Environmental Pollution and Chronic Disease Management – A Prognostics Approach

No abstract available

Health State Estimation

Life's most valuable asset is health. Continuously understanding the state of our health and modeling how it evolves is essential if we wish to improve it. Given the opportunity that people live with more data about their life today than any other time in history, the challenge rests in interweaving this data with the growing body of knowledge to compute and model the health state of an individual continually. This dissertation presents an approach to build a personal model and dynamically estimate the health state of an individual by fusing multi-modal data and domain knowledge. The system is stitched together from four essential abstraction elements: 1. the events in our life, 2. the layers of our biological systems (from molecular to an organism), 3. the functional utilities that arise from biological underpinnings, and 4. how we interact with these utilities in the reality of daily life. Connecting these four elements via graph network blocks forms the backbone by which we instantiate a digital twin of an individual. Edges and nodes in this graph structure are then regularly updated with learning techniques as data is continuously digested. Experiments demonstrate the use of dense and heterogeneous real-world data from a variety of personal and environmental sensors to monitor individual cardiovascular health state. State estimation and individual modeling is the fundamental basis to depart from disease-oriented approaches to a total health continuum paradigm. Precision in predicting health requires understanding state trajectory. By encasing this estimation within a navigational approach, a systematic guidance framework can plan actions to transition a current state towards a desired one. This work concludes by presenting this framework of combining the health state and personal graph model to perpetually plan and assist us in living life towards our goals.Comment: Ph.D. Dissertation @ University of California, Irvin

From Wearable Sensors to Smart Implants – Towards Pervasive and Personalised Healthcare

<p>Objective: This article discusses the evolution of pervasive healthcare from its inception for activity recognition using wearable sensors to the future of sensing implant deployment and data processing. Methods: We provide an overview of some of the past milestones and recent developments, categorised into different generations of pervasive sensing applications for health monitoring. This is followed by a review on recent technological advances that have allowed unobtrusive continuous sensing combined with diverse technologies to reshape the clinical workflow for both acute and chronic disease management. We discuss the opportunities of pervasive health monitoring through data linkages with other health informatics systems including the mining of health records, clinical trial databases, multi-omics data integration and social media. Conclusion: Technical advances have supported the evolution of the pervasive health paradigm towards preventative, predictive, personalised and participatory medicine. Significance: The sensing technologies discussed in this paper and their future evolution will play a key role in realising the goal of sustainable healthcare systems.</p> <p> </p

Big data driven co-occurring evidence discovery in chronic obstructive pulmonary disease patients

© 2017, The Author(s). Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that affects airflow to the lungs. Discovering the co-occurrence of COPD with other diseases, symptoms, and medications is invaluable to medical staff. Building co-occurrence indexes and finding causal relationships with COPD can be difficult because often times disease prevalence within a population influences results. A method which can better separate occurrence within COPD patients from population prevalence would be desirable. Large hospital systems may potentially have tens of millions of patient records spanning decades of collection and a big data approach that is scalable is desirable. The presented method, Co-Occurring Evidence Discovery (COED), presents a methodology and framework to address these issues. Methods: Natural Language Processing methods are used to examine 64,371 deidentified clinical notes and discover associations between COPD and medical terms. Apache cTAKES is leveraged to annotate and structure clinical notes. Several extensions to cTAKES have been written to parallelize the annotation of large sets of clinical notes. A co-occurrence score is presented which can penalize scores based on term prevalence, as well as a baseline method traditionally used for finding co-occurrence. These scoring systems are implemented using Apache Spark. Dictionaries of ground truth terms for diseases, medications, and symptoms have been created using clinical domain knowledge. COED and baseline methods are compared using precision, recall, and F1 score. Results: The highest scoring diseases using COED are lung and respiratory diseases. In contrast, baseline methods for co-occurrence rank diseases with high population prevalence highest. Medications and symptoms evaluated with COED share similar results. When evaluated against ground truth dictionaries, the maximum improvements in recall for symptoms, diseases, and medications were 0.212, 0.130, and 0.174. The maximum improvements in precision for symptoms, diseases, and medications were 0.303, 0.333, and 0.180. Median increase in F1 score for symptoms, diseases, and medications were 38.1%, 23.0%, and 17.1%. A paired t-test was performed and F1 score increases were found to be statistically significant, where p < 0.01. Conclusion: Penalizing terms which are highly frequent in the corpus results in better precision and recall performance. Penalizing frequently occurring terms gives a better picture of the diseases, symptoms, and medications co-occurring with COPD. Using a mathematical and computational approach rather than purely expert driven approach, large dictionaries of COPD related terms can be assembled in a short amount of time

