Early Detection Monitoring Research Articles

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment (2747)

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment (2747)

Combination of Sensor Data and Health Monitoring for Early Detection of Subclinical Ketosis in Dairy Cows.

Subclinical ketosis is a metabolic disease in early lactation. It contributes to economic losses because of reduced milk yield and may promote the development of secondary diseases. Thus, an early detection seems desirable as it enables the farmer to initiate countermeasures. To support early detection, we examine different types of data recordings and use them to build a flexible algorithm that predicts the occurence of subclinical ketosis. This approach shows promising results and can be seen as a step toward automatic health monitoring in farm animals.

A Framework for Aquatic Invasive Species Surveillance Site Selection and Prioritization in the US waters of the Laurentian Great Lakes.

Risk-based prioritization for early detection monitoring is of utmost importance to prevent and mitigate invasive species impacts. The Great Lakes Water Quality Agreement, a binational commitment between the United States and Canada to restore and protect the waters of the Laurentian Great Lakes, identifies aquatic invasive species (AIS) as one of ten priority issues (annexes) that must be addressed to ensure the chemical, physical, and biological integrity of the Great Lakes. The Agreement calls out the need for a comprehensive strategy for detecting and tracking new and potentially invasive species. Yet, with a surface water area of 95, 000 square miles (246, 049 square km) and shoreline length of 10, 210 miles (16, 431 km), the Great Lakes represent a daunting challenge for prioritizing where AIS surveillance activities should occur. Our goal was to develop a spatially-explicit and quantitative approach for identifying the highest risk sites for AIS introduction into the US waters of the Great Lakes based on the cumulative risk of new introductions (including range expansions) from a range of pathways and associated taxa. We estimate "invasion risk" scores for nearly 6,000 sites (9 km x 9 km) across the Great Lakes basin using proxy measures for propagule pressure weighted by the proportion of taxa associated with each proxy variable. Proxy variables include human population, number of ship visits, marina size, number of ponds, and number of natural or artificial aquatic connections. In total, we identify more than 1,800 sites with invasion risk scores >0. A small subset of these 1,800+ sites accounts for a majority of predicted propagule pressure and are therefore logical targets for future surveillance and AIS prevention efforts. Many of the highest risk sites are located in western Lake Erie, southern Lake Michigan, and the St. Clair-Detroit River System.

Squamous cell carcinoma in an atrophic scar of Porphyria Cutanea Tarda

Introduction: Porphyria’s are group of inherited metabolic disorders of heme biosynthesis. Porphyria cutanea tarda (PCT) the most frequent type of porphyria worldwide and present with skin symptoms only. PCT develops due to acquired deficiency in fifth enzyme Uroporphyrinogen deaminase (UROD) in hepatocytes. Skin cancers are known to arise from site of trauma or chronic irritation like scars, ulcers, sinuses of diverse aetiology. Squamous cell carcinoma, Basal cell carcinoma, Adenocarcinoma are the common carcinoma identified in these situations. Hereby we present a case squamous cell carcinoma in an atrophic scar of PCT. Case Report: A 65 years old male, diagnosed case of PCT since 20 years, presented with non-healing ulcer on left cheek since 6 months. It was overlying a preexisting scar of PCT and was progressively increasing in size. Dermatological examination shows single well-defined ulcer on left malar area with rolled out edge and pale granulation tissue on floor. Diagnosis of Squamous cell carcinoma was confirmed on histopathological examination. Patient underwent wide local excision with 1cm margin all around with propeller flap reconstruction which was conducted by plastic surgeons. Conclusion: Patients of Porphyria Cutanea Tarda are at high risk of facial malignancy and need stringent monitoring for early detection and timely management. Keywords: Porphyria cutanea tarda squamous cell carcinoma atrophic scar.

