scholarly journals NE-Motion: Visual Analysis of Stroke Patients Using Motion Sensor Networks

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4482
Author(s):  
Rodrigo Colnago Contreras ◽  
Avinash Parnandi ◽  
Bruno Gomes Coelho ◽  
Claudio Silva ◽  
Heidi Schambra ◽  
...  
Keyword(s):  
Visual Analysis ◽  
Treatment Strategies ◽  
Motion Capture Data ◽  
Motion Sensors ◽  
Healthy Individuals ◽  
Stroke Patients ◽  
Close Collaboration ◽  
Domain Experts ◽  
Bedside Test ◽  
Detailed Assessment

A large number of stroke survivors suffer from a significant decrease in upper extremity (UE) function, requiring rehabilitation therapy to boost recovery of UE motion. Assessing the efficacy of treatment strategies is a challenging problem in this context, and is typically accomplished by observing the performance of patients during their execution of daily activities. A more detailed assessment of UE impairment can be undertaken with a clinical bedside test, the UE Fugl–Meyer Assessment, but it fails to examine compensatory movements of functioning body segments that are used to bypass impairment. In this work, we use a graph learning method to build a visualization tool tailored to support the analysis of stroke patients. Called NE-Motion, or Network Environment for Motion Capture Data Analysis, the proposed analytic tool handles a set of time series captured by motion sensors worn by patients so as to enable visual analytic resources to identify abnormalities in movement patterns. Developed in close collaboration with domain experts, NE-Motion is capable of uncovering important phenomena, such as compensation while revealing differences between stroke patients and healthy individuals. The effectiveness of NE-Motion is shown in two case studies designed to analyze particular patients and to compare groups of subjects.

TV-MV Analytics: A visual analytics framework to explore time-varying multivariate data

2019 ◽  
Vol 19 (1) ◽  
pp. 3-23
Author(s):  
Aurea Soriano-Vargas ◽  
Bernd Hamann ◽  
Maria Cristina F de Oliveira
Keyword(s):  
Visual Analytics ◽  
Visual Analysis ◽  
Multivariate Data ◽  
Visual Exploration ◽  
Data Sets ◽  
Time Varying ◽  
Domain Experts ◽  
Data Mining Algorithms ◽  
Temporal Relationships ◽  
Visualization Techniques

We present an integrated interactive framework for the visual analysis of time-varying multivariate data sets. As part of our research, we performed in-depth studies concerning the applicability of visualization techniques to obtain valuable insights. We consolidated the considered analysis and visualization methods in one framework, called TV-MV Analytics. TV-MV Analytics effectively combines visualization and data mining algorithms providing the following capabilities: (1) visual exploration of multivariate data at different temporal scales, and (2) a hierarchical small multiples visualization combined with interactive clustering and multidimensional projection to detect temporal relationships in the data. We demonstrate the value of our framework for specific scenarios, by studying three use cases that were validated and discussed with domain experts.

scholarly journals Antibiotic prophylaxis for prevention against Lyme disease following tick bite: an updated systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guozhong Zhou ◽  
Xin Xu ◽  
Yu Zhang ◽  
Peng Yue ◽  
Shiqi Luo ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Antibiotic Prophylaxis ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Tick Bite ◽  
Cochrane Library ◽  
Control Group ◽  
Sufficient Power ◽  
Detailed Assessment ◽  
Meta Analyses