The effect of short-term changes in air pollution on respiratory and cardiovascular morbidity in Nicosia, Cyprus.

Presented at the 6th International Conference on Urban Air Quality, Limassol, March, 2007. Short-paper was submitted for peer-review and appears in proceedings of the conference.This study investigates the effect of daily changes in levels of PM10 on the daily volume of respiratory and cardiovascular admissions in Nicosia, Cyprus during 1995-2004. After controlling for long- (year and month) and short-term (day of the week) patterns as well as the effect of weather in Generalized Additive Poisson models, some positive associations were observed with all-cause and cause-specific admissions. Risk of hospitalization increased stepwise across quartiles of days with increasing levels of PM10 by 1.3% (-0.3, 2.8), 4.9% (3.3, 6.6), 5.6% (3.9, 7.3) as compared to days with the lowest concentrations. For every 10μg/m3 increase in daily average PM10 concentration, there was a 1.2% (-0.1%, 2.4%) increase in cardiovascular admissions. With respects to respiratory admissions, an effect was observed only in the warm season with a 1.8% (-0.22, 3.85) increase in admissions per 10μg/m3 increase in PM10. The effect on respiratory admissions seemed to be much stronger in women and, surprisingly, restricted to people of adult age

A Survey of Multimodal Information Fusion for Smart Healthcare: Mapping the Journey from Data to Wisdom

Multimodal medical data fusion has emerged as a transformative approach in smart healthcare, enabling a comprehensive understanding of patient health and personalized treatment plans. In this paper, a journey from data to information to knowledge to wisdom (DIKW) is explored through multimodal fusion for smart healthcare. We present a comprehensive review of multimodal medical data fusion focused on the integration of various data modalities. The review explores different approaches such as feature selection, rule-based systems, machine learning, deep learning, and natural language processing, for fusing and analyzing multimodal data. This paper also highlights the challenges associated with multimodal fusion in healthcare. By synthesizing the reviewed frameworks and theories, it proposes a generic framework for multimodal medical data fusion that aligns with the DIKW model. Moreover, it discusses future directions related to the four pillars of healthcare: Predictive, Preventive, Personalized, and Participatory approaches. The components of the comprehensive survey presented in this paper form the foundation for more successful implementation of multimodal fusion in smart healthcare. Our findings can guide researchers and practitioners in leveraging the power of multimodal fusion with the state-of-the-art approaches to revolutionize healthcare and improve patient outcomes.Comment: This work has been submitted to the ELSEVIER for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl

Am J Epidemiol

The exposome has been defined as the totality of exposures individuals experience over the course of their lives and how those exposures affect health. Three domains of the exposome have been identified: internal, specific external, and general external. Internal factors are those that are unique to the individual, and specific external factors include occupational exposures and lifestyle factors. The general external domain includes sociodemographic factors such as educational level and financial status. Eliciting information on the exposome is daunting and not feasible at present; the undertaking may never be fully realized. A variety of tools have been identified to measure the exposome. Biomarker measurements will be one of the major tools in exposomic studies. However, exposure data can also be obtained from other sources such as sensors, geographic information systems, and conventional tools such as survey instruments. Proof-of-concept studies are being conducted that show the promise of exposomic investigation and the integration of different kinds of data. The inherent value of exposomic data in epidemiologic studies is that they can provide greater understanding of the relationships among a broad range of chemical and other risk factors and health conditions and ultimately lead to more effective and efficient disease prevention and control.CC999999/Intramural CDC HHS/United States2017-08-15T00:00:00Z27519539PMC502532