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This chapter describes an AUTO-ML strategy to detect COVID on chest X-rays utilizing Transfer Learning feature extraction and the AutoML TPOT framework in order to identify lung illnesses (such as COVID or pneumonia). MobileNet is a lightweight network that uses depthwise separable convolution to deepen the network while decreasing parameters and computation. AutoML is a revolutionary concept of automated machine learning (AML) that automates the process of building an ML pipeline inside a constrained computing framework. The term “AutoML” can mean a number of different things depending on context. AutoML has risen to prominence in both the business world and the academic community thanks to the ever-increasing capabilities of modern computers. Python Optimised ML Pipeline (TPOT) is a Python-based ML tool that optimizes pipeline efficiency via genetic programming. We use TPOT builds models for extracted MobileNet network features from COVID-19 image data. The f1-score of 0.79 classifies Normal, Viral Pneumonia, and Lung Opacity.

Continuous cardiac monitoring has been increasingly adopted to prevent heart diseases, especially the case of Chagas disease, a chronic condition that can degrade the heart condition, leading to sudden cardiac death. Unfortunately, a common challenge for these systems is the low-quality and high level of noise in ECG signal collection. Also, generic techniques to assess the ECG quality can discard useful information in these so-called chagasic ECG signals. To mitigate this issue, this work proposes a 1D CNN network to assess the quality of the ECG signal for chagasic patients and compare it to the state of art techniques. Segments of 10 s were extracted from 200 1-lead ECG Holter signals. Different feature extractions were considered such as morphological fiducial points, interval duration, and statistical features, aiming to classify 400 segments into four signal quality types: Acceptable ECG, Non-ECG, Wandering Baseline (WB), and AC Interference (ACI) segments. The proposed CNN architecture achieves a $$0.90 \pm 0.02$$accuracy in the multi-classification experiment and also $$0.94 \pm 0.01$$when considering only acceptable ECG against the other three classes. Also, we presented a complementary experiment showing that, after removing noisy segments, we improved morphological recognition (based on QRS wave) by 33% of the entire ECG data. The proposed noise detector may be applied as a useful tool for pre-processing chagasic ECG signals.

<abstract><p>About 6.5 million people are infected with Chagas disease (CD) globally, and WHO estimates that $ &gt; million people worldwide suffer from ChHD. Sudden cardiac death (SCD) represents one of the leading causes of death worldwide and affects approximately 65% of ChHD patients at a rate of 24 per 1000 patient-years, much greater than the SCD rate in the general population. Its occurrence in the specific context of ChHD needs to be better exploited. This paper provides the first evidence supporting the use of machine learning (ML) methods within non-invasive tests: patients' clinical data and cardiac restitution metrics (CRM) features extracted from ECG-Holter recordings as an adjunct in the SCD risk assessment in ChHD. The feature selection (FS) flows evaluated 5 different groups of attributes formed from patients' clinical and physiological data to identify relevant attributes among 57 features reported by 315 patients at HUCFF-UFRJ. The FS flow with FS techniques (variance, ANOVA, and recursive feature elimination) and Naive Bayes (NB) model achieved the best classification performance with 90.63% recall (sensitivity) and 80.55% AUC. The initial feature set is reduced to a subset of 13 features (4 Classification; 1 Treatment; 1 CRM; and 7 Heart Tests). The proposed method represents an intelligent diagnostic support system that predicts the high risk of SCD in ChHD patients and highlights the clinical and CRM data that most strongly impact the final outcome.</p></abstract>

