DIRECTED ACYCLIC GRAPH-BASED PATIENT EDUCATION SYSTEM FOR CARDIOVASCULAR PATIENTS IN TAIWAN

2016 ◽  
Vol 16 (01) ◽  
pp. 1640011
Author(s):  
JHEN-LI HUANG ◽  
CHIEN-MING CHEN ◽  
TUN-WEN PAI ◽  
MIN-HUI LIU ◽  
CHAO-HUNG WANG
Keyword(s):  
Cardiovascular Disease ◽  
Patient Education ◽  
Education System ◽  
Directed Acyclic Graph ◽  
Medical Information ◽  
Assessment Tool ◽  
Acyclic Graph ◽  
Video Clips ◽  
Cardiovascular Patients ◽  
Number Of Patients

Background: Cardiovascular disease is the leading global cause of death and the number of patients is expected to grow yearly. Pertinent patient education materials provide adequate medical information to cardiovascular patients to change their behaviors, improve their health status, and reduce medical costs. However, systematic and patient-oriented education materials for cardiovascular disease are currently not available to the public, especially in Chinese. Methods: A directed acyclic graph (DAG) database structure is proposed for storing all created low-demand medical illustrations and video clips. Further, all designed medical media elements are evaluated according to the Patient Education Materials Assessment Tool (PEMAT) to assure the quality of the medical information content. Each media element is automatically annotated by calculating representative keywords; relationships between different media elements are constructed according to keyword associations. Results: A total of 222 video clips and 45 printable medical documents in Chinese were created in the proposed patient education system. This contains fundamental knowledge of diseases, causes of diseases, medical and surgical treatments, and a prognosis of the medical care for the majority of types of cardiovascular disease. It is the first constructive and intelligent patient education system for cardiovascular patients in Taiwan.

scholarly journals Reduction of estimated fluid volumes following initiation of empagliflozin in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the placebo-controlled, randomized EMBLEM trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Michio Shimabukuro ◽  
Hiroki Teragawa ◽  
Yosuke Okada ◽  
Toshinari Takamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Repeated Measures ◽  
Medical Information ◽  
Controlled Trial ◽  
Extracellular Volume ◽  
Cardiovascular Outcomes ◽  
Fluid Volume ◽  
The Body

Abstract Backgrounds/Aim Sodium glucose co-transporter 2 inhibitors promote osmotic/natriuretic diuresis and reduce excess fluid volume, and this improves cardiovascular outcomes, including hospitalization for heart failure. We sought to assess the effect of empagliflozin on estimated fluid volumes in patients with type 2 diabetes and cardiovascular disease (CVD). Methods The study was a post-hoc analysis of the EMBLEM trial (UMIN000024502), an investigator-initiated, multi-center, placebo-controlled, double-blinded, randomized-controlled trial designed primarily to evaluate the effect of 24 weeks of empagliflozin treatment on vascular endothelial function in patients with type 2 diabetes and established CVD. The analysis compared serial changes between empagliflozin (10 mg once daily, n = 52) and placebo (n = 53) in estimated plasma volume (ePV), calculated by the Straus formula and estimated the extracellular volume (eEV), determined by the body surface area, measured at baseline and 4, 12, and 24 weeks after initiation of treatment. Correlations were examined between the changes from baseline to week 24 in each estimated fluid volume parameter and several clinical variables of interest, including N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Results In an analysis using mixed-effects models for repeated measures, relative to placebo empagliflozin reduced ePV by − 2.23% (95% CI − 5.72 to 1.25) at week 4, − 8.07% (− 12.76 to − 3.37) at week 12, and − 5.60% (− 9.87 to − 1.32) at week 24; eEV by − 70.3 mL (95% CI − 136.8 to − 3.8) at week 4, − 135.9 mL (− 209.6 to − 62.3) at week 12, and − 144.4 mL (− 226.3 to − 62.4) at week 24. The effect of empagliflozin on these parameters was mostly consistent across various patient clinical characteristics. The change in log-transformed NT-proBNP was positively correlated with change in ePV (r = 0.351, p = 0.015), but not with change in eEV. Conclusions Our data demonstrated that initiation of empagliflozin treatment substantially reduced estimated fluid volume parameters in patients with type 2 diabetes and CVD, and that this effect was maintained for 24 weeks. Given the early beneficial effect of empagliflozin on cardiovascular outcomes seen in similar patient populations, our findings provide an important insight into the key mechanisms underlying the clinical benefit of the drug. Trial registration University Medical Information Network Clinical Trial Registry, number 000024502