Domain Adaptation for One-Class Classification: Monitoring the Health of Critical Systems Under Limited Information

The failure of a complex and safety critical industrial asset can have extremely high consequences. Close monitoring for early detection of abnormal system conditions is therefore required. Data-driven solutions to this problem have been limited for two reasons: First, safety critical assets aredesigned and maintained to be highly reliable and faults are rare. Fault detection can thus not be solved with supervised learning. Second, complex industrial systems usually have long lifetime during which they face very different operating conditions. In the early life of the system, the collected data is probably not representative of future operating conditions, making it challenging to train a robust model. In this paper, we propose a methodology to monitor the systems in their early life. To do so, we enhance the training dataset with other units from a fleet, for which longer observations are available. Since each unit has its own specificity, we propose to extract features made independent of their origin by three unsupervised feature alignment techniques. First, using a variational encoder, we impose a shared probabilistic encoder/decoder for both units. Second, we introduce a new loss designed to conserve inter-point spacial relationships between the input and the learned features. Last, wepropose to train in an adversarial manner a discriminator on the origin of the features. Once aligned, the features are fed to a one-class classifier to monitor the health of the system. By exploring the different combinations of the proposed alignment strategies, and by testing them on a real case study, a fleet composed of 112 power plants operated in different geographical locations and under very different operating regimes, we demonstrate that this alignment is necessary and beneficial.

Post-MGUS Diagnosis Serum Monoclonal-Protein Velocity and the Progression of Monoclonal Gammopathy of Undetermined Significance to Multiple Myeloma.

Multiple myeloma is a common hematologic malignancy consistently preceded by monoclonal gammopathy of undetermined significance (MGUS). Little is known about postdiagnosis clinical predictors of progression of MGUS to multiple myeloma to guide MGUS management. This study aimed to investigate whether the rate of rise in serum monoclonal protein concentration during the year after MGUS diagnosis-M-protein velocity-predicts progression of MGUS to multiple myeloma. Data from the U.S. Veterans Health Administration system were used. A retrospective cohort of patients with MGUS who progressed to multiple myeloma were matched on age at MGUS diagnosis and race in a 1:4 ratio to the patients with MGUS using incidence density sampling. Kaplan-Meier curves were plotted. Univariable and multivariable conditional logistic regression analyses were fitted from the matched risk sets. A total of 128 cases and 490 matched controls were included. The case group contained a higher percentage of patients with M-protein velocity >0.1 g/dL/year than the control group (44.5% vs. 28.2%, P <0.0001). M-protein velocity of >0.1 g/dL during the year following MGUS diagnosis was positively associated with progression of MGUS to multiple myeloma (multivariable-adjusted odds ratio = 2.15; 95% confidence interval, 1.37-3.35). Patients with a positive M-protein velocity during the year after MGUS diagnosis may be considered for more frequent monitoring for early detection and timely treatment of multiple myeloma. Future prevention studies could target these patients for intervention evaluation. Our results suggest a new clinical predictor of progression to multiple myeloma following MGUS diagnosis, which has potential to identify high-risk patients for management and prevention.

LBA17 - Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA

LBA17 - Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA

LBA85 - Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA

LBA85 - Longitudinal circulating tumour DNA (ctDNA) monitoring for early detection of disease progression and resistance in advanced NSCLC in FLAURA

From Emotions to Mood Disorders: A Survey on Gait Analysis Methodology.

Mood disorders affect more than 300 million people worldwide and can cause devastating consequences. Elderly people and patients with neurological conditions are particularly susceptible to depression. Gait and body movements can be affected by mood disorders, and thus they can be used as a surrogate sign, as well as an objective index for pervasive monitoring of emotion and mood disorders in daily life. Here we review evidence that demonstrates the relationship between gait, emotions and mood disorders, highlighting the potential of a multimodal approach that couples gait data with physiological signals and home-based monitoring for early detection and management of mood disorders. This could enhance self-awareness, enable the development of objective biomarkers that identify high risk subjects and promote subject-specific treatment.

