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Identification of Allergens in Azuki (Adzuki) Bean Allergy. J Investig Allergol Clin Immunol 2024; 34:139-140. [PMID: 37669086 DOI: 10.18176/jiaci.0930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
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Heart Rate Variability Measurement Can Be a Point-of-Care Sensing Tool for Screening Postpartum Depression: Differentiation from Adjustment Disorder. SENSORS (BASEL, SWITZERLAND) 2024; 24:1459. [PMID: 38474995 DOI: 10.3390/s24051459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
Postpartum depression (PPD) is a serious mental health issue among women after childbirth, and screening systems that incorporate questionnaires have been utilized to screen for PPD. These questionnaires are sensitive but less specific, and the additional use of objective measures could be helpful. The present study aimed to verify the usefulness of a measure of autonomic function, heart rate variability (HRV), which has been reported to be dysregulated in people with depression. Among 935 women who had experienced childbirth and completed the Edinburgh Postnatal Depression Scale (EPDS), HRV was measured in EPDS-positive women (n = 45) 1 to 4 weeks after childbirth using a wearable device. The measurement was based on a three-behavioral-state paradigm with a 5 min duration, consisting of rest (Rest), task load (Task), and rest-after-task (After) states, and the low-frequency power (LF), the high-frequency power (HF), and their ratio (LF/HF) were calculated. Among the women included in this study, 12 were diagnosed with PPD and 33 were diagnosed with adjustment disorder (AJD). Women with PPD showed a lack of adequate HRV regulation in response to the task load, accompanying a high LF/HF score in the Rest state. On the other hand, women with AJD exhibited high HF and reduced LF/HF during the After state. A linear discriminant analysis using HRV indices and heart rate (HR) revealed that both the differentiation of PPD and AJD patients from the controls and that of PPD patients from AJD patients were possible. The sensitivity and specificity for PPD vs. AJD were 75.0% and 90.9%, respectively. Using this paradigm, an HRV measurement revealed the characteristic autonomic profiles of PPD and AJD, suggesting that it may serve as a point-of-care sensing tool in PPD screening systems.
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Protein-Ligand Interaction Analyses with Nuclear Magnetic Resonance Spectroscopy Enhanced by Dissolution Triplet Dynamic Nuclear Polarization. J Phys Chem Lett 2023:6241-6247. [PMID: 37401781 DOI: 10.1021/acs.jpclett.3c01002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
Solution-state nuclear magnetic resonance spectroscopy (NMR) is a powerful method for the analysis of intermolecular interactions within a biomolecular system. However, low sensitivity is one of the major obstacles of NMR. We improved the sensitivity of solution-state 13C NMR for the observation of intermolecular interactions between protein and ligand using hyperpolarized solution samples at room temperature. Eutectic crystals composed of 13C-salicylic acid and benzoic acid doped with pentacene were hyperpolarized by dynamic nuclear polarization using photoexcited triplet electrons, and a 13C nuclear polarization of 0.72 ± 0.07% was achieved after dissolution. The binding of human serum albumin and 13C-salicylate was observed with several hundred times sensitivity enhancement under mild conditions. The established 13C NMR was applied for pharmaceutical NMR experiments by observation of the partial return of the 13C chemical shift of salicylate by competitive binding with other non-isotope-labeled drugs.
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Pulse rate variability estimation method based on imaging-photoplethysmography and application to telepsychiatry. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083147 DOI: 10.1109/embc40787.2023.10340913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The worldwide adoption of telehealth services may benefit people who otherwise would not be able to access mental health support. In this paper, we present a novel algorithm to obtain reliable pulse and respiration signals from non-contact facial image sequence analysis. The proposed algorithm involved a skin pixel extraction method in the image processing part and signal reconstruction using the spectral information of RGB signal in the signal processing part. The algorithm was tested on 15 healthy subjects in a laboratory setting. The results show that the proposed algorithm can accurately monitor respiration rate (RR), pulse rate (PR), and pulse rate variability (PRV) in rest conditions.Clinical Relevance- The main achievement of this study is enabling non-contact PR and RR signal extraction from facial image sequences, which has potential for future use and support for psychiatrists in telepsychiatry.
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Major Depressive Disorder and Chronic Fatigue Syndrome Show Characteristic Heart Rate Variability Profiles Reflecting Autonomic Dysregulations: Differentiation by Linear Discriminant Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115330. [PMID: 37300057 DOI: 10.3390/s23115330] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
Major depressive disorder (MDD) and chronic fatigue syndrome (CFS) have overlapping symptoms, and differentiation is important to administer the proper treatment. The present study aimed to assess the usefulness of heart rate variability (HRV) indices. Frequency-domain HRV indices, including high-frequency (HF) and low-frequency (LF) components, their sum (LF+HF), and their ratio (LF/HF), were measured in a three-behavioral-state paradigm composed of initial rest (Rest), task load (Task), and post-task rest (After) periods to examine autonomic regulation. It was found that HF was low at Rest in both disorders, but was lower in MDD than in CFS. LF and LF+HF at Rest were low only in MDD. Attenuated responses of LF, HF, LF+HF, and LF/HF to task load and an excessive increase in HF at After were found in both disorders. The results indicate that an overall HRV reduction at Rest may support a diagnosis of MDD. HF reduction was found in CFS, but with a lesser severity. Response disturbances of HRV to Task were observed in both disorders, and would suggest the presence of CFS when the baseline HRV has not been reduced. Linear discriminant analysis using HRV indices was able to differentiate MDD from CFS, with a sensitivity and specificity of 91.8% and 100%, respectively. HRV indices in MDD and CFS show both common and different profiles, and can be useful for the differential diagnosis.
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Screening for Major Depressive Disorder Using a Wearable Ultra-Short-Term HRV Monitor and Signal Quality Indices. SENSORS (BASEL, SWITZERLAND) 2023; 23:3867. [PMID: 37112208 PMCID: PMC10143236 DOI: 10.3390/s23083867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 06/19/2023]
Abstract
To encourage potential major depressive disorder (MDD) patients to attend diagnostic sessions, we developed a novel MDD screening system based on sleep-induced autonomic nervous responses. The proposed method only requires a wristwatch device to be worn for 24 h. We evaluated heart rate variability (HRV) via wrist photoplethysmography (PPG). However, previous studies have indicated that HRV measurements obtained using wearable devices are susceptible to motion artifacts. We propose a novel method to improve screening accuracy by removing unreliable HRV data (identified on the basis of signal quality indices (SQIs) obtained by PPG sensors). The proposed algorithm enables real-time calculation of signal quality indices in the frequency domain (SQI-FD). A clinical study conducted at Maynds Tower Mental Clinic enrolled 40 MDD patients (mean age, 37.5 ± 8.8 years) diagnosed on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and 29 healthy volunteers (mean age, 31.9 ± 13.0 years). Acceleration data were used to identify sleep states, and a linear classification model was trained and tested using HRV and pulse rate data. Ten-fold cross-validation showed a sensitivity of 87.3% (80.3% without SQI-FD data) and specificity of 84.0% (73.3% without SQI-FD data). Thus, SQI-FD drastically improved sensitivity and specificity.
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WCN23-0319 HMGB1/RAGE AXIS COULD BE INVOLVED IN AKI TO CKD TRANSITION VIA MINERALOCORTICOID RECEPTOR-INDUCED INFLAMMATION IN RENAL ISCHEMIA REPERFUSION INJURY MICE MODEL. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
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Correction: Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry. Heart Vessels 2023; 38:412. [PMID: 36508013 DOI: 10.1007/s00380-022-02218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Development of a non-contact 15-second paediatric respiratory rate monitor using microwave radar and its clinical application. Acta Paediatr 2023; 112:493-495. [PMID: 36301152 DOI: 10.1111/apa.16585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/27/2022]
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Effectiveness of patient and staff cohorting to reduce the risk of vancomycin-resistant enterococcus (VRE) acquisition: a retrospective cohort study during a VRE outbreak in Japan. J Hosp Infect 2023; 134:35-42. [PMID: 36669647 DOI: 10.1016/j.jhin.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patient and staff cohorting is part of a bundle approach in the response to multi-drug-resistant organisms, but its effectiveness is not fully clarified. This study compared the risks of acquiring vancomycin-resistant Enterococcus faecium (VREfm) at a hospital during a VREfm outbreak based on contact characteristics in order to better understand the effectiveness of cohorting. METHODS Exposure came from contact with patients with VREfm (infectors), including existing patients with VREfm and patients who acquired VREfm during the study period. Contact was defined as length of contact time, degree of sharing space, and care by the same nurses as those caring for infectors between January and March 2018. The outcome was VREfm acquisition as determined through monthly stool or rectal screening cultures. Incidence rates were calculated based on contact patterns, and incidence rate ratios (IRRs) were compared. FINDINGS Among 272 inpatients (4038 patient-days), 43 patients acquired VREfm with the same or similar pulsotype. Incidence rates were 8.45 per 1000 patient-days when susceptible inpatients were on the same ward as an infector but cared for by different nurses (reference), 16.96 when susceptible inpatients were on the same ward as an infector and cared for by the same nurses [IRR 2.01, 95% confidence interval (CI) 0.62-10.28], and 52.91 when susceptible inpatients shared a room with an infector (IRR 6.26, 95% CI 1.61-35.40). CONCLUSION Compared with susceptible inpatients in a different room from infectors and not being cared for by the same nurses, the risk of VREfm acquisition could be six times higher for susceptible inpatients who are in the same room as infectors, and could be double for susceptible inpatients cared for by the same nurses as infectors.
