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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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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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In February 2020, Macau became one of the first regions where the pandemic of coronavirus or Covid-19 affected the totality of social and economic life leading to increased anxieties over movement and distance. Although Macau has had very few actual cases of the virus – 46 in total –and no deaths from it, the Macau government rapidly instituted a lock down. The aim of this article is to reflect on how the social experience of being in lockdown can provide insights into understanding the type of experience or condition that we provisionally term ‘anxious immobility.’ Such a condition is characterized by a total disruption of everyday rhythms and specifically anxious waiting for the normalization of activity while being the subject of biosocial narratives of quarantine and socially responsible. The paper is based upon 3 months of ethnographic research conducted by two researchers based in Macau. We also reflect upon some aspects of the politics of mobilities in the light of disruptions and friction points between Hong Kong, Macau, mainland China, and the rest of the world.
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COVID-19 has hit the world unprepared, as the deadliest pandemic of the century. Governments and authorities, as leaders and decision makers fighting the virus, enormously tap into the power of artificial intelligence and its predictive models for urgent decision support. This book showcases a collection of important predictive models that used during the pandemic, and discusses and compares their efficacy and limitations. Readers from both healthcare industries and academia can gain unique insights on how predictive models were designed and applied on epidemic data. Taking COVID19 as a case study and showcasing the lessons learnt, this book will enable readers to be better prepared in the event of virus epidemics or pandemics in the future.
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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.
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No existing review has synthesized key questions about acculturation experiences among international migrant workers. This review aimed to explore (1) What are global migrant workers’ experiences with acculturation and acculturative stress? (2) What are acculturative stress coping strategies used by migrant workers? And (3) how effective are these strategies for migrant workers in assisting their acculturation in the host countries? Peer-reviewed and gray literature, without time limitation, were searched in six databases and included if the study: focused on acculturative stress and coping strategies; was conducted with international migrant workers; was published in English; and was empirical. Eleven studies met the inclusion criteria. Three-layered themes of acculturation process and acculturative stress were identified as: individual layer; work-related layer; and social layer. Three key coping strategies were identified: emotion-focused; problem-focused; and appraisal-focused. These coping strategies were used flexibly to increase coping effectiveness and evidence emerged that a particular type of acculturative stress might be solved more effectively by a specific coping strategy. Migrant workers faced numerous challenges in their acculturative process. Understanding this process and their coping strategies could be used in developing research and interventions to improve the well-being of migrant workers.
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Covid-19 has hit the world unprepared, as the deadliest pandemic of the century. Governments and authorities, as leaders and decision makers fighting against the virus, enormously tap on the power of AI and its data analytics models for urgent decision supports at the greatest efforts, ever seen from human history. This book showcases a collection of important data analytics models that were used during the epidemic, and discusses and compares their efficacy and limitations. Readers who from both healthcare industries and academia can gain unique insights on how data analytics models were designed and applied on epidemic data. Taking Covid-19 as a case study, readers especially those who are working in similar fields, would be better prepared in case a new wave of virus epidemic may arise again in the near future.
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Quality of life in general population before and during pandemic is topic need to be address by researcher in terms of mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The study was carried out among Saudi population. Data were collected from general population using questionnaire during the period from 22 August 2021 to 10th January 2022. As a result, total 214 participants have included in this study. Among them prevalent age group include 40 years (n= 63, 29.4%) shadowed by the age group 25-35 (n= 61, 28.5%) while above 60 years group were least frequent (n= 1, 0.5%). On questioning the applicants whether they were satisfied with their health and how would they rate their quality of life, their answers were as follows: yes, or satisfied (n= 86, 40.2%), very Satisfied (n= 102, 47.7%) Dissatisfied (n= 11, 5.1%) and neither satisfied nor dissatisfied (n= 15, 7%). Due to pandemic, they were rate quality of life very good (n= 94, 43.9%), good (n= 63, 29.4 %) poor (n= 5, 2.3 %) and neither good and nor poor (n= 52, 24.3 %). During pandemic 96 participants feel no change in their weight but 110 participants respond that there is increase in coffee intake during the pandemic. Similarly increased in smoking habits and decrease rate in social activities (n=119,41.4%). The psychosomatic well-being of people has been interrupted by disturbing their social activities during pandemic.
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The use of computational tools for medical image processing are promising tools to effectively detect COVID-19 as an alternative to expensive and time-consuming RT-PCR tests. For this specific task, CXR (Chest X-Ray) and CCT (Chest CT Scans) are the most common examinations to support diagnosis through radiology analysis. With these images, it is possible to support diagnosis and determine the disease’s severity stage. Computerized COVID-19 quantification and evaluation require an efficient segmentation process. Essential tasks for automatic segmentation tools are precisely identifying the lungs, lobes, bronchopulmonary segments, and infected regions or lesions. Segmented areas can provide handcrafted or self-learned diagnostic criteria for various applications. This Chapter presents different techniques applied for Chest CT Scans segmentation, considering the state of the art of UNet networks to segment COVID-19 CT scans and a segmentation experiment for network evaluation. Along 200 epochs, a dice coefficient of 0.83 was obtained.
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COVID-19 is a respiratory disorder caused by CoronaVirus and SARS (SARS-CoV2). WHO declared COVID-19 a global pandemic in March 2020 and several nations’ healthcare systems were on the verge of collapsing. With that, became crucial to screen COVID-19-positive patients to maximize limited resources. NAATs and antigen tests are utilized to diagnose COVID-19 infections. NAATs reliably detect SARS-CoV-2 and seldom produce false-negative results. Because of its specificity and sensitivity, RT-PCR can be considered the gold standard for COVID-19 diagnosis. This test’s complex gear is pricey and time-consuming, using skilled specialists to collect throat or nasal mucus samples. These tests require laboratory facilities and a machine for detection and analysis. Deep learning networks have been used for feature extraction and classification of Chest CT-Scan images and as an innovative detection approach in clinical practice. Because of COVID-19 CT scans’ medical characteristics, the lesions are widely spread and display a range of local aspects. Using deep learning to diagnose directly is difficult. In COVID-19, a Transformer and Convolutional Neural Network module are presented to extract local and global information from CT images. This chapter explains transfer learning, considering VGG-16 network, in CT examinations and compares convolutional networks with Vision Transformers (ViT). Vit usage increased VGG-16 network F1-score to 0.94.
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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.
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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.
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<abstract><p>About 6.5 million people are infected with Chagas disease (CD) globally, and WHO estimates that $ > 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>
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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.
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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%.
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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.
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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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