An evaluation of the effectiveness of personalization and self-adaptation for e-Health apps

Context: There are many e-Health mobile apps on the apps store, from apps to improve a user\u27s lifestyle to mental coaching. Whilst these apps might consider user context when they give their interventions, prompts, and encouragements, they still tend to be rigid e.g., not using user context and experience to tailor themselves to the user. Objective: To better engage and tailor to the user, we have previously proposed a Reference Architecture for enabling self-adaptation and AI personalization in e-Health mobile apps. In this work we evaluate the end users’ perception, usability, performance impact, and energy consumption contributed by this Reference Architecture. Method: We do so by implementing a Reference Architecture compliant app and conducting two experiments: a user study and a measurement-based experiment. Results: Although limited in the number of participants, the results of our user study show that usability of the Reference Architecture compliant app is similar to the control app. Users’ perception was found to be positively influenced by the compliant app when compared to the control group. Results of our measurement-based experiment showed some differences in performance and energy consumption measurements between the two apps. The differences are, however, deemed minimal. Conclusions: Our experiments show promising results for an app implemented following our proposed Reference Architecture. This is preliminary evidence that the use of personalization and self-adaptation techniques can be beneficial within the domain of e-Health apps

New Thoughts on Pediatric Genetic Obesity: Pathogenesis, Clinical Characteristics and Treatment Approach

Historically, some genetic syndromes and monogenic forms of obesity have been identified by clinical features and by sequencing candidate genes in patients with severe obesity. The phenotypic expression of genetic factors involved in obesity is variable, thereby allowing to distinguish several clinical pictures of obesity. Monogenic obesity is described as rare and severe early‐onset obesity with abnormal feeding behavior and endocrine disorders. Many of the findings emerged from studying families who displayed a classical Mendelian pattern of inheritance. On the contrary, patients with syndromic obesity show a various degree of intellectual disability, different dysmorphic features, and organ‐specific abnormalities. But to date, not all involved genes have been identified so far. New diagnostic tools, such as genome‐wide studies, array CGH, and whole‐exome sequencing, have highlighted more complex models of inheritance, and even more candidate genes were identified. This increase of knowledge may provide insights into the mechanisms involved in the regulation of body weight and finally lead to specific treatments. In these patients, hyperphagia is often a primary phenotypic component. Substantial gaps in understanding the molecular basis of inherited hyperphagia syndromes are present today with a lack of mechanistic targets that can serve as a basis for pharmacologic and behavioral treatments. We have evaluated retrospectively the literature data on weight, body mass index (BMI), clinical features, treatments, and treatment response in pediatric patients with forms of genetic obesity. However, this chapter provides an updated picture of emerging knowledge outlined by the more comprehensive genetic approaches, trying to outline more candidate genes for these forms of genetic obesity. Relevant papers will be identified through systematic searches of the PubMed, EMBASE and Cochrane databases. All published studies in the English language concerning these disorders will be evaluated. Keywords in the literature search will be entered in all combinations. Searches will be augmented by manually reviewing the reference lists of all original articles and all systematic review articles, with each study being evaluated for inclusion

Classifying Optical (Out)bursts in Cataclysmic Variables: The Distinct Observational Characteristics of Dwarf Novae, Micronovae, Stellar Flares, and Magnetic Gating

Cataclysmic variables can experience short optical brightenings, which are commonly attributed to phenomena such as dwarf novae outbursts, micronovae, donor flares, or magnetic gating bursts. Since these events exhibit similar observational characteristics, their identification has often been ambiguous. In particular, magnetic gating bursts and micronovae have been suggested as alternative interpretations of the same phenomena. Here we show that the timescales and energies separate the optical brightenings into separate clusters consistent with their different classifications. This suggests that micronovae and magnetic gating bursts are in fact separate phenomena. Based on our findings, we develop diagnostic diagrams that can distinguish between these bursts/flares based on their properties. We demonstrate the effectiveness of this approach on observations of a newly identified intermediate polar, CTCV J0333-4451, which we classify as a magnetic gating system. CTCV J0333-4451 is the third highest spin-to-orbital period ratio intermediate polar with magnetic gating, suggesting that these bursts are common among these rare systems

Realtime PCR Is More Sensitive than Multiplex PCR for Diagnosis and Serotyping in Children with Culture Negative Pneumococcal Invasive Disease

Background: Pneumococcal serotyping is usually performed by Quellung reaction, considered the gold standard test. However the method cannot be used on culture-negative samples. Molecular methods can be a useful alternative. The aim of the study was to evaluate the use of Multiplex-sequential-PCR (MS-PCR) or Realtime-PCR on blood samples for diagnosis and serotyping of invasive pneumococcal disease (IPD) in a pediatric clinical setting. Methodology/Principal Findings: Sensitivity and specificity of MS-PCR and Realtime-PCR have been evaluated both on 46 well characterized pneumococcal isolates and on 67 clinical samples from children with culture-negative IPD. No difference in sensitivity and specificity between MS-PCR and Realtime PCR was found when the methods were used on isolates: both methods could type 100 % isolates and the results were always consistent with culture-based methods. On the contrary, when used on clinical samples 43/67 (64.2%) were typeable by MS-PCR and 61/67 (91.0%) by Realtime-PCR (p = 0.0004,K Cohen 0.3, McNemar’s p,0.001). Non-typeability by MS-PCR was associated in 18/20 cases (90.0%) with low bacterial load. The difference between the two methods was present both when they were used on normally sterile fluids (respectively 31/ 33 (93.9%) typeable samples for Realtime-PCR and 24/33 (72.7%) for MS-PCR, p = 0.047, 95%CL 0.03–0.98; K Cohen 0.3; McNemar’s p = 0.0016) and when they were used on nasopharyngeal swabs (respectively 30/34 (88.2%) typeable samples for Realtime-PCR and 19/34 (55.9%) for MS-PCR, p = 0.007, 95%CL 0.04–0.66); the presence of multiple pneumococca