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532 Unexpected expression of hemoglobin α as an endogenous antioxidant in epidermal keratinocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Remote sensing of vital signs by medical radar time-series signal using cardiac peak extraction and adaptive peak detection algorithm: Performance validation on healthy adults and application to neonatal monitoring at an NICU. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 226:107163. [PMID: 36191355 DOI: 10.1016/j.cmpb.2022.107163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Continuous monitoring of vital signs plays a pivotal role in neonatal intensive care units (NICUs). In this paper, we present a system for monitoring fully non-contact medical radar-based vital signs to measure the respiratory rate (RR), heart rate (HR), I:E ratio, and heart rate variability (HRV). In addition, we evaluated its performance in a physiological laboratory and examined its adaptability in an NICU. METHODS A non-contact medical radar-based vital sign monitoring system that includes 24 GHz radar installed in an incubator was developed. To enable reliable monitoring, an advanced signal processing algorithm (i.e., a nonlinear filter to separate respiration and heartbeat signals from the output of radar), template matching to extract cardiac peaks, and an adaptive peak detection algorithm to estimate cardiac peaks in time-series were proposed and implemented in the system. Nine healthy subjects comprising five males and four females (24 ± 5 years) participated in the laboratory test. To evaluate the adaptability of the system in an NICU setting, we tested it with three hospitalized infants, including two neonates. RESULTS The results indicate strong agreement in healthy subjects between the non-contact system and reference contact devices for RR, HR, and inter-beat interval (IBI) measurement, with correlation coefficients of 0.83, 0.96, and 0.94, respectively. As anticipated, the template matching and adaptive peak detection algorithms outperformed the conventional approach. These showed a more accurate IBI close to the reference Bland-Altman analysis (proposed: bias of -3 ms, and 95% limits of agreement ranging from -73 to 67 ms; conventional: bias of -11 ms, and 95% limits of agreement ranging from -229 to 207 ms). Moreover, in the NICU clinical setting, the IBI correlation coefficient and 95% limit of agreement in the conventional method are 0.31 and 91 ms. The corresponding values obtained using the proposed method are 0.93 and 21 ms. CONCLUSION The proposed system introduces a novel approach for NICU monitoring using a non-contact medical radar sensor. The signal processing method combining cardiac peak extraction algorithm with the adaptive peak detection algorithm shows high adaptability in detecting IBI the time series in various application settings.
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The development and clinical application of a novel schizophrenia screening system using yoga-induced autonomic nervous system responses. Front Physiol 2022; 13:902979. [PMID: 36277195 PMCID: PMC9581289 DOI: 10.3389/fphys.2022.902979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background: In severe cases, schizophrenia can result in suicide and social isolation. Diagnosis delay can lead to worsening symptoms, and often results in prolonged therapy. An estimated 50%–80% of patients with schizophrenia are unaware of their condition. Biomarkers for schizophrenia are important for receiving a diagnosis from a psychiatrist at an early stage. Although previous studies have investigated near-infrared spectroscopy as a biomarker for schizophrenia, the required equipment is expensive and not designed for home use. Hence, we developed a novel home-use schizophrenia screening system that uses a wearable device to measure autonomic nervous system responses induced by yoga, which is frequently adopted in rehabilitation for schizophrenia.Materials and methods: The schizophrenia screening system automatically distinguishes patients with schizophrenia from healthy subjects via yoga-induced transient autonomic responses measured with a wearable wireless electrocardiograph (ECG) using linear discriminant analysis (LDA; Z score ≥ 0 → suspected schizophrenia, Z-score < 0 → healthy). The explanatory variables of LDA are averages of four indicators: components of heart rate variability (HRV): the very low-frequency (VLF), the low-frequency (LF), HR, and standard deviation of the NN intervals (SDNN). In the current study, HRV is defined as frequency domain HRV, which is determined by integrating RRI power spectrum densities from 0.0033 to 0.04 Hz (VLF) and 0.04–0.15 Hz (LF), and as time domain HRV, SDNN of which is calculated as the mean of the standard deviations of the RR intervals. These variables were measured before (5 min), during (15 min), and after (5 min) yoga in a 15-min mindfulness-based yoga program for schizophrenia (MYS). The General Health Questionnaire-28 (GHQ28) score was used to assess the severity of mental disorders for patients with schizophrenia and healthy volunteers. Twelve patients with schizophrenia (eight female and four male, 23–60 years old) and 16 healthy volunteers (seven female and nine male, 22–54 years old) were recruited.Results: The schizophrenia screening system achieved sensitivity of 91% and specificity of 81%. Z-scores of LDA were significantly correlated with GHQ28 scores (r = 0.45, p = 0.01).Conclusion: Our proposed system appears to be promising for future automated preliminary schizophrenia screening at home.
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409 Corneoptosis, functional keratinocyte cell death, is tightly associated with spaciotemporal dynamics of epidermal tight junctions. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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An mHealth App for the Non-contact Measurement of Pulmonary Function Using the Smartphone's Built-in Depth Sensor. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3357-3360. [PMID: 36086085 DOI: 10.1109/embc48229.2022.9871451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of smartphones in clinical practice is referred to as mobile health (mHealth). This has attracted great interest in both academia and industry because of its potential to augment healthcare. In this study, we developed an mHealth app for the non-contact measurement of chest-wall movements using the iPhone ' s built-in depth sensor, thereby enabling a pulmonary self-monitoring function for personal use. The depth sensor provides depth values for each pixel and 2D mapping of the chest-wall movements. To extract respiratory signals from the right and left thoracic regions and abdomen, a 2D-depth image-segmentation method was implemented. The method was based on the anatomy and physiology of chest-wall movements, assuming differences in the anterior displacement in the thoracic and abdominal regions. It was observed that the differences were significant in the segmented regions of interest (ROIs) of the right and left thoracic region and abdomen. Respiratory signals extracted from each ROI were compared with the contact bio-impedance signals, which were highly correlated (r=0.94).
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Development of a Novel Vital-Signs-Based Infection Screening Composite-Type Camera With Truncus Motion Removal Algorithm to Detect COVID-19 Within 10 Seconds and Its Clinical Validation. Front Physiol 2022; 13:905931. [PMID: 35812332 PMCID: PMC9257080 DOI: 10.3389/fphys.2022.905931] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: To conduct a rapid preliminary COVID-19 screening prior to polymerase chain reaction (PCR) test under clinical settings, including patient’s body moving conditions in a non-contact manner, we developed a mobile and vital-signs-based infection screening composite-type camera (VISC-Camera) with truncus motion removal algorithm (TMRA) to screen for possibly infected patients. Methods: The VISC-Camera incorporates a stereo depth camera for respiratory rate (RR) determination, a red–green–blue (RGB) camera for heart rate (HR) estimation, and a thermal camera for body temperature (BT) measurement. In addition to the body motion removal algorithm based on the region of interest (ROI) tracking for RR, HR, and BT determination, we adopted TMRA for RR estimation. TMRA is a reduction algorithm of RR count error induced by truncus non-respiratory front-back motion measured using depth-camera-determined neck movement. The VISC-Camera is designed for mobile use and is compact (22 cm × 14 cm × 4 cm), light (800 g), and can be used in continuous operation for over 100 patients with a single battery charge. The VISC-Camera discriminates infected patients from healthy people using a logistic regression algorithm using RR, HR, and BT as explanatory variables. Results are available within 10 s, including imaging and processing time. Clinical testing was conducted on 154 PCR positive COVID-19 inpatients (aged 18–81 years; M/F = 87/67) within the initial 48 h of hospitalization at the First Central Hospital of Mongolia and 147 healthy volunteers (aged 18–85 years, M/F = 70/77). All patients were on treatment with antivirals and had body temperatures <37.5°C. RR measured by visual counting, pulsimeter-determined HR, and BT determined by thermometer were used for references. Result: 10-fold cross-validation revealed 91% sensitivity and 90% specificity with an area under receiver operating characteristic curve of 0.97. The VISC-Camera-determined HR, RR, and BT correlated significantly with those measured using references (RR: r = 0.93, p < 0.001; HR: r = 0.97, p < 0.001; BT: r = 0.72, p < 0.001). Conclusion: Under clinical settings with body motion, the VISC-Camera with TMRA appears promising for the preliminary screening of potential COVID-19 infection for afebrile patients with the possibility of misdiagnosis as asymptomatic.