Abstract Background In areas where Lyme disease is endemic, bites from ticks are common, but no vaccine is currently available against Lyme disease for humans. Therefore, the feasibility of using antibiotic prophylaxis to prevent Lyme disease after a tick bite is worth further exploration. Previous meta-analyses lack sufficient power to demonstrate the efficacy of about antibiotic prophylaxis for the prevention of Lyme disease following a tick bite. In this study, we explored more precise evidence and attempted to identify and update optimum treatment strategies. Methods We searched PubMed, Embase, and the Cochrane Library for studies until March 23, 2021. We included studies if the enrolled patients were randomly allocated to a treatment or control group within 72 h following a tick bite and had no clinical evidence of Lyme disease at enrolment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed for data abstraction. Two authors (GZZ and XX) independently reviewed the abstracts and identified articles for detailed assessment. We used a random-effects model to calculate the pooled results and reported the 95% confidence interval (CI). Study quality was assessed using a modified Jadad scale, and publication bias was assessed using Egger’s test. We calculated the risk ratio (RR) for the rates of unfavorable events in patients who received intervention versus the control group. This study is registered with PROSPERO, number CRD42021245002. Results Six studies (3,766 individuals) were included. The pooled rate of unfavorable events in persons receiving treatment and the control group were 0.4% (95%CI: 0.1–1.1%) and 2.2% (95%CI: 1.6–3.0%), respectively. The pooled RR was 0.38 (95%CI: 0.22–0.66). Subgroup analysis revealed that the pooled RR was 0.29 (95%CI: 0.14–0.60) in the single-use 200-mg doxycycline group; 0.28 (95%CI: 0.05–1.67) in a 10-day course group (Amoxicillin, Penicillin or tetracycline); and 0.73 (95%CI: 0.25–2.08) in a topical antibiotic treatment group (Azithromycin). Conclusions The available evidence supports the use of antibiotics for the prevention of Lyme disease, and reveals advantages of using single-dose; however, further confirmation is needed.

scholarly journals Value of the Frontal Assessment Battery Tool for Assessing the Frontal Lobe Function in Stroke Patients

2020 ◽  
Vol 44 (4) ◽  
pp. 261-272
Author(s):  
Mihyang Han ◽  
Da-Ye Kim ◽  
Ja-Ho Leigh ◽  
Min-Wook Kim
Keyword(s):  
Frontal Lobe ◽  
Mmse Score ◽  
Treatment Strategies ◽  
Correlation Coefficients ◽  
Imaging Study ◽  
Frontal Lobe Dysfunction ◽  
Frontal Assessment Battery ◽  
Stroke Patients ◽  
Assessment Battery ◽  
Frontal Lobe Function

Objective To examine the correlation between the Frontal Assessment Battery (FAB) test, which is used to assess the frontal lobe function, and anatomical lesions as well as the ability of the test to detect frontal lobe dysfunction.Methods Records of stroke patients undergoing a FAB test and Mini-Mental State Examination (MMSE) were retrospectively reviewed. The patients were divided into three groups according to the lesions determined by an imaging study: frontal lobe cortex lesions, frontal subcortical circuit lesions, and other lesions. The FAB scores of the three groups were compared using the Kruskal-Wallis test. The validity of the FAB test to detect frontal lobe dysfunction was assessed by a comparison with the Computerized Neuropsychological Function Test (CNT) using the Spearman correlation coefficient. The correlation coefficients between the FAB test and MMSE were analyzed further based on the MMSE cutoff score.Results Patients with frontal cortex lesions had significantly lower total and subtest scores according to the FAB test than the other patients. The FAB test correlated better with the CNT than the MMSE, particularly in the executive function and memory domains. A high MMSE score (r=0.435) indicated a lower correlation with the FAB test score than a low MMSE score (r=0.714).Conclusion The FAB test could differentiate frontal lobe lesions from others in stroke patients and showed a good correlation with the CNT. Moreover, the FAB test can be used in patients with high MMSE scores to detect frontal lobe dysfunction and determine the treatment strategies for stroke patients.

scholarly journals Predicting the future development of mild cognitive impairment in the cognitively healthy elderly

2020 ◽  
Author(s):  
Bryan Strange ◽  
Linda Zhang ◽  
Alba Sierra-Marcos ◽  
Eva Alfayate ◽  
Jussi Tohka ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Memory ◽  
Statistical Tests ◽  
Treatment Strategies ◽  
Area Under The Curve ◽  
Predictive Performance ◽  
Healthy Individuals ◽  
Healthy Elderly ◽  
Out Of Sample

Identifying measures that predict future cognitive impairment in healthy individuals is necessary to inform treatment strategies for candidate dementia-preventative and modifying interventions. Here, we derive such measures by studying converters who transitioned from cognitively normal at baseline to mild-cognitive impairment (MCI) in a longitudinal study of 1213 elderly participants. We first establish reduced grey matter density (GMD) in left entorhinal cortex (EC) as a biomarker for impending cognitive decline in healthy individuals, employing a matched sampling control for several dementia risk-factors, thereby mitigating the potential effects of bias on our statistical tests. Next, we determine the predictive performance of baseline demographic, genetic, neuropsychological and MRI measures by entering these variables into an elastic net-regularized classifier. Our trained statistical model classified converters and controls with validation Area-Under-the-Curve>0.9, identifying only delayed verbal memory and left EC GMD as relevant predictors for classification. This performance was maintained on test classification of out-of-sample converters and controls. Our results suggest a parsimonious but powerful predictive model for MCI development in the cognitively healthy elderly.

