Artificial Intelligence ECG Analysis in Patients with Short QT Syndrome to Predict Life-Threatening Arrhythmic Events.

Short QT syndrome (SQTS) is an inherited cardiac ion-channel disease related to an increased risk of sudden cardiac death (SCD) in young and otherwise healthy individuals. SCD is often the first clinical presentation in patients with SQTS. However, arrhythmia risk stratification is presently unsatisfactory in asymptomatic patients. In this context, artificial intelligence-based electrocardiogram (ECG) analysis has never been applied to refine risk stratification in patients with SQTS. The purpose of this study was to analyze ECGs from SQTS patients with the aid of different AI algorithms to evaluate their ability to discriminate between subjects with and without documented life-threatening arrhythmic events. The study group included 104 SQTS patients, 37 of whom had a documented major arrhythmic event at presentation and/or during follow-up. Thirteen ECG features were measured independently by three expert cardiologists; then, the dataset was randomly divided into three subsets (training, validation, and testing). Five shallow neural networks were trained, validated, and tested to predict subject-specific class (non-event/event) using different subsets of ECG features. Additionally, several deep learning and machine learning algorithms, such as Vision Transformer, Swin Transformer, MobileNetV3, EfficientNetV2, ConvNextTiny, Capsule Networks, and logistic regression were trained, validated, and tested directly on the scanned ECG images, without any manual feature extraction. Furthermore, a shallow neural network, a 1-D transformer classifier, and a 1-D CNN were trained, validated, and tested on ECG signals extracted from the aforementioned scanned images. Classification metrics were evaluated by means of sensitivity, specificity, positive and negative predictive values, accuracy, and area under the curve. Results prove that artificial intelligence can help clinicians in better stratifying risk of arrhythmia in patients with SQTS. In particular, shallow neural networks' processing features showed the best performance in identifying patients that will not suffer from a potentially lethal event. This could pave the way for refined ECG-based risk stratification in this group of patients, potentially helping in saving the lives of young and otherwise healthy individuals.

Transformer-Based Approach to Melanoma Detection.

Melanoma is a malignant cancer type which develops when DNA damage occurs (mainly due to environmental factors such as ultraviolet rays). Often, melanoma results in intense and aggressive cell growth that, if not caught in time, can bring one toward death. Thus, early identification at the initial stage is fundamental to stopping the spread of cancer. In this paper, a ViT-based architecture able to classify melanoma versus non-cancerous lesions is presented. The proposed predictive model is trained and tested on public skin cancer data from the ISIC challenge, and the obtained results are highly promising. Different classifier configurations are considered and analyzed in order to find the most discriminating one. The best one reached an accuracy of 0.948, sensitivity of 0.928, specificity of 0.967, and AUROC of 0.948.

Development and Validation of an Algorithm for the Digitization of ECG Paper Images.

The electrocardiogram (ECG) signal describes the heart's electrical activity, allowing it to detect several health conditions, including cardiac system abnormalities and dysfunctions. Nowadays, most patient medical records are still paper-based, especially those made in past decades. The importance of collecting digitized ECGs is twofold: firstly, all medical applications can be easily implemented with an engineering approach if the ECGs are treated as signals; secondly, paper ECGs can deteriorate over time, therefore a correct evaluation of the patient's clinical evolution is not always guaranteed. The goal of this paper is the realization of an automatic conversion algorithm from paper-based ECGs (images) to digital ECG signals. The algorithm involves a digitization process tested on an image set of 16 subjects, also with pathologies. The quantitative analysis of the digitization method is carried out by evaluating the repeatability and reproducibility of the algorithm. The digitization accuracy is evaluated both on the entire signal and on six ECG time parameters (R-R peak distance, QRS complex duration, QT interval, PQ interval, P-wave duration, and heart rate). Results demonstrate the algorithm efficiency has an average Pearson correlation coefficient of 0.94 and measurement errors of the ECG time parameters are always less than 1 mm. Due to the promising experimental results, the algorithm could be embedded into a graphical interface, becoming a measurement and collection tool for cardiologists.

Anytime ECG Monitoring through the Use of a Low-Cost, User-Friendly, Wearable Device.

Every year cardiovascular diseases kill the highest number of people worldwide. Among these, pathologies characterized by sporadic symptoms, such as atrial fibrillation, are difficult to be detected as state-of-the-art solutions, e.g., 12-leads electrocardiogram (ECG) or Holter devices, often fail to tackle these kinds of pathologies. Many portable devices have already been proposed, both in literature and in the market. Unfortunately, they all miss relevant features: they are either not wearable or wireless and their usage over a long-term period is often unsuitable. In addition, the quality of recordings is another key factor to perform reliable diagnosis. The ECG WATCH is a device designed for targeting all these issues. It is inexpensive, wearable (size of a watch), and can be used without the need for any medical expertise about positioning or usage. It is non-invasive, it records single-lead ECG in just 10 s, anytime, anywhere, without the need to physically travel to hospitals or cardiologists. It can acquire any of the three peripheral leads; results can be shared with physicians by simply tapping a smartphone app. The ECG WATCH quality has been tested on 30 people and has successfully compared with an electrocardiograph and an ECG simulator, both certified. The app embeds an algorithm for automatically detecting atrial fibrillation, which has been successfully tested with an official ECG simulator on different severity of atrial fibrillation. In this sense, the ECG WATCH is a promising device for anytime cardiac health monitoring.

