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1.
J Med Internet Res ; 23(4): e22042, 2021 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-33900200

RESUMEN

BACKGROUND: Social media networks provide an abundance of diverse information that can be leveraged for data-driven applications across various social and physical sciences. One opportunity to utilize such data exists in the public health domain, where data collection is often constrained by organizational funding and limited user adoption. Furthermore, the efficacy of health interventions is often based on self-reported data, which are not always reliable. Health-promotion strategies for communities facing multiple vulnerabilities, such as men who have sex with men, can benefit from an automated system that not only determines health behavior risk but also suggests appropriate intervention targets. OBJECTIVE: This study aims to determine the value of leveraging social media messages to identify health risk behavior for men who have sex with men. METHODS: The Gay Social Networking Analysis Program was created as a preliminary framework for intelligent web-based health-promotion intervention. The program consisted of a data collection system that automatically gathered social media data, health questionnaires, and clinical results for sexually transmitted diseases and drug tests across 51 participants over 3 months. Machine learning techniques were utilized to assess the relationship between social media messages and participants' offline sexual health and substance use biological outcomes. The F1 score, a weighted average of precision and recall, was used to evaluate each algorithm. Natural language processing techniques were employed to create health behavior risk scores from participant messages. RESULTS: Offline HIV, amphetamine, and methamphetamine use were correctly identified using only social media data, with machine learning models obtaining F1 scores of 82.6%, 85.9%, and 85.3%, respectively. Additionally, constructed risk scores were found to be reasonably comparable to risk scores adapted from the Center for Disease Control. CONCLUSIONS: To our knowledge, our study is the first empirical evaluation of a social media-based public health intervention framework for men who have sex with men. We found that social media data were correlated with offline sexual health and substance use, verified through biological testing. The proof of concept and initial results validate that public health interventions can indeed use social media-based systems to successfully determine offline health risk behaviors. The findings demonstrate the promise of deploying a social media-based just-in-time adaptive intervention to target substance use and HIV risk behavior.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Medios de Comunicación Sociales , Trastornos Relacionados con Sustancias , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Humanos , Aprendizaje Automático , Masculino , Conducta Sexual
2.
J Neuroeng Rehabil ; 14(1): 22, 2017 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-28327161

RESUMEN

BACKGROUND: Activity-based therapy (ABT) for patients with spinal cord injury (SCI), which consists of repetitive use of muscles above and below the spinal lesion, improves locomotion and arm strength. Less data has been published regarding its effects on hand function. We sought to evaluate the effects of a weekly hand-focused therapy program using a novel handgrip device on grip strength and hand function in a SCI cohort. METHODS: Patients with SCI were enrolled in a weekly program that involved activities with the MediSens (Los Angeles, CA) handgrip. These included maximum voluntary contraction (MVC) and a tracking task that required each subject to adjust his/her grip strength according to a pattern displayed on a computer screen. For the latter, performance was measured as mean absolute accuracy (MAA). The Spinal Cord Independence Measure (SCIM) was used to measure each subject's independence prior to and after therapy. RESULTS: Seventeen patients completed the program with average participation duration of 21.3 weeks. The cohort included patients with American Spinal Injury Association (ASIA) Impairment Scale (AIS) A (n = 12), AIS B (n = 1), AIS C (n = 2), and AIS D (n = 2) injuries. The average MVC for the cohort increased from 4.1 N to 21.2 N over 20 weeks, but did not reach statistical significance. The average MAA for the cohort increased from 9.01 to 21.7% at the end of the study (p = .02). The cohort's average SCIM at the end of the study was unchanged compared to baseline. CONCLUSIONS: A weekly handgrip-based ABT program is feasible and efficacious at increasing hand task performance in subjects with SCI.


