Model-based estimation of QT intervals of mouse fetal electrocardiogram.

BACKGROUND: Abnormal prolongation in the QT interval or long QT syndrome (LQTS) is associated with several cardiac complications such as sudden infant death syndrome (SIDS). LQTS is believed to be linked to genetic mutations which can be understood by using animal models, such as mice models. Nevertheless, the research related to fetal QT interval in mice is still limited because of challenges associated with T wave measurements in fetal electrocardiogram (fECG). Reliable measurement of T waves is essential for estimating their end timings for QT interval assessment. RESULTS: A mathematical model was used to estimate QT intervals. Estimated QT intervals were validated with Q-aortic closure (Q-Ac) intervals of Doppler ultrasound (DUS) and comparison between both showed good agreement with a correlation coefficient higher than 0.88 (r > 0.88, P < 0.05). CONCLUSION: Model-based estimation of QT intervals can help in better understanding of QT intervals in fetal mice.

Noninvasive Fetal Electrocardiography in the Diagnosis of Long QT Syndrome: A Case Series.

INTRODUCTION: Early detection and monitoring for malignant arrhythmias is fundamental to prenatal care in long QT syndrome (LQTS). Recently, we studied the feasibility of isolating the fetal electrocardiogram (fECG) and measuring electrocardiographic intervals with a noninvasive fECG device using blind source separation with reference signal. Our aim was to evaluate the ability of fECG to diagnose LQTS. CASE PRESENTATIONS: We identified 3 cases of clinically suspected LQTS based on fetal echocardiogram (2 had sinus bradycardia, 1 had second-degree atrioventricular block with negative maternal anti-SSA/SSB antibody titers). With institutional review board approval, these patients were prospectively enrolled for fECG acquisition. Offline post-processing generated fECG waveforms and calculated QT intervals. Case 1 and 3 had a maternal history of LQTS. Two of the three fetuses with suspected LQTS had confirmed LQTS by postnatal ECG and genetic testing. FECG was able to identify a prolonged corrected QT interval in both cases. One of these also had fetal magnetocardiography (fMCG), which yielded similar findings to the fECG. The third fetus had a normal fECG; fMCG and postnatal ECG were also normal. CONCLUSIONS: In 3 cases, fECG findings corroborated the diagnosis of LQTS. Noninvasive fECG may offer a novel method for fECG that is portable and more clinically accessible.

Feasibility of Non-invasive Fetal Electrocardiographic Interval Measurement in the Outpatient Clinical Setting.

Non-invasive fetal electrocardiography (ECG) is a promising method for evaluating fetal cardiac electrical activity. Despite advances in fetal ECG technology, its ability to provide reliable, interpretable results in a typical outpatient fetal cardiology setting remains unclear. We sought to determine the feasibility of measuring standard ECG intervals in an outpatient fetal cardiology practice using an abdominal fetal ECG device that employs blind source separation with reference, an innovative signal-processing technique for fetal ECG extraction. Women scheduled for clinically indicated outpatient fetal echocardiogram underwent 10 min of fetal ECG acquisition from the maternal abdomen using specialized gel electrodes. A bedside laptop computer performed fetal ECG extraction, allowing real-time visualization of fetal and maternal ECG signals. Offline post-processing of 1 min of recorded data yielded fetal P-wave duration, PR interval, QRS duration, RR interval, QT interval, and QTc. Fifty-five fetuses were studied with gestational age 18-37 weeks, including 13 with abnormal fetal echocardiogram findings and three sets of twins. Interpretable results were obtained in 91% of fetuses, including 85% during the vernix period and 100% of twin fetuses. PR interval and RR interval of 18-24 week gestation fetuses were significantly shorter than those with gestational age 25-31 and 32-37 weeks. Of the six fetuses with abnormal rhythms on fetal echocardiogram, fetal ECG tracing was interpretable in five and matched the rhythm noted on fetal echocardiogram. Abdominal fetal ECG acquisition is feasible for arrhythmia detection and ECG interval calculation in a routine clinical setting.

Investigation on explainable machine learning models to predict chronic kidney diseases.

