RESUMO
Cardiac cine magnetic resonance imaging (MRI) is a widely used technique for the noninvasive assessment of cardiac functions. Deep neural networks have achieved considerable progress in overcoming various challenges in cine MRI analysis. However, deep learning models cannot be used for classification because limited cine MRI data are available. To overcome this problem, features from cine image settings are derived by handcrafting and addition of other clinical features to the classical machine learning approach for ensuring the model fits the MRI device settings and image parameters required in the analysis. In this study, a novel method was proposed for classifying heart disease (cardiomyopathy patient groups) using only segmented output maps. In the encoder-decoder network, the fully convolutional EfficientNetB5-UNet was modified to perform the semantic segmentation of the MRI image slice. A two-dimensional thickness algorithm was used to combine the segmentation outputs for the 2D representation of images of the end-diastole (ED) and end-systole (ES) cardiac volumes. The thickness images were subsequently used for classification by using a few-shot model with an adaptive subspace classifier. Model performance was verified by applying the model to the 2017 MICCAI Medical Image Computing and Computer-Assisted Intervention dataset. High segmentation performance was achieved as follows: the average Dice coefficients of segmentation were 96.24% (ED) and 89.92% (ES) for the left ventricle (LV); the values for the right ventricle (RV) were 92.90% (ED) and 86.92% (ES). The values for myocardium were 88.90% (ED) and 90.48% (ES). An accuracy score of 92% was achieved in the classification of various cardiomyopathy groups without clinical features. A novel rapid analysis approach was proposed for heart disease diagnosis, especially for cardiomyopathy conditions using cine MRI based on segmented output maps.
RESUMO
INTRODUCTION: To date, the total number of COVID-19 deaths is still increasing, including in Central Java, with the third-highest total number of deaths in Indonesia. There are still limited studies related to the cases of COVID-19. Thus, this study's objective was to provide an overview of the characteristics of 4359 COVID-19 death cases in Central Java. METHODS: This research used a cross-sectional descriptive design with univariate, bivariate, and multivariate analysis involving secondary data acquired from a report by the Provincial Health Office of Central Java, recorded up to 13 December 2020. RESULTS: The results showed that the highest frequencies of death cases were contributed from ≥60 years group (n=1897 patients; 43.52%) and the male (n=2497 patients; 57.28%) group. The case fatality rate (CFR) rose with age, and the highest CFR was recorded in the elderly (17.95%), males (7.60%), in Pati District (17.45%), while entrepreneur (14.64%) was the highest reported job. Furthermore, the eldest group (≥60 years) and males were more susceptible to die, with ORs 5.49 (95%CI: 5.15-5.86) and 1.61 (95%CI: 1.51-1.71), sequentially. The majority of death cases had comorbidities (65.79%), while the most prevalent reported comorbidities were diabetes (n=1387, 31.82%) and hypertension (n=817, 18.74%). Meanwhile, patients of old age were more likely to associate comorbidity, p<0.001, OR 1.664 (95%CI: 1.425-1.944). CONCLUSIONS: This study concludes that patients of older age and males may become more vulnerable than younger and females to experience death. Further study is required to measure the relationship between other characteristics of demographics, underlying medical conditions, and fatality.