Electrocardiogram digitization: a practical perspective on the usefulness of a new tool to convert paper electrocardiograms into digital waveform.
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In this paper, we present bidirectional Long Short Term Memory (LSTM) networks, and a modified, full gradient version of the LSTM learning algorithm. We evaluate Bidirectional LSTM (BLSTM) and several other network architectures on the benchmark task of framewise phoneme classification, using the TIMIT database. Our main findings are that bidirectional networks outperform unidirectional ones, and Long Short Term Memory (LSTM) is much faster and also more accurate than both standard Recurrent Neural Nets (RNNs) and time-windowed Multilayer Perceptrons (MLPs). Our results support the view that contextual information is crucial to speech processing, and suggest that BLSTM is an effective architecture with which to exploit it.
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Sixteen children with traumatic asphyxia (TA) over a 10-year period are reported. Follow-up was available in 12 of 14 survivors. Mortality and morbidity are the results of associated injuries or cerebral hypoxia, which are determined by the severity, nature, and duration of the compression force. Associated injuries should be treated in their own right, disregarding the manifestations of TA. The physical findings unique to TA usually resolve spontaneously. Neurologic sequelae such as peripheral nerve injuries or spinal cord injuries may be permanent. The cutaneous lesions uniformly disappear with time. Subconjunctival hemorrhages slowly fade and disappear. Visual defects are rare and usually clear within 24 hours, but may be permanent. No cognitive impairment results in children with uncomplicated TA, and the value of treating cerebral cortical depression with steroids is uncertain.
The association of hypoglycemia and microphallus in the male neonate is presumptive evidence of congenital hypopituitarism. This was observed in four male infants with normal birth weight and length, optic discs, and intelligence, and without gross central nervous system malformations. Plasma and urinary cortisol values were low. Stimulation with metyrapone and insulin hypoglycemia failed to elicit a rise in plasma corticoids, but multiple doses of ACTH evoked a response. Growth hormone responses to arginine, insulin, sleep, L-dopa, and glucagon were uniformly less than 2.5 ng/ml. In three patients, however, length remained within 2 SD of the mean until two years of age; in one, there was a sharp decrease in growth by three months. Two patients had low plasma TSH and thyroxine concentrations within the first month of life. In the other two patients, whose thyroxine levels were measurable, intravenous administration of thyrotropin-releasing factor evoked a normal rise in plasma TSH; serum thyroxine decreased into the hypothyroid range in one after GH therapy was initiated. Plasma prolactin was normal in the first two patients receiving thyroxine replacement therapy. The other two patients had elevated baseline prolactin levels and had an augmented rise in plasma prolactin after administration of TRF. Human chorionic gonadotropin induced a 10- to 15-fold rise in plasma testosterone in the two patients tested. The changes in plasma FSH and LH after luteinizing hormone-releasing factor were either low or in the prepubertal range. In three patients, treated with testosterone enanthate intramuscularly, phallic growth occurred. In addition, all three had a transient increase in height but no acceleration of skeletal maturation. The data suggest a deficiency of hypothalamic hypophysiotropic hormones rather than a primary pituitary defect. Early recognition of this syndrome complex is critical for prompt treatment of the life-threatening cortisol deficiency. The diagnosis is more difficult in affected females because their external genitals are normal. The microphallus is a remediable manifestation of hypopituitarism.
Neonatal asphyxia, defined in this study as delay of greater than 1 minute in onset of spontaneous respiration at birth, occurred in 1% of 13,221 live-born infants of birth weight greater than 500 gm between 1970 and 1971. Seventy-five (56%) of 133 asphyxiated infants survived the neonatal period. Survival was directly related to gestational age. The 65 survivors of asphyxia available for study were seen at a mean age of 4.8 years to determine the incidence and extent of neurologic and developmental abnormalities. Twelve children (18.5%) had severe impairment: nine had both neurologic and intellectual handicaps, two had neurologic impairment alone, and one had intellectual impairment alone. The incidence and severity of impairment were not related to gestational age. Postasphyctic seizures were associated with poor outcome.
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The potential of computers to assist veterinarians in medical management is reviewed. It is argued that computers will contribute to improved patient care by solving the information retrieval and processing problems in medicine. Strategies to accomplish this goal are discussed in detail, and criteria for evaluating diagnostic information systems are proposed.
