Homecare interventions as a Service model for Obstructive sleep Apnea: Delivering personalised phone call using patient profiling and adherence predictions.

BACKGROUND AND OBJECTIVE: Obstructive Sleep Apnea (OSA) is a sleep disorder that leads to different pathologies like depression and cardiovascular problems. The first-line medical treatment for OSA is Continuous Positive Airway Pressure (CPAP) therapy. However, this therapy has the lowest adherence level when compared to other homecare therapies. Consequently, the main objective of this paper is to increase this adherence level with methods that can be replicated in a large number of patients. METHODS: The Homecare Intervention as a Service model can build, verify, and deliver per-sonalised home care interventions. With the Homecare Intervention as a Service model, we build and provide on-demand personalised interventions according to the patient's needs. The 2 core components of this model are patient clustering and CPAP adherence predictions. To define the patient profiles and predict the adherence level, we apply the K-means and the Logistic Regression algorithm respectively. To support these algorithms, we use the CPAP monitoring data and qualitative data on the patients. RESULTS: We demonstrate that there are 3 patient profiles (non-adherent, attempter, and adherent). We draw a comparison with multiple machine learning algorithms to predict CPAP adherence at 30, 60 and 90 days. In this case, the Logistic Regression gives the best results with a f1-score of 0.84 for30 days, 0.79 for 60 days and 0.76 for 90 days. These newly build profiles were to be used to deliver personalised phone call interventions. The phone call intervention shows an increase in adherence by 1.02 h/night for non-adherent patients and 0.69 h/night for attempter patients. CONCLUSIONS: This is the first study in CPAP therapy that formalises the process of transforming raw data into effective home care interventions that can be delivered directly to the patients. In fact,it is the first time that both patient characterisation and predictions based on data are used to provide personalised patient management for CPAP therapy. Our model is flexible to be extended to new types of interventions and other homecare therapies.

The COSPAR Planetary Protection Policy for robotic missions to Mars: A review of current scientific knowledge and future perspectives.

Planetary protection guidance for martian exploration has become a notable point of discussion over the last decade. This is due to increased scientific interest in the habitability of the red planet with updated techniques, missions becoming more attainable by smaller space agencies, and both the private sector and governments engaging in activities to facilitate commercial opportunities and human-crewed missions. The international standards for planetary protection have been developed through consultation with the scientific community and the space agencies by the Committee on Space Research's (COSPAR) Panel on Planetary Protection, which provides guidance for compliance with the Outer Space Treaty of 1967. In 2021, the Panel evaluated recent scientific data and literature regarding the planetary protection requirements for Mars and the implications of this on the guidelines. In this paper, we discuss the COSPAR Planetary Protection Policy for Mars, review the new scientific findings and discuss the next steps required to enable the next generation of robotic missions to Mars.

The COSPAR planetary protection requirements for space missions to Venus.

The Committee on Space Research's (COSPAR) Planetary Protection Policy states that all types of missions to Venus are classified as Category II, as the planet has significant research interest relative to the processes of chemical evolution and the origin of life, but there is only a remote chance that terrestrial contamination can proliferate and compromise future investigations. "Remote chance" essentially implies the absence of environments where terrestrial organisms could survive and replicate. Hence, Category II missions only require simplified planetary protection documentation, including a planetary protection plan that outlines the intended or potential impact targets, brief Pre- and Post-launch analyses detailing impact strategies, and a Post-encounter and End-of-Mission Report. These requirements were applied in previous missions and are foreseen for the numerous new international missions planned for the exploration of Venus, which include NASA's VERITAS and DAVINCI missions, and ESA's EnVision mission. There are also several proposed missions including India's Shukrayaan-1, and Russia's Venera-D. These multiple plans for spacecraft coincide with a recent interest within the scientific community regarding the cloud layers of Venus, which have been suggested by some to be habitable environments. The proposed, privately funded, MIT/Rocket Lab Venus Life Finder mission is specifically designed to assess the habitability of the Venusian clouds and to search for signs of life. It includes up to three atmospheric probes, the first one targeting a launch in 2023. The COSPAR Panel on Planetary Protection evaluated scientific data that underpins the planetary protection requirements for Venus and the implications of this on the current policy. The Panel has done a thorough review of the current knowledge of the planet's conditions prevailing in the clouds. Based on the existing literature, we conclude that the environmental conditions within the Venusian clouds are orders of magnitude drier and more acidic than the tolerated survival limits of any known terrestrial extremophile organism. Because of this future orbital, landed or entry probe missions to Venus do not require extra planetary protection measures. This recommendation may be revised in the future if new observations or reanalysis of past data show any significant increment, of orders of magnitude, in the water content and the pH of the cloud layer.

