The COVIDTW study: Clinical predictors of COVID-19 mortality and a novel AI prognostic model using chest X-ray.

BACKGROUND: There is a lack of published research on the impact of the first wave of the COVID-19 pandemic in Taiwan. We investigated the mortality risk factors among critically ill patients with COVID-19 in Taiwan during the initial wave. Furthermore, we aim to develop a novel AI mortality prediction model using chest X-ray (CXR) alone. METHOD: We retrospectively reviewed the medical records of patients with COVID-19 at Taipei Tzu Chi Hospital from May 15 to July 15 2021. We enrolled adult patients who received invasive mechanical ventilation. The CXR images of each enrolled patient were divided into 4 categories (1st, pre-ETT, ETT, and WORST). To establish a prediction model, we used the MobilenetV3-Small model with "Imagenet" pretrained weights, followed by high Dropout regularization layers. We trained the model with these data with Five-Fold Cross-Validation to evaluate model performance. RESULT: A total of 64 patients were enrolled. The overall mortality rate was 45%. The median time from symptom onset to intubation was 8 days. Vasopressor use and a higher BRIXIA score on the WORST CXR were associated with an increased risk of mortality. The areas under the curve of the 1st, pre-ETT, ETT, and WORST CXRs by the AI model were 0.87, 0.92, 0.96, and 0.93 respectively. CONCLUSION: The mortality rate of COVID-19 patients who receive invasive mechanical ventilation was high. Septic shock and high BRIXIA score were clinical predictors of mortality. The novel AI mortality prediction model using CXR alone exhibited a high performance.

Electrocardiogram Heartbeat Classification for Arrhythmias and Myocardial Infarction.

An electrocardiogram (ECG) is a basic and quick test for evaluating cardiac disorders and is crucial for remote patient monitoring equipment. An accurate ECG signal classification is critical for real-time measurement, analysis, archiving, and transmission of clinical data. Numerous studies have focused on accurate heartbeat classification, and deep neural networks have been suggested for better accuracy and simplicity. We investigated a new model for ECG heartbeat classification and found that it surpasses state-of-the-art models, achieving remarkable accuracy scores of 98.5% on the Physionet MIT-BIH dataset and 98.28% on the PTB database. Furthermore, our model achieves an impressive F1-score of approximately 86.71%, outperforming other models, such as MINA, CRNN, and EXpertRF on the PhysioNet Challenge 2017 dataset.

Anti-Aliasing Attention U-net Model for Skin Lesion Segmentation.

The need for a lightweight and reliable segmentation algorithm is critical in various biomedical image-prediction applications. However, the limited quantity of data presents a significant challenge for image segmentation. Additionally, low image quality negatively impacts the efficiency of segmentation, and previous deep learning models for image segmentation require large parameters with hundreds of millions of computations, resulting in high costs and processing times. In this study, we introduce a new lightweight segmentation model, the mobile anti-aliasing attention u-net model (MAAU), which features both encoder and decoder paths. The encoder incorporates an anti-aliasing layer and convolutional blocks to reduce the spatial resolution of input images while avoiding shift equivariance. The decoder uses an attention block and decoder module to capture prominent features in each channel. To address data-related problems, we implemented data augmentation methods such as flip, rotation, shear, translate, and color distortions, which enhanced segmentation efficiency in the international Skin Image Collaboration (ISIC) 2018 and PH2 datasets. Our experimental results demonstrated that our approach had fewer parameters, only 4.2 million, while it outperformed various state-of-the-art segmentation methods.