The gold standard to detect SARS-CoV-2 infection considers testing methods based on Polymerase Chain Reaction (PCR). Still, the time necessary to confirm patient infection can be lengthy, and the process is expensive. In parallel, X-Ray and CT scans play an important role in the diagnosis and treatment processes. Hence, a trusted automated technique for identifying and quantifying the infected lung regions would be advantageous. Chest X-rays are two-dimensional images of the patient’s chest and provide lung morphological information and other characteristics, like ground-glass opacities (GGO), horizontal linear opacities, or consolidations, which are typical characteristics of pneumonia caused by COVID-19. This chapter presents an AI-based system using multiple Transfer Learning models for COVID-19 classification using Chest X-Rays. In our experimental design, all the classifiers demonstrated satisfactory accuracy, precision, recall, and specificity performance. On the one hand, the Mobilenet architecture outperformed the other CNNs, achieving excellent results for the evaluated metrics. On the other hand, Squeezenet presented a regular result in terms of recall. In medical diagnosis, false negatives can be particularly harmful because a false negative can lead to patients being incorrectly diagnosed as healthy. These results suggest that our Deep Learning classifiers can accurately classify X-ray exams as normal or indicative of COVID-19 with high confidence.

The gold standard to detect SARS-CoV-2 infection consider testing methods based on Polymerase Chain Reaction (PCR). Still, the time necessary to confirm patient infection can be lengthy, and the process is expensive. On the other hand, X-Ray and CT scans play a vital role in the auxiliary diagnosis process. Hence, a trusted automated technique for identifying and quantifying the infected lung regions would be advantageous. Chest X-rays are two-dimensional images of the patient’s chest and provide lung morphological information and other characteristics, like ground-glass opacities (GGO), horizontal linear opacities, or consolidations, which are characteristics of pneumonia caused by COVID-19. But before the computerized diagnostic support system can classify a medical image, a segmentation task should usually be performed to identify relevant areas to be analyzed and reduce the risk of noise and misinterpretation caused by other structures eventually present in the images. This chapter presents an AI-based system for lung segmentation in X-ray images using a U-net CNN model. The system’s performance was evaluated using metrics such as cross-entropy, dice coefficient, and Mean IoU on unseen data. Our study divided the data into training and evaluation sets using an 80/20 train-test split method. The training set was used to train the model, and the evaluation test set was used to evaluate the performance of the trained model. The results of the evaluation showed that the model achieved a Dice Similarity Coefficient (DSC) of 95%, Cross entropy of 97%, and Mean IoU of 86%.

The Covid-19 pandemic evidenced the need Computer Aided Diagnostic Systems to analyze medical images, such as CT and MRI scans and X-rays, to assist specialists in disease diagnosis. CAD systems have been shown to be effective at detecting COVID-19 in chest X-ray and CT images, with some studies reporting high levels of accuracy and sensitivity. Moreover, it can also detect some diseases in patients who may not have symptoms, preventing the spread of the virus. There are some types of CAD systems, such as Machine and Deep Learning-based and Transfer learning-based. This chapter proposes a pipeline for feature extraction and classification of Covid-19 in X-ray images using transfer learning for feature extraction with VGG-16 CNN and machine learning classifiers. Five classifiers were evaluated: Accuracy, Specificity, Sensitivity, Geometric mean, and Area under the curve. The SVM Classifier presented the best performance metrics for Covid-19 classification, achieving 90% accuracy, 97.5% of Specificity, 82.5% of Sensitivity, 89.6% of Geometric mean, and 90% for the AUC metric. On the other hand, the Nearest Centroid (NC) classifier presented poor sensitivity and geometric mean results, achieving 33.9% and 54.07%, respectively.

Fast and efficient malaria diagnostics are essential in efforts to detect and treat the disease in a proper time. The standard approach to diagnose malaria is a microscope exam, which is submitted to a subjective interpretation. Thus, the automating of the diagnosis process with the use of an intelligent system capable of recognizing malaria parasites could aid in the early treatment of the disease. Usually, laboratories capture a minimum set of images in low quality using a system of microscopes based on mobile devices. Due to the poor quality of such data, conventional algorithms do not process those images properly. This paper presents the application of deep learning techniques to improve the accuracy of malaria plasmodium detection in the presented context. In order to increase the number of training sets, deep convolutional generative adversarial networks (DCGAN) were used to generate reliable training data that were introduced in our deep learning model to improve accuracy. A total of 6 experiments were performed and a synthesized dataset of 2.200 images was generated by the DCGAN for the training phase. For a real image database with 600 blood smears with malaria plasmodium, the proposed Deep Learning architecture obtained the accuracy of 100% for the plasmodium detection. The results are promising and the solution could be employed to support a mass medical diagnosis system.

