Improving Access and Mental Health for Youth Through Virtual Models of Care

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through mobile devices. This longitudinal study uses participatory action research with mixed methods. The majority of participants identified themselves as Caucasian (66.9%). Expectedly, the demographics revealed that Anxiety Disorders and Mood Disorders were highly prevalent within the sample (71.9% and 67.5% respectively). Findings from the qualitative summary established that both staff and youth found the software and platform beneficial

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

ECG analysis and classification using CSVM, MSVM and SIMCA classifiers

Reliable ECG classification can potentially lead to better detection methods and increase accurate diagnosis of arrhythmia, thus improving quality of care. This thesis investigated the use of two novel classification algorithms: CSVM and SIMCA, and assessed their performance in classifying ECG beats. The project aimed to introduce a new way to interactively support patient care in and out of the hospital and develop new classification algorithms for arrhythmia detection and diagnosis. Wave (P-QRS-T) detection was performed using the WFDB Software Package and multiresolution wavelets. Fourier and PCs were selected as time-frequency features in the ECG signal; these provided the input to the classifiers in the form of DFT and PCA coefficients. ECG beat classification was performed using binary SVM. MSVM, CSVM, and SIMCA; these were subsequently used for simultaneously classifying either four or six types of cardiac conditions. Binary SVM classification with 100% accuracy was achieved when applied on feature-reduced ECG signals from well-established databases using PCA. The CSVM algorithm and MSVM were used to classify four ECG beat types: NORMAL, PVC, APC, and FUSION or PFUS; these were from the MIT-BIH arrhythmia database (precordial lead group and limb lead II). Different numbers of Fourier coefficients were considered in order to identify the optimal number of features to be presented to the classifier. SMO was used to compute hyper-plane parameters and threshold values for both MSVM and CSVM during the classifier training phase. The best classification accuracy was achieved using fifty Fourier coefficients. With the new CSVM classifier framework, accuracies of 99%, 100%, 98%, and 99% were obtained using datasets from one, two, three, and four precordial leads, respectively. In addition, using CSVM it was possible to successfully classify four types of ECG beat signals extracted from limb lead simultaneously with 97% accuracy, a significant improvement on the 83% accuracy achieved using the MSVM classification model. In addition, further analysis of the following four beat types was made: NORMAL, PVC, SVPB, and FUSION. These signals were obtained from the European ST-T Database. Accuracies between 86% and 94% were obtained for MSVM and CSVM classification, respectively, using 100 Fourier coefficients for reconstructing individual ECG beats. Further analysis presented an effective ECG arrhythmia classification scheme consisting of PCA as a feature reduction method and a SIMCA classifier to differentiate between either four or six different types of arrhythmia. In separate studies, six and four types of beats (including NORMAL, PVC, APC, RBBB, LBBB, and FUSION beats) with time domain features were extracted from the MIT-BIH arrhythmia database and the St Petersburg INCART 12-lead Arrhythmia Database (incartdb) respectively. Between 10 and 30 PCs, coefficients were selected for reconstructing individual ECG beats in the feature selection phase. The average classification accuracy of the proposed scheme was 98.61% and 97.78 % using the limb lead and precordial lead datasets, respectively. In addition, using MSVM and SIMCA classifiers with four ECG beat types achieved an average classification accuracy of 76.83% and 98.33% respectively. The effectiveness of the proposed algorithms was finally confirmed by successfully classifying both the six beat and four beat types of signal respectively with a high accuracy ratio

Multichannel Analysis of Intracardiac Electrograms - Supporting Diagnosis and Treatment of Cardiac Arrhythmias

Cardiologists diagnose and treat atrial tachycardias using electroanatomical mapping systems. These can be combined with multipolar catheters to record intracardiac electrograms. Within this thesis, various signal processing techniques were implemented and benchmarked to analyze electrograms. They support the physician in diagnosis and treatment of atrial flutter and atrial fibrillation. The developed methods were assessed using simulated data and demonstrated on clinical cases

Digital signal processing and artificial intelligence for the automated classification of food allergy

