scholarly journals Relationships between motor and cognitive functions and subsequent post-stroke mood disorders revealed by machine learning analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Seiji Hama ◽  
Kazumasa Yoshimura ◽  
Akiko Yanagawa ◽  
Koji Shimonaga ◽  
Akira Furui ◽  
...  
Keyword(s):  
Neural Network ◽  
Dimensionality Reduction ◽  
Mood Disorders ◽  
Cognitive Functions ◽  
Network Architecture ◽  
Negative Impact ◽  
Characteristic Curve ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke

Abstract Mood disorders (e.g. depression, apathy, and anxiety) are often observed in stroke patients, exhibiting a negative impact on functional recovery associated with various physical disorders and cognitive dysfunction. Consequently, post-stroke symptoms are complex and difficult to understand. In this study, we aimed to clarify the cross-sectional relationship between mood disorders and motor/cognitive functions in stroke patients. An artificial neural network architecture was devised to predict three types of mood disorders from 36 evaluation indices obtained from functional, physical, and cognitive tests on 274 patients. The relationship between mood disorders and motor/cognitive functions were comprehensively analysed by performing input dimensionality reduction for the neural network. The receiver operating characteristic curve from the prediction exhibited a moderate to high area under the curve above 0.85. Moreover, the input dimensionality reduction retrieved the evaluation indices that are more strongly related to mood disorders. The analysis results suggest a stress threshold hypothesis, in which stroke-induced lesions promote stress vulnerability and may trigger mood disorders.

scholarly journals Electrocardiogram Analysis of Post-Stroke Elderly People Using One-dimensional Convolutional Neural Network Model with Gradient-weighted Class Activation Mapping

2021 ◽  
Author(s):  
Eric S. Ho ◽  
Zhaoyi Ding
Keyword(s):  
Neural Network ◽  
Characteristic Curve ◽  
Stroke Model ◽  
Stroke Patients ◽  
Convolutional Network ◽  
One Dimensional ◽  
Post Stroke ◽  
Model Interpretation ◽  
Primary Focus ◽  
Activation Mapping

Background and purposes: Stroke is the second leading cause of death globally after ischemic heart disease, also a risk factor of cardioembolic stroke. Thus, we postulate that heartbeats encapsulate vital signals related to stroke. With the rapid advancement of deep neural networks (DNNs), it emerges as a powerful tool to decipher intriguing heartbeat patterns associated with post-stroke patients. In this study, we propose the use of a one-dimensional convolutional network (1D-CNN) architecture to build a binary classifier that distinguishes electrocardiogram s (ECGs) between the post-stroke and the stroke-free. Methods: We have built two 1D-CNNs that were used to identify distinct patterns from an openly accessible ECG dataset collected from elderly post-stroke patients. In addition to prediction accuracy, which is the primary focus of existing ECG deep neural network methods, we have utilized Gradient-weighted Class Activation Mapping (GRAD-CAM) to ease model interpretation by uncovering ECG patterns captured by our model. Results: Our stroke model has achieved ~90% accuracy and 0.95 area under the Receiver Operating Characteristic curve. Findings suggest that the core PQRST complex alone is important but not sufficient to differentiate the post-stroke and the stroke-free. Conclusions: We have developed an accurate stroke model using the latest DNN method. Importantly, our work has illustrated an approach to enhance model interpretation, overcoming the black-box issue facing DNN, fostering higher user confidence and adoption of DNN in medicine.

scholarly journals Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1641
Author(s):  
Lien T. K. Nguyen ◽  
Binh N. Do ◽  
Dinh N. Vu ◽  
Khue M. Pham ◽  
Manh-Tan Vu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diet Quality ◽  
Negative Impact ◽  
Cross Sectional Study ◽  
World Health ◽  
Short Version ◽  
Linear Regression Models ◽  
Stroke Patients ◽  
Disability Score ◽  
Cross Sectional

Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.

scholarly journals Deep Learning Versus Logistic Regression to Predict Opioid Dose Reduction After Spinal Cord Stimulation

Neurosurgery ◽  
2020 ◽  
Vol 67 (Supplement_1) ◽  
Author(s):  
Syed M Adil ◽  
Lefko T Charalambous ◽  
Kelly R Murphy ◽  
Shervin Rahimpour ◽  
Stephen C Harward ◽  
...  
Keyword(s):  
Neural Network ◽  
Spinal Cord ◽  
Deep Learning ◽  
Dose Reduction ◽  
Spinal Cord Stimulation ◽  
Network Architecture ◽  
Characteristic Curve ◽  
Model Performance ◽  
Health Crisis ◽  
Opioid Dose

