MULTI-AGENT INTELLIGENT SYSTEM FOR PREDICTION OF RISK OF CARDIOVASCULAR COMPLICATIONS WITH SYNERGY CHANNELS

Author(s):  
Ольга Владимировна Шаталова ◽  
Дмитрий Андреевич Медников ◽  
Зейнаб Усама Протасова

Цель исследования заключается в повышении качества прогнозирования ишемической болезни сердца путем учета синергетического эффекта наличия сопутствующих заболеваний и факторов профессиональной среды посредством многоагентных интеллектуальных систем. Методы исследования. Для прогнозирования ишемической болезни сердца предложена базовая структура многоагентной интеллектуальной системы, содержащая «сильные» и «слабые» классификаторы. При этом «слабые» классификаторы разделены на четыре группы, первая из которых осуществляет анализ данных, полученных на основе традиционных факторов риска ишемической болезни сердца, вторая - на основе анализа электрокардиологических исследований, третья группа «слабых» классификаторов предназначена для диагностики сопутствующих заболеваний и синдромов по предикторам, используемых первыми двумя группами агентов, а четвертая - анализирует факторы риска окружающей среды. Мультиагентная система позволяет управлять процессом принятия решений посредством сочетания экспертных оценок, статистических данных и текущей информации. Результаты. Проведены экспериментальные исследования различных модификаций предложенной модели классификатора, заключающихся в последовательном исключении из агрегатора решений «слабых» классификаторов на различных иерархических уровнях. В ходе экспериментального оценивания и в результате математического моделирования было показано, что при использовании всех информативных признаков уверенность в правильном прогнозе по риску ишемической болезни сердца превышает величину 0,8. Показатели качества прогнозирования выше, чем у известной системы прогнозирования ишемической болезни сердца - превышает SCORE, в среднем, на 14%. Выводы. Анализ показателей качества классификации в экспериментальной группе обследуемых с различным показателем ишемического риска и в контрольной группе, составленной из машинистов электролокомотивов, для которых релевантными показателями ишемических рисков являются вибрационная болезнь и пребывание в электромагнитных полях, показал, что учет влияния этих факторов риска в контрольной группе повышает диагностическую эффективность на семь процентов по сравнению с экспериментальной группой, выступающей как фоновая The aim of the study is to improve the quality of predicting coronary heart disease by taking into account the synergistic effect of the presence of concomitant diseases and occupational factors through multi-agent intelligent systems. Research methods. To predict coronary heart disease, a basic structure of a multi-agent intelligent system is proposed, which contains “strong” and “weak” classifiers. At the same time, the "weak" classifiers are divided into four groups, the first of which analyzes data obtained on the basis of traditional risk factors for coronary heart disease, the second - based on the analysis of electrocardiological studies, the third group of "weak" classifiers is intended for the diagnosis of concomitant diseases and syndromes based on predictors used by the first two groups of agents, and the fourth analyzes environmental risk factors. The mobile system allows you to manage the decision-making process through a combination of expert assessments, statistical data and current information. Results. Experimental studies of various modifications of the proposed model of the classifier, consisting in the sequential exclusion from the aggregator of decisions of "weak" classifiers at various hierarchical levels, have been carried out. In the course of experimental evaluation and as a result of mathematical modeling, it was shown that when using all informative signs, the confidence in the correct forecast for the risk of coronary heart disease exceeds 0.8. The indicators of the quality of prediction are higher than those of the known predictive system for coronary heart disease - they exceed SCORE, on average, by 14%. Conclusions. Analysis of the classification quality indicators in the experimental group of subjects with different ischemic risk indicators and in the control group made up of electric locomotive drivers, for whom vibration sickness and exposure to electromagnetic fields are relevant indicators of ischemic risks, showed that taking into account the influence of these risk factors in the control group increases diagnostic efficiency by seven percent compared with the experimental group serving as background

