Development of a monitoring system for COVID-19 monitoring in early stages

Covid-19 is considered the most infectious virus today. Likewise, the struggle to mitigate the effects of the variants, the flexibility in some measures such as the use of face masks, the advancement of vaccination and prevention and self-care campaigns continue to be topics of research and of global interest. The world health authorities published that the disease was characterized by presenting the same symptoms as the flu along with a complex picture where in the most serious cases they lead to difficulty breathing due to pneumonia, sepsis and septic shock that can lead to death. Some systems implemented for taking body temperature such as thermographic cameras, digital thermometers, for the description of symptoms in the people they analyze at the time of carrying out the epidemiological fences are not enough, since they handle low precision, are taken in isolation, individually or randomly and is not suitable for characterizing interest groups. Then, establishing risk levels by measuring non-invasive variables can be considered inputs into prevention campaigns and a low-cost way of monitoring the community. This article shows the design of a non-invasive embedded device for the measurement of 5 priority variables for the detection of the risk of covid-19 infection. The proposed device was duly calibrated and synchronized for the acquisition of data from 594 people in the city of Bucaramanga, Colombia, who authorize the monitoring of the symptoms. The people must be in a state of rest to be able to acquire the data with great accuracy, in this way the data is entered into the system in charge of doing the monitoring analysis. Additionally, the implementation of an interface that allows the visualization of results, laying the foundations for the development of automatic learning techniques or models for the risk classification in future work

Heart Diseases Diagnosis Using Artificial Neural Networks

Information technology has virtually altered every aspect of human life in the present era. The application of informatics in the health sector is rapidly gaining prominence and the benefits of this innovative paradigm are being realized across the globe. This evolution produced large number of patients’ data that can be employed by computer technologies and machine learning techniques, and turned into useful information and knowledge. This data can be used to develop expert systems to help in diagnosing some life-threating diseases such as heart diseases, with less cost, processing time and improved diagnosis accuracy. Even though, modern medicine is generating huge amount of data every day, little has been done to use this available data to solve challenges faced in the successful diagnosis of heart diseases. Highlighting the need for more research into the usage of robust data mining techniques to help health care professionals in the diagnosis of heart diseases and other debilitating disease conditions. Based on the foregoing, this thesis aims to develop a health informatics system for the classification of heart diseases using data mining techniques focusing on Radial Basis functions and emerging Neural Networks approach. The presented research involves three development stages; firstly, the development of a preliminary classification system for Coronary Artery Disease (CAD) using Radial Basis Function (RBF) neural networks. The research then deploys the deep learning approach to detect three different types of heart diseases i.e. Sleep Apnea, Arrhythmias and CAD by designing two novel classification systems; the first adopt a novel deep neural network method (with Rectified Linear unit activation) design as the second approach in this thesis and the other implements a novel multilayer kernel machine to mimic the behaviour of deep learning as the third approach. Additionally, this thesis uses a dataset obtained from patients, and employs normalization and feature extraction means to explore it in a unique way that facilitates its usage for training and validating different classification methods. This unique dataset is useful to researchers and practitioners working in heart disease treatment and diagnosis. The findings from the study reveal that the proposed models have high classification performance that is comparable, or perhaps exceed in some cases, the existing automated and manual methods of heart disease diagnosis. Besides, the proposed deep-learning models provide better performance when applied on large data sets (e.g., in the case of Sleep Apnea), with reasonable performance with smaller data sets. The proposed system for clinical diagnoses of heart diseases, contributes to the accurate detection of such disease, and could serve as an important tool in the area of clinic support system. The outcome of this study in form of implementation tool can be used by cardiologists to help them make more consistent diagnosis of heart diseases

Risk stratification by analysis of electrocardiographic morphology following acute coronary syndromes

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2009.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references (p. 95-100).Patients who have suffered an acute coronary syndrome (ACS) are at elevated risk of future adverse events, including fatal arrhythmias or myocardial infarction. Risk stratification--he identification of high-risk patients--s an important step in determining who is most likely to benefit from aggressive treatments. We propose a new automated risk stratification technique that uses the long-term electrocardiographic data routinely recorded in the days following an ACS. Data obtained from clinical drug trials indicates that our technique, called MV-DF (morphologic variability diagnostic frequencies), can significantly improve prognostication for ACS patients. Patients with MV-DF values in the highest quartile show a more than five-fold elevated risk of death in the 90 days following a non-ST-elevation ACS. We also propose techniques to construct models of the dynamics of cardiac behavior. Preliminary results suggest that such techniques may be useful for short-term prediction of fatal arrhythmias. Our results suggest that long-term ECG-based risk assessment techniques--n particular, methods incorporating information about morphologic variability--re an effective and practical way to select appropriate treatment options for cardiovascular disease patients.by Philip Pohong Sung.M.Eng

