scholarly journals Use of Physiological Data From a Wearable Device to Identify SARS-CoV-2 Infection and Symptoms and Predict COVID-19 Diagnosis: Observational Study

10.2196/26107 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e26107 ◽  
Author(s):  
Robert P Hirten ◽  
Matteo Danieletto ◽  
Lewis Tomalin ◽  
Katie Hyewon Choi ◽  
Micol Zweig ◽  
...  
Keyword(s):  
Observational Study ◽  
Predictive Ability ◽  
Mean Amplitude ◽  
Wearable Device ◽  
Physiological Data ◽  
Circadian Pattern ◽  
Mixed Effect ◽  
Normal Sinus ◽  
Nervous System Function ◽  
The Mean

Background Changes in autonomic nervous system function, characterized by heart rate variability (HRV), have been associated with infection and observed prior to its clinical identification. Objective We performed an evaluation of HRV collected by a wearable device to identify and predict COVID-19 and its related symptoms. Methods Health care workers in the Mount Sinai Health System were prospectively followed in an ongoing observational study using the custom Warrior Watch Study app, which was downloaded to their smartphones. Participants wore an Apple Watch for the duration of the study, measuring HRV throughout the follow-up period. Surveys assessing infection and symptom-related questions were obtained daily. Results Using a mixed-effect cosinor model, the mean amplitude of the circadian pattern of the standard deviation of the interbeat interval of normal sinus beats (SDNN), an HRV metric, differed between subjects with and without COVID-19 (P=.006). The mean amplitude of this circadian pattern differed between individuals during the 7 days before and the 7 days after a COVID-19 diagnosis compared to this metric during uninfected time periods (P=.01). Significant changes in the mean and amplitude of the circadian pattern of the SDNN was observed between the first day of reporting a COVID-19–related symptom compared to all other symptom-free days (P=.01). Conclusions Longitudinally collected HRV metrics from a commonly worn commercial wearable device (Apple Watch) can predict the diagnosis of COVID-19 and identify COVID-19–related symptoms. Prior to the diagnosis of COVID-19 by nasal swab polymerase chain reaction testing, significant changes in HRV were observed, demonstrating the predictive ability of this metric to identify COVID-19 infection.

scholarly journals Use of Physiological Data From a Wearable Device to Identify SARS-CoV-2 Infection and Symptoms and Predict COVID-19 Diagnosis: Observational Study (Preprint)

2020 ◽  
Author(s):  
Robert P Hirten ◽  
Matteo Danieletto ◽  
Lewis Tomalin ◽  
Katie Hyewon Choi ◽  
Micol Zweig ◽  
...  
Keyword(s):  
Observational Study ◽  
Predictive Ability ◽  
Mean Amplitude ◽  
Wearable Device ◽  
Physiological Data ◽  
Circadian Pattern ◽  
Mixed Effect ◽  
Normal Sinus ◽  
Nervous System Function ◽  
The Mean

BACKGROUND Changes in autonomic nervous system function, characterized by heart rate variability (HRV), have been associated with infection and observed prior to its clinical identification. OBJECTIVE We performed an evaluation of HRV collected by a wearable device to identify and predict COVID-19 and its related symptoms. METHODS Health care workers in the Mount Sinai Health System were prospectively followed in an ongoing observational study using the custom Warrior Watch Study app, which was downloaded to their smartphones. Participants wore an Apple Watch for the duration of the study, measuring HRV throughout the follow-up period. Surveys assessing infection and symptom-related questions were obtained daily. RESULTS Using a mixed-effect cosinor model, the mean amplitude of the circadian pattern of the standard deviation of the interbeat interval of normal sinus beats (SDNN), an HRV metric, differed between subjects with and without COVID-19 (<i>P</i>=.006). The mean amplitude of this circadian pattern differed between individuals during the 7 days before and the 7 days after a COVID-19 diagnosis compared to this metric during uninfected time periods (<i>P</i>=.01). Significant changes in the mean and amplitude of the circadian pattern of the SDNN was observed between the first day of reporting a COVID-19–related symptom compared to all other symptom-free days (<i>P</i>=.01). CONCLUSIONS Longitudinally collected HRV metrics from a commonly worn commercial wearable device (Apple Watch) can predict the diagnosis of COVID-19 and identify COVID-19–related symptoms. Prior to the diagnosis of COVID-19 by nasal swab polymerase chain reaction testing, significant changes in HRV were observed, demonstrating the predictive ability of this metric to identify COVID-19 infection.