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Samaneh Mohamadpour ◽  
Azita Pouyanfar ◽  
Zeinab Najar ◽  
Hasan Jafari ◽  
Soheila Rahmani

Background and objectives: The aim of this study was examining the effectiveness of mindfulness-based cognitive group therapy on the quality of life and hope in the patients with coronary heart disease. Methods: The present study was quasi-experimental with pre-test, post-test and follow-up with control group. To fulfill the study, 30 patients were selected randomly and were assigned into experimental (n = 15) and control groups (n = 15). To collect the data, participants of both groups completed demographic information sheet, MacNew Heart Disease Health-Related Quality of Life Questionnaire and Miller Hope Scale, respectively of coronary heart disease questionnaire at pre-test, post-test and follow-up (2 months after the intervention). Participants of experimental group received eight 90-minute intervention sessions. Results: The results of the multivariate covariance analysis with repeated measures showed that mean score quality of life(P<0.05), hope (P<0.001) in participants of the experimental group had a significant difference compared to the participants of the control group at post-test and follow-up. Conclusion: results showed that mindfulness – based stress reduction treatment can be effective in improving life quality and hope in coronary heart disease. Implication for further research and possible clinical applications are discussed.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wei Hao ◽  
Tian Ma ◽  
Chun Feng

Objective. To explore the application effect of meticulous nursing on community elderly patients with coronary heart disease (CHD) under the background of medical treatment partnerships. Methods. A total of 96 elderly CHD patients treated in the community from July 2019 to July 2020 were selected as the research objects and divided into the experimental group (n = 48) and control group (n = 48) by the medical personnel according to their admission order. Clinical routine nursing was performed to the patients in the control group, and meticulous nursing under the background of medical treatment partnerships was conducted to the patients in the experimental group, so as to evaluate their quality of life (QOL) and self-care agency after intervention by the Chinese Questionnaire on Quality of Life in Patients with Cardiovascular Disease (CQQC) and Exercise of Self-Care Agency (ESCA) scale. Results. Compared with the control group after intervention, the patients in the experimental group presented significantly higher ESCA scores, HHI scores, and CQQC scores and longer 6 min walking distance ( P < 0.001 ) and remarkably lower POMS scores ( P < 0.001 ) and had obviously higher numbers of cases with various health-related actions ( P < 0.05 ). Conclusion. Meticulous nursing under the background of medical treatment partnerships is a reliable method for improving the QOL and mood state of community elderly CHD patients, which greatly promotes patients’ self-care agency and expectation. Further research will be conducive to establishing a better solution for patients.


2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Xiaoye Wang

【Abstract】Objective: Toanalyze the efficacy of combined drug therapy for elderly patients with coronary heart disease and hypertension.METHODS:Sixty-six elderly patients with coronary heart disease and hypertension were enrolled from December 2017 to November 2018. They were randomly divided into two groups, 33 patients in each group. Patients in the experimental group received nifedipine. In combination with enalapril, patients enrolled in the control group received nifedipine monotherapy.RESULTS:Compared with the control group, the total effective rate, Serum Nitric Oxide (Serum NO) after treatment, CRP after treatment, HCY after treatment, and blood pressure after treatment were significantly improved (P<0.05). Serum NO and treatment before treatment in the 2 groups. There was no significant difference in pre-CRP, pre-treatment HCY, pre-treatment blood pressure, and adverse reactions during treatment (P>0.05).Conclusion: Theelderly patients with coronary heart disease and hypertension are treated with nifedipine and enalapril.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hai Xu ◽  
Xiwen Zhang ◽  
Kun Yu ◽  
Gang Zhang ◽  
Yafei Shi ◽  
...  

