Recognition of Patient Groups with Sleep Related Disorders using Bio-signal Processing and Deep Learning.

Accurately diagnosing sleep disorders is essential for clinical assessments and treatments. Polysomnography (PSG) has long been used for detection of various sleep disorders. In this research, electrocardiography (ECG) and electromayography (EMG) have been used for recognition of breathing and movement-related sleep disorders. Bio-signal processing has been performed by extracting EMG features exploiting entropy and statistical moments, in addition to developing an iterative pulse peak detection algorithm using synchrosqueezed wavelet transform (SSWT) for reliable extraction of heart rate and breathing-related features from ECG. A deep learning framework has been designed to incorporate EMG and ECG features. The framework has been used to classify four groups: healthy subjects, patients with obstructive sleep apnea (OSA), patients with restless leg syndrome (RLS) and patients with both OSA and RLS. The proposed deep learning framework produced a mean accuracy of 72% and weighted F1 score of 0.57 across subjects for our formulated four-class problem.

Developing Fine-Grained Actigraphies for Rheumatoid Arthritis Patients from a Single Accelerometer Using Machine Learning.

In addition to routine clinical examination, unobtrusive and physical monitoring of Rheumatoid Arthritis (RA) patients provides an important source of information to enable understanding the impact of the disease on quality of life. Besides an increase in sedentary behaviour, pain in RA can negatively impact simple physical activities such as getting out of bed and standing up from a chair. The objective of this work is to develop a method that can generate fine-grained actigraphies to capture the impact of the disease on the daily activities of patients. A processing methodology is presented to automatically tag activity accelerometer data from a cohort of moderate-to-severe RA patients. A study of procesing methods based on machine learning and deep learning is provided. Thirty subjects, 10 RA patients and 20 healthy control subjects, were recruited in the study. A single tri-axial accelerometer was attached to the position of the fifth lumbar vertebra (L5) of each subject with a tag prediction granularity of 3 s. The proposed method is capable of handling unbalanced datasets from tagged data while accounting for long-duration activities such as sitting and lying, as well as short transitions such as sit-to-stand or lying-to-sit. The methodology also includes a novel mechanism for automatically applying a threshold to predictions by their confidence levels, in addition to a logical filter to correct for infeasible sequences of activities. Performance tests showed that the method was able to achieve around 95% accuracy and 81% F-score. The produced actigraphies can be helpful to generate objective RA disease-specific markers of patient mobility in-between clinical site visits.

Transfer Learning with Active Sampling for Rapid Training and Calibration in BCI-P300 Across Health States and Multi-centre Data.

Machine learning and deep learning advancements have boosted Brain-Computer Interface (BCI) performance, but their wide-scale applicability is limited due to factors like individual health, hardware variations, and cultural differences affecting neural data. Studies often focus on uniform single-site experiments in uniform settings, leading to high performance that may not translate well to real-world diversity. Deep learning models aim to enhance BCI classification accuracy, and transfer learning has been suggested to adapt models to individual neural patterns using a base model trained on others' data. This approach promises better generalizability and reduced overfitting, yet challenges remain in handling diverse and imbalanced datasets from different equipment, subjects, multiple centres in different countries, and both healthy and patient populations for effective model transfer and tuning. In a setting characterized by maximal heterogeneity, we proposed P300 wave detection in BCIs employing a convolutional neural network fitted with adaptive transfer learning based on Poison Sampling Disk (PDS) called Active Sampling (AS), which flexibly adjusts the transition from source data to the target domain. Our results reported for subject adaptive with 40% of adaptive fine-tuning that the averaged classification accuracy improved by 5.36% and standard deviation reduced by 12.22% using two distinct, internationally replicated datasets. These results outperformed in classification accuracy, computational time, and training efficiency, mainly due to the proposed Active Sampling (AS) method for transfer learning.

Finding neural correlates of depersonalisation/derealisation disorder via explainable CNN-based analysis guided by clinical assessment scores.

