2022
Autores
Renna, F; Martins, M; Neto, A; Cunha, A; Libanio, D; Dinis-Ribeiro, M; Coimbra, M;
Publicação
DIAGNOSTICS
Abstract
Stomach cancer is the third deadliest type of cancer in the world (0.86 million deaths in 2017). In 2035, a 20% increase will be observed both in incidence and mortality due to demographic effects if no interventions are foreseen. Upper GI endoscopy (UGIE) plays a paramount role in early diagnosis and, therefore, improved survival rates. On the other hand, human and technical factors can contribute to misdiagnosis while performing UGIE. In this scenario, artificial intelligence (AI) has recently shown its potential in compensating for the pitfalls of UGIE, by leveraging deep learning architectures able to efficiently recognize endoscopic patterns from UGIE video data. This work presents a review of the current state-of-the-art algorithms in the application of AI to gastroscopy. It focuses specifically on the threefold tasks of assuring exam completeness (i.e., detecting the presence of blind spots) and assisting in the detection and characterization of clinical findings, both gastric precancerous conditions and neoplastic lesion changes. Early and promising results have already been obtained using well-known deep learning architectures for computer vision, but many algorithmic challenges remain in achieving the vision of AI-assisted UGIE. Future challenges in the roadmap for the effective integration of AI tools within the UGIE clinical practice are discussed, namely the adoption of more robust deep learning architectures and methods able to embed domain knowledge into image/video classifiers as well as the availability of large, annotated datasets.
2022
Autores
Oliveira, J; Nogueira, DM; Ferreira, CA; Jorge, AM; Coimbra, MT;
Publicação
44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society, EMBC 2022, Glasgow, Scotland, United Kingdom, July 11-15, 2022
Abstract
Cardiac auscultation is the key exam to screen cardiac diseases both in developed and developing countries. A heart sound auscultation procedure can detect the presence of murmurs and point to a diagnosis, thus it is an important first-line assessment and also cost-effective tool. The design automatic recommendation systems based on heart sound auscultation can play an important role in boosting the accuracy and the pervasiveness of screening tools. One such as step, consists in detecting the fundamental heart sound states, a process known as segmentation. A faulty segmentation or a wrong estimation of the heart rate might result in an incapability of heart sound classifiers to detect abnormal waves, such as murmurs. In the process of understanding the impact of a faulty segmentation, several common heart sound segmentation errors are studied in detail, namely those where the heart rate is badly estimated and those where S1/S2 and Systolic/Diastolic states are swapped in comparison with the ground truth state sequence. From the tested algorithms, support vector machine (SVMs) and random forest (RFs) shown to be more sensitive to a wrong estimation of the heart rate (an expected drop of 6% and 8% on the overall performance, respectively) than to a swap in the state sequence of events (an expected drop of 1.9% and 4.6%, respectively).
2022
Autores
Ferreira, MC; Costa, PD; Abrantes, D; Hora, J; Felicio, S; Coimbra, M; Dias, TG;
Publicação
TRANSPORTATION RESEARCH PART F-TRAFFIC PSYCHOLOGY AND BEHAVIOUR
Abstract
The continuous growth of the world population and its agglomeration in urban cities, demand an increasing need for mobility, which in turn contributes to the worsening of traffic congestion and pollution in cities. Therefore, it is necessary to promote active travel, such as walking and cycling. However, this is not an easy task, as pedestrians and cyclists are the most vulnerable link in the system, and low levels of safety, security and comfort can contribute to choosing private cars over active travel. Hence, it is essential to understand the determinants that affect the perceptions of pedestrians and cyclists, in order to support the definition of policies that promote the use of active modes of transport. Thus, this article fills an important gap in the literature by identifying and discussing the objective and subjective determinants that affect the perceptions of safety, security and comfort of pedestrians and cyclists, through a systematic review of the literature published in the last ten years. It followed the PRISMA statement guidelines and checklist, resulting in 68 relevant articles that were carefully analyzed. The results show that the perception of safety is negatively affected by fear of traffic-related injuries, fear of falling related to infra-structure and infrastructure maintenance, and negative behavior of drivers. Regarding security, crime was the major concern of pedestrians and cyclists, either with emphasis on the person or on personal property. With regard to comfort, high levels of air and noise pollution, lack of vege-tation, bad weather conditions, slopes and long commuting distances negatively affected the users' perception. The results also suggest that poor lighting affects all domains, providing a negative perception of safety, security and comfort. Similarly, the presence of people is seen as negatively influencing the perception of safety and comfort, while the absence of people nega-tively impacts the perception of security. Therefore, the findings achieved by this study are key to assist in the definition of transport policies and infrastructure creation in large smart cities. Additionally, new transport policies are proposed and discussed.