Objective. To investigate the expression and prognostic value of LncRNA FAF in patients with coronary heart disease. Patients and Methods. 97 patients with coronary heart disease who came to our hospital were selected as the research group (RG), and 97 healthy people who came to our hospital for physical examination during the same period were selected as the control group (CG). The serum LncRNA FAF, plasma homocysteine (HCY), lipoprotein A (Lp-a), serum tumor necrosis factor α (TNF-α), and high-sensitivity C-reactive protein (hsCRP) in the two groups of patients were detected, and their correlations were analyzed. Then, the predictive value and risk factors of FAF for poor prognosis of patients with coronary heart disease were analyzed. Results. The expression of LncRNA FAF in the serum of patients in the RG was significantly lower than that in the CG, and the expressions of HCY, Lp-a, TNF-α, and hsCRP were significantly higher than those in the CG (p <0.05). The AUC of FAF in the diagnosis of coronary heart disease was more than 0.9. FAF was negatively correlated with the coronary lesion vessels, HCY, Lp-a, TNF-α, and hsCRP expressions in patients with coronary heart disease ( p < 0.05 ). The ROC of FAF for predicting poor prognosis in patients with coronary heart disease was greater than 0.9. Low expression of FAF; high expressions of HCY, Lp-a, and hsCRP; and increase of coronary lesion vessels were independent risk factors for poor prognosis in patients with coronary heart disease. Conclusions. LncRNA FAF was lowly expressed in the serum of patients with coronary heart disease, and it was of high value in the diagnosis and prediction of poor prognosis of coronary heart disease. It was also an independent risk factor for poor prognosis of patients with coronary heart disease and may be a potential target for diagnosis and treatment of coronary heart disease.


2019 ◽  
Vol 26 (13) ◽  
pp. 1386-1395 ◽  
Author(s):  
Joy Van de Cauter ◽  
Dirk De Bacquer ◽  
Els Clays ◽  
Delphine De Smedt ◽  
Kornelia Kotseva ◽  
...  

Background Coronary heart disease (CHD) can lead to loss of workability and early retirement. We aimed to investigate return to work (RTW) and its relationship towards psychosocial well-being and health-related quality of life (HRQoL). Design Secondary analyses were applied to cross-sectional data from the EUROASPIRE IV survey (European Action on Secondary and Primary prevention through Intervention to Reduce Events). Methods Participants were examined and interviewed at 6–36 months following the recruiting event. Psychosocial well-being and HRQoL were evaluated by completing the ‘Hospital Anxiety and Depression Scale’ and ‘HeartQoL’ questionnaire. Using generalised mixed models, we calculated the odds ratios for RTW. Depression, anxiety and adjusted means of HeartQoL were estimated accounting for RTW. Results Out of 3291 employed patients, the majority (76.0%) returned to work, of which 85.6% were men, but there was a general underrepresentation of women. Young ( p < 0.001), high-educated ( p < 0.001) patients without prior cardiovascular events ( p < 0.05) were better off regarding RTW. No significant associations with CHD risk factors and cardiac rehabilitation were established. Those that rejoined the workforce were less susceptible to psychosocial distress (anxiety/depression, p < 0.001) and experienced a better quality of life ( p < 0.001). Conclusion These findings provide evidence that non-modifiable factors (sociodemographic factors, cardiovascular history), more than classical risk factors, are associated with RTW, and that patients who resume work display better psychosocial well-being and HRQoL. Our results illustrate a need for tailored cardiac rehabilitation with a focus on work-related aspects, mental health and HRQoL indicators to reach sustainable RTW, especially in vulnerable groups like less educated and elderly patients.


2019 ◽  
Vol 19 (2) ◽  
pp. 134-141 ◽  
Author(s):  
Lena Bosselmann ◽  
Stella V Fangauf ◽  
Birgit Herbeck Belnap ◽  
Mira-Lynn Chavanon ◽  
Jonas Nagel ◽  
...  

Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors. Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany. Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20). Results: Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001). Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Santanu Biswas ◽  
Pradip K. Ghoshal ◽  
Bhubaneswar Halder ◽  
Nripendranath Mandal

The purpose of this study is to establish whether ABO blood group is related to coronary heart disease in an individual in Asian Indian Bengali population of eastern part of India. Two hundred and fifty (250) CHD patients and two hundred and fifty (250) age and sex matched healthy subjects were enrolled in the study. ABO blood group distribution in patients was compared with control group. Frequency of major cardiac risk factors was determined to find any correlation between blood groups and cardiovascular risk factors. The distribution of ABO blood groups in patients versus control group was A in 24.00 versus 21.60%, B in 30.80 versus 32.40%, O in 38.40 versus 21.60%, and AB in 6.80 versus 24.40%. The analysis showed significant difference in frequency of O (OR = 1.857, 95%CI = 1.112–3.100,P=0.018) and AB (OR = 0.447, 95%CI = 0.227–0.882,P=0.020) blood group between healthy controls and CHD individuals. Our results may suggest that the AB blood group decreases the risk of CHD in healthy controls, and it might be due to the higher concentration of high density lipoprotein cholesterol (HDL-c), while the O blood group increases the risk of CHD due to lower HDL-c levels in Bengali population of eastern part of India.


2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Changling Li ◽  
Aijie He

With the improvement of living standards, people have more and more physical health problems. Among them, high-risk cardiovascular diseases such as hypertension, diabetes, and coronary heart disease are the most prominent. The number of cardiology patients is increasing year by year. Effectively improving the treatment of cardiology patients and speeding up the recovery of cardiology patients have become a social problem. This article aims to explore the impact of diverse nursing care on patients in cardiology treatment. This article first gives a detailed introduction to the treatment of diverse nursing and cardiology diseases, then takes 300 cardiology patients in our hospital as experimental subjects, and conducts a controlled experiment of nursing intervention, which is categorized into an experimental group of 150 cases (including 35 cases of hypertension, 46 cases of diabetes, 28 cases of coronary heart disease, 24 cases of angina pectoris, and 17 cases of multiple complications) and a control group of 150 cases (including 30 cases of hypertension, 47 cases of diabetes, 39 cases of coronary heart disease, 21 cases of angina pectoris, and 13 cases of multiple complications). The experimental results showed the following: the general information of the two groups of patients was not statistically different ( P > 0.05 ); after the nursing intervention, the blood glucose levels of the two groups of patients decreased, but the experimental group decreased more significantly and the blood glucose control effect was more obvious; after the intervention, in the experimental group that implemented diversified nursing interventions, the patient’s condition management effect was better and their scores were between 8 and 10; the mental state self-evaluation of the two groups of patients was significantly different from the domestic reference value ( P < 0.05 ), and there is a very significant statistical difference between the two groups after nursing intervention ( P < 0.01 ); after nursing intervention, compared with the control group, the quality of life of the experimental group improved more significantly and the highest score reached about 70; the overall satisfaction of the experimental group with nursing work reached 92%, while the satisfaction of the control group with nursing work was only 44.67%. Studies have shown that diversified care has a positive impact on the rehabilitation of patients in cardiology treatment.


2020 ◽  
Author(s):  
Anita Kärner Köhler ◽  
Tiny Jaarsma ◽  
Pia Tingström ◽  
Staffan Nilsson