Chronic kidney disease (CKD) is a major worldwide health problem, affecting a large proportion of the world's population and leading to higher morbidity and death rates. The early stages of CKD sometimes present without visible symptoms, causing patients to be unaware. Early detection and treatments are critical in reducing complications and improving the overall quality of life for people afflicted. In this work, we investigate the use of an explainable artificial intelligence (XAI)-based strategy, leveraging clinical characteristics, to predict CKD. This study collected clinical data from 491 patients, comprising 56 with CKD and 435 without CKD, encompassing clinical, laboratory, and demographic variables. To develop the predictive model, five machine learning (ML) methods, namely logistic regression (LR), random forest (RF), decision tree (DT), Naïve Bayes (NB), and extreme gradient boosting (XGBoost), were employed. The optimal model was selected based on accuracy and area under the curve (AUC). Additionally, the SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations) algorithms were utilized to demonstrate the influence of the features on the optimal model. Among the five models developed, the XGBoost model achieved the best performance with an AUC of 0.9689 and an accuracy of 93.29%. The analysis of feature importance revealed that creatinine, glycosylated hemoglobin type A1C (HgbA1C), and age were the three most influential features in the XGBoost model. The SHAP force analysis further illustrated the model's visualization of individualized CKD predictions. For further insights into individual predictions, we also utilized the LIME algorithm. This study presents an interpretable ML-based approach for the early prediction of CKD. The SHAP and LIME methods enhance the interpretability of ML models and help clinicians better understand the rationale behind the predicted outcomes more effectively.

MDDBranchNet: A Deep Learning Model for Detecting Major Depressive Disorder Using ECG Signal.

Major depressive disorder (MDD) is a chronic mental illness which affects people's well-being and is often detected at a later stage of depression with a likelihood of suicidal ideation. Early detection of MDD is thus necessary to reduce the impact, however, it requires monitoring vitals in daily living conditions. EEG is generally multi-channel and due to difficulty in signal acquisition, it is unsuitable for home-based monitoring, whereas, wearable sensors can collect single-channel ECG. Classical machine-learning based MDD detection studies commonly use various heart rate variability features. Feature generation, which requires domain knowledge, is often challenging, and requires computation power, often unsuitable for real time processing, MDDBranchNet is a proposed parallel-branch deep learning model for MDD binary classification from a single channel ECG which uses additional ECG-derived signals such as R-R signal and degree distribution time series of horizontal visibility graph. The use of derived branches was able to increase the model's accuracy by around 7%. An optimal 20-second overlapped segmentation of ECG recording was found to be beneficial with a 70% prediction threshold for maximum MDD detection with a minimum false positive rate. The proposed model evaluated MDD prediction from signal excerpts, irrespective of location (first, middle or last one-third of the recording), instead of considering the entire ECG signal with minimal performance variation stressing the idea that MDD phenomena are likely to manifest uniformly throughout the recording.

Identification of Congenital Valvular Murmurs in Young Patients Using Deep Learning-Based Attention Transformers and Phonocardiograms.

One in every four newborns suffers from congenital heart disease (CHD) that causes defects in the heart structure. The current gold-standard assessment technique, echocardiography, causes delays in the diagnosis owing to the need for experts who vary markedly in their ability to detect and interpret pathological patterns. Moreover, echo is still causing cost difficulties for low- and middle-income countries. Here, we developed a deep learning-based attention transformer model to automate the detection of heart murmurs caused by CHD at an early stage of life using cost-effective and widely available phonocardiography (PCG). PCG recordings were obtained from 942 young patients at four major auscultation locations, including the aortic valve (AV), mitral valve (MV), pulmonary valve (PV), and tricuspid valve (TV), and they were annotated by experts as absent, present, or unknown murmurs. A transformation to wavelet features was performed to reduce the dimensionality before the deep learning stage for inferring the medical condition. The performance was validated through 10-fold cross-validation and yielded an average accuracy and sensitivity of 90.23 % and 72.41 %, respectively. The accuracy of discriminating between murmurs' absence and presence reached 76.10 % when evaluated on unseen data. The model had accuracies of 70 %, 88 %, and 86 % in predicting murmur presence in infants, children, and adolescents, respectively. The interpretation of the model revealed proper discrimination between the learned attributes, and AV channel was found important (score 0.75) for the murmur absence predictions while MV and TV were more important for murmur presence predictions. The findings potentiate deep learning as a powerful front-line tool for inferring CHD status in PCG recordings leveraging early detection of heart anomalies in young people. It is suggested as a tool that can be used independently from high-cost machinery or expert assessment.

