35 research outputs found
Advances in Anticoagulation
No full textAdvances in Anticoagulation. Simrat Gill, Chief Resident, Rochester General Hospital Internal Medicine Residency Program; Hassan Saeed, Chief Resident, Rochester General Hospital Internal Medicine Residency Program
Objectives: Characterize the broad range of diseases that fall under the term Thrombophilia Review new changes to guidelines on testing thrombophilia as they pertain to primary care teams (PCP, hospitalists) Discuss prior and upcoming data pertaining to Factor XI inhibitors
A Golden Friendship: A Children\u27s Book
No full textThis picture book is about a 3rd grader named Simrat, and her journey through depression and anxiety. Her parents start noticing symptoms, such as anger, frustration, and sadness. They end up taking her to the child therapist because they realize Simrat needs professional help. Dr. Lavendar recommends they get her an emotional support dog! This is exactly what her parents end up doing. Simrat gets a golden retriever named Gracie. Their journey shows that depression does not go away overnight, but with support and love, it is a lot easier to deal with! Simrat and Gracie grow together. They have their days but eventually, Simrat feels better because of all the great support she has! I have not completed the illustrations yet, so the pages with just text are incomplete. Hopefully, I will finish this soon in the future
Improving stratification and management of patients with atrial fibrillation and heart failure using novel technology
No full textAtrial fibrillation (AF) and heart failure (HF) commonly co-exist, and exhibit higher rates of morbidity and mortality. Treatment remain unclear due to the lack of robust data regarding treatment efficacy in this specific population, and current ones have unpredictable responses. The use of big data and artificial intelligence (AI) based analysis has allowed us to find better ways to identify and sub-categorise this cohort of patients based on treatment response, that can improve outcomes and quality of life.
This PhD looked at the use of big data and machine learning to improve phenotyping and prognoses in patients with AF and HF. A systematic review and meta-analysis of novel screening techniques for AF detection found smartphone photoplethysmography had a high sensitivity and specificity for AF detection when compared to an ECG (n=28 studies). A meta-analysis of 20 comparisons (n=17 studies; n=6,891; 2,299 with AF) found a pooled sensitivity of 94% (95% CI 92-95%) and specificity of 97% (CI 96-98%), with significant heterogeneity (p<0.01). Studies were found to be small, of poor quality and biased.
Following this, a consumer wearable Fitbit device measuring PPG heart rate and physical activity (step count), was embedded within an on-going randomised clinical trial (RATE-AF) to compare the effectiveness of beta blockers and low-dose digoxin in AF rate control. Over 143 million heart rate recordings and 23 million corresponding physical activity intervals were collected over a mean of 20 weeks. No significant difference was seen in heart rate control with beta-blockers or low-dose digoxin, the regression coefficient was 1.22 (95% CI -2.82 to 5.27; p=0.55). There remained no difference in heart rate after adjusting for clinical variables (p=0.75), and individual physical activity (p=0.74). Conventional trial assessments and a wearable neural network trained on sensor data, were used to predict future trial outcomes. The wearable neural network showed a similar performance for predicting future New York Heart Association class: F1 score 0.55 (95% CI 0.40 to 0.70), versus 0.59 for electrocardiogram and 6-minute walk test (95% CI 0.44 to 0.74; p=0.72 for comparison).
The limitations of conventional statistical analysis in the presence of multi-morbidity were highlighted in the meta-analysis, assessing beta-blocker efficacy in heart failure with reduced ejection fraction (HFrEF) and renal dysfunction. This was only able to detect a weak interaction between beta blocker efficacy and renal function, with low power (p=0.021). An AI based clustering technique was evaluated to overcome this. The clustering technique identified clusters of HFrEF patients with different beta-blocker efficacy in sinus rhythm and AF. A cluster of older patients in sinus rhythm were found to have no benefit from beta-blockers, and a cluster of younger patients with AF were found to have a significant benefit.