Innovative Mini Ultralight Radioprobes to Track Lagrangian Turbulence Fluctuations within Warm Clouds: Electronic Design.

Characterization of dynamics inside clouds remains a challenging task for weather forecasting and climate modeling as cloud properties depend on interdependent natural processes at micro- and macro-scales. Turbulence plays an important role in particle dynamics inside clouds; however, turbulence mechanisms are not yet fully understood partly due to the difficulty of measuring clouds at the smallest scales. To address these knowledge gaps, an experimental method for measuring the influence of small-scale turbulence in cloud formation in situ and producing an in-field cloud Lagrangian dataset is being developed by means of innovative ultralight radioprobes. This paper presents the electronic system design along with the obtained results from laboratory and field experiments regarding these compact (diameter ≈30 cm), lightweight (≈20 g), and expendable devices designed to passively float and track small-scale turbulence fluctuations inside warm clouds. The fully customized mini-radioprobe board (5 cm × 5 cm) embeds sensors to measure local fluctuations and transmit data to the ground in near real time. The tests confirm that the newly developed probes perform well, providing accurate information about atmospheric turbulence as referenced in space. The integration of multiple radioprobes allows for a systematic and accurate monitoring of atmospheric turbulence and its impact on cloud formation.

A Comparison of Deep Learning Techniques for Arterial Blood Pressure Prediction.

Continuous vital signal monitoring is becoming more relevant in preventing diseases that afflict a large part of the world's population; for this reason, healthcare equipment should be easy to wear and simple to use. Non-intrusive and non-invasive detection methods are a basic requirement for wearable medical devices, especially when these are used in sports applications or by the elderly for self-monitoring. Arterial blood pressure (ABP) is an essential physiological parameter for health monitoring. Most blood pressure measurement devices determine the systolic and diastolic arterial blood pressure through the inflation and the deflation of a cuff. This technique is uncomfortable for the user and may result in anxiety, and consequently affect the blood pressure and its measurement. The purpose of this paper is the continuous measurement of the ABP through a cuffless, non-intrusive approach. The approach of this paper is based on deep learning techniques where several neural networks are used to infer ABP, starting from photoplethysmogram (PPG) and electrocardiogram (ECG) signals. The ABP was predicted first by utilizing only PPG and then by using both PPG and ECG. Convolutional neural networks (ResNet and WaveNet) and recurrent neural networks (LSTM) were compared and analyzed for the regression task. Results show that the use of the ECG has resulted in improved performance for every proposed configuration. The best performing configuration was obtained with a ResNet followed by three LSTM layers: this led to a mean absolute error (MAE) of 4.118 mmHg on and 2.228 mmHg on systolic and diastolic blood pressures, respectively. The results comply with the American National Standards of the Association for the Advancement of Medical Instrumentation. ECG, PPG, and ABP measurements were extracted from the MIMIC database, which contains clinical signal data reflecting real measurements. The results were validated on a custom dataset created at Neuronica Lab, Politecnico di Torino.

External validation of a deep-learning model to predict severe acute kidney injury based on urine output changes in critically ill patients.

OBJECTIVES: The purpose of this study was to externally validate algorithms (previously developed and trained in two United States populations) aimed at early detection of severe oliguric AKI (stage 2/3 KDIGO) in intensive care units patients. METHODS: The independent cohort was composed of 10'596 patients from the university hospital ICU of Amsterdam (the "AmsterdamUMC database") admitted to their intensive care units. In this cohort, we analysed the accuracy of algorithms based on logistic regression and deep learning methods. The accuracy of investigated algorithms had previously been tested with electronic intensive care unit (eICU) and MIMIC-III patients. RESULTS: The deep learning model had an area under the ROC curve (AUC) of 0,907 (± 0,007SE) with a sensitivity and specificity of 80% and 89%, respectively, for identifying oliguric AKI episodes. Logistic regression models had an AUC of 0,877 (± 0,005SE) with a sensitivity and specificity of 80% and 81%, respectively. These results were comparable to those obtained in the two US populations upon which the algorithms were previously developed and trained. CONCLUSION: External validation on the European sample confirmed the accuracy of the algorithms, previously investigated in the US population. The models show high accuracy in both the European and the American databases even though the two cohorts differ in a range of demographic and clinical characteristics, further underlining the validity and the generalizability of the two analytical approaches.

Multi-step rainfall forecasting using deep learning approach.

