and reliable confidence for real-time clinical deployment. High-capacity deep learning models are computationally expensive, and naive acceleration may discard important diagnostic information and reduce confidence reliability. This study proposes a trainable, backbone-agnostic efficiency layer that reallocates computation toward diagnostically relevant regions while preserving global image context and confidence reliability. METHODS: The proposed framework learns differentiable spatial localization to identify candidate regions of interest and performs compute-controlled selection to retain informative regions for classification. This enables conditional computation without requiring external segmentation. The method was evaluated on a revised multi-source corpus constructed from three public brain tumor MRI datasets, including the Fernando Feltrin collection, the Nickparvar dataset, and the BRISC dataset, after harmonization of the classification images used in this study. Experiments were conducted across three magnetic resonance imaging modalities (T1, contrast-enhanced T1, and T2) and multiple convolutional neural network backbones using a controlled inference protocol with consistent hardware and batch settings. RESULTS: The proposed method achieved consistent efficiency improvements across modalities and backbones. Inference throughput increased by 2.3-5.7 times while maintaining classification accuracy comparable to strong baseline models. Calibration analysis showed that removing the calibration component increased expected calibration error from 0.0100 to 0.0535, indicating reduced confidence reliability. Visual analysis confirmed that the model consistently focused on clinically relevant tumor regions. CONCLUSIONS: The proposed framework improves efficiency while preserving diagnostic accuracy and confidence reliability. By combining adaptive region selection, compute control, and calibration, the method enables fast and trustworthy brain tumor classification suitable for resource-constrained and real-time clinical environments.

A MiXed-Reality automatic system for enhanced precision in craniotomy procedure for meningioma resection: A multicentric study.

Albanesi A, Schiariti M, Morelli F … +11 more , Offi M, Mattioli L, Barbieri EM, Grisoli M, Masini V, Milesi D, Ferroli P, Redaelli ACL, Massimi L, Stifano V, Votta E

Comput Methods Programs Biomed · 2026 Aug · PMID 42092366 · Publisher ↗

BACKGROUND AND OBJECTIVE: Craniotomy is the standard surgical approach in neuro-oncology for accessing and removing brain tumors. Despite being the clinical gold standard, conventional image-guided systems such as neuron... BACKGROUND AND OBJECTIVE: Craniotomy is the standard surgical approach in neuro-oncology for accessing and removing brain tumors. Despite being the clinical gold standard, conventional image-guided systems such as neuronavigation platforms suffer from high costs, limited ergonomics, and 2D visual constraints that can hinder surgical precision and usability. This study presents and validates a standalone mixed reality system for automatic craniotomy planning and intra-operative guidance, designed to provide an ergonomic, cost-effective, and intuitive alternative to traditional neuronavigation. METHODS: The system, composed of a laptop and a HoloLens 2 headset, integrates automatic craniotomy planning, hologram-to-patient registration, and real-time 3D visualization. A multicentric in vitro study was conducted with ten neurosurgeons performing craniotomies on a custom 3D-printed phantom with four tumor models, using both the mixed reality system and a commercial neuronavigation platform. Performance metrics included craniotomy extension, percentage of tumor exposure, craniotomy centering, and procedural time. RESULTS: The mixed reality system achieved craniotomy extension, tumor exposure and craniotomy centering comparable or superior to conventional neuronavigation, with improved inter-operator consistency and no significant increase in procedural time. Hologram-to-patient registration achieved a root mean squared error of 1.31 ± 0.17 mm and a target registration error of 2.3 ± 0.6 mm. User acceptance of the proposed system was high, as confirmed by four standardized questionnaires. CONCLUSION: The proposed mixed reality system demonstrates the potential to serve as a viable, ergonomic, and lower-cost alternative to traditional neuronavigation platforms, supporting accurate and intuitive craniotomy planning and execution.

Three-dimensional oxygen maps of tumors in real time - Analysis in the context of active tumor vasculature.