Obstructive Sleep Apnea compliance: verifications and validations of personalized interventions for PAP therapy.

The Positive Airway Pressure (PAP) therapy is the most capable therapy against Obstruction Sleep Apnea (OSA). PAP therapy prevents the narrowing and collapsing of the soft tissues of the upper airway. A patient diagnosed with OSA is expected to use their CPAP machines every night for at least more than 4h for experiencing any clinical improvement. However, for the last two decades, trials were carried out to improve compliance and understand factors impacting compliance, but there were not enough conclusive results. With the advent of big data analytic and real-time monitoring, new opportunities open up to tackle this compliance issue. This paper's significant contribution is a novel framework that blends multiple external verification and validation carried out by different healthcare stakeholders. We provide a systematic verification and validation process to push towards explainable data analytic and automatic learning processes. We also present a complete mHealth solution that includes two mobile applications. The first application is for delivering tailored interventions directly to the patients. The second application is bound to different healthcare stakeholders for the verification and validation process.

Thermodynamic data and modeling of the water and ammonia-water phase diagrams up to 2.2 GPa for planetary geophysics.

We present new experimental data on the liquidus of ice polymorphs in the H(2)O-NH(3) system under pressure, and use all available data to develop a new thermodynamic model predicting the phase behavior in this system in the ranges (0-2.2 GPa; 175-360 K; 0-33 wt % NH(3)). Liquidus data have been obtained with a cryogenic optical sapphire-anvil cell coupled to a Raman spectrometer. We improve upon pre-existing thermodynamic formulations for the specific volumes and heat capacities of the solid and liquid phase in the pure H(2)O phase diagram to ensure applicability of the model in the low-temperature metastable domain down to 175 K. We compute the phase equilibria in the pure H(2)O system with this new model. Then we develop a pressure-temperature dependent activity model to describe the effect of ammonia on phase transitions. We show that aqueous ammonia solutions behave as regular solutions at low pressures, and as close-to-ideal solutions at pressure above 600 MPa. The computation of phase equilibria in the H(2)O-NH(3) system shows that ice III cannot exist at concentrations above 5-10 wt % NH(3) (depending on pressure), and ice V is not expected to form above 25%-27% NH(3). We eventually address the applications of this new model for thermal and evolution models of icy satellites.

Formation, habitability, and detection of extrasolar moons.

The diversity and quantity of moons in the Solar System suggest a manifold population of natural satellites exist around extrasolar planets. Of peculiar interest from an astrobiological perspective, the number of sizable moons in the stellar habitable zones may outnumber planets in these circumstellar regions. With technological and theoretical methods now allowing for the detection of sub-Earth-sized extrasolar planets, the first detection of an extrasolar moon appears feasible. In this review, we summarize formation channels of massive exomoons that are potentially detectable with current or near-future instruments. We discuss the orbital effects that govern exomoon evolution, we present a framework to characterize an exomoon's stellar plus planetary illumination as well as its tidal heating, and we address the techniques that have been proposed to search for exomoons. Most notably, we show that natural satellites in the range of 0.1-0.5 Earth mass (i) are potentially habitable, (ii) can form within the circumplanetary debris and gas disk or via capture from a binary, and (iii) are detectable with current technology.

Thermodynamic model for water and high-pressure ices up to 2.2 GPa and down to the metastable domain.

We propose a thermodynamic model of the properties of liquid water and ices I, III, V, and VI that can be used in the ranges of 0-2200 MPa and 180-360 K. This model is the first to be applicable to all H(2)O phases in these wide ranges, which exceed the stability domain of all phases. Developing empirical or semiempirical expressions for the specific volumes of liquid water or ices has been necessary. The model has been tested on available experimental data sets. The specific volume of liquid water is reproduced with an accuracy better than 1%. The error on the specific volume of ices remains within 2%. The model has also been used to describe the melting curves of high-pressure ice polymorphs and compared with new Simon equations fitting available data. Our calculations suggest a slight revision of the triple point positions in the H(2)O phase diagram. We have ensured the reliability of our model up to 1.5 GPa, and we have shown that it can be used with good confidence up to 2.2 GPa. In order to show the validity of this model in the low-temperature domains, the melting curve of ice Ih in the water-ammonia system has been modeled. This curve is reproduced with good accuracy down to 180 K, at a 1 bar pressure. It shows that this model can be used in further studies for modeling equilibriums involving liquid or solid phases of H(2)O under pressure and for investigating the effect of inhibitors in complex water-rich systems.