Real-time alerting system for COVID-19 and other stress events using wearable data.

Early detection of infectious diseases is crucial for reducing transmission and facilitating early intervention. In this study, we built a real-time smartwatch-based alerting system that detects aberrant physiological and activity signals (heart rates and steps) associated with the onset of early infection and implemented this system in a prospective study. In a cohort of 3,318 participants, of whom 84 were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this system generated alerts for pre-symptomatic and asymptomatic SARS-CoV-2 infection in 67 (80%) of the infected individuals. Pre-symptomatic signals were observed at a median of 3 days before symptom onset. Examination of detailed survey responses provided by the participants revealed that other respiratory infections as well as events not associated with infection, such as stress, alcohol consumption and travel, could also trigger alerts, albeit at a much lower mean frequency (1.15 alert days per person compared to 3.42 alert days per person for coronavirus disease 2019 cases). Thus, analysis of smartwatch signals by an online detection algorithm provides advance warning of SARS-CoV-2 infection in a high percentage of cases. This study shows that a real-time alerting system can be used for early detection of infection and other stressors and employed on an open-source platform that is scalable to millions of users.

Real-time Alerting System for COVID-19 Using Wearable Data.

Early detection of infectious disease is crucial for reducing transmission and facilitating early intervention. We built a real-time smartwatch-based alerting system for the detection of aberrant physiological and activity signals (e.g. resting heart rate, steps) associated with early infection onset at the individual level. Upon applying this system to a cohort of 3,246 participants, we found that alerts were generated for pre-symptomatic and asymptomatic COVID-19 infections in 78% of cases, and pre-symptomatic signals were observed a median of three days prior to symptom onset. Furthermore, by examining over 100,000 survey annotations, we found that other respiratory infections as well as events not associated with COVID-19 (e.g. stress, alcohol consumption, travel) could trigger alerts, albeit at a lower mean period (1.9 days) than those observed in the COVID-19 cases (4.3 days). Thus this system has potential both for advanced warning of COVID-19 as well as a general system for measuring health via detection of physiological shifts from personal baselines. The system is open-source and scalable to millions of users, offering a personal health monitoring system that can operate in real time on a global scale.

A scalable, secure, and interoperable platform for deep data-driven health management.

The large amount of biomedical data derived from wearable sensors, electronic health records, and molecular profiling (e.g., genomics data) is rapidly transforming our healthcare systems. The increasing scale and scope of biomedical data not only is generating enormous opportunities for improving health outcomes but also raises new challenges ranging from data acquisition and storage to data analysis and utilization. To meet these challenges, we developed the Personal Health Dashboard (PHD), which utilizes state-of-the-art security and scalability technologies to provide an end-to-end solution for big biomedical data analytics. The PHD platform is an open-source software framework that can be easily configured and deployed to any big data health project to store, organize, and process complex biomedical data sets, support real-time data analysis at both the individual level and the cohort level, and ensure participant privacy at every step. In addition to presenting the system, we illustrate the use of the PHD framework for large-scale applications in emerging multi-omics disease studies, such as collecting and visualization of diverse data types (wearable, clinical, omics) at a personal level, investigation of insulin resistance, and an infrastructure for the detection of presymptomatic COVID-19.

Prediction of Stress Map in Ascending Aorta - Optimization of the Coaxial Position in Transcatheter Aortic Valve Replacement. / Predição do Mapa de Estresse em Aorta Ascendente: Otimização da Posição Coaxial no Implante Valvar Aórtico Percutâneo.

BACKGROUD: Transcatheter aortic valve replacement (TAVR) can reduce mortality among patients with aortic stenosis. Knowledge of pressure distribution and shear stress at the aortic wall may help identify critical regions, where aortic remodeling process may occur. Here a numerical simulation study of the influence of positioning of the prosthetic valve orifice on the flow field is presented. OBJECTIVE: The present analysis provides a perspective of great variance on flow behavior due only to angle changes. METHODS: A 3D model was generated from computed tomography angiography of a patient who had undergone a TAVR. Different mass flow rates were imposed at the inlet valve. RESULTS: Small variations of the tilt angle could modify the nature of the flow, displacing the position of the vortices, and altering the prerssure distribution and the location of high wall shear stress. CONCLUSION: These hemodynamic features may be relevant in the aortic remodeling process and distribution of the stress mapping and could help, in the near future, the optimization of the percutaneous prosthesis implantation. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