One-Pot Synthesis of a Robust Crosslinker-Free Thermo-Reversible Conducting Hydrogel Electrode for Epidermal Electronics.

Traditional epidermal electrodes, typically made of silver/silver chloride (Ag/AgCl), have been widely used in various applications, including electrophysiological recordings and biosignal monitoring. However, they present limitations due to inherent material mismatches with the skin. This often results in high interface impedance, discomfort, and potential skin irritation, particularly during prolonged use or for individuals with sensitive skin. While various tissue-mimicking materials have been explored, their mechanical advantages often come at the expense of conductivity, resulting in low-quality recordings. We herein report the facile fabrication of conducting and stretchable hydrogels using a "one-pot" method. This approach involves the synthesis of a natural hydrogel, termed Golde, composed of abundant and eco-friendly components, including gelatin, chitosan, and glycerol. To enhance the conductivity of the hydrogel, various conducting materials, such as poly(3,4-ethylenedioxythiophene) polystyrenesulfonate (PEDOT:PSS), thermally reduced graphene (TRG), and MXene, are introduced. The resulting conducting hydrogels exhibit remarkable robustness, do not require crosslinkers, and possess a unique thermo-reversible property, simplifying the fabrication process and ensuring enhanced long-term stability. Moreover, their fabrication is sustainable, as it employs environmentally friendly materials and processes while retaining their skin-friendly characteristics. The resulting hydrogel electrodes were tested for electrocardiogram (ECG) signal acquisition and outperformed commercial electrodes even when implemented in an all-flexible electrode setup simply using copper tape, owing to their inherent adhesiveness.

Circadian assessment of heart failure using explainable deep learning and novel multi-parameter polar images.

BACKGROUND AND OBJECTIVE: Heart failure (HF) is a multi-faceted and life-threatening syndrome that affects more than 64.3 million people worldwide. Current gold-standard screening technique, echocardiography, neglects cardiovascular information regulated by the circadian rhythm and does not incorporate knowledge from patient profiles. In this study, we propose a novel multi-parameter approach to assess heart failure using heart rate variability (HRV) and patient clinical information. METHODS: In this approach, features from 24-hour HRV and clinical information were combined as a single polar image and fed to a 2D deep learning model to infer the HF condition. The edges of the polar image correspond to the timely variation of different features, each of which carries information on the function of the heart, and internal illustrates color-coded patient clinical information. RESULTS: Under a leave-one-subject-out cross-validation scheme and using 7,575 polar images from a multi-center cohort (American and Greek) of 303 coronary artery disease patients (median age: 58 years [50-65], median body mass index (BMI): 27.28 kg/m2 [24.91-29.41]), the model yielded mean values for the area under the receiver operating characteristics curve (AUC), sensitivity, specificity, normalized Matthews correlation coefficient (NMCC), and accuracy of 0.883, 90.68%, 95.19%, 0.93, and 92.62%, respectively. Moreover, interpretation of the model showed proper attention to key hourly intervals and clinical information for each HF stage. CONCLUSIONS: The proposed approach could be a powerful early HF screening tool and a supplemental circadian enhancement to echocardiography which sets the basis for next-generation personalized healthcare.

Transient pain and discomfort when wearing high-heeled shoes.

In the dynamic world of fashion, high-heeled footwear is revered as a symbol of style, luxury and sophistication. Yet, beneath the facade of elegance of classy footwear lies the harsh reality of discomfort and pain. Thus, this study aims to investigate the influence of wearing high-heeled shoes on the sensation of pain across different body regions over a period of 6 h. It involved fifty female participants, all habitual wearers of high-heeled shoes, aged between 20 and 30 years. Each participant kept a record of their perceptions of pain and discomfort every hour for a total of 6 h using a 0-10 pain scale with 0 indicating no pain and 10 indicating severe pain. The findings reveal a progressive rise in pain throughout wear, with the most intense pain reported in the back, calcaneus, and metatarsals. The analysis shows that after approximately 3.5 h, participants experience significant increases in pain levels. However, the relationship between heel height and pain is not linear. It appears that a heel height of 7.5 cm is the threshold where overall body pain becomes significant. The study suggests that a duration of 3.5 h of wear and a heel height of 7.5 cm serve as critical points to decrease overall body pain. Moreover, beyond this heel height, knee pain diminishes compared to other body areas possibly due to the shift towards a more neutral posture. The study findings, coupled with the recommendations, can assist footwear designers in crafting not only stylish but also comfortable shoes.