scholarly journals IoT-enabled directed acyclic graph in spark cluster

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jahwan Koo ◽  
Nawab Muhammad Faseeh Qureshi ◽  
Isma Farah Siddiqui ◽  
Asad Abbas ◽  
Ali Kashif Bashir
Keyword(s):  
Distributed Computing ◽  
Real Time ◽  
Directed Acyclic Graph ◽  
Random Access ◽  
Heterogeneous Data ◽  
The Body ◽  
Computing Environment ◽  
Time Data ◽  
Acyclic Graph ◽  
Sensory Data

Abstract Real-time data streaming fetches live sensory segments of the dataset in the heterogeneous distributed computing environment. This process assembles data chunks at a rapid encapsulation rate through a streaming technique that bundles sensor segments into multiple micro-batches and extracts into a repository, respectively. Recently, the acquisition process is enhanced with an additional feature of exchanging IoT devices’ dataset comprised of two components: (i) sensory data and (ii) metadata. The body of sensory data includes record information, and the metadata part consists of logs, heterogeneous events, and routing path tables to transmit micro-batch streams into the repository. Real-time acquisition procedure uses the Directed Acyclic Graph (DAG) to extract live query outcomes from in-place micro-batches through MapReduce stages and returns a result set. However, few bottlenecks affect the performance during the execution process, such as (i) homogeneous micro-batches formation only, (ii) complexity of dataset diversification, (iii) heterogeneous data tuples processing, and (iv) linear DAG workflow only. As a result, it produces huge processing latency and the additional cost of extracting event-enabled IoT datasets. Thus, the Spark cluster that processes Resilient Distributed Dataset (RDD) in a fast-pace using Random access memory (RAM) defies expected robustness in processing IoT streams in the distributed computing environment. This paper presents an IoT-enabled Directed Acyclic Graph (I-DAG) technique that labels micro-batches at the stage of building a stream event and arranges stream elements with event labels. In the next step, heterogeneous stream events are processed through the I-DAG workflow, which has non-linear DAG operation for extracting queries’ results in a Spark cluster. The performance evaluation shows that I-DAG resolves homogeneous IoT-enabled stream event issues and provides an effective stream event heterogeneous solution for IoT-enabled datasets in spark clusters.

Risk identification and modeling for blockchain-enabled container shipping

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Son Nguyen ◽  
Peggy Shu-Ling Chen ◽  
Yuquan Du
Keyword(s):  
Design Methodology ◽  
Directed Acyclic Graph ◽  
Risk Identification ◽  
Container Shipping ◽  
Content Type ◽  
Acyclic Graph ◽  
Operational Risks ◽  
Systems Security ◽  
Event Risk ◽  
Potential Risks

PurposeAlthough being considered for adoption by stakeholders in container shipping, application of blockchain is hindered by different factors. This paper investigates the potential operational risks of blockchain-integrated container shipping systems as one of such barriers.Design/methodology/approachLiterature review is employed as the method of risk identification. Scientific articles, special institutional reports and publications of blockchain solution providers were included in an inclusive qualitative analysis. A directed acyclic graph (DAG) was constructed and analyzed based on network topological metrics.FindingsTwenty-eight potential risks and 47 connections were identified in three groups of initiative, transitional and sequel. The DAG analysis results reflect a relatively well-connected network of identified hazardous events (HEs), suggesting the pervasiveness of information risks and various multiple-event risk scenarios. The criticality of the connected systems' security and information accuracy are also indicated.Originality/valueThis paper indicates the changes of container shipping operational risk in the process of blockchain integration by using updated data. It creates awareness of the emerging risks, provides their insights and establishes the basis for further research.

scholarly journals MicroRNA as Biomarkers for Platelet Function and Maturity in Patients with Cardiovascular Disease