FUNDAMENTO: O implante valvar aórtico percutâneo (TAVR, do inglês Transcatheter Aortic Valve Replacement) reduz a mortalidade de pacientes portadores de estenose aórtica grave. O conhecimento da distribuição da pressão e tensão de cisalhamento na parede aórtica pode ajudar na identificação de regiões críticas, onde o processo de remodelamento aórtico pode ocorrer. Neste trabalho é apresentado um estudo de simulação computacional da influência do posicionamento do orifício valvar protético na hemodinâmica na raiz de aorta e segmento ascendente. OBJETIVOS: A presente análise apresenta um estudo da variação do padrão de fluxo devido a alterações no ângulo do orifício valvar. MÉTODOS: Um modelo tridimensional foi gerado a partir do exame de angiotomografia computadorizada da aorta de um paciente que foi submetido ao procedimento de TAVR. Diferentes vazões de fluxo foram impostas através do orifício valvar. RESULTADOS: Pequenas variações no ângulo de inclinação causaram mudanças no padrão de fluxo, com deslocamento na posição dos vórtices, na distribuição de pressão e no local de alta tensão cisalhante na parede aórtica. CONCLUSÃO: Essas características hemodinâmicas podem ser importantes no processo de remodelamento aórtico e distribuição de tensão, além de auxiliar, em um futuro próximo, a otimização do posicionamento da prótese valvar percutânea. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).

Control of Multiferroic properties in BiFeO3 nanoparticles.

BiFeO3 (BFO) nanoparticles (NPs) were synthesized using the sol-gel method at different calcination temperatures from 400 °C to 600 °C. XRD studies have confirmed that all BFO NPs show distorted rhombohedral crystals that match the R3c space group. We found evidence of local structural strain that develops with increasing particle size as suggested by TEM and Raman spectroscopy measurements. Magnetic measurements suggest that NPs have two distinct regimes: a ferromagnetic-like one at low temperatures and a superparamagnetic-like one at room temperature. The crossover temperature increases with NPs size, suggesting a size-dependent blocking magnetic regime. Similarly, local piezoelectric measurements at room temperature in single NP have confirmed a ferroelectric order with a NP size-dependent d33 coefficient. An analysis of both the ferroelectric and the magnetic results suggest that ferromagnetism and ferroelectricity coexist at room temperature in NPs. Our results lead to the possibility of tailoring the ferroic order in multifunctional materials by means of NP size.

Visión del profesorado de educación física hacia su asignatura en Chile / Physical education teacher's vision towards its subject in Chile

RESUMENEN: El propósito de este estudio es determinar cómo los profesores de Educación Física perciben su asignatura, en cuánto a los factores que afectan la calidad de la clase, las condiciones del establecimiento educacional, y el apoyo que se recibe de la autoridad educativa, según sexo y establecimiento educacional en donde los docentes se desempeñan. Se encuestó a 93 profesores de Educación Física, de 6 Regiones de Chile, pertenecientes a establecimientos Municipales, Particulares Subvencionados y Particulares Privados. Los resultados más significativos revelan que el profesorado de Educación Física considera que el factor predominante sobre la calidad de la clase tiene relación con la falta de motivación por parte de los estudiantes, y el que menos afecta es el poco conocimiento de algunas áreas por parte de los docentes. Profesores y Profesoras consideran que sus establecimientos cuentan con las condiciones para desarrollar una buena clase y también tienen el apoyo de las autoridades educativas. Como conclusión, se logró identificar que no existen grandes diferencias en cuanto a la visión del profesor de Educación Física en Chile según sexo, sin embargo, se detectaron mayores diferencias según tipo de establecimiento donde los docentes se desempeñan.