Abstract Background Cardiac rehabilitation including patient education is effective after coronary heart disease (CHD). However, risk factors remain, and patients report fear for recurrence during recovery. Problem-based learning is a pedagogical method, where patients work self-directed in small groups with problem solving of real-life situations to manage CHD risk factors and self-care. The aim of the study was to demonstrate the better effectiveness of patient problem-based learning over home-sent patient information for evaluating long-term effects of patient empowerment and self-care in patients with CHD. The hypothesis tested was that one year of problem-based learning improves patients’ empowerment- and self-efficacy, to change self-care compared to one year of standardised home-sent patient information after CHD. Methods We randomly assigned 157 patients (78% male; age 68±8.5 years) with CHD verified by percutaneous coronary intervention (PCI) (70.1%) or coronary artery by-pass surgery (CABG) and CABG+PCI or myocardial infarction (29.9%) to problem-based learning (experimental group; n = 79) or home-sent patient information group (controls; n = 78). The problem-based learning intervention consisted of patient education in primary care by nurses tutoring groups of 6-9 patients on 13 occasions over one year. Controls received home- sent patient information on 11 occasions during the study year. Results At the one-year follow-up, the primary outcome, patient empowerment, did not significantly differ between the experimental group and controls. We found no significant differences between the groups regarding the secondary outcomes e.g. self-efficacy, although we found significant differences for body mass index (BMI) [-0.17 (SD 1.5) vs. 0.50 (SD 1.6), P=0.033 ], body weight [-0.83 (SD) 4.45 vs. 1.14 kg (SD 4.85), P=0.026 ] and HDL cholesterol [0.1 (SD 0.7) vs. 0.0 mmol/L (SD 0.3), P=0.038 ] favouring the experimental group compared to controls. Conclusions The problem-based learning- and the home-sent patient information interventions had similar results regarding patient empowerment. However, problem-based learning exhibited significant effects on weight loss, BMI, and HDL cholesterol levels, indicating that this intervention positively affected risk factors compared to the home-sent patient information intervention. Trial registration : NCT01462799 (February 2020)


Author(s):  
Nikolay I. Panev ◽  
Natalya A. Evseeva ◽  
Sergey N. Filimonov ◽  
Olga Yu. Korotenko ◽  
Olga N. Blazhina ◽  
...  

Introduction. There are data on the effects of dust on the respiratory system and the cardiovascular system. The main measures for preventing diseases of the circulatory system aimed to identify and eliminate risk factors. However, the prevalence of risk factors for coronary heart disease among coal mine workers with anthracosilicosis has not been sufficiently studied, determining the study's relevance. The study aimed to learn the frequency of risk factors for coronary heart disease in coal industry workers with anthracosilicosis. Materials and methods. We examined 269 miners working in conditions of dustiness exceeding the maximum permissible concentration by ten or more times: 139 miners with a previously established diagnosis of anthracosilicosis and 130 miners of the control group without dust pathology of the lungs. All of them underwent a comprehensive clinical, instrumental, and laboratory examination of the respiratory and cardiovascular systems to detect anthracosilicosis and coronary heart disease, as well as to assess its risk factors. Results. In miners with anthracosilicosis, coronary heart disease was 3.5 times more common (30.94%) than in the control group (8.46%). We have identified a high incidence of coronary heart disease in the age group of 45 and more years and with the experience of working in dust conditions of 20 and more years. In miners with anthracosilicosis combined with coronary heart disease, arterial hypertension was 1.6 times more common (58.14%) than without concomitant coronary heart disease - 35.42%. Miners with a combination of anthracosilicosis and coronary heart disease were three times more likely (20.93%) than those without coronary heart disease (6.25%) to have a metabolic syndrome. According to the Tanner index, significant risk factors for coronary heart disease were the presence of an andromorphic constitutional-morphological type and the formation of a complication of anthracosilicosis - respiratory failure. The evaluation of biochemical blood tests showed that the most significant markers of coronary heart disease risk were hyperhomocysteinemia, increased levels of C-reactive protein, fibrinogen, and soluble fibrin-monomer complexes. Conclusions. We found that the most significant risk of developing coronary heart disease in miners is 45 years and older. There are also other risk factors: work experience in harmful working conditions of 20 years or more; the presence of arterial hypertension; metabolic syndrome; andromorphic constitutional-morphological type according to the Tanner index. Risk factors are respiratory failure, hyperhomocysteinemia, hyperfibrinogenemia, increased soluble fibrin-monomer complexes, and C - reactive protein. It is necessary to consider all risks in developing programs of medical and preventive measures for employees of the coal industry.


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