Electrical and Electronic Engineering - Research Publications

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    Automated recognition of major depressive disorder from cardiovascular and respiratory physiological signals.
    Zitouni, MS ; Lih Oh, S ; Vicnesh, J ; Khandoker, A ; Acharya, UR (Frontiers Media S.A., 2022)
    Major Depressive Disorder (MDD) is a neurohormonal disorder that causes persistent negative thoughts, mood and feelings, often accompanied with suicidal ideation (SI). Current clinical diagnostic approaches are solely based on psychiatric interview questionnaires. Thus, a computational intelligence tool for the automated detection of MDD with and without suicidal ideation is presented in this study. Since MDD is proven to affect cardiovascular and respiratory systems, the aim of the study is to automatically identify the disorder severity in MDD patients using corresponding multi-modal physiological signals, including electrocardiogram (ECG), finger photoplethysmography (PPG) and respiratory signals (RSP). Data from 88 subjects were used in this study, out of which 25 were MDD patients without SI (MDDSI-), 18 MDD patients with SI (MDDSI+), and 45 normal subjects. Multi-modal physiological signals were acquired from each subject, including ECG, RSP, and PPG signals, and then pre-processed. Discrete wavelet transform (DWT) was applied to the signals, which were decomposed up to six levels, and then eleven nonlinear features were extracted. The features were ranked according to the analysis of variance test and Marginal Fisher Analysis was employed to reduce the feature set, after which the reduced features were ranked again to select the most discriminatory features. Support vector machine with polynomial radial basis function (SVM-RBF) as well as k-nearest neighbor (KNN) classifiers were used to classify the significant features. The performance of the classifiers was evaluated in a 10-fold cross validation scheme. The best performance achieved for the classification of MDDSI+ patients was up to 85.2%, by using selected features from the obtained multi-modal signals with SVM-RBF, while it was up to 96.6% for the detection of MDD patients against healthy subjects. This work is a step toward the utilization of automated tools in diagnostics and monitoring of MDD patients in a personalized and wearable healthcare system.
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    Correlation between maternal and fetal heart rate increases with fetal mouse age in typical development and is disturbed in autism mouse model treated with valproic acid.
    Widatalla, N ; Khandoker, A ; Yoshida, C ; Nakanishi, K ; Fukase, M ; Suzuki, A ; Saito, M ; Kimura, Y ; Kasahara, Y (Frontiers Media SA, 2022)
    INTRODUCTION: Autism spectrum disorder (ASD) is considered a significant behavioral problem that is characterized by impairment in social interaction and communication. It is believed that some cases of ASD originate in the intrauterine maternal environment. Therefore, we hypothesized that there might be qualitative changes in the interaction between the mother and fetus in ASD during the prenatal period, hence, we investigated the similarity patterns between maternal and fetal heart rate (HR). METHODS: In this study, we first demonstrate the presence and formation of similarities between maternal and fetal RR interval (RRI) collected from typical developmental mice at different embryonic days (EDs), ED13.5, ED15.5, ED17.5, and ED18.5. The similarities were quantified by means of cross-correlation (CC) and magnitude-squared coherence (MSC) analyses. Correlation analysis between the CC coefficients and EDs and between MSC coefficients and EDs showed that the same coefficients increase with EDs, suggesting that similarities between maternal and fetal RRI are associated with typical fetal development. Next, because maternal and fetal similarities were indicative of development, a comparison analysis between the autism mouse model (injected with valproic acid (VPA)), and the control group (injected with saline) was performed for ED15.5 and ED18.5. RESULTS: The results of the comparison showed that the CC and MSC coefficients of VPA fetuses were significantly lower than that of the control group. The lower coefficients in VPA-treated mice suggest that they could be one of the features of ASD symptoms. The findings of this study can assist in identifying potential ASD causes during the prenatal period.
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    A two-step pre-processing tool to remove Gaussian and ectopic noise for heart rate variability analysis.
    Saleem, S ; Khandoker, AH ; Alkhodari, M ; Hadjileontiadis, LJ ; Jelinek, HF (Springer Science and Business Media LLC, 2022-11-01)
    Artifacts in the Electrocardiogram (ECG) degrade the quality of the recorded signal and are not conducive to heart rate variability (HRV) analysis. The two types of noise most often found in ECG recordings are technical and physiological artifacts. Current preprocessing methods primarily attend to ectopic beats but do not consider technical issues that affect the ECG. A secondary aim of this study was to investigate the effect of increasing increments of artifacts on 24 of the most used HRV measures. A two-step preprocessing approach for denoising HRV is introduced which targets each type of noise separately. First, the technical artifacts in the ECG are eliminated by applying complete ensemble empirical mode decomposition with adaptive noise. The second step removes physiological artifacts from the HRV signal using a combination filter of single dependent rank order mean and an adaptive filtering algorithm. The performance of the two-step pre-processing tool showed a high correlation coefficient of 0.846 and RMSE value of 7.69 × 10-5 for 6% of added ectopic beats and 6 dB Gaussian noise. All HRV measures studied except HF peak and LF peak are significantly affected by both types of noise. Frequency measures of Total power, HF power, and LF power and fragmentation measures; PAS, PIP, and PSS are the most sensitive to both types of noise.
