Multiple representations
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Introduction:In recent years several standardized modeling methods have been proposed that separate health related data models from their underlying technical data model. These methods presuppose representation of information independently of (or uninfluenced by) technical considerations. Among these methods is the Detailed Clinical Model (DCM) paradigm. One of the pillars of this paradigm is that all representations convey the same meaning and are independent of the technical standard that is used and the DCM standard claims to achieve that. In this paper we will challenge that claim by modeling the specific DCMs in two different technical standards (CDA and FHIR) and testing if messages based on these models are interconvertible. Methods: We identified and categorized the problems that may arise when mapping or combining multiple standards creating representations of selected DCMs in both FHIR and CDA to determine possible fundamental problems using a technology independent model (DCM) to represent technical models (FHIR and CDA). To test if the theoretical problems we encountered while creating our example messages also occur during the actual transformation, and to determine any additional problems, we attempted to transform the Clinical Document Architecture (CDA) representations of the DCMs to the FHIR representations using Extensible Style sheet Language Transformations (XSLT). Results: Most aspects of the DCMs could be properly represented in both FHIR and CDA, and can be transformed from CDA to FHIR. However, we identified fundamental issues where information was lost or its meaning was changed. This results in fundamental difficulties during the implementation of the standards and when transforming one standard to another. Conclusion: Our research shows that possible loss and change of meaning and lack of interconvertibility occurs when implementing two separate technical standards based on the same DCMs. This indicates that it does matter which technical standard is used to implement a DCM.
The processes that organize different thoughts and memories, allowing the separation of currently relevant and irrelevant information, are collectively known as cognitive control. The neuronal mechanisms of these processes can be investigated by place cell ensemble recordings during behaviors and environmental manipulations that present cognitive control challenges to selectively represent one of multiple possible alternative estimates of location. We review place cell studies that investigate responses to manipulations that dissociate the environment into two or more spatial frames of locations, often times to test notions of pattern separation. Manipulations, such as continuously rotating the recording chamber reveal that the ensemble discharge in hippocampus self-organizes into multiple, transiently-organized representations of space, each defined by the subset of coactive cells. Ensemble discharge in the hippocampus alternates between separate representations of frame-specific positions on timescales from 25 ms to several seconds. The dynamic, functional grouping of discharge into transiently co-active subsets of cells is predicted by the animal's changing behavioral needs. In addition to identifying neural correlates of cognitive control in hippocampus, these observations demonstrate that the separation of neuronal activity into distinctive representations depends on ongoing cognitive demands and that what can appear as noise, deviations from receptive field tuning, can substantially be the result of these internal knowledge-guided fluctuations. These findings inspire a new perspective that should be taken into account when investigating pattern separation--a perspective that emphasizes changes in hippocampal neural discharge that are happening on a short timescale and does not assume that patterns of neural discharge are steady and stationary across the several minutes of the recordings.
- MeSH
- buňky místa fyziologie MeSH
- hipokampus fyziologie MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- modely neurologické * MeSH
- prostorová paměť fyziologie MeSH
- prostorové učení fyziologie MeSH
- vnímání prostoru fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Research Support, N.I.H., Extramural MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
BACKGROUND: Remote measurement technology (RMT) involves the use of wearable devices and smartphone apps to measure health outcomes in everyday life. RMT with feedback in the form of data visual representations can facilitate self-management of chronic health conditions, promote health care engagement, and present opportunities for intervention. Studies to date focus broadly on multiple dimensions of service users' design preferences and RMT user experiences (eg, health variables of perceived importance and perceived quality of medical advice provided) as opposed to data visualization preferences. OBJECTIVE: This study aims to explore data visualization preferences and priorities in RMT, with individuals living with depression, those with epilepsy, and those with multiple sclerosis (MS). METHODS: A triangulated qualitative study comparing and thematically synthesizing focus group discussions with user reviews of existing self-management apps and a systematic review of RMT data visualization preferences. A total of 45 people participated in 6 focus groups across the 3 health conditions (depression, n=17; epilepsy, n=11; and MS, n=17). RESULTS: Thematic analysis validated a major theme around design preferences and recommendations and identified a further four minor themes: (1) data reporting, (2) impact of visualization, (3) moderators of visualization preferences, and (4) system-related factors and features. CONCLUSIONS: When used effectively, data visualizations are valuable, engaging components of RMT. Easy to use and intuitive data visualization design was lauded by individuals with neurological and psychiatric conditions. Apps design needs to consider the unique requirements of service users. Overall, this study offers RMT developers a comprehensive outline of the data visualization preferences of individuals living with depression, epilepsy, and MS.
