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Healthcare
Clinical AI, diagnostic bias, patient safety and medical-device regulation — the healthcare front of AI ethics, daily.
Toward an Information Infrastructure for Global Health Improvement
Profound global challenges to individual and population health, alongside the opportunities to benefit from digital technology, have spawned the concept of the Learning Health System. Learning Health Systems (LHSs)--which can function at organizational, network, regional, and national levels of scale--have the capability of continuous data-driven self-study that promotes change and improvement. The LHS concept, which originated in the U.S. in 2007, is rapidly gaining attention around the world.
Healthcare Robotics.
THE USE OF robots in healthcare represents an exciting opportunity to help a large number of people.Robots can be used to enable people with cognitive, sensory, and motor impairments, help people who are ill or injured, support caregivers, and aid the clinical workforce.This article highlights several recent advancements on these fronts, and discusses their impact on stakeholders.It also outlines several key technological, logistical, and design challenges faced in healthcare robot adoption, and
Using deep belief network modelling to characterize differences in brain morphometry in schizophrenia
Neuroimaging-based models contribute to increasing our understanding of schizophrenia pathophysiology and can reveal the underlying characteristics of this and other clinical conditions. However, the considerable variability in reported neuroimaging results mirrors the heterogeneity of the disorder. Machine learning methods capable of representing invariant features could circumvent this problem. In this structural MRI study, we trained a deep learning model known as deep belief network (DBN) to
Analysis of a Smartphone-Based Architecture with Multiple Mobility Sensors for Fall Detection
During the last years, many research efforts have been devoted to the definition of Fall Detection Systems (FDSs) that benefit from the inherent computing, communication and sensing capabilities of smartphones. However, employing a smartphone as the unique sensor in a FDS application entails several disadvantages as long as an accurate characterization of the patient's mobility may force to transport this personal device on an unnatural position. This paper presents a smartphone-based architectu
Boosting Cognition: Effects of Multiple-Session Transcranial Direct Current Stimulation on Working Memory
Transcranial direct current stimulation (tDCS) is a promising tool for neurocognitive enhancement. Several studies have shown that just a single session of tDCS over the left dorsolateral pFC (lDLPFC) can improve the core cognitive function of working memory (WM) in healthy adults. Yet, recent studies combining multiple sessions of anodal tDCS over lDLPFC with verbal WM training did not observe additional benefits of tDCS in subsequent stimulation sessions nor transfer of benefits to novel WM ta
Exploring the benefits and challenges of health professionals’ participation in online health communities: Emergence of (dis)empowerment processes and outcomes
BACKGROUND: Various online applications and service has led to the development of online health communities (OHCs), which in addition to the peer-to-peer communication offer patients and other users also interaction with health professionals. While the benefits and challenges of patients and other users' participation in OHCs have been extensively studied, a thorough examination of how health professionals as moderators (i.e., those who provide clinical expertise to patients and other users in O
Efficient multi-scale 3D CNN with fully connected CRF for accurate brain lesion segmentation
We propose a dual pathway, 11-layers deep, three-dimensional Convolutional Neural Network for the challenging task of brain lesion segmentation. The devised architecture is the result of an in-depth analysis of the limitations of current networks proposed for similar applications. To overcome the computational burden of processing 3D medical scans, we have devised an efficient and effective dense training scheme which joins the processing of adjacent image patches into one pass through the netwo
Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study
BACKGROUND: Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. OBJECTIVE: The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. METHODS
Wavelet Entropy and Directed Acyclic Graph Support Vector Machine for Detection of Patients with Unilateral Hearing Loss in MRI Scanning
(Aim) Sensorineural hearing loss (SNHL) is correlated to many neurodegenerative disease. Now more and more computer vision based methods are using to detect it in an automatic way. (Materials) We have in total 49 subjects, scanned by 3.0T MRI (Siemens Medical Solutions, Erlangen, Germany). The subjects contain 14 patients with right-sided hearing loss (RHL), 15 patients with left-sided hearing loss (LHL), and 20 healthy controls (HC). (Method) We treat this as a three-class classification proble
Technology and Poultry Welfare
Consideration of animal welfare is essential to address the consumers' demands and for the long term sustainability of commercial poultry. However, assessing welfare in large poultry flocks, to be able to detect potential welfare risks and to control or minimize its impact is difficult. Current developments in technology and mathematical modelling open new possibilities for real-time automatic monitoring of animal welfare and health. New technological innovations potentially adaptable to commerc
The use of mobile applications to support self-management for people with asthma: a systematic review of controlled studies to identify features associated with clinical effectiveness and adherence