These studies have highlighted the potential wearable devices and AI-based analysis can offer in terms of improving patient care
Cognitive health and links to wellbeing: An exploratory study
No full textFull text is available to authenticated members of The University of Auckland only.Research is now starting to unveil the importance of the brain and the role of cognitive health towards overall health and wellbeing of an individual. Traditionally, the focus has been on maintaining physical health as a way to improve wellbeing. This can be witnessed through increased interest in physical activity, adoption of fitness and health trackers, eating a healthy diet and getting regular health check-ups. In terms of cognitive health, there is not much robust evidence supporting how and why people look after their cognitive health as a way to improve their wellbeing. Even though many tools and activities are now available to improve cognitive health, there is lack of evidence to show how people adopt and engage with these in their daily lives. Thus, two research questions were developed to further explore this area: (1) What is cognitive health and how can it be improved? (2) How and why do people engage in activities (explicit and implicit) aimed at optimising cognitive health? Research question one was answered through a thorough review of the literature. The second research question was addressed by engaging with participants through empathy interviews and observations. Following a detailed analysis of the raw data, several key findings were identified. Cognitive health is not a common term used amongst people, it is rather referred to as brain or mental health, and broken down into various domains such as memory, reaction time, speed of information processing and the ability to think. Memory was the most common and discussed topic amongst all for various reasons. These ranged from maintaining a good quality of life, feeling independent, maintaining strong familial connections, academic success as well as employment performance. Participants also showed a lack of awareness in terms of what kind of activities were good for their brain health but engaged in activities that were part of their daily living such as physical exercise, social interaction, working, studying, reading, social interaction and management of stress. Furthermore, there was a strong sense of curiosity, keenness and openness to learn and understand more about this area of health, which was also emphasised through engagement with the BrainCheck assessment. This study has identified four key opportunity areas in order to improve cognitive health; these were: food and nutrition, cognitive health training, cognitive health assessment and educational awareness
Artificial intelligence to enhance clinical value across the spectrum of cardiovascular healthcare
No full textArtificial intelligence (AI) is increasingly being utilized in healthcare. This article provides clinicians and researchers with a step-wise foundation for
high-value AI that can be applied to a variety of different data modalities. The aim is to improve the transparency and application of AI methods, with
the potential to benefit patients in routine cardiovascular care. Following a clear research hypothesis, an AI-based workflow begins with data selection and pre-processing prior to analysis, with the type of data (structured, semi-structured, or unstructured) determining what type of pre-processing steps and machine-learning algorithms are required. Algorithmic and data validation should be performed to ensure the robustness of the
chosen methodology, followed by an objective evaluation of performance. Seven case studies are provided to highlight the wide variety of data modalities and clinical questions that can benefit from modern AI techniques, with a focus on applying them to cardiovascular disease management
Autologous Transplantation and CAR-T Cell Therapies for Lymphomas
No full textDepartment Meeting: What\u27s the GFR? Removing the Social Construct of Race from Estimates of Kidney Function, Drs. Marvin Grieff, Chris Reynolds, Roberto Vargas
Case Presentation: Autologous Transplantation and CAR-T Cell Therapies for LymphomasAgenda: Case Presentation Diffuse Large B-Cell Lymphoma Autologous Transplantation for Lymphoma CAR-T Therap
Wireless Electricity Theft Detection System Using Zigbee Technology
No full textWireless electricity theft detection system using ZIGBEE technology present an efficient and less costly way to adulterate the wireless technique used in this research paper. This wireless system is used to overcome the theft of electricity via bypassing the energy meter and hence it also controls the revenue losses and utility of the electricity authorised agency . There is always a contract between the consumer and the supplier that the consumer will pay for the electricity consumed by him. But in India near about 32 % of the electricity is consumed but not paid for it i.e. it is being stolen by the consumer hence the need of a system arises that would overcome this theft of electricity but mostly the electricity is being stolen via bypassing the energy meter hence this system recognises such type of theft of electricity. Mainly this system consists of microcontroller, energy meter and a ZIGBEE module to check f or the theft of electricity and then to send a message to the authorised agency which looks after the electricity consumed. The wireless technique used in this system provides the major advantages such as low power consumption and also the low cost of the ZIGBEE module. This system can also have the advantages that it can also be used to detect the theft of the gas, fuel and oil simply by changing the measurement meter used in this system and excellently the theft can be detected at tables by the authorised agencies
Randomized control trial comparing results of platelet rich plasma with steroid injection in subacromial impingement syndrome
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