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Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering

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A special issue of Entropy (ISSN 1099-4300).

Deadline for manuscript submissions: closed (15 May 2020) | Viewed by 37142

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Prof. Dr. Raúl Alcaraz

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Research Group in Electronic, Biomedical and Telecommunication Engineering, Universidad de Castilla-La Mancha, Campus Universitario s/n, 16071 Cuenca, Spain
Interests: entropy; complexity; information theory; information geometry; nonlinear dynamics; computational mathematics and statistics in medicine; biomedical time series analysis; cardiac signal processing
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Prof. Dr. Raimon Jané

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Biomedical Signal Processing and Interpretation Group, Institute for Bioengineering of Catalonia (IBEC), Universitat Politècnica de Catalunya·BarcelonaTech (UPC), 08019 Barcelona, Spain
Interests: multimodal and multiscale biomedical signal processing in cardiorespiratory and neurological diseases and sleep disorders
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Dr. Elisabete Aramendi

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Department of Communications Engineering, University of Basque Country, (UPV/EHU), 48013 Bilbao, Spain
Interests: biomedical signal processing; automated algorithms during resuscitation; management of large resuscitation datasets
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Dr. Félix Fanjul-Vélez

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Biomedical Engineering Group, Electronics Technology, Systems and Automation Engineering Department, University of Cantabria, 39005 Santander, Cantabria, Spain
Interests: biomedical engineering; electromagnetic and acoustic treatment and characterization of biological tissues; clinical diagnostic techniques; fluorescence and spectroscopy; polarization of light; electromagnetic propagation in turbid and turbulent media
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Special Issue Information

Dear Colleagues,

Every year, the Spanish Society of Biomedical Engineering (SEIB) runs a conference to bring together researchers, students, and professionals working in Biomedical Engineering. The objective is to close the gap between engineering and medicine and, thus, to advance diagnosis, monitoring, and therapy of a variety of diseases. This year the SEIB Annual Conference (CASEIB) will be held on 27th–29th of November at the University of Cantabria and, like the previous year, will be supported by Entropy. This is an international journal dealing with the development and/or application of entropy or information-theoretic concepts in a wide variety of applications (for more details, see https://www.mdpi.com/journal/entropy/about). Thus, this Special Issue will collect the most relevant papers dealing with entropy and information theory-based applications presented in this conference. More details can be found on the website: http://caseib.es/2019/revista-entropy/

We look forward to receiving your support for this initiative.

Dr. Raúl Alcaraz
Dr. Raimon Jané
Dr. Elisabete Aramendi
Dr. Félix Fanjul-Vélez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Entropy is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (10 papers)

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Research

19 pages, 8991 KiB

Open AccessFeature PaperArticle

Nonlinear Image Registration and Pixel Classification Pipeline for the Study of Tumor Heterogeneity Maps

by Laura Nicolás-Sáenz, Sara Guerrero-Aspizua, Javier Pascau and Arrate Muñoz-Barrutia

Entropy 2020, 22(9), 946; https://doi.org/10.3390/e22090946 - 28 Aug 2020

Cited by 2 | Viewed by 3219

Abstract

We present a novel method to assess the variations in protein expression and spatial heterogeneity of tumor biopsies with application in computational pathology. This was done using different antigen stains for each tissue section and proceeding with a complex image registration followed by a final step of color segmentation to detect the exact location of the proteins of interest. For proper assessment, the registration needs to be highly accurate for the careful study of the antigen patterns. However, accurate registration of histopathological images comes with three main problems: the high amount of artifacts due to the complex biopsy preparation, the size of the images, and the complexity of the local morphology. Our method manages to achieve an accurate registration of the tissue cuts and segmentation of the positive antigen areas. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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12 pages, 865 KiB

Open AccessArticle

Towards the Prediction of Rearrest during Out-of-Hospital Cardiac Arrest

by Andoni Elola, Elisabete Aramendi, Enrique Rueda, Unai Irusta, Henry Wang and Ahamed Idris

