Introduction: Analyses of large clinical datasets from early arthritis cohorts permit the development of algorithms that may be used for outcome prediction in individual patients. The value added by routine use of mus...
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Introduction: Analyses of large clinical datasets from early arthritis cohorts permit the development of algorithms that may be used for outcome prediction in individual patients. The value added by routine use of musculoskeletal ultrasound (MSUS) in an early arthritis setting, as a component of such predictive algorithms, remains to be determined. Methods: The authors undertook a retrospective analysis of a large, true-to-life, observational inception cohort of early arthritis patients in Newcastle upon Tyne, UK, which included patients with inflammatory arthralgia but no clinically swollen joints. A pragmatic, 10-minute MSUS assessment protocol was developed, and applied to each of these patients at baseline. Logistic regression was used to develop two "risk metrics" that predicted the development of a persistent inflammatory arthritis (PIA), with or without the inclusion of MSUS parameters. Results: A total of 379 enrolled patients were assigned definitive diagnoses after >= 12 months follow-up (median 28 months), of whom 162 (42%) developed a persistent inflammatory arthritis. A risk metric derived from 12 baseline clinical and serological parameters alone had an excellent discriminatory utility with respect to an outcome of PIA (area under receiver operator characteristic (ROC) curve 0.91;95% Cl 0.88 to 0.94). The discriminatory utility of a similar metric, which incorporated MSUS parameters, was not significantly superior (area under ROC curve 0.91;95% Cl 0.89 to 0.94). Neither did this approach identify an added value of MSUS over the use of routine clinical parameters in an algorithm for discriminating PIA patients whose outcome diagnosis was rheumatoid arthritis (RA). Conclusions: MSUS use as a routine component of assessment in an early arthritis clinic did not add substantial discriminatory value to a risk metric for predicting PIA.
Objective Detailed biophysical modeling of deep brain stimulation (DBS) provides a theoretical approach to quantify the cellular response to the applied electric field. However, the most accurate models for performing...
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Objective Detailed biophysical modeling of deep brain stimulation (DBS) provides a theoretical approach to quantify the cellular response to the applied electric field. However, the most accurate models for performing such analyses, patient-specific field-cable (FC) pathway-activation models (PAMs), are so technically demanding to implement that their use in clinical research is greatly limited. predictive algorithms can simplify PAM calculations, but they generally fail to reproduce the output of FC models when evaluated over a wide range of clinically relevant stimulation parameters. Therefore, we set out to develop a novel driving-force (DF) predictive algorithm (DF-Howell), customized to the study of DBS, which can better match FC results. Methods We developed the DF-Howell algorithm and compared its predictions to FC PAM results, as well as to the DF-Peterson algorithm, which is currently the most accurate and generalizable DF-based method. Comparison of the various methods was quantified within the context of subthalamic DBS using activation thresholds of axons representing the internal capsule, hyperdirect pathway, and cerebellothalamic tract for various combinations of fiber diameters, stimulus pulse widths, and electrode configurations. Results The DF-Howell predictor estimated activation of the three axonal pathways with less than a 6.2% mean error with respect to the FC PAM for all 21 cases tested. In 15 of the 21 cases, DF-Howell outperformed DF-Peterson in estimating pathway activation, reducing mean-errors up to 22.5%. Conclusions DF-Howell represents an accurate predictor for estimating axonal pathway activation in patient-specific DBS models, but errors still exist relative to FC PAM calculations. Nonetheless, the tractability of DF algorithms helps to reduce the technical barriers for performing accurate biophysical modeling in clinical DBS research studies.
Purpose: The iPREDICT program aimed to develop an integrated digital health solution capable of continuous data streaming, predicting changes in asthma control, and enabling early intervention. Patients and Methods: A...