A deep learning framework for noninvasive fetal ECG signal extraction.

Introduction: The availability of proactive techniques for health monitoring is essential to reducing fetal mortality and avoiding complications in fetal wellbeing. In harsh circumstances such as pandemics, earthquakes, and low-resource settings, the incompetence of many healthcare systems worldwide in providing essential services, especially for pregnant women, is critical. Being able to continuously monitor the fetus in hospitals and homes in a direct and fast manner is very important in such conditions. Methods: Monitoring the health of the baby can potentially be accomplished through the computation of vital bio-signal measures using a clear fetal electrocardiogram (ECG) signal. The aim of this study is to develop a framework to detect and identify the R-peaks of the fetal ECG directly from a 12 channel abdominal composite signal. Thus, signals were recorded noninvasively from 70 pregnant (healthy and with health conditions) women with no records of fetal abnormalities. The proposed model employs a recurrent neural network architecture to robustly detect the fetal ECG R-peaks. Results: To test the proposed framework, we performed both subject-dependent (5-fold cross-validation) and independent (leave-one-subject-out) tests. The proposed framework achieved average accuracy values of 94.2% and 88.8%, respectively. More specifically, the leave-one-subject-out test accuracy was 86.7% during the challenging period of vernix caseosa layer formation. Furthermore, we computed the fetal heart rate from the detected R-peaks, and the demonstrated results highlight the robustness of the proposed framework. Discussion: This work has the potential to cater to the critical industry of maternal and fetal healthcare as well as advance related applications.

Prediction of heart failure patients with distinct left ventricular ejection fraction levels using circadian ECG features and machine learning.

Heart failure (HF) encompasses a diverse clinical spectrum, including instances of transient HF or HF with recovered ejection fraction, alongside persistent cases. This dynamic condition exhibits a growing prevalence and entails substantial healthcare expenditures, with anticipated escalation in the future. It is essential to classify HF patients into three groups based on their ejection fraction: reduced (HFrEF), mid-range (HFmEF), and preserved (HFpEF), such as for diagnosis, risk assessment, treatment choice, and the ongoing monitoring of heart failure. Nevertheless, obtaining a definitive prediction poses challenges, requiring the reliance on echocardiography. On the contrary, an electrocardiogram (ECG) provides a straightforward, quick, continuous assessment of the patient's cardiac rhythm, serving as a cost-effective adjunct to echocardiography. In this research, we evaluate several machine learning (ML)-based classification models, such as K-nearest neighbors (KNN), neural networks (NN), support vector machines (SVM), and decision trees (TREE), to classify left ventricular ejection fraction (LVEF) for three categories of HF patients at hourly intervals, using 24-hour ECG recordings. Information from heterogeneous group of 303 heart failure patients, encompassing HFpEF, HFmEF, or HFrEF classes, was acquired from a multicenter dataset involving both American and Greek populations. Features extracted from ECG data were employed to train the aforementioned ML classification models, with the training occurring in one-hour intervals. To optimize the classification of LVEF levels in coronary artery disease (CAD) patients, a nested cross-validation approach was employed for hyperparameter tuning. HF patients were best classified using TREE and KNN models, with an overall accuracy of 91.2% and 90.9%, and average area under the curve of the receiver operating characteristics (AUROC) of 0.98, and 0.99, respectively. Furthermore, according to the experimental findings, the time periods of midnight-1 am, 8-9 am, and 10-11 pm were the ones that contributed to the highest classification accuracy. The results pave the way for creating an automated screening system tailored for patients with CAD, utilizing optimal measurement timings aligned with their circadian cycles.

One-Dimensional W-NETR for Non-Invasive Single Channel Fetal ECG Extraction.

