A Conceptual Architecture for an ICT-based Personal Health System for Cardiac Rehabilitation

Traditional cardiac rehabilitation is strongly based on supervised exercise therapy. However, studies show that after leaving a rehabilitative care facility it is difficult for cardiac patients to continue with exercise therapy and overall to conduct the necessary behavioral changes for a healthier life. The novel approach for cardiac rehabilitation presented in this paper is based on including health services (e.g. exercise, support with healthy behavior, etc.) in everyday life. One goal is to foster physical activities which are not solely conducted with the goal to exercise. Another goal is to provide personalized and context-aware health services which proactively assist patients with their disease management. Therefore, a conceptual architecture of an ICT-based personal health system is presented in this paper. The goal is a better alignment with the individual needs of patients and the inclusion of life-long disease management into daily life

Personalized And Situation-Aware Recommendations For Runners

The project uService investigates the transformation of a mobile user into a service super prosumer, i.e., a producer, provider and consumer of services at the same time. The goal is to develop a platform which enables a user to create, discover and consume mobile services anywhere and at any time on the mobile device. uRun is an application scenario of the project in the field of mobile health and fitness. The uRun framework provides a mobile assistance system particularly for runners, which combines Web 2.0 and Web 3.0 technologies and personalized and situation-aware recommendation mechanisms. The ability to create individual and mobile health and fitness services as well as a personalized and situation-aware assistance system based on a semantic knowledge base are considered to provide an edge over existing consumer-centric health care systems. In this article, we describe the recommendation mechanism and the incorporation of semantic knowledge for the uService platform and the uRun framework

Supplementary dydrogesterone is beneficial as luteal phase support in artificial frozen-thawed embryo transfer cycles compared to micronized progesterone alone.

INTRODUCTION The number of frozen embryo transfers increased substantially in recent years. To increase the chances of implantation, endometrial receptivity and embryo competency must be synchronized. Maturation of the endometrium is facilitated by sequential administration of estrogens, followed by administration of progesterone prior to embryo transfer. The use of progesterone is crucial for pregnancy outcomes. This study compares the reproductive outcomes and tolerability of five different regimens of hormonal luteal phase support in artificial frozen embryo transfer cycles, with the objective of determining the best progesterone luteal phase support in this context. DESIGN This is a single-center retrospective cohort study of all women undergoing frozen embryo transfers between 2013 and 2019. After sufficient endometrial thickness was achieved by estradiol, luteal phase support was initiated. The following five different progesterone applications were compared: 1) oral dydrogesterone (30 mg/day), 2) vaginal micronized progesterone gel (90 mg/day), 3) dydrogesterone (20 mg/day) plus micronized progesterone gel (90 mg/day) (dydrogesterone + micronized progesterone gel), 4) micronized progesterone capsules (600 mg/day), and (5) subcutaneous injection of progesterone 25 mg/day (subcutan-P4). The vaginal micronized progesterone gel application served as the reference group. Ultrasound was performed after 12-15 days of oral estrogen (≥4 mg/day) administration. If the endometrial thickness was ≥7 mm, luteal phase support was started, up to six days before frozen embryo transfer, depending on the development of the frozen embryo. The primary outcome was the clinical pregnancy rate. Secondary outcomes included live birth rate, ongoing pregnancy, and miscarriage and biochemical pregnancy rate. RESULTS In total, 391 cycles were included in the study (median age of study participants 35 years; IQR 32-38 years, range 26-46 years). The proportions of blastocysts and single transferred embryos were lower in the micronized progesterone gel group. Differences among the five groups in other baseline characteristics were not significant. Multiple logistic regression analysis, adjusting for pre-defined covariates, showed that the clinical pregnancy rates were higher in the oral dydrogesterone only group (OR = 2.87, 95% CI 1.38-6.00, p=0.005) and in the dydrogesterone + micronized progesterone gel group (OR = 5.19, 95% CI 1.76-15.36, p = 0.003) compared to micronized progesterone gel alone. The live birth rate was higher in the oral dydrogesterone-only group (OR = 2.58; 95% CI 1.11-6.00; p=0.028) and showed no difference in the smaller dydrogesterone + micronized progesterone gel group (OR = 2.49; 95% CI 0.74-8.38; p=0.14) compared with the reference group. CONCLUSION The application of dydrogesterone in addition to micronized progesterone gel was associated with higher clinical pregnancy rate and live birth rate and then the use of micronized progesterone gel alone. DYD should be evaluated as a promising LPS option in FET Cycles

