Identification And Agreement Of First Turn Point By Mathematical Analysis Applied To Heart Rate, Carbon Dioxide Output And Electromyography.

The second heart rate (HR) turn point has been extensively studied, however there are few studies determining the first HR turn point. Also, the use of mathematical and statistical models for determining changes in dynamic characteristics of physiological variables during an incremental cardiopulmonary test has been suggested. To determine the first turn point by analysis of HR, surface electromyography (sEMG), and carbon dioxide output (VCO2) using two mathematical models and to compare the results to those of the visual method. Ten sedentary middle-aged men (53.9 ± 3.2 years old) were submitted to cardiopulmonary exercise testing on an electromagnetic cycle ergometer until exhaustion. Ventilatory variables, HR, and sEMG of the vastus lateralis were obtained in real time. Three methods were used to determine the first turn point: 1) visual analysis based on loss of parallelism between VCO2 and oxygen uptake (VO2); 2) the linear-linear model, based on fitting the curves to the set of VCO2 data (Lin-LinVCO2); 3) a bi-segmental linear regression of Hinkley's algorithm applied to HR (HMM-HR), VCO2 (HMM-VCO2), and sEMG data (HMM-RMS). There were no differences between workload, HR, and ventilatory variable values at the first ventilatory turn point as determined by the five studied parameters (p>0.05). The Bland-Altman plot showed an even distribution of the visual analysis method with Lin-LinVCO2, HMM-HR, HMM-VCO2, and HMM-RMS. The proposed mathematical models were effective in determining the first turn point since they detected the linear pattern change and the deflection point of VCO2, HR responses, and sEMG.17614-2

Automatic analysis and classification of cardiac acoustic signals for long term monitoring