ABSTRACT: The purpose of this study is to determine how Physical Education teahers perceive their subject, in terms of the factors that affects the quality of the class, the conditions of educational establishment, and the support received from the educational authority, according to the sex and the educational establishment where teachers work. 93 Physical Education teachers from 6 different regions of Chile, belonging to Municipal establishments, particular subsidized and private individuals, were surveyed. The most significant results reveal that physical education teachers believe that the factor that most affects the quality of the class, is related to the lack of motivation from the students, and the factor which least affects is the little knowledge about some areas on the part of teachers. Teachers consider that their establishments have the conditions to develop a good lesson and also have the support from educational authorities. As conclusion, it was possible to identify that does not exist great differences in terms of the vision of Physical education teacher in Chile according to the sex, however, huge differences were detected according to the type of establishments where the teachers work

Predição do Mapa de Estresse em Aorta Ascendente: Otimização da Posição Coaxial no Implante Valvar Aórtico Percutâneo / Prediction of Stress Map in Ascending Aorta - Optimization of the Coaxial Position in Transcatheter Aortic Valve Replacement

Resumo Fundamento O implante valvar aórtico percutâneo (TAVR, do inglês Transcatheter Aortic Valve Replacement) reduz a mortalidade de pacientes portadores de estenose aórtica grave. O conhecimento da distribuição da pressão e tensão de cisalhamento na parede aórtica pode ajudar na identificação de regiões críticas, onde o processo de remodelamento aórtico pode ocorrer. Neste trabalho é apresentado um estudo de simulação computacional da influência do posicionamento do orifício valvar protético na hemodinâmica na raiz de aorta e segmento ascendente. Objetivos A presente análise apresenta um estudo da variação do padrão de fluxo devido a alterações no ângulo do orifício valvar. Métodos Um modelo tridimensional foi gerado a partir do exame de angiotomografia computadorizada da aorta de um paciente que foi submetido ao procedimento de TAVR. Diferentes vazões de fluxo foram impostas através do orifício valvar. Resultados Pequenas variações no ângulo de inclinação causaram mudanças no padrão de fluxo, com deslocamento na posição dos vórtices, na distribuição de pressão e no local de alta tensão cisalhante na parede aórtica. Conclusão Essas características hemodinâmicas podem ser importantes no processo de remodelamento aórtico e distribuição de tensão, além de auxiliar, em um futuro próximo, a otimização do posicionamento da prótese valvar percutânea. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Backgroud Transcatheter aortic valve replacement (TAVR) can reduce mortality among patients with aortic stenosis. Knowledge of pressure distribution and shear stress at the aortic wall may help identify critical regions, where aortic remodeling process may occur. Here a numerical simulation study of the influence of positioning of the prosthetic valve orifice on the flow field is presented. Objective The present analysis provides a perspective of great variance on flow behavior due only to angle changes. Methods A 3D model was generated from computed tomography angiography of a patient who had undergone a TAVR. Different mass flow rates were imposed at the inlet valve. Results Small variations of the tilt angle could modify the nature of the flow, displacing the position of the vortices, and altering the prerssure distribution and the location of high wall shear stress. Conclusion These hemodynamic features may be relevant in the aortic remodeling process and distribution of the stress mapping and could help, in the near future, the optimization of the percutaneous prosthesis implantation. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Diseño de un modelo predictivo de pesquisa cardiovascular utilizando árboles de decisión: propensión de pacientes a presentar diabetes tipo 2, hipertensión arterial o dislipidemia: estudio piloto, comuna de Quellón, Chiloé / Design of a predictive model of cardiovascular screening using decision trees: propensity of patients to present type 2 diabetes, arterial hypertension or dyslipidemia: pilot study commune of Quellón, Chiloé

Introducción : En la actualidad, la Minería de Datos es cada vez más popular en el campo de la salud porque existe una necesidad de eficiencia metodológica y analítica para detectar información desconocida y valiosa en datos de salud. Objetivo : Desarrollar un modelo predictivo utilizando técnicas de minería de datos, específicamente Arboles de Decisión, para pesquisar pacientes con propensión a desarrollar Diabetes Tipo II (DM II), Hipertensión Arterial (HTA) o Dislipidemia (DLP). Método : Se analizó el problema de los Factores de Riesgo Cardiovascular Mayores desde una perspectiva de procesos y se estudiaron las técnicas que permiten descubrir el conocimiento del fenómeno almacenado en las bases de datos de Examen de Medicina Preventiva del Adulto (EMPA) de la Población en Control Cardiovascular que presenta DM II, HTA o DLP Resultados : El Algoritmo C5, presenta un mayor poder predictivo, respecto de otros algoritmos de Árbol de Decisión. Se comprobó que las variables Edad y Circunferencia de Cintura fueron las de mayor poder de discriminación en el padecimiento de DM2, HTA o DLP. El algoritmo C5 alcanzó una precisión global de un 83,01% en la partición de prueba, luego en la misma partición el modelo logra discriminar un paciente con algunas de las patologías en el 85,25% de los casos, y uno que no presenta alguna de las patologías en un 80,27% de las oportunidades. Conclusión : La Minería de Datos y en este caso, específicamente los Modelos de Árboles de Decisión son una alternativa válida para la pesquisa cardiovascular temprana.

