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      Evaluation of electrohysterogram measured from different gestational weeks for recognizing preterm delivery: a preliminary study using random Forest

      research-article
      a , a , * , a , a , a , b , 1 , a , c , *
      Biocybernetics and Biomedical Engineering
      PWN-Polish Scientific Publishers
      EHG, electrohysterogram, RF, random forest, PE, preterm delivery before the 26th week of gestation, PL, preterm delivery after the 26th week of gestation, TE, term delivery before the 26th week of gestation, TL, term delivery after the 26th week of gestation, IUPC, intrauterine pressure catheter, TOCO, tocodynamometer, K-NN, K-nearest, LDA, linear discriminant analysis, QDA, quadratic discriminant analysis, SVM, support vector machine, ANN, artificial neural network, DT, decision tree, TPEHG, term-preterm electrohysterogram, RMS, root mean square, τz, zero-crossing, PF, peak frequency, MDF, median frequency, MNF, mean frequency, SE, energy values in signal, SM, maximum values in signal, SS, singular values in signal, SV, variance values in signal, AR, auto-regressive model, Tr, time reversibility, CorrDim, correlation dimension, SampEn, sample entropy, LE, Lyapunov exponent, SD, standard deviation, ADASYN, adaptive synthetic sampling approach, ACC, accuracy, AUC, the area under the curve, ROC, the receiver operating characteristic curve, Electrohysterogram (EHG), Feature extraction, Gestational week, Preterm delivery, Random forest (RF).

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          Abstract

          Developing a computational method for recognizing preterm delivery is important for timely diagnosis and treatment of preterm delivery. The main aim of this study was to evaluate electrohysterogram (EHG) signals recorded at different gestational weeks for recognizing the preterm delivery using random forest (RF). EHG signals from 300 pregnant women were divided into two groups depending on when the signals were recorded: i) preterm and term delivery with EHG recorded before the 26 th week of gestation (denoted by PE and TE group), and ii) preterm and term delivery with EHG recorded during or after the 26 th week of gestation (denoted by PL and TL group). 31 linear features and nonlinear features were derived from each EHG signal, and then compared comprehensively within PE and TE group, and PL and TL group. After employing the adaptive synthetic sampling approach and six-fold cross-validation, the accuracy (ACC), sensitivity, specificity and area under the curve (AUC) were applied to evaluate RF classification. For PL and TL group, RF achieved the ACC of 0.93, sensitivity of 0.89, specificity of 0.97, and AUC of 0.80. Similarly, their corresponding values were 0.92, 0.88, 0.96 and 0.88 for PE and TE group, indicating that RF could be used to recognize preterm delivery effectively with EHG signals recorded before the 26 th week of gestation.

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          Most cited references35

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          Random Forest

          For the task of analyzing survival data to derive risk factors associated with mortality, physicians, researchers, and biostatisticians have typically relied on certain types of regression techniques, most notably the Cox model. With the advent of more widely distributed computing power, methods which require more complex mathematics have become increasingly common. Particularly in this era of “big data” and machine learning, survival analysis has become methodologically broader. This paper aims to explore one technique known as Random Forest. The Random Forest technique is a regression tree technique which uses bootstrap aggregation and randomization of predictors to achieve a high degree of predictive accuracy. The various input parameters of the random forest are explored. Colon cancer data (n = 66,807) from the SEER database is then used to construct both a Cox model and a random forest model to determine how well the models perform on the same data. Both models perform well, achieving a concordance error rate of approximately 18%.
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            Clinical outcomes of near-term infants.

