A survey of the state-of-the-art techniques for cognitive impairment detection in the elderly

With a growing number of elderly people in the UK, more and more of them suffer from various kinds of cognitive impairment. Cognitive impairment can be divided into different stages such as mild cognitive impairment (MCI) and severe cognitive impairment like dementia. Its early detection can be of great importance. However, it is challenging to detect cognitive impairment in the early stage with high accuracy and low cost, when most of the symptoms may not be fully expressed. This survey paper mainly reviews the state of the art techniques for the early detection of cognitive impairment and compares their advantages and weaknesses. In order to build an effective and low-cost automatic system for detecting and monitoring the cognitive impairment for a wide range of elderly people, the applications of computer vision techniques for the early detection of cognitive impairment by monitoring facial expressions, body movements and eye movements are highlighted in this paper. In additional to technique review, the main research challenges for the early detection of cognitive impairment with high accuracy and low cost are analysed in depth. Through carefully comparing and contrasting the currently popular techniques for their advantages and weaknesses, some important research directions are particularly pointed out and highlighted from the viewpoints of the authors alone

Etiologic Structure of Bloodstream Infections

Objective: to assess the etiological structure of bacteremia in various pathological conditions. Material and methods. To check blood sterility, we analyzed results of 4548 blood tests of patients with lower respiratory tract infections, urinary tract infections, endocarditis, burns, cancer, fever of unknown etiology, sepsis. Cultural blood analysis was performed by means of the traditional bacteriological method or using an automated hemocultivator. Results. We isolated 477 clinically significant blood cultures. Gram-positive microorganisms prevailed over gram-negative in terms of the isolation rate, and fungemia was observed considerably most rarely (4.4%). Microbial inoculation found by the automated method was 1.5 times as high as that found by the traditional two-phase medium (14.7 and 9.5%, respectively). The etiological structure of microorganisms isolated as blood cultures in various nosological forms was assessed. Conclusion. We have revealed the prevalence of coagulase-negative staphylococci in patients with fever of unknown etiology (53.7 %), lower respiratory tract infections (39.5 %), endocarditis (31.4 %), burns (30.5 %) compared to other nosological forms. Enterobacteria were isolated with higher frequency in bacteremia in patients with malignant tumors (30.0 %) and urinary system infections (29.4 %), and gram-negative non-fermenting bacteria - with the highest specific weight in the isolated hemoculture associated with burn disease (31.6 %) and urinary system infections (29.4 %), enterococci - with greater frequency in bacteremia in patients with endocarditis (23.5 %).</jats:p

Abstract P059: Telemedicine Data Indicate Short-term Associations Between Clinical Cardiovascular Events and Ambient Particulate Air Pollution

Introduction: Particulate matter (PM) air pollution has been linked to cardiovascular morbidity and mortality with large public health burdens. Although associations between PM and subclinical autonomic and vascular changes have been shown to occur within minutes to hours, studies have been limited in their ability to investigate such short time scales for clinical cardiac events. Accurate onset time is essential for risk estimation of such short exposures, but publically available data lack this information. This study utilized unique telemedicine data to more accurately estimate the short-term effects of PM exposure in triggering acute cardiac events. Hypothesis: We assessed the hypothesis that elevated short-term (1-24 hours) concentrations of coarse PM (2.5 to 10 μm in aerodynamic diameter, PM 10-2.5 ) and fine PM ( &lt; 2.5 μm, PM 2.5 ) in two metropolitan areas in Israel are associated with an increased risk of clinical cardiac events. Methods: We conducted a time-stratified case-crossover study in which cardiac events were identified using time-resolved telemedicine data from the Tel Aviv and Haifa areas, Israel, between 2002 and 2013. Calls to the telemedicine service for cardiac-related symptoms that resulted in an in-home examination by a mobile intensive care and transfer to a hospital were classified into ischemic, arrhythmia, or non-specific events. Onset time was determined by the time of a medical phone call. Ambient pollutant concentrations measured at central monitoring stations were compared between case and control periods using multivariate conditional logistic regression after adjusting for meteorology and other risk factors. We further explored sensitivity for certainty of diagnosis and effect modification by personal characteristics. Results: A total of 7,617 telemedicine subscribers reported 12,661 (20% ischemic, 31% arrhythmic and 49% non-specific) cardiac events that resulted in an evacuation to a hospital over our 12 year period. After adjustment for confounders, a 10 μg/m 3 higher PM 10-2.5 concentration was associated with a greater odds of a clinical cardiac event, with the strongest associations for events due to arrhythmia (OR 1.006, 95% CI: 1.001-1.011) within 12 hours. Similar associations were found at other time points, for ischemic and non-specific cardiac events, as well as for PM 2.5 but these associations often had wider confidence intervals. Risks tended to be higher for subjects who had diabetes, previous ischemic heart disease or were obese, although these differences did not achieve statistical significance. Conclusions: Exposure to PM air pollution over the course of hours may increase the risk of acute clinical cardiac events. Telemedicine allows for more accurate information on event onset and thus can be a powerful tool for epidemiologic studies focusing on short-term exposures to environmental or other stressors. </jats:p