OBJECTIVES: Telehealth is promoted as a strategy to support self-management of long-term conditions. The aim of this systematic review is to identify which information and communication technology features implemented in mobile apps to support asthma self-management are associated with adoption, adherence to usage, and clinical effectiveness. METHODS: We systematically searched 9 databases, scanned reference lists, and undertook manual searches (January 2000 to April 2016). We include randomized
A study of wrist-worn activity measurement as a potential real-world biomarker for late-life depression
BACKGROUND: Late-life depression (LLD) is associated with a decline in physical activity. Typically this is assessed by self-report questionnaires and, more recently, with actigraphy. We sought to explore the utility of a bespoke activity monitor to characterize activity profiles in LLD more precisely. METHOD: The activity monitor was worn for 7 days by 29 adults with LLD and 30 healthy controls. Subjects underwent neuropsychological assessment and quality of life (QoL) (36-item Short-Form Healt
FACE-Q Eye Module for Measuring Patient-Reported Outcomes Following Cosmetic Eye Treatments
IMPORTANCE: Aesthetic eye treatments can dramatically change a person's appearance, but outcomes are rarely measured from the patient perspective. The patient perspective could be measured using an eye-specific patient-reported outcome measure. OBJECTIVE: To describe the development and psychometric evaluation of FACE-Q scales and an adverse effect checklist designed to measure outcomes following cosmetic eye treatments. DESIGN, SETTING, AND PARTICIPANTS: Pretreatment and posttreatment patients
Two distinct patterns of treatment resistance: clinical predictors of treatment resistance in first-episode schizophrenia spectrum psychoses
BACKGROUND: Clozapine remains the only evidence-based antipsychotic for treatment-resistant schizophrenia (TRS). The ability to predict which patients with their first onset of schizophrenia would subsequently meet criteria for treatment resistance (TR) could help to diminish the severe functional disability which may ensue if TR is not recognized and correctly treated. METHOD: This is a 5-year longitudinal assessment of clinical outcomes in a cohort of 246 first-episode schizophrenia spectrum p
The Importance of Visual Feedback Design in BCIs; from Embodiment to Motor Imagery Learning
Brain computer interfaces (BCIs) have been developed and implemented in many areas as a new communication channel between the human brain and external devices. Despite their rapid growth and broad popularity, the inaccurate performance and cost of user-training are yet the main issues that prevent their application out of the research and clinical environment. We previously introduced a BCI system for the control of a very humanlike android that could raise a sense of embodiment and agency in th
Cognitive Decline and Reorganization of Functional Connectivity in Healthy Aging: The Pivotal Role of the Salience Network in the Prediction of Age and Cognitive Performances
Normal aging is related to a decline in specific cognitive processes, in particular in executive functions and memory. In recent years a growing number of studies have focused on changes in brain functional connectivity related to cognitive aging. A common finding is the decreased connectivity within multiple resting state networks, including the default mode network (DMN) and the salience network. In this study, we measured resting state activity using fMRI and explored whether cognitive declin
Method for Improving EEG Based Emotion Recognition by Combining It with Synchronized Biometric and Eye Tracking Technologies in a Non-invasive and Low Cost Way
Technical advances, particularly the integration of wearable and embedded sensors, facilitate tracking of physiological responses in a less intrusive way. Currently, there are many devices that allow gathering biometric measurements from human beings, such as EEG Headsets or Health Bracelets. The massive data sets generated by tracking of EEG and physiology may be used, among other things, to infer knowledge about human moods and emotions. Apart from direct biometric signal measurement, eye trac
Gain-of-Function Research: Ethical Analysis
Gain-of-function (GOF) research involves experimentation that aims or is expected to (and/or, perhaps, actually does) increase the transmissibility and/or virulence of pathogens. Such research, when conducted by responsible scientists, usually aims to improve understanding of disease causing agents, their interaction with human hosts, and/or their potential to cause pandemics. The ultimate objective of such research is to better inform public health and preparedness efforts and/or development of
Wounds research for patient benefit: a 5-year programme of research
Background Complex wounds are those that heal by secondary intention and include lower-limb ulcers, pressure ulcers and some surgical wounds. The care of people with complex wounds is costly, with care mainly being delivered by community nurses. There is a lack of current, high-quality data regarding the numbers and types of people affected, care received and outcomes achieved. Objectives To (1) assess how high-quality data about complex wounds can be captured effectively for use in both service
Optimization of DRASTIC method by artificial neural network, nitrate vulnerability index, and composite DRASTIC models to assess groundwater vulnerability for unconfined aquifer of Shiraz Plain, Iran
BACKGROUND: Extensive human activities and unplanned land uses have put groundwater resources of Shiraz plain at a high risk of nitrate pollution, causing several environmental and human health issues. To address these issues, water resources managers utilize groundwater vulnerability assessment and determination of protection. This study aimed to prepare the vulnerability maps of Shiraz aquifer by using Composite DRASTIC index, Nitrate Vulnerability index, and artificial neural network and also