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AB1140 IMPACT OF COVID-19 NEWS SOURCES ON RHEUMATOID ARTHRITIS PATIENTS’ LIFESTYLE AND THEIR DISEASE ACTIVITY FROM NINJA 2020 COHORT STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundOne of the problems with the COVID-19 epidemic is infodemic. Insufficient and inaccurate information can be confusing and hinder treatment. In Japan, tabloid TV show might be an easily accessible source of information, but its reliability is low and it has a harmful effect on patients’ mental status and lifestyle. There are no reports to examine what is the source of COVID-19 news for patients with rheumatoid arthritis and how these information affect patients’ daily lives and disease activity. By using NinJa, Japanese largest database of rheumatoid arthritis, it may be possible to examine them in detail.ObjectivesTo investigate the impact of the COVID—19 news sources on rheumatoid arthritis patients’ lifestyle and their disease activity using NinJa 2020 cohort study.MethodsAt the timing of collection of patients’ data of NinJa2020, questionnaire about their lifestyle and news source of COVID-19 was given. Questionnaire includes questions about frequency of scheduled visit, going out and exercise, weakness and news source.Results6677 patients out of 15553 patients answered questionnaire. Most patients did not change the interval of scheduled visit. The frequency of hospital visits was “unchanged” in 85.8%, “longer” in 13.6%, and “shortened” in 0.6%. The chances of going out were “unchanged” at 14.4%, “significantly decreased” at 57.5%, “slightly decreased” at 27.8%, and “increased” at 0.3%. 42.6% answered that the amount of exercise did not change, 30.2% answered that it decreased considerably, 26.1% answered that it decreased a little, and 1.1% answered that it increased. Regarding muscular strength and physical strength, 46.0% answered “no change”, 19.9% answered “significantly dropped”, 33.5% answered “slightly dropped”, and 0.6% answered “increased”.The media used as information sources are “newspaper (86.4%)”, “tabloid show (54.5%)”, “family, acquaintances and friends (43.7%)”, and “official web of Ministry of Health, Labor and Welfare and academic societies (9.4. %)”. Respondents often referred to multiple media and 30.6% of them listed three sources (Figure 1). There was a positive correlation between the decrease in frequency of going out and the number of information sources, and a negative correlation between age and the number of information sources. We also found a negative correlation with age for muscle weakness.No correlation was found between the number of information sources and SDAI, CDAI, HAQ-DI, EQ-5D, HADS (A), HADS (D).Figure 1.ConclusionThe more sources of information, the less chance of going out. About 80% of the patients refrained from going out, the opportunity for exercise decreased in more than 50% of the patients, and the decrease in physical fitness was also noticed in nearly 50% of the patients. Newspapers, tabloid shows, and acquaintances were the most common sources of medical information, and relatively few patients used official sources.He provision of accurate information about COVID-19 was important to avoid infodemic. From this questionnaire, more practical information delivery system was required in Japan.Disclosure of InterestsNone declared
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AB0200 COMPARISON OF TREATMENT AND DISEASE ACTIVITY OF BETWEEN EORA AND YORA PATIENTS IN A NATIONWIDE DATABASE OF RHEUMATOID ARTHRITIS IN JAPAN “NINJA”. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundElderly-onset rheumatoid arthritis (EORA) has different characteristics from younger-onset RA (YORA), however, few reports have conducted large-scale and long-term comparisons of treatment and disease activity between EORA and YORA.ObjectivesTo compare the changes in treatment and disease activity of between EORA and YORA patients and to examine the characteristics of patients who achieved remission between them using data of a real-world database in Japan.MethodsAnalysis was performed using data from 2010, 2013, 2016, and 2019 of the National Database of Rheumatic Diseases in Japan (NinJa). Patients were grouped according to age of disease onset into G1: <65 years (divided into G1a <65 years and G1b ≧65 years by the age at analysis), G2: 65-74 years, and G3:≧75 years.ResultsMTX usage rate decreased over time in G2 (58.3% in 2013→55.1% in 2016→54.4% in 2019) and G3 group (41.1→39.5→37.9%). Biologics/JAKi usage rate increased (G1b:24.4→28.2→ 33.3%, G2:19.1→20.3→23.7%, G3:12.3→14.5→19.1%) and steroid usage rate decreased (G1b:49.1→41.8→35.1%, G2:42.2→36.8→29.5%, G3:50.9→45.9→39.2%) in all groups. TNFi usage rate decreased (G1b:19.5→18.0→17.3%, G2:15.4→ 14.1→12.7%, G3:6.2→4.3→5.1%) but IL-6i usage rate increased (G1b:5.2→7.4→9.5%, G2:4.1→4.3→5.9%, G3:2.7→3.4→3.3%) except for the G3 group. CTLA-4Ig usage rate also increased (G1b:3.7→5.3→6.7%, G2:2.7→5.5→5.9%, G3:3.6→6.5→8.1%) in all groups.The SDAI remission rate was increased over time in all groups (G1a:34.4→41.2→44.6%, G1b:25.1→31.4→35.2%, G2:33.1→37.1→42.2%, G3:30.0→35.9→39.3%) and EORA showed similar rate of remission with YORA. In the analysis stratified by SDAI using NinJa 2019, the positive rate of RF and ACPA decreased (ex RF. G3: 71.0→64.5→53.2%, ACPA. G3: 66.4→56.2→46.5%) and the proportion of male increased (ex G3: 23.0→30.3→35.1%) as the disease activity decreased (moderate / high → low → remission) in all groups. Also, the proportion of patients using two or more DMARDs decreased (ex G3: 43.8→35.2→22.4%) and the usage rate of steroid decreased (ex G3:52.5→37.9→30.2%). Furthermore, in a comparison of remission patients in each group, MTX usage rate (G1b:62.9→G2:61.7→G3:40.9%) and biologics/JAKi usage rate decreased (32.5→23.6→15.3%) as the age of onset increased, but the steroid usage rate increased (20.3→20.6→30.2%).ConclusionDisease activity improved over time, regardless of age of onset. EORA showed the same remission achievement rate as YORA, but the treatment content of those who achieved remission differed greatly depending on the age of onset.Disclosure of InterestsToshihiro Matsui Speakers bureau: Abbvie, Asahi Kasei, Ono, Chugai, Eli lilly, Pfizer, Grant/research support from: Abbvie, Asahi Kasei, Chugai, Shigeto Tohma: None declared
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POS0614 THE RELATIONSHIP BETWEEN DISEASE ACTIVITY AND FINANCIAL TOXICITY IN PATIENTS WITH RHEUMATOID ARTHRITIS ON BIOLOGICS: A CROSS-SECTIONAL STUDY USING THE JAPANESE RHEUMATOID ARTHRITIS REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAs the number of rheumatoid arthritis (RA) patients using biologics increases, the health financial issues posed by biologics become more important. The health financial issues posed by biologics have been discussed using health economic indicators such as incremental cost-effectiveness ratios (ICERs), but have not been evaluated using the financial burden of medical expenses (financial toxicity). In the field of malignancies, evaluations using financial burden have been conducted and have shown that the stage of malignancy is associated with financial toxicity. It is not known whether disease activity and financial toxicity are similarly associated in RA patients.ObjectivesThis study aims to evaluate the relationship between RA activity and financial toxicity in RA patients using biologics, who are especially likely to feel the financial burdens.MethodsWe conducted a cross-sectional study of biologic users enrolled in NinJa2020, a database of rheumatoid arthritis patients in Japan collected from April 1, 2020 to March 31, 2021. We defined the users of TNF inhibitor, IL-6 receptor antagonists, T-cell costimulation blocker, Janus kinase inhibitor and biosimilar as biologic users. The main exposure was the disease activity of RA and was measured using DAS28-CRP. Outcome measure was a financial toxicity and was measured using COmprehensive Score for financial Toxicity (COST). This scale is a patient-reported outcome measure (PROM) consisting of 11 items. The responses are recorded on 5-point Likert Scales (ranging from 0 = strongly disagree to 4 = strongly agree). The score by domains ranges from 0 to 44. Higher scores