Geographical validation of the Smart Triage Model by age group.

Infectious diseases in neonates account for half of the under-five mortality in low- and middle-income countries. Data-driven algorithms such as clinical prediction models can be used to efficiently detect critically ill children in order to optimize care and reduce mortality. Thus far, only a handful of prediction models have been externally validated and are limited to neonatal in-hospital mortality.

Neonatal Face and Facial Landmark Detection from Video Recordings.

This paper explores automated face and facial landmark detection of neonates, which is an important first step in many video-based neonatal health applications, such as vital sign estimation, pain assessment, sleep-wake classification, and jaundice detection. Utilising three publicly available datasets of neonates in the clinical environment, 366 images (258 subjects) and 89 (66 subjects) were annotated for training and testing, respectively. Transfer learning was applied to two YOLO-based models, with input training images augmented with random horizontal flipping, photo-metric colour distortion, translation and scaling during each training epoch.

Detection of spreading depression features from the scalp of epileptic patients.

Spreading depression (SD), a pathological cortical negative DC potential, is caused by an elevation of potassium ions in the extracellular space. This leads to a transient relocation of ions within neurons and a slow spread through brain tissue. Our previous research established a correlation between scalp SD and seizures in patients with intractable epilepsy using our novel electroencephalography (EEG).

Evaluating inter-individual variability captured by the Eleveld pharmacokinetics model.

Inter-individual variability in Pharmacokinetic (PK) and Pharmacodynamic (PD) models significantly affects the accuracy of Target Controlled Infusion and closed-loop control of anesthesia. We hypothesize that the novel Eleveld PK model captures more inter-individual variability relevant to both open-loop and closed-loop control design, resulting in reduced variability in PD models identified using the Eleveld PK model's plasma prediction compared to the Schuttler or Schnider PK model. We used a dataset of propofol infusion rates and Depth of Hypnosis measurements across three demographic groups: elderly, obese, and adult.

Blink-related EEG oscillations are neurophysiological indicators of subconcussive head impacts in female soccer players: a preliminary study.

Introduction: Repetitive subconcussive head impacts can lead to subtle neural changes and functional consequences on brain health. However, the objective assessment of these changes remains limited. Resting state blink-related oscillations (BROs), recently discovered neurological responses following spontaneous blinking, are explored in this study to evaluate changes in BRO responses in subconcussive head impacts.

Concurrent recordings of slow DC-potentials and epileptiform discharges: Novel EEG amplifier and signal processing techniques.

Ionic currents within the brain generate voltage oscillations. These bioelectrical activities include ultra-low frequency electroencephalograms (DC-EEG, frequency less than 0.1 Hz) and conventional clinical electroencephalograms (AC-EEG, 0.

Choosing blood pressure thresholds to inform pregnancy care in the community: An analysis of cluster trials.

Objective: To inform digital health design by evaluating diagnostic test properties of antenatal blood pressure (BP) outputs and levels to identify women at risk of adverse outcomes.

Design: Planned secondary analysis of cluster randomised trials.

Setting: India, Pakistan, Mozambique.

Measurement Uncertainty in Clinical Validation Studies of Sensors.

Accurate clinical sensors and devices are essential to support optimal medical decision-making, and accuracy can be demonstrated through the conduct of clinical validation studies using validated reference sensors and/or devices for comparison. Typically unmeasurable, the true reference value can be substituted with an accepted physiological measurement with an associated uncertainty. We describe a basic model of measurement uncertainty that specifies the factors that may degrade the accuracy of an observed measurement value from a sensor, and we detail validation study design strategies that may be used to quantify and minimize these uncertainties.

Effective pandemic policy design through feedback does not need accurate predictions.

The COVID-19 pandemic has had an enormous toll on human health and well-being and led to major social and economic disruptions. Public health interventions in response to burgeoning case numbers and hospitalizations have repeatedly bent down the epidemic curve, effectively creating a feedback control system. Worst case scenarios have been avoided in many places through this responsive feedback.

Noisy Neonatal Chest Sound Separation for High-Quality Heart and Lung Sounds.

Stethoscope-recorded chest sounds provide the opportunity for remote cardio-respiratory health monitoring of neonates. However, reliable monitoring requires high-quality heart and lung sounds. This paper presents novel artificial intelligence-based Non-negative Matrix Factorisation (NMF) and Non-negative Matrix Co-Factorisation (NMCF) methods for neonatal chest sound separation.

Prediction of Neonatal Respiratory Distress in Term Babies at Birth from Digital Stethoscope Recorded Chest Sounds.

Neonatal respiratory distress is a common condition that if left untreated, can lead to short- and long-term complications. This paper investigates the usage of digital stethoscope recorded chest sounds taken within 1 min post-delivery, to enable early detection and prediction of neonatal respiratory distress. Fifty-one term newborns were included in this study, 9 of whom developed respiratory distress.

A New Non-Negative Matrix Co-Factorisation Approach for Noisy Neonatal Chest Sound Separation.