Fetal cardiac monitoring is very helpful in the early detection of the potential risk of fetal cardiac abnormalities, which enables prompt preventative care and ensures safe births. As a result, it is crucial to regularly check on the embryonic heart. Methods of non-invasively fetal ECG extraction from maternal abdominal ECG signal are thoroughly discussed. Although fetal signals are generally obscured by maternal ECG signals and noise, extracting a clean fetal ECG is a significant difficulty. The majority of techniques for fetal ECG extraction include many extraction steps. We describe a unique method for splitting a single-channel maternal abdominal ECG into maternal and fetus ECG employing two parallel U-nets with transformer encoding, which we refer to as W-NEt TRansformers (W-NETR). Due to its enhanced capacity to simulate remote interactions and capture global context, the suggested pipeline utilizes the self-attention mechanism of the transformer. We tested the proposed pipeline on synthetic and real datasets and outperformed the current state-of-the-art deep learning models. The proposed model achieved the best results on both datasets for QRS detection precision, recall, and F1 scores. More specifically, it achieved F1 score of 99.88% and 98.9% on the real ADFECGDB and PCDB datasets, respectively. These encouraging results highlight the suggested W-NETR's effectiveness in precisely extracting the fetal ECG, which was achieved with high SSIM and PSNR values in the results. This provides the bed set for long-term maternal and fetal monitoring via portable devices as the proposed system performs real-time execution.

A machine learning driven monogram for predicting chronic kidney disease stages 3-5.

Chronic kidney disease (CKD) remains one of the most prominent global causes of mortality worldwide, necessitating accurate prediction models for early detection and prevention. In recent years, machine learning (ML) techniques have exhibited promising outcomes across various medical applications. This study introduces a novel ML-driven monogram approach for early identification of individuals at risk for developing CKD stages 3-5. This retrospective study employed a comprehensive dataset comprised of clinical and laboratory variables from a large cohort of diagnosed CKD patients. Advanced ML algorithms, including feature selection and regression models, were applied to build a predictive model. Among 467 participants, 11.56% developed CKD stages 3-5 over a 9-year follow-up. Several factors, such as age, gender, medical history, and laboratory results, independently exhibited significant associations with CKD (p < 0.05) and were utilized to create a risk function. The Linear regression (LR)-based model achieved an impressive R-score (coefficient of determination) of 0.954079, while the support vector machine (SVM) achieved a slightly lower value. An LR-based monogram was developed to facilitate the process of risk identification and management. The ML-driven nomogram demonstrated superior performance when compared to traditional prediction models, showcasing its potential as a valuable clinical tool for the early detection and prevention of CKD. Further studies should focus on refining the model and validating its performance in diverse populations.

Effect of depression on phase coherence between respiratory sinus arrhythmia and respiration during sleep in patients with obstructive sleep apnea.

Introduction: A high prevalence of major depressive disorder (MDD) among Obstructive Sleep Apnea (OSA) patients has been observed in both community and clinical populations. Due to the overlapping symptoms between both disorders, depression is usually misdiagnosed when correlated with OSA. Phase coherence between respiratory sinus arrhythmia (RSA) and respiration (λ RSA-RESP) has been proposed as an alternative measure for assessing vagal activity. Therefore, this study aims to investigate if there is any difference in λ RSA-RESP in OSA patients with and without MDD. Methods: Electrocardiograms (ECG) and breathing signals using overnight polysomnography were collected from 40 OSA subjects with MDD (OSAD+), 40 OSA subjects without MDD (OSAD-), and 38 control subjects (Controls) without MDD and OSA. The interbeat intervals (RRI) and respiratory movement were extracted from 5-min segments of ECG signals with a single apneic event during non-rapid eye movement (NREM) [353 segments] and rapid eye movement (REM) sleep stages [298 segments]. RR intervals (RRI) and respiration were resampled at 10 Hz, and the band passed filtered (0.10-0.4 Hz) before the Hilbert transform was used to extract instantaneous phases of the RSA and respiration. Subsequently, the λ RSA-RESP between RSA and Respiration and Heart Rate Variability (HRV) features were computed. Results: Our results showed that λ RSA-RESP was significantly increased in the OSAD+ group compared to OSAD- group during NREM and REM sleep. This increase was accompanied by a decrease in the low frequency (LF) component of HRV. Discussion: We report that the phase synchronization index between RSA and respiratory movement could provide a useful measure for evaluating depression in OSA patients. Our findings suggest that depression has lowered sympathetic activity when accompanied by OSA, allowing for stronger synchronization between RSA and respiration.

Heart Failure Assessment Using Multiparameter Polar Representations and Deep Learning.

