{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T14:56:11Z","timestamp":1786719371207,"version":"build-2736575974"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82403788"],"award-info":[{"award-number":["82403788"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81770538"],"award-info":[{"award-number":["81770538"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070551"],"award-info":[{"award-number":["82070551"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Nutritional Risk Screening 2002 (NRS2002) is a widely adopted tool for assessing nutritional risk in patients. This study introduces a novel, non-invasive, efficient, and accurate screening approach to complement the traditional NRS2002 assessment, addressing its inherent limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A dataset comprising 672 tongue images from 470 tumor patients was collected. A new predictive analysis system for NRS2002 was developed by integrating two model branches. Machine learning was employed for risk prediction, and a ResNet50 neural network was utilized to extract high-dimensional features from tongue images. This architecture was enhanced with Shuttle Attention mechanism. The final predictions were derived through the fusion of both model branches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The fusion of the two branches significantly improved the model\u2019s ability to capture complex features. For both at-risk and risk-free cohorts, the system demonstrated optimal classification performance across three key metrics: AUC\u202f=\u202f0.919, ACC\u202f=\u202f0.927, and Recall\u202f=\u202f0.888. In ablation studies, the SelectNet module improved ACC and AUC by 17.25 and 16.14%, respectively. Furthermore, the integration of the shuttle attention mechanism led to additional gains, with AUC and ACC increasing by 3.89 and 1.94%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We successfully developed and validated an NRS2002 nutritional risk prediction model based on tongue image characteristics. This tool has the potential to minimize human error, improve dynamic performance, and provide non-invasive, accurate nutritional risk screening. It represents a step forward in personalized medicine and holds substantial clinical value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2025.1752250","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:30:41Z","timestamp":1768228241000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Tongue image analysis for accurate prediction of nutritional risk screening in cancer patients during radiochemotherapy: a feature selection network and aliasing attention mechanism approach"],"prefix":"10.3389","volume":"12","author":[{"given":"Bowen","family":"Yang","sequence":"first","affiliation":[{"name":"Center of Intelligent Medicine, School of Control Science and Engineering, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aohan","family":"Li","sequence":"additional","affiliation":[{"name":"Center of Intelligent Medicine, School of Control Science and Engineering, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Haleem","family":"Mohib","sequence":"additional","affiliation":[{"name":"Center of Intelligent Medicine, School of Control Science and Engineering, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Qiao","sequence":"additional","affiliation":[{"name":"Center of Intelligent Medicine, School of Control Science and Engineering, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HuaiDong","family":"Li","sequence":"additional","affiliation":[{"name":"Center of Intelligent Medicine, School of Control Science and Engineering, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Hospitality and Business Management, Technological and Higher Education Institute of Hong Kong","place":["Hong Kong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Qilu Hospital, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Qilu Hospital, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuying","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Qilu Hospital, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanghui","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Qilu Hospital, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Qilu Hospital, Shandong University","place":["Jinan, Shandong, 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