2021 ◽  
Author(s):  
Oliver Buchhave Pedersen ◽  
Erik Lerkevang Grove ◽  
Steen Dalby Kristensen ◽  
Peter H. Nissen ◽  
Anne-Mette Hvas
Keyword(s):  
Cardiovascular Disease ◽  
Platelet Function ◽  
Assessment Tool ◽  
Platelet Reactivity ◽  
Thrombus Formation ◽  
Quality Assessment Tool ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
Meta Analyses ◽  
Potential Use

AbstractPatients with cardiovascular disease (CVD) are at increased risk of suffering myocardial infarction. Platelets are key players in thrombus formation and, therefore, antiplatelet therapy is crucial in the treatment and prevention of CVD. MicroRNAs (miRs) may hold the potential as biomarkers for platelet function and maturity. This systematic review was conducted using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To identify studies investigating the association between miRs and platelet function and maturity in patients with CVD, PubMed and Embase were searched on October 13 and December 13, 2020 without time boundaries. Risk of bias was evaluated using a standardized quality assessment tool. Of the 16 included studies, 6 studies were rated “good” and 10 studies were rated “fair.” In total, 45 miRs correlated significantly with platelet function or maturity (rho ranging from –0.68 to 0.38, all p < 0.05) or differed significantly between patients with high platelet reactivity and patients with low platelet reactivity (p-values ranging from 0.0001 to 0.05). Only four miRs were investigated in more than two studies, namely miR-223, miR-126, miR-21 and miR-150. Only one study reported on the association between miRs and platelet maturity. In conclusion, a total of 45 miRs were associated with platelet function or maturity in patients with CVD, with miR-223 and miR-126 being the most frequently investigated. However, the majority of the miRs were only investigated in one study. More data are needed on the potential use of miRs as biomarkers for platelet function and maturity in CVD patients.

scholarly journals Delivering healthcare remotely to cardiovascular patients during COVID-19

2020 ◽  
Vol 19 (6) ◽  
pp. 486-494 ◽  
Author(s):  
Lis Neubeck ◽  
Tina Hansen ◽  
Tiny Jaarsma ◽  
Leonie Klompstra ◽  
Robyn Gallagher
Keyword(s):  
Cardiovascular Disease ◽  
Usual Care ◽  
Mobile Apps ◽  
Digital Health ◽  
Well Being ◽  
Search Terms ◽  
Cardiovascular Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Remote Healthcare ◽  
Healthcare Interventions

Background Although attention is focused on addressing the acute situation created by the COVID-19 illness, it is imperative to continue our efforts to prevent cardiovascular morbidity and mortality, particularly during a period of prolonged social isolation which may limit physical activity, adversely affect mental health and reduce access to usual care. One option may be to deliver healthcare interventions remotely through digital healthcare solutions. Therefore, the aim of this paper is to bring together the evidence for remote healthcare during a quarantine situation period to support people living with cardiovascular disease during COVID-19 isolation. Methods The PubMed, CINAHL and Google Scholar were searched using telehealth OR digital health OR mHealth OR eHealth OR mobile apps AND COVID-19 OR quarantine search terms. We also searched for literature relating to cardiovascular disease AND quarantine. Results The literature search identified 45 potentially relevant publications, out of which nine articles were included. Three overarching themes emerged from this review: (1) preparing the workforce and ensuring reimbursement for remote healthcare, (2) supporting mental and physical health and (3) supporting usual care. Conclusion To support people living with cardiovascular disease during COVID-19 isolation and to mitigate the effects of quarantine and adverse effect on mental and physical well-being, we should offer remote healthcare and provide access to their usual care.

scholarly journals The Evolving Phenotypes of Cardiovascular Disease during COVID-19 Pandemic

2021 ◽  
Author(s):  
Michele Correale ◽  
Francesca Croella ◽  
Alessandra Leopizzi ◽  
Pietro Mazzeo ◽  
Lucia Tricarico ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Acute Coronary Syndrome ◽  
New World ◽  
Therapeutic Options ◽  
Atrial Arrhythmias ◽  
Heart Failure Patients ◽  
Coronary Syndrome ◽  
Cardiovascular Patients

