Ontology-driven monitoring of patient's vital signs enabling personalized medical detection and alert

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Ontology-driven monitoring of patient's vital signs enabling personalized medical detection and alert

A major challenge related to caring for patients with chronic conditions is the early detection of exacerbations of the disease. Medical personnel should be contacted immediately in order to intervene in time before an acute state is reached, ensuring patient safety. This paper proposes an approach to an ambient intelligence (AmI) framework supporting real-time remote monitoring of patients diagnosed with congestive heart failure (CHF). Its novelty is the integration of: (i) personalized monitoring of the patients health status and risk stage; (ii) intelligent alerting of the dedicated physician through the construction of medical workflows on-the-fly; and (iii) dynamic adaptation of the vital signs' monitoring environment on any available device or smart phone located in close proximity to the physician depending on new medical measurements, additional disease specifications or the failure of the infrastructure. The intelligence lies in the adoption of semantics providing for a personalized and automated emergency alerting that smoothly interacts with the physician, regardless of his location, ensuring timely intervention during an emergency. It is evaluated on a medical emergency scenario, where in the case of exceeded patient thresholds, medical personnel are localized and contacted, presenting ad hoc information on the patient's condition on the most suited device within the physician's reach

Οικο-Θεολογική διάσταση της προς Ρωμαίους επιστολή (ερμηνευτική και θεολογική προσέγγιση)

Η Οικολογική Κρίση αποτελεί τη συνέπεια ενός άκρατου υλισμού μέσα στον οποίο ζει ο σύγχρονος άνθρωπος. Η αδυναμία του ανθρώπου να προστατεύσει τη φύση δείχνει ότι ο άνθρωπος αντιλαμβάνεται τη θέση του μέσα στην δημιουργία όχι ως θέση ευθύνης για την προστασία του ίδιου και του φυσικού περιβάλλοντος, αλλά ως θέση εξουσίας της φύσης. Για τους Πατέρες της Εκκλησίας, η λύση του Οικολογικού προβλήματος βρίσκεται στη φιλική σχέση που πρέπει να αναπτύξει ο άνθρωπος με τη φύση. Με την έρευνα της Οικολογικής Κρίσης μέσα από την Αγία Γραφή, είναι δυνατόν να φωτιστούν πτυχές της διαφαινόμενης Οικολογικής καταστροφής, να αξιολογηθούν τα σχετικά προβλήματα και να βρεθεί η λύση των δεινών που απειλούν τον πλανήτη μας. Σύμφωνα, λοιπόν με τη θεώρηση της Ορθόδοξης Θεολογίας η Οικολογική Κρίση είναι πρώτιστα θεολογική. Ο απόστολος Παύλος διασώζει με πυκνό λόγο στην προς Ρωμαίους επιστολή του τη θέση του γύρω από τη σχέση του ανθρώπου και της Οικολογικής Κρίσης στον κόσμο. Η κτίση στο σύνολό της υφίσταται τις συνέπειες της ηθικής φθοράς και της αμαρτίας του ανθρώπου. Η οδυνηρή θέση της κτίσης περιγράφεται μέσα από την παρουσία των ωδίνων της που την κάνουν να στενάζει και να βιώνει, ως μη ώφειλε, συνέπειες τις οποίες η ίδια δεν δημιούργησε. Το κείμενο της προς Ρωμαίους επιστολής, αν και αναγνωρίζει ως υπαίτιο της Οικολογικής Κρίσης τον άνθρωπο, την ίδια στιγμή αναφέρεται στην ελπίδα ότι στο τέλος θα αλλάξουν όλα μέσα προς σωτηρία του ανθρώπου και του κόσμου.The ecological crisis is the consequence of an excessive materialism in which modern humans live. The inability of humans to protect nature shows that they perceive their position in creation not as a position of responsibility for the protection of themselves and the natural environment, but as a position of power over nature. According to the Church Fathers, the solution to the ecological problem lies in the friendly relationship that humans should develop with nature. By studying the Ecological Crisis through the Holy Scriptures, it is possible to shed light on aspects of the apparent ecological devastation, evaluate related problems, and find solutions to the dangers threatening our planet. Therefore, according to the perspective of Orthodox Theology, the Ecological Crisis is primarily theological. The apostle Paul, in his letter to the Romans, addresses the position of humans and the Ecological Crisis in the world through his dense discourse. The entire creation suffers the consequences of moral decay and human sin. The painful state of creation is described through the presence of its birth pangs, causing it to groan and experience consequences that it did not create itself. The text of the letter to the Romans acknowledges humans as responsible for the Ecological Crisis, while at the same time referring to the hope that everything will ultimately change towards the salvation of humans and the world

Varying Vaccination Rates Among Patients Seeking Care for Acute Respiratory Illness:A Systematic Review and Meta-analysis

