Given the increasing lifespan of the elderly and the higher proportion of older people in the global population, the incidence rate of neurodegenerative diseases is increasing. The aim of this study ...is to evaluate, by means of computer simulations, developments in the costs of treating and caring for people suffering from Alzheimer's disease (AD) in the EU 28 by 2080, while assuming the introduction of drug administrations at various disease stages.
Impact analysis leverages a mathematical model that compares five different population development scenarios when introducing different types of drugs to the scenarios but without changing the treatment. Changes in the economic burden are considered as of 2023, when new drugs are expected to enter the market.
The results of the simulations show that by prolonging the length of a person's 'stay' in the Mild, Moderate, or Severe stage, the total cost of care for all persons with AD will increase by 2080. For individual scenarios, the percentage of patients and costs increased as follows: Mild by one year, by 10.61%; Mild by two years, by 17.73%; Moderate by one year, by 16.79%; Moderate by two years, by 34.88%; and Severe by one year, by 23.79%. The change in cost development when prolonging the stay in the Mild cognitive impairment stage (by lowering the incidence by 10%, 30%, or 50%) reduced the cost (by 4.88%, 16.78% and 32.48%, respectively).
The results unambiguously show that any intervention prolonging a patient's stay in any stage will incur additional care costs and an increase in the number of persons with AD. Therefore, extending lifespan is important in terms of improving the quality of life of patients, and the introduction of new drugs must consider the additional costs imposed upon society.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Sleep-related breathing disorders are diseases related to pharyngeal airway collapse. It can lead to several health problems such as somnolence, poorer daytime cognitive performance, and ...cardiovascular morbidity and mortality. However, computer-aided diagnostic (CAD) tools play a very important role in the detection of breathing disorders. It is possible to measure breathing activity, but most approaches require some type of device placed on the human body. This paper proposes a novel methodology of an unobtrusive CAD system to the breathing disorder detection. Unobtrusive approach is ensured by ballistocardiography (BCG) sensors located on the measured bed. The significant pieces of information from the signals are extracted by Cartan curvatures. Thereafter, important features are separated from individual samples as an input to our 9-layer deep convolutional neural network. We achieved an average accuracy of 98.00%, sensitivity of 94.26%, and specificity of 99.22% on 4009 regular and 1307 disordered breathing samples.
•Heart contraction mechanical trigger for unobtrusive detection of respiratory disorders is proposed from the mechanical measurement of cardiac contractions.•A novel method is given to calculate this ...mechanical trigger purely from measured mechanical signals without the use of ECG.•The proposed system does not require any equipment attached to a person, and achieved by locating the tensometers on the bed.•The system offers a novel way for a completely unobtrusive diagnosis of breathing-related health problems.
Background and Objectives Automatic detection of breathing disorders plays an important role in the early signalization of respiratory diseases. Measuring methods can be based on electrocardiogram (ECG), sound, oximetry, or respiratory analysis. However, these approaches require devices placed on the human body or they are prone to disturbance by environmental influences. To solve these problems, we proposed a heart contraction mechanical trigger for unobtrusive detection of respiratory disorders from the mechanical measurement of cardiac contractions. We designed a novel method to calculate this mechanical trigger purely from measured mechanical signals without the use of ECG. Methods The approach is a built-on calculation of the so-called euclidean arc length from the signals. In comparison to previous researches, this system does not require any equipment attached to a person. This is achieved by locating the tensometers on the bed. Data from sensors are fused by the Cartan curvatures method to beat-to-beat vector input for the Convolutional neural network (CNN) classifier. Results In sum, 2281 disordered and 5130 normal breathing samples was collected for analysis. The experiments with use of 10-fold cross validation show that accuracy, sensitivity, and specificity reach values of 96.37%, 92.46%, and 98.11% respectively. Conclusions By the approach for detection, the system offers a novel way for a completely unobtrusive diagnosis of breathing-related health problems. The proposed solution can effectively be deployed in all clinical or home environments.
Modeling dynamic systems with Fuzzy Cognitive Maps (FCMs) is characterized by the simplicity of the model representation and its execution. Furthermore, FCMs can easily incorporate human knowledge ...from the given domain. Despite the many advantages of FCMs, there are some drawbacks, too. The quality of knowledge obtained from the domain experts, and any differences and uncertainties in their opinions, has to be improved by different methods. We propose a new approach for handling incompleteness and natural uncertainty in expert evaluation of the connection matrix of a particular FCM. It is based on partial expert estimations and evolutionary algorithms in the role of an expert-driven optimization and outside of the FCM optimization (adaptation) research area known as Interactive Evolutionary Computing (IEC). In the present paper, a modification of IEC for the purposes of FCM optimization is presented, referred to as the IEO-FCM method, i.e., the Interactive Evolutionary Optimization of Fuzzy Cognitive Maps. Experimental results on two control problems suggest that the IEO-FCM method can improve the quality of an FCM even in situations without any measured data necessary for other known learning algorithms.
Despite the ever-increasing offering of SMART technologies (ie, computer-controlled devices acting intelligently and capable of monitoring, analyzing or reporting), a wide gap exists between the ...development of new technological innovations and their adoption in everyday care for older adults.