Objective: Cardiovascular diseases are the leading cause of death worldwide resulting in over 17.9 million deaths each year. Most of these diseases are preventable and treatable, but their progression and outcomes are significantly more positive with early-stage diagnosis and proper disease management. Among the approaches available to assist with the task of early-stage diagnosis and management of cardiac conditions, automatic analysis of auscultatory recordings is one of the most promising ones, since it could be particularly suitable for ambulatory/wearable monitoring. Thus, proper investigation of abnormalities present in cardiac acoustic signals can provide vital clinical information to assist long term monitoring. Cardiac acoustic signals, however, are very susceptible to noise and artifacts, and their characteristics vary largely with the recording conditions which makes the analysis challenging. Additionally, there are challenges in the steps used for automatic analysis and classification of cardiac acoustic signals. Broadly, these steps are the segmentation, feature extraction and subsequent classification of recorded signals using selected features. This thesis presents approaches using novel features with the aim to assist the automatic early-stage detection of cardiovascular diseases with improved performance, using cardiac acoustic signals collected in real-world conditions. Methods: Cardiac auscultatory recordings were studied to identify potential features to help in the classification of recordings from subjects with and without cardiac diseases. The diseases considered in this study for the identification of the symptoms and characteristics are the valvular heart diseases due to stenosis and regurgitation, atrial fibrillation, and splitting of fundamental heart sounds leading to additional lub/dub sounds in the systole or diastole interval of a cardiac cycle. The localisation of cardiac sounds of interest was performed using an adaptive wavelet-based filtering in combination with the Shannon energy envelope and prior information of fundamental heart sounds. This is a prerequisite step for the feature extraction and subsequent classification of recordings, leading to a more precise diagnosis. Localised segments of S1 and S2 sounds, and artifacts, were used to extract a set of perceptual and statistical features using wavelet transform, homomorphic filtering, Hilbert transform and mel-scale filtering, which were then fed to train an ensemble classifier to interpret S1 and S2 sounds. Once sound peaks of interest were identified, features extracted from these peaks, together with the features used for the identification of S1 and S2 sounds, were used to develop an algorithm to classify recorded signals. Overall, 99 features were extracted and statistically analysed using neighborhood component analysis (NCA) to identify the features which showed the greatest ability in classifying recordings. Selected features were then fed to train an ensemble classifier to classify abnormal recordings, and hyperparameters were optimized to evaluate the performance of the trained classifier. Thus, a machine learning-based approach for the automatic identification and classification of S1 and S2, and normal and abnormal recordings, in real-world noisy recordings using a novel feature set is presented. The validity of the proposed algorithm was tested using acoustic signals recorded in real-world, non-controlled environments at four auscultation sites (aortic valve, tricuspid valve, mitral valve, and pulmonary valve), from the subjects with and without cardiac diseases; together with recordings from the three large public databases. The performance metrics of the methodology in relation to classification accuracy (CA), sensitivity (SE), precision (P+), and F1 score, were evaluated. Results: This thesis proposes four different algorithms to automatically classify fundamental heart sounds – S1 and S2; normal fundamental sounds and abnormal additional lub/dub sounds recordings; normal and abnormal recordings; and recordings with heart valve disorders, namely the mitral stenosis (MS), mitral regurgitation (MR), mitral valve prolapse (MVP), aortic stenosis (AS) and murmurs, using cardiac acoustic signals. The results obtained from these algorithms were as follows: • The algorithm to classify S1 and S2 sounds achieved an average SE of 91.59% and 89.78%, and F1 score of 90.65% and 89.42%, in classifying S1 and S2, respectively. 87 features were extracted and statistically studied to identify the top 14 features which showed the best capabilities in classifying S1 and S2, and artifacts. The analysis showed that the most relevant features were those extracted using Maximum Overlap Discrete Wavelet Transform (MODWT) and Hilbert transform. • The algorithm to classify normal fundamental heart sounds and abnormal additional lub/dub sounds in the systole or diastole intervals of a cardiac cycle, achieved an average SE of 89.15%, P+ of 89.71%, F1 of 89.41%, and CA of 95.11% using the test dataset from the PASCAL database. The top 10 features that achieved the highest weights in classifying these recordings were also identified. • Normal and abnormal classification of recordings using the proposed algorithm achieved a mean CA of 94.172%, and SE of 92.38%, in classifying recordings from the different databases. Among the top 10 acoustic features identified, the deterministic energy of the sound peaks of interest and the instantaneous frequency extracted using the Hilbert Huang-transform, achieved the highest weights. • The machine learning-based approach proposed to classify recordings of heart valve disorders (AS, MS, MR, and MVP) achieved an average CA of 98.26% and SE of 95.83%. 99 acoustic features were extracted and their abilities to differentiate these abnormalities were examined using weights obtained from the neighborhood component analysis (NCA). The top 10 features which showed the greatest abilities in classifying these abnormalities using recordings from the different databases were also identified. The achieved results demonstrate the ability of the algorithms to automatically identify and classify cardiac sounds. This work provides the basis for measurements of many useful clinical attributes of cardiac acoustic signals and can potentially help in monitoring the overall cardiac health for longer duration. The work presented in this thesis is the first-of-its-kind to validate the results using both, normal and pathological cardiac acoustic signals, recorded for a long continuous duration of 5 minutes at four different auscultation sites in non-controlled real-world conditions.Open Acces

Hidden Markov Models

Hidden Markov Models (HMMs), although known for decades, have made a big career nowadays and are still in state of development. This book presents theoretical issues and a variety of HMMs applications in speech recognition and synthesis, medicine, neurosciences, computational biology, bioinformatics, seismology, environment protection and engineering. I hope that the reader will find this book useful and helpful for their own research

A review of smart homes in healthcare

The technology of Smart Homes (SH), as an instance of ambient assisted living technologies, is designed to assist the homes’ residents accomplishing their daily-living activities and thus having a better quality of life while preserving their privacy. A SH system is usually equipped with a collection of inter-related software and hardware components to monitor the living space by capturing the behaviour of the resident and understanding his activities. By doing so the system can inform about risky situations and take actions on behalf of the resident to his satisfaction. The present survey will address technologies and analysis methods and bring examples of the state of the art research studies in order to provide background for the research community. In particular, the survey will expose infrastructure technologies such as sensors and communication platforms along with artificial intelligence techniques used for modeling and recognizing activities. A brief overview of approaches used to develop Human–Computer interfaces for SH systems is given. The survey also highlights the challenges and research trends in this area

A real-time data mining technique applied for critical ECG rhythm on handheld device

