The Application of Deep Learning Algorithms for PPG Signal Processing and Classification

Photoplethysmography (PPG) is widely used in wearable devices due to its conveniency and cost-effective nature. From this signal, several biomarkers can be collected, such as heart and respiration rate. For the usual acquisition scenarios, PPG is an artefact-ridden signal, which mandates the need for the designated classification algorithms to be able to reduce the noise component effect on the classification. Within the selected classification algorithm, the hyperparameters’ adjustment is of utmost importance. This study aimed to develop a deep learning model for robust PPG wave detection, which includes finding each beat’s temporal limits, from which the peak can be determined. A study database consisting of 1100 records was created from experimental PPG measurements performed in 47 participants. Different deep learning models were implemented to classify the PPG: Long Short-Term Memory (LSTM), Bidirectional LSTM, and Convolutional Neural Network (CNN). The Bidirectional LSTM and the CNN-LSTM were investigated, using the PPG Synchrosqueezed Fourier Transform (SSFT) as the models’ input. Accuracy, precision, recall, and F1-score were evaluated for all models. The CNN-LSTM algorithm, with an SSFT input, was the best performing model with accuracy, precision, and recall of 0.894, 0.923, and 0.914, respectively. This model has shown to be competent in PPG detection and delineation tasks, under noise-corrupted signals, which justifies the use of this innovative approach.

Investigating whether serum IGF-1 and IGFBP-3 levels reflect the height outcome in prepubertal children upon rhGH therapy: LG growth study database

Serum insulin-like growth factor-1 (IGF-I) and IGF binding protein-3 (IGFBP-3) levels can be used to monitor the safety of recombinant human growth hormone (rhGH) therapy. In this study, we evaluated the changes in serum IGF-I and IGFBP-3 levels during rhGH therapy as a marker of height outcome in prepubertal children. Totally, 705 prepubertal children with short stature were enrolled from the LG Growth Study Database. Data for three groups of subjects were obtained as follows: Idiopathic GH deficiency (IGHD; n = 486); idiopathic short stature (n = 66); small for gestational age (n = 153). Serum IGF-I and IGFBP-3 levels at the baseline and after the 1st and 2nd year of rhGH therapy, as well as the Δheight standard deviation score (SDS), were obtained. Δheight SDS after the 1st and 2nd year of rhGH therapy had notably increased compared to that at the baseline for all three groups. IGF-I and IGFBP-3 levels in all three groups were significantly increased compared to those at the baseline (p <0.001). Δheight SDS was positively correlated with ΔIGF-1 SDS after the 1st year of therapy, ΔIGFBP-3 SDS after the 2nd year of therapy in the IGHD group, and ΔIGF-I SDS and ΔIGFBP-3 SDS after the 2nd year of therapy (p < 0.05), regardless of whether the height at the baseline was a covariate. The increase in IGF-I and IGFBP-3 levels during rhGH therapy was related to the growth response in children with IGHD. Therefore, it may be valuable to measure the change in serum IGF-I and IGFBP-3 levels, especially the latter, during rhGH treatment to predict the growth response upon long-term treatment.

Unplanned Readmissions to the Intensive Care Unit Among Geriatric Trauma Patients

Background Unplanned readmission/bounceback to the intensive care unit (ICUBB) is a prevalent issue in the medical community. The geriatric population is incompletely studied in regard to ICUBB. We sought to determine if ICUBB in older patients was associated with higher risk of mortality. We hypothesized that, of those who were older, those with ICUBB would have higher mortality compared to those with no ICUBB. Further, we hypothesized that of those with ICUBB, older age would lead to higher mortality. Methods The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003 to 2018 for all trauma patients of age ≥40 years. Those with advance directives were excluded. Adjusted analysis in the form of logistic regressions controlling for demographic and injury covariates and clustering by facility were used to assess the adjusted impact of ICUBB and age on mortality. Results 363,778 patients were aged ≥40 years. When comparing mortalities between the age 40 and 49 years group and those in older groups, a dramatic increase in mortality was observed between those in each respective age category with ICUBB vs non-ICUBB. This trend was most prominent in those in the 90+ years age group (ICUBB: AOR: 34.78, P < .001; non-ICUBB: AOR: 9.08, P < .001). A second model only including patients who had ICUBB found that patients of age ≥65 years had significantly higher odds of mortality (AOR: 4.10, P < .001) when compared to their younger counterparts (age <65 years). Discussion An ICUBB seems to exacerbate mortality rates as age increases. This profound increase in mortality calls for strategies to be developed, especially in the older population, to attempt to mitigate the factors leading to ICUBB.

An Investigation of Brain Signal Characteristics between Hafiz/Hafizah Subjects and Non-Hafiz/Hafizah Subjects

Tahfiz education has gain its popularity among Malaysians thus expand the circle of hafiz and hafizah all over the country. This study has been done to investigate effect of memorizing Al-Quran by determining the difference between hafiz/hafizah subjects and non-hafiz/hafizah subjects in terms of their focus using brain signal characteristics. 10 subjects (5 hafiz/hafizah and 5 non-hafiz/hafizah) have been participated in this study. Database of EEG was recorded by using EegoSport (ANT Neuro, ES-230, The Netherlands) while listening no music, rock music, instrumental music and Al-Quran audio simultaneously with Continuous Performance Task (CPT). The classification has been done by using machine learning method. Decision Tree method have obtained the highest accuracy (96.63%) for PSD Burg by using beta wave. The finding shows that hafiz/hafizah group were more focus in all given tasks compared to non-hafiz/hafizah group. Statistical analysis by using Wilcoxon Signed-Ranks Test found that the designed methodology was significant with 95% confidence interval.