Remote Outpatient Temperature Monitoring for Early Detection of Febrile Neutropenia After Chemotherapy

Remote Outpatient Temperature Monitoring for Early Detection of Febrile Neutropenia After Chemotherapy

Total body irradiation dose and risk of subsequent neoplasms following allogeneic hematopoietic cell transplantation

AbstractWe examined the impact of total body irradiation (TBI) dose and fractionation on risk of subsequent malignant neoplasms (SMNs) in the era of reduced-intensity and nonmyeloablative conditioning regimens for hematopoietic cell transplantation (HCT). Among 4905 1-year survivors of allogeneic HCT for hematologic malignancies (N = 4500) or nonmalignant disorders (N = 405) who received transplants between 1969 and 2014, we identified 581 SMNs (excluding squamous and basal cell of skin) in 499 individuals. With a median length of follow-up of 12.5 years, the cumulative incidence of SMNs by 30 years after HCT was 22.0%. Compared with age-, sex-, and calendar year–matched Surveillance, Epidemiology, and End Results (SEER) population rates, the standardized incidence ratio (SIR) of SMNs was increased 2.8-fold. The highest SIRs were for SMNs of bones (SIR, 28.8), oral cavity (SIR, 13.8), skin (SIR, 7.3), central nervous system (SIR, 6.0), and endocrine organs (SIR, 4.9). The highest excess absolute risks (EARs) were seen with breast cancer (EAR, 2.2) and cancers of the oral cavity (EAR, 1.5) and skin (EAR, 1.5) per 1000 person-years. The highest incidence of SMNs was in survivors exposed to unfractionated (600-1000 cGy) or high-dose fractionated (1440-1750 cGy) TBI. For patients receiving low-dose TBI, the incidence was comparable to myeloablative chemotherapy alone, although still twofold higher than in the general population. These data demonstrate a strong effect of TBI dose, dose fractionation, and risk of SMNs after HCT. The cumulative incidence of SMNs increases with follow-up time; thus, HCT survivors require lifetime monitoring for early detection and effective therapy of SMNs.

Clinical efficacy and safety of alemtuzumab in postmarketing practice

Clinical trials confirm alemtuzumab efficacy for multiple sclerosis treatment in terms of both conventional measures and combined criteria such as NEDA (no evidence of disease activity). However, established drug efficacy and convenient dosing schedule are balanced by the risk of serious adverse events. Therefore, it is necessary to inform physicians about the benefits of alemtuzumab therapy along with the pattern of its safety profile.The present review provides the analysis of alemtuzumab real-world studies in Europe, USA and other parts of the world. The information obtained can help physicians to prescribe and administer the drug properly and to perform effective safety monitoring for early detection of adverse events and saving the maximum treatment benefit for the patient.

Predicting Successful Catheter Drainage in Patients With Pancreatic Fistula After Pancreatoduodenectomy.

The objective of this study was to identify predictors for successful minimally invasive catheter drainage (ie, survival without relaparotomy) for pancreatic fistula after pancreatoduodenectomy. Included were consecutive patients undergoing catheter drainage as first intervention for pancreatic fistula after pancreatoduodenectomy (2005-2013) in 9 Dutch centers. Possible prognostic factors for successful catheter drainage (ie, survival without relaparotomy) were selected using Akaike information criterion. Included were 227 patients after 2196 pancreatoduodenectomies. Primary catheter drainage was successful in 175 (77%) of 227 patients. Multivariable logistic regression revealed the following negative prognostic factors for success: male sex (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.21-1.00; P = 0.049), higher age (for every 5 years over 50; OR, 0.69; 95% CI, 0.57-0.84; P < 0.001), and respiratory failure at time of catheter drainage (OR, 0.10; 95% CI, 0.03-0.33; P < 0.001). A prognostic model incorporating these factors yielded an area under the curve of 0.76 and demonstrated a success range of 98% to 14%. Male sex, higher age, and respiratory failure are associated with a low success rate of catheter drainage in patients with pancreatic fistula after pancreatoduodenectomy. These patients might benefit from an intensified postoperative monitoring for early detection and management of pancreatic fistula to prevent respiratory failure.

