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At least 19 records

Falls Risk Classification of Older Adults Using Deep Neural Networks and Transfer Learning

Prior research in falls risk classification using inertial sensors has relied on the use of engineered features, which has concluded in a feature space containing hundreds of features that are likely redundant and possibly irrelevant. In this paper, we propose using fully convolutional neural networks (FCNNs) to classify older adults at low or high risk of falling using inertial sensor data collected from a smartphone. Due to the limited nature of older adult inertial gait data sets, we first pre-train the FCNN models using a publicly available data set for pedestrian activity recognition. Then via transfer learning, we train the network for falls risk classification. We reveal that via transfer learning, our falls risk classifier obtains an area under the receiver operating characteristic curve of 93.3%, which is 10.6% higher than the equivalent model trained without the use of transfer learning. Moreover, we show that our method outperforms other standard machine learning classifiers trained on features developed in prior research.

60 APPLIED LIFE SCIENCES↗

Gastrointestinal stromal tumor risk classification: spectral CT quantitative parameters

Purpose: To examine the value of spectral CT quantitative parameters in gastrointestinal stromal tumor (GIST) risk classification. Materials and methods: This retrospective study was approved by the institutional review board. The requirement for informed consent was signed. The authors evaluated 86 patients (30 high risk, 22 medium risk, 28 low risk, and 6 very low risk; mean age: 59 years [range 19–83 years]) with pathologically confirmed GIST who underwent plain and triple-phase contrast-enhanced CT with spectral CT imaging mode from March 2015 through September 2017, with manual follow-up. Quantitative parameters including the CT value of 70 keV monochromatic images, the slope of spectral curves, and the normalized iodine concentration (NIC) and water (iodine) concentrations were measured and calculated, and conducted a power analysis of the above data. Results: (1) The CT values at 70 keV of the high-risk group were higher than the intermediate and low groups in each of the enhanced phases (P ≤ 0.001), no significant differences in the intermediate-risk and low-risk groups were noted (P = 0.874, 0.871, 0.831, respectively). (2) The slope of the spectral curve of the high-risk group was higher than those of the intermediate and low groups in each of the enhanced phases (P ≤ 0.001), and there were no significant differences between the intermediate- and low-risk groups (P = 0.069, 0.466, 0.840, respectively). (3) The NIC of the high-risk group significantly differed from the lower risk groups (P ≤ 0.001). There was also no significant difference observed between the intermediate- and low-risk groups (P = 0.671, 0.457, 0.833, respectively). (4) The power analysis results show that only the low-risk group with delay period is 0.530, the rest groups are all greater than 0.999. Conclusion: Dual-energy spectral CT with quantitative analysis may help to increase the accuracy in differentiating the pathological risk classification of GIST between high risk and non-high risk, preoperatively. There were limitations for distinguishing the intermediate- and low-risk groups.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A novel risk classification system for 30-day mortality in children undergoing surgery

A simple, objective and accurate way of grouping children undergoing surgery into clinically relevant risk groups is needed. The purpose of this study, is to develop and validate a preoperative risk classification system for postsurgical 30-day mortality for children undergoing a wide variety of operations. The National Surgical Quality Improvement Project-Pediatric participant use file data for calendar years 2012–2014 was analyzed to determine preoperative variables most associated with death within 30 days of operation (D30). Risk groups were created using classification tree analysis based on these preoperative variables. The resulting risk groups were validated using 2015 data, and applied to neonates and higher risk CPT codes to determine validity in high-risk subpopulations. A five-level risk classification was found to be most accurate. The preoperative need for ventilation, oxygen support, inotropic support, sepsis, the need for emergent surgery and a do not resuscitate order defined non-overlapping groups with observed rates of D30 that vary from 0.075% (Very Low Risk) to 38.6% (Very High Risk). When CPT codes where death was never observed are eliminated or when the system is applied to neonates, the groupings remained predictive of death in an ordinal manner.

60 APPLIED LIFE SCIENCES↗

Application of Unbiased Estimators to Group Classification Risk Estimation

We consider the problem of construction of point and interval estimators for the Bayesian risk of a group classification decision rule provided that the elements of training samples have distributions belonging to the same one-parameter exponential family. We propose a solution to this problem using the asymptotic normality and efficiency of an unbiased risk estimator. An example of application of the obtained theoretical results is given.