scholarly journals Longitudinal Physiological Data from a Wearable Device Identifies SARS-CoV-2 Infection and Symptoms and Predicts COVID-19 Diagnosis

2020 ◽  
Author(s):  
Robert P. Hirten ◽  
Matteo Danieletto ◽  
Lewis Tomalin ◽  
Katie Hyewon Choi ◽  
Micol Zweig ◽  
...  
Keyword(s):  
Digital Health ◽  
Predictive Ability ◽  
Mean Amplitude ◽  
Wearable Device ◽  
Physiological Data ◽  
Circadian Pattern ◽  
Mixed Effect ◽  
Normal Sinus ◽  
The Mean ◽  
Mount Sinai

ABSTRACTBackgroundChanges in autonomic nervous system function, characterized by heart rate variability (HRV), have been associated with and observed prior to the clinical identification of infection. We performed an evaluation of this metric collected by wearable devices, to identify and predict Coronavirus disease 2019 (COVID-19) and its related symptoms.MethodsHealth care workers in the Mount Sinai Health System were prospectively followed in an ongoing observational study using the custom Warrior Watch Study App which was downloaded to their smartphones. Participants wore an Apple Watch for the duration of the study measuring HRV throughout the follow up period. Survey’s assessing infection and symptom related questions were obtained daily.FindingsUsing a mixed-effect COSINOR model the mean amplitude of the circadian pattern of the standard deviation of the interbeat interval of normal sinus beats (SDNN), a HRV metric, differed between subjects with and without COVID-19 (p=0.006). The mean amplitude of this circadian pattern differed between individuals during the 7 days before and the 7 days after a COVID-19 diagnosis compared to this metric during uninfected time periods (p=0.01). Significant changes in the mean MESOR and amplitude of the circadian pattern of the SDNN was observed between the first day of reporting a COVID-19 related symptom compared to all other symptom free days (p=0.01).InterpretationLongitudinally collected HRV metrics from a commonly worn commercial wearable device (Apple Watch) can identify the diagnosis of COVID-19 and COVID-19 related symptoms. Prior to the diagnosis of COVID-19 by nasal PCR, significant changes in HRV were observed demonstrating its predictive ability to identify COVID-19 infection.FundingSupport was provided by the Ehrenkranz Lab For Human Resilience, the BioMedical Engineering and Imaging Institute, The Hasso Plattner Institute for Digital Health at Mount Sinai, The Mount Sinai Clinical Intelligence Center and The Dr. Henry D. Janowitz Division of Gastroenterology.

scholarly journals Lower Interstitial Glucose Concentrations but Higher Glucose Variability during Low-Energy Diet Compared to Regular Diet—An Observational Study in Females with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3687
Author(s):  
Inger Nilsen ◽  
Agneta Andersson ◽  
Anna Laurenius ◽  
Johanna Osterberg ◽  
Magnus Sundbom ◽  
...  
Keyword(s):  
Observational Study ◽  
Dietary Intake ◽  
Area Under The Curve ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Low Energy ◽  
Regular Diet ◽  
Interstitial Glucose ◽  
The Mean ◽  
Low Energy Diet

This is an observational study of interstitial glucose (IG) concentrations, IG variability and dietary intake under free-living conditions in 46 females with obesity but without diabetes. We used continuous glucose monitoring, open-ended food recording and step monitoring during regular dietary intake followed by a low-energy diet (LED). Thirty-nine participants completed both study periods. The mean BMI at baseline was 43.6 ± 6.2 kg/m2. Three weeks of LED resulted in a mean weight loss of 5.2% with a significant reduction in diurnal IG concentration but with greater glycemic variability observed during LED. The mean 24 h IG concentration decreased from 5.8 ± 0.5 mmol/L during the regular diet period to 5.4 ± 0.5 mmol/L (p < 0.001) during LED, while the mean amplitude of glycemic excursion increased from 1.5 ± 0.7 to 1.7 ± 0.7 mmol/L (p = 0.031). The positive incremental area under the curve at breakfast was significantly larger for LED compared to regular diet. The daily fiber intake and the glycemic index of breakfast meals were significantly associated with the glycemic variability during regular dietary intake. In conclusion, the 24 h mean IG concentration was lower but with more pronounced glycemic variability during LED compared to a regular diet.