SUN-167 Quetiapine-Induced Hypertriglyceridemia and Hyperglycemia Presenting as Simultaneous Diabetic Ketoacidosis and Acute Pancreatitis

Background: Quetiapine-induced metabolic emergencies such as diabetic ketoacidosis (DKA) and acute pancreatitis (AP) are rare. We describe a case of new-onset hypertriglyceridemia (HTG) and diabetes mellitus (DM) following the initiation of quetiapine, presenting as concurrent new-onset DKA and AP. Clinical Case: A 34 year-old male with bipolar disorder and schizophrenia presented with three days of epigastric pain, nausea, and vomiting. He had no prior history of DM or dyslipidemia (DLD). He reported long-standing use of divalproex, benztropine, and haloperidol. He had started quetiapine three months prior, at which time glycosylated hemoglobin A1c (HgbA1c) was 5.7% and non-fasting triglyceride (TG) level was 266 (range 30-150 mg/dL). He was a smoker, but denied alcohol or drug use. On admission, he was hypertensive, tachycardic, and febrile with significant abdominal pain. His blood glucose was 522 (range 55-110 mg/dL) with an anion gap of 27 (range 5-17), venous pH of 7.18 (range 7.33-7.43), bicarbonate of 7 (range 23-31 mEq/L), and serum creatinine of 1.8 (0.6-1.4 mg/dL). He also had an elevated serum lipase of 317 (range 5-55 U/L), TG of 2436 (range 30-150 mg/dL), and computed tomography confirmed peri-pancreatic edema consistent with AP. Thyroid function tests were normal. Abdominal ultrasound was negative for cholelithiasis. He was treated with aggressive intravenous (IV) hydration and IV insulin, and later transitioned to subcutaneous (SQ) insulin after resolution of DKA. Quetiapine was stopped and he was discharged on haloperidol, benztropine, fenofibrate, and SQ insulin. Due to improving BG levels, insulin was gradually tapered over the next few weeks and subsequently discontinued. HgbA1c obtained three months later was 5.7% (off insulin) and fasting TG level was 212 mg/dL. Discussion: Second generation antipsychotics (SGAs), particularly olanzapine and clozapine, are known to cause metabolic abnormalities such as weight gain, hyperglycemia, and hyperlipidemia. Although quetiapine is described to have low risk for development of diabetes or lipid abnormalities, it can cause life-threatening complications like DKA and AP. While DKA has been reported in many case series, AP is exceedingly rare. There are fewer than ten reported cases with or without HTG following quetiapine use, usually within the first year of drug initiation. Since many of these patients do not have pre-existing DLD or DM, it is important for providers and patients to be aware of the risk of developing these life-threatening complications, even with a relatively safe SGA. Current guidelines recognize the importance of laboratory monitoring for early detection of metabolic disturbances in patients taking SGAs; however, recommendations regarding frequency of monitoring remain variable. Updated surveillance parameters are needed to facilitate the prevention of such metabolic emergencies.

Type 1 Diabetes Risk in African-Ancestry Participants and Utility of an Ancestry-Specific Genetic Risk Score.

Genetic risk scores (GRS) have been developed that differentiate individuals with type 1 diabetes from those with other forms of diabetes and are starting to be used for population screening; however, most studies were conducted in European-ancestry populations. This study identifies novel genetic variants associated with type 1 diabetes risk in African-ancestry participants and develops an African-specific GRS. We generated single nucleotide polymorphism (SNP) data with the ImmunoChip on 1,021 African-ancestry participants with type 1 diabetes and 2,928 control participants. HLA class I and class II alleles were imputed using SNP2HLA. Logistic regression models were used to identify genome-wide significant (P < 5.0 × 10-8) SNPs associated with type 1 diabetes in the African-ancestry samples and validate SNPs associated with risk in known European-ancestry loci (P < 2.79 × 10-5). African-specific (HLA-DQA1*03:01-HLA-DQB1*02:01) and known European-ancestry HLA haplotypes (HLA-DRB1*03:01-HLA-DQA1*05:01-HLA-DQB1*02:01, HLA-DRB1*04:01-HLA-DQA1*03:01-HLA-DQB1*03:02) were significantly associated with type 1 diabetes risk. Among European-ancestry defined non-HLA risk loci, six risk loci were significantly associated with type 1 diabetes in subjects of African ancestry. An African-specific GRS provided strong prediction of type 1 diabetes risk (area under the curve 0.871), performing significantly better than a European-based GRS and two polygenic risk scores in independent discovery and validation cohorts. Genetic risk of type 1 diabetes includes ancestry-specific, disease-associated variants. The GRS developed here provides improved prediction of type 1 diabetes in African-ancestry subjects and a means to identify groups of individuals who would benefit from immune monitoring for early detection of islet autoimmunity.

