Performance Feedback A Common Thread in the Process to Provide Optimal Heart Failure Care⁎⁎Editorials published in the Journal of the American College of Cardiology reflect the views of the authors and do not necessarily represent the views of JACC or the American College of Cardiology.

Current software community players like academy and industry have been changing the traditional paradigms of software engineering towards context-awareness and distributed computing. Nowadays, service-oriented computing and context-aware computing are two emerging paradigms that are changing the way of designing, developing, providing and consuming software services. Whilst service-oriented computing is based on service-oriented architectures and it is focused on modelling functionality and providing flexible software services, context-aware computing is based on the context life cycle and it allows processing and changing the behaviour of such services given certain context information. The synergy between both paradigms is a core research topic in ubiquitous and pervasive computing widely applied to the Internet of Things and Smart Cities.In the present PhD thesis, we exploit this synergy by focusing on context-aware computing from the perspective of service-oriented computing, which is also known as context-aware service-oriented computing. Such research topic involves the management of context within different essential phases of the context life cycle that show how the context data moves from phase to phase in software services within the paradigm of the service-oriented computing. Hence, the work done in this thesis involves different components and processes that have the aim to accomplish the context life cycle, namely the acquisition, modelling, reasoning and dissemination of the context in service-oriented computing. Particularly, we make an effort to provide both a context ontology for context modelling, context reasoning and high-level context dissemination, and a context-aware monitoring architecture for context acquisition and low-level context dissemination.Such work of the thesis has been motivated for contributing in the solution of different issues mainly identified in the phases of context modelling and context acquisition that are a strong basis of the context life cycle. Firstly, in the context modelling we mainly identified the proliferation of several context models presenting some problems about: reusability, extensibility and adaptation. Secondly, in the context acquisition we mainly identified that existing monitoring infrastructures are not prepared to support the constant changes in their context and the context of other entities, including the services that they are supervising which provoke the provisioning of context data that is not reliable. In summary, this thesis explores three big research questions: 1) What context data to acquire and to model? This involves the study of the current state of the art of context models, specifically: which are these proposals and how are they related, what are their structural characteristics, what context information is the most addressed, and what are their most consolidated definitions. 2) How to model context data? This involves the development of a three-level context ontology with the aim of improving the reusability, extensibility and adaptation capabilities of existing context models. 3) How to acquire context data? This involves the development of a context-aware monitoring architecture that can be easily configured, adapted or evolved according to the constant changes of the context.The context model and the architecture proposed in this PhD thesis are validated through different scenarios and use cases, highlighting their integration in SUPERSEDE (www.supersede.eu), a European project in the H2020 program for fulfilling some requirements of data acquisition and management demonstrating that the context life cycle is supported.Els actors actuals de la comunitat de software, com l'acadèmia o la indústria, han anat canviant els paradigmes tradicionals de l'enginyeria de software cap a la sensibilitat al context i la computació distribuïda. Avui dia, la computació orientada a serveis i la computació conscient del context són dos paradigmes emergents que estan canviant la forma de dissenyar, desenvolupar, proporcionar i consumir serveis de software. Mentre que la computació orientada a serveis es basa en arquitectures orientades a serveis i se centra en el modelatge de la funcionalitat i la prestació de serveis de software flexibles, la computació sensible al context es basa en el cicle de vida del context i permet el processament i canviar el comportament d'aquest tipus de serveis donada una determinada informació del context. La sinergia entre els dos paradigmes és un tema central de recerca a la computació ubiqua i omnipresent, àmpliament aplicada a la Internet de les coses i les ciutats intel·ligents. En la present tesi doctoral explotem aquesta sinèrgia, centrant-se en la computació sensible al context des de la perspectiva de la computació orientada a serveis, que també es coneix com computació orientada a serveis sensibles al context. Tal tema de recerca implica la gestió de contexts en diferents fases essencials del cicle de vida del context que mostren com les dades de context es mouen d'una fase a l’altra en serveis de software dins del paradigma de la computació orientada a serveis. Per tant, el treball realitzat en aquesta tesi consisteix en diferents components i processos que tenen l'objectiu d'aconseguir el cicle de vida del context, és a dir, l'adquisició, el modelatge, el raonament i la difusió del context en computació orientada a serveis. En particular, fem un esforç per proporcionar tant una ontologia de context per a la modelització, raonament i difusió del context d'alt nivell, i una arquitectura de monitorització sensible al context per a l'adquisició i difusió del context de baix nivell. Aquest treball de tesi ha estat motivat per contribuir a la solució dels diferents problemes identificats principalment en les fases de modelatge de context i adquisició de context que són una base sòlida del cicle de vida del context. En primer lloc, en el modelatge de context es van identificar principalment la proliferació de diversos models de context que presenten alguns problemes sobre: reutilització, l'extensibilitat i l'adaptació. En segon lloc, en l'adquisició del context identifiquem principalment que les infraestructures de monitorització existents no estan preparats per suportar els canvis constants en el seu context i el context d'altres entitats, incloent-hi els serveis que s'estan supervisant, que provoquen un aprovisionament de dades de context que no és fiable. En resum, aquesta tesi explora tres grans preguntes de recerca: 1) Quines dades de context cal adquirir i modelar? Això implica l'estudi de l'estat actual de la tècnica dels models de context, en concret: ¿quines són aquestes propostes i com es relacionen, quines són les seves característiques estructurals, quina informació de context és la més adreçada, i quines són les seves definicions més consolidades. 2) Com modelar les dades de context? Això implica el desenvolupament d'una ontologia de context de tres nivells amb l'objectiu de millorar les capacitats de reutilització, extensibilitat i adaptació dels models de context existents. 3) Com adquirir dades de context? Això implica el desenvolupament d'una arquitectura de monitorització sensible al context que pot ser fàcilment configurat o adaptat d'acord amb els canvis del context. El model de context i l'arquitectura proposada en aquesta tesi doctoral es validen a través de diferents escenaris i casos d'ús, destacant la seva integració en SUPERSEDE, un projecte europeu en el programa H2020 per al compliment d'alguns requisits d'adquisició i gestió de dades que demostra que es dóna suport al cicle de vida del context