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    Editorial: Methods and applications in computational physiology and medicine.
    Khandoker, AH ; Castiglioni, P ; Greenstein, JL ; Zhao, J ; Schlindwein, FS ; Elgendi, M ; Winslow, RL ; Struzik, ZR (Frontiers Media SA, 2022)
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    Similarities between maternal and fetal RR interval tachograms and their association with fetal development.
    Widatalla, N ; Khandoker, A ; Alkhodari, M ; Koide, K ; Yoshida, C ; Kasahara, Y ; Kimura, Y ; Saito, M (Frontiers Media SA, 2022)
    An association between maternal and fetal heart rate (HR) has been reported but, so far, little is known about its physiological implication and importance relative to fetal development. Associations between both HRs were investigated previously by performing beat-by-beat coupling analysis and correlation analysis between average maternal and fetal HRs. However, studies reporting on the presence of similarities between maternal and fetal HRs or RR intervals (RRIs) over the short term (e.g., 5-min) at different gestational ages (GAs) are scarce. Here, we demonstrate the presence of similarities in the variations exhibited by maternal and fetal RRl tachograms (RRITs). To quantify the same similarities, a cross-correlation (CC) analysis between resampled maternal and fetal RRITs was conducted; RRITs were obtained from non-invasive electrocardiogram (ECG). The degree of similarity between maternal and fetal RRITs (bmfRRITs) was quantified by calculating four CC coefficients. CC analysis was performed for a total of 330 segments (two 5-min segments from 158 subjects and one 5-min from 14 subjects). To investigate the association of the similarity bmfRRITs with fetal development, the linear correlation between the calculated CC coefficients and GA was calculated. The results from the latter analysis showed that similarities bmfRRITs are common occurrences, they can be negative or positive, and they increase with GA suggesting the presence of a regulation that is associated with proper fetal development. To get an insight into the physiological mechanisms involved in the similarity bmfRRITs, the association of the same similarity with maternal and fetal HR variability (HRV) was investigated by comparing the means of two groups in which one of them had higher CC values compared to the other. The two groups were created by using the data from the 158 subjects where fetal RRI (fRRI) calculation from two 5-min ECG segments was feasible. The results of the comparison showed that the maternal very low frequency (VLF) HRV parameter is potentially associated with the similarity bmfRRITs implying that maternal hormones could be linked to the regulations involved in the similarity bmfRRITs. Our findings in this study reinforce the role of the maternal intrauterine environment on fetal development.
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    Biosignal processing methods to explore the effects of side-dominance on patterns of bi- and unilateral standing stability in healthy young adults.
    Négyesi, J ; Petró, B ; Salman, DN ; Khandoker, A ; Katona, P ; Wang, Z ; Almaazmi, AISQ ; Hortobágyi, T ; Váczi, M ; Rácz, K ; Pálya, Z ; Grand, L ; Kiss, RM ; Nagatomi, R (Frontiers Media S.A., 2022)
    We examined the effects of side-dominance on the laterality of standing stability using ground reaction force, motion capture (MoCap), and EMG data in healthy young adults. We recruited participants with strong right (n = 15) and left (n = 9) hand and leg dominance (side-dominance). They stood on one or two legs on a pair of synchronized force platforms for 50 s with 60 s rest between three randomized stance trials. In addition to 23 CoP-related variables, we also computed six MoCap variables representing each lower-limb joint motion time series. Moreover, 39 time- and frequency-domain features of EMG data from five muscles in three muscle groups were analyzed. Data from the multitude of biosignals converged and revealed concordant patterns: no differences occurred between left- and right-side dominant participants in kinetic, kinematic, or EMG outcomes during bipedal stance. Regarding single leg stance, larger knee but lower ankle joint kinematic values appeared in left vs right-sided participants during non-dominant stance. Left-vs right-sided participants also had lower medial gastrocnemius EMG activation during non-dominant stance. While right-side dominant participants always produced larger values for kinematic data of ankle joint and medial gastrocnemius EMG activation during non-dominant vs dominant unilateral stance, this pattern was the opposite for left-sided participants, showing larger values when standing on their dominant vs non-dominant leg, i.e., participants had a more stable balance when standing on their right leg. Our results suggest that side-dominance affects biomechanical and neuromuscular control strategies during unilateral standing.
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    The gold-standard treatment for social anxiety disorder: A roadmap for the future.