97 MATHEMATICS AND COMPUTING↗

Third-Party Supplier Risk Re-Classification Using Multi-Model Semantic Voting and External Web Augmentation

Risk decisions in many third-party risk management (TPRM) workflows rely on static inherent risk questionnaires (IRQ). These static forms provide a snapshot of the vendor from the business users’ perspective, as these requests are processed without cross-referencing for evidence. Consequently, responses can be misinformed or embellished with inaccuracies, thereby masking the vendor’s true risk to the enterprise. This paper presents a multi-stage verification framework to augment IRQs with web evidence and a deterministic ensemble of large language model assessors to reclassify risk. In a case study of 100 submissions previously misclassified as low risk, the proposed framework correctly identified 76% of the cases as high risk, while the existing workflow identified none. McNemar’s continuity corrected statistics of 74 were obtained with a two sided p-value of 2.65 × 10-23, indicating a significantly more effective workflow compared to the legacy model.

99 - GENERAL AND MISCELLANEOUS↗

WE-A-BRF-01: Dual-Energy CT Imaging in Diagnostic Imaging and Radiation Therapy

The quantification accuracy of dual-energy imaging is influenced by the fundamentals of x-ray physics, system geometry, data acquisition hardware/protocol, system calibration, and image processing technique. This symposium will provide updates on the following advanced application areas: Mammography. Volumetric breast density techniques based on standard mammograms require estimation of breast thickness, which is difficult to accurately measure. By comparison, calculation of breast density using dual energy mammography does not require measurement of breast thickness. Dual energy mammography has been implemented using both energy integrating flat panel detectors in conjunction with beam energy switching and energy resolved photon counting detectors. These techniques have been optimized using simulation studies and validated using physical phantoms and postmortem breasts. Chemical decomposition was used as the gold standard for volumetric breast density measurement in postmortem breasts. Breast density measurements have also been compared with results from four-category BI-RADS density rankings, standard image thresholding and Fuzzy k-mean clustering techniques. These studies indicate that dual energy mammography can be used to accurately measure volumetric breast density. Cardiovascular CT. The predicative accuracy of risk models for recurrent stroke and cardiac arrest depends heavily on accurate differentiation of thrombus or calcium from iodine in left atrial appendage or coronary arteries. The amount of energy separation is constrained by image noise; therefore, optimal kVp, beam filtration, and balanced flux are essential for the quantification accuracy of iodine and calcium. The basis materials are combined linearly to generate monochromatic energy images, where CT# accuracy and CNR are energy dependent. With optimal monochromatic energy, the mean iodine concentration for the thrombus, circulatory stasis, and control groups are significantly different. Risk classification based on calcium scores shows excellent agreement with classification on the basis of conventional coronary artery calcium scoring. These studies demonstrate dual-energy cardiovascular CT can potentially be a noninvasive and sensitive modality in high risk patients. On-board KV/MV Imaging. To enhance soft tissue contrast and reduce metal artifacts, we have developed a dual-energy CBCT technique and a novel on-board kV/MV imaging technique based on hardware available on modern linear accelerators. We have also evaluated the feasibility of these two techniques in various phantom studies. Optimal techniques (energy, beam filtration, # of overlapping projections, etc) have been investigated with unique calibration procedures, which leads to successful decomposition of imaged material into acrylic-aluminum basis material pair. This enables the synthesis of virtual monochromatic (VM) CBCT images that demonstrate much less beam hardening, significantly reduced metal artifacts, and/or higher soft tissue CNR compared to single-energy CBCT. Adaptive Radiation Therapy. DECT could actually contribute to the area of Dose-Guided Radiation Therapy (or Adaptive Therapy). The application of DECT imaging using 80kV and 140 kV combinations could potentially increase the image quality by reducing the bone or high density material artifacts and also increase the soft tissue contrast by a light contrast agent. The result of this higher contrast / quality images is beneficial for deformable image registration / segmentation algorithm to improve its accuracy hence to make adaptive therapy less time consuming in its recontouring process. The real time re-planning prior to per treatment fraction could become more realistic with this improvement especially in hypofractional SBRT cases. Learning Objectives: Learn recent developments of dual-energy imaging in diagnosis and radiation therapy; Understand the unique clinical problem and required quantification accuracy in each application; Understand the different approaches to optimize dual-energy imaging techniques for different applications.

