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This paper presents an algorithm that applies metrics derived from automatic QRS detection and segmentation in electrocardiogram signals for analyzing Heart Rate Variability to study the evolution of metrics in the frequency domain of a clinical procedure. The analysis was performed on three sets of elderly people, who are categorized according to frailty phenotype. The first set was comprised of frail elderly, the second pre-frail elderly, and the third robust elderly. Investigators from many disciplines have been encouraged to contribute to the understanding of molecular and physiological changes in multiple systems that may increase the vulnerability of frail elderly. In this work, the frailty phenotype can be characterized by unintentional weight loss, as self-reported, fatigue assessed by self-report, grip strength (measured directly), physical activity level assessed by self-report and gait speed (measured). The results obtained demonstrate the existence of significant differences between Heart Rate Variability metrics for the three groups, especially considering a higher preponderance for sympathetic nervous system for the group of robust patients in response to postural maneuver.
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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.
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The extent of citizens' trust in government determines the success or failure of e-government initiatives. Nevertheless, the idiosyncrasies of the concept and the broad spectrum of its approach still present relevant challenges. This work presents a systematic literature review on e-government trust while elaborating and summarizing a conceptual analysis of trust, introducing evaluation methods for government trust, and compiling relevant research on e-government trust and intentional behavior. A total of 26 key factors that constitute trust have been identified and classified into six categories: Government trust, Trust in Internet and technology (TiIT), Trust in e-government (TiEG), Personal Beliefs, Trustworthiness, and Trust of intermediary (ToI). The value added of this work consists of developing a conceptual framework of TiEG to provide a significant reference for future in-depth studies and research on e-government trust.
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The visual analysis of cardiotocographic examinations is a very subjective process. The accurate detection and segmentation of the fetal heart rate (FHR) features and their correlation with the uterine contractions in time allow a better diagnostic and the possibility of anticipation of many problems related to fetal distress. This paper presents a computerized diagnostic aid system based on digital signal processing techniques to detect and segment changes in the FHR and the uterine tone signals automatically. After a pre-processing phase, the FHR baseline detection is calculated. An auxiliary signal called detection line is proposed to support the detection and segmentation processes. Then, the Hilbert transform is used with an adaptive threshold for identifying fiducial points on the fetal and maternal signals. For an antepartum (before labor) database, the positive predictivity value (PPV) is 96.80% for the FHR decelerations, and 96.18% for the FHR accelerations. For an intrapartum (during labor) database, the PPV found was 91.31% for the uterine contractions, 94.01% for the FHR decelerations, and 100% for the FHR accelerations. For the whole set of exams, PPV and SE were both 100% for the identification of FHR DIP II and prolonged decelerations.
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Over the past several decades, the dichotomy between traditional and emerging donors has been based upon the notion that emerging donors (such as China) support authoritarian regimes and use foreign aid to pursue their economic interests at the expense of the poor in the recipient countries. Accordingly, Western donors, media, and scholars portray Chinese aid as non-poverty-focused. This study aims to review and analyze whether the dichotomy between traditional and emerging donors is still relevant in the current aid system and to propose a new and rigorous criterion for recategorizing donors. In terms of methodology, this study relies on secondary data, including scholarly works on traditional and emerging donors and foreign aid policy documents. Conclusions based on the research indicate that the divide between traditional donors and (re)emerging donors is becoming more ambiguous. The literature review indicates that the two donors’ aids had a mixed impact and that their approaches were similar. This paper highlights the importance of developing different recategorization criteria depending on the impact of aid.
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Since the beginning of 2020, Coronavirus Disease 19 (COVID-19) has attracted the attention of the World Health Organization (WHO). This paper looks into the infection mechanism, patient symptoms, and laboratory diagnosis, followed by an extensive assessment of different technologies and computerized models (based on Electrocardiographic signals (ECG), Voice, and X-ray techniques) proposed as a diagnostic tool for the accurate detection of COVID-19. The found papers showed high accuracy rate results, ranging between 85.70% and 100%, and F1-Scores from 89.52% to 100%. With this state-of-the-art, we concluded that the models proposed for the detection of COVID-19 already have significant results, but the area still has room for improvement, given the vast symptomatology and the better comprehension of individuals’ evolution of the disease.
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Crowdsensing exploits the sensing abilities offered by smart phones and users' mobility. Users can mutually help each other as a community with the aid of crowdsensing. The potential of crowdsensing has yet to be fully realized for improving public health. A protocol based on gamification to encoura...