Prediction and diagnosis of renal cell carcinoma using nuclear magnetic resonance-based serum metabolomics and self-organizing maps
// Hong Zheng 1 , Jiansong Ji 2 , Liangcai Zhao 1 , Minjiang Chen 1, 2 , An Shi 3 , Linlin Pan 1 , Yiran Huang 3 , Huajie Zhang 1 , Baijun Dong 3 , Hongchang Gao 1 1 School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, China 2 Lishui Central Hospital, The Fifth Affiliated Hospital, Wenzhou Medical University, Lishui, 323000, China 3 Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China Correspondence to: Hongc
Mobile health: the power of wearables, sensors, and apps to transform clinical trials
Mobile technology has become a ubiquitous part of everyday life, and the practical utility of mobile devices for improving human health is only now being realized. Wireless medical sensors, or mobile biosensors, are one such technology that is allowing the accumulation of real-time biometric data that may hold valuable clues for treating even some of the most devastating human diseases. From wearable gadgets to sophisticated implantable medical devices, the information retrieved from mobile tech
Effects of Three Motivationally Targeted Mobile Device Applications on Initial Physical Activity and Sedentary Behavior Change in Midlife and Older Adults: A Randomized Trial
BACKGROUND: While there has been an explosion of mobile device applications (apps) promoting healthful behaviors, including physical activity and sedentary patterns, surprisingly few have been based explicitly on strategies drawn from behavioral theory and evidence. OBJECTIVE: This study provided an initial 8-week evaluation of three different customized physical activity-sedentary behavior apps drawn from conceptually distinct motivational frames in comparison with a commercially available cont
Emerging technologies to measure neighborhood conditions in public health: implications for interventions and next steps
Adverse neighborhood conditions play an important role beyond individual characteristics. There is increasing interest in identifying specific characteristics of the social and built environments adversely affecting health outcomes. Most research has assessed aspects of such exposures via self-reported instruments or census data. Potential threats in the local environment may be subject to short-term changes that can only be measured with more nimble technology. The advent of new technologies ma
Discrimination of Breast Cancer with Microcalcifications on Mammography by Deep Learning
Microcalcification is an effective indicator of early breast cancer. To improve the diagnostic accuracy of microcalcifications, this study evaluates the performance of deep learning-based models on large datasets for its discrimination. A semi-automated segmentation method was used to characterize all microcalcifications. A discrimination classifier model was constructed to assess the accuracies of microcalcifications and breast masses, either in isolation or combination, for classifying breast
Retrieval of Brain Tumors by Adaptive Spatial Pooling and Fisher Vector Representation
Content-based image retrieval (CBIR) techniques have currently gained increasing popularity in the medical field because they can use numerous and valuable archived images to support clinical decisions. In this paper, we concentrate on developing a CBIR system for retrieving brain tumors in T1-weighted contrast-enhanced MRI images. Specifically, when the user roughly outlines the tumor region of a query image, brain tumor images in the database of the same pathological type are expected to be re
Social Foundations of Health Care Inequality and Treatment Bias
It is widely assumed that the use of medical care will lead to improvements in health, yet questions remain about the medical system's contributions to health disparities. In this review, we examine these issues with a specific focus on how health care systems may actually generate or exacerbate health disparities. We review current knowledge about inequality and bias in the health care system, including the epidemiology of such patterns and their underlying mechanisms. Over the past three decad
Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences
OBJECTIVE: Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and s
Which professional (non-technical) competencies are most important to the success of graduate veterinarians? A Best Evidence Medical Education (BEME) systematic review: BEME Guide No. 38
BACKGROUND: Despite the growing prominence of professional (non-technical) competencies in veterinary education, the evidence to support their importance to veterinary graduates is unclear. AIM: To summarize current evidence within the veterinary literature for the importance of professional competencies to graduate success. METHODS: A systematic search of electronic databases was conducted (CAB Abstracts, Web of Science, PubMed, PsycINFO, ERIC, Australian and British Education Index, Dissertati
Information and Communication Technologies (ICTs) and Autistic Spectrum Disorders (ASD)
The aim of this report is to provide systematic analysis of studies investigating ICT tools for children with Autistic Spectrum Disorders. They are categorized into ICT assessment tools and ICT intervention tools. The review outlines the origin of each tool, its functionality by describing certain technological features and how it attributes to this scientific field. On the one hand, there are many ICT tools that contribute in the diagnosis of ASD. On the other hand, ICT intervention tools play
Variation Interpretation Predictors: Principles, Types, Performance, and Choice