60 APPLIED LIFE SCIENCES↗

Bayesian classification of falls risk

Background. Prior research in falls risk prediction often relies on qualitative and/or clinical methods. There are two challenges with these methods. First, qualitative methods typically use falls history to determine falls risk. Second, clinical methods do not quantify the uncertainty in the classification decision. In this paper, we propose using Bayesian classification to predict falls risk using vectors of gait variables shown to contribute to falls risk. Research Questions: (1) Using a vector of risk ratios for specific gait variables shown to contribute to falls risk, how can older adults be classified as low or high falls risk? and (2) how can the uncertainty in the classifier decision be quantified when using a vector of gait variables? Methods. Using a pressure sensitive walkway, biomechanical measurements of gait were collected from 854 adults over the age of 65. In our method, we first determine low and high falls risk labels for vectors of risk ratios using the k-means algorithm. Next, the posterior probability of low or high falls risk class membership is obtained from a two component Gaussian mixture model (GMM) of gait vectors, which enables risk assessment directly from the underlying biomechanics. We classify the gait vectors using a threshold based on Youden's J statistic. Results. Through a Monte Carlo simulation and an analysis of the receiver operating characteristic (ROC), we demonstrate that our Bayesian classifier, when compared to the k-means falls risk labels, achieves an accuracy greater than 96% at predicting low or high falls risk. Significance. Our analysis indicates that our approach based on a Bayesian framework and an individual's underlying biomechanics can predict falls risk while quantifying uncertainty in the classification decision.

59 BASIC BIOLOGICAL SCIENCES↗

Non-Rhabdomyosarcoma Soft Tissue Sarcomas in Children: A Surveillance, Epidemiology, and End Results Analysis Validating COG Risk Stratifications

Purpose: Non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) are a heterogeneous group of sarcomas that encompass over 35 histologies. With an incidence of ∼500 cases per year in the United States in those <20 years of age, NRSTS are rare and therefore difficult to study in pediatric populations. We used the large Surveillance, Epidemiology, and End Results (SEER) database to validate the prognostic ability of the Children's Oncology Group (COG) risk classification system and to define patient, tumor, and treatment characteristics. Methods and Materials: From SEER data from 1988 to 2007, we identified patients ≤18 years of age with NRSTS. Data for age, sex, year of diagnosis, race, registry, histology, grade, primary size, primary site, stage, radiation therapy, and survival outcomes were analyzed. Patients with nonmetastatic grossly resected low-grade tumors of any size or high-grade tumors ≤5 cm were considered low risk. Cases of nonmetastatic tumors that were high grade, >5 cm, or unresectable were considered intermediate risk. Patients with nodal or distant metastases were considered high risk. Results: A total of 941 patients met the review criteria. On univariate analysis, black race, malignant peripheral nerve sheath (MPNST) histology, tumors >5 cm, nonextremity primary, lymph node involvement, radiation therapy, and higher risk group were associated with significantly worse overall survival (OS) and cancer-specific survival (CSS). On multivariate analysis, MPNST histology, chemotherapy-resistant histology, and higher risk group were significantly poor prognostic factors for OS and CSS. Compared to low-risk patients, intermediate patients showed poorer OS (hazard ratio [HR]: 6.08, 95% confidence interval [CI]: 3.53-10.47, P<.001) and CSS (HR: 6.27; 95% CI: 3.44-11.43, P<.001), and high-risk patients had the worst OS (HR: 13.35, 95% CI: 8.18-21.76, P<.001) and CSS (HR: 14.65, 95% CI: 8.49-25.28, P<.001). Conclusions: The current COG risk group stratification for children with NRSTS has been validated with a large number of children in the SEER database.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

ORCHID: Orchestrated Retrieval-Augmented Classification of High-Risk Property with Intelligent Decision-Making

High-Risk Property (HRP) classification is critical at U.S. Department of Energy (DOE) sites, where inventories include sensitive and often dual-use equipment. Compliance must track evolving rules designated by various export control policies to make transparent and auditable decisions. Traditional expert-only workflows are time-consuming, backlog-prone, and struggle to keep pace with shifting regulatory boundaries. We propose ORCHID, a modular agentic framework for HRP classification that pairs retrieval-augmented generation (RAG) with human oversight to produce policy based outputs that can be audited. Small cooperating agents—retrieval, description refiner, classifier, validator, and feedback logger—coordinate via agent-to-agent messaging and invoke tools through the Model Context Protocol (MCP) for model-agnostic on-premise operation. The interface follows an "Item to Evidence to Decision" loop with step-by-step reasoning, on-policy citations, and append-only audit bundles (run-cards, prompts, evidence). In preliminary tests on real HRP cases, ORCHID improves accuracy and traceability over a non-agentic baseline while deferring uncertain items to Subject Matter Experts (SMEs). The demonstration shows single item submission, grounded citations, SME feedback capture, and exportable audit artifacts—illustrating a practical path to trustworthy LLM assistance in sensitive DOE compliance workflows.

