Ambient Intelligence in Healthcare: A State-of-the-Art

Information technology advancement leads to an innovative paradigm called Ambient Intelligence (AmI). A digital environment is employed along with AmI to enable individuals to be aware to their behaviors, needs, emotions and gestures. Several applications of the AmI systems in healthcare environment attract several researchers. AmI is considered one of the recent technologies that support hospitals, patients, and specialists for personal healthcare with the aid of artificial intelligence techniques and wireless sensor networks. The improvement in the wearable devices, mobile devices, embedded software and wireless technologies open the doors to advanced applications in the AmI paradigm. The WSN and the BAN collect medical data to be used for the progress of the intelligent systems adapted inevitably. The current study outlines the AmI role in healthcare concerning with its relational and technological nature. Health

A deep-learning model to continuously predict severe acute kidney injury based on urine output changes in critically ill patients

BACKGROUND: Acute Kidney Injury (AKI), a frequentcomplication of pateints in theIntensive Care Unit (ICU), is associated with a high mortality rate. Early prediction of AKI is essential in order to trigger the use of preventive careactions.METHODS: The aim of this study was to ascertain the accuracy of two mathematical analysis models in obtaining a predictive score for AKI development. A deep learning model based on a urine output trends was compared with a logistic regression analysis for AKI prediction in stages 2 and 3 (defined as the simultaneous increase of serum creatinine and decrease of urine output, according to the Acute Kidney Injury Network (AKIN) guidelines). Two retrospective datasets including 35,573 ICU patients were analyzed. Urine output data were used to train and test the logistic regression and the deep learning model.RESULTS: The deep learning model definedan area under the curve (AUC) of 0.89 (±0.01), sensitivity=0.8 and specificity=0.84, which was higher than the logistic regression analysis. The deep learning model was able to predict 88% of AKI cases more than 12h before their onset: for every 6 patients identified as being at risk of AKI by the deep learning model, 5 experienced the event. On the contrary, for every 12 patients not considered to be at risk by the model, 2 developed AKI.CONCLUSION: In conclusion, by using urine output trends, deep learning analysis was able to predict AKI episodes more than 12h in advance, and with a higher accuracy than the classical urine output thresholds. We suggest that this algorithm could be integrated inthe ICU setting to better manage, and potentially prevent, AKI episodes

GRU-D-Weibull: A Novel Real-Time Individualized Endpoint Prediction

Accurate prediction models for individual-level endpoints and time-to-endpoints are crucial in clinical practice. In this study, we propose a novel approach, GRU-D-Weibull, which combines gated recurrent units with decay (GRU-D) to model the Weibull distribution. Our method enables real-time individualized endpoint prediction and population-level risk management. Using a cohort of 6,879 patients with stage 4 chronic kidney disease (CKD4), we evaluated the performance of GRU-D-Weibull in endpoint prediction. The C-index of GRU-D-Weibull was ~0.7 at the index date and increased to ~0.77 after 4.3 years of follow-up, similar to random survival forest. Our approach achieved an absolute L1-loss of ~1.1 years (SD 0.95) at the CKD4 index date and a minimum of ~0.45 years (SD0.3) at 4 years of follow-up, outperforming competing methods significantly. GRU-D-Weibull consistently constrained the predicted survival probability at the time of an event within a smaller and more fixed range compared to other models throughout the follow-up period. We observed significant correlations between the error in point estimates and missing proportions of input features at the index date (correlations from ~0.1 to ~0.3), which diminished within 1 year as more data became available. By post-training recalibration, we successfully aligned the predicted and observed survival probabilities across multiple prediction horizons at different time points during follow-up. Our findings demonstrate the considerable potential of GRU-D-Weibull as the next-generation architecture for endpoint risk management, capable of generating various endpoint estimates for real-time monitoring using clinical data.Comment: 30 pages, 7 figures, 4 supplementary figure

Risk assessment for progression of Diabetic Nephropathy based on patient history analysis