Heart failure refers to the inability of the heart to pump enough amount of blood to the body. Nearly 7 million people die every year because of its complications. Current gold-standard screening techniques through echocardiography do not incorporate information about the circadian rhythm of the heart and clinical information of patients. In this vein, we propose a novel approach to integrate 24-hour heart rate variability (HRV) features and patient profile information in a single multi-parameter and color-coded polar representation. The proposed approach was validated by training a deep learning model from 7,575 generated images to predict heart failure groups, i.e., preserved, mid-range, and reduced left ventricular ejection fraction. The developed model had overall accuracy, sensitivity, and specificity of 93%, 88%, and 95%, respectively. Moreover, it had a high area under the receiver operating characteristics curve (AUROC) of 0.88 and an area under the precision-recalled curve (AUPR) of 0.79. The novel approach proposed in this study suggests a new protocol for assessing cardiovascular diseases to act as a complementary tool to echocardiography as it provides insights on the circadian rhythm of the heart and can be potentially personalized according to patient clinical profile information.Clinical relevance- Implementing polar representations with deep learning in clinical settings to supplement echocardiography leverages continuous monitoring of the heart's circadian rhythm and personalized cardiovascular medicine while reducing the burden on medical practitioners.

EEG-based Emotion Recognition Using Sub-Band Time-Delay Correlations.

Emotion recognition is a challenging task with many potential applications in psychology, psychiatry, and human-computer interaction (HCI). The use of time-delay information in the controlled time-delay stability (cTDS) algorithm can help to capture the temporal dynamics of EEG signals, including sub-band information and bi-directional coupling that can aid in emotion recognition and identification of specific connectivity patterns between brain rhythms. Incorporating EEG frequency bands can be used to design better emotion recognition systems. This paper evaluates the cTDS algorithm for binary classification tasks of arousal and valence using EEG sub-band signals. This method achieved a high accuracy of 91.1% for arousal and 91.7% for valence based on one electrode recording site at Fp1. The cTDS algorithm is a promising approach to analyzing brain network interactions. It can be particularly applicable to arousal and valence classification tasks, especially within a complex, multimodal feature space associated with understanding psychiatric disorders and HCI applications.

Non-invasive technologies for heart failure, systolic and diastolic dysfunction modeling: a scoping review.

The growing global prevalence of heart failure (HF) necessitates innovative methods for early diagnosis and classification of myocardial dysfunction. In recent decades, non-invasive sensor-based technologies have significantly advanced cardiac care. These technologies ease research, aid in early detection, confirm hemodynamic parameters, and support clinical decision-making for assessing myocardial performance. This discussion explores validated enhancements, challenges, and future trends in heart failure and dysfunction modeling, all grounded in the use of non-invasive sensing technologies. This synthesis of methodologies addresses real-world complexities and predicts transformative shifts in cardiac assessment. A comprehensive search was performed across five databases, including PubMed, Web of Science, Scopus, IEEE Xplore, and Google Scholar, to find articles published between 2009 and March 2023. The aim was to identify research projects displaying excellence in quality assessment of their proposed methodologies, achieved through a comparative criteria-based rating approach. The intention was to pinpoint distinctive features that differentiate these projects from others with comparable objectives. The techniques identified for the diagnosis, classification, and characterization of heart failure, systolic and diastolic dysfunction encompass two primary categories. The first involves indirect interaction with the patient, such as ballistocardiogram (BCG), impedance cardiography (ICG), photoplethysmography (PPG), and electrocardiogram (ECG). These methods translate or convey the effects of myocardial activity. The second category comprises non-contact sensing setups like cardiac simulators based on imaging tools, where the manifestations of myocardial performance propagate through a medium. Contemporary non-invasive sensor-based methodologies are primarily tailored for home, remote, and continuous monitoring of myocardial performance. These techniques leverage machine learning approaches, proving encouraging outcomes. Evaluation of algorithms is centered on how clinical endpoints are selected, showing promising progress in assessing these approaches' efficacy.

Inflammation, oxidative stress and mitochondrial dysfunction in the progression of type II diabetes mellitus with coexisting hypertension.