Das, Sanjay [ORNL] (ORCID:0009000542591915)↗

A knowledge-informed large language model framework for U.S. nuclear power plant shutdown initiating event classification for probabilistic risk assessment

Identifying and classifying shutdown initiating events (SDIEs) is critical for developing shutdown probabilistic risk assessment for nuclear power plants. Existing computational approaches cannot achieve satisfactory performance due to the challenges of unavailable large, labeled datasets, imbalanced event types, and label noise. To address these challenges, we propose a hybrid pipeline that integrates a knowledge-informed machine learning model to prescreen non-SDIEs and a large language model (LLM) to classify SDIEs into four types. In the prescreening stage, we proposed a set of 44 SDIE text patterns that consist of the most salient keywords and phrases from six SDIE types. Text vectorization based on the SDIE patterns generates feature vectors that are highly separable by using a simple binary classifier. The second stage builds Bidirectional Encoder Representations from Transformers (BERT)-based LLM, which learns generic English language representations from self-supervised pretraining on a large dataset and adapts to SDIE classification by fine-tuning it on an SDIE dataset. The proposed approaches are evaluated on a dataset with 10,928 events using precision, recall ratio, F 1 score, and average accuracy. In conclusion, the results demonstrate that the prescreening stage can exclude more than 97% non-SDIEs, and the LLM achieves an average accuracy of 95.1% for SDIE classification.

99 - GENERAL AND MISCELLANEOUS↗

Crash Risks Evaluation of Urban Expressways: A Case Study in Shanghai

We report that proactive traffic safety management systems can reduce crashes by identifying crash precursors, evaluating real-time crash risks, and implementing suitable interventions. The basic prerequisite for developing such a system is to propose a reliable crash risk evaluation model that takes real-time traffic flow data as input. Previous studies have primarily focused on real-time crash prediction using some statistical or machine-learning methods. However, further quantitative evaluation and classification of crash risks have been ignored. In this study, we conduct a systematic crash risk evaluation workflow, including crash risk prediction, crash risk quantification, and crash risk classification. Specifically, the crash risk prediction using an extended logit model is proposed, from which CAS, CSD, UAS, DAS, DTV are identified to be contributing factors of crash risks. Then a crash risk quantification model based on the parameter evaluation of the extended logit model is developed. The crash risks of urban expressways and their spatial-temporal evolution trends are quantified. Finally, the crash risks are classified into high crash risk level, moderate crash risk level, and low crash risk level by the k-means cluster algorithm. Then the threshold boundaries of different crash risk levels are determined. The research results provide a proactive guidance for traffic safety management of urban expressways.

33 ADVANCED PROPULSION SYSTEMS↗

Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of breast cancer.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

ROBUSTNESS OF DECISION INSIGHTS UNDER ALTERNATIVE ALEATORY/EPISTEMIC UNCERTAINTY CLASSIFICATIONS

The Risk-Informed Safety Margin Characterization (RISMC) pathway is a set of activities defined under the U.S. Department of Energy Light Water Reactor Sustainability Program. The overarching objective of RISMC is to support plant life-extension decision-making by providing a state-of-knowledge characterization of safety margins in key systems, structures, and components (SSCs). A key technical challenge is to establish the conceptual and technical feasibility of analyzing safety margin in a risk-informed way, which, unlike conventionally defined deterministic margin analysis, would be founded on probabilistic characterizations of SSC performance. Evaluation of probabilistic safety margins will in general entail the uncertainty characterization both of the prospective challenge to the performance of an SSC ("load") and of its "capacity" to withstand that challenge. The RISMC framework contrasts sharply with the traditional probabilistic risk assessment (PRA) structure in that the underlying models are not inherently aleatory. Rather, they are largely deterministic physical/engineering models with ambiguities about the appropriate uncertainty classification of many model parameters. The current analysis demonstrates that if the distinction between epistemic and aleatory uncertainties is to be preserved in a RISMC-like modeling environment, then it is unlikely that analysis insights supporting decision-making will in general be robust under recategorization of input uncertainties. If it is believed there is a true conceptual distinction between epistemic and aleatory uncertainty (as opposed to the distinction being primarily a legacy of the PRA paradigm) then a consistent and defensible basis must be established by which to categorize input uncertainties.

probabilistic risk assessment↗