- MeSH
- deprese * psychologie MeSH
- dospělí MeSH
- epilepsie * psychologie MeSH
- kvalitativní výzkum * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mobilní aplikace MeSH
- nositelná elektronika MeSH
- pacientova volba psychologie statistika a číselné údaje MeSH
- roztroušená skleróza * psychologie MeSH
- senioři MeSH
- telemedicína MeSH
- vizualizace dat MeSH
- zjišťování skupinových postojů * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system. The cause of MS is still unknown, and the role of innate immunity is still poorly understood. OBJECTIVE: The goal of this study was to understand whether, compared to healthy controls, the elements of innate immunity are altered in the blood of MS patients in the remitting phase. METHODS: A total of 77 naïve MS patients and 50 healthy controls were included in this cohort study. Peripheral blood samples were collected and analyzed. All the calculations were performed with the statistical system R (r-project.org). RESULTS: The results showed that MS patients had significantly lower relative representations of granulocytes than healthy controls, while the relative representations of monocytes remained unchanged. CD64- and PD-L1-positive granulocytes exhibited a nonsignificant decreasing trend, while granulocytes with other membrane markers remained noticeably unchanged. CONCLUSION: The results of this study suggest that studies of the causes of MS and its treatment should also be focused on the elements of the innate immune response.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: An early diagnosis together with an accurate disease progression monitoring of multiple sclerosis is an important component of successful disease management. Prior studies have established that multiple sclerosis is correlated with speech discrepancies. Early research using objective acoustic measurements has discovered measurable dysarthria. METHOD: The objective was to determine the potential clinical utility of machine learning and deep learning/AI approaches for the aiding of diagnosis, biomarker extraction and progression monitoring of multiple sclerosis using speech recordings. A corpus of 65 MS-positive and 66 healthy individuals reading the same text aloud was used for targeted acoustic feature extraction utilizing automatic phoneme segmentation. A series of binary classification models was trained, tuned, and evaluated regarding their Accuracy and area-under-the-curve. RESULTS: The Random Forest model performed best, achieving an Accuracy of 0.82 on the validation dataset and an area-under-the-curve of 0.76 across 5 k-fold cycles on the training dataset. 5 out of 7 acoustic features were statistically significant. CONCLUSION: Machine learning and artificial intelligence in automatic analyses of voice recordings for aiding multiple sclerosis diagnosis and progression tracking seems promising. Further clinical validation of these methods and their mapping onto multiple sclerosis progression is needed, as well as a validating utility for English-speaking populations.
- MeSH
- lidé MeSH
- pilotní projekty MeSH
- řeč * MeSH
- roztroušená skleróza * MeSH
- strojové učení MeSH
- umělá inteligence MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
On the Carousel maze, rats are trained to avoid a sector of a circular rotating arena, punishable by a mild electric foot-shock. In the room frame (RF) variant, the punishable sector remains stable relative to the room, while in the arena frame (AF) version, the sector rotates with the arena. The rats therefore need to disregard local olfactory, tactile and self-motion cues in RF condition and distal extra-maze landmarks in the AF task. In both primates and rodents, the coordination of various spatial reference frames is thought to depend on the posterior parietal cortex (PPC). We have previously shown that PPC-lesioned rats can solve both variants of the Carousel avoidance task. Here we aimed to determine the effects of bilateral thermocoagulation lesion of the PPC in Long-Evans rats on the ability to transition between multiple spatial strategies. The rats were first trained in five sessions in one condition and then another five sessions in the other. The following training schemes were used: RF to AF, RF to RF reversal (sector on the opposite side), and AF to RF. We found a PPC lesion-associated impairment in the transition from the AF to RF task, but not vice versa. Furthermore, PPC lesion impaired performance in RF reversal. In accordance to the literature, we also found an impairment in navigation guided by intra-maze visuospatial cues, but not by extra-maze cues in the water maze. Therefore, the PPC lesion-induced impairment is neither specific to distant cues nor to allocentric processing. Our results thus indicate a role of the PPC in the flexibility in spatial behaviors guided by visual orientation cues.