Dziurman G, Radzikowska N, Drzał A … +6 more , Murzyn A, Świerzewski P, Szczygieł M, Romanowska-Dixon B, Krzykawska-Serda M, Elas M

Comput Methods Programs Biomed · 2026 Aug · PMID 42085882 · Publisher ↗

BACKGROUND AND OBJECTIVE: Characterizing the tumor microenvironment (TME) requires integrating multiple physiological features, including oxygenation, vascularity, and redox status. While EPR oxygen imaging (EPROI) provi... BACKGROUND AND OBJECTIVE: Characterizing the tumor microenvironment (TME) requires integrating multiple physiological features, including oxygenation, vascularity, and redox status. While EPR oxygen imaging (EPROI) provides spatial pO₂ maps, conventional metrics such as median pO₂ or hypoxic fraction (HF) may not fully capture vascular characteristics. This study aimed to identify EPROI-derived parameters that best reflect tumor vasculature by correlating oxygenation metrics with Doppler ultrasound vascular imaging and redox kinetics. METHODS: Mel270 uveal melanoma tumors were implanted in the intrascapular fat pad of SCID mice, providing a highly vascularized niche. Non-invasive imaging included ultrasound (anatomical and Doppler) and EPROI for pO₂ mapping. EPR spectroscopy of the nitroxide redox probe was used to estimate tissue redox status. Parameters extracted included median pO₂, HF20, VC40, VC60, vascular fraction (PV), and kinetic descriptors (α, β, mean amplitude). Correlation analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression, with Leave-One-Out Cross-Validation (LOOCV) and Partial Least Squares Regression (PLSR), as well as principal component analysis (PCA) were performed to identify the most informative metrics. RESULTS: VC40 and VC60, representing the upper tail of the pO₂ histogram, showed moderate correlations with vascularity (PV), median pO₂, and redox kinetics (β), outperforming HF20. Both LASSO and PCA confirmed VC40/VC60 as the most robust single parameters for vascular characterization, as well as the best predictors of median pO, with a secondary contribution from mean amplitude and PV. As expected, median pO₂ correlated negatively with metastasis, while HF20 correlated negatively with PV in PCA analysis. Tumor size did not correlate with oxygenation or vascularity. CONCLUSIONS: Advanced evaluation of the tumor microenvironment requires complementary parameters like VC40/VC60 and HF20/pO₂ to capture its full complexity, integrating oxygenation, vascularity, and redox data. Future work should adopt advanced histogram-based and machine learning methods, as widely used in MRI, to fully exploit spatial oxygen and vascular network imaging data.

HIPPA-DGCN: Survival analysis on whole slide images via hyper-image patches and position-aware dense graph convolutional networks.

Xie H, Xu T, Yang H … +4 more , Lyu M, Chen C, Tong C, Liu S

Comput Methods Programs Biomed · 2026 Aug · PMID 42081855 · Publisher ↗

BACKGROUND AND OBJECTIVE: Whole Slide Images (WSIs) are the gold standard for cancer diagnosis and prognosis. However, the enormous scale of WSIs presents significant challenges for effective information aggregation in s... BACKGROUND AND OBJECTIVE: Whole Slide Images (WSIs) are the gold standard for cancer diagnosis and prognosis. However, the enormous scale of WSIs presents significant challenges for effective information aggregation in survival analysis, limiting prognostic accuracy and clinical applicability. This study aims to develop a computationally efficient framework for accurate and interpretable survival prediction from WSIs. METHODS: We propose HIPPA-DGCN, a novel framework that utilizes hyper-image patch clustering for feature distillation and a position-aware dense graph convolutional network for global context modeling. This architecture is designed to efficiently integrate pathological features with their spatial relationships. RESULTS: Extensive evaluation on seven public datasets (five from TCGA and two from CPTAC) demonstrates state-of-the-art performance. Our method achieves superior prognostic accuracy while drastically improving computational efficiency, reducing model parameters to 0.73M and computational cost to 0.08 GFLOPs per WSI. The model generates interpretable attention maps that highlight histopathological regions with significant prognostic relevance. CONCLUSIONS: HIPPA-DGCN provides an accurate, efficient, and interpretable solution for WSI-based survival analysis. Its lightweight architecture and robust performance make it particularly suitable for clinical deployment in resource-constrained environments, potentially enhancing cancer prognosis workflows.