scholarly journals Exercise Intensity during Olympic-Distance Triathlon in Well-Trained Age-Group Athletes: An Observational Study

Sports ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 18
Author(s):  
Atsushi Aoyagi ◽  
Keisuke Ishikura ◽  
Yoshiharu Nabekura
Keyword(s):  
Heart Rate ◽  
Observational Study ◽  
Exercise Intensity ◽  
Time Range ◽  
Age Group ◽  
Slow Group ◽  
H 41 ◽  
The Mean ◽  
Aerobic And Anaerobic ◽  
Very High

The aim of this study was to examine the exercise intensity during the swimming, cycling, and running legs of nondraft legal, Olympic-distance triathlons in well-trained, age-group triathletes. Seventeen male triathletes completed incremental swimming, cycling, and running tests to exhaustion. Heart rate (HR) and workload corresponding to aerobic and anaerobic thresholds, maximal workloads, and maximal HR (HRmax) in each exercise mode were analyzed. HR and workload were monitored throughout the race. The intensity distributions in three HR zones for each discipline and five workload zones in cycling and running were quantified. The subjects were then assigned to a fast or slow group based on the total race time (range, 2 h 07 min–2 h 41 min). The mean percentages of HRmax in the swimming, cycling, and running legs were 89.8% ± 3.7%, 91.1% ± 4.4%, and 90.7% ± 5.1%, respectively, for all participants. The mean percentage of HRmax and intensity distributions during the swimming and cycling legs were similar between groups. In the running leg, the faster group spent relatively more time above HR at anaerobic threshold (AnT) and between workload at AnT and maximal workload. In conclusion, well-trained male triathletes performed at very high intensity throughout a nondraft legal, Olympic-distance triathlon race, and sustaining higher intensity during running might play a role in the success of these athletes.

Kidney function decline is associated with an accelerated increase in plasma homocysteine in older adults: a longitudinal study

2021 ◽  
pp. 1-21
Author(s):  
Hui Zhang ◽  
Yi Li ◽  
Meng Hao ◽  
Xiaoyan Jiang ◽  
Jiucun Wang ◽  
...  
Keyword(s):  
Kidney Function ◽  
Repeated Measurements ◽  
Baseline Survey ◽  
Mixed Effect ◽  
Pronounced Increase ◽  
Crude Model ◽  
The Mean ◽  
Kidney Function Decline ◽  
Over Time

Abstract Background: Few studies have been conducted to investigate the association of kidney function decline with the trajectories of homocysteine (Hcy) over time, using repeated measurements. We aimed to investigate the association of kidney function with changes in plasma Hcy levels over time. Methods: Data were collected from the Rugao Longevity and Ageing Study. In detail, plasma Hcy and creatinine levels were measured in both waves (waves 2, 3 and 4) during the 3.5-year follow-up (N = 1135). Wave 2 was regarded as the baseline survey. The estimated glomerular filtration rate (eGFR) was calculated based on creatinine. Subjects were categorized into four groups according to quartiles of eGFR at baseline. Linear mixed-effect models were used to investigate the association of eGFR with subsequent plasma Hcy levels. Results: The mean eGFR at baseline was 90.84 (11.42) mL/min/1.73 m2. The mean plasma Hcy level was 14.09 (6.82) at baseline and increased to 16.28 (8.27) and 17.36 (10.39) μmol/L during follow-ups. In the crude model, the interaction between time and eGFR at baseline was significant (β = −0.02, 95% CI: −0.02 to −0.01, p = 0.002). After adjusting for confounding factors, a significant relationship remained (β = −0.02, 95% CI: −0.02 to −0.01, p = 0.003), suggesting that kidney function decline at baseline was associated with a faster increase in Hcy levels. Conclusion: Kidney function decline is associated with a more pronounced increase in plasma Hcy levels. Further studies with longer follow-up periods and larger sample sizes are needed to validate our findings.

