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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.
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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.
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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.
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The adoption of computer-aided diagnosis and treatment systems based on different types of artificial neural networks (ANNs) is already a reality in several hospital and ambulatory premises. This chapter aims to present a discussion focused on the challenges and trends of adopting these computerized systems, highlighting solutions based on different types and approaches of ANN, more specifically, feed-forward, recurrent, and deep convolutional architectures. One section is focused on the application of AI/ANN solutions to support cardiology in different applications, such as the classification of the heart structure and functional behavior based on echocardiography images; the automatic analysis of the heart electric activity based on ECG signals; and the diagnosis support of angiogram images during surgical interventions. Finally, a case study is presented based on the application of a deep learning convolutional network together with a recent technique called transfer learning to detect brain tumors using an MRI images data set. According to the findings, the model has a high degree of specificity (precision of 0.93 and recall of 0.94 for images with no brain tumor) and can be used as a screening tool for images that do not contain a brain tumor. The f1-score for images with brain tumor was 0.93. The results achieved are very promising and the proposed solution may be considered to be used as a computer-aided diagnosis tool based on deep learning convolutional neural networks. Future works will consider other techniques and compare them with the one presented here. With the comprehensive approach and overview of multiple applications, it is valid to conclude that computer-aided diagnosis and treatment systems are important tools to be considered today and will be an essential part of the trend of personalized medicine over the coming years.
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At the beginning of 2020, the World Health Organization (WHO) started a coordinated global effort to counterattack the potential exponential spread of the SARS-Cov2 virus, responsible for the coronavirus disease, officially named COVID-19. This comprehensive initiative included a research roadmap published in March 2020, including nine dimensions, from epidemiological research to diagnostic tools and vaccine development. With an unprecedented case, the areas of study related to the pandemic received funds and strong attention from different research communities (universities, government, industry, etc.), resulting in an exponential increase in the number of publications and results achieved in such a small window of time. Outstanding research cooperation projects were implemented during the outbreak, and innovative technologies were developed and improved significantly. Clinical and laboratory processes were improved, while managerial personnel were supported by a countless number of models and computational tools for the decision-making process. This chapter aims to introduce an overview of this favorable scenario and highlight a necessary discussion about ethical issues in research related to the COVID-19 and the challenge of low-quality research, focusing only on the publication of techniques and approaches with limited scientific evidence or even practical application. A legacy of lessons learned from this unique period of human history should influence and guide the scientific and industrial communities for the future.
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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.
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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.
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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.
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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
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This book is a compilation of the best papers presented at the APEF 2019 conference which was held on 25th and 26th July 2019 at the Grand Copthorne Waterfront in Singapore. With a great number of submissions, it presents the latest research findings in economics and finance and discusses relevant issues in today's world. The book is a useful resource for readers who want access to economics, finance and business research focusing on the Asia-Pacific region.
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Battery electric vehicles (BEVs) are living up to their claims as consumers choose them more frequently. The increasing demand for sustainable vehicles translates into the global need for specific components, materials, and infrastructures and drives the regulatory frameworks in each country. While BEVs offer environmental benefits and global business opportunities, the technology has not yet gained mainstream acceptance. Thus, this work aims to investigate the characteristics of BEV users and their role in the diffusion of products to larger segments, as this may vary from country to country. For this purpose, a survey based on the Unified Theory of Acceptance and Use of Technology 2 (UTAUT-2) (Venkatesh et al., 2012) framework and structural equation modeling (SmartPLS) was adopted. The results indicated that, except for the constructs of effort expectancy (EE) and social influence (SI), the predictors in the model performed well in this context. Current users are satisfied with their vehicles and are supportive of BEVs in the future. The analysis also revealed that in addition to the availability of financial resources, early adopters are attracted by new technologies in a way that leads them to make decisions outside of the traditional influence of the other members of society. It is suggested to leverage the perceived benefits of status, differentiation, or uniqueness motives, to appeal to those seeking to appear trendy and tech-savvy in society. Companies and policymakers should acknowledge the peculiarities of early customers in their communication strategies to reach a wider audience around the globe and encourage the adoption of BEV technology.
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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.
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Faculty of Business and Law
- Alessandro Lampo (1)
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