Abstract INTRODUCTION Opioid misuse persists as a public health crisis affecting approximately one in four Americans.1 Spinal cord stimulation (SCS) is a neuromodulation strategy to treat chronic pain, with one goal being decreased opioid consumption. Accurate prognostication about SCS success is key in optimizing surgical decision making for both physicians and patients. Deep learning, using neural network models such as the multilayer perceptron (MLP), enables accurate prediction of non-linear patterns and has widespread applications in healthcare. METHODS The IBM MarketScan® (IBM) database was queried for all patients ≥ 18 years old undergoing SCS from January 2010 to December 2015. Patients were categorized into opioid dose groups as follows: No Use, ≤ 20 morphine milligram equivalents (MME), 20–50 MME, 50–90 MME, and &gt;90 MME. We defined “opiate weaning” as moving into a lower opioid dose group (or remaining in the No Use group) during the 12 months following permanent SCS implantation. After pre-processing, there were 62 predictors spanning demographics, comorbidities, and pain medication history. We compared an MLP with four hidden layers to the LR model with L1 regularization. Model performance was assessed using area under the receiver operating characteristic curve (AUC) with 5-fold nested cross-validation. RESULTS Ultimately, 6,124 patients were included, of which 77% had used opioids for &gt;90 days within the 1-year pre-SCS and 72% had used &gt;5 types of medications during the 90 days prior to SCS. The mean age was 56 ± 13 years old. Collectively, 2,037 (33%) patients experienced opiate weaning. The AUC was 0.74 for the MLP and 0.73 for the LR model. CONCLUSION To our knowledge, we present the first use of deep learning to predict opioid weaning after SCS. Model performance was slightly better than regularized LR. Future efforts should focus on optimization of neural network architecture and hyperparameters to further improve model performance. Models should also be calibrated and externally validated on an independent dataset. Ultimately, such tools may assist both physicians and patients in predicting opioid dose reduction after SCS.

scholarly journals Studi Epidemiologi Kualitas Hidup Penderita Paska Stroke di RSUD Propinsi Nusa Tenggara Barat

2019 ◽  
Vol 5 (1) ◽  
pp. 53
Author(s):  
Ilsa Hunaifi ◽  
Pujiarohman Pujiarohman
Keyword(s):  
Quality Of Life ◽  
General Hospital ◽  
Normal Population ◽  
Social Health ◽  
Average Score ◽  
Life Questionnaire ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke

troke is a leading cause of mortality and morbidity in Indonesia.  Post stroke patients has a higher disability hence results in poor quality of life compared with normal population. In Indonesia, studies related to the quality of life of post-stroke patients are scarce, so studies are required to explore the quality of life of post-stroke patients, particularly in West Nusa Tenggara. Aim of this study is to determine the epidemiology of quality of life for post-stroke patients in West Nusa Tenggara. Methods of this study is An Observational with cross-sectional design was performed in population of post-stroke patients admitted to West Nusa Tenggara General Hospital. The quality of life of post stroke patient was evaluated with SSQOL (Stroke Specific Quality of Life) questionnaire. The collected data was analyzed by the appropriate test. Result of this study is the average age of subject is 60.33±10.68 years. Hypertension is a major risk factor of stroke. The average SSQOL score is 177.02±45.75. SSQOL assesses 4 dimension are physical, functional, psychological and social health. Based on the physical dimension, the average score is 17.00, the functional dimension, the average score is 14.91, the psychological dimension, the average score is 13.17 and the social health dimension  the average score is 13.44.  The quality of life for post-stroke patients in West Nusa Tenggara General Hospital is good.

scholarly journals Studi Fenomenologi: Pengalaman Keluarga Merawat Penderita Pasca Stroke di Kota Jambi Tahun 2019

2019 ◽  
Vol 19 (3) ◽  
pp. 476
Author(s):  
Kadarwati Kadarwati ◽  
Rahmi Ulfa ◽  
Elvi Oktarina
Keyword(s):  
Negative Impact ◽  
Structured Interview ◽  
Daily Activities ◽  
Stroke Patients ◽  
Descriptive Phenomenology ◽  
Economic Changes ◽  
Team Members ◽  
Knowledge And Skills ◽  
Post Stroke ◽  
Psychological Conditions