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Purpose: The iPREDICT program aimed to develop an integrated digital health solution capable of continuous data streaming, predicting changes in asthma control, and enabling early intervention. Patients and Methods: As part of the iPREDICT program, asthma triggers were characterized by surveying 221 patients (aged >18 years) with self-reported asthma for a risk-benefit analysis of parameters predictive of changes in disease control. Seventeen healthy volunteers (age 25-65 years) tested 13 devices to measure these parameters and assessed their usability attributes. Results: Patients identified irritants such as chemicals, allergens, weather changes, and physical activity as triggers that were the most relevant to deteriorating asthma control. Device testing in healthy volunteers revealed variable data formats/units and quality issues, such as missing data and low signal-to-noise ratio. Based on user preference and data capture validity, a spirometer, vital sign monitor, and sleep monitor formed the iPREDICT integrated system for continuous data streaming to develop a personalized/predictive algorithm for asthma control. Conclusion: These findings emphasize the need to systematically compare devices based on several parameters, including usability and data quality, to develop integrated digital technology programs for asthma care.
Background: The current incidence of major complications in paediatric craniofacial surgery in North America has not been accurately defined. In this report, the Pediatric Craniofacial Collaborative Group evaluates th...
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Background: The current incidence of major complications in paediatric craniofacial surgery in North America has not been accurately defined. In this report, the Pediatric Craniofacial Collaborative Group evaluates the incidence and determines the independent predictors of major perioperative complications using a multicentre database. Methods: The Pediatric Craniofacial Surgery Perioperative Registry was queried for subjects undergoing complex cranial vault reconstruction surgery over a 5-year period. Major perioperative complications were identified through a structured a priori consensus process. Logistic regression was applied to identify predictors of a major perioperative complication with bootstrapping to evaluate discrimination accuracy and provide internal validity of the multivariable model. Results: A total of 1814 patients from 33 institutions in the US and Canada were analysed;15% were reported to have a major perioperative complication. Multivariable predictors included ASA physical status 3 or 4 (P = 0.005), craniofacial syndrome (P = 0.008), antifibrinolytic administered (P = 0.003), blood product transfusion >50 ml kg(-1) (P<0.001), and surgery duration over 5 h (P<0.001). Bootstrapping indicated that the predictive algorithm had good internal validity and excellent discrimination and model performance. A perioperative complication was estimated to increase the hospital length of stay by an average of 3 days (P<0.001). Conclusions: The predictive algorithm can be used as a prognostic tool to risk stratify patients and thereby potentially reduce morbidity and mortality. Craniofacial teams can utilise these predictors of complications to identify high-risk patients. Based on this information, further prospective quality improvement initiatives may decrease complications, and reduce morbidity and mortality.
Stream Processing Systems (SPSs) dynamically process input events. Since the input is usually not a constant flow, presenting rate fluctuations, many works in the literature propose to dynamically replicate SPS operat...
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Stream Processing Systems (SPSs) dynamically process input events. Since the input is usually not a constant flow, presenting rate fluctuations, many works in the literature propose to dynamically replicate SPS operators, aiming at reducing the processing bottleneck induced by such fluctuations. However, these SPSs do not consider the problem of load balancing of the replicas or the cost involved in reconfiguring the system whenever the number of replicas changes. We present in this paper a predictive model which, based on input rate variation, execution time of operators, and queued events, dynamically defines the necessary current number of replicas of each operator. A predictor, composed of different models (i.e., mathematical and Machine Learning ones), predicts the input rate. We also propose a Storm -based SPS, named PA-SPS, which uses such a predictive model, not requiring reboot reconfiguration when the number of operators replica change. PA-SPS also implements a load balancer that distributes incoming events evenly among replicas of an operator. We have conducted experiments on Google Cloud Platform (GCP) for evaluation PA-SPS using real traffic traces of different applications and also compared it with Storm and other existing SPSs.
INTRODUCTION: The American College of Surgeons-National Surgical Quality Improvement Program Surgical Risk Calculator is a tool developed to use 21 individual patient characteristics to make predictions for occurrence...
