Continuous digital health

© 2015 IEEE. A transformation is underway regarding how we deal with our health, not only because mobile Internet technology has made it possible to have continuous access to personal health information, but also because breaking the trend of ever-growing healthcare costs is increasingly necessary. Connectivity, interoperability, sensing, and instant feedback through smartphones all provide new opportunities for gaining insights into our health behavior. Such insights improve our understanding of what motivates people to make healthier changes throughout their lifetimes. Thus, this special issue reviews and shares advances in wireless, connected, and mobile health research that expand the possibilities

New machine learning methods demonstrate the existence of a human stylome

Earlier research has shown that established authors can be distinguished by measuring specific properties of their writings, their stylome as it were. Here, we examine writings of less experienced authors. We succeed in distinguishing between these authors with a very high probability, which implies that a stylome exists even in the general population. However, the number of traits needed for so successful a distinction is an order of magnitude larger than assumed so far. Furthermore, traits referring to syntactic patterns prove less distinctive than traits referring to vocabulary, but much more distinctive than expected on the basis of current generativist theories of language learning

An Evaluation Method for Context-Aware Systems in U-Health

Proceedings of: 3rd International Symposium on Ambient Intelligence (ISAmI 2012) Salamanca, March 28-30, 2012Evaluations for context-aware systems can not be conducted in the same manner evaluation is understood for other software systems where the concept of large corpus data, the establishment of ground truth and the metrics of precision and recall are used. Evaluation for changeable systems like context-aware and specially developed for AmI environments needs to be conducted to assess the impact and awareness of the users. E-Health represents a challenging domain where users(patients, patients' relatives and healthcare professionals) are very sensitive to systems' response. If system failure occurs it can conducts to a bad diagnosis or medication, or treatment. So a user-centred evaluation system is need to provide the system with users' feedback. In this paper, we present an evaluation method for context aware systems in AmI environments and specially to u-Heatlh domainFunded by projects CICYT TIN2008-06742-C02-02/TSI, CICYTTEC2008-06732 C02-02/TEC, SINPROB, CAM MADRINET S-0505/TIC/0255 and DPS2008-07029-C02-02.Publicad

In Situ Detection of HY-Specific T Cells in Acute Graft-versus-Host Disease–Affected Male Skin after Sex-Mismatched Stem Cell Transplantation

HY-specific T cells are presumed to play a role in acute graft-versus-host disease (aGVHD) after female-to-male stem cell transplantation (SCT). However, infiltrates of these T cells in aGVHD-affected tissues have not yet been reported. We evaluated the application of HLA-A2/HY dextramers for the in situ detection of HY-specific T cells in cryopreserved skin biopsy specimens. We applied the HLA-A2/HY dextramers on cryopreserved skin biopsy specimens from seven male HLA-A2+ pediatric patients who underwent stem cell transplantation with confirmed aGVHD involving the skin. The dextramers demonstrated the presence of HY-specific T cells. In skin biopsy specimens of three male recipients of female grafts, 68% to 78% of all skin-infiltrating CD8+ T cells were HY-specific, whereas these cells were absent in biopsy specimens collected from sex-matched patient–donor pairs. Although this study involved a small and heterogeneous patient group, our results strongly support the hypothesis that HY-specific T cells are actively involved in the pathophysiology of aGVHD after sex-mismatched stem cell transplantation

Demographics and additional haematologic cancers of patients with histiocytic/dendritic cell neoplasms

Aims: The discovery of somatic genetic alterations established many histiocytic disorders as haematologic neoplasms. We aimed to investigate the demographic characteristics and additional haematologic cancers of patients diagnosed with histiocytic disorders in The Netherlands. Methods and results: We retrieved data on histiocytosis patients from the Dutch Nationwide Pathology Databank (Palga). During 1993 to 2022, more than 4000 patients with a pathologist-assigned diagnosis of a histiocytic disorder were registered in Palga. Xanthogranulomas were the most common subtype, challenging the prevailing assumption that Langerhans cell histiocytosis (LCH) is the most common histiocytic disorder. LCH and juvenile xanthogranuloma (JXG) had a peak incidence in the first years of life; males were overrepresented among all histiocytosis subgroups. 118 patients had a histiocytic disorder and an additional haematologic malignancy, including 107 (91%) adults at the time of histiocytosis diagnosis. In 16/118 patients, both entities had been analysed for the same genetic alteration(s). In 11 of these 16 patients, identical genetic alterations had been detected in both haematologic neoplasms. This included two patients with PAX5 p.P80R mutated B cell acute lymphoblastic leukaemia and secondary histiocytic sarcoma, further supporting that PAX5 alterations may predispose (precursor) B cells to differentiate into the myeloid lineage. All 4/11 patients with myeloid neoplasms as their additional haematologic malignancy had shared N/KRAS mutations. Conclusions: This population-based study highlights the frequency of xanthogranulomas. Furthermore, our data add to the growing evidence supporting clonal relationships between histiocytic/dendritic cell neoplasms and additional myeloid or lymphoid malignancies. Particularly adult histiocytosis patients should be carefully evaluated for the development of these associated haematologic cancers.</p