Asunto(s)
Rehabilitación Neurológica/instrumentación , Dispositivos de Autoayuda , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Femenino , Fuerza de la Mano , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto
3.
J Neuroeng Rehabil ; 14(1): 77, 2017 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-28720144

RESUMEN

BACKGROUND: Approximately 33% of the patients with lumbar spinal stenosis (LSS) who undergo surgery are not satisfied with their postoperative clinical outcomes. Therefore, identifying predictors for postoperative outcome and groups of patients who will benefit from the surgical intervention is of significant clinical benefit. However, many of the studied predictors to date suffer from subjective recall bias, lack fine digital measures, and yield poor correlation to outcomes. METHODS: This study utilized smart-shoes to capture gait parameters extracted preoperatively during a 10 m self-paced walking test, which was hypothesized to provide objective, digital measurements regarding the level of gait impairment caused by LSS symptoms, with the goal of predicting postoperative outcomes in a cohort of LSS patients who received lumbar decompression and/or fusion surgery. The Oswestry Disability Index (ODI) and predominant pain level measured via the Visual Analogue Scale (VAS) were used as the postoperative clinical outcome variables. RESULTS: The gait parameters extracted from the smart-shoes made statistically significant predictions of the postoperative improvement in ODI (RMSE =0.13, r=0.93, and p<3.92×10-7) and predominant pain level (RMSE =0.19, r=0.83, and p<1.28×10-4). Additionally, the gait parameters produced greater prediction accuracy compared to the clinical variables that had been previously investigated. CONCLUSIONS: The reported results herein support the hypothesis that the measurement of gait characteristics by our smart-shoe system can provide accurate predictions of the surgical outcomes, assisting clinicians in identifying which LSS patient population can benefit from the surgical intervention and optimize treatment strategies.


Asunto(s)
Vértebras Lumbares/cirugía , Zapatos , Estenosis Espinal/cirugía , Adulto , Anciano , Fenómenos Biomecánicos , Estudios de Cohortes , Descompresión Quirúrgica , Evaluación de la Discapacidad , Femenino , Marcha , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/epidemiología , Proyectos Piloto , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Resultado del Tratamiento , Caminata
4.
Sensors (Basel) ; 17(8)2017 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-28771168

RESUMEN

To address the need for asthma self-management in pediatrics, the authors present the feasibility of a mobile health (mHealth) platform built on their prior work in an asthmatic adult and child. Real-time asthma attack risk was assessed through physiological and environmental sensors. Data were sent to a cloud via a smartwatch application (app) using Health Insurance Portability and Accountability Act (HIPAA)-compliant cryptography and combined with online source data. A risk level (high, medium or low) was determined using a random forest classifier and then sent to the app to be visualized as animated dragon graphics for easy interpretation by children. The feasibility of the system was first tested on an adult with moderate asthma, then usability was examined on a child with mild asthma over several weeks. It was found during feasibility testing that the system is able to assess asthma risk with 80.10 ± 14.13% accuracy. During usability testing, it was able to continuously collect sensor data, and the child was able to wear, easily understand and enjoy the use of the system. If tested in more individuals, this system may lead to an effective self-management program that can reduce hospitalization in those who suffer from asthma.


Asunto(s)
Asma , Niño , Humanos , Automanejo , Telemedicina , Interfaz Usuario-Computador , Tecnología Inalámbrica
5.
IEEE Sens J ; 16(4): 1054-1061, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36452935

RESUMEN

Poor adherence to prescription medication can compromise treatment effectiveness and cost the billions of dollars in unnecessary health care expenses. Though various interventions have been proposed for estimating adherence rates, few have been shown to be effective. Digital systems are capable of estimating adherence without extensive user involvement and can potentially provide higher accuracy with lower user burden than manual methods. In this paper, we propose a smartwatch-based system for detecting several motions that may be predictors of medication adherence, using built-in triaxial accelerometers and gyroscopes. The efficacy of the proposed technique is confirmed through a survey of medication ingestion habits and experimental results on movement classification.

6.
Pervasive Mob Comput ; 28: 69-80, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27293387

RESUMEN

Time series subsequence matching has importance in a variety of areas in healthcare informatics. These include case-based diagnosis and treatment as well as discovery of trends among patients. However, few medical systems employ subsequence matching due to high computational and memory complexities. This manuscript proposes a randomized Monte Carlo sampling method to broaden search criteria with minimal increases in computational and memory complexities over R-NN indexing. Information gain improves while producing result sets that approximate the theoretical result space, query results increase by several orders of magnitude, and recall is improved with no signi cant degradation to precision over R-NN matching.

7.
J Cardiovasc Nurs ; 30(1): 51-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-24365871

RESUMEN

BACKGROUND: The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited. OBJECTIVE: The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization. METHODS: A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58-83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met. RESULTS: The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL. CONCLUSION: Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF.


