Predictive Modelling and Its Visualization for Telehealth Data - Concept and Implementation of an Interactive Viewer.

BACKGROUND: Predictive modelling is becoming increasingly important in the healthcare sector. A comprehensive understanding of obtained models and their predictions is indispensable for the development and later acceptance of such systems. OBJECTIVES: A general concept of a toolset that supports data scientists in the development of predictive models in the telehealth context had to be developed and subsequently implemented. METHODS: Based on surveys the user requirements were determined. The concept development was based on the data model of the 'HerzMobil Tirol' telehealth program. The implementation was conducted in MATLAB. RESULTS: A list of requirements was identified, based on which a viewer was implemented. CONCLUSION: The developed viewer concept and its implementation facilitate a deeper insight and a better understanding of the development process of predictive models in the telehealth context.

Staphylococcus aureus sepsis in rheumatoid arthritis.

Patients with rheumatoid arthritis (RA) are at increased risk of infection. In this study, we determined the risk of and risk factors for Staphyococcus aureus (S. aureus) sepsis in RA. We assembled a retrospective nested case-control subset of RA patients with S. aureus sepsis from the Barnes-Jewish Hospital Medical Informatics database, confirmed the diagnoses, and collected data electronically and by chart review. We used multivariate logistic regression to identify independent risk factors for S. aureus sepsis, with risk expressed as odds ratios (ORs). We extracted data on the length of hospitalization and 30-day and 1-year mortality from the Medical Informatics database for all cases and controls. There were 48 confirmed S. aureus sepsis cases and 232 confirmed controls in the RA cohort. In multivariate analysis, indwelling central venous catheter (OR 15.97; 95 % CI 5.09-50.10; p < 0.01) and congestive heart failure (OR 2.89; 95 % CI 1.26-6.63; p = 0.01) were independently associated with risk of S. aureus sepsis, while treatment with disease-modifying anti-rheumatic drugs (DMARDs), both biologic and non-biologic, was not. S. aureus sepsis was associated with increased 30-day and 1-year mortality (OR 7.37; 95 % CI 2.86-19.0; p < 0.01 for 30-day and OR 5.24; 95 % CI 2.51-10.94; p < 0.01 for 1-year mortality) and longer hospitalization (p < 0.01). Treatment with biologic DMARDs was not associated with longer hospitalization (p = 0.89). Indwelling central venous catheters and congestive heart failure increased the risk of S. aureus sepsis in this observational cohort of patients with RA. Treatment with biologic and non-biologic DMARDs did not increase this risk.

Spatial cluster analysis of nanoscopically mapped serotonin receptors for classification of fixed brain tissue.

We present a cluster spatial analysis method using nanoscopic dSTORM images to determine changes in protein cluster distributions within brain tissue. Such methods are suitable to investigate human brain tissue and will help to achieve a deeper understanding of brain disease along with aiding drug development. Human brain tissue samples are usually treated postmortem via standard fixation protocols, which are established in clinical laboratories. Therefore, our localization microscopy-based method was adapted to characterize protein density and protein cluster localization in samples fixed using different protocols followed by common fluorescent immunohistochemistry techniques. The localization microscopy allows nanoscopic mapping of serotonin 5-HT1A receptor groups within a two-dimensional image of a brain tissue slice. These nanoscopically mapped proteins can be confined to clusters by applying the proposed statistical spatial analysis. Selected features of such clusters were subsequently used to characterize and classify the tissue. Samples were obtained from different types of patients, fixed with different preparation methods, and finally stored in a human tissue bank. To verify the proposed method, samples of a cryopreserved healthy brain have been compared with epitope-retrieved and paraffin-fixed tissues. Furthermore, samples of healthy brain tissues were compared with data obtained from patients suffering from mental illnesses (e.g., major depressive disorder). Our work demonstrates the applicability of localization microscopy and image analysis methods for comparison and classification of human brain tissues at a nanoscopic level. Furthermore, the presented workflow marks a unique technological advance in the characterization of protein distributions in brain tissue sections.

Effects of early recruits on temperate sessile marine community composition depend on other species recruiting at the time.