Multi-view semi-supervised adversarial attention network for drug repurposing.

Fan M, He D, Liu Q … +7 more , Liu Q, Wang F, Li H, Wang H, Shan S, Zhang J, Hou Y

Comput Methods Programs Biomed · 2026 Aug · PMID 42070482 · Publisher ↗

BACKGROUND AND OBJECTIVE: Drug repositioning represents an efficient strategy for uncovering new therapeutic indications for approved drugs. However, most existing prediction methods rely on similarity data and overlook... BACKGROUND AND OBJECTIVE: Drug repositioning represents an efficient strategy for uncovering new therapeutic indications for approved drugs. However, most existing prediction methods rely on similarity data and overlook biological and chemical information. In addition, data sparsity and randomly selected negative samples further limit predictive performance. METHODS: We propose the Multi-view Semi-Supervised Adversarial Attention Network (M-SSAAN) for drug-disease association prediction. M-SSAAN combines structural and similarity embeddings to generate multi-view representations, and employs attention mechanisms along with semi-supervised adversarial learning to alleviate data sparsity and enhance robustness. RESULTS: The effectiveness of M-SSAAN was evaluated through comparative experiments, ablation studies, and strategy analyses. In addition, case studies on ibuprofen indications and zero-shot predictions for lung cancer further demonstrate the model's ability to identify reliable drug-disease associations. CONCLUSION: These results highlight the strong potential of M-SSAAN as a powerful and reliable tool for drug discovery.

Integrating evolutionary game theory with SEIRS models: A spatial epidemic simulator for strategy-based interventions.

Mendzik P, Borys D

Comput Methods Programs Biomed · 2026 Aug · PMID 42070481 · Publisher ↗

BACKGROUND AND OBJECTIVE: This study investigates how adaptive individual behavior influences epidemic dynamics in spatially structured populations. Specifically, it examines how payoff-driven strategy evolution interact... BACKGROUND AND OBJECTIVE: This study investigates how adaptive individual behavior influences epidemic dynamics in spatially structured populations. Specifically, it examines how payoff-driven strategy evolution interacts with spatial SEIRS dynamics to shape epidemic outcomes. METHODS: We construct a simulation framework that integrates a spatial SEIRS epidemic model with evolutionary game dynamics based on a Hawk-Dove formulation of behavioral strategies, including vaccination and freeriding. Strategies evolve through payoff-driven adaptation driven by local interactions, while disease transmission follows spatially localized SEIRS dynamics on a two-dimensional lattice. All core scenarios were repeated N=15 times with independent random seeds; results are reported as mean ± standard deviation (SD) with 95% confidence intervals. RESULTS: Behavioral adaptation and spatial structure strongly affect epidemic outcomes. Under high infection penalty (λ=3), epidemics in populations without freeriders were rapidly suppressed (7.0±8.2 cumulative deaths; 95% CI: 2.9-11.1). Introducing 1000 permanent freeriders (62.5% of the population) raised mortality to 187.1±75.0 deaths (95% CI: 149.2-225.1) and extended epidemic duration to 376.4±58.1 generations. Under low infection penalty (λ=1), mortality reached 187.3±25.0 deaths even without freeriders, confirming that perceived infection severity is a key driver of vaccination uptake. Two-dimensional sensitivity sweeps identify a critical freerider cluster size of approximately 300-500 agents (corresponding to 15.6-31.3% of the 1600-agent population used in the main analysis) and a sharp vaccination-cost threshold near C≈0.2-0.5, beyond which epidemic duration approaches the full simulation window regardless of transmission rate. CONCLUSIONS: The framework reveals key feedbacks between individual decision-making and epidemic spread, highlighting the limitations of voluntary vaccination in the presence of permanent non-compliant agents and low perceived infection risk.