Mental health disorders are typically diagnosed based on subjective reports (e.g., through questionnaires) followed by clinical interviews to evaluate the self-reported symptoms. Therefore, considering the interconnected nature of psychiatric disorders, their accurate diagnosis is a real challenge without indicators of underlying physiological dysfunction. Depersonalisation/derealisation disorder (DPD) is an example of dissociative disorder affecting 1-2 % of the population. DPD is characterised mainly by persistent disembodiment, detachment from surroundings, and feelings of emotional numbness, which can significantly impact patients' quality of life. The underlying neural correlates of DPD have been investigated for years to understand and help with a more accurate and in-time diagnosis of the disorder. However, in terms of EEG studies, which hold great importance due to their convenient and inexpensive nature, the literature has often been based on hypotheses proposed by experts in the field, which require prior knowledge of the disorder. In addition, participants' labelling in research experiments is often derived from the outcome of the Cambridge Depersonalisation Scale (CDS), a subjective assessment to quantify the level of depersonalisation/derealisation, the threshold and reliability of which might be challenged. As a result, we aimed to propose a novel end-to-end EEG processing pipeline based on deep neural networks for DPD biomarker discovery, which requires no prior handcrafted labelled data. Alternatively, it can assimilate knowledge from clinical outcomes like CDS as well as data-driven patterns that differentiate individual brain responses. In addition, the structure of the proposed model targets the uncertainty in CDS scores by using them as prior information only to guide the unsupervised learning task in a multi-task learning scenario. A comprehensive evaluation has been done to confirm the significance of the proposed deep structure, including new ways of network visualisation to investigate spectral, spatial, and temporal information derived in the learning process. We argued that the proposed EEG analytics could also be applied to investigate other psychological and mental disorders currently indicated on the basis of clinical assessment scores. The code to reproduce the results presented in this paper is openly accessible at https://github.com/AbbasSalami/DPD_Analysis.

Prioritizing COVID-19 vaccine allocation in resource poor settings: Towards an Artificial Intelligence-enabled and Geospatial-assisted decision support framework.

OBJECTIVES: To propose a novel framework for COVID-19 vaccine allocation based on three components of Vulnerability, Vaccination, and Values (3Vs). METHODS: A combination of geospatial data analysis and artificial intelligence methods for evaluating vulnerability factors at the local level and allocate vaccines according to a dynamic mechanism for updating vulnerability and vaccine uptake. RESULTS: A novel approach is introduced including (I) Vulnerability data collection (including country-specific data on demographic, socioeconomic, epidemiological, healthcare, and environmental factors), (II) Vaccination prioritization through estimation of a unique Vulnerability Index composed of a range of factors selected and weighed through an Artificial Intelligence (AI-enabled) expert elicitation survey and scientific literature screening, and (III) Values consideration by identification of the most effective GIS-assisted allocation of vaccines at the local level, considering context-specific constraints and objectives. CONCLUSIONS: We showcase the performance of the 3Vs strategy by comparing it to the actual vaccination rollout in Kenya. We show that under the current strategy, socially vulnerable individuals comprise only 45% of all vaccinated people in Kenya while if the 3Vs strategy was implemented, this group would be the first to receive vaccines.

A Generic Deep Learning Based Cough Analysis System From Clinically Validated Samples for Point-of-Need Covid-19 Test and Severity Levels.