scholarly journals VOLARE: Visual analysis of disease-associated microbiome-immune system interplay

2018 ◽  
Author(s):  
Janet C. Siebert ◽  
Charles Preston Neff ◽  
Jennifer M. Schneider ◽  
EmiLie H. Regner ◽  
Neha Ohri ◽  
...  
Keyword(s):  
Immune System ◽  
Web Application ◽  
Visual Analysis ◽  
System Development ◽  
Patient Specific ◽  
Domain Experts ◽  
Immune System Development ◽  
Interactive Environment ◽  
System Logs ◽  
Linear Regressions

AbstractBackgroundRelationships between specific microbes and proper immune system development, composition, and function have been reported in a number of studies. However, researchers have discovered only a fraction of the likely relationships. High-dimensional “omic” methodologies such as 16S ribosomal RNA (rRNA) sequencing and Time-of-flight mass cytometry (CyTOF) immunophenotyping generate data that support generation of hypotheses, with the potential to identify additional relationships at a level of granularity ripe for further experimentation. Pairwise linear regressions between microbial and host immune features is one approach for quantifying relationships between “omes”, and the differences in these relationships across study cohorts or arms. This approach yields a top table of candidate results. However, the top table alone lacks the detail that domain experts need to vet candidate results for follow-up experiments.ResultsTo support this vetting, we developed VOLARE (Visualization Of LineAr Regression Elements), a web application that integrates a searchable top table, small in-line graphs illustrating the fitted models, a network summarizing the top table, and on-demand detailed regression plots showing full sample-level detail. We applied VOLARE to three case studies—microbiome:cytokine data from fecal samples in HIV, microbiome:cytokine data in inflammatory bowel disease and spondyloarthritis, and microbiome:immune cell data from gut biopsies in HIV. We present both patient-specific phenomena and relationships that differ by disease state. We also analyzed interaction data from system logs to characterize usage scenarios. This log analysis revealed that, in using VOLARE, domain experts frequently generated detailed regression plots, suggesting that this detail aids the vetting of results.ConclusionsSystematically integrating microbe:immune cell readouts through pairwise linear regressions and presenting the top table in an interactive environment supports the vetting of results for scientific relevance. VOLARE allows domain experts to control the analysis of their results, screening dozens of candidate relationships with ease. This interactive environment transcends the limitations of a static top table.

Hyperthermia Exacerbates Ischaemic Brain Injury

2009 ◽  
Vol 4 (4) ◽  
pp. 274-284 ◽  
Author(s):  
C. X. Wang ◽  
A. Stroink ◽  
J. M. Casto ◽  
K. Kattner
Keyword(s):  
Brain Injury ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Future Research ◽  
Preclinical Studies ◽  
Stroke Patients ◽  
Research Directions ◽  
Ischaemic Brain ◽  
Future Research Directions ◽  
Ischaemic Brain Injury

Hyperthermia frequently occurs in stroke patients. Hyperthermia negatively correlates with clinical outcome and adversely effects treatment regiments otherwise successful under normothermic conditions. Preclinical studies also demonstrate that hyperthermia converts salvageable penumbra to ischaemic infarct. The present article reviews the knowledge accumulated from both clinical and preclinical studies about hyperthermia and ischaemic brain injury, examines current treatment strategies and discusses future research directions.