Stroke has a negative impact on families who provide care for post-stroke patients, the effect of which is due to functional deficits experienced by post-stroke sufferers which result in dependence on families for daily activities. The research objective was to explore in depth the experiences of families caring for post-stroke sufferers in Jambi city in 2019. This study used a qualitative method with a descriptive phenomenology approach. Participants in this study amounted to nine people who were selected using purposive sampling. Data is collected by semi-structured interview in duration of 60-90 minutes. Data analysis using the colaizzi method. The results found four themes, namely: dependence on daily activities on the family, family efforts to fulfill self-care activities, constraints faced by caregivers and family expectations. Conclusion: Families experience limited knowledge and skills, difficulties in meeting patients' ADLs, changes in physical conditions, changes in rest and sleep, changes in psychological conditions, changes in social activities, and economic changes. Therefore families need to get education from doctors, nurses and stroke team members starting from the time the patient is admitted to the hospital and re-evaluated when the patient is going home, about the knowledge and skills to treat post-stroke patients at home.

scholarly journals Efektivitas Alih Baring Tiap 2 Jam Terhadap Pencegahan Ulkus Dekubitus pada Pasien Pasca Stroke dengan Tirah Baring Lama di Bangsal Saraf RSUD Arifin Achmad Pekanbaru

2017 ◽  
Vol 4 (2) ◽  
pp. 133
Author(s):  
Bevi Dewi Citra ◽  
Hermes C. Sitompul ◽  
Tuti Restuastuti
Keyword(s):  
Intervention Study ◽  
Preventive Intervention ◽  
Decubitus Ulcer ◽  
Medical Rehabilitation ◽  
Neurological Deficits ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke ◽  
Rehabilitation Programs ◽  
Significant Difference

Neurological deficits on stroke patients can caused immobility. Decubitus ulcer is one of immobilty’s complication.Two hours repositioning is one of medical rehabilitation programs in decubitus prevention. The aim of this study is todescribe effectiveness of two hours repositioning to prevent decubitus ulcer, especially on post-stroke patients. Thisstudy was a preventive intervention study with cross-sectional approach. Sample consists of 32 patients. Group Iconsists of 16 patients with repositioning intervention. On the otherhand, group II consists of 16 patients withoutrepositioning intervention. Then, this two groups were compared and were looked for the effectiveness. from thisstudy, we knew that prevalence of decubitus ulcer on post-stroke patients are 19.4% with the effectiveness of two hoursrepositioning is 87.5%. There was significant difference between these two groups to prevent decubitus. it occurred ongeriatric patients with percentage of 75%. Its Proportion for female: male are 2:1. It is commonly occurred on firstweek hospitalization, especially grade 2 (33.3%). It is mostly located on sacrum (100%).

scholarly journals High Prevalence of Poststroke Depression in Ischemic Stroke Patients in Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Fikru Tsehayneh ◽  
Abenet Tafesse
Keyword(s):  
Depressive Symptoms ◽  
Negative Impact ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Limited Information ◽  
Poststroke Depression ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Patient Health

Background. There is limited information and research carried out regarding the prevalence of poststroke depression (PSD) in the study area. Psychiatric disorders complicate a significant proportion of patients suffering from stroke. This of course have a great negative impact on our knowledge about poststroke depression in Ethiopia, and poststroke depression complicates a significant number of stroke patients and their rehabilitation. Methods. A cross-sectional study on all patients aged above 18 years and diagnosed with stroke in the past two years who attended the neurology follow-up clinics of Tikur Anbessa Specialized Hospital (TASH) and Zewditu Memorial Hospital (ZMH) was done by using a structured questionnaire containing Patient Health Questionnaire-9 (PHQ-9) depression screening tool. Result. Of 84 patients who were eligible for the study, 32.2% of patients have depressive symptoms. Women (OR 0.001, 95% CI 0.12–0.87) and aphasic patients (OR 0.034, 95% CI 0.19–1.27) were more likely to have depressive symptoms. Conclusion. Depressive symptoms after stroke are common in Ethiopian patients. Our study demonstrates female and aphasic patients are more likely to screen positive for PSD. Hence, screening all poststroke patients with different screening tools is practical, and further studies are needed to assess the validity of these screening tools and also to assess PSD as a predictor of stroke outcome.

scholarly journals Depression and functional disability in stroke patients

2020 ◽  
Author(s):  
Puji Astuti ◽  
Kusnanto ◽  
Ferra Dwi Novitasari
Keyword(s):  
Functional Disability ◽  
Recovery Process ◽  
Simple Random Sampling ◽  
Observational Research ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
Design And Methods ◽  
Depressive Episodes