Asunto(s)
Insuficiencia Cardíaca/terapia , Calidad de Vida , Autocuidado , Telemetría , Teleenfermería , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
8.
Sensors (Basel) ; 15(10): 26783-800, 2015 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-26506354

RESUMEN

This paper introduces a human posture tracking platform to identify the human postures of sitting, standing or lying down, based on a smartwatch. This work develops such a system as a proof-of-concept study to investigate a smartwatch's ability to be used in future remote health monitoring systems and applications. This work validates the smartwatches' ability to track the posture of users accurately in a laboratory setting while reducing the sampling rate to potentially improve battery life, the first steps in verifying that such a system would work in future clinical settings. The algorithm developed classifies the transitions between three posture states of sitting, standing and lying down, by identifying these transition movements, as well as other movements that might be mistaken for these transitions. The system is trained and developed on a Samsung Galaxy Gear smartwatch, and the algorithm was validated through a leave-one-subject-out cross-validation of 20 subjects. The system can identify the appropriate transitions at only 10 Hz with an F-score of 0.930, indicating its ability to effectively replace smart phones, if needed.


Asunto(s)
Vestuario , Monitoreo Ambulatorio/instrumentación , Postura/fisiología , Teléfono Inteligente , Telemedicina/instrumentación , Adulto , Humanos , Monitoreo Ambulatorio/métodos , Adulto Joven
9.
J Neuroeng Rehabil ; 11: 121, 2014 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-25117936

RESUMEN

BACKGROUND: The current methods of assessing motor function rely primarily on the clinician's judgment of the patient's physical examination and the patient's self-administered surveys. Recently, computerized handgrip tools have been designed as an objective method to quantify upper-extremity motor function. This pilot study explores the use of the MediSens handgrip as a potential clinical tool for objectively assessing the motor function of the hand. METHODS: Eleven patients with cervical spondylotic myelopathy (CSM) were followed for three months. Eighteen age-matched healthy participants were followed for two months. The neuromotor function and the patient-perceived motor function of these patients were assessed with the MediSens device and the Oswestry Disability Index respectively. The MediSens device utilized a target tracking test to investigate the neuromotor capacity of the participants. The mean absolute error (MAE) between the target curve and the curve tracing achieved by the participants was used as the assessment metric. The patients' adjusted MediSens MAE scores were then compared to the controls. The CSM patients were further classified as either "functional" or "nonfunctional" in order to validate the system's responsiveness. Finally, the correlation between the MediSens MAE score and the ODI score was investigated. RESULTS: The control participants had lower MediSens MAE scores of 8.09%±1.60%, while the cervical spinal disorder patients had greater MediSens MAE scores of 11.24%±6.29%. Following surgery, the functional CSM patients had an average MediSens MAE score of 7.13%±1.60%, while the nonfunctional CSM patients had an average score of 12.41%±6.32%. The MediSens MAE and the ODI scores showed a statistically significant correlation (r=-0.341, p<1.14×10⁻5). A Bland-Altman plot was then used to validate the agreement between the two scores. Furthermore, the percentage improvement of the the two scores after receiving the surgical intervention showed a significant correlation (r=-0.723, p<0.04). CONCLUSIONS: The MediSens handgrip device is capable of identifying patients with impaired motor function of the hand. The MediSens handgrip scores correlate with the ODI scores and may serve as an objective alternative for assessing motor function of the hand.


Asunto(s)
Fuerza de la Mano/fisiología , Actividad Motora/fisiología , Examen Neurológico/instrumentación , Espondilosis/fisiopatología , Extremidad Superior/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Vértebras Cervicales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Espondilosis/complicaciones
10.
Nat Commun ; 15(1): 5440, 2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-38937447

RESUMEN

Continuous renal replacement therapy (CRRT) is a form of dialysis prescribed to severely ill patients who cannot tolerate regular hemodialysis. However, as the patients are typically very ill to begin with, there is always uncertainty whether they will survive during or after CRRT treatment. Because of outcome uncertainty, a large percentage of patients treated with CRRT do not survive, utilizing scarce resources and raising false hope in patients and their families. To address these issues, we present a machine learning-based algorithm to predict short-term survival in patients being initiated on CRRT. We use information extracted from electronic health records from patients who were placed on CRRT at multiple institutions to train a model that predicts CRRT survival outcome; on a held-out test set, the model achieves an area under the receiver operating curve of 0.848 (CI = 0.822-0.870). Feature importance, error, and subgroup analyses provide insight into bias and relevant features for model prediction. Overall, we demonstrate the potential for predictive machine learning models to assist clinicians in alleviating the uncertainty of CRRT patient survival outcomes, with opportunities for future improvement through further data collection and advanced modeling.