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The adoption of project management techniques is a crucial decision for corporate governance in construction companies since the management of areas such as risk, cost, and communications is essential for the success or failure of an endeavor. Nevertheless, different frameworks based on traditional or agile methodologies are available with several approaches, which may create several ways to manage projects. The primary purpose of this work is to investigate the adequate project management methodology for the construction industry from a general perspective and consider a case study from Macau. The methodology considered semi-structured interviews and a survey comparing international and local project managers from the construction industry. The interviews indicate that most construction project managers still follow empirical methods with no specific methodology but consider the adoption of traditional waterfall approaches. In contrast, according to the survey, most project managers and construction managers agree that the project's efficacy needs to increase, namely in planning, waste minimization, communication increase, and focus on the Client's feedback. In addition, there seems to be a clear indication that agile methodology could be implemented in several types of projects, including hospitality development projects. A hybrid development approach based on the Waterfall and Agile methodologies as a tool for the project management area may provide a more suitable methodology for project managers to follow.
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In recent years, the integration of Machine Learning (ML) techniques in the field of healthcare and public health has emerged as a powerful tool for improving decision-making processes [...]
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It is plausible to assume that the component waves in ECG signals constitute a unique human characteristic because morphology and amplitudes of recorded beats are governed by multiple individual factors. According to the best of our knowledge, the issue of automatically classifying different ’identities’ of QRS morphology has not been explored within the literature. This work proposes five alternative mathematical models for representing different QRS morphologies providing the extraction of a set of features related to QRS shape. The technique incorporates mechanisms of combining the mathematical functions Gaussian, Mexican-Hat and Rayleigh probability density function and also a mechanism for clipping the waveform of those functions. The searching for the optimal parameters which minimize the normalized RMS error between each mathematical model and a given QRS search window enables to find an optimal model. Such modeling behaves as a robust alternative for delineating heartbeats, classifying beat morphologies, detecting subtle and anomalous changes, compression of QRS complex windows among others. The validation process evaluates the ability of each model to represent different QRS morphology classes within 159 full ECG signal records from QT database and 584 QRS search windows from MIT-BIH Arrhythmia database. From the experimental results, we rank the winning rates for which each mathematical model best models and also discriminates the most predominant QRS morphologies Rs, rS, RS, qR, qRs, R, rR’s and QS. Furthermore, the average time errors computed for QRS onset and offset locations when using the corresponding winner mathematical models for delineation purposes were, respectively, 12.87±8.5 ms and 1.47±10.06 ms.
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The use of learning analytics (LA) in real-world educational applications is growing very fast as academic institutions realize the positive potential that is possible if LA is integrated in decision making. Education in schools on public health need to evolve in response to the new knowledge and th...
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Background and objective Intrauterine Growth Restriction (IUGR) is a condition in which a fetus does not grow to the expected weight during pregnancy. There are several well documented causes in the literature for this issue, such as maternal disorder, and genetic influences. Nevertheless, besides the risk during pregnancy and labour periods, in a long term perspective, the impact of IUGR condition during the child development is an area of research itself. The main objective of this work is to propose a machine learning solution to identify the most significant features of importance based on physiological, clinical or socioeconomic factors correlated with previous IUGR condition after 10 years of birth. Methods In this work, 41 IUGR (18 male) and 34 Non-IUGR (22 male) children were followed up 9 years after the birth, in average (9.1786 ± 0.6784 years old). A group of machine learning algorithms is proposed to classify children previously identified as born under IUGR condition based on 24-hours monitoring of ECG (Holter) and blood pressure (ABPM), and other clinical and socioeconomic attributes. In additional, an algorithm of relevance determination based on the classifier is also proposed, to determine the level of importance of the considered features. Results The proposed classification solution achieved accuracy up to 94.73%, and better performance than seven state-of-the-art machine learning algorithms. Also, relevant latent factors related to HRV and BP monitoring are proposed, such as: day-time heart rate (day-time HR), day-night systolic blood pressure (day-night SBP), 24-hour standard deviation (SD) of SBP, dropped, morning cortisol creatinine, 24-hour mean of SDs of all NN intervals for each 5 minutes segment (24-hour SDNNi), among others. Conclusion With outstanding accuracy of our proposed solutions, the classification system and the indication of relevant attributes may support medical teams on the clinical monitoring of IUGR children during their childhood development.