Detection of Aβ plaque-associated astrogliosis in Alzheimer’s disease brain by spectroscopic imaging and immunohistochemistry

Recent work using micro-Fourier transform infrared (μFTIR) imaging has revealed that a lipid-rich layer surrounds many plaques in post-mortem Alzheimer’s brain. However, the origin of this lipid layer is not known, nor is its role in the pathogenesis of Alzheimer’s disease (AD). Here, we studied the biochemistry of plaques in situ using a model of AD. We combined FTIR, Raman and immunofluorescence images, showing that astrocyte processes co-localise with the lipid-ring surrounding many plaques. We used μFTIR imaging to rapidly measure chemical signatures of plaques over large fields of view, and selected plaques for higher resolution analysis with Raman. Raman maps showed similar lipid-rings and dense protein cores as in FTIR images, but also revealed cell bodies. We confirmed the presence of plaques using amylo-glo staining, and measured astrocytes using immunohistochemistry, revealing astrocyte colocalisation with lipid-rings. This work is important because it correlates biochemically changes surrounding the plaque with the biological process of astrogliosis

The Alberta Heart Failure Etiology and Analysis Research Team (HEART) study

Background Nationally, symptomatic heart failure affects 1.5-2% of Canadians, incurs $3 billion in hospital costs annually and the global burden is expected to double in the next 1–2 decades. The current one-year mortality rate after diagnosis of heart failure remains high at >25%. Consequently, new therapeutic strategies need to be developed for this debilitating condition. Methods/Design The objective of the Alberta HEART program (http://albertaheartresearch.ca) is to develop novel diagnostic, therapeutic and prognostic approaches to patients with heart failure with preserved ejection fraction. We hypothesize that novel imaging techniques and biomarkers will aid in describing heart failure with preserved ejection fraction. Furthermore, the development of new diagnostic criteria will allow us to: 1) better define risk factors associated with heart failure with preserved ejection fraction; 2) elucidate clinical, cellular and molecular mechanisms involved with the development and progression of heart failure with preserved ejection fraction; 3) design and test new therapeutic strategies for patients with heart failure with preserved ejection fraction. Additionally, Alberta HEART provides training and education for enhancing translational medicine, knowledge translation and clinical practice in heart failure. This is a prospective observational cohort study of patients with, or at risk for, heart failure. Patients will have sequential testing including quality of life and clinical outcomes over 12 months. After that time, study participants will be passively followed via linkage to external administrative databases. Clinical outcomes of interest include death, hospitalization, emergency department visits, physician resource use and/or heart transplant. Patients will be followed for a total of 5 years. Discussion Alberta HEART has the primary objective to define new diagnostic criteria for patients with heart failure with preserved ejection fraction. New criteria will allow for targeted therapies, diagnostic tests and further understanding of the patients, both at-risk for and with heart failure

The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs

Since 2006, the Canadian Cardiovascular Society heart failure (HF) guidelines have published annual focused updates for cardiovascular care providers. The 2010 Canadian Cardiovascular Society HF guidelines update focuses on an increasing issue in the western world - HF in ethnic minorities - and in an uncommon but important setting - the pregnant patient. Additionally, due to increasing attention recently given to the assessment of how care is delivered and measured, two critically important topics - disease management programs in HF and quality assurance - have been included. Both of these topics were written from a clinical perspective. It is hoped that the present update will become a useful tool for health care providers and planners in the ongoing evolution of care for HF patients in Canada. © 2010 Pulsus Group Inc. All rights reserved