    Chowdhury, N ; Khandoker, AH (Frontiers Media SA, 2022)
    Exposure therapy (ET), which follows the Pavlovian extinction model, is regarded as the gold-standard treatment for social anxiety disorder (SAD). The prospect of virtual reality in lieu of a traditional laboratory setting for the treatment of SAD has not been rigorously explored. The aim of the review was to summarize, find gaps in the current literature, and formulate future research direction by identifying two broad research questions: the comparative efficacy between in vivo ET and virtual reality exposure therapy (VRET) and the effectiveness of the Pavlovian extinction model in treating SAD. The criteria for effectiveness were effect size, relapse prevention, attrition rate and ecological validity. A literature search on recent randomized controlled trials yielded a total of 6 original studies (N=358), excluding duplication and overlapping participants. All studies supported that VRET was as effective as in vivo ET. Behavioral therapy that follows classical conditioning principles has a high attrition and relapse rate. Comparisons were drawn between the efficacy of the Pavlovian extinction model and other existing models, including third-wave approaches. The neural markers are suggested to be included as efficacy measures in treating SAD. The gold-standard treatment for SAD requires a paradigm shift through rigorous longitudinal comparative studies.
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    Beyond Pathogen Filtration: Possibility of Smart Masks as Wearable Devices for Personal and Group Health and Safety Management.
    Lee, P ; Kim, H ; Kim, Y ; Choi, W ; Zitouni, MS ; Khandoker, A ; Jelinek, HF ; Hadjileontiadis, L ; Lee, U ; Jeong, Y (JMIR Publications, 2022-06-21)
    Face masks are an important way to combat the COVID-19 pandemic. However, the prolonged pandemic has revealed confounding problems with the current face masks, including not only the spread of the disease but also concurrent psychological, social, and economic complications. As face masks have been worn for a long time, people have been interested in expanding the purpose of masks from protection to comfort and health, leading to the release of various "smart" mask products around the world. To envision how the smart masks will be extended, this paper reviewed 25 smart masks (12 from commercial products and 13 from academic prototypes) that emerged after the pandemic. While most smart masks presented in the market focus on resolving problems with user breathing discomfort, which arise from prolonged use, academic prototypes were designed for not only sensing COVID-19 but also general health monitoring aspects. Further, we investigated several specific sensors that can be incorporated into the mask for expanding biophysical features. On a larger scale, we discussed the architecture and possible applications with the help of connected smart masks. Namely, beyond a personal sensing application, a group or community sensing application may share an aggregate version of information with the broader population. In addition, this kind of collaborative sensing will also address the challenges of individual sensing, such as reliability and coverage. Lastly, we identified possible service application fields and further considerations for actual use. Along with daily-life health monitoring, smart masks may function as a general respiratory health tool for sports training, in an emergency room or ambulatory setting, as protection for industry workers and firefighters, and for soldier safety and survivability. For further considerations, we investigated design aspects in terms of sensor reliability and reproducibility, ergonomic design for user acceptance, and privacy-aware data-handling. Overall, we aim to explore new possibilities by examining the latest research, sensor technologies, and application platform perspectives for smart masks as one of the promising wearable devices. By integrating biomarkers of respiration symptoms, a smart mask can be a truly cutting-edge device that expands further knowledge on health monitoring to reach the next level of wearables.
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    Privacy Aware Affective State Recognition From Visual Data
    Zitouni, MS ; Lee, P ; Lee, U ; Hadjileontiadis, LJ ; Khandoker, A (Institute of Electrical and Electronics Engineers (IEEE), 2022-01-01)
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    Deep learning identifies cardiac coupling between mother and fetus during gestation.
    Alkhodari, M ; Widatalla, N ; Wahbah, M ; Al Sakaji, R ; Funamoto, K ; Krishnan, A ; Kimura, Y ; Khandoker, AH (Frontiers Media SA, 2022)
    In the last two decades, stillbirth has caused around 2 million fetal deaths worldwide. Although current ultrasound tools are reliably used for the assessment of fetal growth during pregnancy, it still raises safety issues on the fetus, requires skilled providers, and has economic concerns in less developed countries. Here, we propose deep coherence, a novel artificial intelligence (AI) approach that relies on 1 min non-invasive electrocardiography (ECG) to explain the association between maternal and fetal heartbeats during pregnancy. We validated the performance of this approach using a trained deep learning tool on a total of 941 one minute maternal-fetal R-peaks segments collected from 172 pregnant women (20-40 weeks). The high accuracy achieved by the tool (90%) in identifying coupling scenarios demonstrated the potential of using AI as a monitoring tool for frequent evaluation of fetal development. The interpretability of deep learning was significant in explaining synchronization mechanisms between the maternal and fetal heartbeats. This study could potentially pave the way toward the integration of automated deep learning tools in clinical practice to provide timely and continuous fetal monitoring while reducing triage, side-effects, and costs associated with current clinical devices.