AbstractCOVID-19 pandemic has negatively impacted the management of patients with acute and chronic cardiovascular disease: acute coronary syndrome patients were often not timely reperfused, heart failure patients not adequately followed up and titrated, atrial arrhythmias not efficaciously treated and became chronic. New phenotypes of cardiovascular patients were more and more frequent during COVID-19 pandemic and are expected to be even more frequent in the next future in the new world shaped by the pandemic. We therefore aimed to briefly summarize the main changes in the phenotype of cardiovascular patients in the COVID-19 era, focusing on new clinical challenges and possible therapeutic options.

151 Optimising Bone Health on Sheffield Frailty Unit Through Quality Improvement

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
C M Orton ◽  
N E Sinson ◽  
R Blythe ◽  
J Hogan ◽  
N A Vethanayagam ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Fracture Risk ◽  
Fragility Fracture ◽  
Bone Health ◽  
Assessment Tool ◽  
Health Assessment ◽  
Fragility Fractures ◽  
Improvement Project ◽  
Number Of Patients ◽  
Fracture Risk Assessment Tool

Abstract Introduction NICE and the National Osteoporosis Guidance Group (NOGG) advise on evaluation of fracture risk and osteoporosis treatment1,2, with evidence suggesting that screening and treatment reduces the risk of fragility fractures 3,4,5. However, it is often overlooked in the management of older patients within secondary care. Audit data from Sheffield Frailty Unit (SFU) in 2018 showed that national guidance was not routinely followed. Fracture Risk Assessment Tool (FRAX®) scores were not calculated and bone health was poorly managed. Therefore, we undertook a quality improvement project aiming to optimise bone health in patients presenting to SFU. Method & Intervention In January 2019 we collaborated with Sheffield Metabolic Bone Centre (MBC) to develop a pathway aiming to improve bone health assessment and management in patients presenting to SFU with a fall or fragility fracture. This included a user-friendly flow chart with accompanying guidelines, alongside education for staff. Performance was re-evaluated in May 2019, following which a tick box prompt was added to post take ward round documentation. A re-audit was performed in March 2020. Results In March 2018 0% of patients presenting with a fall had a FRAX® score calculated and only 40% of those with a new fragility fracture were managed according to guidelines. In May 2019, this had improved to 18% and 100% respectively. In March 2020 86% of patients had a FRAX® score calculated appropriately and 100% of fragility fractures were managed according to guidelines. In both re-audits 100% of FRAX® scores were acted on appropriately. Conclusions There has been a significant increase in the number of patients who have their bone health appropriately assessed and managed after presenting to SFU. However, achieving optimum care is under constant review with the aim to deliver more treatment on SFU, thereby reducing the need for repeat visits to the MBC.

Understandability, actionability and suitability of educational videos on dietary management for hypertension

2022 ◽  
pp. 001789692110722
Author(s):  
Mohd Ramadan Ab Hamid ◽  
Nur Dalia Binti Mohd Yusof ◽  
Siti Sabariah Buhari
Keyword(s):  
Patient Education ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Dietary Management ◽  
Educational Video ◽  
Lifestyle Modifications ◽  
Educational Tools ◽  
Suitability Assessment ◽  
Educational Videos ◽  
Convenience Sampling

Background: Educational video is a productive means to advocate lifestyle modifications such as changes in the dietary routine. This study assesses the understandability, actionability and suitability of newly developed educational videos aimed at encouraging dietary adjustments among hypertension patients. Method: In all, 183 participants were recruited via convenience sampling and rated the understandability, actionability and suitability of the videos using the Patient Education Materials Assessment Tool for Audio-Visual material (PEMAT-A/V) and the Suitability Assessment of Materials (SAM) scale. Results: Eleven videos were developed from five main topics related to the dietary management of hypertension. Participants agreed that all videos were highly understandable, actionable and suitable for use as educational tools, with scores of more than 85%, 89% and 80%, respectively. Conclusion/Implications: Overall, the newly developed videos gained high scores for understandability, actionability and suitability. This finding reflects positive acceptance of the videos among various healthcare professionals and patients with hypertension.

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