Next-generation sequencing methods have revolutionized the speed of generating variation information. Sequence data have a plethora of applications and will increasingly be used for disease diagnosis. Interpretation of the identified variants is usually not possible with experimental methods. This has caused a bottleneck that many computational methods aim at addressing. Fast and efficient methods for explaining the significance and mechanisms of detected variants are required for efficient prec
Cohort profile of the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register: current status and recent enhancement of an Electronic Mental Health Record-derived data resource
PURPOSE: The South London and Maudsley National Health Service (NHS) Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register and its Clinical Record Interactive Search (CRIS) application were developed in 2008, generating a research repository of real-time, anonymised, structured and open-text data derived from the electronic health record system used by SLaM, a large mental healthcare provider in southeast London. In this paper, we update this register's descriptive data, and descr
COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015), a global –clinical evaluations, serum biomarkers, genetic studies and neuroimaging– prospective, multicenter, non-interventional, long-term study on Parkinson’s disease progression
BACKGROUND: Parkinson's disease (PD) is a progressive neurodegenerative disorder causing motor and non-motor symptoms that can affect independence, social adjustment and the quality of life (QoL) of both patients and caregivers. Studies designed to find diagnostic and/or progression biomarkers of PD are needed. We describe here the study protocol of COPPADIS-2015 (COhort of Patients with PArkinson's DIsease in Spain, 2015), an integral PD project based on four aspects/concepts: 1) PD as a global
Effects of virtual reality-based rehabilitation on distal upper extremity function and health-related quality of life: a single-blinded, randomized controlled trial
BACKGROUND: Virtual reality (VR)-based rehabilitation has been reported to have beneficial effects on upper extremity function in stroke survivors; however, there is limited information about its effects on distal upper extremity function and health-related quality of life (HRQoL). The purpose of the present study was to examine the effects of VR-based rehabilitation combined with standard occupational therapy on distal upper extremity function and HRQoL, and compare the findings to those of amo
In Vivo, In Vitro, and In Silico Characterization of Peptoids as Antimicrobial Agents
Bacterial resistance to conventional antibiotics is a global threat that has spurred the development of antimicrobial peptides (AMPs) and their mimetics as novel anti-infective agents. While the bioavailability of AMPs is often reduced due to protease activity, the non-natural structure of AMP mimetics renders them robust to proteolytic degradation, thus offering a distinct advantage for their clinical application. We explore the therapeutic potential of N-substituted glycines, or peptoids, as A
Classification of Asthma Based on Nonlinear Analysis of Breathing Pattern
Normal human breathing exhibits complex variability in both respiratory rhythm and volume. Analyzing such nonlinear fluctuations may provide clinically relevant information in patients with complex illnesses such as asthma. We compared the cycle-by-cycle fluctuations of inter-breath interval (IBI) and lung volume (LV) among healthy volunteers and patients with various types of asthma. Continuous respiratory datasets were collected from forty age-matched men including 10 healthy volunteers, 10 pa
Integration of genomic, transcriptomic and proteomic data identifies two biologically distinct subtypes of invasive lobular breast cancer
Invasive lobular carcinoma (ILC) is the second most frequently occurring histological breast cancer subtype after invasive ductal carcinoma (IDC), accounting for around 10% of all breast cancers. The molecular processes that drive the development of ILC are still largely unknown. We have performed a comprehensive genomic, transcriptomic and proteomic analysis of a large ILC patient cohort and present here an integrated molecular portrait of ILC. Mutations in CDH1 and in the PI3K pathway are the
Scalable Predictive Analysis in Critically Ill Patients Using a Visual Open Data Analysis Platform
With the accumulation of large amounts of health related data, predictive analytics could stimulate the transformation of reactive medicine towards Predictive, Preventive and Personalized (PPPM) Medicine, ultimately affecting both cost and quality of care. However, high-dimensionality and high-complexity of the data involved, prevents data-driven methods from easy translation into clinically relevant models. Additionally, the application of cutting edge predictive methods and data manipulation r
Methodological Issues in Predicting Pediatric Epilepsy Surgery Candidates through Natural Language Processing and Machine Learning
OBJECTIVE: We describe the development and evaluation of a system that uses machine learning and natural language processing techniques to identify potential candidates for surgical intervention for drug-resistant pediatric epilepsy. The data are comprised of free-text clinical notes extracted from the electronic health record (EHR). Both known clinical outcomes from the EHR and manual chart annotations provide gold standards for the patient's status. The following hypotheses are then tested: 1)
Development of Health Parameter Model for Risk Prediction of CVD Using SVM
Current methods of cardiovascular risk assessment are performed using health factors which are often based on the Framingham study. However, these methods have significant limitations due to their poor sensitivity and specificity. We have compared the parameters from the Framingham equation with linear regression analysis to establish the effect of training of the model for the local database. Support vector machine was used to determine the effectiveness of machine learning approach with the Fr