indicated better results and lower financial toxicity. Multiple linear regression models adjusted for age, sex, disease duration, co-payments for anti-rheumatic drugs, work status, financial support systems were conducted to assess the relationship between the disease activity of RA and financial toxicity. As a secondary analysis, we excluded patients with zero copayments and performed the same analysis as in the main analysis. We used multiple imputation to deal with missing values.ResultsAmong 15553 cases in the NinJa database, 649 cases for which RA disease activity and COST were available were included. The median age of the patients was 70 (interquartile range [IQR],56 -77), 83.7% were female. The median copayment amount was ¥12978 per month (IQR 637.2 to 24204.1). The median DAS28-CRP was 1.99 (IQR, 1. - 2.72). The median financial toxicity (COST score) was 21 (IQR 0-27) (Figure 1). In the main analysis using multiple linear regression, COST significantly decreased with disease activity of RA (per 1-pt DAS28-CRP, -1.16 [95% CI -2.04 - -0.28]). In the secondary analysis, COST significantly decreased with disease activity of RA (per 1-pt DAS28-CRP, -1.69 [95% CI -2.29 - -1.10]). Statistical significance was defined as a two-sided p-value < 0.05. All statistical analyses were conducted using STATA 17.0 (Stata Corp LP, College Station, TX). The National Hospital Organization’s research ethics committees evaluated and authorized the NinJa study.ConclusionHigh disease activity of RA was associated with high financial toxicity in biologic users. We reaffirmed the importance of financial considerations and empathy for RA patients using biologics, and suggested a potential demand for more financial support for RA patients who are refractory to treatment.Disclosure of InterestsNone declared
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A medical radar system for non-contact vital sign monitoring and clinical performance evaluation in hospitalized older patients. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103597] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Design and Evaluation of Digital Filters for Non-Contact Measuring of HRV using Medical Radar and Its Application in Bedside Patient Monitoring System. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6962-6965. [PMID: 34892705 DOI: 10.1109/embc46164.2021.9629643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A non-contact bedside monitoring system using medical radar is expected to be applied to clinical fields. Our previous studies have developed a monitoring system based on medical radar for measuring respiratory rate (RR) and heart rate (HR). Heart rate variability (HRV), which is essentially implemented in advanced monitoring system, such as prognosis prediction, is a more challenging biological information than the RR and HR. In this study, we designed a HRV measurement filter and proposed a method to evaluate the optimal cardiac signal extraction filter for HRV measurement. Because the cardiac component in the radar signal is much smaller than the respiratory component, it is necessary to extract the cardiac element from the radar output signal using digital filters. It depends on the characteristics of the filter whether the HRV information is kept in the extracted cardiac signal or not. A cardiac signal extraction filter that is not distorted in the time domain and does not miss the cardiac component must be adopted. Therefore, we focused on evaluating the interval between the R-peak of the electrocardiogram (ECG) and the radar-cardio peak of the cardiac signal measured by radar (R-radar interval). This is based on the fact that the time between heart depolarization and ventricular contraction is measured as the R-radar interval. A band-pass filter (BPF) with several bandwidths and a nonlinear filter, locally projective adaptive signal separation (LoPASS), were analyzed and compared. The optimal filter was quantitatively evaluated by analyzing the distribution and standard deviation of the R-radar intervals. The performance of this monitoring system was evaluated in elderly patient at the Yokohama Hospital, Japan.
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Non-contact Measurement of Pulse Rate Variability Using a Webcam and Application to Mental Illness Screening System. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7016-7019. [PMID: 34892718 DOI: 10.1109/embc46164.2021.9630038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic is a global health crisis. Mental health is critical in such uncertain situations, particularly when people are required to significantly restrict their movements and change their lifestyles. Under these conditions, many countries have turned to telemedicine to strengthen and expand mental health services. Our research group previously developed a mental illness screening system based on heart rate variability (HRV) analysis, enabling an objective and easy mental health self-check. This screening system cannot be used for telemedicine because it uses electrocardiography (ECG) and contact photoplethysmography (PPG), that are not widely available outside of a clinical setting. The purpose of this study is to enable the extension of the aforementioned system to telemedicine by the application of non-contact PPG using an RGB webcam, also called imaging- photoplethysmography (iPPG). The iPPG measurement errors occur due to changes in the relative position between the camera and the target, and due to changes in light. Conventionally, in image processing, the pixel value of the entire face region is used. We propose skin pixel extraction to eliminate blinks, eye movements, and changes in light and shadow. In signal processing, the green channel signal is conventionally used as a pulse wave owing to the absorption characteristics of blood flow. Taking advantage of the fact that the red and blue channels contain noise, we propose a signal reconstruction method for removing noise and strengthening the signal in the pulse rate variability (PRV) frequency band by weighting the three signals of the RGB camera. We conducted an experiment with 13 healthy subjects, and showed that the PRV index and pulse rate (PR) errors estimated by the proposed method were smaller than those of the conventional method. The correlation coefficients between estimated values by the proposed method and reference values of LF, HF, and PR were 0.86, 0.69, and 0.96, respectively.
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190 Staphylococcus cohnii can alleviate diverse skin inflammation. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Large-Scale Prospective Genome-Wide Association Study of Oxaliplatin in Stage II/III Colon Cancer and Neuropathy. Ann Oncol 2021; 32:1434-1441. [PMID: 34391895 DOI: 10.1016/j.annonc.2021.08.1745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE The severity of oxaliplatin (L-OHP)-induced peripheral sensory neuropathy (PSN) exhibits substantial interpatient variability, and some patients suffer from long-term, persisting PSN. OBJECTIVE To identify single-nucleotide polymorphisms (SNPs) predicting L-OHP-induced PSN using a genome-wide association study (GWAS) approach. DESIGN, SETTING, PARTICIPANTS A large prospective GWAS including 1,379 patients with stage II/III colon cancer who received L-OHP-based adjuvant chemotherapy (mFOLFOX6/CAPOX) under the phase II (JOIN/JFMC41) or the phase III (ACHIVE/JFMC47) trial. MAIN OUTCOMES AND MEASURES First, GWAS comparison of worst grade PSN (grade 0/1 vs. 2/3) was performed. Next, to minimize the impact of ambiguity in PSN grading, extreme PSN phenotypes were selected and analyzed by GWAS. SNPs that could predict time to recovery from PSN were also evaluated. In addition, SNPs associated with L-OHP-induced allergic reactions (AR) and time to disease recurrence were explored. RESULTS No SNPs exceeded the genome-wide significance (p < 5.0 × 10-8) in either GWAS comparison of worst grade PSN, extreme PSN phenotypes, or time to recovery from PSN. Association study focusing on AR or time to disease recurrence also failed to reveal any significant SNPs. CONCLUSION AND RELEVANCE Our results highlight the challenges of utilizing SNPs for predicting susceptibility to L-OHP-induced PSN in daily clinical practice.