Rainfall prediction is immensely crucial in daily life routine as well as for water resource management, stochastic hydrology, rain run-off modeling and flood risk mitigation. Quantitative prediction of rainfall time series is extremely challenging as compared to other meteorological parameters due to its variability in local features that involves temporal and spatial scales. Consequently, this requires a highly complex system having an advance model to accurately capture the highly non linear processes occurring in the climate. The focus of this work is direct prediction of multistep forecasting, where a separate time series model for each forecasting horizon is considered and forecasts are computed using observed data samples. Forecasting in this method is performed by proposing a deep learning approach, i.e, Temporal Deep Belief Network (DBN). The best model is selected from several baseline models on the basis of performance analysis metrics. The results suggest that the temporal DBN model outperforms the conventional Convolutional Neural Network (CNN) specifically on rainfall time series forecasting. According to our experimentation, a modified DBN with hidden layes (300-200-100-10) performs best with 4.59E-05, 0.0068 and 0.94 values of MSE, RMSE and R value respectively on testing samples. However, we found that training DBN is more exhaustive and computationally intensive than other deep learning architectures. Findings of this research can be further utilized as basis for the advance forecasting of other weather parameters with same climate conditions.

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 frequent complication of pateints in the Intensive Care Unit (ICU), is associated with a high mortality rate. Early prediction of AKI is essential in order to trigger the use of preventive care actions. 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 defined an 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 12 h 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 12 h in advance, and with a higher accuracy than the classical urine output thresholds. We suggest that this algorithm could be integrated in the ICU setting to better manage, and potentially prevent, AKI episodes.

The GH-EXIN neural network for hierarchical clustering.

Hierarchical clustering is an important tool for extracting information from data in a multi-resolution way. It is more meaningful if driven by data, as in the case of divisive algorithms, which split data until no more division is allowed. However, they have the drawback of the splitting threshold setting. The neural networks can address this problem, because they basically depend on data. The growing hierarchical GH-EXIN neural network builds a hierarchical tree in an incremental (data-driven architecture) and self-organized way. It is a top-down technique which defines the horizontal growth by means of an anisotropic region of influence, based on the novel idea of neighborhood convex hull. It also reallocates data and detects outliers by using a novel approach on all the leaves, simultaneously. Its complexity is estimated and an analysis of its user-dependent parameters is given. The advantages of the proposed approach, with regard to the best existing networks, are shown and analyzed, qualitatively and quantitatively, both in benchmark synthetic problems and in a real application (image recognition from video), in order to test the performance in building hierarchical trees. Furthermore, an important and very promising application of GH-EXIN in two-way hierarchical clustering, for the analysis of gene expression data in the study of the colorectal cancer is described.

The Growing Curvilinear Component Analysis (GCCA) neural network.

Big high dimensional data is becoming a challenging field of research. There exist a lot of techniques which infer information. However, because of the curse of dimensionality, a necessary step is the dimensionality reduction (DR) of the information. DR can be performed by linear and nonlinear algorithms. In general, linear algorithms are faster because of less computational burden. A related problem is dealing with time-varying high dimensional data, where the time dependence is due to nonstationary data distribution. Data stream algorithms are not able to project in lower dimensional spaces. Indeed, only linear projections, like principal component analysis (PCA), are used in real time while nonlinear techniques need the whole database (offline). The Growing Curvilinear Component Analysis (GCCA) neural network addresses this problem; it has a self-organized incremental architecture adapting to the changing data distribution and performs simultaneously the data quantization and projection by using CCA, a nonlinear distance-preserving reduction technique. This is achieved by introducing the idea of "seed", pair of neurons which colonize the input domain, and "bridge", a novel kind of edge in the manifold graph, which signals the data non-stationarity. Some artificial examples and a real application are given, with a comparison with other existing techniques.

A new dynamic tactile display for reconfigurable braille: implementation and tests.

Different tactile interfaces have been proposed to represent either text (braille) or, in a few cases, tactile large-area screens as replacements for visual displays. None of the implementations so far can be customized to match users' preferences, perceptual differences and skills. Optimal choices in these respects are still debated; we approach a solution by designing a flexible device allowing the user to choose key parameters of tactile transduction. We present here a new dynamic tactile display, a 8 × 8 matrix of plastic pins based on well-established and reliable piezoelectric technology to offer high resolution (pin gap 0.7mm) as well as tunable strength of the pins displacement, and refresh rate up to 50s(-1). It can reproduce arbitrary patterns, allowing it to serve the dual purpose of providing, depending on contingent user needs, tactile rendering of non-character information, and reconfigurable braille rendering. Given the relevance of the latter functionality for the expected average user, we considered testing braille encoding by volunteers a benchmark of primary importance. Tests were performed to assess the acceptance and usability with minimal training, and to check whether the offered flexibility was indeed perceived by the subject as an added value compared to conventional braille devices. Different mappings between braille dots and actual tactile pins were implemented to match user needs. Performances of eight experienced braille readers were defined as the fraction of correct identifications of rendered content. Different information contents were tested (median performance on random strings, words, sentences identification was about 75%, 85%, 98%, respectively, with a significant increase, p < 0.01), obtaining statistically significant improvements in performance during the tests (p < 0.05). Experimental results, together with qualitative ratings provided by the subjects, show a good acceptance and the effectiveness of the proposed solution.