Undergraduate student experiences in remote lab courses during the COVID-19 pandemic

The 2020&ndash;2021 academic year was a unique time for many instructors who had to adapt their courses to be conducted remotely due to the COVID-19 pandemic. This was especially challenging for physics lab courses, which usually emphasize hands-on experiments. Although many courses have now returned to in-person teaching, the possibility remains of future disasters necessitating similar remote courses. It is important to understand how undergraduate students experienced remote physics lab courses during the pandemic, including what aspects of the courses contributed to positive student outcomes. To investigate this, we surveyed over 5000 students from 24 different institutions, asking how the students engaged with their physics lab courses during the 2020&ndash;2021 academic year. Here, we describe the frequency with which the students performed various class activities, aspects of the course environment, challenges the students faced, aspects of the courses the students found enjoyable, and some student outcomes. We further study the impact of the course activities and course environment on four of the outcomes (self-reported learning of lab skills, self-reported learning of concepts, course enjoyment, and development of a sense of community). We find that students who were provided clear expectations, had enough time for their coursework, frequently worked in groups, and frequently had access to guidance from their instructors were more likely to report positive outcomes. This work demonstrates the importance of certain aspects of lab courses for several desirable outcomes in remote lab courses during a pandemic, with findings that may transfer to in-person or remote lab courses in the future. &nbsp;</p

Juvenile Facility Staff Contestations of Change

This article explores juvenile facility frontline staff members’ contestations of change to custodial practices aimed at reducing restraints, introducing trauma-informed practices, and downsizing juvenile facilities. Drawing from qualitative research about frontline staff members in a U.S. state undergoing reform, the article points to the ways that the reforms challenge staff members’ investments in behavioral control practices as a vehicle for achieving order and control in their everyday lives as workers. It also points to shifts in the broader political economy of punishment at the local, facility level, and the subsequent impact on staff member perceptions of order, control and criminality

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with &gt;80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Constructing a Nd:YAG Laser

A diode-pumped, continuous wave, Nd:YAG laser is a solid state laser commonly used in medicine, manufacturing, and research. The Nd:YAG laser is also interesting to study and analyze in college laboratories. One can characterize basic properties of the laser such as power versus diode current at various temperatures or study the more complex linear and nonlinear dynamics of the YAG laser under modulation.\ud A Nd:YAG laser uses a crystal lasing medium. This medium is made by replacing some of the yttrium ions in a yttrium aluminum garnet (YAG) with triply ionized neodymium, Nd(III). The laser commonly emits light at 1.06 µm.\ud This experiment will consist of the design and construction of the laser apparatus as well as research about the laser physics behind the Nd:YAG

Noninvasive glucose monitoring: New opportunities opened by mid-infrared quantum cascade laser spectroscopy