Heart Rate Characteristic Index Monitoring for Early Detection of Infections in Very Low Birth Weight Infants

The aim of this study is 1) to determine the sensitivity and specificity of continuous heart rate characteristics (HRC) monitoring in detection of infections and 2) to evaluate whether HRC monitoring detects infections prior to onset of clinical symptoms in very low birth weight (VLBW) infants. A retrospective cohort study was conducted analyzing HRC scores and episodes of infection for VLBW infants in the Neonatal Intensive Care Unit (NICU) at Cincinnati Children’s Hospital Medical Center from January 2015 through May 2016. HRC scores were acquired using the HRC monitor system and entered into the electronic medical record by bedside staff. Culture-positive and culture-negative clinical infections were recorded. Positive HRC scores were defined as an increase 1 point above the baseline or the first rise above 2. HRC scores within 24 hours and also within the 5-day period before the start of antibiotics for infections were analyzed for sensitivity, specificity, positive predictive value and negative predictive value for detection of neonatal infection. The HRC score increase 1 point above the baseline or the first rise above 2 in the 24 hours before the start of antibiotics for infectious events had a sensitivity of 68.0%, a specificity of 10.8%. Positive predictive value (PPV) and negative predictive value (NPV) were 34.0% and 33.3%, respectively. The PPV and NPV were modestly higher for elevated HRC scores during the 5-day period before infections, 41.1% and 66.7%, respectively. In our single-center retrospective study, elevated HRC scores had limited ability to detect infection. More than half of the positive monitor events were not related to infection. The potential clinical impact of the monitor to detect infection before the onset of clinical symptoms was limited and the risk for unnecessary evaluation and treatment was high.

Biofilms shaping compositions of macrofouling assemblages: An initial barrier against NIS settlement?

Biofilms shaping compositions of macrofouling assemblages: An initial barrier against NIS settlement?

NOninvasive Monitoring for Early Detection of Atrial Fibrillation: rationale and design of the NOMED-AF study.

NOninvasive Monitoring for Early Detection of Atrial Fibrillation: rationale and design of the NOMED-AF study.