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Non-contact heart rate variability monitoring using Doppler radars located beneath bed mattress: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2021; 5:ytab273. [PMID: 34377923 PMCID: PMC8350353 DOI: 10.1093/ehjcr/ytab273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/08/2021] [Accepted: 07/05/2021] [Indexed: 11/19/2022]
Abstract
Background Heart rate variability (HRV) has been investigated previously in autonomic nervous system-related clinical settings. In these settings, HRV is determined by the time-series heartbeat peak-to-peak intervals using electrocardiography (ECG). To reduce patient discomfort, we designed a Doppler radar-based autonomic nervous activity monitoring system (ANMS) that allows cardiopulmonary monitoring without using ECG electrodes or spirometry monitoring. Case summary Using our non-contact ANMS, we observed a bedridden 80-year-old female patient with terminal phase sepsis developed the daytime Cheyne-Stokes respiration (CSR) associated with the attenuation of the low frequency (LF) and high frequency (HF) of HRV components 20 days prior to her death. The patient developed a marked linear decrease in the LF and the HF of HRV components for over 3 days in a row. Furthermore, after the decrease both the LF and the HF showed low and linear values. Around the intersection of the two lines, the decreasing LF and HF lines and the constant LF and HF lines, the ANMS automatically detected the daytime CSR pathogenesis. The attenuation rate of HF (1340 ms2/day) was higher than that of LF (956 ms2/day). Heart rate increased by ∼10 b.p.m. during these 3 days. Discussion We detected CSR-associated LF and HF attenuation in a patient with terminal phase sepsis using our ANMS. The proposed system without lead appears promising for future applications in clinical settings, such as remote cardiac monitoring of patients with heart failure at home or in long-term acute care facilities.
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Return-to-Work Screening by Linear Discriminant Analysis of Heart Rate Variability Indices in Depressed Subjects. SENSORS 2021; 21:s21155177. [PMID: 34372412 PMCID: PMC8347333 DOI: 10.3390/s21155177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 12/22/2022]
Abstract
Using a linear discriminant analysis of heart rate variability (HRV) indices, the present study sought to verify the usefulness of autonomic measurement in major depressive disorder (MDD) patients by assessing the feasibility of their return to work after sick leave. When reinstatement was scheduled, patients’ HRV was measured using a wearable electrocardiogram device. The outcome of the reinstatement was evaluated at one month after returning to work. HRV indices including high- and low-frequency components were calculated in three conditions within a session: initial rest, mental task, and rest after task. A linear discriminant function was made using the HRV indices of 30 MDD patients from our previous study to effectively discriminate the successful reinstatement from the unsuccessful reinstatement; this was then tested on 52 patients who participated in the present study. The discriminant function showed that the sensitivity and specificity in discriminating successful from unsuccessful returns were 95.8% and 35.7%, respectively. Sensitivity is high, indicating that normal HRV is required for a successful return, and that the discriminant analysis of HRV indices is useful for return-to-work screening in MDD patients. On the other hand, specificity is low, suggesting that other factors may also affect the outcome of reinstatement.
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POS0286 INCIDENCE OF MALIGNANCIES IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS: DATA FROM A LARGE JAPANESE NATIONAL REGISTRY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patients (pts) with rheumatoid arthritis (RA) have an increased risk of some malignancies vs the general population, and this can vary by region/race.1,2 Data on the epidemiology and impact of biological (b)DMARDs and targeted synthetic (ts)DMARDs, such as Janus kinase (JAK) inhibitors, on the incidence of malignancies in Japanese pts with RA are limited. The National Database of Rheumatic Diseases in Japan (NinJa) is one of the largest RA registries in Japan.Objectives:To evaluate the incidence of malignancies in Japanese pts with RA using NinJa registry data.Methods:This retrospective observational study analysed NinJa registry data for Japanese pts with RA aged ≥18 years with ≥1 data entry between 2013 (first JAK inhibitor approval for RA in Japan) and 2018. The overall cohort included all pts with RA, and two sub-cohorts were analysed: pts exposed and unexposed to bDMARDs (exposure defined as ≥1 bDMARD reported in database). Crude incidence rates (IRs) for malignancies (including non-melanoma skin cancer) were calculated as the number of events per 100 pt-years of follow-up (time between start of follow-up or the date of first bDMARD exposure [for bDMARD-exposed pts] and end of observation period, or withdrawal from database). The most recent data for incidence of malignancy in the Japanese general population (2013–2017 data from the National Cancer Center, Japan) were used to calculate standardised incidence ratios (SIRs) and age- and sex-adjusted standardised rates (ASRs) for malignancies. Cross-sectional (per calendar year) and cumulative analyses were performed for the overall cohort. Cumulative rates were calculated for sub-cohorts, and all cumulative analyses were repeated excluding pts exposed to JAK inhibitors (ie ≥1 JAK inhibitor reported in database).Results:Data were collected for 26 607 Japanese pts with RA from 2013–2018. In the cross-sectional analysis (Table 1), the SIR and ASR for malignancies in all pts with RA were generally consistent from 2013–2018. In the cumulative analysis, the SIR (95% CI) for malignancies from 2013–2018 was 0.97 (0.91, 1.03) in all pts with RA, and 0.93 (0.82, 1.04) and 0.99 (0.92, 1.07) in pts exposed and unexposed to bDMARDs, respectively (Figure 1). Adjusting for age/sex, the cumulative ASR (95% CI) for malignancies from 2013–2018 was 0.83 (0.76, 0.90) in all pts with RA, and 0.82 (0.69, 0.95) and 0.86 (0.77, 0.96) in pts exposed and unexposed to bDMARDs, respectively (Figure 1). In all cohorts, the cumulative SIR and ASR were similar when pts exposed to JAK inhibitors were excluded (Figure 1).Table 1.Cross-sectional analysis of the incidence of malignancies in Japanese pts with RA from 2013–2018All RA2013 (N=13 423)2014 (N=15 584)2015 (N=15 751)2016 (N=16 107)2017 (N=15 994)2018(N=15 003)Total follow-up, PY13 35314 86614 82914 97014 74814 898Pts with events, n140164174168161211Crude IRa(95% CI)1.05(0.89, 1.24)1.10(0.95, 1.29)1.17(1.01, 1.36)1.12(0.97, 1.31)1.09(0.94, 1.27)1.42(1.24, 1.62)ASRa,b(95% CI)0.76(0.60, 0.93)0.76(0.62, 0.90)0.90(0.68, 1.11)0.88(0.68, 1.07)0.80(0.62, 0.98)0.88(0.74, 1.01)SIRb(95% CI)0.97(0.82, 1.14)1.01(0.86, 1.17)1.02(0.87, 1.18)0.88(0.75, 1.02)0.86(0.73, 1.00)1.10(0.95, 1.25)aIR/ASR were calculated as number of events per 100 PY of follow-upbData from a Japanese general population database of malignancy incidence from 2013–2017, provided by the Center for Cancer Control and Information Services, National Cancer Center, JapanPY, pt-yearsConclusion:The incidence of malignancies in Japanese pts with RA, registered in the NinJa database from 2013–2018, was similar to that in the Japanese general population. The SIR and ASR for malignancies were comparable in pts exposed and unexposed to bDMARDs. In all cohorts, rates did not increase when pts exposed to JAK inhibitors were included.References:[1] Dougados et al. Ann Rheum Dis 2014; 73: 62-68.[2] Parikh-Patel et al. Cancer Causes Control 2009; 20: 1001-1010.Acknowledgements:Study sponsored by Pfizer Inc. Medical writing support was provided by Christina Viegelmann, CMC Connect, and funded by Pfizer Inc.Disclosure of Interests:Toshihiro Matsui Speakers bureau: Astellas, Ayumi, Chugai, Daiichi-Sankyo, Eli Lilly, Ono, Pfizer Inc, Takeda, Tanabe-Mitsubishi, Consultant of: Pfizer Inc, Grant/research support from: Chugai, Naonobu Sugiyama Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Shigeyuki Toyoizumi Employee of: Pfizer R&D Japan, Fujio Matsuyama Consultant of: Pfizer Inc, Employee of: CRECON Medical Assessment Inc, Tatsunori Murata Consultant of: Pfizer Inc, Employee of: CRECON Medical Assessment Inc, Yukitomo Urata Speakers bureau: Asahi Kasei, Chugai, Eli Lilly, Pfizer Inc, Consultant of: AbbVie, Asahi Kasei, Chugai, Pfizer Inc, Kimito Kawahata Speakers bureau: Pfizer Inc, Consultant of: Pfizer Inc, Grant/research support from: Pfizer Inc, Shigeto Tohma Speakers bureau: Astellas, Ayumi, Chugai, Ono, Pfizer Inc, Takeda, Consultant of: Pfizer Inc
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Development of a Novel Web Camera-Based Contact-Free Major Depressive Disorder Screening System Using Autonomic Nervous Responses Induced by a Mental Task and Its Clinical Application. Front Physiol 2021; 12:642986. [PMID: 34054567 PMCID: PMC8160373 DOI: 10.3389/fphys.2021.642986] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/23/2021] [Indexed: 12/28/2022] Open
Abstract
Background To increase the consultation rate of potential major depressive disorder (MDD) patients, we developed a contact-type fingertip photoplethysmography-based MDD screening system. With the outbreak of SARS-CoV-2, we developed an alternative to contact-type fingertip photoplethysmography: a novel web camera-based contact-free MDD screening system (WCF-MSS) for non-contact measurement of autonomic transient responses induced by a mental task. Methods The WCF-MSS measures time-series interbeat intervals (IBI) by monitoring color tone changes in the facial region of interest induced by arterial pulsation using a web camera (1920 × 1080 pixels, 30 frames/s). Artifacts caused by body movements and head shakes are reduced. The WCF-MSS evaluates autonomic nervous activation from time-series IBI by calculating LF (0.04-0.15 Hz) components of heart rate variability (HRV) corresponding to sympathetic and parasympathetic nervous activity and HF (0.15-0.4 Hz) components equivalent to parasympathetic activities. The clinical test procedure comprises a pre-rest period (Pre-R; 140 s), mental task period (MT; 100 s), and post-rest period (Post-R; 120 s). The WCF-MSS uses logistic regression analysis to discriminate MDD patients from healthy volunteers via an optimal combination of four explanatory variables determined by a minimum redundancy maximum relevance algorithm: HF during MT (HF MT ), the percentage change of LF from pre-rest to MT (%ΔLF(Pre-R⇒MT) ), the percentage change of HF from pre-rest to MT (%ΔHF(Pre-R⇒MT) ), and the percentage change of HF from MT to post-rest (%ΔHF(MT⇒Post-R) ). To clinically test the WCF-MSS, 26 MDD patients (16 males and 10 females, 20-58 years) were recruited from BESLI Clinic in Tokyo, and 27 healthy volunteers (15 males and 12 females, 18-60 years) were recruited from Tokyo Metropolitan University and RICOH Company, Ltd. Electrocardiography was used to calculate HRV variables as references. Result The WCF-MSS achieved 73% sensitivity and 85% specificity on 5-fold cross-validation. IBI correlated significantly with IBI from reference electrocardiography (r = 0.97, p < 0.0001). Logit scores and subjective self-rating depression scale scores correlated significantly (r = 0.43, p < 0.05). Conclusion The WCF-MSS seems a promising contact-free MDD screening apparatus. This method enables web camera built-in smartphones to be used as MDD screening systems.