A lightweight vision transformer with context-aware convolution and uniformity normalization for Alzheimer's Disease diagnosis.

Lu SY, Zhu Z, Zhang B … +2 more , Zhang YD, Yao YD

Comput Methods Programs Biomed · 2026 Aug · PMID 42070480 · Publisher ↗

BACKGROUND: Early and accurate diagnosis of Alzheimer's Disease (AD) is crucial for effective clinical intervention. METHOD: In this study, we propose a lightweight vision transformer architecture specifically designed f... BACKGROUND: Early and accurate diagnosis of Alzheimer's Disease (AD) is crucial for effective clinical intervention. METHOD: In this study, we propose a lightweight vision transformer architecture specifically designed for AD classification using 2D brain MRI slices. LICAUN-ViT incorporates three key innovations: Mono-Head Self-Attention (MOHSA) to reduce computational overhead, Uniformity Normalization (Uni-Norm) to mitigate oversmoothing and enhance feature diversity, and Context-Aware Convolution (CAC) to integrate long-range dependencies with local structural features. RESULTS: Evaluated on two benchmark datasets derived from the Alzheimer's Disease Neuroimaging Initiative (ADNI), our model achieves state-of-the-art performance with an accuracy of 93.03 % on axial slices and 94.15 % on sagittal slices, while maintaining relatively low floating-point operations (FLOPs) for efficient deployment. Extensive ablation studies and singular value analyses confirm the effectiveness and robustness of the proposed components. CONCLUSION: These results demonstrate that the proposed model offers a computationally efficient and promising solution for automated AD diagnosis, with strong potential for clinical integration.

CEP-IP: An explainable framework for cell subpopulation identification in single-cell transcriptomics.

Wong KK

Comput Methods Programs Biomed · 2026 Aug · PMID 42070479 · Publisher ↗

BACKGROUND AND OBJECTIVE: Single-cell RNA sequencing (scRNA-seq) frameworks lack explainable approaches for identifying cell subpopulations harboring strong pairwise monotonic gene-module relationships between a gene of... BACKGROUND AND OBJECTIVE: Single-cell RNA sequencing (scRNA-seq) frameworks lack explainable approaches for identifying cell subpopulations harboring strong pairwise monotonic gene-module relationships between a gene of interest (GOI) and its co-expressed genes. In this study, CEP-IP is introduced as a novel explainable machine learning framework to address this gap. METHODS: Prostate cancer (PCa) scRNA-seq dataset was used as the initial dataset, whereby TRPM4 served as the GOI and its co-expressed ribosomal genes (Ribo) were identified via Spearman-Kendall dual-filter (i.e., dual-filtered genes, DFG). Next, generalized additive modeling quantified the strength of TRPM4-Ribo relationship, represented by deviance explained (DE). TRPM4-Ribo's DE was then assigned to individual cells via cell explanatory power (CEP) classification, identifying cells harboring the TRPM4-Ribo module [i.e., top-ranked explanatory power (TREP) cells]. TRPM4-Ribo transcriptional space was then stratified into pre-IP and post-IP regions using inflection point (IP) analysis, producing four distinct cell subpopulations per patient for pathway analysis. Validation was performed in the Allen middle temporal gyrus (MTG) and Neftel glioblastoma multiforme (GBM) transcriptomically heterogeneous datasets. RESULTS: TRPM4-Ribo modeling outperformed alternative gene set modules (FDR<0.05). In each PCa patient, CEP-IP yielded four cell subpopulations, where pre-IP TREP cells showed enrichment of immune-related processes, and post-IP TREP cells were enriched for ribosomal, translation, and cell adhesion pathways. In the MTG validation dataset (CARM1P1-DFG module), post-IP TREP cells showed enrichment of neuron projection ontologies. In the GBM dataset, FOXM1 was the sole GOI yielding mesenchymal-state DFG, with FOXM1-DFG post-IP TREP cells enriched for cell division and microtubule pathways; 3D trajectory analysis demonstrated continuous trajectories of TREP cells that were obscured in 2D embeddings. CONCLUSIONS: CEP-IP identifies biologically distinct cell subpopulations in three independent scRNA-seq datasets. The framework may generalize to other pairwise GOI-DFG module in single-cell transcriptomics beyond the datasets investigated in this study.