Asunto(s)
Algoritmos , Terapia de Reemplazo Renal Continuo , Aprendizaje Automático , Humanos , Terapia de Reemplazo Renal Continuo/métodos , Masculino , Femenino , Persona de Mediana Edad , Registros Electrónicos de Salud , Anciano , Curva ROC , Terapia de Reemplazo Renal/métodos , Terapia de Reemplazo Renal/mortalidad
11.
LGBT Health ; 10(7): 560-565, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37219872

RESUMEN

Purpose: We sought to understand technology-based communication regarding mpox (monkeypox) among gay, bisexual, and other men who have sex with men (GBMSM) during the global outbreak in 2022. Methods: Forty-four GBMSM (Mage = 25.3 years, 68.2% cisgender, 43.2% non-White) living in the United States participated. From May 2022 to August 2022, all text data related to mpox (174 instances) were downloaded from the smartphones of GBMSM. Text data and smartphone app usage were analyzed. Results: Content analysis revealed 10 text-based themes and 7 app categories. GBMSM primarily used search and browser, texting, and gay dating apps to share vaccine updates, seek mpox vaccination, find general mpox information, share mpox information with other GBMSM, and discuss links between mpox and gay culture. Data visualizations revealed that changes in communication themes and app usage were responsive to major milestones in the mpox outbreak. Conclusion: GBMSM used apps to facilitate a community-driven mpox response.


Asunto(s)
Infecciones por VIH , Mpox , Minorías Sexuales y de Género , Masculino , Humanos , Estados Unidos , Adulto , Homosexualidad Masculina , Teléfono Inteligente , Infecciones por VIH/prevención & control
12.
Res Sq ; 2023 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-38014280

RESUMEN

Continuous renal replacement therapy (CRRT) is a form of dialysis prescribed to severely ill patients who cannot tolerate regular hemodialysis. However, as the patients are typically very ill to begin with, there is always uncertainty as to whether they will survive during or after CRRT treatment. Because of outcome uncertainty, a large percentage of patients treated with CRRT do not survive, utilizing scarce resources and raising false hope in patients and their families. To address these issues, we present a machine-learning-based algorithm to predict if patients will survive after being treated with CRRT. We use information extracted from electronic health records from patients who were placed on CRRT at multiple institutions to train a model that predicts CRRT survival outcome; on a held-out test set, the model achieved an area under the receiver operating curve of 0.929 (CI=0.917-0.942). Feature importance, error, and subgroup analyses identified consistently, mean corpuscular volume as a driving feature for model predictions. Overall, we demonstrate the potential for predictive machine-learning models to assist clinicians in alleviating the uncertainty of CRRT patient survival outcomes, with opportunities for future improvement through further data collection and advanced modeling.

13.
J Neuroeng Rehabil ; 9: 38, 2012 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-22691460

RESUMEN

BACKGROUND: A complete spinal cord transection results in loss of all supraspinal motor control below the level of the injury. The neural circuitry in the lumbosacral spinal cord, however, can generate locomotor patterns in the hindlimbs of rats and cats with the aid of motor training, epidural stimulation and/or administration of monoaminergic agonists. We hypothesized that there are patterns of EMG signals from the forelimbs during quadrupedal locomotion that uniquely represent a signal for the "intent" to step with the hindlimbs. These observations led us to determine whether this type of "indirect" volitional control of stepping can be achieved after a complete spinal cord injury. The objective of this study was to develop an electronic bridge across the lesion of the spinal cord to facilitate hindlimb stepping after a complete mid-thoracic spinal cord injury in adult rats. METHODS: We developed an electronic spinal bridge that can detect specific patterns of EMG activity from the forelimb muscles to initiate electrical-enabling motor control (eEmc) of the lumbosacral spinal cord to enable quadrupedal stepping after a complete spinal cord transection in rats. A moving window detection algorithm was implemented in a small microprocessor to detect biceps brachii EMG activity bilaterally that then was used to initiate and terminate epidural stimulation in the lumbosacral spinal cord. We found dominant frequencies of 180-220 Hz in the EMG of the forelimb muscles during active periods, whereas these frequencies were between 0-10 Hz when the muscles were inactive. RESULTS AND CONCLUSIONS: Once the algorithm was validated to represent kinematically appropriate quadrupedal stepping, we observed that the algorithm could reliably detect, initiate, and facilitate stepping under different pharmacological conditions and at various treadmill speeds.