Sudden cardiac arrest is often caused by ventricular arrhythmias and these episodes can lead to death for patients with chronic heart disease. Hence, detection of such arrhythmia is crucial in mobile ECG monitoring. In this research, a systematic study is carried out to investigate the possible limitations that are preventing the realisation of a real-time ECG arrhythmia data-mining algorithm suitable for application on mobile devices. Based on the findings, a computationally lightweight algorithm is devised and tested. Ventricular tachycardia (VT) is the most common type of ventricular arrhythmias and is also the deadliest.. A ventricular tachycardia (VT) episode is due to a disorder ofthe regular contractions ofthe heart. It occurs when the human heart ventricles generate a rapid heartbeat which disrupts the regular physiology cycle. The normal sinus rhythm (NSR) of a regular human heart beat signal has its signature PQRST waveform and in regular pattern. Whereas, the characteristics of a ventricular tachycardia (VT) signal waveforms are short R-R intervals, widen QRS duration and the absence of P-waves. Each type of ECG arrhythmia previously mentioned has a unique waveform signature that can be exploited as features to be used for the realization of an automated ECG analysis application. In order to extract this known ECG waveform feature, a time-domain analysis is proposed for feature extraction. Cross-correlation allows the computation of a co-efficient that quantifies the similarity between two times-series. Hence, by cross-correlating known ECG waveform templates with an unknown ECG signal, the coefficient can indicate the similarities. In previous published work, a preliminary study was carried out. The cross-correlation coefficient wave (CCW) technique was introduced for feature extraction. The outcome ofthis work presents CCW as a promising feature to differentiate between NSR, VT and Vfib signals. Moreover, cross-correlation computation does not require high computational overhead. Next, an automated detection algorithm requires a classification mechanism to make sense of the feature extracted. A further study is conducted and published, a fuzzy set k-NN classifier was introduced for the classification of CCW feature extracted from ECG signal segments. A training set of size 180 is used. The outcome of the study indicates that the computationally light-weight fuzzy k-NN classifier can reliably classify between NSR and VT signals, the class detection rate is low for classifying Vfib signal using the fuzzy k-NN classifier. Hence, a modified algorithm known as fuzzy hybrid classifier is proposed. By implementing an expert knowledge based fuzzy inference system for classification of ECG signal; the Vfib signal detection rate was improved. The comparison outcome was that the hybrid fuzzy classifier is able to achieve 91.1% correct rate, 100% sensitivity and 100% specificity. The previously mentioned result outperforms the compared classifiers. The proposed detection and classification algorithm is able to achieve high accuracy in analysing ECG signal feature of NSR, VT and Vfib nature. Moreover, the proposed classifier is successfully implemented on a smart mobile device and it is able to perform data-mining of the ECG signal with satisfiable results

Pragmatic Evaluation of Health Monitoring & Analysis Models from an Empirical Perspective

Implementing and deploying several linked modules that can conduct real-time analysis and recommendation of patient datasets is necessary for designing health monitoring and analysis models. These databases include, but are not limited to, blood test results, computer tomography (CT) scans, MRI scans, PET scans, and other imaging tests. A combination of signal processing and image processing methods are used to process them. These methods include data collection, pre-processing, feature extraction and selection, classification, and context-specific post-processing. Researchers have put forward a variety of machine learning (ML) and deep learning (DL) techniques to carry out these tasks, which help with the high-accuracy categorization of these datasets. However, the internal operational features and the quantitative and qualitative performance indicators of each of these models differ. These models also demonstrate various functional subtleties, contextual benefits, application-specific constraints, and deployment-specific future research directions. It is difficult for researchers to pinpoint models that perform well for their application-specific use cases because of the vast range of performance. In order to reduce this uncertainty, this paper discusses a review of several Health Monitoring & Analysis Models in terms of their internal operational features & performance measurements. Readers will be able to recognise models that are appropriate for their application-specific use cases based on this discussion. When compared to other models, it was shown that Convolutional Neural Networks (CNNs), Masked Region CNN (MRCNN), Recurrent NN (RNN), Q-Learning, and Reinforcement learning models had greater analytical performance. They are hence suitable for clinical use cases. These models' worse scaling performance is a result of their increased complexity and higher implementation costs. This paper compares evaluated models in terms of accuracy, computational latency, deployment complexity, scalability, and deployment cost metrics to analyse such scenarios. This comparison will help users choose the best models for their performance-specific use cases. In this article, a new Health Monitoring Metric (HMM), which integrates many performance indicators to identify the best-performing models under various real-time patient settings, is reviewed to make the process of model selection even easier for real-time scenarios