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The adoption of IoT for smart health applications is a relevant tool for distributed and intelligent automatic diagnostic systems. This work proposes the development of an integrated solution to monitor maternal and fetal signals for high-risk pregnancies based on IoT sensors, feature extraction based on data analytics, and an intelligent diagnostic aid system based on a 1-D convolutional neural network (CNN) classifier. The fetal heart rate and a group of maternal clinical indicators, such as the uterine tonus activity, blood pressure, heart rate, temperature, and oxygen saturation are monitored. Multiple data sources generate a significant amount of data in different formats and rates. An emergency diagnostic subsystem is proposed based on a fog computing layer and the best accuracy was 92.59% for both maternal and fetal emergency. A smart health analytics system is proposed for multiple feature extraction and the calculation of linear and nonlinear measures. Finally, a classification technique is proposed as a prediction system for maternal, fetal, and simultaneous health status classification, considering six possible outputs. Different classifiers are evaluated and a proposed CNN presented the best results, with the F1-score ranging from 0.74 to 0.91. The results are validated based on the diagnosis provided by two specialists. The results show that the proposed system is a viable solution for maternal and fetal ambulatory monitoring based on IoT.
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Corporate leaders are constantly dealing with stress in parallel with continuous decision-making processes. The impact of acute stress on decision-making activities is a relevant area of study to evaluate the impact of the decisions made, and create tools and mechanisms to cope with the inevitable exposure to stress and better manage its impact. The intersection of leadership and neurosciences techniques is called Neuroleadership. In this work, an experiment is proposed to detect and measure the emotional arousal of two groups of business professionals, divided into two groups. The first one is the intervention/stress group, n=30, exposed to stressful conditions, and the control group, n=14, not exposed to stress. The participants are submitted to a sequence of computerized stimuli, such as watching videos, answering survey questions, and making decisions in a realistic office environment. The Galvanic Skin Response (GSR) biosensor monitors emotional arousal in real-time. The experiment design implemented stressors such as visual effects, defacement, unfairness, and time-constraint for the intervention group, followed by decision-making tasks. The results indicate that emotional arousal was statistically significantly higher for the intervention/stress group, considering Shapiro and Mann-Whitney tests. The work indicates that GSR is a reliable stress detector and may be useful to predict negative impacts on executive professionals during decision-making activities.
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Objective: This study highlights the potential of an Electrocardiogram (ECG) as a powerful tool for early diagnosis of COVID-19 in critically ill patients with limited access to CT–Scan rooms. Methods: In this investigation, 3 categories of patient status were considered: Low, Moderate, and Severe. For each patient, 2 different body positions have been used to collect 2 ECG signals. Then, from each collected signal, 10 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) were extracted every 1s ECG time-series length to serve as entries for 19 Machine learning classifiers within a leave-one-out cross-validation procedure. Four different classification scenarios were tested: Low vs. Moderate, Low vs. Severe, Moderate vs. Severe and one Multi-class comparison (All vs. All). Results: The classification report results were: (1) Low vs. Moderate - 100% of Accuracy and 100% of F1–Score; (2) Low vs. Severe - Accuracy of 91.67% and an F1–Score of 94.92%; (3) Moderate vs. Severe - Accuracy of 94.12% and an F1–Score of 96.43%; and (4) All vs All - 78.57% of Accuracy and 84.75% of F1–Score. Conclusion: The results indicate that the applied methodology could be considered a good tool for distinguishing COVID-19’s different severity stages using ECG signals. Significance: The findings highlight the potential of ECG as a fast and effective tool for COVID-19 examination. In comparison to previous studies using the same database, this study shows a 7.57% improvement in diagnostic accuracy for the All vs All comparison.
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The identification of barriers for e-commerce to thrive in specific countries is a topic of great interest. This work proposes two models to study the barriers to B2C e-commerce adoption in Portugal, highlighting obstacles less exploited by previous research: the impact of offline shopping pleasure and the influence of the distance to shopping malls on online shopping intent. An online survey was conducted based on different constructs. A multivariate OLS hierarchical regression was used to analyse the proposed models regarding the intention to buy online and the number of online purchases. The results revealed that customer satisfaction is a strong predictor of intent to buy online and that perceived product risk remains a barrier to e-commerce. Consumers living in high urbanised areas have more propensity to buy online. Helpful information is provided regarding the impact of context, culture, product, and individual barriers, showing that multichannel strategies are best suited for success.