Blood cancer differentiation based on IR spectroscopy and chemometrics.

Xie L, Guo S, Liu T … +7 more , Tang X, Ji R, Shen X, Xu Y, Chen L, Wang S, Bocklitz T

Comput Methods Programs Biomed · 2026 Aug · PMID 42068720 · Publisher ↗

BACKGROUND AND OBJECTIVE: White blood cells (WBCs) and their subpopulations play critical roles in detecting blood cancers due to their distinct biological and biochemical characteristics. Infrared (IR) spectroscopy offe... BACKGROUND AND OBJECTIVE: White blood cells (WBCs) and their subpopulations play critical roles in detecting blood cancers due to their distinct biological and biochemical characteristics. Infrared (IR) spectroscopy offers a rapid, label-free, and non-destructive approach to probe molecular composition, making it a promising tool for biomedical diagnostics. The objective of this proof-of-principle study is to investigate the possibility of IR spectroscopy combined with chemometrics to differentiate leukemia from lymphoma, and to assess the capability of whole WBCs and their subpopulations in distinguishing the two diseases. METHODS: We based our study on 21 pediatric patients including 11 leukemia and 10 lymphoma cases, with in total 86,016 IR spectra measured from whole WBCs and the subpopulations. Data pipeline was established, including steps of spectral preprocessing, classification, and data fusion. Particularly, data fusion was implemented via low-, middle-, and high-level strategies, with the aim of combining spectra from different cell types and investigating their capability of differentiating the two blood cancers. RESULTS: The classification, both with and without data fusion, was benchmarked via the patient-wise cross-validation. A balanced accuracy of 80.0% was achieved based on IR spectra of whole WBCs. Further improvement was observed when combining whole WBCs and its subpopulations, with the best performance of 90.0% from combining whole WBCs and granulocytes with high-level data fusion strategy. The performance was observed consistent for both linear and nonlinear classifications based on linear discriminant analysis (LDA) and support vector machine (SVM), respectively. CONCLUSIONS: The results indicate the promising potential of IR spectroscopy of blood samples to distinguish leukemia and lymphoma with the help of chemometric approaches. Further, WBC subpopulations, particularly granulocytes, were proven to contain complementary information to whole WBCs for differentiating leukemia from lymphoma. This provides critical insights for biomedical practice in blood cancer diagnostics.

Unveiling the causal pathway of Parkinson's disease dysphonia: A voice causal generative model (VCGM) approach.