Entropy 2020, 22(7), 758; https://doi.org/10.3390/e22070758 - 09 Jul 2020

Cited by 12 | Viewed by 2873

Abstract

A secondary arrest is frequent in patients that recover spontaneous circulation after an out-of-hospital cardiac arrest (OHCA). Rearrest events are associated to worse patient outcomes, but little is known on the heart dynamics that lead to rearrest. The prediction of rearrest could help improve OHCA patient outcomes. The aim of this study was to develop a machine learning model to predict rearrest. A random forest classifier based on 21 heart rate variability (HRV) and electrocardiogram (ECG) features was designed. An analysis interval of 2

\min

after recovery of spontaneous circulation was used to compute the features. The model was trained and tested using a repeated cross-validation procedure, on a cohort of 162 OHCA patients (55 with rearrest). The median (interquartile range) sensitivity (rearrest) and specificity (no-rearrest) of the model were 67.3% (9.1%) and 67.3% (10.3%), respectively, with median areas under the receiver operating characteristics and the precision–recall curves of 0.69 and 0.53, respectively. This is the first machine learning model to predict rearrest, and would provide clinically valuable information to the clinician in an automated way. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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17 pages, 5053 KiB

Open AccessArticle

Multi-scale Entropy Evaluates the Proarrhythmic Condition of Persistent Atrial Fibrillation Patients Predicting Early Failure of Electrical Cardioversion

by Eva María Cirugeda Roldan, Sofía Calero, Víctor Manuel Hidalgo, José Enero, José Joaquín Rieta and Raúl Alcaraz

Entropy 2020, 22(7), 748; https://doi.org/10.3390/e22070748 - 07 Jul 2020

Cited by 2 | Viewed by 2204

Abstract

Atrial fibrillation (AF) is nowadays the most common cardiac arrhythmia, being associated with an increase in cardiovascular mortality and morbidity. When AF lasts for more than seven days, it is classified as persistent AF and external interventions are required for its termination. A well-established alternative for that purpose is electrical cardioversion (ECV). While ECV is able to initially restore sinus rhythm (SR) in more than 90% of patients, rates of AF recurrence as high as 20–30% have been found after only a few weeks of follow-up. Hence, new methods for evaluating the proarrhythmic condition of a patient before the intervention can serve as efficient predictors about the high risk of early failure of ECV, thus facilitating optimal management of AF patients. Among the wide variety of predictors that have been proposed to date, those based on estimating organization of the fibrillatory (f-) waves from the surface electrocardiogram (ECG) have reported very promising results. However, the existing methods are based on traditional entropy measures, which only assess a single time scale and often are unable to fully characterize the dynamics generated by highly complex systems, such as the heart during AF. The present work then explores whether a multi-scale entropy (MSE) analysis of the f-waves may provide early prediction of AF recurrence after ECV. In addition to the common MSE, two improved versions have also been analyzed, composite MSE (CMSE) and refined MSE (RMSE). When analyzing 70 patients under ECV, of which 31 maintained SR and 39 relapsed to AF after a four week follow-up, the three methods provided similar performance. However, RMSE reported a slightly better discriminant ability of 86%, thus improving the other multi-scale-based outcomes by 3–9% and other previously proposed predictors of ECV by 15–30%. This outcome suggests that investigation of dynamics at large time scales yields novel insights about the underlying complex processes generating f-waves, which could provide individual proarrhythmic condition estimation, thus improving preoperative predictions of ECV early failure. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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15 pages, 2727 KiB

Open AccessArticle

Robust Characterization of the Uterine Myoelectrical Activity in Different Obstetric Scenarios

by Javier Mas-Cabo, Yiyao Ye-Lin, Javier Garcia-Casado, Alba Díaz-Martinez, Alfredo Perales-Marin, Rogelio Monfort-Ortiz, Alba Roca-Prats, Ángel López-Corral and Gema Prats-Boluda