In the present study an automatic algorithm for detection and contouring of multiple sclerosis (MS) lesions in brain magnetic resonance (MR) images is introduced. This algorithm automatically detects MS lesions in axial proton density, T2-weighted, gadolinium enhanced, and fast fluid attenuated inversion recovery (FLAIR) brain MR images. Automated detection consists of three main stages: (1) detection and contouring of all hyperintense signal regions within the image; (2) partial elimination of false positive segments (defined herein as artifacts) by size, shape index, and anatomical location; (3) the use of an artificial neural paradigm (Back-Propagation) for final removal of artifacts by differentiating them from true MS lesions. The algorithm was applied to 45 images acquired from 14 MS patients. The algorithm's sensitivity was 0.87 and the specificity 0.96. In 34 images, 100% of the lesions were detected. The algorithm potentially may serve as a useful preprocessing tool for quantitative MS monitoring via magnetic resonance imaging.
AIM: The aim of this study was to detail the incidence of cerebral palsy in children born before 32 weeks of gestation and to evaluate the scholastic and intellectual performance in non-handicapped children. POPULATION AND METHODS: The population included 63 survivors hospitalized in 1984-85 (gestational age: 30.06 +/- 1.21 weeks; birth weight: 1386 +/- 267 g; inborn 60%; male: 38.7%; small for gestational age: 4.8%; hyaline membrane disease: 32%; European: 98.4%). Neurodevelopmental assessment was performed by pediatricians and psychologists using Wisc-R, visual screening by Monoyer scale, hearing by audiometry realized by oto-rhinolaryngologists. RESULTS: There were 62 survivors (one child dead by sudden infant death syndrome). Fifty children evaluated at a mean age of 9.3 +/- 0.7 years and written data available for another eight. Twelve children presented with cerebral palsy. Risk factors were ultrasound abnormalities of parenchymal brain and male gender. In children without cerebral palsy, we observed 12 visual and two hearing impairment. Three were in special education, 32 were in an age-appropriate level, nine with one year below. Neonatal events were not associated with the Wisc-R results except for ultrasound abnormalities of parenchymal brain. Wisc-R was strongly correlated with familial economic and education level. CONCLUSION: School performances in non-handicapped children born before 32 weeks is satisfying. Intellectual performance is mainly correlated with familial economic and education level.
This paper provides an introduction to the field of information visualization (IV) and a discussion of its application to medical systems. More specifically, it aims at: (i) defining what IV is and what are its goals (ii) highlighting the similarities and differences between IV and traditional medical imaging (iii) illustrating the potential of IV for medical applications by examining several examples of implemented systems and (iv) giving some general indications about the purposes and the effective exploitation of an IV component into a medical system.
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Research in case-based reasoning has explored the ideas of retrieving and adapting previous experience in the form of cases. The retrieval process uses an index vocabulary which attempts to capture content and context of previous cases. Current approaches to empirical evaluation of case-based reasoning systems often do not consider the crucial role which a content-oriented index vocabulary plays in the various stages of the case-based reasoning process. We will address this issue by describing an evaluation of our case-based discovery system IULIAN. Based on this description, we will propose a general schema for content-oriented evaluation of case-based reasoning systems.
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Hypermedia data browsing is a mean for improving information access. However, the overload and the heterogeneity of medical information, as well as the multitude of possible navigational paths, turn the consultation of data into a difficult task. We present in this paper a solution for the development of adaptive user interfaces in a hypermedia data browsing environment. It is based on the capitalization of the users knowledge in the decision-making process, expressed in terms of navigational paths and of data presentation modes that are customized to the user's preferences and practice. This capitalization offers the user a way to automatically store and reuse the experience accumulated in browsing through patient records. We illustrate our approach with the implementation of HEMA, a clinical workstation prototype that we have specialized for the cardiology domain.
Male vulnerability to neurodevelopmental disorders remains controversial. For one disorder, reading disability, this sex bias has been interpreted as an artifact of referral bias. We investigated sex differences for the incidence of reading disability within a large prospective sample of White (N = 16,910) and Black (N = 15,313) children derived from the National Collaborative Perinatal Project (NCPP). Children were classified as having either moderate or severe reading disability when they had reading scores lower than 1.5 or 2.0 standard errors of prediction, respectively, given their age and intelligence. Reading disability was about twice as common in boys than girls (p < .001), irrespective of race, severity of disability, or exclusion of children with attentional disturbances or high activity levels. We conclude that there is a clear sex bias toward males for the incidence of reading disabilities.
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