Leiyong G, Yu L, Zheng X

Comput Methods Programs Biomed · 2026 Aug · PMID 42068719 · Publisher ↗

BACKGROUND: Although artificial intelligence (AI) models have demonstrated high accuracy in diagnosing Parkinson's disease (PD) from speech signals, their "black-box" nature prevents mechanistic understanding of vocal im... BACKGROUND: Although artificial intelligence (AI) models have demonstrated high accuracy in diagnosing Parkinson's disease (PD) from speech signals, their "black-box" nature prevents mechanistic understanding of vocal impairment, limiting clinical trust and utility. A paradigm shift from correlation-based explanation to causal reasoning is needed to unlock the potential of AI in computational medicine. METHODS: We propose the Voice Causal Generative Model (VCGM), a novel computational framework designed to infer physiologically plausible causal pathways from observational speech data. The core technical innovation of VCGM is the integration of biophysical knowledge as hard constraints within a linear non-Gaussian acyclic model. We formalize this in Theorem 1, which proves that these domain-specific hierarchical constraints guarantee the unique identifiability of the underlying causal structure, a condition unachievable by unconstrained methods. We implemented VCGM using a constrained DirectLiNGAM algorithm and conducted rigorous validation, including bootstrap analysis for stability, an ablation study, and comparison with traditional causal discovery algorithms. RESULTS: The VCGM uncovered a stable, medically plausible causal pathway for PD dysphonia. The model revealed a hierarchical cascade from disease status to physiological instability (e.g., the robust Shimmer→HNR pathway) and finally to acoustic distortion (e.g., HNR→MFCC2). VCGM reduced physiologically implausible edges by 100% compared to unconstrained LiNGAM (5 implausible edges) and GES (5 implausible edges). while a conventional SHAP-based associative model failed to provide any directional mechanistic insights. CONCLUSION: The VCGM provides a validated, "white-box" framework for deconstructing pathophysiology from complex biosignals. Its primary technical contribution is a provably identifiable modeling approach that makes causal discovery feasible and reliable in hierarchically structured domains. It marks a critical step from the associative "what" to the causal "why" in computational biomedicine, offering a blueprint for more transparent, trustworthy, and clinically insightful AI systems. To facilitate clinical translation and reproducibility, all code and data are publicly available under an open-source license.

Video-based computational analysis of spontaneous movements in preterm infants: A longitudinal neuromotor assessment.

Moro M, Sigismondi S, Gismondi LA … +6 more , Tacchino C, Uccella S, Ramenghi LA, Moretti P, Odone F, Casadio M

Comput Methods Programs Biomed · 2026 Aug · PMID 42066382 · Publisher ↗

BACKGROUND AND OBJECTIVE: Monitoring the spontaneous movements of preterm infants is crucial for the early detection of potential neuromotor deficits. Recent advances in human pose estimation have made markerless video-b... BACKGROUND AND OBJECTIVE: Monitoring the spontaneous movements of preterm infants is crucial for the early detection of potential neuromotor deficits. Recent advances in human pose estimation have made markerless video-based methods a valid, non-intrusive, and cost-effective option for analyzing these movements. This paper aims to explore the efficacy of video-based markerless techniques in assessing infants' spontaneous movements, with a focus on identifying early signs of developmental abnormalities. METHODS: We conducted a longitudinal study with two acquisition sessions to evaluate the stability and consistency of our video-based analysis over time. Our approach builds on previous methodologies by incorporating advanced techniques for feature detection, parameter extraction, feature selection, and classification. Emphasis was placed on the interpretability and clinical relevance of the extracted motion parameters. RESULTS: The results highlight the effectiveness of our approach in identifying subtle changes in infants' motion patterns that may indicate neuromotor deficits. We observed differences in the detection of these deficits across the acquisition sessions, with our method achieving a maximum test accuracy of 90%. CONCLUSION: Our findings support the potential of markerless video-based analysis as a valuable tool in the support of the early detection of neuromotor deficits in preterm infants. The high accuracy and clinical relevance of our approach suggest it could play a critical role in early intervention strategies.

In silico modeling of transcatheter heart valve oversizing and ellipticity, Part I: Establishing credibility of an advanced model.