Entropy 2020, 22(7), 743; https://doi.org/10.3390/e22070743 - 05 Jul 2020

Cited by 16 | Viewed by 2449

Abstract

Electrohysterography (EHG) has been shown to provide relevant information on uterine activity and could be used for predicting preterm labor and identifying other maternal fetal risks. The extraction of high-quality robust features is a key factor in achieving satisfactory prediction systems from EHG. Temporal, spectral, and non-linear EHG parameters have been computed to characterize EHG signals, sometimes obtaining controversial results, especially for non-linear parameters. The goal of this work was to assess the performance of EHG parameters in identifying those robust enough for uterine electrophysiological characterization. EHG signals were picked up in different obstetric scenarios: antepartum, including women who delivered on term, labor, and post-partum. The results revealed that the 10th and 90th percentiles, for parameters with falling and rising trends as labor approaches, respectively, differentiate between these obstetric scenarios better than median analysis window values. Root-mean-square amplitude, spectral decile 3, and spectral moment ratio showed consistent tendencies for the different obstetric scenarios as well as non-linear parameters: Lempel–Ziv, sample entropy, spectral entropy, and SD1/SD2 when computed in the fast wave high bandwidth. These findings would make it possible to extract high quality and robust EHG features to improve computer-aided assessment tools for pregnancy, labor, and postpartum progress and identify maternal fetal risks. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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16 pages, 2193 KiB

Open AccessArticle

Application of Classification Algorithms to Diffuse Reflectance Spectroscopy Measurements for Ex Vivo Characterization of Biological Tissues

by Félix Fanjul-Vélez, Sandra Pampín-Suárez and José Luis Arce-Diego

Entropy 2020, 22(7), 736; https://doi.org/10.3390/e22070736 - 03 Jul 2020

Cited by 15 | Viewed by 2420

Abstract

Biological tissue identification in real clinical scenarios is a relevant and unsolved medical problem, particularly in the operating room. Although it could be thought that healthy tissue identification is an immediate task, in practice there are several clinical situations that greatly impede this process. For instance, it could be challenging in open surgery in complex areas, such as the neck, where different structures are quite close together, with bleeding and other artifacts affecting visual inspection. Solving this issue requires, on one hand, a high contrast noninvasive technique and, on the other hand, powerful classification algorithms. Regarding the technique, optical diffuse reflectance spectroscopy has demonstrated such capabilities in the discrimination of tumoral and healthy biological tissues. The complex signals obtained, in the form of spectra, need to be adequately computed in order to extract relevant information for discrimination. As usual, accurate discrimination relies on massive measurements, some of which serve as training sets for the classification algorithms. In this work, diffuse reflectance spectroscopy is proposed, implemented, and tested as a potential technique for healthy tissue discrimination. A specific setup is built and spectral measurements on several ex vivo porcine tissues are obtained. The massive data obtained are then analyzed for classification purposes. First of all, considerations about normalization, detrending and noise are taken into account. Dimensionality reduction and tendencies extraction are also considered. Featured spectral characteristics, principal component or linear discrimination analysis are applied, as long as classification approaches based on k-nearest neighbors (k-NN), quadratic discrimination analysis (QDA) or Naïve Bayes (NB). Relevant parameters about classification accuracy are obtained and compared, including ANOVA tests. The results show promising values of specificity and sensitivity of the technique for some classification algorithms, even over 95%, which could be relevant for clinical applications in the operating room. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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17 pages, 3923 KiB

Open AccessArticle

A Deep Learning Approach for Featureless Robust Quality Assessment of Intermittent Atrial Fibrillation Recordings from Portable and Wearable Devices

by Álvaro Huerta Herraiz, Arturo Martínez-Rodrigo, Vicente Bertomeu-González, Aurelio Quesada, José J. Rieta and Raúl Alcaraz