In an attempt to reduce the infection rate of the COrona VIrus Disease-19 (Covid-19) countries around the world have echoed the exigency for an economical, accessible, point-of-need diagnostic test to identify Covid-19 carriers so that they (individuals who test positive) can be advised to self isolate rather than the entire community. Availability of a quick turn-around time diagnostic test would essentially mean that life, in general, can return to normality-at-large. In this regards, studies concurrent in time with ours have investigated different respiratory sounds, including cough, to recognise potential Covid-19 carriers. However, these studies lack clinical control and rely on Internet users confirming their test results in a web questionnaire (crowdsourcing) thus rendering their analysis inadequate. We seek to evaluate the detection performance of a primary screening tool of Covid-19 solely based on the cough sound from 8,380 clinically validated samples with laboratory molecular-test (2,339 Covid-19 positive and 6,041 Covid-19 negative) under quantitative RT-PCR (qRT-PCR) from certified laboratories. All collected samples were clinically labelled, i.e., Covid-19 positive or negative, according to the results in addition to the disease severity based on the qRT-PCR threshold cycle (Ct) and lymphocytes count from the patients. Our proposed generic method is an algorithm based on Empirical Mode Decomposition (EMD) for cough sound detection with subsequent classification based on a tensor of audio sonographs and deep artificial neural network classifier with convolutional layers called 'DeepCough'. Two different versions of DeepCough based on the number of tensor dimensions, i.e., DeepCough2D and DeepCough3D, have been investigated. These methods have been deployed in a multi-platform prototype web-app 'CoughDetect'. Covid-19 recognition results rates achieved a promising AUC (Area Under Curve) of [Formula: see text] 98 . 80 % ± 0 . 83 % , sensitivity of [Formula: see text] 96 . 43 % ± 1 . 85 % , and specificity of [Formula: see text] 96 . 20 % ± 1 . 74 % and average AUC of [Formula: see text] 81 . 08 % ± 5 . 05 % for the recognition of three severity levels. Our proposed web tool as a point-of-need primary diagnostic test for Covid-19 facilitates the rapid detection of the infection. We believe it has the potential to significantly hamper the Covid-19 pandemic across the world.

Explainable artificial intelligence based analysis for interpreting infant fNIRS data in developmental cognitive neuroscience.

In the last decades, non-invasive and portable neuroimaging techniques, such as functional near infrared spectroscopy (fNIRS), have allowed researchers to study the mechanisms underlying the functional cognitive development of the human brain, thus furthering the potential of Developmental Cognitive Neuroscience (DCN). However, the traditional paradigms used for the analysis of infant fNIRS data are still quite limited. Here, we introduce a multivariate pattern analysis for fNIRS data, xMVPA, that is powered by eXplainable Artificial Intelligence (XAI). The proposed approach is exemplified in a study that investigates visual and auditory processing in six-month-old infants. xMVPA not only identified patterns of cortical interactions, which confirmed the existent literature; in the form of conceptual linguistic representations, it also provided evidence for brain networks engaged in the processing of visual and auditory stimuli that were previously overlooked by other methods, while demonstrating similar statistical performance.

Single-Trial Recognition of Video Gamer's Expertise from Brain Haemodynamic and Facial Emotion Responses.

With an increase in consumer demand of video gaming entertainment, the game industry is exploring novel ways of game interaction such as providing direct interfaces between the game and the gamers' cognitive or affective responses. In this work, gamer's brain activity has been imaged using functional near infrared spectroscopy (fNIRS) whilst they watch video of a video game (League of Legends) they play. A video of the face of the participants is also recorded for each of a total of 15 trials where a trial is defined as watching a gameplay video. From the data collected, i.e., gamer's fNIRS data in combination with emotional state estimation from gamer's facial expressions, the expertise level of the gamers has been decoded per trial in a multi-modal framework comprising of unsupervised deep feature learning and classification by state-of-the-art models. The best tri-class classification accuracy is obtained using a cascade of random convolutional kernel transform (ROCKET) feature extraction method and deep classifier at 91.44%. This is the first work that aims at decoding expertise level of gamers using non-restrictive and portable technologies for brain imaging, and emotional state recognition derived from gamers' facial expressions. This work has profound implications for novel designs of future human interactions with video games and brain-controlled games.

Characterization of a Raspberry Pi as the Core for a Low-cost Multimodal EEG-fNIRS Platform.