Boxwell S, Armfield D, Cahalane RME … +5 more , Hickey W, Cook S, Kelly P, Cardiff P, McNamara LM

Comput Methods Programs Biomed · 2026 Aug · PMID 42066381 · Publisher ↗

BACKGROUND AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is the most common modality of treatment for aortic stenosis. However, transcatheter heart valves (THVs) can be prone to early failure and an incr... BACKGROUND AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is the most common modality of treatment for aortic stenosis. However, transcatheter heart valves (THVs) can be prone to early failure and an increase in thrombogenic events, yet the risk factors associated with these failure modes remain poorly understood. Computational modeling may be used to predict biomechanical and hemodynamic indices associated with degeneration and thrombogenicity, however existing models do not fully account for complex stent and leaflet material behavior, and establishing model credibility according to ASME VV-40 is required. METHODS: In this study, we developed an advanced structural and hemodynamic in silico framework to predict the in vitro performance of a supra-annular, self-expanding THV across a range of clinically-relevant expansion and ellipticity indices. The THV was modelled by incorporating a novel 3-fiber material model for pericardium tissue leaflets and a super-elastic nitinol stent. RESULTS: Calculation verification was conducted and, on this basis, we provide recommendations on mesh density, element integration and target time increment. Following verification, we validated our models with radial force, structural high-speed camera and hemodynamic particle image velocimetry testing across multiple THV deployment configurations. In the 'nominal sizing, circular' case, we predicted a similar geometric orifice area (4.35 vs 4.02 cm), pinwheeling index (2.6% vs 2.7%), stent deflection (1.95 vs 1.76 mm) and flow velocity (1.33 vs 1.27 m/s) to in vitro data. CONCLUSION: We validated a novel structural and hemodynamic in silico framework for studying THVs, which will be applied to understand deployment factors contributing to structural degeneration and thrombogenicity. This framework also holds potential for guiding next-generation THV design and predictive procedural modeling.

MRI-based CFD simulations of transient blood flow in compliant aortas using the LDDMM framework.

Lin D, Westenberg J, Lamb H … +1 more , Kenjereš S

Comput Methods Programs Biomed · 2026 Aug · PMID 42061168 · Publisher ↗

BACKGROUND: Traditional CFD analyses often rely on static (rigid) vascular geometries, which neglect the physiologically relevant motion of the aortic wall. This simplification can lead to inaccuracies in estimating key... BACKGROUND: Traditional CFD analyses often rely on static (rigid) vascular geometries, which neglect the physiologically relevant motion of the aortic wall. This simplification can lead to inaccuracies in estimating key hemodynamic biomarkers, such as wall shear stress (WSS) and oscillatory shear index (OSI). METHODS: This study introduces the Large Deformation Diffeomorphic Metric Mapping (LDDMM) method to enable computationally efficient simulations of transient blood flow in compliant, subject- and patient-specific aortas derived from 4D Flow MRI data. The proposed framework simplifies CFD pre-processing, improves morphing accuracy, and enables physiologically realistic motion of the thoracic aorta, including its side-branches. The method was applied to two aortic geometries: a healthy case (HC) and a case with thoracic aortic aneurysm (TAA) located in the ascending region. RESULTS: The results were compared with those obtained from fixed aortic geometries extracted at peak systole. Hemodynamic biomarkers showed significant differences between static and moving geometries. For the healthy case (HC), the differences were 18% for the time-averaged wall shear stress (TAWSS) and 46% for the oscillatory shear index (OSI). For the thoracic aorta aneurysm (TAA) case, the corresponding values were 14% and 47%, respectively. CONCLUSION: These findings highlight the importance of incorporating aortic wall motion in hemodynamic simulations. The developed LDDMM-based framework can be readily extended to other imaging modalities, such as ultrasound or computed tomography, and is recommended for future CFD analyses of compliant aortas.

Integrating EMT dynamics in model-based metastasis prediction.

