In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low delay. To validate performance, we perform OPNET simulations of mobile WiMAX medium access control and physical layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channel's conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704×576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.
Emerging high efficiency video compression methods and wider availability of wireless network infrastructure will significantly advance existing m-health applications. For medical video communications, the emerging video compression and network standards support low-delay and high-resolution video transmission, at the clinically acquired resolution and frame rates. Such advances are expected to further promote the adoption of m-health systems for remote diagnosis and emergency incidents in daily clinical practice. This paper compares the performance of the emerging high efficiency video coding (HEVC) standard to the current state-of-the-art H.264/AVC standard. The experimental evaluation, based on five atherosclerotic plaque ultrasound videos encoded at QCIF, CIF, and 4CIF resolutions demonstrates that 50% reductions in bitrate requirements is possible for equivalent clinical quality.
Artificial intelligence (AI) is increasingly applied in a wide range of healthcare and Intensive Care Unit (ICU) areas to serve—among others—as a tool for disease detection and prediction, as well as for healthcare resources’ management. Since sepsis is a high mortality and rapidly developing organ dysfunction disease afflicting millions in ICUs and costing huge amounts to treat, the area can benefit from the use of AI tools for early and informed diagnosis and antibiotic administration. Additionally, resource allocation plays a crucial role when patient flow is increased, and resources are limited. At the same time, sensitive data use raises the need for ethical guidelines and reflective datasets. Additionally, explainable AI is applied to handle AI opaqueness. This study aims to present existing clinical approaches for infection assessment in terms of scoring systems and diagnostic biomarkers, along with their limitations, and an extensive overview of AI applications in healthcare and ICUs in terms of (a) sepsis detection/prediction and sepsis mortality prediction, (b) length of ICU/hospital stay prediction, and (c) ICU admission/hospitalization prediction after Emergency Department admission, each constituting an important factor towards either prompt interventions and improved patient wellbeing or efficient resource management. Challenges of AI applications in ICU are addressed, along with useful recommendations to mitigate them. Explainable AI applications in ICU are described, and their value in validating, and translating predictions in the clinical setting is highlighted. The most important findings and future directions including multimodal data use and Transformer-based models are discussed. The goal is to make research in AI advances in ICU and particularly sepsis prediction more accessible and provide useful directions on future work.
12 July 2017 in IEEE Journal of Biomedical and Health Informatics
The wider adoption of mobile Health video communication systems in standard clinical practice requires real-time control to provide for adequate levels of clinical video quality to support reliable diagnosis. The latter can only be achieved with real-time adaptation to time-varying wireless networks' state to guarantee clinically acceptable performance throughout the streaming session, while conforming to device capabilities for supporting real-time encoding. We propose an adaptive video encoding framework based on multi-objective optimization that jointly maximizes the encoded video's quality and encoding rate (in frames per second) while minimizing bitrate demands. For this purpose, we construct a dense encoding space and use linear regression to estimate forward prediction models for quality, bitrate, and computational complexity. The prediction models are then used in an adaptive control framework that can fine-tune video encoding based on real-time constraints. We validate the system using a leave-one-out algorithm applied to ten ultrasound videos of the common carotid artery. The prediction models can estimate structural similarity quality with a median accuracy error of less than 1%, bitrate demands with deviation error of 10% or less, and encoding frame rate within a 6% margin. Real-time adaptation at a group of pictures level is demonstrated using the high efficiency video coding standard. The effectiveness of the proposed framework compared to static, nonadaptive approaches is demonstrated for different modes of operation, achieving significant quality gains, bitrate demands reductions, and performance improvements, in real-life scenarios imposing time-varying constraints. Our approach is generic and should be applicable to other medical video modalities with different applications.
This study proposes a unifying framework for m-Health video communication systems that provides for the joint optimization of video quality, bitrate demands, and encoding time. The framework is video modality and infrastructure independent and facilitates adaptation to the best available encoding mode that satisfies underlying technology and application imposed constraints. The scalability of the proposed algorithm is demonstrated using different HEVC encoding configurations and realistic modelling of 802.11× wireless infrastructure for emergency scenery and response videos. Extensive experimentation shows that a jointly optimal solution in the encoding time, bitrate, and video quality space is feasible.
Explainable artificial intelligence (AI) focuses on developing models and algorithms that provide transparent and interpretable insights into decision-making processes. By elucidating the reasoning behind AI-driven diagnoses and treatment recommendations, explainability can gain the trust of healthcare experts and assist them in difficult diagnostic tasks. Sepsis is characterized as a serious condition that happens when the immune system of the body has an extreme response to an infection, causing tissue and organ damage and leading to death. Physicians face challenges in diagnosing and treating sepsis due to its complex pathogenesis. This work aims to provide an overview of the recent studies that propose explainable AI models in the prediction of sepsis onset and sepsis mortality using intensive care data. The general findings showed that explainable AI can provide the most significant features guiding the decision-making process of the model. Future research will investigate explainability through argumentation theory using intensive care data focused on sepsis patients.