In remotely sensed images, high intra-class variance and inter-class similarity are ubiquitous due to complex scenes and objects with multivariate features, making semantic segmentation a challenging task. Deep convolutional neural networks can solve this problem by modelling the context of features and improving their discriminability. However, current learning paradigms model the feature affinity in spatial dimension and channel dimension separately and then fuse them in a sequential or parallel manner, leading to suboptimal performance. In this study, we first analyze this problem practically and summarize it as attention bias that reduces the capability of network in distinguishing weak and discretely distributed objects from wide-range objects with internal connectivity, when modeled only in spatial or channel domain. To jointly model both spatial and channel affinity, we design a synergistic attention module (SAM), which allows for channel-wise affinity extraction while preserving spatial details. In addition, we propose a synergistic attention perception neural network (SAPNet) for the semantic segmentation of remote sensing images. The hierarchical-embedded synergistic attention perception module aggregates SAM-refined features and decoded features. As a result, SAPNet enriches inference clues with desired spatial and channel details. Experiments on three benchmark datasets show that SAPNet is competitive in accuracy and adaptability compared with state-of-the-art methods. The experiments also validate the hypothesis of attention bias and the efficiency of SAM.

High spatial resolution remote sensing images (HRRSIs) contain intricate details and varied spectral distributions, making their semantic segmentation a challenging task. To address this problem, it is crucial to adequately capture both local and global contexts to reduce semantic ambiguity. While self-attention modules in vision transformers capture long-range context, they tend to sacrifice local details. In this article, we propose a geometric prior-guided interactive network (GPINet), a hybrid network that refines features across encoder and decoder stages. First of all, a dual branch structure encoder with local-global interaction modules (LGIMs) is designed to fully exploit local and global contexts for feature refinement. Unlike commonly used skip connections or concatenations, the LGIMs bilaterally couple and exchange CNN features with transformer features by lossless transformation and elaborating cross-attention. Moreover, we introduce a geometric prior generation module (GPGM) that iteratively updates the randomly initialized geometric prior. Subsequently, the geometric priors are stored and used to guide feature recovery. Finally, a weighted summation is applied to the upsampled decoded features and geometric priors. By comprehensively capturing contexts and enabling lossless decoding and deterministic inference, GPINet allows the network to learn discriminative representations for accurately specifying pixel-level semantics. Experiments on three benchmark datasets demonstrate the superiority of the proposed GPINet over state-of-the-art methods. Furthermore, we validate the effectiveness of geometric priors and compare the model sizes.

Background: Chronic obstructive pulmonary disease (COPD) poses a large burden on health care. Severe COPD exacerbations require emergency department visits or inpatient stays, often cause an irreversible decline in lung function and health status, and account for 90.3% of the total medical cost related to COPD. Many severe COPD exacerbations are deemed preventable with appropriate outpatient care. Current models for predicting severe COPD exacerbations lack accuracy, making it difficult to effectively target patients at high risk for preventive care management to reduce severe COPD exacerbations and improve outcomes. Objective: The aim of this study is to develop a more accurate model to predict severe COPD exacerbations. Methods: We examined all patients with COPD who visited the University of Washington Medicine facilities between 2011 and 2019 and identified 278 candidate features. By performing secondary analysis on 43,576 University of Washington Medicine data instances from 2011 to 2019, we created a machine learning model to predict severe COPD exacerbations in the next year for patients with COPD. Results: The final model had an area under the receiver operating characteristic curve of 0.866. When using the top 9.99% (752/7529) of the patients with the largest predicted risk to set the cutoff threshold for binary classification, the model gained an accuracy of 90.33% (6801/7529), a sensitivity of 56.6% (103/182), and a specificity of 91.17% (6698/7347). Conclusions: Our model provided a more accurate prediction of severe COPD exacerbations in the next year compared with prior published models. After further improvement of its performance measures (eg, by adding features extracted from clinical notes), our model could be used in a decision support tool to guide the identification of patients with COPD and at high risk for care management to improve outcomes. International Registered Report Identifier (IRRID): RR2-10.2196/13783