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300MO Impact of dihydropyrimidine dehydrogenase (DPD) genotype on fluoropyrimidine-related toxicity in Asian population. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Development and Clinical Application of a Novel Non-contact Early Airflow Limitation Screening System Using an Infrared Time-of-Flight Depth Image Sensor. Front Physiol 2020; 11:552942. [PMID: 33013479 PMCID: PMC7516262 DOI: 10.3389/fphys.2020.552942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/19/2020] [Indexed: 11/13/2022] Open
Abstract
Obstructive pulmonary diseases, such as diffuse panbronchiolitis (DPB), asthma, chronic obstructive pulmonary disease (COPD), and asthma COPD overlap syndrome (ACOS) trigger a severe reaction at some situations. Detecting early airflow limitation caused by diseases above is critical to stop the progression. Thus, there is a need for tools to enable self-screening of early airflow limitation at home. Here, we developed a novel non-contact early airflow limitation screening system (EAFL-SS) that does not require calibration to the individual by a spirometer. The system is based on an infrared time-of-flight (ToF) depth image sensor, which is integrated into several smartphones for photography focusing or augmented reality. The EAFL-SS comprised an 850 nm infrared ToF depth image sensor (224 × 171 pixels) and custom-built data processing algorithms to visualize anterior-thorax three-dimensional motions in real-time. Multiple linear regression analysis was used to determine the amount of air compulsorily exhaled after maximal inspiration (referred to as the forced vital capacity, FVCEAFL–SS) from the ToF-derived anterior-thorax forced vital capacity (FVC), height, and body mass index as explanatory variables and spirometer-derived FVC as the objective variable. The non-contact measurement is automatically started when an examinee is sitting 35 cm away from the EAFL-SS. A clinical test was conducted with 32 COPD patients (27/5 M/F, 67–93 years) as typical airflow limitation cases recruited at St. Marianna University Hospital and 21 healthy volunteers (10/11 M/F, 23–79 years). The EAFL-SS was used to monitor the respiration of examinees during forced exhalation while sitting still, and a spirometer was used simultaneously as a reference. The forced expiratory volume in 1 s (FEV1%EAFL–SS) was evaluated as a percentage of the FVCEAFL–SS, where values less than 70% indicated suspected airflow limitation. Leave-one-out cross-validation analysis revealed that this system provided 81% sensitivity and 90% specificity. Further, the FEV1EAFL–SS values were closely correlated with that measured using a spirometer (r = 0.85, p < 0.0001). Hence, EAFL-SS appears promising for early airflow limitation screening at home.
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Changes in Heart Rate Variability after Yoga are Dependent on Heart Rate Variability at Baseline and during Yoga: A Study Showing Autonomic Normalization Effect in Yoga-Naïve and Experienced Subjects. Int J Yoga 2020; 13:160-167. [PMID: 32669772 PMCID: PMC7336948 DOI: 10.4103/ijoy.ijoy_39_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/31/2019] [Accepted: 12/12/2019] [Indexed: 12/04/2022] Open
Abstract
Background: Yoga therapy is widely applied to the maintenance of health and to treatment of various illnesses. Previous researches indicate the involvement of autonomic control in its effects, although the general agreement has not been reached regarding the acute modulation of autonomic function. Aim: The present study aimed at revealing the acute effect of yoga on the autonomic activity using heart rate variability (HRV) measurement. Methods: Twenty-seven healthy controls participated in the present study. Fifteen of them (39.5 ± 8.5 years old) were naïve and 12 (45.1 ± 7.0 years old) were experienced in yoga. Yoga skills included breath awareness, two types of asana, and two types of pranayama. HRV was measured at the baseline, during yoga, and at the resting state after yoga. Results: In both yoga-naïve and experienced participants, the changes in low-frequency (LF) component of HRV and its ratio to high-frequency (HF) component (LF/HF) after yoga were found to be correlated negatively with the baseline data. The changes in LF after yoga were also correlated with LF during yoga. The changes in HF as well as the raw HRV data after yoga were not related to the baseline HRV or the HRV during yoga. Conclusion: The results indicate that yoga leads to an increase in LF when LF is low and leads to a decrease in LF when it is high at the baseline. This normalization of LF is dependent on the autonomic modulation during yoga and may underlie the clinical effectiveness of yoga therapy both in yoga-naïve and experienced subjects.
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Visualisation of epidemiological map using an Internet of Things infectious disease surveillance platform. Crit Care 2020; 24:400. [PMID: 32646460 PMCID: PMC7344024 DOI: 10.1186/s13054-020-03132-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/01/2020] [Indexed: 11/10/2022] Open
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Usefulness of heart rate variability indices in assessing the risk of an unsuccessful return to work after sick leave in depressed patients. Neuropsychopharmacol Rep 2020; 40:239-245. [PMID: 32627417 PMCID: PMC7722666 DOI: 10.1002/npr2.12121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/30/2020] [Accepted: 05/18/2020] [Indexed: 01/20/2023] Open
Abstract
AIM The present study aimed to examine whether heart rate variability (HRV) indices in depressed patients measured at return to work after sick leave are related to the outcome of reinstatement. METHODS This study included 30 workers who took a leave of absence due to major depressive disorder. HRV was measured twice, once when participants left work and another when they returned to work. One month after returning to work, 19 participants continued their original work (successful return group), while 11 failed to perform their original work (unsuccessful return group). HRV indices including high- and low-frequency components (HF and LF) were calculated in three conditions within a session lasting for about 5 minutes, initial rest (Rest), mental task (Task), and rest after task (After), and were compared between the two participant groups. Psychological states were evaluated using Self-rating Depression Scale and State-Trait Anxiety Inventory. RESULTS No significant differences were observed in the HRV indices on leaving work between groups. On returning to work, the "unsuccessful return group" exhibited lower HF Rest score, higher HF Task/Rest ratio, and higher LF/HF Rest score than the "successful return group." Psychological scores improved in both groups. CONCLUSION These results indicate that autonomic dysregulations revealed by HRV measurement at return to work after a leave of absence in MDD patients were related to the outcome of reinstatement and can serve as useful information for the assessment of the risk of unsuccessful return.
