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Coronavirus disease (COVID-19) represents one of the greatest challenges to public health in modern history. As the disease continues to spread globally, medical and allied healthcare professionals have become one of the most affected sectors. Stress and anxiety are indirect effects of the COVID-19 pandemic. Therefore, it is paramount to understand and categorize their perceived levels of stress, as it can be a detonating factor leading to mental illness. Here, we propose a computer-based method to better understand stress in healthcare workers facing COVID-19 at the beginning of the pandemic. We based our study on a representative sample of healthcare professionals attending to COVID-19 patients in the northeast region of Mexico, at the beginning of the pandemic. We used a machine learning classification algorithm to obtain a visualization model to analyze perceived stress. The C5.0 decision tree algorithm was used to study datasets. We carried out an initial preprocessing statistical analysis for a group of 101 participants. We performed chi-square tests for all questions, individually, in order to validate stress level calculation (p < 0.05) and a calculated Cronbach's alpha of 0.94 and McDonald's omega of 0.95, demonstrating good internal consistency in the dataset. The obtained model failed to classify only 6 out of the 101, missing two cases for mild, three for moderate and one for severe (accuracy of 94.1%). We performed statistical correlation analysis to ensure integrity of the method. In addition, based on the decision tree model, we concluded that severe stress cases can be related mostly to high levels of xenophobia and compulsive stress. Thus, showing that applied machine learning algorithms represent valuable tools in the assessment of perceived stress, which can potentially be adapted to other areas of the medical field.

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Real-life implementation of the Internet of Things (IoT) in healthcare requires sufficient quality of service (QoS) to transmit the collected data successfully. However, unsolved challenges in prioritization and congestion issues limit the functionality of IoT networks by increasing the likelihood of packet loss, latency, and high-power consumption in healthcare systems. This study proposes a priority-based cross-layer congestion control protocol called QCCP, which is managed by communication devices' transport and medium access control (MAC) layers. Unlike existing methods, the novelty of QCCP is how it estimates and resolves wireless channel congestion because it does not generate control packets, operates in a distributed manner, and only has a one-bit overhead. Furthermore, at the same time, QCCP offers packet scheduling considering each packet's network load and QoS. The results of the experiments demonstrated that with a 95% confidence level, QCCP achieves sufficient performance to support the QoS requirements for the transmission of health signals. Finally, the comparison study shows that QCCP outperforms other TCP protocols, with 64.31% higher throughput, 18.66% less packet loss, and 47.87% less latency.

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RESUMO

The objective of this work is to perform image quality assessment (IQA) of eye fundus images in the context of digital fundoscopy with topological data analysis (TDA) and machine learning methods. Eye health remains inaccessible for a large amount of the global population. Digital tools that automize the eye exam could be used to address this issue. IQA is a fundamental step in digital fundoscopy for clinical applications; it is one of the first steps in the preprocessing stages of computer-aided diagnosis (CAD) systems using eye fundus images. Images from the EyePACS dataset were used, and quality labels from previous works in the literature were selected. Cubical complexes were used to represent the images; the grayscale version was, then, used to calculate a persistent homology on the simplex and represented with persistence diagrams. Then, 30 vectorized topological descriptors were calculated from each image and used as input to a classification algorithm. Six different algorithms were tested for this study (SVM, decision tree, k-NN, random forest, logistic regression (LoGit), MLP). LoGit was selected and used for the classification of all images, given the low computational cost it carries. Performance results on the validation subset showed a global accuracy of 0.932, precision of 0.912 for label "quality" and 0.952 for label "no quality", recall of 0.932 for label "quality" and 0.912 for label "no quality", AUC of 0.980, F1 score of 0.932, and a Matthews correlation coefficient of 0.864. This work offers evidence for the use of topological methods for the process of quality assessment of eye fundus images, where a relatively small vector of characteristics (30 in this case) can enclose enough information for an algorithm to yield classification results useful in the clinical settings of a digital fundoscopy pipeline for CAD.

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Wellness is a term often used to talk about optimal health as "dynamic balance of physical, emotional, social, spiritual, and intellectual health." While healthcare is a term about care offered to patients for improving their health. We use both terms, as well as the Business Model Canvas (BMC) methodology, to design a digital ecosystem model for healthcare and wellness called DE4HW; the model considers economic, technological, and legal asymmetries, which are present on e-services beyond geographical regions. BMC methodology was embedded into the global project strategy called: IBOT (Initiate, Build, Operate and Transfer); it is a methodology to establish a functional, integrated national telemedicine network and virtual education network; of which we took its phases rationale. The results in this work illustrate the design of DE4HW model, into the first phase of IBOT, enriched with the BMC, which enables us to define actors, their interactions, rules and protocols, in order to build DE4HW, while IBOT strategy manages the project goal, up to the transfer phase, where an integral service platform of healthcare and wellness is turned over to stakeholders.

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