Automated Cardiac Rhythm Diagnosis for Electrophysiological Studies, an Enhanced Classifier Approach

INTRODUCTION Heart function can be impaired by rhythm disturbances (cardiac arrhythmia), illustrated by electrocardiogram (ECG) recordings. Computerised arrhythmia diagnosis is well established for ECG’s but less for intracardiac electrophysiological (EP) testing. Accurate diagnosis is pre-requisite for delivering appropriate treatment to patients however existing algorithms misdiagnose a proportion of arrhythmias. Studies suggested artificial intelligence (AI) classifiers are accurate using ECG and intracardiac electrogram features and reviews suggested new features might augment diagnosis. This study aimed to develop an accurate cardiac rhythm diagnostic algorithm for electrophysiological (EP) studies with potential application as a generic rhythm classifier. METHOD An ethically approved prospective clinical study collected clinical history, right atrial and right ventricular intracardiac electrograms, beat-to-beat cardiac stroke volume, body motion and body temperature data during EP studies. An iterative system development life-cycle was used, including knowledge management and classifier development sub-processes. Domain expert knowledge and clinical arrhythmia diagnosis were modelled, synthesised as AI classifiers and used to classify cardiac rhythms. RESULTS Data collected from 65 patients was pre-processed into instances for classifier inputs. Decision tree, naïve Bayes, neural network, support vector machine and inference engine classifiers developed using Matlab showed good performance and were combined as a production system in a mixture-of-experts multi-classifier system. 18 different rhythms were classified, with the naïve Bayes classifier used to classify 11 rhythms, decision tree 4 rhythms, neural network and support vector machine one each, unclassified instances by the inference engine classifier and final class allocation using decision rule. Production system showed overall correct clasification rate 0.960; error 0.040; mean sensitivity 0.855; mean specificity 0.977; mean κ 0.767; mean positive predictive value 0.792; mean negative predictive value 0.975; mean Pearson’s phi 0.787, with P 0.9 for sinus node dysfunction and atrio-ventricular nodal/ junctional tachycardias. Temperature, accelerometry and QT interval were assessed as features by a comparison of algorithm performances with each feature removed and found not to affect classification performance. An evaluation showed 10 beat analysis performed better than 5 beat analysis. CONCLUSIONS Modelling of the clinical diagnosis process produced an AI based mixture-of-experts multi-classifier system, which accurately diagnosed different 18 cardiac rhythms. The naïve Bayes classifier performed best and classified 11 rhythms. Features for clinical symptoms and predisposing factors, atrial electrogram morphology and changes in stroke volume were found to influence rhythm classification. High performances encourage further development and potential future improvements include: a larger sample dataset; inclusion of His and coronary sinus electrograms; data mining for unknown features with significant influence on diagnosis; binary classification. The aim to classify rhythm using artificial intelligence suitable for use during EP studies was satisfied and the research hypothesis that it outperformed current algorithms was accepted. The system was likely to be able to accept updates but needs conversion as a precursor to use in a live clinical environment

