Expiratory and inspiratory cries detection using different signals' decomposition techniques

This paper addresses the problem of automatic cry signal segmentation for the purposes of infant cry analysis. The main goal is to automatically detect expiratory and inspiratory phases from recorded cry signals. The approach used in this paper is made up of three stages: signal decomposition, features extraction, and classification. In the first stage, short-time Fourier transform, empirical mode decomposition (EMD), and wavelet packet transform have been considered. In the second stage, various set of features have been extracted, and in the third stage, two supervised learning methods, Gaussian mixture models and hidden Markov models, with four and five states, have been discussed as well. The main goal of this work is to investigate the EMD performance and to compare it with the other standard decomposition techniques. A combination of two and three intrinsic mode functions (IMFs) that resulted from EMD has been used to represent cry signal. The performance of nine different segmentation systems has been evaluated. The experiments for each system have been repeated several times with different training and testing datasets, randomly chosen using a 10-fold cross-validation procedure. The lowest global classification error rates of around 8.9% and 11.06% have been achieved using a Gaussian mixture models classifier and a hidden Markov models classifier, respectively. Among all IMF combinations, the winner combination is IMF3+IMF4+IMF5

Domain adaptation for EEG-based, cross-subject epileptic seizure prediction

The ability to predict the occurrence of an epileptic seizure is a safeguard against patient injury and health complications. However, a major challenge in seizure prediction arises from the significant variability observed in patient data. Common patient-specific approaches, which apply to each patient independently, often perform poorly for other patients due to the data variability. The aim of this study is to propose deep learning models which can handle this variability and generalize across various patients. This study addresses this challenge by introducing a novel cross-subject and multi-subject prediction models. Multiple-subject modeling broadens the scope of patient-specific modeling to account for the data from a dedicated ensemble of patients, thereby providing some useful, though relatively modest, level of generalization. The basic neural network architecture of this model is then adapted to cross-subject prediction, thereby providing a broader, more realistic, context of application. For accrued performance, and generalization ability, cross-subject modeling is enhanced by domain adaptation. Experimental evaluation using the publicly available CHB-MIT and SIENA data datasets shows that our multiple-subject model achieved better performance compared to existing works. However, the cross-subject faces challenges when applied to different patients. Finally, through investigating three domain adaptation methods, the model accuracy has been notably improved by 10.30% and 7.4% for the CHB-MIT and SIENA datasets, respectively

EEG oscillatory power and complexity for epileptic seizure detection

Monitoring patients at risk of epileptic seizure is critical for optimal treatment and ensuing the reduction of seizure risk and complications. In general, seizure detection is done manually in hospitals and involves time-consuming visual inspection and interpretation by experts of electroencephalography (EEG) recordings. The purpose of this study is to investigate the pertinence of band-limited spectral power and signal complexity in order to discriminate between seizure and seizure-free EEG brain activity. The signal complexity and spectral power are evaluated in five frequency intervals, namely, the delta, theta, alpha, beta, and gamma bands, to be used as EEG signal feature representation. Classification of seizure and seizure-free data was performed by prevalent potent classifiers. Substantial comparative performance evaluation experiments were performed on a large EEG data record of 341 patients in the Temple University Hospital EEG seizure database. Based on statistically validated criteria, results show the efficiency of band-limited spectral power and signal complexity when using random forest and gradient-boosting decision tree classifiers (95% of the area under the curve (AUC) and 91% for both F-measure and accuracy). These results support the use of these automatic classification schemes to assist the practicing neurologist interpret EEG records more accurately and without tedious visual inspection

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Body Image Dissatisfaction and Psychological Distress among Adults with Excessive Body Weight

info:eu-repo/semantics/publishe