2022
Autores
Lopes, I; Silva, A; Coimbra, MT; Ribeiro, MD; Libânio, D; Renna, F;
Publicação
44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society, EMBC 2022, Glasgow, Scotland, United Kingdom, July 11-15, 2022
Abstract
This work focuses on detection of upper gas-trointestinal (GI) landmarks, which are important anatomical areas of the upper GI tract digestive system that should be photodocumented during endoscopy to guarantee a complete examination. The aim of this work consisted in testing new automatic algorithms, specifically based on convolutional neural network (CNN) systems, able to detect upper GI landmarks, that can help to avoid the presence of blind spots during esophagogastroduodenoscopy. We tested pre-trained CNN architectures, such as the ResNet-50 and VGG-16, in conjunction with different training approaches, including the use of class weights, batch normalization, dropout, and data augmentation. The ResNet-50 model trained with class weights was the best performing CNN, achieving an accuracy of 71.79% and a Mathews Correlation Coefficient (MCC) of 65.06%. The combination of supervised and unsupervised learning was also explored to increase classification performance. In particular, convolutional autoencoder architectures trained with unlabeled GI images were used to extract representative features. Such features were then concatenated with those extracted by the pre-trained ResNet-50 architecture. This approach achieved a classification accuracy of 72.45% and an MCC of 65.08%. Clinical relevance - Esophagogastroduodenoscopy (EGD) photodocumentation is essential to guarantee that all areas of the upper GI system are examined avoiding blind spots. This work has the objective to help the EGD photodocumentation monitorization by testing new CNN-based systems able to detect EGD landmarks.
2022
Autores
Maximino, J; Coimbra, MT; Pedrosa, J;
Publicação
44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society, EMBC 2022, Glasgow, Scotland, United Kingdom, July 11-15, 2022
Abstract
The coronavirus disease 2019 (COVID-19) evolved into a global pandemic, responsible for a significant number of infections and deaths. In this scenario, point-of-care ultrasound (POCUS) has emerged as a viable and safe imaging modality. Computer vision (CV) solutions have been proposed to aid clinicians in POCUS image interpretation, namely detection/segmentation of structures and image/patient classification but relevant challenges still remain. As such, the aim of this study is to develop CV algorithms, using Deep Learning techniques, to create tools that can aid doctors in the diagnosis of viral and bacterial pneumonia (VP and BP) through POCUS exams. To do so, convolutional neural networks were designed to perform in classification tasks. The architectures chosen to build these models were the VGG16, ResNet50, DenseNet169 e MobileNetV2. Patients images were divided in three classes: healthy (HE), BP and VP (which includes COVID-19). Through a comparative study, which was based on several performance metrics, the model based on the DenseNet169 architecture was designated as the best performing model, achieving 78% average accuracy value of the five iterations of 5- Fold Cross-Validation. Given that the currently available POCUS datasets for COVID-19 are still limited, the training of the models was negatively affected by such and the models were not tested in an independent dataset. Furthermore, it was also not possible to perform lesion detection tasks. Nonetheless, in order to provide explainability and understanding of the models, Gradient-weighted Class Activation Mapping (GradCAM) were used as a tool to highlight the most relevant classification regions. Clinical relevance - Reveals the potential of POCUS to support COVID-19 screening. The results are very promising although the dataset is limite
2023
Autores
Elola, A; Aramendi, E; Oliveira, J; Renna, F; Coimbra, MT; Reyna, MA; Sameni, R; Clifford, GD; Rad, AB;
Publicação
IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS
Abstract
Objective: Murmurs are abnormal heart sounds, identified by experts through cardiac auscultation. The murmur grade, a quantitative measure of the murmur intensity, is strongly correlated with the patient's clinical condition. This work aims to estimate each patient's murmur grade (i.e., absent, soft, loud) from multiple auscultation location phonocardiograms (PCGs) of a large population of pediatric patients from a low-resource rural area. Methods: The Mel spectrogram representation of each PCG recording is given to an ensemble of 15 convolutional residual neural networks with channel-wise attention mechanisms to classify each PCG recording. The final murmur grade for each patient is derived based on the proposed decision rule and considering all estimated labels for available recordings. The proposed method is cross-validated on a dataset consisting of 3456 PCG recordings from 1007 patients using a stratified ten-fold cross-validation. Additionally, the method was tested on a hidden test set comprised of 1538 PCG recordings from 442 patients. Results: The overall cross-validation performances for patient-level murmur gradings are 86.3% and 81.6% in terms of the unweighted average of sensitivities and F1-scores, respectively. The sensitivities (and F1-scores) for absent, soft, and loud murmurs are 90.7% (93.6%), 75.8% (66.8%), and 92.3% (84.2%), respectively. On the test set, the algorithm achieves an unweighted average of sensitivities of 80.4% and an F1-score of 75.8%. Conclusions: This study provides a potential approach for algorithmic pre-screening in low-resource settings with relatively high expert screening costs. Significance: The proposed method represents a significant step beyond detection of murmurs, providing characterization of intensity, which may provide an enhanced classification of clinical outcomes.
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