Tuberous sclerosis complex

Clinical characteristics Tuberous sclerosis complex (TSC) involves abnormalities of the skin (hypomelanotic macules, confetti skin lesions, facial angiofibromas, shagreen patches, fibrous cephalic plaques, ungual fibromas); brain (subependymal nodules, cortical dysplasias, and subependymal giant cell astrocytomas [SEGAs], seizures, intellectual disability / developmental delay, psychiatric illness); kidney (angiomyolipomas, cysts, renal cell carcinomas); heart (rhabdomyomas, arrhythmias); and lungs (lymphangioleiomyomatosis [LAM], multifocal micronodular pneumonocyte hyperplasia). Central nervous system tumors are the leading cause of morbidity and mortality; renal disease is the second leading cause of early death. Diagnosis/testing The diagnosis of TSC is established in a proband with one of the following: Two major clinical features One major clinical feature and two or more minor features Identification of a heterozygous pathogenic variant in TSC1 or TSC2 by molecular genetic testing Management Treatment of manifestations: For enlarging SEGAs: mTOR inhibitors; neurosurgery when size causes life-threatening neurologic symptoms. For seizures: vigabatrin and other anti-seizure medication, and on occasion, epilepsy surgery. For renal angiomyolipomas >4 cm, or >3 cm and growing rapidly: mTOR inhibitors are the recommended first line of therapy with secondary therapy options being embolization, renal sparing surgery, or ablative therapy. For facial angiofibromas: topical mTOR inhibitors. For symptomatic cardiac rhabdomyomas: surgical intervention or consideration of mTOR inhibitor therapy. For LAM: mTOR inhibitors. Prevention of secondary complications: For those on vigabatrin therapy, vision testing within four weeks of therapy initiation, at three-month intervals while on treatment, and three to six months after treatment is discontinued. Surveillance: Brain MRI every one to three years in asymptomatic individuals with TSC younger than age 25 years to monitor for new occurrence of SEGAs; those with asymptomatic SEGA in childhood should continue to be imaged periodically in adulthood; for those with large or growing SEGA or SEGA causing ventricular enlargement, more frequent brain MRIs as deemed clinically appropriate; screening for TSC-associated neuropsychiatric disorder (TAND) at least annually with comprehensive formal evaluation for TAND at key developmental time points; EEG in individuals with known or suspected seizure activity; MRI of the abdomen to assess for progression of angiomyolipoma and renal cystic disease every one to three years; assess renal function (glomerular filtration rate and blood pressure) at least annually; echocardiogram every one to three years in asymptomatic infants and children with cardiac rhabdomyomas until regression is documented; clinical screening for LAM symptoms (exertional dyspnea and shortness of breath) at each clinic visit in women older than age 18 years or those who report respiratory symptoms; high-resolution computed tomography (HRCT) every five to ten years in asymptomatic individuals at risk for LAM (adult females age >18 years) even when there are no signs of LAM on baseline examination; annual pulmonary function testing and HRCT every two to three years for individuals with lung cysts detected by HRCT; annual dermatologic examination; dental examination every six months; annual ophthalmology evaluation in those with previously identified ophthalmologic lesions or vision symptoms. Agents/circumstances to avoid: Smoking; estrogen use; nephrectomy. Evaluation of relatives at risk: Identifying affected relatives enables monitoring for early detection of problems associated with TSC, which leads to earlier treatment and better outcomes. Genetic counseling TSC is inherited in an autosomal dominant manner. Two thirds of affected individuals have TSC as the result of a de novo pathogenic variant. The offspring of an affected individual are at a 50% risk of inheriting the pathogenic variant. If the pathogenic variant has been identified in an affected family member, prenatal testing for a pregnancy at increased risk and preimplantation genetic testing are possible.

The Population Need in Genetic Tests for Predisposition to Breast Cancer

The article presents the results of sociological survey of women of the Republic of Tatarstan (Russia) concerning establishment of level of awareness about risks of development of oncologic diseases, need for application of genetic tests determining predisposition to breast and ovary cancer and also motives of acceptance or nonacceptance of existing modes of diagnostic and prevention of oncologic diseases. The breast and ovary cancer are among the most prevalent causes of female mortality in Russia. It is established that females with gene mutations BRCA1 and BRCA2 have a higher risk of development of breast and ovary cancer. Therefore, to determine character of genes BRCA in human genome is actual for prevention of oncologic diseases. The early diagnostic of oncologic diseases can significantly increase effectiveness of struggle with similar illnesses. The obtained data shows superficial awareness of Russian females about problem of breast and ovary cancer. The majority knows about existence of gene predisposition to disease but are not aware of characteristics of diagnostic, prevention and treatment of of these types of oncologic diseases. The female respondents in most cases are favorable to pass genetic diagnostic. However, they demonstrate nonacceptance of such radical mode of problem solution as preventive surgery of ablation of potentially dangerous organ. The most of female respondents prefer strategies of traditional monitoring for early detection of disease. The main causes of refusal of early gene diagnostic and preventive surgery are related, besides psychological and personal phobias, to such factors as distrust to health care system and uncertainty in qualification and accessibility of medical care.