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A Non-contact Spirometer with Time-of-Flight Sensor for Assessment of Pulmonary Function. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:4114-4117. [PMID: 33018903 DOI: 10.1109/embc44109.2020.9176606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Assessment of pulmonary function is vital for early detection of chronic diseases such as chronic obstructive pulmonary disease (COPD) in home healthcare. However, monitoring of pulmonary function is often omitted owing to the heavy burden that the use of specific medical devices places on the patients. In this study, we developed a non-contact spirometer using a time-of-flight sensor that measures very small displacements caused by chest wall motion during breathing. However, this sensor occasionally failed when estimating the values from breathing waveforms because their shape depends on the subject test experience. As a result, further measurements were required to address motion artifacts. To accomplish high accuracy estimation in the face of these factors, we developed methods to estimate parameters from a part of the waveform and remove outliers from multiple-region measurements. According to laboratory experiments, the proposed system achieved an absolute error of 5.26 % and a correlation coefficient of 0.88. This study also addressed the limitations of depth sensor measurements, thereby contributing to the implementation of high-accuracy COPD screening.
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A Pneumonia Screening System based on Parasympathetic Activity Monitoring in Non-contact Way using Compact Radars Beneath the Bed Mattress. J Infect 2020; 81:e142-e144. [PMID: 32505581 PMCID: PMC7271866 DOI: 10.1016/j.jinf.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022]
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SAT0124 RISK OF SERIOUS INFECTION, MALIGNANCY, OR DEATH IN JAPANESE RHEUMATOID ARTHRITIS PATIENTS TREATED WITH A COMBINATION OF ABATACEPT AND TACROLIMUS: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Both Abatacept (ABT) and Tacrolimus (Tac) suppress T cell immunity, but it is unknown whether combinations of these will increase the risk of adverse events.Objectives:To evaluate whether combining ABT and Tac increases the risk of infection and malignancy compared to their individual use in Japanese rheumatoid arthritis (RA) patients.Methods:We conducted a retrospective cohort study of RA patients using the multicenter database in Japan (NinJa). The dataset was clinical information at a certain point within each year, and the point was any point selected by a registered physician. RA was clinically diagnosed in the dataset. (1)We analyzed the data from RA patients registered in NinJa during the period from April 2010 to March 2019. In this study, we compared three groups who received Tac, ABT or a combination of both. We included patients who had just begun initiating treatment with ABT or Tac, and we excluded patients who used TNF inhibitors, IL-6 inhibitors, and Jak inhibitors in the first year. The primary outcome was defined the composite events including infections that require hospitalization, newly diagnosed malignancy, and death from any cause after initiation of ABT or Tac. We assessed whether the combination contributed to increase the risk of outcome by performing a Cox regression analysis.Results:Among the 27032 RA patients in the registry, 2009 patients were included. The Tac, ABT and combination groups consisted of 1328, 563 and 118 patients, respectively. (Figure 1) (Table 1) Primary outcomes occurred in 149 (13.4%), 62 (13.5%), 14 (13.9%) patients, of the Tac, ABT and combination groups, respectively. The incidence between groups was not significantly different (p= 0.638). (Figure 2) A Cox regression analysis was adjusted for the following parameters: age, sex, disease duration, modified health assessment questionnaire, disease activity score 28-CRP, CRP, use of prednisolone, and use of methotrexate. The analysis revealed no significant differences between groups. The hazard ratio (95% confidence interval) was as follows: Tac 1.00 (Ref), ABT 1.02 (0.74-1.40), and combination 1.15 (0.65-2.05).Table 1.baseline characteristicsTacrolimusAbataceptCombinationp valueN (person-year)1328 (2505)563 (944)118 (193)age (median [IQR])69.00 [60.00, 76.00]70.00 [61.00, 76.00]67.00 [59.00, 74.00]0.169*sex female (%)1038 (78.2)468 (83.1)97 (82.2)0.039†disease duration (yr) (median [IQR])9.00 [4.00, 18.00]11.00 [5.00, 21.00]11.00 [7.00, 20.00]0.002*Steinbrocker stage (%)I285 (23.5)82 (15.6)12 (12.1)<0.001†II361 (29.8)125 (23.8)25 (25.3)III232 (19.1)150 (28.5)31 (31.3)IV334 (27.6)169 (32.1)31 (31.3)mHAQ (median [IQR])0.25 [0.00, 0.75]0.38 [0.00, 1.00]0.50 [0.00, 1.13]<0.001*DAS28CRP (median [IQR])2.58 [1.88, 3.40]2.77 [2.09, 3.62]3.01 [2.27, 3.98]<0.001*CRP (mg/dL) (median [IQR])0.30 [0.10, 1.02]0.35 [0.13, 1.10]0.30 [0.14, 0.82]0.590*RF positivity (%)708/895 (79.1)331/400 (82.8)57/71 (80.3)0.314†Tacrolimus (mg/d) (median [IQR])1.50 [1.00, 2.00]0.00 [0.00, 0.00]2.00 [1.00, 2.50]<0.001*MTX use (%)619 (46.6)264 (46.9)32 (27.1)<0.001†PSL use (%)749 (56.4)299 (53.1)71 (60.2)0.253†Abbreviations: anti-CCP, anti-cyclic citrullinated peptide; mHAQ, modified Health Assessment Questionnaire; MTX, methotrexate; PSL, prednisolone; RF, rheumatoid factor * Kruskal-Wallis test; † chi square test; ‡ analysis of variance (ANOVA)Conclusion:The combination of ABT and Tac does not increase the risk of adverse events in patients with rheumatoid arthritis in Japan when compared to the use ABT or Tac alone. Further evaluation is needed.References:[1]Matsui T, et al. Ann Rheum Dis 2007;66:1221–6.Disclosure of Interests:Kenichiro Tokunaga: None declared, Kunihiko Matsui: None declared, Hideto Oshikawa: None declared, Toshihiro Matsui Paid instructor for: Chugai Pharmaceutical Co., LTD., Janssen Pharmaceutical K,K,, Shigeto Tohma: None declared
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Lack of association between a disease-susceptible single-nucleotide polymorphism, rs2230926 of TNFAIP3, and tumour necrosis factor inhibitor therapeutic failure in Japanese patients with rheumatoid arthritis. Scand J Rheumatol 2020; 49:253-255. [PMID: 32406335 DOI: 10.1080/03009742.2020.1716992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Infection Screening System Using Thermography and CCD Camera with Good Stability and Swiftness for Non-contact Vital-Signs Measurement by Feature Matching and MUSIC Algorithm. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3183-3186. [PMID: 31946564 DOI: 10.1109/embc.2019.8857027] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Screening systems for infectious diseases based on fever have been implemented at international airports to prevent the spread of infection for over a decade. Currently, only Infrared Thermography (IRT) is used for screening and measuring facial skin temperature, which is one of clinical indicators of potential infection. Aiming at higher accuracy in screening, our group adopted heart rate (HR) and respiration rate (RR) for the first time as the new screening parameters. In our previous study, we proposed a screening system based on dual image sensors, which include IRT and a charged-coupled devices (CCD) camera. The sensors can measure three vital signs simultaneously, namely HR, RR, and facial skin temperature. For the measurement of RR in this system, stability and swiftness must be applied for application in airports. In this study, we introduce feature matching and multiple signal classification (MUSIC) algorithm in this system. Feature matching between thermal images and RGB images captured by a CCD camera and IRT, respectively, is used to detect the nose and mouth in IRT, which helps extract respiration signals corresponding to airflow from breathing. In addition, the MUSIC algorithm improves the accuracy of RR frequency estimations in limited time respiration signal and achieves swiftness. The proposed method improves stability by simultaneously detecting the nose and mouth in thermal images, and enhances the accuracy of estimated RR using the MUSIC algorithm. By using this system, we evaluate the accuracy of the estimated vital signs. The performance of this screening system was evaluated using data obtained from 12 influenza patients and 13 healthy subjects at a clinical facility in Fukushima, Japan.