Diabetes is a growing problem throughout the world, and for many people with diabetes it is imperative to closely monitor their glucose level throughout the day. Diabetes creates large swings in the glucose concentration in blood posing imminent dangers such as seizures, unconsciousness, and if not treated, death as well as long term complications such as heart and blood vessel disease, kidney failure, and nerve damage. Fortunately, administration of medication or insulin can mitigate these high and low swings of blood sugar. However, in order to accurately administer these medications one needs to closely monitor their blood sugar levels. Current methods of monitoring blood glucose concentrations involve a painful finger prick or a monitor which needs to be embedded under the skin. The development of a noninvasive, pain-free, continuous glucose monitor would therefore improve the quality of life and health of hundreds of millions of people suffering with diabetes. Mid-infrared quantum cascade laser spectroscopy has the potential to satisfy these needs. We have developed a noninvasive glucose sensor based on mid-infrared quantum cascade laser spectroscopy which operates in the 8 - 10 μm wavelengths region. This wavelength range contains unique spectral absorption features of glucose, particularly the C-O stretching mode at 9.5 μm, which are much stronger than that of other carbohydrates in this range. The light penetrates into the dermis layer of the skin where it is absorbed by the glucose molecules in the interstitial fluid. The light is then backscattered off of the collagen fibers and collected using the integrating sphere and mercury cadmium telluride (MCT) detector. We analyze a series of collected spectra using multivariate algorithms, including principal component (PC) regression and partial least square (PLS) regression, to determine the wavelengths that correspond to highest variance. We consistently see a strong correlation with the predicted PC loading vector of the spectra and the known glucose absorption spectrum. In a small-scale usability study with the most recent generation of the sensor, we have predicted in vivo glucose concentrations of single subjects with over 80% accuracy with 66% of the results falling within ±15% error. After implementation of a finger demobilizer clip and pressure sensor on the sample port of the integrating sphere we were able to increase the accuracy of the predicted glucose concentrations to over 90% with 91% of the results falling within ±15% error for a single subject. The latter results are just shy of clinical accuracy, 95% of results falling within ±15% error, as determined by the FDA. Lastly, we propose a new experiment to test the feasibility of in vivo blood alcohol monitoring through the skin using the sensor we have developed. Blood alcohol monitoring has its own set of useful applications; however, beyond these independent applications, adapting our sensor for blood alcohol monitoring could improve the accuracy of the glucose sensor. The spectral features of ethanol closely overlap with features in the glucose spectrum within the 8 - 10 μm window. Not only are the spectra similar, but the concentrations of ethanol and glucose in the blood can be very similar implying that it is important to consider blood alcohol concentrations when optically monitoring glucose concentrations in the interstitial fluid

Noninvasive glucose monitoring: New opportunities opened by mid-infrared quantum cascade laser spectroscopy

Diabetes is a growing problem throughout the world, and for many people with diabetes it is imperative to closely monitor their glucose level throughout the day. Diabetes creates large swings in the glucose concentration in blood posing imminent dangers such as seizures, unconsciousness, and if not treated, death as well as long term complications such as heart and blood vessel disease, kidney failure, and nerve damage. Fortunately, administration of medication or insulin can mitigate these high and low swings of blood sugar. However, in order to accurately administer these medications one needs to closely monitor their blood sugar levels. Current methods of monitoring blood glucose concentrations involve a painful finger prick or a monitor which needs to be embedded under the skin. The development of a noninvasive, pain-free, continuous glucose monitor would therefore improve the quality of life and health of hundreds of millions of people suffering with diabetes. Mid-infrared quantum cascade laser spectroscopy has the potential to satisfy these needs. We have developed a noninvasive glucose sensor based on mid-infrared quantum cascade laser spectroscopy which operates in the 8 - 10 μm wavelengths region. This wavelength range contains unique spectral absorption features of glucose, particularly the C-O stretching mode at 9.5 μm, which are much stronger than that of other carbohydrates in this range. The light penetrates into the dermis layer of the skin where it is absorbed by the glucose molecules in the interstitial fluid. The light is then backscattered off of the collagen fibers and collected using the integrating sphere and mercury cadmium telluride (MCT) detector. We analyze a series of collected spectra using multivariate algorithms, including principal component (PC) regression and partial least square (PLS) regression, to determine the wavelengths that correspond to highest variance. We consistently see a strong correlation with the predicted PC loading vector of the spectra and the known glucose absorption spectrum. In a small-scale usability study with the most recent generation of the sensor, we have predicted in vivo glucose concentrations of single subjects with over 80% accuracy with 66% of the results falling within ±15% error. After implementation of a finger demobilizer clip and pressure sensor on the sample port of the integrating sphere we were able to increase the accuracy of the predicted glucose concentrations to over 90% with 91% of the results falling within ±15% error for a single subject. The latter results are just shy of clinical accuracy, 95% of results falling within ±15% error, as determined by the FDA. Lastly, we propose a new experiment to test the feasibility of in vivo blood alcohol monitoring through the skin using the sensor we have developed. Blood alcohol monitoring has its own set of useful applications; however, beyond these independent applications, adapting our sensor for blood alcohol monitoring could improve the accuracy of the glucose sensor. The spectral features of ethanol closely overlap with features in the glucose spectrum within the 8 - 10 μm window. Not only are the spectra similar, but the concentrations of ethanol and glucose in the blood can be very similar implying that it is important to consider blood alcohol concentrations when optically monitoring glucose concentrations in the interstitial fluid