This book offers an objective and dispassionate analysis of modern educational architecture allowing us to notice gaps. The fundamental question addressed is whether our education system will embrace knowledge-based society and have the foresight to better prepare future generations. If educators around the world step back for a moment, it is not difficult to notice that unanswered questions about education are looming everywhere. The existent academic literature on education is abundant and embracing. In consequence, one can ask why is this book necessary? Indeed, this book is the result of senior university professors sharing their learnings and anticipating the pivotal issues facing all education professionals. According to the United Nations, by 2050, 68% of the world’s population will be living in urban areas. This fact cannot be ignored as it is one of the drivers of the profile of the future students. The reasons to organize this publication are many, but among them three stand out which also function as the driving forces behind this project: (1) University professors teach future generations based on models grounded on knowledge advanced by past experiences; (2) The decisive requirement to understand the needs of the new generations of university millennial students; and (3) What are the critical challenges of global societies? "This book problematizes the issues concerning education, and its main contribution is to answer the need to rethink education, face contemporary challenges, and reorganize the way public policies address education. It critically analyses the challenges of global societies in a decentralized perspective, not only reflecting a western perspective of education and knowledge production. The project's originality comes from the contemporaneity of the topics covered, from the interdisciplinary perspective, and from the specific attention given to trends around education." —Cátia Miriam Costa, Researcher and Invited Assistant Professor, Centre for International Studies, Perfil Ciência

The global pandemic triggered by the Corona Virus Disease firstly detected in 2019 (COVID-19), entered the fourth year with many unknown aspects that need to be continuously studied by the medical and academic communities. According to the World Health Organization (WHO), until January 2023, more than 650 million cases were officially accounted (with probably much more non tested cases) with 6,656,601 deaths officially linked to the COVID-19 as plausible root cause. In this Chapter, an overview of some relevant technical aspects related to the COVID-19 pandemic is presented, divided in three parts. First, the advances are highlighted, including the development of new technologies in different areas such as medical devices, vaccines, and computerized system for medical support. Second, the focus is on relevant challenges, including the discussion on how computerized diagnostic supporting systems based on Artificial Intelligence are in fact ready to effectively help on clinical processes, from the perspective of the model proposed by NASA, Technology Readiness Levels (TRL). Finally, two trends are presented with increased necessity of computerized systems to deal with the Long Covid and the interest on Precision Medicine digital tools. Analyzing these three aspects (advances, challenges, and trends) may provide a broader understanding of the impact of the COVID-19 pandemic on the development of Computerized Diagnostic Support Systems.

The scientific literature indicates that pregnant women with COVID-19 are at an increased risk for developing more severe illness conditions when compared with non-pregnant women. The risk of admission to an ICU (Intensive Care Unit) and the need for mechanical ventilator support is three times higher. More significantly, statistics indicate that these patients are also at 70% increased risk of evolving to severe states or even death. In addition, other previous illnesses and age greater than 35 years old increase the risk for the mother and the fetus, including a higher number of cesarean sections, higher systolic and diastolic maternal blood pressure, increasing the risk of eclampsia, and, in some cases, preterm birth. Additionally, pregnant women have more Emotional lability/fluctuations (between positive and negative feelings) during the entire pregnancy. The emotional instability and brain fog that takes place during gestation may open vulnerability for neuropsychiatric symptoms of long COVID, which this population was not studied in depth. The present Chapter characterizes the database presented in this work with clinical and survey data collected about emotions and feelings using the Coronavirus Perinatal Experiences—Impact Survey (COPE-IS). Pregnant women with or without COVID-19 symptoms who gave birth at the Assis Chateaubriand Maternity Hospital (MEAC), a public maternity of the Federal University of Ceara, Brazil, were recruited. In total, 72 mother-infant dyads were included in the study and are considered in this exploratory analysis. The participants have undergone serological tests for SARS-CoV-2 antibody detection and a nasopharyngeal swab test for COVID-19 diagnoses by RT-PCR. A comprehensive Exploratory Data Analysis (EDA) is performed using frequency distribution analysis of multiple types of variables generated from numerical data, multiple-choice, categorized, and Likert-scale questions.