A nefropatia diabética (ND) é uma das complicações mais comuns em doentes com diabetes. Trata-se de uma doença crónica que afeta progressivamente os rins, podendo resultar numa insuficiência renal. A digitalização permitiu aos hospitais armazenar as informações dos doentes em registos de saúde eletrónicos (RSE). A aplicação de algoritmos de Machine Learning (ML) a estes dados pode permitir a previsão do risco na evolução destes doentes, conduzindo a uma melhor gestão da doença. O principal objetivo deste trabalho é criar um modelo preditivo que tire partido do historial do doente presente nos RSE. Foi aplicado neste trabalho o maior conjunto de dados de doentes portugueses com DN, seguidos durante 22 anos pela Associação Protetora dos Diabéticos de Portugal (APDP). Foi desenvolvida uma abordagem longitudinal na fase de pré-processamento de dados, permitindo que estes fossem servidos como entrada para dezasseis algoritmos de ML distintos. Após a avaliação e análise dos respetivos resultados, o Light Gradient Boosting Machine foi identificado como o melhor modelo, apresentando boas capacidades de previsão. Esta conclusão foi apoiada não só pela avaliação de várias métricas de classificação em dados de treino, teste e validação, mas também pela avaliação do seu desempenho por cada estádio da doença. Para além disso, os modelos foram analisados utilizando gráficos de feature ranking e através de análise estatística. Como complemento, são ainda apresentados a interpretabilidade dos resultados através do método SHAP, assim como a distribuição do modelo utilizando o Gradio e os servidores da Hugging Face. Através da integração de técnicas ML, de um método de interpretação e de uma aplicação Web que fornece acesso ao modelo, este estudo oferece uma abordagem potencialmente eficaz para antecipar a evolução da ND, permitindo que os profissionais de saúde tomem decisões informadas para a prestação de cuidados personalizados e gestão da doença

ROLE OF MACHINE VISION FOR IDENTIFICATION OF KIDNEY STONES USING MULTI FEATURES ANALYSIS

The purpose of this study is to highlight the significance of machine vision for the Classification of kidney stone identification. A novel optimized fused texture features frame work was designed to identify the stones in kidney.  A fused 234 texture feature namely (GLCM, RLM and Histogram) feature set was acquired by each region of interest (ROI). It was observed that on each image 8 ROI’s of sizes (16x16, 20x20 and 22x22) were taken. It was difficult to handle a large feature space 280800 (1200x234). Now to overcome this data handling issue we have applied feature optimization technique namely POE+ACC and acquired 30 most optimized features set for each ROI. The optimized fused features data set 3600(1200x30) was used to four machine vision Classifiers that is Random Forest, MLP, j48 and Naïve Bayes. Finally, it was observed that Random Forest provides best results of 90% accuracy on ROI 22x22 among the above discussed deployed Classifier

Pervasive intelligent models to predict the outcome of COVID-19 patients

Nowadays, there is an increasing need to understand the behavior of COVID-19. After the Directorate-General of Health of Portugal made available the infected patient’s data, it became possible to analyze it and gather some conclusions, obtaining a better understanding of the matter. In this context, the project developed—ioCOVID19—Intelligent Decision Support Platform aims to identify patterns and develop intelligent models to predict and support clinical decisions. This article explores which typologies are associated with different outcomes to help clinicians fight the virus with a decision support system. So, to achieve this purpose, classification algorithms were used, and one target was studied—Patients outcome, that is, to predict if the patient will die or recover. Regarding the obtained results, the model that stood out is composed of scenario s4 (composed of all comorbidities, symptoms, and age), the decision tree algorithm, and the oversampling sampling method. The obtained results by the studied metrics were (in order of importance): Sensitivity of 95.20%, Accuracy of 90.67%, and Specificity of 86.08%. The models were deployed as a service, and they are part of a clinical decision support system that is available for authorized users anywhere and anytime.This research was funded by Portugal 2020 program through NORTE-01-02B7-FEDER-048344