21 research outputs found

    Prediction of incident cardiovascular events using machine learning and CMR radiomics.

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    OBJECTIVES: Evaluation of the feasibility of using cardiovascular magnetic resonance (CMR) radiomics in the prediction of incident atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), and stroke using machine learning techniques. METHODS: We identified participants from the UK Biobank who experienced incident AF, HF, MI, or stroke during the continuous longitudinal follow-up. The CMR indices and the vascular risk factors (VRFs) as well as the CMR images were obtained for each participant. Three-segmented regions of interest (ROIs) were computed: right ventricle cavity, left ventricle (LV) cavity, and LV myocardium in end-systole and end-diastole phases. Radiomics features were extracted from the 3D volumes of the ROIs. Seven integrative models were built for each incident cardiovascular disease (CVD) as an outcome. Each model was built with VRF, CMR indices, and radiomics features and a combination of them. Support vector machine was used for classification. To assess the model performance, the accuracy, sensitivity, specificity, and AUC were reported. RESULTS: AF prediction model using the VRF+CMR+Rad model (accuracy: 0.71, AUC 0.76) obtained the best result. However, the AUC was similar to the VRF+Rad model. HF showed the most significant improvement with the inclusion of CMR metrics (VRF+CMR+Rad: 0.79, AUC 0.84). Moreover, adding only the radiomics features to the VRF reached an almost similarly good performance (VRF+Rad: accuracy 0.77, AUC 0.83). Prediction models looking into incident MI and stroke reached slightly smaller improvement. CONCLUSIONS: Radiomics features may provide incremental predictive value over VRF and CMR indices in the prediction of incident CVDs. KEY POINTS: ‱ Prediction of incident atrial fibrillation, heart failure, stroke, and myocardial infarction using machine learning techniques. ‱ CMR radiomics, vascular risk factors, and standard CMR indices will be considered in the machine learning models. ‱ The experiments show that radiomics features can provide incremental predictive value over VRF and CMR indices in the prediction of incident cardiovascular diseases

    Muerte celular programada en protozoarios: el caso de Giardia intestinalis

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    Giardia intestinalises considerado uno de los eucariotas mĂĄs antiguos y su poca complejidad representa una valiosa oportunidad para desentrañar los misterios de procesos vitales de eucariotas mĂĄs complejos. Esta caracterĂ­stica Ășnica de G. intestinalisy el hecho de que su genoma estĂ© completamente secuenciado y disponible, y que todo su ciclo de vida puede ser reproducido in vitro, hacen de este parĂĄsito un modelo ideal para estudiar mecanismos celulares, entre ellos, la muerte celular programada. Desde el punto de vista morfolĂłgico y molecular, la apoptosis es uno de los tipos mĂĄs complejos de muerte celular programada, la cual es un proceso normal durante el desarrollo celular, y tiene un papel esencial en el control de la proliferaciĂłn celular y en la respuesta a retos inmunolĂłgicos o a daños celulares. Recientemente, se ha reportado que en protozoos, entre ellos Giardia, podrĂ­a ocurrir un tipo de muerte celular programada similar a la apoptosis y los resultados de nuestros laboratorios apoyan esta hipĂłtesis; sin embargo, no se han identificado hasta el momento las molĂ©culas relacionadas con los procesos de apoptosis en estos parĂĄsitos. La presente revisiĂłn abarca una descripciĂłn de la morfologĂ­a y estructura de las formas de vida de G. intestinalis de su ciclo biolĂłgico, de la parasitosis que causa y de las estrategias quimioterapĂ©uticas para su tratamiento. Asimismo, se hace un repaso de lo que hasta ahora se conoce sobre apoptosis en protozoarios, y especĂ­ficamente en G. intestinalis, y se describen algunos resultados de nuestro grupo que apoyan la existencia de muerte celular programada en este parĂĄsit

    A start-up process for the design of a multi-sided digital platform for social innovation