Even with more than 12 billion vaccine doses administered globally, the Covid-19 pandemic has caused several global economic, social, environmental, and healthcare impacts. Computer Aided Diagnostic (CAD) systems can serve as a complementary method to aid doctors in identifying regions of interest in images and help detect diseases. In addition, these systems can help doctors analyze the status of the disease and check for their progress or regression. To analyze the viability of using CNNs for differentiating Covid-19 CT positive images from Covid-19 CT negative images, we used a dataset collected by Union Hospital (HUST-UH) and Liyuan Hospital (HUST-LH) and made available at the Kaggle platform. The main objective of this chapter is to present results from applying two state-of-the-art CNNs on a Covid-19 CT Scan images database to evaluate the possibility of differentiating images with imaging features associated with Covid-19 pneumonia from images with imaging features irrelevant to Covid-19 pneumonia. Two pre-trained neural networks, ResNet50 and MobileNet, were fine-tuned for the datasets under analysis. Both CNNs obtained promising results, with the ResNet50 network achieving a Precision of 0.97, a Recall of 0.96, an F1-score of 0.96, and 39 false negatives. The MobileNet classifier obtained a Precision of 0.94, a Recall of 0.94, an F1-score of 0.94, and a total of 20 false negatives.

The COVID-19 pandemic has posed a significant public health challenge on a global scale. It is imperative that we continue to undertake research in order to identify early markers of disease progression, enhance patient care through prompt diagnosis, identification of high-risk patients, early prevention, and efficient allocation of medical resources. In this particular study, we obtained 100 5-min electrocardiograms (ECGs) from 50 COVID-19 volunteers in two different positions, namely upright and supine, who were categorized as either moderately or critically ill. We used classification algorithms to analyze heart rate variability (HRV) metrics derived from the ECGs of the volunteers with the goal of predicting the severity of illness. Our study choose a configuration pro SVC that achieved 76% of accuracy, and 0.84 on F1 Score in predicting the severity of Covid-19 based on HRV metrics.

The continuous development of robust machine learning algorithms in recent years has helped to improve the solutions of many studies in many fields of medicine, rapid diagnosis and detection of high-risk patients with poor prognosis as the coronavirus disease 2019 (COVID-19) spreads globally, and also early prevention of patients and optimization of medical resources. Here, we propose a fully automated machine learning system to classify the severity of COVID-19 from electrocardiogram (ECG) signals. We retrospectively collected 100 5-minute ECGs from 50 patients in two different positions, upright and supine. We processed the surface ECG to obtain QRS complexes and HRV indices for RR series, including a total of 43 features. We compared 19 machine learning classification algorithms that yielded different approaches explained in a methodology session.

