Intelligent clinical decision support system for managing COPD patients

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Health remote monitoring systems (HRMSs) play a crucial role in managing COPD patients by identifying anomalies in their biometric signs and alerting healthcare professionals. By analyzing the relationships between biometric signs and environmental factors, it is possible to develop artificial intelligence models that are capable of inferring patients’ future health deterioration risks. In this research work, we review recent works in this area and develop an intelligent clinical decision support system (CIDSS) that is capable of providing early information concerning patient health evolution and risk analysis in order to support the treatment of COPD patients. The present work’s CIDSS is composed of two main modules: the vital signs prediction module and the early warning score calculation module, which generate the patient health information and deterioration risks, respectively. Additionally, the CIDSS generates alerts whenever a biometric sign measurement falls outside the allowed range for a patient or in case a basal value changes significantly. Finally, the system was implemented and assessed in a real case and validated in clinical terms through an evaluation survey answered by healthcare professionals involved in the project. In conclusion, the CIDSS proves to be a useful and valuable tool for medical and healthcare professionals, enabling proactive intervention and facilitating adjustments to the medical treatment of patients.info:eu-repo/semantics/publishedVersio

On the sub-micron aerosol size distribution in a coastal-rural site at El Arenosillo Station (SW – Spain)

This study focuses on the analysis of the sub-micron aerosol characteristics at El Arenosillo Station, a rural and coastal environment in South-western Spain between 1 August 2004 and 31 July 2006 (594 days). The mean total concentration (NT) was 8660 cm−3 and the mean concentrations in the nucleation (NNUC), Aitken (NAIT) and accumulation (NACC) particle size ranges were 2830 cm−3, 4110 cm−3 and 1720 cm−3, respectively. Median size distribution was characterised by a single-modal fit, with a geometric diameter, median number concentration and geometric standard deviation of 60 nm, 5390 cm−3 and 2.31, respectively. Characterisation of primary emissions, secondary particle formation, changes to meteorology and long-term transport has been necessary to understand the seasonal and annual variability of the total and modal particle concentration. Number concentrations exhibited a diurnal pattern with maximum concentrations around noon. This was governed by the concentrations of the nucleation and Aitken modes during the warm seasons and only by the nucleation mode during the cold seasons. Similar monthly mean total concentrations were observed throughout the year due to a clear inverse variation between the monthly mean NNUC and NACC. It was related to the impact of desert dust and continental air masses on the monthly mean particle levels. These air masses were associated with high values of NACC which suppressed the new particle formation (decreasing NNUC). Each day was classified according to a land breeze flow or a synoptic pattern influence. The median size distribution for desert dust and continental aerosol was dominated by the Aitken and accumulation modes, and marine air masses were dominated by the nucleation and Aitken modes. Particles moved offshore due to the land breeze and had an impact on the particle burden at noon, especially when the wind was blowing from the NW sector in the morning during summer time. This increased NNUC and NAIT by factors of 3.1 and 2.4, respectively. Nucleation events with the typical "banana" shape were characterised by a mean particle nucleation rate of 0.74 cm−3 s−1, a mean growth rate of 1.96 nm h−1 and a mean total duration of 9.25 h (starting at 10:55 GMT and ending at 20:10 GMT). They were observed for 48 days. Other nucleation events were identified as those produced by the emissions from the industrial areas located at a distance of 35 km. They were observed for 42 days. Both nucleation events were strongly linked to the marine air mass origin

On the sub-micron aerosol size distribution in a coastal-rural site at El Arenosillo Station (SW – Spain)

This study focuses on the analysis of the sub-micron aerosol characteristics at El Arenosillo Station, a rural and coastal environment in South-western Spain between 1 August 2004 and 31 July 2006 (594 days). The mean total concentration (<i>N</i><sub>T</sub>) was 8660 cm<sup>−3</sup> and the mean concentrations in the nucleation (<i>N</i><sub>NUC</sub>), Aitken (<i>N</i><sub>AIT</sub>) and accumulation (<i>N</i><sub>ACC</sub>) particle size ranges were 2830 cm<sup>−3</sup>, 4110 cm<sup>−3</sup> and 1720 cm<sup>−3</sup>, respectively. Median size distribution was characterised by a single-modal fit, with a geometric diameter, median number concentration and geometric standard deviation of 60 nm, 5390 cm<sup>−3</sup> and 2.31, respectively. Characterisation of primary emissions, secondary particle formation, changes to meteorology and long-term transport has been necessary to understand the seasonal and annual variability of the total and modal particle concentration. Number concentrations exhibited a diurnal pattern with maximum concentrations around noon. This was governed by the concentrations of the nucleation and Aitken modes during the warm seasons and only by the nucleation mode during the cold seasons. Similar monthly mean total concentrations were observed throughout the year due to a clear inverse variation between the monthly mean <i>N</i><sub>NUC</sub> and <i>N</i><sub>ACC</sub>. It was related to the impact of desert dust and continental air masses on the monthly mean particle levels. These air masses were associated with high values of <i>N</i><sub>ACC</sub> which suppressed the new particle formation (decreasing <i>N</i><sub>NUC</sub>). Each day was classified according to a land breeze flow or a synoptic pattern influence. The median size distribution for desert dust and continental aerosol was dominated by the Aitken and accumulation modes, and marine air masses were dominated by the nucleation and Aitken modes. Particles moved offshore due to the land breeze and had an impact on the particle burden at noon, especially when the wind was blowing from the NW sector in the morning during summer time. This increased <i>N</i><sub>NUC</sub> and <i>N</i><sub>AIT</sub> by factors of 3.1 and 2.4, respectively. Nucleation events with the typical "banana" shape were characterised by a mean particle nucleation rate of 0.74 cm<sup>−3</sup> s<sup>−1</sup>, a mean growth rate of 1.96 nm h<sup>−1</sup> and a mean total duration of 9.25 h (starting at 10:55 GMT and ending at 20:10 GMT). They were observed for 48 days. Other nucleation events were identified as those produced by the emissions from the industrial areas located at a distance of 35 km. They were observed for 42 days. Both nucleation events were strongly linked to the marine air mass origin