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INTRODUCTION: The American College of Surgeons-National Surgical Quality Improvement Program Surgical Risk Calculator is a tool developed to use 21 individual patient characteristics to make predictions for occurrence of 13 general and 2 procedure-specific outcomes. The goal of this study was to evaluate the performance of the Surgical Risk Calculator in predicting outcomes in patients receiving posterior lumbar fusion. METHODS: American College of Surgeons-National Surgical Quality Improvement Program Participant Use File for 2015 was queried for patients with age >= 18 years undergoing single-level posterior lumbar fusion (PLF) surgery. Individual patient characteristics were entered into the online risk calculator interface to retrieve the predicted estimated risk for perioperative outcomes and complications. Following this, predictive performance was analyzed by computing Brier score, c-statistic, and sensitivity values for all observed outcomes. RESULTS: A total of 2808 patients undergoing single-level PLF were included in the analysis. Overall, a very low incidence of 30-day postoperative complications was observed with the procedure (0.9%-6.3%). Poor predictive performance was found for all outcomes, including read-missions (c-statistic = 0.63;sensitivity = 15.28%;Brier score = 0.048) and returns to operating room (c-statistic = 0.56;sensitivity = 21.05%;Brier score = 0.032). The best performance was observed for venous thromboembolism (c-statistic = 0.66: Brier score = 0.008), although sensitivity was poor (3.85%) on account of low incidence. predictive performance for length of stay revealed good agreement between observed and predicted values with the exception of prolonged predicted hospital stays (>3.5 days). CONCLUSIONS: This study assesses the performance of the risk calculator for a homogenous population of patients undergoing a single-level PLF. Although the calculator did not fare well in predicting most outcomes, results need to be interpreted in t
Crime prediction research has been biased toward spatial factors, and insufficient research has detailed predictions regarding temporal factors. To build an industrially practical crime prediction system, it is necess...
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ISBN:
(纸本)9781665494755
Crime prediction research has been biased toward spatial factors, and insufficient research has detailed predictions regarding temporal factors. To build an industrially practical crime prediction system, it is necessary to develop a method that considers both temporal and spatial risk factors. This study estimates the effect of time-variant variables such as the day of the week, season, weather, and events for a fundamental analysis of time-based crime prediction. However, because crime data are often imbalanced data with extremely few positive classes, subdividing the data spatially and temporally makes it difficult to estimate the parameters. Therefore, we attempted to solve this problem by dividing the city into clusters with high spatial homogeneity and analyzing each cluster. We observed different effects of time-varying factors for different types of crime.
A future application of aggregation algorithms could be to search for inhibitors of the pathogenic aggregation that underlies Alzheimer‘s, Parkinson‘s and other neurodegenerative diseases. Author
A future application of aggregation algorithms could be to search for inhibitors of the pathogenic aggregation that underlies Alzheimer‘s, Parkinson‘s and other neurodegenerative diseases. Author
Seit den 1960er Jahren wird an der Entwicklung einer künstlichen Bauchspeicheldrüse gearbeitet, dem sogenannten Closed-Loop-System. Es entstand aus dem technischen Verständnis für einen geschlossen...
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Every system, however big or small, is always a part of a bigger system and in turn consists of a number of smaller subsystems. This is true for both natural and technical systems. According to Systems Architecture, i...
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ISBN:
(纸本)9781479901067
Every system, however big or small, is always a part of a bigger system and in turn consists of a number of smaller subsystems. This is true for both natural and technical systems. According to Systems Architecture, in order to be successful, any complex technical system has to take into account its place in the hierarchy of other systems, as well as interdependency between the components of the system on each level. The principles of Systems Architecture are universal, but there is hardly a more important area where they need to be applied than the area of sustainability. An important conclusion of applying the principles of Systems Architecture to sustainable development is that the system itself must be sustainable. This paper presents an approach to designing sustainable system architecture for buildings based on a predictive algorithm, using a specific example of a building-integrated renewable energy control system.
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