Obtaining high quality heart and lung sounds enables clinicians to accurately assess a newborns cardio-respiratory health and provide timely care. However, noisy chest sound recordings are common, hindering timely and accurate assessment. A new Non-negative Matrix Co-Factorisation based approach is proposed to separate noisy chest sound recordings into heart, lung and noise components to address this problem.

Night to night variability of pulse oximetry features in children at home and at the hospital.

. Investigation of the night-to-night (NtN) variability of pulse oximetry features in children with suspicion of Sleep Apnea..

Model-plant mismatch detection for cross-directional processes.

This paper presents a two-component framework to detect model-plant mismatch (MPM) in cross-directional (CD) processes on paper machines under model-predictive control. First, routine operating data is used for system identification in closed loop; second, a one-class support vector machine (SVM) is trained to predict MPM. The iterative identification method alternates between identifying the finite impulse response coefficients of the spatial and temporal models.

The Effect of Low-Dose Intraoperative Ketamine on Closed-Loop-Controlled General Anesthesia: A Randomized Controlled Equivalence Trial.

Background: Closed-loop control of propofol-remifentanil anesthesia using the processed electroencephalography depth-of-hypnosis index provided by the NeuroSENSE monitor (WAVCNS) has been previously described. The purpose of this placebo-controlled study was to evaluate the performance (percentage time within ±10 units of the setpoint during the maintenance of anesthesia) of a closed-loop propofol-remifentanil controller during induction and maintenance of anesthesia in the presence of a low dose of ketamine.

Methods: Following ethical approval and informed consent, American Society of Anesthesiologist (ASA) physical status I-II patients aged 19-54 years, scheduled for elective orthopedic surgery requiring general anesthesia for >60 minutes duration, were enrolled in a double-blind randomized, placebo-controlled, 2-group equivalence trial.

Whole blood genome-wide transcriptome profiling and metagenomics next-generation sequencing in young infants with suspected sepsis in a low-and middle-income country: A study protocol.

Conducting collaborative and comprehensive epidemiological research on neonatal sepsis in low- and middle-income countries (LMICs) is challenging due to a lack of diagnostic tests. This prospective study protocol aims to obtain epidemiological data on bacterial sepsis in newborns and young infants at Kamuzu Central Hospital in Lilongwe, Malawi. The main goal is to determine if the use of whole blood transcriptome host immune response signatures can help in the identification of infants who have sepsis of bacterial causes.

Neonatal Heart and Lung Sound Quality Assessment for Robust Heart and Breathing Rate Estimation for Telehealth Applications.

With advances in digital stethoscopes, internet of things, signal processing and machine learning, chest sounds can be easily collected and transmitted to the cloud for remote monitoring and diagnosis. However, low quality of recordings complicates remote monitoring and diagnosis, particularly for neonatal care. This paper proposes a new method to objectively and automatically assess the signal quality to improve the accuracy and reliability of heart rate (HR) and breathing rate (BR) estimation from noisy neonatal chest sounds.

Association of cortical spreading depression and seizures in patients with medically intractable epilepsy.

Objective: Monitoring of the ultra-low frequency potentials, particularly cortical spreading depression (CSD), is excluded in epilepsy monitoring due to technical barriers imposed by the scalp ultra-low frequency electroencephalogram (EEG). As a result, clinical studies of CSD have been limited to invasive EEG. Therefore, the occurrence of CSD and its interaction with epileptiform field potentials (EFP) require investigation in epilepsy monitoring.

Robust PID control of propofol anaesthesia: Uncertainty limits performance, not PID structure.

Background And Objective: New proposals to improve the regulation of hypnosis in anaesthesia based on the development of advanced control structures emerge continuously. However, a fair study to analyse the real benefits of these structures compared to simpler clinically validated PID-based solutions has not been presented so far. The main objective of this work is to analyse the performance limitations associated with using a filtered PID controller, as compared to a high-order controller, represented through a Youla parameter.

Individualized closed-loop anesthesia through patient model partitioning.

Closed-loop controlled drug dosing has the potential of revolutionizing clinical anesthesia. However, inter-patient variability in drug sensitivity poses a central challenge to the synthesis of safe controllers. Identifying a full individual pharmacokinetic-pharmacodynamic (PKPD) model for this synthesis is clinically infeasible due to limited excitation of PKPD dynamics and presence of unmodeled disturbances.

Smart triage: triage and management of sepsis in children using the point-of-care Pediatric Rapid Sepsis Trigger (PRST) tool.

Background: Sepsis is the leading cause of death and disability in children. Every hour of delay in treatment is associated with an escalating risk of morbidity and mortality. The burden of sepsis is greatest in low- and middle-income countries where timely treatment may not occur due to delays in diagnosis and prioritization of critically ill children.

Effect of ketamine on the NeuroSENSE WAV during propofol anesthesia; a randomized feasibility trial.

Dose-dependent effects of ketamine on processed electroencephalographic depth-of-hypnosis indices have been reported. Limited data are available for the NeuroSENSE WAV index. Our aim was to establish the feasibility of closed-loop propofol-remifentanil anesthesia guided by the WAV index in the presence of an analgesic dose of ketamine.