As a by-product of the ‘information revolution’ which is currently unfolding, lifetimes of man (and indeed computer) hours are being allocated for the automated and intelligent interpretation of data. This is particularly true in medical and clinical settings, where research into machine-assisted diagnosis of physiological conditions gains momentum daily. Of the conditions which have been addressed, however, automated classification of allergy has not been investigated, even though the numbers of allergic persons are rising, and undiagnosed allergies are most likely to elicit fatal consequences. On the basis of the observations of allergists who conduct oral food challenges (OFCs), activity-based analyses of allergy tests were performed. Algorithms were investigated and validated by a pilot study which verified that accelerometer-based inquiry of human movements is particularly well-suited for objective appraisal of activity. However, when these analyses were applied to OFCs, accelerometer-based investigations were found to provide very poor separation between allergic and non-allergic persons, and it was concluded that the avenues explored in this thesis are inadequate for the classification of allergy. Heart rate variability (HRV) analysis is known to provide very significant diagnostic information for many conditions. Owing to this, electrocardiograms (ECGs) were recorded during OFCs for the purpose of assessing the effect that allergy induces on HRV features. It was found that with appropriate analysis, excellent separation between allergic and nonallergic subjects can be obtained. These results were, however, obtained with manual QRS annotations, and these are not a viable methodology for real-time diagnostic applications. Even so, this was the first work which has categorically correlated changes in HRV features to the onset of allergic events, and manual annotations yield undeniable affirmation of this. Fostered by the successful results which were obtained with manual classifications, automatic QRS detection algorithms were investigated to facilitate the fully automated classification of allergy. The results which were obtained by this process are very promising. Most importantly, the work that is presented in this thesis did not obtain any false positive classifications. This is a most desirable result for OFC classification, as it allows complete confidence to be attributed to classifications of allergy. Furthermore, these results could be particularly advantageous in clinical settings, as machine-based classification can detect the onset of allergy which can allow for early termination of OFCs. Consequently, machine-based monitoring of OFCs has in this work been shown to possess the capacity to significantly and safely advance the current state of clinical art of allergy diagnosi

Strategies for neural networks in ballistocardiography with a view towards hardware implementation

A thesis submitted for the degree of Doctor of Philosophy at the University of LutonThe work described in this thesis is based on the results of a clinical trial conducted by the research team at the Medical Informatics Unit of the University of Cambridge, which show that the Ballistocardiogram (BCG) has prognostic value in detecting impaired left ventricular function before it becomes clinically overt as myocardial infarction leading to sudden death. The objective of this study is to develop and demonstrate a framework for realising an on-line BCG signal classification model in a portable device that would have the potential to find pathological signs as early as possible for home health care. Two new on-line automatic BeG classification models for time domain BeG classification are proposed. Both systems are based on a two stage process: input feature extraction followed by a neural classifier. One system uses a principal component analysis neural network, and the other a discrete wavelet transform, to reduce the input dimensionality. Results of the classification, dimensionality reduction, and comparison are presented. It is indicated that the combined wavelet transform and MLP system has a more reliable performance than the combined neural networks system, in situations where the data available to determine the network parameters is limited. Moreover, the wavelet transfonn requires no prior knowledge of the statistical distribution of data samples and the computation complexity and training time are reduced. Overall, a methodology for realising an automatic BeG classification system for a portable instrument is presented. A fully paralJel neural network design for a low cost platform using field programmable gate arrays (Xilinx's XC4000 series) is explored. This addresses the potential speed requirements in the biomedical signal processing field. It also demonstrates a flexible hardware design approach so that an instrument's parameters can be updated as data expands with time. To reduce the hardware design complexity and to increase the system performance, a hybrid learning algorithm using random optimisation and the backpropagation rule is developed to achieve an efficient weight update mechanism in low weight precision learning. The simulation results show that the hybrid learning algorithm is effective in solving the network paralysis problem and the convergence is much faster than by the standard backpropagation rule. The hidden and output layer nodes have been mapped on Xilinx FPGAs with automatic placement and routing tools. The static time analysis results suggests that the proposed network implementation could generate 2.7 billion connections per second performance

Novel Low Complexity Biomedical Signal Processing Techniques for Online Applications

