The counting of surgical instruments is an important task to ensure surgical safety and patient health. However, due to the uncertainty of manual operations, there is a risk of missing or miscounting instruments. Applying computer vision technology to the instrument counting process can not only improve efficiency, but also reduce medical disputes and promote the development of medical informatization. However, during the counting process, surgical instruments may be densely arranged or obstruct each other, and they may be affected by different lighting environments, all of which can affect the accuracy of instrument recognition. In addition, similar instruments may have only minor differences in appearance and shape, which increases the difficulty of identification. To address these issues, this paper improves the YOLOv7x object detection algorithm and applies it to the surgical instrument detection task. First, the RepLK Block module is introduced into the YOLOv7x backbone network, which can increase the effective receptive field and guide the network to learn more shape features. Second, the ODConv structure is introduced into the neck module of the network, which can significantly enhance the feature extraction ability of the basic convolution operation of the CNN and capture more rich contextual information. At the same time, we created the OSI26 data set, which contains 452 images and 26 surgical instruments, for model training and evaluation. The experimental results show that our improved algorithm exhibits higher accuracy and robustness in surgical instrument detection tasks, with F1, AP, AP50, and AP75 reaching 94.7%, 91.5%, 99.1%, and 98.2%, respectively, which are 4.6%, 3.1%, 3.6%, and 3.9% higher than the baseline. Compared to other mainstream object detection algorithms, our method has significant advantages. These results demonstrate that our method can more accurately identify surgical instruments, thereby improving surgical safety and patient health.

Medication recommendation systems are developed to recommend suitable medications tailored to specific patient. Previous researches primarily focus on learning medication representations, which have yielded notable advances. However, these methods are limited to capturing personalized patient representations due to the following primary limitations: (i) unable to capture the differences in the impact of diseases/procedures on patients across various patient health states; (ii) fail to model the direct causal relationships between medications and specific health state of patients, resulting in an inability to determine which specific disease each medication is treating. To address these limitations, we propose CausalMed, a patient health state-centric model capable of enhancing the personalization of patient representations. Specifically, CausalMed first captures the causal relationship between diseases/procedures and medications through causal discovery and evaluates their causal effects. Building upon this, CausalMed focuses on analyzing the health state of patients, capturing the dynamic differences of diseases/procedures in different health states of patients, and transforming diseases/procedures into medications on direct causal relationships. Ultimately, CausalMed integrates information from longitudinal visits to recommend medication combinations. Extensive experiments on real-world datasets show that our method learns more personalized patient representation and outperforms state-of-the-art models in accuracy and safety.

Recently, causal feature selection (CFS) has attracted considerable attention due to its outstanding interpretability and predictability performance. Such a method primarily includes the Markov blanket (MB) discovery and feature selection based on Granger causality. Representatively, the max-min MB (MMMB) can mine an optimal feature subset, i.e., MB; however, it is unsuitable for streaming features. Online streaming feature selection (OSFS) via online process streaming features can determine parents and children (PC), a subset of MB; however, it cannot mine the MB of the target attribute (T), i.e., a given feature, thus resulting in insufficient prediction accuracy. The Granger selection method (GSM) establishes a causal matrix of all features by performing excessively time; however, it cannot achieve a high prediction accuracy and only forecasts fixed multivariate time series data. To address these issues, we proposed an online CFS for streaming features (OCFSSFs) that mine MB containing PC and spouse and adopt the interleaving PC and spouse learning method. Furthermore, it distinguishes between PC and spouse in real time and can identify children with parents online when identifying spouses. We experimentally evaluated the proposed algorithm on synthetic datasets using precision, recall, and distance. In addition, the algorithm was tested on real-world and time series datasets using classification precision, the number of selected features, and running time. The results validated the effectiveness of the proposed algorithm.