Urban public space initiatives and health in Africa: A mixed-methods systematic review

Public space initiatives (PSIs) in African cities can significantly promote health and social well-being, yet their implementation and impact are unknown across the continent. There is a substantial gap in literature on PSIs in African countries, with most studies concentrated in wealthier cities and lacking comprehensive assessments of long-term health impacts. The objective of this study was to synthesise evidence on the typology, location, features, and outcomes of these initiatives as well as the guiding principles that underlie their design and implementation. Employing a mixed-methods model, the study systematically reviews peer-reviewed and grey literature articles, focusing on the types, settings, and outcomes of PSIs. Data is analyzed using the CASP appraisal tool and thematic analysis. We analysed 47 studies, 15 of which were mixed methods, 22 qualitative and 10 quantitative. Sports accounted for 50% of initiatives. 30 of the 47 papers originated from South Africa. Communities viewed initiatives’ wellbeing impacts through social, economic, and ecological lenses, with health being but one dimension. The sustainability of initiatives was often limited by funding, historical marginalization, and competing land uses. Findings underscore the need for more comprehensive, long-term evaluations and cross-sector collaborations to sustain and enhance health-promoting public spaces in African cities

Mass distributions and morphological and chemical characterization of urban aerosols in the continental Balkan area (Belgrade)

This work presents characteristics of atmospheric aerosols of urban central Balkans area, using a size-segregated aerosol sampling method, calculation of mass distributions, SEM/EDX characterization, and ICP/MS analysis. Three types of mass distributions were observed: distribution with a pronounced domination of coarse mode, bimodal distribution, and distribution with minimum at 1 μm describing the urban aerosol. SEM/EDX analyses have shown morphological difference and variation in the content of elements in samples. EDX spectra demonstrate that particles generally contain the following elements: Al, Ca, K, Fe, Mg, Ni, K, Si, S. Additionally, the presence of As, Br, Sn, and Zn found in air masses from southeast segment points out the anthropogenic activities most probably from mining activities in southeastern part of Serbia. The ratio Al/Si equivalent to the ratio of desert dust was associated with air masses coming from southeastern and southwestern segments, pointing to influences from North Africa and Middle East desert areas whereas the Al/Si ratio in other samples is significantly lower. In several samples, we found high values of aluminum in the nucleation mode. Samples with low share of crustal elements in the coarse mode are collected when Mediterranean air masses prevailed, while high share in the coarse mode was associated with continental air masses that could be one of the approaches for identification of the aerosol origin. Graphical abstract ᅟ.This work presents characteristics of atmospheric aerosols of urban central Balkans area, using a size-segregated aerosol sampling method, calculation of mass distributions, SEM/EDX characterization, and ICP/MS analysis. Three types of mass distributions were observed: distribution with a pronounced domination of coarse mode, bimodal distribution, and distribution with minimum at 1 mu m describing the urban aerosol. SEM/EDX analyses have shown morphological difference and variation in the content of elements in samples. EDX spectra demonstrate that particles generally contain the following elements: Al, Ca, K, Fe, Mg, Ni, K, Si, S. Additionally, the presence of As, Br, Sn, and Zn found in air masses from southeast segment points out the anthropogenic activities most probably from mining activities in southeastern part of Serbia. The ratio Al/Si equivalent to the ratio of desert dust was associated with air masses coming from southeastern and southwestern segments, pointing to influences from North Africa and Middle East desert areas whereas the Al/Si ratio in other samples is significantly lower. In several samples, we found high values of aluminum in the nucleation mode. Samples with low share of crustal elements in the coarse mode are collected when Mediterranean air masses prevailed, while high share in the coarse mode was associated with continental air masses that could be one of the approaches for identification of the aerosol origin

Fungemia in the French department of Mayotte, Indian Ocean: A 10 years survey

International audienceOBJECTIVE: This study aimed at providing original data on fungemia in the Centre Hospitalier de Mayotte in terms of prevalence, epidemiological characteristics of infected patients, yeast species distribution and profile of in vitro antifungals susceptibility. METHODS: A total of 223 positive blood cultures for yeasts were retrospectively reported during the period April 2010-April 2020. RESULTS: Ninety-five episodes were identified corresponding to an incidence rate of 3.7 cases/100,000 inhabitants. The average age of patients was 33.5 years, and 63.3% patients were hospitalized in intensive care unit. The main co-morbidities were surgery in the 30 days prior to fungemia (27.8%), neoplasia (22.8%), parenteral nutrition (17.7%), diabetes (16.5%) and immunosuppressive medications (31.6%). Candida spp accounted for the majority of isolates (92.4%) with a predominance of non-albicans species (55.8% vs 33.7%), including C. albicans (33.7%), C. tropicalis (30.5%) and C. parapsilosis (20%). The antifungal susceptibility profiles did not differ from expected results for each species and did not change significantly over time. DISCUSSION: Fungemia remain frequent hospital infections associated with high mortality in Mayotte. The vast majority of fungemia was due to Candida spp. Non-albicansCandida species reach half of the Candida isolates with a high percentage of C. tropicalis. Surprisingly, no case of candidemia due to C. glabrata were identified. The management of candidemia remains satisfactory and the treatment was adapted according to the international recommendations. However, the high susceptibility of Candida spp. isolates to fluconazole may invite to reconsider the use of this molecule as empirical and first-line treatment of candidemia in Mayotte