148 research outputs found
Detection of Self-Reported Stress Level from Wearable Sensor Data Using Machine Learning and Deep Learning-Based Classifiers: Is It Feasible?
No full textSocial, emotional and psychological state of a person are strictly related to their physical and mental health. Wellbeing can be disrupted by numerous factors, such as an extremely dynamic life that lead individuals to be more prone to stress. When a person is stressed, the body reacts in different ways, e.g., with headaches, sweating, heart palpitations. Some of these alterations can be quantified and measured with portable devices, such as smartwatches and wristbands, which potentially could be exploited for developing automatic stress measuring systems and prediction. In this work, we describe four different approaches to the problem by developing machine learning and deep-learning based pipelines for the detection of stress using wearable sensor data. The work was conducted on the SMILE dataset, which included features extracted from 60-minute sequences of electrocardiogram, galvanic skin response and skin temperature collected in 45 subjects. Results are less encouraging than expected, with accuracy and F1 score that reach maximum 0.57 and 0.62 respectively. The obtained results evidence the difficulties in modeling data in the wild to build a reliable stress detection algorithm. Further research studies are needed to demonstrate the feasibility of this tool
Importance of blood pressure control in chronic kidney disease
No full textArterial hypertension together with proteinuria is one of the most important factors associated with the progression of both diabetic and nondiabetic chronic kidney disease. In this review, the role of hypertension and proteinuria in renal disease progression, the BP target that should be achieved to slow the progression of renal damage, and the influence of baseline and current proteinuria on the renoprotective effects of antihypertensive therapy are discussed thoroughly. The interaction between the renoprotective effects of specific antihypertensive agents--mostly angiotensin-converting enzyme inhibitors and angiotensin receptor blockers--and the level of achieved BP also are evaluated. The body of evidence provided by several studies emphasizes the importance of both lowering BP and inhibiting the renin-angiotensin system as specific goals for renal and cardiovascular protection in chronic kidney diseas
Spontaneous low-protein intake in older CKD patients: one diet may not fit all
No full textBackgroundProtein restriction has been extended to stage 3 chronic kidney disease (CKD) regardless of age in the latest K-DOQI guidelines for the dietary management of patients with CKD. However, in elderly CKD patients there is a tendency to a spontaneous reduction in protein and energy intake that may impair the overall nutritional status. The aim of our study is to assess whether there are differences in malnutrition, exercise capacity and inflammatory status in elderly CKD patients with spontaneously low protein intake (sLPI) compared with patients with normal protein intake (NPI).MethodsWe performed a cross-sectional analysis of 123 incident patients. Malnutrition was assessed using Malnutrition Inflammation Score (MIS) and serum markers; As for physical performance, we used Short Physical Performance Battery (SPPB) and handgrip strength.ResultsWe found that in older patients with advanced CKD, as many as 68% had low spontaneous protein intake, and they were more malnourished evaluated with MIS (25% vs. 10%, p = 0.033), protein-energy wasting (PEW) (43% vs. 14%, p = 0.002) and nPCR (0.63[0.51–0.69] vs. 0.95[0.87–1.1], p < 0.0001). They also had worse body composition, in terms of lower mid-arm muscular circumference (MAMC), fat tissue index (FTI) and higher overhydration (OH). sLPI patients also had higher levels of IL6 (4.6[2.9–8.9] vs. 2.8[0.8–5.1], p = 0.002). Moreover, sLPI patients were frailer (33% vs. 24%, p = 0.037) and had poorer physical performance especially when assessed with (SPPB) (7[5–9] vs. 9[7–10], p = 0.004) and gait test time (6.08 + 2 vs. 7.22 + 2.7, p = 0.04). sLPI was associated with lower physical performance [SPPB OR, 0.79 (0.46–0.97), p = 0.046] and malnutrition [MIS 1.6 (1.05–3.5), p = 0.041] independently from patients’ age and eGFR.ConclusionWe found that in older patients with advanced CKD, up to 68% had low spontaneous protein intake and were frailer, more malnourished and with lower physical performance. These findings emphasize the importance of assessing patients’ needs, and personalized approaches with individual risk–benefit assessments should be sought. To achieve the best possible outcomes, targeted interventions should use all available tools
Assessing Personal Exposure to Airborne Particulate Matter with Wearable Sensors and Ventilation Rate Models
No full textAir pollution is a major contributor to global morbidity and mortality. Accurate assessment of individual's exposure to air pollution is important to quantify the impact of air pollution on human health. Historically, human exposure to air pollution has been quantified using pollutant concentrations from fixed air quality monitoring stations. This approach does not consider the subject's activities and the differences between indoor and outdoor air pollution; however, these limitations can be overcome using wearable sensors. In this work, we propose a new approach to measure personal exposure to airborne Particulate Matter (PM) that consists in using a wearable/portable air quality sensor to measure air quality at the subject's location, a wearable Heart Rate (HR) sensor to collect HR timeseries, and a ventilation rate (VE) model to estimate the volume of inhaled air per minute (L/min) based on HR and other subject's covariates. Finally, VE and PM timeseries are combined to estimate the inhaled pollutant doses over time, as a measure of personal exposure. To model VE as a function of HR, 4 literature models are considered. The estimates obtained with the 4 models are compared in 3 representative subjects. Initial data analysis showed that the 4 models may drive to statistically significant differences in exposure estimates, thus the choice of the model can be a critical aspect of this approach. Regardless of the model used, timeseries of inhaled PM revealed significant daily variations in pollutant exposure, highlighting the importance of methodologies for accurate personal exposure assessment