Quantitative analysis of static equilibrium in women after mastectomy

2014 ◽  
Vol 14 (1) ◽  
pp. 81-87
Author(s):  
Maciej Rachwał ◽  
Justyna Drzał-Grabiec ◽  
Katarzyna Walicka-Cupryś ◽  
Aleksandra Truszczyńska
Keyword(s):  
Mean Amplitude ◽  
Control Group ◽  
Foot Pressure ◽  
Locomotor System ◽  
Center Of Foot Pressure ◽  
The Mean ◽  
Almost All ◽  
Posture Stability ◽  
Mastectomy Group ◽  
Better Than

Abstract Background: The post-mastectomy changes to the locomotor system are related to the scar and adhesion or to the lymphatic edema after amputation which, in turn, lead to local and global distraction of the work of the muscles. These changes lead to body statics disturbance that changes the projection of the center of gravity and worsens motor response due to changing of the muscle sensitivity. Objective: The aim of the study was to evaluate the static balance of women after undergoing mastectomy. Methods: The study included 150 women, including 75 who underwent mastectomy (mean age: 60±7.6) years, mean body mass index (BMI): 26 (±3.6) kg/m2) and 75 who were placed in the control group with matched age and BMI. The study was conducted using a tensometric platform. Results: Statistically significant differences were found for almost all parameters between the post-mastectomy group and group of healthy women, regarding center of foot pressure (COP) path length in the Y and X axes and the mean amplitude of COP. Conclusions: First, the findings revealed that balance in post-mastectomy women is significantly better than in the control group. Second, physiotherapeutic treatment of post-mastectomy women may have improved their posture stability compared with their peers.

Growth of fingers at an unstable diffusing interface in a porous medium or Hele-Shaw cell

1969 ◽  
Vol 39 (3) ◽  
pp. 477-495 ◽  
Author(s):  
R. A. Wooding
Keyword(s):  
Porous Medium ◽  
Numerical Solutions ◽  
Hyperbolic Equations ◽  
Saturated Porous Medium ◽  
Mean Amplitude ◽  
Wave Number ◽  
Two Fluids ◽  
Averaged Equations ◽  
The Mean ◽  
Hele Shaw Cell

Waves at an unstable horizontal interface between two fluids moving vertically through a saturated porous medium are observed to grow rapidly to become fingers (i.e. the amplitude greatly exceeds the wavelength). For a diffusing interface, in experiments using a Hele-Shaw cell, the mean amplitude taken over many fingers grows approximately as (time)2, followed by a transition to a growth proportional to time. Correspondingly, the mean wave-number decreases approximately as (time)−½. Because of the rapid increase in amplitude, longitudinal dispersion ultimately becomes negligible relative to wave growth. To represent the observed quantities at large time, the transport equation is suitably weighted and averaged over the horizontal plane. Hyperbolic equations result, and the ascending and descending zones containing the fronts of the fingers are replaced by discontinuities. These averaged equations form an unclosed set, but closure is achieved by assuming a law for the mean wave-number based on similarity. It is found that the mean amplitude is fairly insensitive to changes in wave-number. Numerical solutions of the averaged equations give more detailed information about the growth behaviour, in excellent agreement with the similarity results and with the Hele-Shaw experiments.

Do methods of hospital pre-alerts influence the on-scene times for acute pre-hospital stroke patients? A retrospective observational study

2021 ◽  
Vol 6 (2) ◽  
pp. 19-25
Author(s):  
Jacob Gunn
Keyword(s):  
Standard Deviation ◽  
Observational Study ◽  
Acute Stroke ◽  
Ambulance Service ◽  
Time Saving ◽  
North East ◽  
Admission Policies ◽  
The Mean ◽  
Time Critical ◽  
Mean Time

