Application of Functional Data Analysis for the Prediction of Maximum Heart Rate

Maximum heart rate (MHR) is widely used in the prescription and monitoring of exercise intensity, and also as a criterion for the termination of sub-maximal aerobic fitness tests in clinical populations. Traditionally, MHR is predicted from an age-based formula, usually 220−age. These formulae, however, are prone to high predictive errors that potentially could lead to inaccurately prescribed or quantified training or inappropriate fitness test termination. In this paper, we used functional data analysis (FDA) to create a new method to predict MHR. It uses heart rate data gathered every 5 seconds during a low intensity, sub-maximal exercise test. FDA allows the use of all the information recorded by monitoring devices in the form of a function, reducing the amount of information needed to generalize a model, besides minimizing the curse of dimensionality. The functional data model created reduced the predictive error by more than 50% compared to current models within the literature. This new approach has important benefits to clinicians and practitioners when using MHR to test fitness or prescribe exerciseThis work was supported in part by the Spanish Ministry of Economy and Competitiveness under Project TIN2015-73566-JIN, in part by the European Regional Development Fund (ERDF/FEDER), the Consellería de Cultura, Educación e Ordenación Universitaria (2016-2019), under Grant ED431G/08, in part by the Reference Competitive Group (2014-2017) under Grant GRC2014/030, in part by the 2016 Postdoctoral Training Grants, and in part by the European Regional Development Fund (ERDF)S

GreenSCIES – Green Smart Community Integrated Energy Systems – Integration with Data Centres

The GreenSCIES project aims to deliver low carbon, affordable energy through a novel smart energy system that connects flexible electricity demands such as heat pumps and electric vehicles to intermittent renewable energy sources such as solar power. This paper presents the results of the feasibility study of a 5th generation district mobility, power and heat network in the London Borough of Islington. The smart network facilitates the transition to electric vehicles and vehicle-to-grid supply to make the most of intermittent renewable energy and ensure end-users always get the best tariff. Heating and cooling are provided by heat pumps in buildings connected to a local network, which integrates thermal energy storage and waste heat recovered from local datacentres. Artificial intelligence underpins the system optimisation and demand side response. Low carbon heating and cooling is achieved by sharing heat between buildings and by shifting the timing of their demand to off-peak cheaper electricity; this requires a sophisticated control system and thermal energy storage. The feasibility study also worked with key stakeholders to understand the views of end-users and others in the supply chain. The role of key thermal energy providers such as Transport for London and Data Centres is fundamental. The preliminary results indicate that the smart network can deliver up to 25% reduction on energy bills and 80% CO2 savings compared to a baseline scenario with gas boilers, chillers and grid electricity. As the electricity grid decarbonises further it is forecasted that the network will tend to net zero carbon before 2050. The GreenSCIES concept is suitable to be replicated throughout the country and has the potential to become a world-leading example

Integration of High Temperature Heat Networks with Low Carbon Ambient Loop Systems

Heat networks are a key technology proposed in the UK Government's Clean Growth Strategy for delivering low carbon and low-cost energy to urban communities in the UK. Currently, around 2% of all heat in the UK is provided by heat networks compared to other countries such as Sweden/ Denmark, where they have more than 30% delivered in this way. Most of the Scandinavian systems use high temperature 3rd or 4th generation heat networks (>50-80ºC) [>122-176ºF] and these are often driven by fossil fuel powered Combined Heat and Power (CHP), which are carbon intensive and also impact on local pollution/ particulates. In the UK there is a drive towards 5th generation heat networks involving ambient temperature loops (13 - 25ºC) [55-77ºF]. These systems deliver additional benefits and savings as they are able to share heat/coolth across the network and capture waste heat from secondary heat sources like the heat from London Underground ventilation shafts and local data centres. They utilise heat pumps to deliver heat or cold from the loop to individual applications or buildings and they avoid emissions of particulates associated with CHP. This paper investigates how existing 3rd and 4th generation networks can be connected into 5th generation systems. It uses the 3rd generation Bunhill CHP installation in the London borough of Islington as a case study to investigate the relative performance when converting a system. The paper describes the techno-economic models developed to show how the Bunhill installation might perform when connected to 5th generation, including CAPEX and engineering connection approaches

Use of non-invasive ventilation (NIV) in patients with acute respiratory failure in emergency departments: a systematized review