Poor understanding of brain recovery after injury, sparsity of evaluations and limited availability of healthcare services hinders the success of neurorehabilitation programs in rural communities. The availability of neuroimaging ca-pacities in remote communities can alleviate this scenario supporting neurorehabilitation programs in remote settings. This research aims at building a multimodal EEG-fNIRS neuroimaging platform deployable to rural communities to support neurorehabilitation efforts. A Raspberry Pi 4 is chosen as the CPU for the platform responsible for presenting the neurorehabilitation stimuli, acquiring, processing and storing concurrent neuroimaging records as well as the proper synchronization between the neuroimaging streams. We present here two experiments to assess the feasibility and characterization of the Raspberry Pi as the core for a multimodal EEG-fNIRS neuroimaging platform; one over controlled conditions using a combination of synthetic and real data, and another from a full test during resting state. CPU usage, RAM usage and operation temperature were measured during the tests with mean operational records below 40% for CPU cores, 13.6% for memory and 58.85 ° C for temperatures. Package loss was inexistent on synthetic data and negligible on experimental data. Current consumption can be satisfied with a 1000 mAh 5V battery. The Raspberry Pi 4 was able to cope with the required workload in conditions of operation similar to those needed to support a neurorehabilitation evaluation.

Symptoms of depersonalisation/derealisation disorder as measured by brain electrical activity: A systematic review.

Depersonalisation/derealisation disorder (DPD) refers to frequent and persistent detachment from bodily self and disengagement from the outside world. As a dissociative disorder, DPD affects 1-2 % of the population, but takes 7-12 years on average to be accurately diagnosed. In this systematic review, we comprehensively describe research targeting the neural correlates of core DPD symptoms, covering publications between 1992 and 2020 that have used electrophysiological techniques. The aim was to investigate the diagnostic potential of these relatively inexpensive and convenient neuroimaging tools. We review the EEG power spectrum, components of the event-related potential (ERP), as well as vestibular and heartbeat evoked potentials as likely electrophysiological biomarkers to study DPD symptoms. We argue that acute anxiety- or trauma-related impairments in the integration of interoceptive and exteroceptive signals play a key role in the formation of DPD symptoms, and that future research needs analysis methods that can take this integration into account. We suggest tools for prospective studies of electrophysiological DPD biomarkers, which are urgently needed to fully develop their diagnostic potential.

Performance predictors of motor imagery brain-computer interface based on spatial abilities for upper limb rehabilitation.

Motor Imagery based BCIs (MI-BCIs) allow the control of devices and communication by imagining different mental tasks. Despite many years of research, BCIs are still not the most accurate systems to control applications, due to two main factors: signal processing with classification, and users. It is admitted that BCI control involves certain characteristics and abilities in its users for optimal results. In this study, spatial abilities are evaluated in relation to MI-BCI control regarding flexion and extension mental tasks. Results show considerable correlation (r=0.49) between block design test (visual motor execution and spatial visualization) and extension-rest tasks. Additionally, rotation test (mental rotation task) presents significant correlation (r=0.56) to flexion-rest tasks.

Deep Learning for Health Informatics.

With a massive influx of multimodality data, the role of data analytics in health informatics has grown rapidly in the last decade. This has also prompted increasing interests in the generation of analytical, data driven models based on machine learning in health informatics. Deep learning, a technique with its foundation in artificial neural networks, is emerging in recent years as a powerful tool for machine learning, promising to reshape the future of artificial intelligence. Rapid improvements in computational power, fast data storage, and parallelization have also contributed to the rapid uptake of the technology in addition to its predictive power and ability to generate automatically optimized high-level features and semantic interpretation from the input data. This article presents a comprehensive up-to-date review of research employing deep learning in health informatics, providing a critical analysis of the relative merit, and potential pitfalls of the technique as well as its future outlook. The paper mainly focuses on key applications of deep learning in the fields of translational bioinformatics, medical imaging, pervasive sensing, medical informatics, and public health.

EALab (Eye Activity Lab): a MATLAB Toolbox for Variable Extraction, Multivariate Analysis and Classification of Eye-Movement Data.