Introduction : Data Mining is increasingly popular in the health field because there is a need for an efficient analytical methodology to detect unknown and valuable information of health data. Objective : To develop a predictive model using data mining techniques, specifically Decision Trees, to investigate patients with a propensity to develop Type II Diabetes, Arterial Hypertension or Dyslipidemia. The data of adult patients presenting Type II diabetes, Hypertension or Dyslipidemia being followed in a preventive cardiovascular control program were analyzed with the aim of unveiling phenomena that could help develop the prediction of these risk factors. Results : With respect to other decision tree algorithms, Algorithm C 5, showed a greater predictive power. The variables age and waist circumference had the greatest power of discrimination for DM2, HTA or DLP. The C 5 algorithm reached a global precision of 83.01% in the test partition. Then, in the same partition the model managed to discriminate a patient with some of the risk factors in 85.25% of cases, and to rule out any of them in 80.27% of cases. Conclusion : Data Mining, specifically decisión tree models, is a valid alternative for early detection of cardiovascular of risk factors.

Impacto de la vacunación contra el rotavirus sobre la morbilidad y mortalidad en diarreas / Impact of the vaccination against rotavirus on morbidity and mortality in diarrhea

Introducción. Venezuela incluyó la vacuna contra rotavirus a partir del año 2006. El Estado Táchira ha alcanzado una cobertura promedio de 60%. El objetivo es evaluar el impacto de la vacunación contra rotavirus sobre las diarreas en menores de 5 años, en el Estado Táchira, Venezuela, durante los años 2000 a 2012. Métodos. Estudio epidemiológico de evaluación del impacto de la vacuna antirotavirus sobre las tasas de morbimortalidad por diarreas. Resultados. Se observó una tendencia a la disminución de la morbilidad y la mortalidad en el período 2000 a 2012, especialmente en menores de 1 año. La diferencia entre las tasas de muerte promedio entre el periodo prevacunal (2000-2005) y postvacunal (2006-2012) para los menores de 1 año fue estadísticamente significativa (p=0,01; IC 95%: 4322,2- 12537,1). Durante el periodo prevacunal (20002005), la tasa promedio de casos por 100.000 en menores de 5 años era de 12.207,7 y en el postvacunal (2006-2012) era de 10.126,3. La diferencia en las muertes en menores de 5 años fue de 72% (IC 95%=62-81). Conclusiones. La vacunación contra rotavirus tiene un impacto favorable en la disminución de las tasas de diarrea en menores de 5 años, especialmente en menores de 1 año. Es una estrategia efectiva en la prevención de muertes por esta causa en poblaciones menores de 5 años.

Introduction. Venezuela included rotavirus vaccine from the year 2006. Tachira State has reached 60% average coverage. The objective was to assess the impact of vaccination against rotavirus diarrhea in children under 5 years, Táchira State, Venezuela, during the years 2000-2012. Methods. Evaluation of the impact of the vaccine anti-rotavirus epidemiological study on the rates of mortality and morbidity by diarrhea. Results. There was a trend to decrease morbidity and mortality in the period 2000 to 2012, especially under the age of 1 year. The difference between average death rates between the prevaccination period (2000-2005) and postvaccination period (2006-2012) was statistically significant for children under 1 year (p=0.01;CI 95%: 4322.2-12537.1). During the prevacunal period (2000-2005), the average rate of cases per 100,000 in children under 5 years was 12,207.7 and postvacunal period (2006-2012) was 10,126.3. The difference in deaths in children under 5 years was 72 (CI 95% 62-81). Conclusions. The vaccination against rotavirus has a favorable impact on reducing rates of diarrhea in children under 5 years, particularly in the group of children under 1 years. It is an effective strategy in the prevention of deaths from this cause in under-five population.