El objetivo de esta revisión es revisar el uso de ventilación mecánica no invasiva (VMNI) en la insuficiencia respiratoria aguda (IRA) en el servicio de urgencias. Para ello se realizará una revisión sistemática cualitativa en distintas bases de datos, identificando artículos con la temática expuesta con una estrategia única; limitado a hallazgos de los últimos 5 años en español e inglés. En un estudio realizado en la población pediátrica se concluyó que el manejo precoz de la IRA y el uso de cánulas nasales de alto flujo reducía el tiempo de hospitalización, las derivaciones a hospitales especializados, y otorgaba más autonomía a los hospitales regionales en su manejo, disminuyendo así el número de pacientes que precisaban del uso de técnicas invasivas. En el caso de pacientes con reagudización de la enfermedad pulmonar obstructiva crónica (EPOC), y su manejo precoz en el ámbito prehospitalario, se observó un aumento de la mortalidad en aquellos pacientes que fueron sometidos a alto flujo comparado con la oxigenoterapia convencional. Según los resultados de un metanálisis, se revisó que no había ningún beneficio en el uso de cánulas nasales de alto flujo frente a la terapia convencional o la VMNI, en el servicio de urgencias, en términos de necesidad de intubación, fallo de tratamiento, hospitalización y mortalidad. Los datos no son concluyentes en ninguno de los estudios revisados y no hay acuerdo entre autores. Existe escasa bibliografía respecto al uso de VMNI en el servicio de urgencias, debido a que la gran mayoría de los estudios se centran en el uso de esta técnica en las unidades de cuidados intensivos. En conclusión existe heterogeneidad en los resultados de los artículos revisados respecto al uso de VMNI en el servicio de urgencias.The aim of this study si to revise the use of non-invasive ventilation (NIV) in patients with acute respiratory failure in emergency departments. A systematized database review will be carried out by the search of articles attending the presented subject following a unique approach; restricting the results to findings in the last five years either in Spanish or English. A research performed in paediatric population concluded that the early management of acute respiratory failure and the use of high flow nasal cannulae reduced the hospitalization period and the referral to specialized hospitals, and gave more independence to regional hospitals in its management; reducing, therefore, the number of patients needing the implementation of invasive procedures. With respect to patients with exacerbations of the chroni

Neural interval-censored Cox regression with feature selection

The classical Cox model emerged in 1972 promoting breakthroughs in how patient prognosis is quantified using time-to-event analysis in biomedicine. One of the most useful characteristics of the model for practitioners is the interpretability of the variables in the analysis. However, this comes at the price of introducing strong assumptions concerning the functional form of the regression model. To break this gap, this paper aims to exploit the explainability advantages of the classical Cox model in the setting of interval-censoring using a new Lasso neural network that simultaneously selects the most relevant variables while quantifying non-linear relations between predictors and survival times. The gain of the new method is illustrated empirically in an extensive simulation study with examples that involve linear and non-linear ground dependencies. We also demonstrate the performance of our strategy in the analysis of physiological, clinical and accelerometer data from the NHANES 2003-2006 waves to predict the effect of physical activity on the survival of patients. Our method outperforms the prior results in the literature that use the traditional Cox model

Physiological and psychological effects of laughter therapy among paediatric population: a systematized review