Biomedical signal processing has become a very active domain of research nowadays. With the advent of portable monitoring devices, from accelerometer-enabled bracelets and smart-phones to more advanced vital sign tracking body area networks, this field has been receiving unprecedented attention. Indeed, portable health monitoring can help uncover the underlying dynamics of human health in a way that has not been possible before. Several challenges have emerged however, as these devices present key differences in terms of signal acquisition and processing in comparison with conventional methods. Hardware constraints such as processing power and limited battery capacity make most established techniques unsuitable and therefore, the need for low-complexity yet robust signal processing methods has appeared. Another issue that needs to be addressed is the quality of the signals captured by these devices. Unlike in clinical scenarios, in portable health monitoring subjects are constantly performing their daily activities. Moreover, signals maybe captured from unconventional locations and subsequently, be prone to perturbations. In order to obtain reliable measures from these monitoring devices, one needs to acquire dependable signal quality measures, to avoid false alarms. Indeed, hardware limitations and low-quality signals can greatly influence the performance of portable monitoring devices. Nevertheless, most devices offer simultaneous acquisition of multiple physiological parameters, such as electrocardiogram (ECG) and photoplethysmogram (PPG). Through multi-modal signal processing the overall performance can be improved, for instance by deriving parameters such as heart rate estimation from the most reliable and uncontaminated source. This thesis is therefore, dedicated to propose novel low-complexity biomedical processing techniques for real-time/online applications. Throughout this dissertation, several bio-signals such as the ECG, PPG, and electroencephalogram (EEG) are investigated. %There is an emphasis on ECG processing techniques, as most of the bio-signals recorded today reflect information about the heart. The main contribution of this dissertation consists in two signal processing techniques: 1) a novel ECG QRS-complex detection and delineation technique, and 2) a short-term event extraction technique for biomedical signals. The former is based on a processing technique called mathematical morphology (MM), and adaptively uses subject QRS-complex amplitude- and morphological attributes for a robust detection and delineation. This method is generalized to intra-cardiac electrograms for atrial activation detection during atrial fibrillation. The second method, called the Relative-Energy algorithm, uses short- and long-term signal energies to highlight events of interest and discard unwanted activities. Collectively, the results obtained by these methods suggest that while presenting low-computational costs, they can efficiently and robustly extract biomedical events of interest. Using the relative energy algorithm, a continuous non-binary ECG signal quality index is presented. The ECG quality is determined by creating a cleaned-up version of the input ECG and calculating the correlation coefficient between the cleaned-up and the original ECG. The proposed quality index is fast and can be implemented online, making it suitable for portable monitoring scenarios

Temporal pattern recognition in multiparameter ICU data

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2007.Includes bibliographical references (leaves 210-219).Intensive Care Unit (ICU) patients are physiologically fragile and require vigilant monitoring and support. The myriad of data gathered from biosensors and clinical information systems has created a challenge for clinicians to assimilate and interpret such large volumes of data. Physiologic measurements in the ICU are inherently noisy, multidimensional, and can readily fluctuate in response to therapeutic interventions as well as evolving pathophysiologic states. ICU patient monitoring systems may potentially improve the efficiency, accuracy and timeliness of clinical decision-making in intensive care. However, the aforementioned characteristics of ICU data can pose a significant signal processing and pattern recognition challenge---often leading to false and clinically irrelevant alarms. We have developed a temporal database of several thousand ICU patient records to facilitate research in advanced monitoring systems. The MIMIC-II database includes high-resolution physiologic waveforms such as ECG, blood pressures waveforms, vital sign trends, laboratory data, fluid balance, therapy profiles, and clinical progress notes over each patient's ICU stay. We quantitatively and qualitatively characterize the MIMIC-II database and include examples of clinical studies that can be supported by its unique attributes. We also introduce a novel algorithm for identifying "similar" temporal patterns that may illuminate hidden information in physiologic time series. The discovery of multi-parameter temporal patterns that are predictive of physiologic instability may aid clinicians in optimizing care. In this thesis, we introduce a novel temporal similarity metric based on a transformation of time series data into an intuitive symbolic representation.(cont.) The symbolic transform is based on a wavelet decomposition to characterize time series dynamics at multiple time scales. The symbolic transformation allows us to utilize classical information retrieval algorithms based on a vector-space model. Our algorithm is capable of assessing the similarity between multi-dimensional time series and is computationally efficient. We utilized our algorithm to identify similar physiologic patterns in hemodynamic time series from ICU patients. The results of this thesis demonstrate that statistical similarities between different patient time series may have meaningful physiologic interpretations in the detection of impending hemodynamic deterioration. Thus, our framework may be of potential use in clinical decision-support systems. As a generalized time series similarity metric, the algorithms that are described have applications in several other domains as well.by Mohammed Saeed.Ph.D

Sensor Signal and Information Processing II

In the current age of information explosion, newly invented technological sensors and software are now tightly integrated with our everyday lives. Many sensor processing algorithms have incorporated some forms of computational intelligence as part of their core framework in problem solving. These algorithms have the capacity to generalize and discover knowledge for themselves and learn new information whenever unseen data are captured. The primary aim of sensor processing is to develop techniques to interpret, understand, and act on information contained in the data. The interest of this book is in developing intelligent signal processing in order to pave the way for smart sensors. This involves mathematical advancement of nonlinear signal processing theory and its applications that extend far beyond traditional techniques. It bridges the boundary between theory and application, developing novel theoretically inspired methodologies targeting both longstanding and emergent signal processing applications. The topic ranges from phishing detection to integration of terrestrial laser scanning, and from fault diagnosis to bio-inspiring filtering. The book will appeal to established practitioners, along with researchers and students in the emerging field of smart sensors processing