Asunto(s)
Miembro Anterior/fisiología , Miembro Posterior/fisiología , Locomoción/fisiología , Traumatismos de la Médula Espinal/rehabilitación , Médula Espinal/fisiología , Algoritmos , Animales , Interpretación Estadística de Datos , Estimulación Eléctrica , Electrodos Implantados , Electromiografía , Electrónica , Femenino , Análisis de Fourier , Microcomputadores , Músculo Esquelético/inervación , Músculo Esquelético/fisiología , Vías Nerviosas , Ratas , Ratas Sprague-Dawley
14.
Comput Commun ; 35(2): 207-220, 2012 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-22267882

RESUMEN

Network lifetime and energy-efficiency are viewed as the dominating considerations in designing cluster-based communication protocols for wireless sensor networks. This paper analytically provides the optimal cluster size that minimizes the total energy expenditure in such networks, where all sensors communicate data through their elected cluster heads to the base station in a decentralized fashion. LEACH, LEACH-Coverage, and DBS comprise three cluster-based protocols investigated in this paper that do not require any centralized support from a certain node. The analytical outcomes are given in the form of closed-form expressions for various widely-used network configurations. Extensive simulations on different networks are used to confirm the expectations based on the analytical results. To obtain a thorough understanding of the results, cluster number variability problem is identified and inspected from the energy consumption point of view.

15.
IEEE Trans Pattern Anal Mach Intell ; 44(3): 1278-1288, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-32894706

RESUMEN

In many machine learning applications, we are faced with incomplete datasets. In the literature, missing data imputation techniques have been mostly concerned with filling missing values. However, the existence of missing values is synonymous with uncertainties not only over the distribution of missing values but also over target class assignments that require careful consideration. In this paper, we propose a simple and effective method for imputing missing features and estimating the distribution of target assignments given incomplete data. In order to make imputations, we train a simple and effective generator network to generate imputations that a discriminator network is tasked to distinguish. Following this, a predictor network is trained using the imputed samples from the generator network to capture the classification uncertainties and make predictions accordingly. The proposed method is evaluated on CIFAR-10 and MNIST image datasets as well as five real-world tabular classification datasets, under different missingness rates and structures. Our experimental results show the effectiveness of the proposed method in generating imputations as well as providing estimates for the class uncertainties in a classification task when faced with missing values.


Asunto(s)
Algoritmos , Aprendizaje Automático
16.
JMIR Mhealth Uhealth ; 10(5): e23887, 2022 05 23.
Artículo en Inglés | MEDLINE | ID: mdl-35604762