Entropy 2020, 22(7), 733; https://doi.org/10.3390/e22070733 - 01 Jul 2020

Cited by 22 | Viewed by 3680

Abstract

Atrial fibrillation (AF) is the most common heart rhythm disturbance in clinical practice. It often starts with asymptomatic and very short episodes, which are extremely difficult to detect without long-term monitoring of the patient’s electrocardiogram (ECG). Although recent portable and wearable devices may become very useful in this context, they often record ECG signals strongly corrupted with noise and artifacts. This impairs automatized ulterior analyses that could only be conducted reliably through a previous stage of automatic identification of high-quality ECG intervals. So far, a variety of techniques for ECG quality assessment have been proposed, but poor performances have been reported on recordings from patients with AF. This work introduces a novel deep learning-based algorithm to robustly identify high-quality ECG segments within the challenging environment of single-lead recordings alternating sinus rhythm, AF episodes and other rhythms. The method is based on the high learning capability of a convolutional neural network, which has been trained with 2-D images obtained when turning ECG signals into wavelet scalograms. For its validation, almost 100,000 ECG segments from three different databases have been analyzed during 500 learning-testing iterations, thus involving more than 320,000 ECGs analyzed in total. The obtained results have revealed a discriminant ability to detect high-quality and discard low-quality ECG excerpts of about 93%, only misclassifying around 5% of clean AF segments as noisy ones. In addition, the method has also been able to deal with raw ECG recordings, without requiring signal preprocessing or feature extraction as previous stages. Consequently, it is particularly suitable for portable and wearable devices embedding, facilitating early detection of AF as well as other automatized diagnostic facilities by reliably providing high-quality ECG excerpts to further processing stages. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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22 pages, 3238 KiB

Open AccessArticle

Groupwise Non-Rigid Registration with Deep Learning: An Affordable Solution Applied to 2D Cardiac Cine MRI Reconstruction

by Elena Martín-González, Teresa Sevilla, Ana Revilla-Orodea, Pablo Casaseca-de-la-Higuera and Carlos Alberola-López

Entropy 2020, 22(6), 687; https://doi.org/10.3390/e22060687 - 19 Jun 2020

Cited by 5 | Viewed by 3010

Abstract

Groupwise image (GW) registration is customarily used for subsequent processing in medical imaging. However, it is computationally expensive due to repeated calculation of transformations and gradients. In this paper, we propose a deep learning (DL) architecture that achieves GW elastic registration of a 2D dynamic sequence on an affordable average GPU. Our solution, referred to as dGW, is a simplified version of the well-known U-net. In our GW solution, the image that the other images are registered to, referred to in the paper as template image, is iteratively obtained together with the registered images. Design and evaluation have been carried out using 2D cine cardiac MR slices from 2 databases respectively consisting of 89 and 41 subjects. The first database was used for training and validation with 66.6–33.3% split. The second one was used for validation (50%) and testing (50%). Additional network hyperparameters, which are—in essence—those that control the transformation smoothness degree, are obtained by means of a forward selection procedure. Our results show a 9-fold runtime reduction with respect to an optimization-based implementation; in addition, making use of the well-known structural similarity (SSIM) index we have obtained significative differences with dGW with respect to an alternative DL solution based on Voxelmorph. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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20 pages, 2664 KiB

Open AccessArticle

Assessment of Airflow and Oximetry Signals to Detect Pediatric Sleep Apnea-Hypopnea Syndrome Using AdaBoost

by Jorge Jiménez-García, Gonzalo C. Gutiérrez-Tobal, María García, Leila Kheirandish-Gozal, Adrián Martín-Montero, Daniel Álvarez, Félix del Campo, David Gozal and Roberto Hornero