Demographics and additional haematologic cancers of patients with histiocytic/dendritic cell neoplasms

Aims: The discovery of somatic genetic alterations established many histiocytic disorders as haematologic neoplasms. We aimed to investigate the demographic characteristics and additional haematologic cancers of patients diagnosed with histiocytic disorders in The Netherlands. Methods and results: We retrieved data on histiocytosis patients from the Dutch Nationwide Pathology Databank (Palga). During 1993 to 2022, more than 4000 patients with a pathologist-assigned diagnosis of a histiocytic disorder were registered in Palga. Xanthogranulomas were the most common subtype, challenging the prevailing assumption that Langerhans cell histiocytosis (LCH) is the most common histiocytic disorder. LCH and juvenile xanthogranuloma (JXG) had a peak incidence in the first years of life; males were overrepresented among all histiocytosis subgroups. 118 patients had a histiocytic disorder and an additional haematologic malignancy, including 107 (91%) adults at the time of histiocytosis diagnosis. In 16/118 patients, both entities had been analysed for the same genetic alteration(s). In 11 of these 16 patients, identical genetic alterations had been detected in both haematologic neoplasms. This included two patients with PAX5 p.P80R mutated B cell acute lymphoblastic leukaemia and secondary histiocytic sarcoma, further supporting that PAX5 alterations may predispose (precursor) B cells to differentiate into the myeloid lineage. All 4/11 patients with myeloid neoplasms as their additional haematologic malignancy had shared N/KRAS mutations. Conclusions: This population-based study highlights the frequency of xanthogranulomas. Furthermore, our data add to the growing evidence supporting clonal relationships between histiocytic/dendritic cell neoplasms and additional myeloid or lymphoid malignancies. Particularly adult histiocytosis patients should be carefully evaluated for the development of these associated haematologic cancers.</p

Adaptation of an Evaluation System for e-Health Environments

Proceedings of: 14th International Conference, KES 2010, Cardiff, UK, September 8-10, 2010The increase in ageing of European population implies a high cost in economy and society in any European country and it can be reduced if we pay attention and develop home care systems. Evaluation of these systems is a critical and challenging issue but seldom tackled. It is important before evaluating a system to figure out what is the evaluation goal. In our case, such a goal is to evaluate enhanced user experience and beyond the evaluation goal it is also a central concern about what to evaluate. In this paper we propose a multi-agent home care system where we describe how agents coordinate their decisions to provide e-services to patients when at home after hospitalization. Finally we center our proposal on the adaptation of an evaluation system, previously developed, to support the challenges of an e-Health environment and also the multi-user evaluation. These evaluation methods (online/offline) will provide user's (patients, patient's relatives and healthcare professionals) feedback into the system.This work was supported in part by Projects CICYT TIN2008-06742-C02-02/ TSI, CICYT TEC2008-06732-C02-02/TEC, CAM CONTEXTS (S2009/ TIC-1485) and DPS2008-07029-C02-02.Publicad

Coffee consumption is associated with a reduced risk of colorectal cancer recurrence and all-cause mortality

Coffee consumption has been associated with a reduced risk of developing colorectal cancer (CRC). However, it is not clear whether coffee consumption is related to CRC progression. Hence, we assessed the association of coffee consumption with CRC recurrence and all-cause mortality using data from a prospective cohort study of 1719 stage I–III CRC patients in the Netherlands. Coffee consumption and other lifestyle characteristics were self-reported using questionnaires at the time of diagnosis. We retrieved recurrence and all-cause mortality data from the Netherlands Cancer Registry and the Personal Records Database, respectively. Cox proportional hazard regression models with and without restricted cubic splines were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, education, smoking status, cancer stage and tumor location. We observed 257 recurrences during a 6.2-year median follow-up and 309 deaths during a 6.6-year median follow-up. Consuming more than 4 cups/d of coffee compared to an intake of &lt;2 cups/d was associated with a 32% lower risk of CRC recurrence (95% CI: 0.49, 0.94,). The association between coffee consumption and all-cause mortality was U-shaped; coffee intake seemed optimal at 3–5 cups/d with the lowest risk at 4 cups/d (HR: 0.68, 95% CI: 0.53, 0.88). Our results suggest that coffee consumption may be associated with a lower risk of CRC recurrence and all-cause mortality. The association between coffee consumption and all-cause mortality appeared nonlinear. More studies are needed to understand the mechanism by which coffee consumption might improve CRC prognosis.</p