A rapid review of machine learning approaches for telemedicine in the scope of COVID-19.

The COVID-19 pandemic has rapidly spread around the world. The rapid transmission of the virus is a threat that hinders the ability to contain the disease propagation. The pandemic forced widespread conversion of in-person to virtual care delivery through telemedicine. Given this gap, this article aims at providing a literature review of machine learning-based telemedicine applications to mitigate COVID-19. A rapid review of the literature was conducted in six electronic databases published from 2015 through 2020. The process of data extraction was documented using a PRISMA flowchart for inclusion and exclusion of studies. As a result, the literature search identified 1.733 articles, from which 16 articles were included in the review. We developed an updated taxonomy and identified challenges, open questions, and current data types. Our taxonomy and discussion contribute with a significant degree of coverage from subjects related to the use of machine learning to improve telemedicine in response to the COVID-19 pandemic. The evidence identified by this rapid review suggests that machine learning, in combination with telemedicine, can provide a strategy to control outbreaks by providing smart triage of patients and remote monitoring. Also, the use of telemedicine during future outbreaks could be further explored and refined.

First and second COVID-19 waves in Brazil: A cross-sectional study of patients' characteristics related to hospitalization and in-hospital mortality.

BACKGROUND: Background The second wave of the COVID-19 pandemic was more aggressive in Brazil compared to other countries around the globe. Considering the Brazilian peculiarities, we analyze the in-hospital mortality concerning socio-epidemiological characteristics of patients and the health system of all states during the first and second waves of COVID-19. METHODS: We performed a cross-sectional study of hospitalized patients with positive RT-PCR for SARS-CoV-2 in Brazil. Data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe) and comprised the period from February 25, 2020, to April 30, 2021, separated in two waves on November 5, 2020. We performed a descriptive study of patients analyzing socio-demographic characteristics, symptoms, comorbidities, and risk factors stratified by age. In addition, we analyzed in-hospital and intensive care unit (ICU) mortality in both waves and how it varies in each Brazilian state. FINDINGS: Between February 25, 2020 and April 30, 2021, 678 235 patients were admitted with a positive RT-PCR for SARS-CoV-2, with 325 903 and 352 332 patients for the first and second wave, respectively. The mean age of patients was 59 · 65 (IQR 48 · 0 - 72 · 0). In total, 379 817 (56 · 00%) patients had a risk factor or comorbidity. In-hospital mortality increased from 34 · 81% in the first to 39 · 30% in the second wave. In the second wave, there were more ICU admissions, use of non-invasive and invasive ventilation, and increased mortality for younger age groups. The southern and southeastern regions of Brazil had the highest hospitalization rates per 100 000 inhabitants. However, the in-hospital mortality rate was higher in the northern and northeastern states of the country. Racial differences were observed in clinical outcomes, with White being the most prevalent hospitalized population, but with Blacks/Browns (Pardos) having higher mortality rates. Younger age groups had more considerable differences in mortality as compared to groups with and without comorbidities in both waves. INTERPRETATION: We observed a more considerable burden on the Brazilian hospital system throughout the second wave. Furthermore, the north and northeast of Brazil, which present lower Human Development Indexes, concentrated the worst in-hospital mortality rates. The highest mortality rates are also shown among vulnerable social groups. Finally, we believe that the results can help to understand the behavior of the COVID-19 pandemic in Brazil, helping to define public policies, allocate resources, and improve strategies for vaccination of priority groups. FUNDING: Coordinating Agency for Advanced Training of Graduate Personnel (CAPES) (C.F. 001), and National Council for Scientific and Technological Development (CNPq) (No. 309537/2020-7).

A Survey About Real-Time Location Systems in Healthcare Environments.

Every year healthcare organizations suffer from several issues, such as unapropriated workflow, thousands of deaths caused by medical errors, counterfeit drugs, and increasing costs. To offer better patient care and increase profit, hospitals could adopt solutions that help remedy these problems. Real-Time Location Systems have the potential to deal with many of these issues, as well as offering means for developing new and intelligent solutions. This kind of system enables tracking assets and people, allowing several improvements. Even though the benefits of such solutions are well known and desired by healthcare providers, their large scale adoption is still distant. In this article, we surveyed Real-Time Location Systems usage in hospitals. While developing this survey, we observed a need for organizing important aspects of healthcare-oriented Real-Time Location Systems. Therefore, we analyzed challenges regarding this topic and a taxonomy proposed. This survey offers researchers and developers ways to comprehend the challenges surrounding this area while proposing a classification of aspects that a Real-Time Location System for healthcare environments must assess for it to be successful.

Exploring publish/subscribe, multilevel cloud elasticity, and data compression in telemedicine.

BACKGROUND AND OBJECTIVE: Multiple medical specialties rely on image data, typically following the Digital Imaging and Communications in Medicine (DICOM) ISO 12052 standard, to support diagnosis through telemedicine. Remote analysis by different physicians requires the same image to be transmitted simultaneously to different destinations in real-time. This scenario poses a need for a large number of resources to store and transmit DICOM images in real-time, which has been explored using some cloud-based solutions. However, these solutions lack strategies to improve the performance through the cloud elasticity feature. In this context, this article proposes a cloud-based publish/subscribe (PubSub) model, called PS2DICOM, which employs multilevel resource elasticity to improve the performance of DICOM data transmissions. METHODS: A prototype is implemented to evaluate PS2DICOM. A PubSub communication model is adopted, considering the coexistence of two classes of users: (i) image data producers (publishers); and (ii) image data consumers (subscribers). PS2DICOM employs a cloud infrastructure to guarantee service availability and performance through resource elasticity in two levels of the cloud: (i) brokers and (ii) data storage. In addition, images are compressed prior to the transmission to reduce the demand for network resources using one of three different algorithms: (i) DEFLATE, (ii) LZMA, and (iii) BZIP2. PS2DICOM employs dynamic data compression levels at the client side to improve network performance according to the current available network throughput. RESULTS: Results indicate that PS2DICOM can improve transmission quality, storage capabilities, querying, and retrieving of DICOM images. The general efficiency gain is approximately 35% in data sending and receiving operations. This gain is resultant from the two levels of elasticity, allowing resources to be scaled up or down automatically in a transparent manner. CONCLUSIONS: The contributions of PS2DICOM are twofold: (i) multilevel cloud elasticity to adapt the computing resources on demand; (ii) adaptive data compression to meet the network quality and optimize data transmission. Results suggest that the use of compression in medical image data using PS2DICOM can improve the transmission efficiency, allowing the team of specialists to communicate in real-time, even when they are geographically distant.