Pneumococcal DNA is not detectable in the blood of healthy carrier children by real-time PCR targeting the lytA gene

The diagnosis of invasive pneumococcal disease (IPD) is currently based on culture methods, which lack sensitivity, especially after antibiotic therapy. Molecular methods have improved sensitivity and do not require viable bacteria; however, their use is complicated by reports of low specificity with some assays. The present study investigated the specificity of a real-time PCR targeting lytA for the detection of IPD. A group of 147 healthy children, aged 6 months to 16 years (mean 6.4 years, median 4.9 years, interquartile range 6.4 years), who were in hospital for routine examinations, were tested for pneumococcal carrier status and for the presence of detectable pneumococcal DNA in their blood by real-time PCR targeting the pneumococcal lytA gene. In addition, 35 culture-positive biological samples were analysed. Urine was examined for the presence of pneumococcal DNA and C-polysaccharide antigen. Carriage was detected in 77 of the 147 subjects (52.4 %); however, regardless of carrier status, none of the subjects had a positive result from blood. Analysis of the culture-positive biological samples yielded positive results in 100 % (15/15) of cerebrospinal fluid samples and 95 % (19/20) of blood samples. All urine samples from healthy carriers were negative for DNA, whilst antigenuria was detected in 44/77 carriers (57.1 %). In conclusion, real-time PCR is both sensitive and specific and can be a useful tool in the routine diagnosis of IPD. Its sensitivity, which surpasses that of other methods for this purpose, does not come at the cost of reduced specificity

Oxidative Methanol Reforming for Hydrogen-fed HT-PEMFC: Applications in the Naval Sector

CO2 emissions from marine transport contributes to about 3% of the overall greenhouse gas (GHG) emissions. International regulations and the Paris agreement require to cut them by 50% by 2050. Moreover, the latest International Maritime Organization (IMO) regulations strongly limits SOx emissions. One of the most promising alternatives to conventional fuels is hydrogen, which can meet the environmental targets set by the international community, if coupled with H2-fed PEM fuel cells (PEMFCs) due to their high efficiency. On-board H2 production starting from a suitable liquid source can be competitive compared to compressed/liquid H2. Methanol (MeOH) is a suitable candidate due to: high H2 content, relatively low reforming temperature, absence of sulfur compounds, and the possibility of being obtained from renewable materials. This work investigates the coupling of autothermal oxidative MeOH steam reforming (OSRM) with high temperature PEMFCs (HT-PEMFCs). The latter outperforms low temperature (LT) PEMFCs, concerning resistance to CO poisoning and high operating temperature, allowing an integrated OSMR reactor – HT-PEMFC and energetically self-sustaining system. The integrated system has also been designed considering also MeOH storage tank and the main auxiliary units, and the dimensions appear very interesting for the installation on board of ships, also in terms of emissions

Evaluation of qualitative and semi-quantitative cut offs for rapid diagnostic lateral flow test in relation to serology for the detection of SARS-CoV-2 antibodies: findings of a prospective study

There is limited information to compare the qualitative and semi-quantitative performance of rapid diagnostic tests (RDT) and serology for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, the objective of the study was (a) to compare the efficacy of SARS-CoV-2 antibody detection between RDT and laboratory serology, trying to identify appropriate semi-quantitative cut-offs for RDT in relation with quantitative serology values and to (b) evaluate diagnostic accuracy of RDT compared to the NAAT gold standard in an unselected adult population

The Fall in Antibody Response to SARS-CoV-2: a Longitudinal Study of Asymptomatic to Critically Ill Patients Up to 10 Months after Recovery

The aim of this study was to assess the long-term dynamics and factors associated with the serological response against the severe acute respiratory syndrome coronavirus 2 after primary infection. A prospective longitudinal study was conducted with monthly serological follow-up during the first 4 months, and then at 6, 8, and 10 months after the disease onset of all recovered adult in- and outpatients with coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) during the first wave (from March to May 2020). A total of 546 individuals were included (289 female, mean age 53.1 years), mostly with mild COVID-19 (370, 68.3%). Patients were followed for a median of 302 days (interquartile range, 186 to 311). The overall seroconversion rate within 2 months was 32% for IgM and 90% for IgG. Seroreversion was observed in 90% of patients for IgM at 4 months and in 47% for IgG at 10 months. Older age, number of symptoms at acute onset, and severity of acute COVID-19 were all independent predictors of long-term immunity both for IgM (beta, linear regression coefficient, 1.10, P = 0.001; beta 5.15 P = 0.014; beta 43.84 P = 0.021, respectively) and for IgG (beta 1.43 P < 0.001; beta 10.46 P < 0.001; beta 46.79 P, 0.001, respectively), whereas the initial IgG peak was associated only with IgG duration (beta 1.12, P < 0.001). IgM antibodies disappeared at 4 months, and IgG antibodies declined in about half of patients 10 months after acute COVID-19. These effects varied depending on the intensity of the initial antibody response, age, and burden of acute COVID-19