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    A social innovation is a novel solution to a social problem that is more effective, efficient, sustainable for which the value created accrues primarily to society as a whole rather than private individuals. Social innovations come in various forms such as (1) doing something good in/for society; (2) changing social practices and/or structure, (3) contribute to urban and community development and (4) re-organize work processes. In an aging world where life expectancy is steadily increasing and there is decline in the number of children and in total fertility the consequences for the healthcare system and the elder population are significant; therefore, social innovations are needed (in the form of changed social practices) aiming to reduce healthcare costs and improve the life quality of those aging. Smart Homes / Smart Living serve goals of wellbeing of the residents of the home and eldercare among others. Thus, the realization of these goals could be considered as a potential social innovation for eldercare in specific. However, these products and services in this domain are generally unknown by the general public – so potential consumers lack of awareness of the potential benefits that smart home products can help them realize. Thus, a social innovation is proposed in the context of health and wellbeing through the design of a smart living multi-sided digital platform. This platform is a mean to improve the lives of citizens in the context of health and wellbeing, especially for those aging through information access, information exchange around Smart Living products/services, interaction with the relatives/community/neighborhood as well as with caretakers. The focus of a solution in this work is on the group of end-users of elders and voluntary caretakers. From previous research foundational requirements were identified for the platform: 1) an online community for contact, solutions, social wellbeing, interaction with the neighborhood and a digital marketplace for applications; 2) an information exchange platform, between providers and end-users (business to consumer), 3) a portal for bundled, services and solutions (business to consumer) and 4) an intervention instrument for the municipality (government to consumer). Through two workshops and considerable work within the project team 9 requirements and 3 critical issues were identified. The requirements derived were built into a prototype (mockup) which was also built into a clickable model for its evaluation through usability testing with potential end-users. 100% of the participants agreed that they would use or recommend the platform if available and 4 out of 6 participants rated 4 or 5 in a scale of 1 to 5 the user experience of the artifact. Some issues regarding the navigation in two functionalities were pointed for improvement. There was learning of few important points in this design stage: (1) to collect requirements for the artifact and prioritize the critical design issues is key. (2) involve the end-user in the design process to validate and evaluate the artifact from the very beginning is a critical for acceptance (of the prototype), which is pre-condition for acceptance of the final artifact and (3) using familiar patterns when designing a prototype help potential users to feel more acquainted with the artifact. Building on the main outcomes of the design of the artifact section, a survey was prepared to further evaluate the design made- it was sent to 401 voluntary caretakers in the South-Holland province of the Netherlands with a response rate of 38% with an average age of 71 years – thus being a key target group of end users. A total of 7 questions were analyzed trying to understand the potential impact of the platform as well as to see who could potentially benefit among several stakeholders. In terms of who would benefit with the platform, the results suggest that Voluntary caretakers, Volunteers, People with physical disabilities and the Municipality would strongly benefit from the platform. Whereas Product providers, General Citizens, Service providers, People with mental disabilities, Young elderly (55 - 75 years old) and Elderly (75+) would somehow benefit from the platform. Two questions in the survey were asked to explore a set of features that could help validate certain design options that were considered to be important by the design team. With the new requirements derived and results of the usability test the following mockup was constructed as an updated version that emerged from the previous one. In the survey the first mockup was shown to the voluntary caretakers and then they were asked the question ‘the platform would help me with?’. A total of 14 potential benefits (capabilities) were presented to the respondents to be scored from 1 to 7 in terms of much the platform could help. After a dimension reduction using a statistical method (Principal Components Analysis), according to the caretakers’ answers, the artifact’s main impact is on two capabilities namely (1) socially inclusive active aging and (2) independent and comfortable aging in place. Based on the findings and the knowledge drawn from the entire process the suggested main outcome is the following set of principles/steps for starting –up the design of digital platforms for social innovation: Stating the problem in terms of a capabilities gap Tapping on / setting-up a living lab Involve the end user at every single stage of the process Elicit requirements and prioritize critical design issues throughout Use familiar patterns in the design of the artifact's interface Evaluate the artifact through usability testing Evaluate the artifact through its capabilitiesICTEngineering Systems and ServicesTechnology, Policy and Managemen

    Association between heart rate variability and allostatic load in healthy individuals: a scoping review protocol

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    Allostatic load (AL) is a multidimensional model that is increasingly being used to assess wear and tear in the human body due to chronic stress. The concept of allostatic load has been operationalized through the allostatic load index (ALI), which includes different biomarkers related to chronic stress and that assigns an AL score to each individual. Higher ALI has been associated with a higher incidence of negative physical and mental health outcomes. Heart rate variability (HRV) has been associated with different stress response biomarkers, and has been proposed as a biomarker of chronic stress. However, there is very little evidence about the association between HRV and ALI, and few published studies have shown great methodological heterogeneity. The aim of this scoping review is to characterize the evidence of the association between HRV and ALI in healthy individuals
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