RESUMEN

BACKGROUND: On-body wearable sensors have been used to predict adverse outcomes such as hospitalizations or fall, thereby enabling clinicians to develop better intervention guidelines and personalized models of care to prevent harmful outcomes. In our previous work, we introduced a generic remote patient monitoring framework (Sensing At-Risk Population) that draws on the classification of human movements using a 3-axial accelerometer and the extraction of indoor localization using Bluetooth low energy beacons, in concert. Using the same framework, this paper addresses the longitudinal analyses of a group of patients in a skilled nursing facility. We try to investigate if the metrics derived from a remote patient monitoring system comprised of physical activity and indoor localization sensors, as well as their association with therapist assessments, provide additional insight into the recovery process of patients receiving rehabilitation. OBJECTIVE: The aim of this paper is twofold: (1) to observe longitudinal changes of sensor-based physical activity and indoor localization features of patients receiving rehabilitation at a skilled nursing facility and (2) to investigate if the sensor-based longitudinal changes can complement patients' changes captured by therapist assessments over the course of rehabilitation in the skilled nursing facility. METHODS: From June 2016 to November 2017, patients were recruited after admission to a subacute rehabilitation center in Los Angeles, CA. Longitudinal cohort study of patients at a skilled nursing facility was followed over the course of 21 days. At the time of discharge from the skilled nursing facility, the patients were either readmitted to the hospital for continued care or discharged to a community setting. A longitudinal study of the physical therapy, occupational therapy, and sensor-based data assessments was performed. A generalized linear mixed model was used to find associations between functional measures with sensor-based features. Occupational therapy and physical therapy assessments were performed at the time of admission and once a week during the skilled nursing facility admission. RESULTS: Of the 110 individuals in the analytic sample with mean age of 79.4 (SD 5.9) years, 79 (72%) were female and 31 (28%) were male participants. The energy intensity of an individual while in the therapy area was positively associated with transfer activities (ß=.22; SE 0.08; P=.02). Sitting energy intensity showed positive association with transfer activities (ß=.16; SE 0.07; P=.02). Lying down energy intensity was negatively associated with hygiene activities (ß=-.27; SE 0.14; P=.04). The interaction of sitting energy intensity with time (ß=-.13; SE 0.06; P=.04) was associated with toileting activities. CONCLUSIONS: This study demonstrates that a combination of indoor localization and physical activity tracking produces a series of features, a subset of which can provide crucial information to the story line of daily and longitudinal activity patterns of patients receiving rehabilitation at a skilled nursing facility. The findings suggest that detecting physical activity changes within locations may offer some insight into better characterizing patients' progress or decline.


Asunto(s)
Alta del Paciente , Instituciones de Cuidados Especializados de Enfermería , Anciano , Estudios de Cohortes , Ejercicio Físico , Femenino , Humanos , Estudios Longitudinales , Masculino
17.
Sci Rep ; 12(1): 7733, 2022 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-35545644

RESUMEN

Spinal cord stimulation enhanced restoration of motor function following spinal cord injury (SCI) in unblinded studies. To determine whether training combined with transcutaneous electrical spinal cord stimulation (tSCS), with or without systemic serotonergic treatment with buspirone (busp), could improve hand function in individuals with severe hand paralysis following SCI, we assessed ten subjects in a double-blind, sham-controlled, crossover study. All treatments-busp, tSCS, and the busp plus tSCS-reduced muscle tone and spasm frequency. Buspirone did not have any discernible impact on grip force or manual dexterity when administered alone or in combination with tSCS. In contrast, grip force, sinusoidal force generation and grip-release rate improved significantly after 6 weeks of tSCS in 5 out of 10 subjects who had residual grip force within the range of 0.1-1.5 N at the baseline evaluation. Improved hand function was sustained in subjects with residual grip force 2-5 months after the tSCS and buspirone treatment. We conclude that tSCS combined with training improves hand strength and manual dexterity in subjects with SCI who have residual grip strength greater than 0.1 N. Buspirone did not significantly improve the hand function nor add to the effect of stimulation.


Asunto(s)
Traumatismos de la Médula Espinal , Estimulación de la Médula Espinal , Estimulación Eléctrica Transcutánea del Nervio , Buspirona , Estudios Cruzados , Fuerza de la Mano , Humanos , Médula Espinal/fisiología , Traumatismos de la Médula Espinal/terapia
18.
Artículo en Inglés | MEDLINE | ID: mdl-35329265

