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Introduction: SARS-CoV-2, a virus responsible for the emergence of the life-threatening disease known as COVID-19, exhibits a diverse range of clinical manifestations. The spectrum of symptoms varies widely, encompassing mild to severe presentations, while a considerable portion of the population remains asymptomatic. COVID-19, primarily a respiratory virus, has been linked to cardiovascular complications in some patients. Notably, cardiac issues can also arise after recovery, contributing to post-acute COVID-19 syndrome, a significant concern for patient health. The present study intends to evaluate the post-acute COVID-19 syndrome cardiovascular effect through ECG by comparing patients affected with cardiac diseases without COVID-19 diagnosis report (class 1) and patients with cardiac pathologies who present post-acute COVID-19 syndrome (class 2). Methods: From 2 body positions, a total of 10 non-linear features, extracted every 1 second under a multi-band analysis performed by Discrete Wavelet Transform (DWT), have been compressed by 6 statistical metrics to serve as inputs for an individual feature analysis by the means of Mann-Whitney U-test and XROC classification. Results and Discussion: 480 Mann-Whitney U-test statistical analyses and XROC discrimination approaches have been done. The percentage of statistical analysis with significant differences (p<0.05) was 30.42% (146 out of 480). The best overall results were obtained by approximating the feature Energy, with the data compressor Kurtosis in the body position Down. Those results were 83.33% of Accuracy, 83.33% of Sensitivity, 83.33% of Specificity and 87.50% of AUC. Conclusions: The results show that the applied methodology can be a way to show changes in cardiac behaviour provoked by post-acute COVID-19 syndrome.

The area of clinical decision support systems (CDSS) is facing a boost in research and development with the increasing amount of data in clinical analysis together with new tools to support patient care. This creates a vibrant and challenging environment for the medical and technical staff. This chapter presents a discussion about the challenges and trends of CDSS considering big data and patient-centered constraints. Two case studies are presented in detail. The first presents the development of a big data and AI classification system for maternal and fetal ambulatory monitoring, composed by different solutions such as the implementation of an Internet of Things sensors and devices network, a fuzzy inference system for emergency alarms, a feature extraction model based on signal processing of the fetal and maternal data, and finally a deep learning classifier with six convolutional layers achieving an F1-score of 0.89 for the case of both maternal and fetal as harmful. The system was designed to support maternal–fetal ambulatory premises in developing countries, where the demand is extremely high and the number of medical specialists is very low. The second case study considered two artificial intelligence approaches to providing efficient prediction of infections for clinical decision support during the COVID-19 pandemic in Brazil. First, LSTM recurrent neural networks were considered with the model achieving R2=0.93 and MAE=40,604.4 in average, while the best, R2=0.9939, was achieved for the time series 3. Second, an open-source framework called H2O AutoML was considered with the “stacked ensemble” approach and presented the best performance followed by XGBoost. Brazil has been one of the most challenging environments during the pandemic and where efficient predictions may be the difference in saving lives. The presentation of such different approaches (ambulatory monitoring and epidemiology data) is important to illustrate the large spectrum of AI tools to support clinical decision-making.

Objetivo: Explorar a aplicação de inteligência artificial (IA) na predição da idade óssea a partir de imagens de raios-X. Método: Utilizou-se a Metodologia Interdisciplinar para o Desenvolvimento de Tecnologias em Saúde (MIDTS) para desenvolver uma ferramenta de predição. O treinamento foi realizado com redes neurais convolucionais (CNNs) usando um conjunto de dados de 14.036 imagens de raios-X. Resultados: A ferramenta alcançou um coeficiente de determinação (R²) de 0,94807 e um Erro Médio Absoluto (MAE) de 6,97, destacando sua precisão e potencial de aplicação clínica. Conclusão: O projeto demonstrou grande potencial para aprimorar a predição da idade óssea, com possibilidades de evolução conforme a base de dados aumenta e a IA se torna mais sofisticada.

Following the World Health Organization proclaims a pandemic due to a disease that originated in China and advances rapidly across the globe, studies to predict the behavior of epidemics have become increasingly popular, mainly related to COVID-19. The critical point of these studies is to discuss the disease's behavior and the progression of the virus's natural course. However, the prediction of the actual number of infected people has proved to be a difficult task, due to a wide range of factors, such as mass testing, social isolation, underreporting of cases, among others. Therefore, the objective of this work is to understand the behavior of COVID-19 in the state of Ceará to forecast the total number of infected people and to aid in government decisions to control the outbreak of the virus and minimize social impacts and economics caused by the pandemic. So, to understand the behavior of COVID-19, this work discusses some forecast techniques using machine learning, logistic regression, filters, and epidemiologic models. Also, this work brings a new approach to the problem, bringing together data from Ceará with those from China, generating a hybrid dataset, and providing promising results. Finally, this work still compares the different approaches and techniques presented, opening opportunities for future discussions on the topic. The study obtains predictions with R2 score of 0.99 to short-term predictions and 0.93 to long-term predictions.

Background: Maternal infections are linked to neurodevelopmental impairments, highlighting the need to investigate SARS-CoV-2-induced immune activation. Objective: This study aimed to evaluate the impact of maternal infection on neurodevelopment and investigate whether cytokine and chemokine profiles predict delays at 24 months. Methods: Conducted in Brazil (January 2021–March 2022), this follow-up study included 18 SARS-CoV-2 positive pregnant women at 35–37 weeks’ gestation, 15 umbilical cord blood samples, and blood samples from 15 children at 6 months and 14 at 24 months. Developmental delay was defined using the Bayley Scales of Infant and Toddler Development, Third Edition, with scores below 90 in cognitive, communication, or motor domains. Results: At 6 months, 33.3% of infants exhibited cognitive delays, 20% communication delays, and 40% motor delays, increasing to 35.71%, 64.29%, and 57.14% at 24 months, respectively. Elevated interferon-gamma and tumor necrosis factor-alpha in cord blood correlated with cognitive delays, while interleukin (IL)-6, IL-8, IL-17, and IL-1β were associated with motor delays. Increased C-X-C motif chemokine ligand 10 and other cytokines were associated with communication delays. Conclusion: Maternal SARS-CoV-2 may impact infant neurodevelopment, as early cytokine elevations correlate with delays, highlighting the importance of early monitoring and interventions to reduce long-term effects. Impact: Prenatal SARS-COV-2 infection in pregnant women is linked to developmental delays in toddlers, with cytokine and chemokine changes associated with neurodevelopmental outcomes at 24 months. This study shows the long-term impact of maternal SARS-COV-2 infection on child development, highlighting inflammatory markers like IFN-γ, TNFα, IL-6, IL-8, IL-17, IL-1β, and CXCL10. Identifying specific cytokines correlating with cognitive, communication, and motor delays suggests potential biomarkers for early intervention. Conducted in Fortaleza, Brazil, the study emphasizes understanding local epidemiological impacts on child development, especially in regions with high infection rates. (Figure presented.)