In 2020, the World Health Organization declared the Coronavirus Disease 19 a global pandemic. While detecting COVID-19 is essential in controlling the disease, prognosis prediction is crucial in reducing disease complications and patient mortality. For that, standard protocols consider adopting medical imaging tools to analyze cases of pneumonia and complications. Nevertheless, some patients develop different symptoms and/or cannot be moved to a CT-Scan room. In other cases, the devices are not available. The adoption of ambulatory monitoring examinations, such as Electrocardiography (ECG), can be considered a viable tool to address the patient’s cardiovascular condition and to act as a predictor for future disease outcomes. In this investigation, ten non-linear features (Energy, Approximate Entropy, Logarithmic Entropy, Shannon Entropy, Hurst Exponent, Lyapunov Exponent, Higuchi Fractal Dimension, Katz Fractal Dimension, Correlation Dimension and Detrended Fluctuation Analysis) extracted from 2 ECG signals (collected from 2 different patient’s positions). Windows of 1 second segments in 6 ways of windowing signal analysis crops were evaluated employing statistical analysis. Three categories of outcomes are considered for the patient status: Low, Moderate, and Severe, and four combinations for classification scenarios are tested:  (Low vs. Moderate, Low vs. Severe, Moderate vs. Severe) and 1 Multi-class comparison  (All vs. All)). The results indicate that some statistically significant parameter distributions were found for all comparisons.  (Low vs. Moderate—Approximate Entropy p-value = 0.0067 < 0.05, Low vs. Severe—Correlation Dimension p-value = 0.0087 < 0.05, Moderate vs. Severe—Correlation Dimension p-value = 0.0029 < 0.05, All vs. All—Correlation Dimension p-value = 0.0185 < 0.05. The non-linear analysis of the time-frequency representation of the ECG signal can be considered a promising tool for describing and distinguishing the COVID-19 severity activity along its different stages.

In the last few years, the tourism industry has experienced rapid expansion and diversification, making it one of the fastest-growing financial industries in the world. Consequently, the hotel industry has significantly affected the environment's long-term viability. Many hotels have begun voluntarily implementing environmentally sustainable practices as they become more aware of their ecological footprint. There has been a great deal of discussion about the effects of hotel operations on the environment and tourism sustainability in Macau. It is because of these negative impacts that hoteliers have adopted green practices in an attempt to minimize them. By developing sustainability reports, hotels can set goals, measure performance, and manage change, resulting in better sustainability. It could also be viewed as a strategy to enhance the company’s sustainability reporting to ensure stakeholders know what the company does. The objective of this study is twofold based on the analysis of the official sustainability reports of four major hotel chains. Firstly, seven categories of sustainable practices effectively adopted by these chain hotels are identified and clusterized. Second, it is presented in which areas some hotels performed more efficiently than others, considering the UN Sustainable Development Goals (SDGs) as a reference. The results allow a comprehensive clusterized analysis of the industry in a highly developed gaming and entertainment area of South China and create a clear comparison between relevant players and their concerns about sustainability practices.

Nowadays, the increasing number of medical diagnostic data and clinical data provide more complementary references for doctors to make diagnosis to patients. For example, with medical data, such as electrocardiography (ECG), machine learning algorithms can be used to identify and diagnose heart disease to reduce the workload of doctors. However, ECG data is always exposed to various kinds of noise and interference in reality, and medical diagnostics only based on one-dimensional ECG data is not trustable enough. By extracting new features from other types of medical data, we can implement enhanced recognition methods, called multimodal learning. Multimodal learning helps models to process data from a range of different sources, eliminate the requirement for training each single learning modality, and improve the robustness of models with the diversity of data. Growing number of articles in recent years have been devoted to investigating how to extract data from different sources and build accurate multimodal machine learning models, or deep learning models for medical diagnostics. This paper reviews and summarizes several recent papers that dealing with multimodal machine learning in disease detection, and identify topics for future research.

Citizens' trust in eGovernment is crucial for the successful implementation of new electronic services. This relationship in the Greater Bay Area (GBA) plays an essential role since the Government services rely on mobile mini-programs This study investigates the trust towards government service mini-programs in WeChat and Alipay. A user feedback questionnaire was designed, and a total of 609 valid samples were collected from Shenzhen, Guangzhou, Hong Kong, and Macau. The findings imply that competence, integrity, and benevolence are the key components of trust in e-government (TIEG). TIEG positively influences perceived value (PV), which positively affects citizens' Intention to adopt service mini-programs. PV significantly mediates the relationship between TIEG and Intention. Although TIEG does not effectively reduce perceived risk (PR), risk issues cannot be ignored in the adoption process. Finally, this article proposes relevant implications and suggestions for the GBA government agents and policy makers.