FONZIE: An optimized pipeline for minisatellite marker discovery and primer design from large sequence data sets

<p>Abstract</p> <p>Background</p> <p>Micro-and minisatellites are among the most powerful genetic markers known to date. They have been used as tools for a large number of applications ranging from gene mapping to phylogenetic studies and isolate typing. However, identifying micro-and minisatellite markers on large sequence data sets is often a laborious process.</p> <p>Results</p> <p>FONZIE was designed to successively 1) perform a search for markers via the external software Tandem Repeat Finder, 2) exclude user-defined specific genomic regions, 3) screen for the size and the percent matches of each relevant marker found by Tandem Repeat Finder, 4) evaluate marker specificity (i.e., occurrence of the marker as a single copy in the genome) using BLAST2.0, 5) design minisatellite primer pairs via the external software Primer3, and 6) check the specificity of each final PCR product by BLAST. A final file returns to users all the results required to amplify markers. A biological validation of the approach was performed using the whole genome sequence of the phytopathogenic fungus <it>Leptosphaeria maculans</it>, showing that more than 90% of the minisatellite primer pairs generated by the pipeline amplified a PCR product, 44.8% of which showed agarose-gel resolvable polymorphism between isolates. Segregation analyses confirmed that the polymorphic minisatellites corresponded to single-locus markers.</p> <p>Conclusion</p> <p>FONZIE is a stand-alone and user-friendly application developed to minimize tedious manual operations, reduce errors, and speed up the search for efficient minisatellite and microsatellite markers departing from whole-genome sequence data. This pipeline facilitates the integration of data and provides a set of specific primer sequences for PCR amplification of single-locus markers. FONZIE is freely downloadable at: <url>http://www.versailles-grignon.inra.fr/bioger/equipes/leptosphaeria_maculans/outils_d_analyses/fonzie</url></p

Towards nationally curated data archives for clinical radiology image analysis at scale: Learnings from national data collection in response to a pandemic

The prevalence of the coronavirus SARS-CoV-2 disease has resulted in the unprecedented collection of health data to support research. Historically, coordinating the collation of such datasets on a national scale has been challenging to execute for several reasons, including issues with data privacy, the lack of data reporting standards, interoperable technologies, and distribution methods. The coronavirus SARS-CoV-2 disease pandemic has highlighted the importance of collaboration between government bodies, healthcare institutions, academic researchers and commercial companies in overcoming these issues during times of urgency. The National COVID-19 Chest Imaging Database, led by NHSX, British Society of Thoracic Imaging, Royal Surrey NHS Foundation Trust and Faculty, is an example of such a national initiative. Here, we summarise the experiences and challenges of setting up the National COVID-19 Chest Imaging Database, and the implications for future ambitions of national data curation in medical imaging to advance the safe adoption of artificial intelligence in healthcare

Effects of dapagliflozin in DAPA-HF according to background heart failure therapy

Aims In the DAPA-HF trial, the SGLT2 inhibitor dapagliflozin reduced the risk of worsening heart failure (HF) and death in patients with HF and reduced ejection fraction. We examined whether this benefit was consistent in relation to background HF therapy. Methods and results In this post hoc analysis, we examined the effect of study treatment in the following yes/no subgroups: diuretic, digoxin, mineralocorticoid receptor antagonist (MRA), sacubitril/valsartan, ivabradine, implanted cardioverter-defibrillating (ICD) device, and cardiac resynchronization therapy. We also examined the effect of study drug according to angiotensin-converting enzyme inhibitor/angiotensin receptor blocker dose, beta-blocker (BB) dose, and MRA (≥50% and &amp;lt;50% of target dose). We analysed the primary composite endpoint of cardiovascular death or a worsening HF event. Most randomized patients (n = 4744) were treated with a diuretic (84%), renin–angiotensin system (RAS) blocker (94%), and BB (96%); 52% of those taking a BB and 38% taking a RAS blocker were treated with ≥50% of the recommended dose. Overall, the dapagliflozin vs. placebo hazard ratio (HR) was 0.74 [95% confidence interval (CI) 0.65–0.85] for the primary composite endpoint (P &amp;lt; 0.0001). The effect of dapagliflozin was consistent across all subgroups examined: the HR ranged from 0.57 to 0.86 for primary endpoint, with no significant randomized treatment-by-subgroup interaction. For example, the HR in patients taking a RAS blocker, BB, and MRA at baseline was 0.72 (95% CI 0.61–0.86) compared with 0.77 (95% CI 0.63–0.94) in those not on all three of these treatments (P-interaction 0.64). Conclusion The benefit of dapagliflozin was consistent regardless of background therapy for HF