Abstract 3000: Epidemiology of Cerebrovascular Diseases Among Chinese with Diabetes Mellitus in Toronto: A Retrospective Ten Years Case-mix Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Susy Lam ◽  
Joseph Y Chu
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Stroke Patients ◽  
Stroke Incidence ◽  
Small Vessels ◽  
Guideline Values ◽  
Co Morbidity ◽  
Stroke Type

BACKGROUND: An article published in Neurology Asia(2006;11:13-18) by Chu etal provided essential data to investigate whether specific genetic or environmental differences exist within the diabetic-Chinese stroke community. Insight into distinctive epidemiologic and cerebrovascular patterns will bring forth effectively focused treatment and prevention. From that basis, we hypothesized: Chinese who had stroke-history within 15 years are more commonly diabetic than Europeans, and Chinese more frequently have small vessels disease (SVD) than Europeans. METHODS: Patients seen during 2001-2011 at the Toronto Queensway Professional Center Neurology clinic and at William Osler Health System, Brampton Site, were investigated. Chinese diabetic stroke patients were selected by last name and birth country; similarly diagnosed European patients were age-sex matched correspondingly. Risk factors were acknowledged if patients were given explicit medical treatments. Otherwise, guideline values were obtained from the WHO criteria. Data was collected through screening patient charts for the following: diabetic prevalence through screening stroke patients (122 Chinese, 880 European) excluding TIAs, subarachnoid and subdural haemorrhages; etiology and stroke type comparison in patients with DM (48 Chinese, 127 European); risk factors differences between Chinese and Europeans with DM. Odds ratios and unpaired two-sample t-testing were used to confirm significance. RESULTS: Significance confirmed (P<0.05): Chinese had higher DM and stroke incidence than Europeans (28.7% vs. 23.2%). Diabetic Chinese more frequently had SVD (51.1% vs. 44.1%), specifically lacunar stroke (47.9% vs. 36.4%). The co-morbidity of SVD risk factors of hypertension, hyperlipidemia and overweight were more frequent in Chinese (Table 1.0). Furthermore, SVD frequency dominated over large vessels disease (LVD) in the Chinese (Table 1.1). Table 1.0 - RISK FACTOR INCIDENCE Overweight HBP HPL Chinese, SVD 26.9% 53.8% 36.5% European, SVD 16.5% 33.1% 23.6% OR Chinese/Euro.1.86 2.36 1.86 Table 1.1 - STROKE TYPE AND RISK Overweight, SVD Overweight, LVD Hyperlipidemia, SVD Hyperlipidemia, LVD Hypertension, SVD Hypertension, LVD : Chinese 26.9% 7.7% 36.5% 15.0% 53.8% 25.0% OR SVD/LVD 4.42 3.26 3.50 European 16.5% 7.9% 23.6% 15.0% 33.1% 26.0% OR SVD/LVD 2.32 1.76 1.41 CONCLUSIONS: Chinese with stroke are more frequently diabetic than Europeans. Diabetic Chinese are especially susceptible to small vessels disease and certain stroke risk factors are more frequent compared to the Europeans. Risk factor prevalence and stroke types differ considerably between Chinese and Europeans within Toronto, which may imply that specific treatment strategies are required to target towards each population.

Abstract P542: Management and Outcome of Stroke Patients With Tandem Carotid Occlusion in the ESCAPE NA1-Trial

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Martha Marko ◽  
Petra Cimflova ◽  
Nishita Singh ◽  
Johanna Ospel ◽  
Nima Kashani ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Carotid Stenting ◽  
Carotid Occlusion ◽  
Catheter Angiography ◽  
Stroke Patients ◽  
Treatment Allocation ◽  
Tandem Occlusion ◽  
Stent Treatment ◽  
Selection Of Patients ◽  
Selection Of

Background: The optimal treatment for stroke patients with tandem cervical carotid occlusion is debated. We analyzed the treatment strategies and outcomes of tandem occlusion patients in the ESCAPE NA1 trial. Methods: ESCAPE NA1 was a multicenter international randomized trial of nerinetide vs. placebo in patients with acute ischemic stroke who underwent EVT. We defined tandem occlusions as complete occlusion of the cervical ICA on catheter angiography. The influence of tandem occlusions on outcome was analyzed using regression modeling with adjustment for age, sex, baseline NIHSS and ASPECTS, occlusion location, thrombolysis and treatment allocation. Results: 115 of 1105 patients (10.4%) had tandem occlusions. 73/115 tandem patients (66.0%) received treatment for the cervical occlusion: 21.9% were stented before thrombectomy, 68.5% were stented after thrombectomy, and 8.2% had angioplasty alone. Successful reperfusion was significantly higher in patients who had thrombectomy first followed by carotid treatment (eTICI 2b-3: 40/40 (100.0%)) or carotid angioplasty before and cervical stent after intracranial thrombectomy (9/10 (90.0%)) compared to carotid intervention before intracranial thrombectomy: (19/23 (82.1%), p=0.016). 90-day mRS 0-2 was achieved in 82/115 patients (71.3%) with tandem occlusions (treated occlusions: 74.0%, untreated: 66.7%) compared to 579/981 (59.5%) patients without tandem occlusions. In adjusted analysis, tandem occlusion was not predictive of outcome. In the subgroup of tandem patients, cervical stent-treatment was nominally associated with better outcomes (OR 2.2, 95% CI 0.5 - 9.2). Conclusion: Cervical carotid stenting may improve outcomes for EVT patients with tandem occlusions, but these results are limited by the sample size and non-randomized selection of patients for stenting.