Introduction: Stroke is one of the leading causes of death and disability worldwide. The ambulance service is often the first medical service to reach an acute stroke patient, and due to the time-critical nature of stroke, a time-critical assessment and rapid transport to a hyper acute stroke unit are essential. As stroke services have been centralised, different hospitals have implemented different pre-alert admission policies that may affect the on-scene time of the attending ambulance crew. The aim of this study is to investigate if the different pre-alert admission policies affect time on scene.Method: The current study is a retrospective quantitative observational study using data routinely collected by North East Ambulance Service NHS Foundation Trust. The time on scene was divided into two variables; group one was a telephone pre-alert in which a telephone discussion with the receiving hospital is required before they accept admission of the patient. Group two was a radio-style pre-alert in which the attending clinician makes an autonomous decision on the receiving hospital and alerts them via a short radio message of the incoming patient. These times were then compared to identify if there was any difference between them.Results: Data on 927 patients over a three-month period, from October to December 2019, who had received the full stroke bundle of care, were within the thrombolysis window and recorded as a stroke by the attending clinician, were split into the variable groups and reported on. The mean time on scene for a telephone call pre-alert was 33 minutes and 19 seconds, with a standard deviation of 13 minutes and 8 seconds. The mean on-scene time for a radio pre-alert was 28 minutes and 24 seconds, with a standard deviation of 11 minutes and 51 seconds.Conclusion: A pre-alert given via radio instead of via telephone is shown to have a mean time saving of 4 minutes and 55 seconds, representing an important decrease in time which could be beneficial to patients.

Complications of the Mustard Operation

1986 ◽  
Vol 8 (4) ◽  
pp. 106-126
Keyword(s):  
Heart Block ◽  
Normal Sinus Rhythm ◽  
Venous Blood ◽  
Resting Heart Rate ◽  
Normal Sinus ◽  
Mustard Operation ◽  
Mitral Orifice ◽  
The Mean ◽  
Degree Heart Block

Eight pediatric cardiac centers pooled clinical and ECG data from 372 patients who survived the Mustard operation (intraatrial baffle directing pulmonary venous blood to the tricuspid orifice and systemic venous blood to the mitral orifice) for at least 3 months. The follow-up period ranged from 0.4 to 15.9 years, and the mean age at operation was 2 years. The mean resting heart rate for patients who had the Mustard operation was consistently lower than age-matched controls. During the year of operation, 76% of patients had normal sinus rhythm; this percentage declined yearly to 57% by the end of the eighth postoperative year. Active arrhythmias increased after the tenth year. Second or third-degree heart block occurred in 33% of patients during the year of operation and changed very little thereafter. Of the total 372 patients, 39 received pacemakers, 52% during the year of surgery and 48% evenly distributed throughout the follow-up period.

scholarly journals STROKE OUTCOMES IN NON-DIABETIC, DENOVO DIABETIC AND DIABETIC INDIAN PATIENTS MEASURED BY MODIFIED RANKIN SCALE: AN OBSERVATIONAL STUDY

2017 ◽  
Vol 9 (8) ◽  
pp. 94
Author(s):  
Syed Junaid Ahmed ◽  
Abdur Rahman Mohd Masood ◽  
Safiya Sumana ◽  
Khadeer Ahmed Ghori ◽  
Javed Akhtar Ansari ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Observational Study ◽  
Hospital Admission ◽  
Acute Stroke ◽  
Mean Difference ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Mean

Objective: Hyperglycemia is a known risk factor which adversely impacts the outcomes in stroke patients compared to patients with normal blood glucose levels. Patients suffering from an acute stroke who are previously nonhyperglycemic may show elevated blood glucose levels. The present study was designed to measure the outcomes in denovo diabetic and diabetic stroke patients compared to nondiabetics.Methods: A prospective observational study over a period of 6 mo, in which 103 patients were divided into three cohorts based on their blood glucose levels (nondiabetic, denovo diabetic and diabetics). The modified Rankin scale (mRS) score was calculated at in-hospital admission and discharge in these three cohorts. The initial and final scores were correlated and mean differences with respect to outcomes between all the three cohorts was calculated.Results: The mean mRS at the time of hospital admission in diabetics and nondiabetics was 3.6±0.81 and 3.3±0.78 which decreased to 2.8±0.95 and 2.9±0.83 respectively at the time of discharge. The mean mRS score in denovo diabetic stroke patients during in-hospital admission was 4±0.81 which was calculated as 3.7±0.85 at the time of discharge. The mean difference in mRS score in diabetics vs non-diabetics was found to be 0.73±0.8 (p =<0.001). The mean difference in mRS score of denovo diabetics vs non-diabetics and denovo diabetics vs diabetics was 0.30±0.63 and 0.38±0.61 respectively (p = 0.1).Conclusion: Results of these observational study in Indian patients, highlights the need for controlling hyperglycemia in stroke patients to improve outcomes and to prevent mortality arising out of acute stroke attacks.

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