            To test the hypothesis that near-term infants have more medical problems after birth than full-term infants and that hospital stays might be prolonged and costs increased. Electronic medical record database sorting was conducted of 7474 neonatal records and subset analyses of near-term (n = 120) and full-term (n = 125) neonatal records. Cost information was accessed. Length of hospital stay, Apgar scores, clinical diagnoses (temperature instability, jaundice, hypoglycemia, suspicion of sepsis, apnea and bradycardia, respiratory distress), treatment with an intravenous infusion, delay in discharge to home, and hospital costs were assessed. Data from 90 near-term and 95 full-term infants were analyzed. Median length of stay was similar for near-term and full-term infants, but wide variations in hospital stay were documented for near-term infants after both vaginal and cesarean deliveries. Near-term and full-term infants had comparable 1- and 5-minute Apgar scores. Nearly all clinical outcomes analyzed differed significantly between near-term and full-term neonates: temperature instability, hypoglycemia, respiratory distress, and jaundice. Near-term infants were evaluated for possible sepsis more frequently than full-term infants (36.7% vs 12.6%; odds ratio: 3.97) and more often received intravenous infusions. Cost analysis revealed a relative increase in total costs for near-term infants of 2.93 (mean) and 1.39 (median), resulting in a cost difference of 2630 dollars (mean) and 429 dollars (median) per near-term infant. Near-term infants had significantly more medical problems and increased hospital costs compared with contemporaneous full-term infants. Near-term infants may represent an unrecognized at-risk neonatal population.
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              Uterine electromyography: a critical review.

              On the basis of a literature review, this work summarizes uterine animal and human electromyographic information obtained at cellular, myometrial, and abdominal levels during gestation and parturition. We show that both internal and external electromyograms occur in phase with intrauterine pressure increase and exhibit similar spectra, including a slow wave (0.01 < frequency < 0.03 Hz) probably because of mechanical artifacts and a fast wave whose frequency content can be subdivided into a low-frequency band always present in every contraction and a high-frequency band related to efficient parturition contractions. Application of classic spectral techniques to electromyogram envelopes has identified group propagation but not pacemaker areas. However, no time delay or classic propagation has been demonstrated by applying the same spectral techniques to the electromyogram itself, probably because of the nonlinearity and three-dimensional nature of the propagating process.
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                Author and article information

                Contributors
                Journal
                Biocybern Biomed Eng
                Biocybern Biomed Eng
                Biocybernetics and Biomedical Engineering
                PWN-Polish Scientific Publishers
                0208-5216
                0208-5216
                1 January 2020
                Jan-Mar 2020
                : 40
                : 1
                : 352-362
                Affiliations
                [a ]College of Life Science and Bioengineering, Beijing University of Technology, Intelligent Physiological Measurement and Clinical Translation, Beijing International Platform for Scientific and Technological Cooperation, Beijing, China
                [b ]Beijing Haidian Maternal and Children Health Hospital, Beijing, China
                [c ]Centre for Intelligent Healthcare, Faculty of Health and Life Science, Coventry University, Coventry, UK
                Author notes
                [1]

                Co-first author.

                Article
                S0208-5216(19)30489-9
                10.1016/j.bbe.2019.12.003
                7153772
                32308250
                5264405c-16fb-4b69-ad9b-6da88f2de774
                © 2019 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 June 2019
                : 12 November 2019
                : 4 December 2019
                Categories
                Article

                ehg, electrohysterogram,rf, random forest,pe, preterm delivery before the 26th week of gestation,pl, preterm delivery after the 26th week of gestation,te, term delivery before the 26th week of gestation,tl, term delivery after the 26th week of gestation,iupc, intrauterine pressure catheter,toco, tocodynamometer,k-nn, k-nearest,lda, linear discriminant analysis,qda, quadratic discriminant analysis,svm, support vector machine,ann, artificial neural network,dt, decision tree,tpehg, term-preterm electrohysterogram,rms, root mean square,τz, zero-crossing,pf, peak frequency,mdf, median frequency,mnf, mean frequency,se, energy values in signal,sm, maximum values in signal,ss, singular values in signal,sv, variance values in signal,ar, auto-regressive model,tr, time reversibility,corrdim, correlation dimension,sampen, sample entropy,le, lyapunov exponent,sd, standard deviation,adasyn, adaptive synthetic sampling approach,acc, accuracy,auc, the area under the curve,roc, the receiver operating characteristic curve,electrohysterogram (ehg),feature extraction,gestational week,preterm delivery,random forest (rf).

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