Entropy 2020, 22(6), 670; https://doi.org/10.3390/e22060670 - 17 Jun 2020

Cited by 21 | Viewed by 4166

Abstract

The reference standard to diagnose pediatric Obstructive Sleep Apnea (OSA) syndrome is an overnight polysomnographic evaluation. When polysomnography is either unavailable or has limited availability, OSA screening may comprise the automatic analysis of a minimum number of signals. The primary objective of this study was to evaluate the complementarity of airflow (AF) and oximetry (SpO₂) signals to automatically detect pediatric OSA. Additionally, a secondary goal was to assess the utility of a multiclass AdaBoost classifier to predict OSA severity in children. We extracted the same features from AF and SpO₂ signals from 974 pediatric subjects. We also obtained the 3% Oxygen Desaturation Index (ODI) as a common clinically used variable. Then, feature selection was conducted using the Fast Correlation-Based Filter method and AdaBoost classifiers were evaluated. Models combining ODI 3% and AF features outperformed the diagnostic performance of each signal alone, reaching 0.39 Cohens’s kappa in the four-class classification task. OSA vs. No OSA accuracies reached 81.28%, 82.05% and 90.26% in the apnea–hypopnea index cutoffs 1, 5 and 10 events/h, respectively. The most relevant information from SpO₂ was redundant with ODI 3%, and AF was complementary to them. Thus, the joint analysis of AF and SpO₂ enhanced the diagnostic performance of each signal alone using AdaBoost, thereby enabling a potential screening alternative for OSA in children. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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16 pages, 5229 KiB

Open AccessArticle

A Deep Learning Approach for Segmentation of Red Blood Cell Images and Malaria Detection

by Maria Delgado-Ortet, Angel Molina, Santiago Alférez, José Rodellar and Anna Merino

Entropy 2020, 22(6), 657; https://doi.org/10.3390/e22060657 - 13 Jun 2020

Cited by 37 | Viewed by 6150

Abstract

Malaria is an endemic life-threating disease caused by the unicellular protozoan parasites of the genus Plasmodium. Confirming the presence of parasites early in all malaria cases ensures species-specific antimalarial treatment, reducing the mortality rate, and points to other illnesses in negative cases. However, the gold standard remains the light microscopy of May-Grünwald–Giemsa (MGG)-stained thin and thick peripheral blood (PB) films. This is a time-consuming procedure, dependent on a pathologist’s skills, meaning that healthcare providers may encounter difficulty in diagnosing malaria in places where it is not endemic. This work presents a novel three-stage pipeline to (1) segment erythrocytes, (2) crop and mask them, and (3) classify them into malaria infected or not. The first and third steps involved the design, training, validation and testing of a Segmentation Neural Network and a Convolutional Neural Network from scratch using a Graphic Processing Unit. Segmentation achieved a global accuracy of 93.72% over the test set and the specificity for malaria detection in red blood cells (RBCs) was 87.04%. This work shows the potential that deep learning has in the digital pathology field and opens the way for future improvements, as well as for broadening the use of the created networks. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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17 pages, 4412 KiB

Open AccessArticle

Rhythm Analysis during Cardiopulmonary Resuscitation Using Convolutional Neural Networks

by Iraia Isasi, Unai Irusta, Elisabete Aramendi, Trygve Eftestøl, Jo Kramer-Johansen and Lars Wik

Entropy 2020, 22(6), 595; https://doi.org/10.3390/e22060595 - 27 May 2020

Cited by 23 | Viewed by 5800

Abstract

Chest compressions during cardiopulmonary resuscitation (CPR) induce artifacts in the ECG that may provoque inaccurate rhythm classification by the algorithm of the defibrillator. The objective of this study was to design an algorithm to produce reliable shock/no-shock decisions during CPR using convolutional neural [...] Read more.

s

extracted during chest compressions were used, whereof 586 were shockable and 2733 nonshockable. Chest compression artifacts were removed using a Recursive Least Squares (RLS) filter, and the filtered ECG was fed to a CNN classifier with three convolutional blocks and two fully connected layers for the shock/no-shock classification. A 5-fold cross validation architecture was adopted to train/test the algorithm, and the proccess was repeated 100 times to statistically characterize the performance. The proposed architecture was compared to the most accurate algorithms that include handcrafted ECG features and a random forest classifier (baseline model). The median (90% confidence interval) sensitivity, specificity, accuracy and balanced accuracy of the method were 95.8% (94.6–96.8), 96.1% (95.8–96.5), 96.1% (95.7–96.4) and 96.0% (95.5–96.5), respectively. The proposed algorithm outperformed the baseline model by 0.6-points in accuracy. This new approach shows the potential of deep learning methods to provide reliable diagnosis of the cardiac rhythm without interrupting chest compression therapy. Full article

(This article belongs to the Special Issue Selected Papers from 37th Annual Conference of Spanish Society of Biomedical Engineering)

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