Anthropometric indices of sarcopenia in patients with Chronic Kidney Disease
No full textThe Chronic Kidney Disease (CKD) is a kidney dysfunction for which the estimated Glomerular Filtration Rate (eGFR) result
Accelerated AGEing: The Impact of Advanced Glycation End Products on the Prognosis of Chronic Kidney Disease
No full textAdvanced glycation end products (AGEs) are aging products. In chronic kidney disease (CKD), AGEs accumulate due to the increased production, reduced excretion, and the imbalance between oxidant/antioxidant capacities. CKD is therefore a model of aging. The aim of this review is to summarize the present knowledge of AGEs in CKD onset and progression, also focusing on CKD-related disorders (cardiovascular diseases, sarcopenia, and nutritional imbalance) and CKD mortality. The role of AGEs as etiopathogenetic molecules, as well as potential markers of disease progression and/or therapeutic targets, will be discussed
Peritoneal dialysis related peritonitis: insights from a long-term analysis of an Italian center
No full textBackground: Peritonitis is a common and severe complication of peritoneal dialysis (PD). For comparative analysis standardized definitions as well as measurements and outcomes are crucial. However, most PD-related peritonitis studies have been using heterogenous definitions and variable methods to measure outcomes. The ISPD 2022 guidelines have revised and clarified numerous definitions and proposed new peritonitis categories and outcomes. Methods: Between 1st January 2009 and 31st May 2023, 267 patients who started PD at our institution were included in the study. All PD-related peritonitis episodes that occurred in our unit during the study period were collected. The new definitions and outcomes of ISPD 2022 recommendations were employed. Results: The overall peritonitis rate was 0.25 episode/patient year. Patient cumulative probability of remaining peritonitis-free at one year was 84.2%. The medical cure and refractory peritonitis rates were equal to 70.3 and 22.4%, respectively. Culture-negative peritonitis accounted for 25.6% of all specimens. The rates of peritonitis associated death, hemodialysis transfer, catheter removal and hospitalization were 6.8%, 18.3%, 18.7% and 64.4%, respectively. Relapsing, repeat, recurrent and enteric peritonitis accounted for 7.8%, 6.8%, 4.1% and 2.7% of all episodes, respectively. Catheter insertion, catheter related and pre-PD peritonitis were 4.2, 2.1 and 0.5%. Conclusions: The implementation of PD-related peritonitis reports using standardized definitions and outcome measurements is of paramount importance to enhance clinical practice and to allow comparative studies
Towards allosteric modulators of Hsp90
No full textHsp90 is an established anti-apoptotic target in cancer therapy.1 Most of the known small-molecule inhibitors that have shown potent antitumor activity target the Hsp90 N-terminal domain and directly inhibit its ATP-ase activity.2 However, many of these molecules display important secondary effects. A different approach to Hsp90 inhibition consists of targeting the protein C-terminal domain (CTD) and modulating its chaperone activity through allosteric effects. Using an original computational approach, allosteric hot-spots in the CTD have been recently identified that control interdomain communication.3 A combination of virtual and experimental screening enabled identification of 1 (Eupomatenoid-2, Figure 1) as a lead for further development.3 Four diversification areas have been identified (R1-R4, Figure 1).
Chemical approaches to the (glyco)diversification at R4 will be presented,4 along with alternative synthetic pathways for the synthesis of the 2-phenyl-benzofuran core and its diversification at R1.
Preliminary results indicate that the compounds obtained so far are CTD ligands and are able to modulate Hsp90 activity
Relationship between number of daily exchanges at CAPD start with clinical outcomes
No full textBackground: Peritoneal dialysis (PD) continues to be demanding for patients affected by kidney failure. In kidney failure patients with residual kidney function, the employment of incremental PD, a less onerous dialytic prescription, could translate into a decrease burden on both health systems and patients. Methods: Between 1st January 2009 and 31st December 2021, 182 patients who started continuous ambulatory peritoneal dialysis (CAPD) at our institution were included in the study. The CAPD population was divided into three groups according to the initial number of daily CAPD exchanges prescribed: one or two (50 patients, CAPD-1/2 group), three (97 patients, CAPD-3 group) and four (35 patients, CAPD-4 group), respectively. Results: Multivariate analysis showed a difference in term of peritonitis free survival in CAPD-1/2 in comparison to CAPD-3 (hazard ratio (HR): 2.20, p = 0.014) and CAPD-4 (HR: 2.98, p < 0.01). A tendency towards a lower hospitalisation rate (CAPD-3 and CAPD-4 vs. CAPD-1/2, p = 0.11 and 0.13, respectively) and decreased mortality (CAPD-3 and CAPD-4 vs. CAPD-1/2, p = 0.13 and 0.22, respectively) in patients who started PD with less than three daily exchanges was detected. No discrepancy of the difference of the mean values between baseline and 24 months residual kidney function was observed among the three groups (p = 0.33). Conclusions: One- or two-exchange CAPD start was associated with a lower risk of peritonitis in comparison to three- or four-exchange start. Furthermore, an initial PD prescription with less than three exchanges may be associated with an advantage in term of hospitalisation rate and patient survival
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