509 - Influence of Self-perceptions of aging and attitudes towards aging on perceived health status

ObjectivesPerceived health status is an important health indicator related to successfulaging and older people’s quality of life. Perceived health status depends on biological, social and psychological factors, for example, at a social level, depends on comparisons with the peer group that individuals carry out and on attitudes towards aging, ageism andhow older people believe they are viewed by society. The aim of this study was to exploreattitudes towards aging and self-perceptions of aging among Spanish middle age and older people and to identify the influence on perceived health status.MethodThe sample comprised 1,124 individuals with ages between 50 to 98 years-old (M= 64.84, SD= 10.12) from the Aging in Spain Longitudinal Study database, Pilot Survey (ELES-PS).ResultsAlmost 70 per cent of the participants stated that old age begins at a specific chronological age and half of them considered that society treats older people with indifference. Self-perceptions of aging and attitudes towards aging were significant predictors that explain a 12.2% in the variance of perceived health status.DiscussionResults from this study highlight the importance of perceptions and attitudestowards aging for older adults’ health. Addressing negative self-perceptions of aging andnegative attitudes towards aging can be particularly useful because they are associated with more pessimistic expectancies about the aging process.

Trends in amyloidosis in spondyloarthritis: results from the Spanish National Inpatient Registry over a 17-year period (1999–2015)—TREND-EspA study

ObjectiveTo assess the incidence of amyloidosis and trends therein in patients with spondyloarthritis (SpA) over a long period (17 years).MethodsAn observational retrospective population-based matched cohort study was conducted. All the admissions of patients with SpA, including ankylosing spondylitis (AS), psoriatic arthritis (PsA), arthritis associated with inflammatory bowel disease (SpA-IBD) and reactive arthritis (ReA), reported between 1999 and 2015, were analysed and a control group matched by age, sex and year of admission was selected. Incidence rates for amyloidosis were calculated. Generalised linear models were used for trend analysis and unconditional logistic regression for calculating crude and adjusted ORs (AOR) to assess the association between amyloidosis and SpA.ResultsThe study database contained data on 107 140 admissions in each group. Between 1999 and 2015, 792 patients in the SpA cohort (0.7% of all admissions) had a diagnosis of amyloidosis versus 68 in the non-SpA cohort (0.1%) (p<0.001). From 1999 to 2015, incidence rates of amyloidosis tended to decrease in the SpA cohort (−4.63%/year overall), while they increased in the Non-SpA cohort (+10.25%/year overall). We found strong associations of amyloidosis with all SpAs (AOR 10.4; 95% CI 8.2 to 13.3) and with each type studied (AORs 10.05 (7.84 to 12. 88) for AS, 9.5 (7.3 to 12.4) for PsA, 22.9 (16.6 to 31.7) for SpA-IBD and 10.1 (6.1 to 16.7) for ReA).ConclusionsIncidence of amyloidosis among patients with SpA has strongly decreased in Spain. Amyloidosis is most strongly associated with SpA-IBD while the strength of association with PsA and ReA is similar to that with AS.

Transcending Conventional Biometry Frontiers: Diffusive Dynamics PPG Biometry

This paper presents the first photoplethysmographic (PPG) signal dynamic-based biometric authentication system with a Siamese convolutional neural network (CNN). Our method extracts the PPG signal’s biometric characteristics from its diffusive dynamics, characterized by geometric patterns in the (p,q)-planes specific to the 0–1 test. PPG signal diffusive dynamics are strongly dependent on the vascular bed’s biostructure, unique to each individual. The dynamic characteristics of the PPG signal are more stable over time than its morphological features, particularly in the presence of psychosomatic conditions. Besides its robustness, our biometric method is anti-spoofing, given the complex nature of the blood network. Our proposal trains using a national research study database with 40 real-world PPG signals measured with commercial equipment. Biometric system results for input data, raw and preprocessed, are studied and compared with eight primary biometric methods related to PPG, achieving the best equal error rate (ERR) and processing times with a single attempt, among all of them.

Maternal Depressive Risk in Prenatal versus Postnatal Surgical Closure of Myelomeningocele: Associations with Parenting Stress and Child Outcomes

<b><i>Introduction:</i></b> Depressive risk is higher for mothers of infants with chronic medical conditions. The present study examined maternal depressive risk and associations with parent and child outcomes among mothers of young children who were randomized to either prenatal or postnatal surgical closure for myelomeningocele. <b><i>Methods:</i></b> Using the Management of Myelomeningocele Study database, maternal depressive risk was examined at 3 time points as follows: prior to birth, 12 months, and 30 months post birth. Separate multivariate analyses examined associations among change in depressive risk (between baseline and 30 months), parenting stress, and child outcomes at 30 months. <b><i>Results:</i></b> Mean scores were in the minimal depressive risk range at all the time points. Post birth depressive risk did not differ by prenatal versus postnatal surgery. Mean change scores reflected a decrease in depressive risk during the first 30 months. Only 1.1–4.5% of mothers reported depressive risk in the moderate to severe range across time points. Increased depressive risk during the first 30 months was associated with increased parenting stress scores and slightly lower child cognitive scores at 30 months. <b><i>Conclusion:</i></b> Most mothers reported minimal depressive risk that decreased over time, regardless of whether their infant underwent prenatal or postnatal surgery. Only a small percentage of mothers endorsed moderate to severe depressive risk, but an increase in depressive risk over time was associated with higher parental stress and slightly lower child cognitive development.