Semantic segmentation of remote sensing imagery is a fundamental task in intelligent interpretation. Since deep convolutional neural networks (DCNNs) performed considerable insight in learning implicit representations from data, numerous works in recent years have transferred the DCNN-based model to remote sensing data analysis. However, the wide-range observation areas, complex and diverse objects and illumination and imaging angle influence the pixels easily confused, leading to undesirable results. Therefore, a remote sensing imagery semantic segmentation neural network, named HCANet, is proposed to generate representative and discriminative representations for dense predictions. HCANet hybridizes cross-level contextual and attentive representations to emphasize the distinguishability of learned features. First of all, a cross-level contextual representation module (CCRM) is devised to exploit and harness the superpixel contextual information. Moreover, a hybrid representation enhancement module (HREM) is designed to fuse cross-level contextual and self-attentive representations flexibly. Furthermore, the decoder incorporates DUpsampling operation to boost the efficiency losslessly. The extensive experiments are implemented on the Vaihingen and Potsdam benchmarks. In addition, the results indicate that HCANet achieves excellent performance on overall accuracy and mean intersection over union. In addition, the ablation study further verifies the superiority of CCRM.

Background: Asthma affects a large proportion of the population and leads to many hospital encounters involving both hospitalizations and emergency department visits every year. To lower the number of such encounters, many health care systems and health plans deploy predictive models to prospectively identify patients at high risk and offer them care management services for preventive care. However, the previous models do not have sufficient accuracy for serving this purpose well. Embracing the modeling strategy of examining many candidate features, we built a new machine learning model to forecast future asthma hospital encounters of patients with asthma at Intermountain Healthcare, a nonacademic health care system. This model is more accurate than the previously published models. However, it is unclear how well our modeling strategy generalizes to academic health care systems, whose patient composition differs from that of Intermountain Healthcare. Objective: This study aims to evaluate the generalizability of our modeling strategy to the University of Washington Medicine (UWM), an academic health care system. Methods: All adult patients with asthma who visited UWM facilities between 2011 and 2018 served as the patient cohort. We considered 234 candidate features. Through a secondary analysis of 82,888 UWM data instances from 2011 to 2018, we built a machine learning model to forecast asthma hospital encounters of patients with asthma in the subsequent 12 months. Results: Our UWM model yielded an area under the receiver operating characteristic curve (AUC) of 0.902. When placing the cutoff point for making binary classification at the top 10% (1464/14,644) of patients with asthma with the largest forecasted risk, our UWM model yielded an accuracy of 90.6% (13,268/14,644), a sensitivity of 70.2% (153/218), and a specificity of 90.91% (13,115/14,426). Conclusions: Our modeling strategy showed excellent generalizability to the UWM, leading to a model with an AUC that is higher than all of the AUCs previously reported in the literature for forecasting asthma hospital encounters. After further optimization, our model could be used to facilitate the efficient and effective allocation of asthma care management resources to improve outcomes. International Registered Report Identifier (IRRID): RR2-10.2196/resprot.5039

Semantic segmentation of remote sensing images (RSIs) is pivotal for numerous applications in urban planning, agricultural monitoring, and environmental conservation. However, traditional approaches have primarily emphasized learning within the spatial domain, which frequently leads to less than optimal discrimination of features. Considering the inherent spectral qualities of RSIs, it is essential to bolster these representations by incorporating the spectral context in conjunction with spatial information to improve discriminative capacity. In this paper, we introduce the spectral–spatial context-boosted network (SSCBNet), an innovative network designed to enhance the accuracy semantic segmentation in RSIs. SSCBNet integrates synergetic attention (SYA) layers and cross-fusion modules (CFMs) to harness both spectral and spatial information, addressing the intrinsic complexities of urban and natural landscapes within RSIs. Extensive experiments on the ISPRS Potsdam and LoveDA datasets reveal that SSCBNet surpasses existing state-of-the-art models, achieving remarkable results in $F_1$-scores, overall accuracy (OA), and mean intersection over union (mIoU). Ablation studies confirm the significant contribution of SYA layers and CFMs to the model’s performance, emphasizing the effectiveness of these components in capturing detailed contextual cues.