Background: Stroke patients often suffer from depression, a mental disorder that worsens their condition and slows down the recovery process. Depression is the leading cause of functional disability due to inability to cope with daily stressors and to function independently in their activities. The purpose of this study is to analyze the relationship between depression and functional disability levels in post-stroke patients. Design and Methods: This is an analytic observational research with a cross-sectional approach. The population in exam consisted of all 4-12 week post-stroke patient in the hospital (about 139 patients). The study focused on 104 respondents, who were selected using simple random sampling techniques. Results: The results show that 62.5% stroke patients suffered mild depressive episodes after the stroke while 58.7% experienced mild disabilities. Analysis results using the Pearson Product Moment Test obtained P=0,000. This shows there is a relationship between the level of depression and the degree of functional disability in post-stroke patients. Conclusions: It can be concluded that there is a significant relationship between the levels of post-stroke depression and the functional disability. Families are expected to provide a safe, supportive, and comfortable environment to lessen the level of depression.

scholarly journals Nutritional assessment in patients with cirrhosis

2012 ◽  
Vol 49 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Sabrina Alves Fernandes ◽  
Lilian Bassani ◽  
Flávia Feijó Nunes ◽  
Maria Eugênia Deutrich Aydos ◽  
Alexandro Vaesken Alves ◽  
...  
Keyword(s):  
Phase Angle ◽  
Nutritional Assessment ◽  
Negative Impact ◽  
Characteristic Curve ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Assessment Method ◽  
Receiver Operator Characteristic Curve ◽  
Cross Sectional ◽  
Cirrhotic Patients

CONTEXT: Malnutrition in cirrhotic patients with end-stage disease is common, and the degree of nutritional debilitation can play an important role in the pathogenesis of complications and cause a negative impact on prognosis. However, it involves difficulties and controversies regarding the identification of the best nutritional assessment method. OBJECTIVE: To identify a method that provides a safe and effective nutritional diagnosis. METHODS: Cross-sectional study with 129 cirrhotic patients. Anthropometric measurements, subjective global assessment, hand grip strength and bioelectrical impedance. RESULTS: Through phase angle of bioelectrical impedance analysis (BIA) method, significant associations with Child-Pugh (P = 0.008), age group and gender were observed. The ROC (receiver operator characteristic) curve was generated to determine the best cutoff point of the phase angle of cirrhotic patients, serving as one of the reference parameters for the nutritional assessment with bioimpedance in this study, considering the classification through Child-Pugh score as the reference standard for the clinical conditions of patients with cirrhosis. CONCLUSIONS: The assessment through bioelectrical impedance presented a statistically significant correlation with Child-Pugh score. The identification of phase angle of 5.44º is the new parameter suggested for the classification of the nutritional conditions of cirrhotic patients.

scholarly journals HUBUNGAN ANTARA DUKUNGAN KELUARGA DENGAN KEMAMPUAN PERAWATAN DIRI (SELF CARE) PADA PASIEN PASCA STROKE DI RSUD PIRNGADI KOTA MEDAN

2019 ◽  
Vol 2 (2) ◽  
pp. 70
Author(s):  
Patimah Sari Siregar ◽  
Elis Anggeria
Keyword(s):  
Family Support ◽  
Self Care ◽  
Rank Correlation ◽  
Sampling Technique ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke ◽  
Need Support ◽  
The Family ◽  
The Relationship

Stroke is a condition of brain experiencing neurodegenerative disorders such as local or global, occuring in sudden emergence, progressive, and fast. Impaired nerve function in stroke caused by circulatory disorders of the brain non-traumatic. Post-stroke patients need support and help the family in the treatment himself. This study aims to determine the relationship between family support with self-care skills  in patients with post-stroke. The study design is analytic survey with cross sectional approach. The study populations were 40 people and samples of this study were all post-stroke patients who were undergoing rehabilitation of physiotherapy with drawn by saturated sampling technique. The results showed that 47.5% of respondents got enough family support, and 55% of respondents have the ability of self-care with some aid. Based on the test results from Spearman Rank correlation, family support with self-care skills  has a correlation coefficient of 0.38 and Sig. (2-tailed) 0.01, meaning there is a relationship between family support and self-care skills on post-stroke patients in the Royal Prima Hospital Medan. In conclusion, this study shows that family support and self-care skills strongly influence at the level of the patient's recovery. It is hoped that families to be more attentive to the needs and provide optimal support either support of awards/emotional, facilities and support information.

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