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Development of a low-cost, portable, pediatric infection screening system using simultaneous measurement of multiple vital signs. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:7181-7184. [PMID: 31947491 DOI: 10.1109/embc.2019.8857689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The primary cause of death among children under age 5 years is acute respiratory infection, such as pneumonia. Detection of infection at the earliest point of contagion is necessary, to reduce morbidity and prevent infectious disease epidemics; therefore, identifying abnormal vital signs is essential. For early detection of pediatric infections, we developed a low-cost, portable, rapid screening system of pediatric infection. The system simultaneously measures three vital signs: heart rate (HR), respiration rate (RR), and body temperature (Temp) within 10 seconds using a pulse sensor, Doppler radar, and an infrared thermopile. Vital sign signal processing and computation are conducted using an Arduino Nano microprocessor, enabling the small, lightweight, and portable design of this system. Moreover, the cost-effectiveness of the system facilitates system applications in developing countries, which have the highest levels of pediatric mortality. We conducted trial measurement in Bayangol Health Center, Ulaanbaatar, Mongolia in 2019. A total of 50 children (age 1-14 years, 26 boys/24 girls) were enrolled in this study. Bland-Altman plot and Pearson correlation methods were used to evaluate the accuracy of the proposed system. The correlation coefficients were calculated as HR: r=0.92, RR: r=0.8, and Temp: r=0.82, with p<; 0.01. The system appears promising for rapid and convenient detection of infection in children.
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Non-contact monitoring of heart rate variability using medical radar for the evaluation of dynamic changes in autonomic nervous activity during a head-up tilt test. J Med Eng Technol 2019; 43:411-417. [PMID: 31769314 DOI: 10.1080/03091902.2019.1687771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Electrocardiography (ECG) is a mandatory standard for monitoring electrical activity of the heart in many clinical settings such as intensive care and emergency units. However, in situations wherein the skin is damaged, such as acute burn injuries, it is impossible to efficiently attach electrodes to the skin. In this study, we developed a non-contact cardiac monitoring system using a 24-GHz medical radar for directly measuring the beat-to-beat heart mechanical activity at a distance from a subject. The heart rate variability (HRV) was analysed using an autoregressive model (AR) from the measured beat-to-beat intervals during a head-up tilt test. To investigate the feasibility of the proposed system, we compared medical radar and ECG recording by using Lin's correlation coefficient and Bland-Altman analysis, which showed a negligible mean difference from the substantial agreement of Lin's correlation coefficient of 0.9 between the radar and ECG. The non-contact radar clearly monitored dynamic changes in HRV indices induced by the head-up tilt test. This type of non-contact HRV-sensing technique as an alternative approach has significant potential for advancing personal healthcare in both clinical and out-of-hospital settings.
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Stable Contactless Sensing of Vital Signs Using RGB-Thermal Image Fusion System with Facial Tracking for Infection Screening. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:4371-4374. [PMID: 30441322 DOI: 10.1109/embc.2018.8513300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Infrared thermography (IRT) has been used to screen febrile passengers in international airports for over a decade. However, fever-based infection screening using IRT suffered from low sensitivity because measurements can be affected by ambient temperature, humidity, etc. In our previous study, we proposed an RGB-thermal image fusion system to measure vital signs i.e., the RGB camera detects tiny changes in color from facial skin, associated with blood flow, to estimate heart rate, and IRT senses temperature changes around the nasal area, caused by respiration, to measure respiratory rate). The inclusion of heart and respiratory rates lead to increased screening accuracy. In the present study, to promote the widespread use of our system in real-world settings, a face detection and tracking method was developed and implemented into the system, thereby enabling the accurate and stable measurement of vital signs. We assessed heart and respiratory rate estimation via an RGB-thermal image fusion system using Bland-Altman plots and statistical analysis.
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Clinical Application of Multiple Vital Signs-Based Infection Screening System in a Mongolian Hospital: Optimization of Facial Temperature Measurement by Thermography at Various Ambient Temperature Conditions Using Linear Regression Analysis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:5313-5316. [PMID: 30441536 DOI: 10.1109/embc.2018.8513513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fever is one significant sign of infection. Hence, infrared thermography systems are important for detecting infected suspects in public places. Reliable temperature measurements by thermography are influenced by several factors, including environmental conditions. This paper proposes a linear regression analysis-based facial temperature optimization method to improve the accuracy of multiple vital signs-based infection screening at various ambient temperatures. To obtain the relationship between ambient temperature and thermography measurements, 20 instances of axillary temperature, thermography measurements of facial temperature, and five different ambient temperature values at the time of measurement were used as a training set for a linear regression model. Temperatures from a total of 30 subjects were recalculated by the model. The screening system was evaluated using the temperature both before and after optimization to demonstrate the accuracy of the optimization method. A k-nearest neighbor algorithm was used to classify potentially infected patients from healthy subjects. Although the system has already been evaluated in restricted environmental conditions, this is the first time it was tested in Ulaanbaatar, Mongolia. The results show that the Pearson's correlation coefficient between optimum and axillary temperatures increased to r = 0.82. Paired t-tests revealed that the optimized temperature became statistically highly significant (p<0.001) for differentiating potentially infected patients from healthy subjects. Finally, the system achieved a sensitivity score of 91% and a negative predictive value of 92%. These values are higher than those obtained without temperature optimization. The proposed optimization method is feasible and can notably improve screening performance.
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Subgroup analyses of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with 2 and 4 courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P1.06-07 Targeting Photo-Therapy for Malignant Pleural Mesothelioma; Near Infrared Photoimmunotherapy Targeting Podoplanin. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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P1.12-07 Near Infrared Photoimmunotherapy Targeting DLL3 Against Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Randomized clinical trial of extensive intraoperative peritoneal lavage versus standard treatment for resectable advanced gastric cancer (CCOG 1102 trial). Br J Surg 2019; 106:1602-1610. [PMID: 31573086 DOI: 10.1002/bjs.11303] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/27/2019] [Accepted: 06/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND A survival benefit of extensive intraoperative peritoneal lavage (EIPL) has been reported in patients with gastric cancer with positive peritoneal cytology. The hypothesis of this study was that EIPL may reduce peritoneal recurrence in patients with advanced gastric cancer who undergo surgery with curative intent. METHODS This was an open-label, multi-institutional, randomized, phase 3 trial to assess the effects of EIPL versus standard treatment after curative gastrectomy for resectable gastric cancer of T3 status or above. The primary endpoint was disease-free survival (DFS); secondary endpoints were overall survival, peritoneal recurrence-free survival and incidence of adverse events. RESULTS Between July 2011 and January 2014, 314 patients were enrolled from 15 institutions and 295 patients were analysed (145 and 150 in the EIPL and no-EIPL groups respectively). The 3-year DFS rate was 63·9 (95 per cent c.i. 55·5 to 71·2) per cent in the EIPL group and 59·7 (51·3 to 67·1) per cent in the control group (hazard ratio (HR) 0·81, 95 per cent c.i. 0·57 to 1·16; P = 0·249). The 3-year overall survival rate was 75·0 (67·1 to 81·3) per cent in the EIPL group and 73·7 (65·9 to 80·1) per cent in the control group (HR 0·91, 0·60 to 1·37; P = 0·634). Peritoneal recurrence-free survival was not significantly different between the two groups (HR 0·92, 0·62 to 1·36; P = 0·676). No intraoperative complications related to EIPL were observed. CONCLUSION EIPL did not improve survival or peritoneal recurrence in patients who underwent gastrectomy for advanced gastric cancer. Registration number: 000005907 (http://www.umin.ac.jp/ctr/index.htm).
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Inter-Study Precision of Cancer Cell Radiosensitivity As Assessed By Colony Formation Assay. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Impact of Early Salvage Radiotherapy in Patients with Biochemical Recurrence after Radical Prostatectomy: Results of a Multi-institutional Retrospective Study. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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A novel machine-learning-based infection screening system via 2013-2017 seasonal influenza patients' vital signs as training datasets. J Infect 2019; 78:409-421. [PMID: 30797793 DOI: 10.1016/j.jinf.2019.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
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Twenty-four-hour continuous and remote monitoring of respiratory rate using a medical radar system for the early detection of pneumonia in symptomatic elderly bedridden hospitalized patients. Clin Case Rep 2019; 7:83-86. [PMID: 30656014 PMCID: PMC6333072 DOI: 10.1002/ccr3.1922] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/01/2018] [Accepted: 10/26/2018] [Indexed: 11/11/2022] Open
Abstract
Respiratory rate is often measured manually and discontinuously by counting of chest wall movements in routine clinical practice. We introduce a novel approach to investigate respiration dynamics using a noncontact medical radar system for identifying patient at risk of infection. The system enables early detection of pneumonia in bedridden hospitalized patients.
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