Background: Complications following influenza infection are a major cause of morbidity and mortality, and the Centers for Disease Control Advisory Committee on Immunization Practices recommends universal annual vaccination. However, vaccination rates have remained significantly lower than the Department of Health and Human Services goal. The aim of this work was to assess the vaccination rate among patients who present to health care providers with influenza-like illness and identify groups with lower vaccination rates. Methods: We performed a systematic search of the PubMed and EMBASE databases with a time frame of January 1, 2010, to March 1, 2019 and focused on the vaccination rate among patients seeking care for acute respiratory illness in the United States. A random effects meta-analysis was performed to estimate the pooled seasonal influenza vaccination rate, and we used a time trend analysis to identify differences in annual vaccination over time. Results: The overall pooled influenza vaccination rate was 48.61% (whites: 50.87%; blacks: 36.05%; Hispanics: 41.45%). There was no significant difference among gender groups (men: 46.43%; women: 50.11%). Interestingly, the vaccination rate varied by age group and was significantly higher among adults aged >65 (78.04%) and significantly lower among children 9-17 years old (36.45%). Finally, we found a significant upward time trend in the overall influenza vaccination rate among whites (coef. = .0107; P = .027). Conclusions: In conclusion, because of the significantly lower influenza vaccination rates in black and Hispanic communities, societal initiatives and community outreach programs should focus on these populations and on children and adolescents aged 9-17 years

Molecular Distributions in Gene Regulatory Dynamics

We show how one may analytically compute the stationary density of the distribution of molecular constituents in populations of cells in the presence of noise arising from either bursting transcription or translation, or noise in degradation rates arising from low numbers of molecules. We have compared our results with an analysis of the same model systems (either inducible or repressible operons) in the absence of any stochastic effects, and shown the correspondence between behaviour in the deterministic system and the stochastic analogs. We have identified key dimensionless parameters that control the appearance of one or two steady states in the deterministic case, or unimodal and bimodal densities in the stochastic systems, and detailed the analytic requirements for the occurrence of different behaviours. This approach provides, in some situations, an alternative to computationally intensive stochastic simulations. Our results indicate that, within the context of the simple models we have examined, bursting and degradation noise cannot be distinguished analytically when present alone.Comment: 14 pages, 12 figures. Conferences: "2010 Annual Meeting of The Society of Mathematical Biology", Rio de Janeiro (Brazil), 24-29/07/2010. "First International workshop on Differential and Integral Equations with Applications in Biology and Medicine", Aegean University, Karlovassi, Samos island (Greece), 6-10/09/201

Stochastic signalling rewires the interaction map of a multiple feedback network during yeast evolution

During evolution, genetic networks are rewired through strengthening or weakening their interactions to develop new regulatory schemes. In the galactose network, the GAL1/GAL3 paralogues and the GAL2 gene enhance their own expression mediated by the Gal4p transcriptional activator. The wiring strength in these feedback loops is set by the number of Gal4p binding sites. Here we show using synthetic circuits that multiplying the binding sites increases the expression of a gene under the direct control of an activator, but this enhancement is not fed back in the circuit. The feedback loops are rather activated by genes that have frequent stochastic bursts and fast RNA decay rates. In this way, rapid adaptation to galactose can be triggered even by weakly expressed genes. Our results indicate that nonlinear stochastic transcriptional responses enable feedback loops to function autonomously, or contrary to what is dictated by the strength of interactions enclosing the circuit

Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study

OBJECTIVES: Identify risk factors for Clostridium difficile infection (CDI) and assess CDI outcomes among Australian patients with a haematological malignancy. METHODS: A retrospective cohort study involving all patients admitted to hospitals in Western Australia with a haematological malignancy from July 2011 to June 2012. Hospital admission data were linked with all hospital investigated CDI case data. Potential risk factors were assessed by logistic regression. The risk of death within 60 and 90 days of CDI was assessed by Cox Proportional Hazards regression. RESULTS: There were 2085 patients of whom 65 had at least one CDI. Twenty percent of CDI cases were either community-acquired, indeterminate source or had only single-day admissions in the 28 days prior to CDI. Using logistic regression, having acute lymphocytic leukaemia, neutropenia and having had bacterial pneumonia or another bacterial infection were associated with CDI. CDI was associated with an increased risk of death within 60 and 90 days post CDI, but only two deaths had CDI recorded as an antecedent factor. Ribotyping information was available for 33 of the 65 CDIs. There were 19 different ribotypes identified. CONCLUSIONS: Neutropenia was strongly associated with CDI. While having CDI is a risk factor for death, in many cases it may not be a direct contributor to death but may reflect patients having higher morbidity. A wide variety of C. difficile ribotypes were found and community-acquired infection may be under-estimated in these patients

Roles for H2A.Z and Its Acetylation in GAL1 Transcription and Gene Induction, but Not GAL1-Transcriptional Memory

H2A.Z does not appear to have a role in GAL1 transcriptional memory, but it does have both acetylation-dependent and acetylation-independent roles in GAL1 induction and expression