El objetivo de este estudio es revisar los efectos fisiológicos y psicológicos de la risoterapia en la población pediátrica. Para ello se ha realizado una revisión sistematizada en distintas bases de datos según los criterios de la declaración PRISMA modificados, identificando artículos relacionados con la temática expuesta; limitado a hallazgos de la última década en castellano, inglés, portugués o francés. La risoterapia principalmente torna en la figura de los payasos de hospital. El clowning en el ámbito hospitalario supone un efecto positivo en el proceso de hospitalización del niño. Se ha constatado que la interacción con los payasos de hospital supone una disminución de la ansiedad en el niño, mejorando la adherencia al tratamiento. Existe una amplia aceptación del personal sanitario de los payasos afirmando que facilitan el proceso terapéutico y el manejo del paciente pediátrico ante procedimientos diagnóstico-terapéuticos o la separación de los progenitores. Diversas son las herramientas utilizadas para entablar relación terapéutica con el infante, como es el humor, el juego, la música, el teatro y los trucos de magia. La hospitalización pediátrica debe procurar tanto una terapia física como una atención y cuidado a las repercusiones psicológicas que el proceso conlleva, donde el personal de enfermería asuma su papel en el cuidado integral del paciente, teniendo en cuenta las distintas herramientas del cuidado. La risoterapia, considerada como medicina complementaria, ayuda al abordaje integral en el manejo de estos pacientes, que constituyen un grupo vulnerable a los ambientes hostiles, como resulta el hospital, por lo cual se necesita de un equipo multidisciplinar cohesionado donde prime la comunicación.The aim of this study is to review the physiological and psychological effects of laughter therapy among paediatric population. A systematic database review will be carried according to the modified PRISMA’s statement criteria. To do so, articles that may reflect the chosen topic will be researched. This research will be limited to last decade discoveries in languages such as: Spanish, English, Portuguese and French. Laughter therapy is performed by specialised trained clowns, known as “Clown-Doctors”. It has been recognised in the hospital environment that hospital clowning offers a positive impact to the children’s hospitalisation process. Moreover, studies confirm that the interaction with Clown-Doctors lessens the children’s anxiety. This also contributes to the ensuring higher rates of adherence to medical treatment. Furthermore, it has been widely recognised by health professionals that Clown-Doctors facilitate therapeutic processes and the handling of paediatric patients when diagnostic-therapeutic procedures or parent’s separation occur. Humour, games, music and magic tricks are some of tools used to create a therapeutic relationship with the child. Paediatric hospitalisation should guarantee both physical therapy and the proper care of possible psychological side effects that the process may produce. Nursing staff therefore, must ensure they provide an integral care to the patient having in mind the different caring tools at their disposition. Laughter therapy, as a complementary treatment, ensures a holistic approach in the taking care of the paediatric population. These patients constitute a vulnerable group in hostile environments such as that of hospitals. For this reason, a cohesive multidisciplinary team, in which communication is prioritised, is necessary

Initial assessment of a 5th generation district energy network in central London

© 2019 ASHRAE. The paper introduces a concept design for the UK's first large-scale fifth generation (5G) smart energy network using an area in central London as a case study. The proposed system will incorporate a range of different renewables and secondary energy sources that will supply a large proportion of the energy demand of the overall district network capacity. The network will operate at close to ambient temperature, approximately 15-25°C (59-77°F) as a single loop system, with individual heat pumps for each end user or building connected to the network. The system also integrates thermal and electrical storage to create additional flexibility for the network and smart control for demand-side management. The paper describes the proposed 5G network concept and details the selected components of the system, in particular urban location. Key outcomes of the study presented in this paper provide understanding of the relative performance of individual technologies in a complex system using a techno-economic modelling approach

Developing novel 5th generation district energy networks

Integrated smartly controlled energy networks have the potential to deliver significant reductions in carbon emissions, improve air quality and reduce energy costs for end-users across the world. This paper introduces a novel methodology for the development of integrated thermal, power and mobility 5th generation (5G) smart energy networks. The proposed 5G concept builds on state of the art by connecting flexible electricity demands such as heat pumps, and electric vehicles to intermittent, renewable and secondary energy sources and storage using artificial intelligence to facilitate optimal control and to maximise revenue and carbon savings. The proposed innovative method is being applied in central London through the development of two independent 5G smart energy schemes. The proposed schemes will incorporate a range of different renewables and secondary energy sources, for example, waste heat from local data centres and the London Underground that will supply a large proportion of the energy demand of the overall district network capacity. Both networks will operate at close to ambient temperature, approximately 15–25 °C as a so-called ‘ambient loop’ system, with individual heat pumps for each end-user or building connected to the network. The system also integrates thermal and electrical storage to create additional flexibility for the network and smart control for demand-side management. A smart management system flexibly controls individual assets such as heat pumps and electric vehicles in response to price signals reflecting the intermittency of renewable energy sources on the electricity grid. The ambient district thermal loop will distribute low carbon energy to a range of end users. Results presented in this paper provide an understanding of capital costs associated with integrated smart energy systems and the relative performance of individual technologies in a complex system using a techno-economic modelling approach. Overall, this paper demonstrates that the implementation of the 5G concept results in lower energy costs to consumers while at the same time transforming a large existing urban area to a near zero-carbon energy system in terms of heating, cooling, electricity and transport