This study aims to explore the barriers and concerns related to the adoption of SMART technologies among different groups of stakeholders.
Data from 4 sources were used: semistructured in-person or internet-based interviews with professional caregivers (n=12), structured email interviews with experts in the area of aging (n=9), a web-based survey of older adults (>55 years) attending the Virtual University of the Third Age (n=369), and a case study on the adoption of new technology by an older adult care facility.
Although all stakeholders noted the potential of SMART technologies to improve older adult care, multiple barriers to their adoption were identified. Caregivers perceived older adults as disinterested or incompetent in using technology, reported preferring known strategies over new technologies, and noted own fears of using technology. Experts viewed technologies as essential but expressed concerns about cost, low digital competency of older adults, and lack of support or willingness to implement technologies in older adult care. Older adults reported few concerns overall, but among the mentioned concerns were lack of ability or interest, misuse of data, and limited usefulness (in specific subgroups or situations). In addition, older adults' ratings of the usefulness of different technologies correlated with their self-rating of digital competency (r=0.258; P<.001).
Older adults appeared to have more positive views of various technologies than professional caregivers; however, their concerns varied by the type of technology. Lack of competence and lack of support were among the common themes, suggesting that educationally oriented programs for both older adults and their caregivers should be pursued.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Cells produce reactive oxygen species (ROS) as a metabolic by-product. ROS molecules trigger oxidative stress as a feedback response that significantly initiates biological processes such as ...autophagy, apoptosis, and necrosis. Furthermore, extensive research has revealed that hydrogen peroxide (H2O2) is an important ROS entity and plays a crucial role in several physiological processes, including cell differentiation, cell signalling, and apoptosis. However, excessive production of H2O2 has been shown to disrupt biomolecules and cell organelles, leading to an inflammatory response and contributing to the development of health complications such as collagen deposition, aging, liver fibrosis, sepsis, ulcerative colitis, etc. Extracts of different plant species, phytochemicals, and Lactobacillus sp (probiotic) have been reported for their anti-oxidant potential. In this view, the researchers have gained significant interest in exploring the potential plants spp., their phytochemicals, and the potential of Lactobacillus sp. strains that exhibit anti-oxidant properties and health benefits. Thus, the current review focuses on comprehending the information related to the formation of H2O2, the factors influencing it, and their pathophysiology imposed on human health. Moreover, this review also discussed the anti-oxidant potential and role of different extract of plants, Lactobacillus sp. and their fermented products in curbing H2O2‑induced oxidative stress in both in-vitro and in-vivo models via boosting the anti-oxidative activity, inhibiting of important enzyme release and downregulation of cytochrome c, cleaved caspases-3, − 8, and − 9 expression. In particular, this knowledge will assist R&D sections in biopharmaceutical and food industries in developing herbal medicine and probiotics-based or derived food products that can effectively alleviate oxidative stress issues induced by H2O2 generation.
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•Oxidative damage-induced H2O2 overexpression leads to inflammation and ROS production.•H2O2-induced oxidative stress is linked to aging, liver fibrosis, sepsis, ulcerative colitis and cancer.•Plant extracts, phytocompounds, and Lactobacillus sp. and its fermented products have potential to curb oxidative stress.
The escalating global prevalence of type 2 diabetes and prediabetes presents a major public health challenge. Physical activity plays a critical role in managing (pre)diabetes; however, adherence to ...physical activity recommendations remains low. The ENERGISED trial was designed to address these challenges by integrating mHealth tools into the routine practice of general practitioners, aiming for a significant, scalable impact in (pre)diabetes patient care through increased physical activity and reduced sedentary behaviour.
The mHealth intervention for the ENERGISED trial was developed according to the mHealth development and evaluation framework, which includes the active participation of (pre)diabetes patients. This iterative process encompasses four sequential phases: (a) conceptualisation to identify key aspects of the intervention; (b) formative research including two focus groups with (pre)diabetes patients (n = 14) to tailor the intervention to the needs and preferences of the target population; (c) pre-testing using think-aloud patient interviews (n = 7) to optimise the intervention components; and (d) piloting (n = 10) to refine the intervention to its final form.
The final intervention comprises six types of text messages, each embodying different behaviour change techniques. Some of the messages, such as those providing interim reviews of the patients' weekly step goal or feedback on their weekly performance, are delivered at fixed times of the week. Others are triggered just in time by specific physical behaviour events as detected by the Fitbit activity tracker: for example, prompts to increase walking pace are triggered after 5 min of continuous walking; and prompts to interrupt sitting following 30 min of uninterrupted sitting. For patients without a smartphone or reliable internet connection, the intervention is adapted to ensure inclusivity. Patients receive on average three to six messages per week for 12 months. During the first six months, the text messaging is supplemented with monthly phone counselling to enable personalisation of the intervention, assistance with technical issues, and enhancement of adherence.