RESUMEN

Background: Exposure to air pollution is associated with acute pediatric asthma exacerbations, including reduced lung function, rescue medication usage, and increased symptoms; however, most studies are limited in investigating longitudinal changes in these acute effects. This study aims to investigate the effects of daily air pollution exposure on acute pediatric asthma exacerbation risk using a repeated-measures design. Methods: We conducted a panel study of 40 children aged 8−16 years with moderate-to-severe asthma. We deployed the Biomedical REAI-Time Health Evaluation (BREATHE) Kit developed in the Los Angeles PRISMS Center to continuously monitor personal exposure to particulate matter of aerodynamic diameter < 2.5 µm (PM2.5), relative humidity and temperature, geolocation (GPS), and asthma outcomes including lung function, medication use, and symptoms for 14 days. Hourly ambient (PM2.5, nitrogen dioxide (NO2), ozone (O3)) and traffic-related (nitrogen oxides (NOx) and PM2.5) air pollution exposures were modeled based on location. We used mixed-effects models to examine the association of same day and lagged (up to 2 days) exposures with daily changes in % predicted forced expiratory volume in 1 s (FEV1) and % predicted peak expiratory flow (PEF), count of rescue inhaler puffs, and symptoms. Results: Participants were on average 12.0 years old (range: 8.4−16.8) with mean (SD) morning %predicted FEV1 of 67.9% (17.3%) and PEF of 69.1% (18.4%) and 1.4 (3.5) puffs per day of rescue inhaler use. Participants reported chest tightness, wheeze, trouble breathing, and cough symptoms on 36.4%, 17.5%, 32.3%, and 42.9%, respectively (n = 217 person-days). One SD increase in previous day O3 exposure was associated with reduced morning (beta [95% CI]: −4.11 [−6.86, −1.36]), evening (−2.65 [−5.19, −0.10]) and daily average %predicted FEV1 (−3.45 [−6.42, −0.47]). Daily (lag 0) exposure to traffic-related PM2.5 exposure was associated with reduced morning %predicted PEF (−3.97 [−7.69, −0.26]) and greater odds of "feeling scared of trouble breathing" symptom (odds ratio [95% CI]: 1.83 [1.03, 3.24]). Exposure to ambient O3, NOx, and NO was significantly associated with increased rescue inhaler use (rate ratio [95% CI]: O3 1.52 [1.02, 2.27], NOx 1.61 [1.23, 2.11], NO 1.80 [1.37, 2.35]). Conclusions: We found significant associations of air pollution exposure with lung function, rescue inhaler use, and "feeling scared of trouble breathing." Our study demonstrates the potential of informatics and wearable sensor technologies at collecting highly resolved, contextual, and personal exposure data for understanding acute pediatric asthma triggers.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Asma , Ozono , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Asma/epidemiología , Niño , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Humanos , Dióxido de Nitrógeno , Ozono/análisis , Material Particulado/efectos adversos , Material Particulado/análisis
19.
Pervasive Mob Comput ; 7(6): 746-760, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22347840

RESUMEN

In this paper, we present a technique to recognize the position of sensors on the human body. Automatic on-body device localization ensures correctness and accuracy of measurements in health and medical monitoring systems. In addition, it provides opportunities to improve the performance and usability of ubiquitous devices. Our technique uses accelerometers to capture motion data to estimate the location of the device on the user's body, using mixed supervised and unsupervised time series analysis methods. We have evaluated our technique with extensive experiments on 25 subjects. On average, our technique achieves 89% accuracy in estimating the location of devices on the body. In order to study the feasibility of classification of left limbs from right limbs (e.g., left arm vs. right arm), we performed analysis, based of which no meaningful classification was observed. Personalized ultraviolet monitoring and wireless transmission power control comprise two immediate applications of our on-body device localization approach. Such applications, along with their corresponding feasibility studies, are discussed.

20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2021: 2303-2309, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34891747

RESUMEN

The adoption of electronic health records (EHRs) has made patient data increasingly accessible, precipitating the development of various clinical decision support systems and data-driven models to help physicians. However, missing data are common in EHR-derived datasets, which can introduce significant uncertainty, if not invalidating the use of a predictive model. Machine learning (ML)-based imputation methods have shown promise in various domains for the task of estimating values and reducing uncertainty to the point that a predictive model can be employed. We introduce Autopopulus, a novel framework that enables the design and evaluation of various autoencoder architectures for efficient imputation on large datasets. Autopopulus implements existing autoencoder methods as well as a new technique that outputs a range of estimated values (rather than point estimates), and demonstrates a workflow that helps users make an informed decision on an appropriate imputation method. To further illustrate Autopopulus' utility, we use it to identify not only which imputation methods can most accurately impute on a large clinical dataset, but to also identify the imputation methods that enable downstream predictive models to achieve the best performance for prediction of chronic kidney disease (CKD) progression.


Asunto(s)
Registros Electrónicos de Salud , Proyectos de Investigación , Conjuntos de Datos como Asunto , Progresión de la Enfermedad , Humanos , Insuficiencia Renal Crónica/diagnóstico , Programas Informáticos , Incertidumbre
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