In many environments recruitment of dispersive propagules (e.g. seeds, spores and larvae) can vary from situations when particular taxa recruit in relative isolation to times when they recruit simultaneously with other, functionally quite different taxa. Differences in the identity and density of recruiting taxa can have important consequences on community structure, but it is still not clear how the effects of individual taxa on communities are modified when they recruit together with other species. Using an experimental approach we compared early development of a temperate marine sessile community after the recruitment of mixtures of botryllid ascidians and barnacles to that when barnacles or botryllid ascidians recruited alone. Communities exposed to recruitment of botryllid ascidians in isolation differed from those that received barnacles, a mixture of botryllids and barnacles or no recruitment in 2-week-old communities. These early differences were driven by higher abundances of the species that were present as initial recruits in experimental treatments. After 2 months communities also differed between barnacle and mixed recruitment treatments but not mixed and botryllid or botryllid and barnacle treatments. These differences were not directly due to differences in the abundances of our manipulated taxa but occurred because of two abundant arborescent bryozoans, Bugula dentata, which occupied more space in communities that initially received mixed recruitment than in those that received barnacle or no recruitment, and Zoobotryon verticillatum, which occupied more space in communities that initially received only barnacle recruitment than those that initially received botryllid or mixed recruitment. These effects did not persist, and communities did not differ after 6 months. These results suggest that, more generally, species may influence community dynamics differently when they recruit alongside other species than when they recruit in relative isolation.

Contrasting effects of variable species recruitment on marine sessile communities.

The species composition, density, and frequency of recruitment into any given habitat are highly variable in most biological systems that rely on dispersive propagules (larvae, seeds, spores, etc.). There are few direct experimental studies of how recruitment variation between single species influences the composition and assembly of whole communities in many of these systems. We manipulated recruitment of a variety of single taxa and followed their effects on the subsequent development of hard-substrate communities of sessile animals living in temperate marine waters. The effects of recruitment on communities were complex. Patterns of recruitment of individual species influenced community structure, but these effects varied greatly depending on the identity of species recruits, the time of community development, and location across three different sites. Variable recruitment of arborescent bryozoans and didemnid ascidians had little effect on community structure. At one site, recruitment of the colonial ascidian Botryllus schlosseri had short-lived effects on community structure, while barnacles had more persistent effects. At another site, recruitment of B. schlosseri and the bryozoan Watersipora subtorquata had strong persistent effects on community structure, dominating space where they recruited and influencing the abundances of a variety of different taxa. Differences in the effects of species recruitment on communities appear to be caused by differences between the ecology and life history of recruiting species as well as differences in background processes between sites. These results demonstrate that discrete recruitment events that vary between single species can be important drivers of community composition but are likely to be heavily influenced by the local environment, even within a single species.

Effects of pulse versus steady recruitment on sessile marine communities.

Variation in patterns of propagule establishment (recruitment) has important effects on population dynamics and the structure of some communities. Most experimental studies have varied recruitment by changing the nature of a single event early in community development, but recruitment can also vary from steady rates of arrival to highly episodic 'pulse' events, causing differences in the temporal spacing of individuals recruiting into patches. We examined whether two different temporal patterns of recruitment of sessile invertebrates affected temperate marine communities in southeastern Australia in two experiments that were run at different times at the same site and that manipulated several different species. Target species entered communities as either a single pulse of recruits within a 2-week period or steady input of the same total number of recruits over a longer time period (5-6 weeks). The pattern of recruitment had variable effects on community structure. The colonial ascidian Botryllus schlosseri did not have a strong influence on community structure whether it recruited in a single pulse or steadily. The cover of B. schlosseri was higher when recruitment occurred as a single pulse. In a second experiment, botryllid ascidians caused changes in the composition of communities when they recruited steadily compared to when they did not recruit or didemnids recruited, but caused no differences in communities when they recruited in a shorter pulse. In contrast, recruitment frequency of didemnid ascidians had little effect, though their presence/absence caused community differences. Though we found that different temporal recruitment patterns can alter community composition, the life history and ecology of particular taxa as well as differences in environmental background processes are likely to influence the strength of these effects.