The participatory development of the ENERGISED mHealth intervention, incorporating just-in-time prompts, has the potential to significantly enhance the capacity of general practitioners for personalised behavioural counselling on physical activity in (pre)diabetes patients, with implications for broader applications in primary care.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aims
A reduction of habitual physical activity due to prolonged COVID‐19 quarantine can have serious consequences for patients with cardiovascular diseases, such as heart failure. This study aimed to ...explore the effect of COVID‐19 nationwide quarantine on accelerometer‐assessed physical activity of heart failure patients.
Methods and results
We analysed the daily number of steps in 26 heart failure patients during a 6‐week period that included 3 weeks immediately preceding the onset of the quarantine and the first 3 weeks of the quarantine. The daily number of steps was assessed using a wrist‐worn accelerometer worn by the patients as part of an ongoing randomized controlled trial. Multilevel modelling was used to explore the effect of the quarantine on the daily step count adjusted for weather conditions. As compared with the 3 weeks before the onset of the quarantine, the step count was significantly lower during each of the first 3 weeks of the quarantine (P < 0.05). When the daily step count was averaged across the 3 weeks before and during the quarantine, the decrease amounted to 1134 (SE 189) steps per day (P < 0.001), which translated to a 16.2% decrease.
Conclusions
The introduction of the nationwide quarantine due to COVID‐19 had a detrimental effect on the level of habitual physical activity in heart failure patients, leading to an abrupt decrease of daily step count that lasted for at least the 3‐week study period. Staying active and maintaining sufficient levels of physical activity during the COVID‐19 pandemic are essential despite the unfavourable circumstances of quarantine.
The growing number of patients with type 2 diabetes and prediabetes is a major public health concern. Physical activity is a cornerstone of diabetes management and may prevent its onset in ...prediabetes patients. Despite this, many patients with (pre)diabetes remain physically inactive. Primary care physicians are well-situated to deliver interventions to increase their patients' physical activity levels. However, effective and sustainable physical activity interventions for (pre)diabetes patients that can be translated into routine primary care are lacking.
We describe the rationale and protocol for a 12-month pragmatic, multicentre, randomised, controlled trial assessing the effectiveness of an mHealth intervention delivered in general practice to increase physical activity and reduce sedentary behaviour of patients with prediabetes and type 2 diabetes (ENERGISED). Twenty-one general practices will recruit 340 patients with (pre)diabetes during routine health check-ups. Patients allocated to the active control arm will receive a Fitbit activity tracker to self-monitor their daily steps and try to achieve the recommended step goal. Patients allocated to the intervention arm will additionally receive the mHealth intervention, including the delivery of several text messages per week, with some of them delivered just in time, based on data continuously collected by the Fitbit tracker. The trial consists of two phases, each lasting six months: the lead-in phase, when the mHealth intervention will be supported with human phone counselling, and the maintenance phase, when the intervention will be fully automated. The primary outcome, average ambulatory activity (steps/day) measured by a wrist-worn accelerometer, will be assessed at the end of the maintenance phase at 12 months.
The trial has several strengths, such as the choice of active control to isolate the net effect of the intervention beyond simple self-monitoring with an activity tracker, broad eligibility criteria allowing for the inclusion of patients without a smartphone, procedures to minimise selection bias, and involvement of a relatively large number of general practices. These design choices contribute to the trial's pragmatic character and ensure that the intervention, if effective, can be translated into routine primary care practice, allowing important public health benefits.
ClinicalTrials.gov (NCT05351359, 28/04/2022).
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Czech older adults have lower rates of physical activity than the average population and lag behind in the use of digital technologies, compared with their peers from other European countries.
This ...study aims to assess the feasibility of intensive behavior monitoring through technology in Czech adults aged ≥50 years.
Participants (N=30; mean age 61.2 years, SD 6.8 years, range 50-74 years; 16/30, 53% male; 7/30, 23% retired) were monitored for 12 weeks while wearing a Fitbit Charge 2 monitor and completed three 8-day bursts of intensive data collection through surveys presented on a custom-made mobile app. Web-based surveys were also completed before and at the end of the 12-week period (along with poststudy focus groups) to evaluate participants' perceptions of their experience in the study.
All 30 participants completed the study. Across the three 8-day bursts, participants completed 1454 out of 1744 (83% compliance rate) surveys administered 3 times per day on a pseudorandom schedule, 451 out of 559 (81% compliance rate) end-of-day surveys, and 736 episodes of self-reported planned physical activity (with 29/736, 3.9% of the reports initiated but returned without data). The overall rating of using the mobile app and Fitbit was above average (74.5 out of 100 on the System Usability Scale). The majority reported that the Fitbit (27/30, 90%) and mobile app (25/30, 83%) were easy to use and rated their experience positively (25/30, 83%). Focus groups revealed that some surveys were missed owing to notifications not being noticed or that participants needed a longer time window for survey completion. Some found wearing the monitor in hot weather or at night uncomfortable, but overall, participants were highly motivated to complete the surveys and be compliant with the study procedures.
The use of a mobile survey app coupled with a wearable device appears feasible for use among Czech older adults. Participants in this study tolerated the intensive assessment schedule well, but lower compliance may be expected in studies of more diverse groups of older adults. Some difficulties were noted with the pairing and synchronization of devices on some types of smartphones, posing challenges for large-scale studies.
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