Recent advances in the reliability of the eye-tracking methodology as well as the increasing availability of affordable non-intrusive technology have opened the door to new research opportunities in a variety of areas and applications. This has raised increasing interest within disciplines such as medicine, business and education for analysing human perceptual and psychological processes based on eye-tracking data. However, most of the currently available software requires programming skills and focuses on the analysis of a limited set of eye-movement measures (e.g., saccades and fixations), thus excluding other measures of interest to the classification of a determined state or condition. This paper describes 'EALab', a MATLAB toolbox aimed at easing the extraction, multivariate analysis and classification stages of eye-activity data collected from commercial and independent eye trackers. The processing implemented in this toolbox enables to evaluate variables extracted from a wide range of measures including saccades, fixations, blinks, pupil diameter and glissades. Using EALab does not require any programming and the analysis can be performed through a user-friendly graphical user interface (GUI) consisting of three processing modules: 1) eye-activity measure extraction interface, 2) variable selection and analysis interface, and 3) classification interface.

Disparity in Frontal Lobe Connectivity on a Complex Bimanual Motor Task Aids in Classification of Operator Skill Level.

Objective metrics of technical performance (e.g., dexterity, time, and path length) are insufficient to fully characterize operator skill level, which may be encoded deep within neural function. Unlike reports that capture plasticity across days or weeks, this articles studies long-term plasticity in functional connectivity that occurs over years of professional task practice. Optical neuroimaging data are acquired from professional surgeons of varying experience on a complex bimanual coordination task with the aim of investigating learning-related disparity in frontal lobe functional connectivity that arises as a consequence of motor skill level. The results suggest that prefrontal and premotor seed connectivity is more critical during naïve versus expert performance. Given learning-related differences in connectivity, a least-squares support vector machine with a radial basis function kernel is employed to evaluate skill level using connectivity data. The results demonstrate discrimination of operator skill level with accuracy ≥0.82 and Multiclass Matthew's Correlation Coefficient ≥0.70. Furthermore, these indices are improved when local (i.e., within-region) rather than inter-regional (i.e., between-region) frontal connectivity is considered (p = 0.002). The results suggest that it is possible to classify operator skill level with good accuracy from functional connectivity data, upon which objective assessment and neurofeedback may be used to improve operator performance during technical skill training.

From Wearable Sensors to Smart Implants--Toward Pervasive and Personalized Healthcare.

OBJECTIVE: This paper discusses the evolution of pervasive healthcare from its inception for activity recognition using wearable sensors to the future of sensing implant deployment and data processing. METHODS: We provide an overview of some of the past milestones and recent developments, categorized into different generations of pervasive sensing applications for health monitoring. This is followed by a review on recent technological advances that have allowed unobtrusive continuous sensing combined with diverse technologies to reshape the clinical workflow for both acute and chronic disease management. We discuss the opportunities of pervasive health monitoring through data linkages with other health informatics systems including the mining of health records, clinical trial databases, multiomics data integration, and social media. CONCLUSION: Technical advances have supported the evolution of the pervasive health paradigm toward preventative, predictive, personalized, and participatory medicine. SIGNIFICANCE: The sensing technologies discussed in this paper and their future evolution will play a key role in realizing the goal of sustainable healthcare systems.

Big data for health.

This paper provides an overview of recent developments in big data in the context of biomedical and health informatics. It outlines the key characteristics of big data and how medical and health informatics, translational bioinformatics, sensor informatics, and imaging informatics will benefit from an integrated approach of piecing together different aspects of personalized information from a diverse range of data sources, both structured and unstructured, covering genomics, proteomics, metabolomics, as well as imaging, clinical diagnosis, and long-term continuous physiological sensing of an individual. It is expected that recent advances in big data will expand our knowledge for testing new hypotheses about disease management from diagnosis to prevention to personalized treatment. The rise of big data, however, also raises challenges in terms of privacy, security, data ownership, data stewardship, and governance. This paper discusses some of the existing activities and future opportunities related to big data for health, outlining some of the key underlying issues that need to be tackled.