Wycislok A, Kardynska M, Smieja J

Comput Methods Programs Biomed · 2026 Aug · PMID 42061167 · Publisher ↗

BACKGROUND AND OBJECTIVES: Metastatic tumors are the primary causes of death for most cancer patients. Therefore, their detection and treatment is crucial for improving life expectancy in these patients. However, that re... BACKGROUND AND OBJECTIVES: Metastatic tumors are the primary causes of death for most cancer patients. Therefore, their detection and treatment is crucial for improving life expectancy in these patients. However, that requires medical imaging that incurs large expenses for any healthcare system in terms of money and workforce involved. Prediction of time of detectable metastasis is therefore of utmost importance, both from the patient's viewpoint and from the healthcare system perspective. METHODS: In this work, we have focused on epithelial-to-mesenchymal transition (EMT) as a crucial step in metastasis and transforming growth factor beta (TGF-β) as a critical regulator of this process. We present a novel mathematical modeling approach that leverages TGF-β dynamics and EMT signaling to provide distribution parameters for a model describing the growth of the primary tumor and its metastases under chemotherapy and radiotherapy treatment. Next, a virtual patients cohort is generated, in which patients are differentiated with parameters sampled from that distribution and a simulation of tumor growth and its response to the therapy is run for each patient. Simulation results, in the form of metastasis-free survival and overall survival curves, are subsequently compared to available clinical data. RESULTS AND CONCLUSIONS: As the modeling results are in concordance with clinical data, it yields two conclusions, one of clinical importance and the other important for development of similar models. It shows that it is the dynamics of how TGF-β level changes that might be more important than its absolute level. This explains why, despite known TGF-β association with metastatic processes, its value as a prognostic marker has so far been arguable. Moreover, it provides a recommendation to replace single measurements with a series of them, thus helping to increase prognosis accuracy without having to resort to expensive imaging techniques. From the modeling perspective, the approach presented here shows how to take into account patient-specific intracellular processes to generate virtual patient population, thus bringing it closer to an actual population.

Tracheostomy weaning in patients with severe acquired brain injury: External validation of machine learning models.

Liuzzi P, Hakiki B, Draghi F … +15 more , De Nisco A, Romoli AM, Maccanti D, Grippo A, Burali R, Magliacano A, Estraneo A, Comanducci A, Navarro J, Tramonti C, Carli V, Balbi P, Macchi C, Cecchi F, Mannini A

Comput Methods Programs Biomed · 2026 Aug · PMID 42054969 · Publisher ↗

BACKGROUND AND OBJECTIVE: Our primary aim was to externally validate previously developed machine-learning (ML) models for predicting the probability of tracheostomy decannulation after 3 months from admission to rehabil... BACKGROUND AND OBJECTIVE: Our primary aim was to externally validate previously developed machine-learning (ML) models for predicting the probability of tracheostomy decannulation after 3 months from admission to rehabilitation inpatient in patients with severe Acquired Brain Injury (sABI) using a new external and temporally-independent multicentric prospective dataset. A secondary aim was to evaluate the timing of decannulation and to assess model calibration and clinical net benefit. METHODS: External validation data was collected within the PRABI study, comprising 435 sABI patients admitted between January 2020 and April 2024 across four centers. A previously trained ensemble model and a AdaBoost SVR model were used to predict decannulation probability and timing on such external dataset, respectively. Performance was assessed using metrics such as accuracy, Area Under the Receiver Operating Characteristic curve (AUROC), sensitivity, and median absolute error. RESULTS: The external validation dataset included 402 patients. The ensemble model achieved an accuracy of 81.8 % and an AUROC of 0.85 for decannulation probability, with sensitivity and specificity of 76.4 % and 86.2 %, respectively. The AdaBoost SVR model predicted decannulation timing with a median absolute error of 26.2 days and an accuracy of 76.2 % when predictions were dichotomized at the 90-days threshold. CONCLUSIONS: This study successfully validated the ML models on an independent dataset, demonstrating their robustness and generalizability. Accurate prediction of decannulation probability and timing is crucial for optimizing the management of sABI patients, reducing infection risks, enhancing recovery, and facilitating smoother transitions to home care. External validation is a critical step for ensuring the reliability of ML models in diverse clinical settings, paving the way for their integration into clinical practice.
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