Introduction: Type II diabetes mellitus (T2DM) is a metabolic disorder that poses a serious health concern worldwide due to its rising prevalence. Hypertension (HT) is a frequent comorbidity of T2DM, with the co-occurrence of both conditions increasing the risk of diabetes-associated complications. Inflammation and oxidative stress (OS) have been identified as leading factors in the development and progression of both T2DM and HT. However, OS and inflammation processes associated with these two comorbidities are not fully understood. This study aimed to explore changes in the levels of plasma and urinary inflammatory and OS biomarkers, along with mitochondrial OS biomarkers connected to mitochondrial dysfunction (MitD). These markers may provide a more comprehensive perspective associated with disease progression from no diabetes, and prediabetes, to T2DM coexisting with HT in a cohort of patients attending a diabetes health clinic in Australia. Methods: Three-hundred and eighty-four participants were divided into four groups according to disease status: 210 healthy controls, 55 prediabetic patients, 32 T2DM, and 87 patients with T2DM and HT (T2DM+HT). Kruskal-Wallis and χ2 tests were conducted between the four groups to detect significant differences for numerical and categorical variables, respectively. Results and discussion: For the transition from prediabetes to T2DM, interleukin-10 (IL-10), C-reactive protein (CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG), humanin (HN), and p66Shc were the most discriminatory biomarkers, generally displaying elevated levels of inflammation and OS in T2DM, in addition to disrupted mitochondrial function as revealed by p66Shc and HN. Disease progression from T2DM to T2DM+HT indicated lower levels of inflammation and OS as revealed through IL-10, interleukin-6 (IL-6), interleukin-1ß (IL-1ß), 8-OHdG and oxidized glutathione (GSSG) levels, most likely due to antihypertensive medication use in the T2DM +HT patient group. The results also indicated better mitochondrial function in this group as shown through higher HN and lower p66Shc levels, which can also be attributed to medication use. However, monocyte chemoattractant protein-1 (MCP-1) levels appeared to be independent of medication, providing an effective biomarker even in the presence of medication use. The results of this study suggest that a more comprehensive review of inflammation and OS biomarkers is more effective in discriminating between the stages of T2DM progression in the presence or absence of HT. Our results further indicate the usefulness of medication use, especially with respect to the known involvement of inflammation and OS in disease progression, highlighting specific biomarkers during disease progression and therefore allowing a more targeted individualized treatment plan.

LSTM-Modeling of Emotion Recognition Using Peripheral Physiological Signals in Naturalistic Conversations.

The automated recognition of human emotions plays an important role in developing machines with emotional intelligence. Major research efforts are dedicated to the development of emotion recognition methods. However, most of the affective computing models are based on images, audio, videos and brain signals. Literature lacks works that focus on utilizing only peripheral signals for emotion recognition (ER), which can be ideally implemented in daily life settings. Therefore, this paper present a framework for ER on the arousal and valence space, based on using multi-modal peripheral signals. The data used in this work were collected during a debate between two people using wearable devices. The emotions of the participants were rated by multiple raters and converted into classes in correspondence to the arousal and valence space. The use of a dynamic threshold for ratings conversion was investigated. An ER model is proposed that uses a Long Short-Term Memory (LSTM)-based architecture for classification. The model uses heart rate (HR), temperature (T), and electrodermal activity (EDA) signals as its inputs with emotional cues. Additionally, a post-processing prediction mechanism is introduced to enhance the recognition performance. The model is implemented to study the use of individual and different combinations of the peripheral signals, as well as utilizing annotations from different ratings. Additionally, it is employed for classification of valence and arousal in an independent and combined fashion, under subject dependent and independent scenarios. The experimental results have justified the efficient performance of the proposed framework, achieving classification accuracy 96% and 93% for the independent and combined classification scenarios, accordingly. The comparison of the achieved performance against the baseline methods shows the superiority of the proposed framework and the ability to recognize arousal-valance levels with high accuracy from peripheral signals, in real-life scenarios.

The role of artificial intelligence in hypertensive disorders of pregnancy: towards personalized healthcare.

INTRODUCTION: Guidelines advise ongoing follow-up of patients after hypertensive disorders of pregnancy (HDP) to assess cardiovascular risk and manage future patient-specific pregnancy conditions. However, there are limited tools available to monitor patients, with those available tending to be simple risk assessments that lack personalization. A promising approach could be the emerging artificial intelligence (AI)-based techniques, developed from big patient datasets to provide personalized recommendations for preventive advice. AREAS COVERED: In this narrative review, we discuss the impact of integrating AI and big data analysis for personalized cardiovascular care, focusing on the management of HDP. EXPERT OPINION: The pathophysiological response of women to pregnancy varies, and deeper insight into each response can be gained through a deeper analysis of the medical history of pregnant women based on clinical records and imaging data. Further research is required to be able to implement AI for clinical cases using multi-modality and multi-organ assessment, and this could expand both knowledge on pregnancy-related disorders and personalized treatment planning.