scholarly journals Dementia Patient Segmentation Using EMR Data Visualization: A Design Study

2019 ◽  
Vol 16 (18) ◽  
pp. 3438 ◽  
Author(s):  
Hyoji Ha ◽  
Jihye Lee ◽  
Hyunwoo Han ◽  
Sungyun Bae ◽  
Sangjoon Son ◽  
...  
Keyword(s):  
Medical Record ◽  
Visual Analysis ◽  
Qualitative Evaluation ◽  
Record Management ◽  
Radial Coordinate ◽  
Dementia Patient ◽  
Biomedical Data ◽  
Record System ◽  
Efficient Treatment ◽  
Domain Experts

(1) Background: The Electronic Medical Record system, which is a digital medical record management architecture, is critical for reliable medical research. It facilitates the investigation of disease patterns and efficient treatment via collaboration with data scientists. (2) Methods: In this study, we present multidimensional visual tools for the analysis of multidimensional datasets via a combination of 3-dimensional radial coordinate visualization (3D RadVis) and many-objective optimization (e.g., Parallel Coordinates). Also, we propose a user-driven research design to facilitate visualization. We followed a design process to (1) understand the demands of domain experts, (2) define the problems based on relevant works, (3) design visualization, (4) implement visualization, and (5) enable qualitative evaluation by domain experts. (3) Results: This study provides clinical insight into dementia based on EMR data via visual analysis. Results of a case study based on questionnaires surveying daily living activities indicated that daily behaviors influenced the progression of dementia. (4) Conclusions: This study provides a visual analytical tool to support cluster segmentation. Using this tool, we segmented dementia patients into clusters and interpreted the behavioral patterns of each group. This study contributes to biomedical data interpretation based on a visual approach.

scholarly journals Trials in Sleep Apnea and Stroke

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 366-372
Author(s):  
Mark I. Boulos ◽  
Laavanya Dharmakulaseelan ◽  
Devin L. Brown ◽  
Richard H. Swartz
Keyword(s):  
Sleep Apnea ◽  
Randomized Controlled Trials ◽  
Treatment Strategies ◽  
Lessons Learned ◽  
Controlled Trials ◽  
Stroke Patients ◽  
Vascular Events ◽  
Randomized Controlled ◽  
Obstructive Sleep

Few randomized controlled trials have evaluated the effectiveness of continuous positive airway pressure (CPAP) in reducing recurrent vascular events and mortality in poststroke obstructive sleep apnea (OSA). To date, results have been mixed, most studies were underpowered and definitive conclusions are not available. Using lessons learned from prior negative trials in stroke, we reappraise prior randomized controlled trials that examined the use of CPAP in treating poststroke OSA and propose the following considerations: (1) Intervention-based changes, such as ensuring that patients are using CPAP for at least 4 hours per night (eg, through use of improvements in CPAP technology that make it easier for patients to use), as well as considering alternative treatment strategies for poststroke OSA; (2) Population-based changes (ie, including stroke patients with severe and symptomatic OSA and CPAP noncompliers); and (3) Changes to timing of intervention and follow-up (ie, early initiation of CPAP therapy within the first 48 hours of stroke and long-term follow-up calculated in accordance with sample size to ensure adequate power). Given the burden of vascular morbidity and mortality in stroke patients with OSA, there is a strong need to learn from past negative trials and explore innovative stroke prevention strategies to improve stroke-free survival.

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