Blood Pressure Estimation from Photoplethysmography with Motion Artifacts Using Long Short Term Memory Network

Continuous measurement of the Blood Pressure (BP) is important in hypertensive patientsand elderly population. Traditional cuff based methods are difficult to use since it is uncomfortable towear a cuff throughout the day. A more suitable method is to estimate the BP using the Photoplethysmography(PPG) signal. However, it is difficult to estimate a BP when the PPG is corrupted withMotion Artifacts (MAs). In this paper, Long Short Term Memory (LSTM) an extension of RecurrentNeural Networks (RNN) is used used to improve the accuracy of the estimation of the BP from thecorrupted PPG. It shows that an accuracy of 97.86 is achieved.

Adaptive Aging Safety of Guidance Marks in Rail Transit Connection Systems Based on Eye Movement Data

The aim of this study was to meet the visual cognition needs of the elderly population for the guidance marks and safety guidance marks of the rail transit connection system. Based on the visual characteristics of the elderly population, this paper firstly determined the visual field and sight range of the marks of the elderly population from three aspects—visual angle, visual distance, and height of the elderly population—and constructed the visual recognition space of the elderly population. Then, from the perspective of the setting position, the setting height, and the deflection angle, an adaptive aging safety design method for the guidance marks in the rail transit connection system is proposed. Then, based on the eye movement data of fixation duration, initial fixation duration, and the number of visits, a visual behavior index model is constructed to iteratively optimize the adaptive aging safety design of guidance marks in a rail transit connection system. A radar map is used to calculate the comprehensive index of visual behavior to determine the optimal scheme. Finally, taking the traffic connection system of Shanghai Songjiang University Town Station as an example, the eye movement data of 37 participants were collected, according to the principle that each connection path should only be taken once per person; the above method was used to design 7 connection path guidance marks for an adaptive aging safety design. The results showed that the comprehensive index of visual behavior of different paths had different degrees of improvement of up to 14.00%, which verified the effectiveness of the design method. The research results have certain theoretical significance and application value for the adaptive aging safety design and retrofit of guidance marks of rail transit connection systems.

Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

The demographic development suggests a dramatic growth in the number of elderly patients undergoing surgery in Europe. Most red blood cell transfusions (RBCT) are administered to older people, but little is known about perioperative transfusion practices in this population. In this secondary analysis of the prospective observational multicentre European Transfusion Practice and Outcome Study (ETPOS), we specifically evaluated intraoperative transfusion practices and the related outcomes of 3149 patients aged 65 years and older. Enrolled patients underwent elective surgery in 123 European hospitals, received at least one RBCT intraoperatively and were followed up for 30 days maximum. The mean haemoglobin value at the beginning of surgery was 108 (21) g/l, 84 (15) g/l before transfusion and 101 (16) g/l at the end of surgery. A median of 2 [1–2] units of RBCT were administered. Mostly, more than one transfusion trigger was present, with physiological triggers being preeminent. We revealed a descriptive association between each intraoperatively administered RBCT and mortality and discharge respectively, within the first 10 postoperative days but not thereafter. In our unadjusted model the hazard ratio (HR) for mortality was 1.11 (95% CI: 1.08–1.15) and the HR for discharge was 0.78 (95% CI: 0.74–0.83). After adjustment for several variables, such as age, preoperative haemoglobin and blood loss, the HR for mortality was 1.10 (95% CI: 1.05–1.15) and HR for discharge was 0.82 (95% CI: 0.78–0.87). Pre-operative anaemia in European elderly surgical patients is undertreated. Various triggers seem to support the decision for RBCT. A closer monitoring of elderly patients receiving intraoperative RBCT for the first 10 postoperative days might be justifiable. Further research on the causal relationship between RBCT and outcomes and on optimal transfusion strategies in the elderly population is warranted. A thorough analysis of different time periods within the first 30 postoperative days is recommended.

Cost-effectiveness of quadrivalent versus trivalent inactivated influenza vaccines for the Portuguese elderly population

Background Quadrivalent Inactivated Vaccine (QIV) is expected to replace Trivalent Inactivated Vaccine (TIV) over time. In Portugal, TIV is free of charge for risk groups, which include older adults. In its turn, QIV – which provides broader protection as it includes an additional lineage B strain – was introduced in Portugal in October 2018, but only from the influenza season 2019/20 was provided free of charge for the risk groups. This study evaluates the cost-effectiveness of switching from TIV to QIV from the National Health Service perspective in the Portuguese elderly mainland population (≥65 years old). Methods A decision tree model was developed to compare TIV and QIV, based on Portuguese hospitalization data for the 2015/16 influenza season. The primary health economic outcome under consideration was the Incremental Cost-Effectiveness Ratio (ICER). In addition, a one-Way Sensitivity Analysis was performed to evaluate the impact of model parameters on the ICER; Probabilistic Sensitivity Analysis was also carried out to analyze the robustness of the base case results. Results The high cost of QIV (approximately three times the cost of TIV) would lead to a total increment of 5,283,047 €, and the resulting ICER would be 26,403,007€/QALY, mainly above the usual willingness-to-pay threshold. Conclusions From the National Health Service perspective, our findings reveal that QIV is not cost-effective for the Portuguese elderly population due to the high cost. If the QIV costs were the same as the TIV, then QIV would be cost-effective.

Epidemiology, diagnosis, and assessment of diabetes mellitus in the elderly population: a purposive review

The elderly population with diabetes mellitus is rapidly growing worldwide and has become a major social burden with significant impact on health and economics. This social category requires considerations that are not traditionally associated with diabetes mellitus management. Several epidemiological studies have shown that the prevalence of diabetes mellitus increases with advancing age. According to the recent International Diabetes Federation (IDF) published data, the number of people with diabetes mellitus among those 65 and over has reached 136 million (19.3%) with more frequent diabetes mellitus complications and co-morbidities compared to the young counterparts. Cardiovascular complications are the leading cause of death and the quality of life is strongly impacted by geriatric syndromes such as poor vision, dementia and functional dependence. The elderly diabetic population is classified into three categories; the robust, the fragile and the patient at the end of life. In practical terms, they can also be classified into two categories: the autonomous patients and the dependent patients, requiring support and assistance. Keywords: diabetes mellitus, elderly, epidemiology, geriatric syndromes, geriatric evaluation.