Learning Biosignals with Deep Learning

The healthcare system, which is ubiquitously recognized as one of the most influential system in society, is facing new challenges since the start of the decade.The myriad of physiological data generated by individuals, namely in the healthcare system, is generating a burden on physicians, losing effectiveness on the collection of patient data. Information systems and, in particular, novel deep learning (DL) algorithms have been prompting a way to take this problem. This thesis has the aim to have an impact in biosignal research and industry by presenting DL solutions that could empower this field. For this purpose an extensive study of how to incorporate and implement Convolutional Neural Networks (CNN), Recursive Neural Networks (RNN) and Fully Connected Networks in biosignal studies is discussed. Different architecture configurations were explored for signal processing and decision making and were implemented in three different scenarios: (1) Biosignal learning and synthesis; (2) Electrocardiogram (ECG) biometric systems, and; (3) Electrocardiogram (ECG) anomaly detection systems. In (1) a RNN-based architecture was able to replicate autonomously three types of biosignals with a high degree of confidence. As for (2) three CNN-based architectures, and a RNN-based architecture (same used in (1)) were used for both biometric identification, reaching values above 90% for electrode-base datasets (Fantasia, ECG-ID and MIT-BIH) and 75% for off-person dataset (CYBHi), and biometric authentication, achieving Equal Error Rates (EER) of near 0% for Fantasia and MIT-BIH and bellow 4% for CYBHi. As for (3) the abstraction of healthy clean the ECG signal and detection of its deviation was made and tested in two different scenarios: presence of noise using autoencoder and fully-connected network (reaching 99% accuracy for binary classification and 71% for multi-class), and; arrhythmia events by including a RNN to the previous architecture (57% accuracy and 61% sensitivity). In sum, these systems are shown to be capable of producing novel results. The incorporation of several AI systems into one could provide to be the next generation of preventive medicine, as the machines have access to different physiological and anatomical states, it could produce more informed solutions for the issues that one may face in the future increasing the performance of autonomous preventing systems that could be used in every-day life in remote places where the access to medicine is limited. These systems will also help the study of the signal behaviour and how they are made in real life context as explainable AI could trigger this perception and link the inner states of a network with the biological traits.O sistema de saúde, que é ubiquamente reconhecido como um dos sistemas mais influentes da sociedade, enfrenta novos desafios desde o ínicio da década. A miríade de dados fisiológicos gerados por indíviduos, nomeadamente no sistema de saúde, está a gerar um fardo para os médicos, perdendo a eficiência no conjunto dos dados do paciente. Os sistemas de informação e, mais espcificamente, da inovação de algoritmos de aprendizagem profunda (DL) têm sido usados na procura de uma solução para este problema. Esta tese tem o objetivo de ter um impacto na pesquisa e na indústria de biosinais, apresentando soluções de DL que poderiam melhorar esta área de investigação. Para esse fim, é discutido um extenso estudo de como incorporar e implementar redes neurais convolucionais (CNN), redes neurais recursivas (RNN) e redes totalmente conectadas para o estudo de biosinais. Diferentes arquiteturas foram exploradas para processamento e tomada de decisão de sinais e foram implementadas em três cenários diferentes: (1) Aprendizagem e síntese de biosinais; (2) sistemas biométricos com o uso de eletrocardiograma (ECG), e; (3) Sistema de detecção de anomalias no ECG. Em (1) uma arquitetura baseada na RNN foi capaz de replicar autonomamente três tipos de sinais biológicos com um alto grau de confiança. Quanto a (2) três arquiteturas baseadas em CNN e uma arquitetura baseada em RNN (a mesma usada em (1)) foram usadas para ambas as identificações, atingindo valores acima de 90 % para conjuntos de dados à base de eletrodos (Fantasia, ECG-ID e MIT -BIH) e 75 % para o conjunto de dados fora da pessoa (CYBHi) e autenticação, atingindo taxas de erro iguais (EER) de quase 0 % para Fantasia e MIT-BIH e abaixo de 4 % para CYBHi. Quanto a (3) a abstração de sinais limpos e assimptomáticos de ECG e a detecção do seu desvio foram feitas e testadas em dois cenários diferentes: na presença de ruído usando um autocodificador e uma rede totalmente conectada (atingindo 99 % de precisão na classificação binária e 71 % na multi-classe), e; eventos de arritmia incluindo um RNN na arquitetura anterior (57 % de precisão e 61 % de sensibilidade). Em suma, esses sistemas são mais uma vez demonstrados como capazes de produzir resultados inovadores. A incorporação de vários sistemas de inteligência artificial em um unico sistema pederá desencadear a próxima geração de medicina preventiva. Os algoritmos ao terem acesso a diferentes estados fisiológicos e anatómicos, podem produzir soluções mais informadas para os problemas que se possam enfrentar no futuro, aumentando o desempenho de sistemas autónomos de prevenção que poderiam ser usados na vida quotidiana, nomeadamente em locais remotos onde o acesso à medicinas é limitado. Estes sistemas também ajudarão o estudo do comportamento do sinal e como eles são feitos no contexto da vida real, pois a IA explicável pode desencadear essa percepção e vincular os estados internos de uma rede às características biológicas

