Tag Archives: Journals

Digital Health: Wearable Sensor Data Can Predict Heart Failure 6 Days Before Hospitalization

From a “Circulation: Heart Failure” Journal study (Feb 25, 2020):

Circulation Heart Failure logoThe study shows that wearable sensors coupled with machine learning analytics have predictive accuracy comparable to implanted devices.

We demonstrate that machine learning analytics using data from a wearable sensor can accurately predict hospitalization for heart failure exacerbation…at a median time of 6.5 days before the admission.

Heart failure (HF) is a major public health problem affecting >23 million patients worldwide. Hospitalization costs for HF represent 80% of costs attributed to HF care. Thus, accurate and timely detection of worsening HF could allow for interventions aimed at reducing the risk of HF admission.

Data collected by the sensor are streamed to a phone and then encrypted and uploaded to a cloud analytics platform.
Data collected by the sensor are streamed to a phone and then encrypted and uploaded to a cloud analytics platform.

Several such approaches have been tested. Tracking of daily weight, as recommended by current HF guidelines, did not lead to reduction of the risk of HF hospitalization, most likely because the weight gain is a contemporaneous or lagging indicator rather than a leading event. Interventions based on intrathoracic impedance monitoring also did not result in reduction of readmission risk. The results suggest that physiological parameters other than weight or intrathoracic impedance in isolation may be needed to detect HF decompensation in a timely manner. In fact, 28% reduction of rehospitalization rates has been shown with interventions based on pulmonary artery hemodynamic monitoring. More recently, in the MultiSENSE study (Multisensor Chronic Evaluation in Ambulatory HF Patients), an algorithm based on physiological data from sensors in the implantable cardiac resynchronization therapy defibrillators, was shown to have 70% sensitivity in predicting the risk of HF hospitalization or outpatient visit with intravenous therapies for worsening of HF.

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Health Study: Low-Dose Aspirin Reduces Risks Of Bone Fracture (BMJ)

From a BMJ Open Journal study release (February 20, 2020):

BMJ Open JournalAspirin is an inhibitor of prostaglandin production and may influence the cellular basis of bone remodelling responsible for maintaining the material and structural strength of bone.

The consistent findings of reduced risk of fracture across studies included in this review is encouraging. It is important to keep in mind that studies were quite diverse in design, populations included, data collection methods and follow-up periods and we did observe high heterogeneity especially for fracture risk. While we need to interpret this finding with some caution, there appeared to be a consistent indication that aspirin use is associated with positive bone outcomes. 

The anti-inflammatory effects of aspirin via prostaglandin inhibition have recently gained attention. Chronic low-grade inflammation contributes to age-related cardiovascular, neurological, respiratory and musculoskeletal conditions. Low-grade inflammation is associated with increased bone loss and fracture risk. Prostaglandin, an important inflammatory mediator, is likely to have a key role in bone remodelling attributable to inflammation. Prostaglandin E2 stimulates bone resorption and formation and is produced largely from cyclooxygenase-2 induction. Prostaglandins acutely inhibit osteoclast function. However, their chronic effect is to stimulate bone resorption by increasing replication of osteoclast precursors, and differentiation to mature osteoclasts.

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Diet Studies: Repeated “Diet Switching” Found To Increase Mortality Risks

From a Science Journal study (Feb 21, 2020):

Science Advances Feb 2020We suggest this increase in mortality seen on DR in the 4-day switch treatment is due to either accrued physiological costs or more probable, a carryover of deaths directly resulting from the rich diet, but recorded on the DR diet.

A closer examination of the timing of mortality within the 4-day switching paradigm showed that the mortality response was strongest in the second 48 hours after exposure to both DR and rich diets.

Ageing has attracted extensive scientific interest, from both a fundamental and biomedical perspective. Dietary restriction (DR) extends health and life span across taxa, from baker’s yeast to mice, with very few exceptions (12). The reduction in total calories—or restriction of macronutrients, such as protein—extends life span reliably (35). Although the precise universal mechanisms that connect DR to ageing remain elusive, translation of DR’s health benefits to human medicine is deemed possible. The widespread assumption of DR’s translational potential originates from the notion that DR’s beneficial effects are facilitated by shared evolutionary conserved mechanisms, as beneficial effects of DR are observed across taxa.

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