Intelligent Biosignal Processing in Wearable and Implantable Sensors

This reprint provides a collection of papers illustrating the state-of-the-art of smart processing of data coming from wearable, implantable or portable sensors. Each paper presents the design, databases used, methodological background, obtained results, and their interpretation for biomedical applications. Revealing examples are brain–machine interfaces for medical rehabilitation, the evaluation of sympathetic nerve activity, a novel automated diagnostic tool based on ECG data to diagnose COVID-19, machine learning-based hypertension risk assessment by means of photoplethysmography and electrocardiography signals, Parkinsonian gait assessment using machine learning tools, thorough analysis of compressive sensing of ECG signals, development of a nanotechnology application for decoding vagus-nerve activity, detection of liver dysfunction using a wearable electronic nose system, prosthetic hand control using surface electromyography, epileptic seizure detection using a CNN, and premature ventricular contraction detection using deep metric learning. Thus, this reprint presents significant clinical applications as well as valuable new research issues, providing current illustrations of this new field of research by addressing the promises, challenges, and hurdles associated with the synergy of biosignal processing and AI through 16 different pertinent studies. Covering a wide range of research and application areas, this book is an excellent resource for researchers, physicians, academics, and PhD or master students working on (bio)signal and image processing, AI, biomaterials, biomechanics, and biotechnology with applications in medicine

Recent Trends in Computational Research on Diseases

Recent advances in information technology have brought forth a paradigm shift in science, especially in the biology and medical fields. Statistical methodologies based on high-performance computing and big data analysis are now indispensable for the qualitative and quantitative understanding of experimental results. In fact, the last few decades have witnessed drastic improvements in high-throughput experiments in health science, for example, mass spectrometry, DNA microarray, next generation sequencing, etc. Those methods have been providing massive data involving four major branches of omics (genomics, transcriptomics, proteomics, and metabolomics). Information about amino acid sequences, protein structures, and molecular structures are fundamental data for the prediction of bioactivity of chemical compounds when screening drugs. On the other hand, cell imaging, clinical imaging, and personal healthcare devices are also providing important data concerning the human body and disease. In parallel, various methods of mathematical modelling such as machine learning have developed rapidly. All of these types of data can be utilized in computational approaches to understand disease mechanisms, diagnosis, prognosis, drug discovery, drug repositioning, disease biomarkers, driver mutations, copy number variations, disease pathways, and much more. In this Special Issue, we have published 8 excellent papers dedicated to a variety of computational problems in the biomedical field from the genomic level to the whole-person physiological level

Next generation sequencing for the molecular analysis of sarcomeric and non-sarcomeric genes in patients with hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is a common genetic heart disorder characterized by unexplained left ventricle hypertrophy associated with non-dilated ventricular chambers. Several genes encoding heart sarcomeric proteins have been associated to HCM, but a small proportion of HCM patients harbor alterations in other non-sarcomeric loci. The variable expression of HCM seems influenced by genetic modifier factors and new sequencing technologies are redefining the understanding of genotype-phenotype relationships, even if the interpretations of the numerous identified variants pose several challenges.We investigated 62 sarcomeric and non-sarcomeric genes in 41 HCM cases and in 3 HCM-related disorders patients. We found that 82% of the patients harbored at least one rare nsSNV: 11% of the patients showed only sarcomere nsSNVs, 20% of cases harbored at least one sarcomeric nsSNV with at least a desmosomal one and 14% displayed at least one desmosomal nsSNV but no other sarcomere change. We reported an association between desmosomal variations and the pathogenesis of HCM that has not been described to date. We employed an integrated approach that combines multiple tools for the prediction, annotation and visualization of functional variants. Several different methods were employed to predict the functional consequences of alleles that result in amino acid substitutions, to study the effect of some variants over the splicing process and to investigate the impact of these changes respect to the evolutionary conservation. Genotype-phenotype correlations were carried out for inspecting the involvement of each gene in age onset and clinical variability of HCM. Statistical analyses revealed an inverse correlation between the number of nsSNVs and age at onset, and a relationship between the clinical variability and number and type of variants. Then, we describe the clinical, pathological, and molecular features of the novel LAMP2 c.453delT mutation in one of our HCM-related disorders patients affected by Danon disease characterized by severe hypertrophic cardiomyopathy, mild intellectual impairment and rapid progression to heart failure, requiring heart transplant. Immunohistochemical analysis of LAMP2 in the explanted heart revealed a mosaic pattern of distribution, with discrete clusters of either stained or unstained cardiac myocytes, the latter being more frequent in the septum. Interestingly, multiple foci of microscarring were found on histology in the Left Ventricle (LV) free wall and septum. Our findings suggest that several features may contribute to the early and severe cardiac phenotype in female patients affected by Danon disease. In conclusion, this work aims to extend the mutational spectrum of HCM and to contribute in defining the molecular pathogenesis and inheritance pattern(s) of this condition. Besides, we delineate a specific procedure for the identification of the most likely pathogenetic variants for a next generation sequencing approach embodied in a clinical contex