- MeSH
- bludiště - učení fyziologie MeSH
- chování zvířat MeSH
- elektrický šok MeSH
- elektrokoagulace MeSH
- krysa rodu rattus MeSH
- orientace MeSH
- podněty MeSH
- potkani Long-Evans MeSH
- prostorová navigace fyziologie MeSH
- temenní lalok zranění patologie fyziologie MeSH
- učení vyhýbat se fyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Cieľ: Skleróza multiplex sa vyznačuje rôznorodým klinickým priebehom a vysokou invaliditou ochorenia. Cieľom štúdie bolo identifikovať a analyzovať kvalitu života pacientov so sclerosis multiplex. Metódy: Autori zozbierali údaje pomocou nástroja WHOQOL-BREF. Výskumnú vzorku tvorilo 81,40 % žien a 18,60 % mužov. Z hľadiska veku bolo najväčšie zastúpenie u osôb vo veku 31-50 rokov (56,98 %). Výskumná vzorka bola rozdelená do dvoch skupín: osoby s dĺžkou ochorenia do 11 rokov (60,47 %) a osoby s dĺžkou trvania ochorenia nad 11 rokov (39,53 %). Výsledky: Zistenia výskumu v každej doméne sme porovnali so štandardnou populáciou. Štatistická významnosť bola potvrdená vo fyzickej doméne v oblasti mobility (p = 0,002**). Bolesť a diskomfort boli v oboch skupinách vnímané pozitívnejšie (M = 2,54 a M = 2,93) ako v populačnom štandarde (PN = 4,03). Potvrdili sme štatistickú významnosť prežívania v oblasti koncentrácie (p = 0,045*). Dostupnosť zdravotníckych služieb sa ukázala ako dôležitá (p = 0,027**) v environmentálnej oblasti. Pri porovnaní oboch skupín z hľadiska trvania ochorenia sa potvrdila štatistická významnosť v doméne spokojnosti so zdravím (p = 0,049*). Záver: Znížená schopnosť samostatného pohybu predstavuje najväčšiu koreláciu so zníženou kvalitou života. Pre pacientov so sklerózou multiplex je vhodné vytvoriť check listy a rehabilitačné programy na zlepšenie kvality ich života.
Objective: Multiple sclerosis is characterized by a diverse clinical course and high disability of the disease. The aim of the study was to identify and analyse the quality of life of patients with multiple sclerosis. Methods: The authors collected data using WHOQOL-BREF tool. The research sample consisted of 81.40% women and 18.60% men. In terms of age, the largest representation was recorded in persons aged 31-50 (56.98%). The research sample was divided into two groups: persons with a disease duration of up to 11 years (60.47%), and persons with a disease duration over 11 years (39.53%). Results: We compared the research findings in each domain with the standard population Statistical significance was confirmed in the physical domain in the area of mobility (p = 0.002**). Pain and discomfort were perceived more positively in both groups (M = 2.54 and M = 2.93) than in the population standard (PN = 4.03). We confirmed the statistical significance of survival in the area of concentration (p = 0.045*). The availability of health services proved to be important (p = 0.027**) in the environmental field. When comparing both groups in terms of disease duration, statistical significance was confirmed in the health satisfaction domain (p = 0.049*). Conclusion: Decreased ability to move independently represents the greatest correlation with decreased quality of life. For patients with multiple sclerosis, it is advisable to create checklists and rehabilitation programs to improve their quality of life.
- MeSH
- dospělí MeSH
- klinická studie jako téma MeSH
- kouření škodlivé účinky MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nedostatek vitaminu D patologie MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- roztroušená skleróza * epidemiologie patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
Introduction: Recent studies of patients with multiple sclerosis (MS) have revealed disturbances in distinct components of social cognition, such as impaired mentalizing and empathy. The present study investigated this socio-cognitive profile in MS patients in more detail, by examining their performance on tasks measuring more fundamental components of social cognition and any associated disruptions to gray-matter volume (GMV). Methods: We compared 43 patients with relapse-remitting MS with 43 age- and sex-matched healthy controls (HCs) on clinical characteristics (depression, fatigue), cognitive processing speed, and three aspects of low-level social cognition; specifically, imitative tendencies, visual perspective taking, and emotion recognition. Using voxel-based morphometry, we then explored relationships between GMV and these clinical and behavioral measures. Results: Patients exhibited significantly slower processing speed, poorer perspective taking, and less imitation compared with HCs. These impairments were related to reduced GMV throughout the putamen, thalami, and anterior insula, predominantly in the left hemisphere. Surprisingly, differences between the groups in emotion recognition were not significant. Conclusion: Less imitation and poorer perspective taking indicate a cognitive self-bias when faced with conflicting self- and other-representations. This suggests that impaired self-other distinction, and an associated subcortical pattern of GM atrophy, might underlie the socio-cognitive disturbances observed in MS.
- Publikační typ
- časopisecké články MeSH
Multiple sclerosis (MS) is a devastating immune-mediated disorder of the central nervous system resulting in progressive disability accumulation. As there is no cure available yet for MS, the primary therapeutic objective is to reduce relapses and to slow down disability progression as early as possible during the disease to maintain and/or improve health-related quality of life. However, optimizing treatment for people with MS (pwMS) is complex and challenging due to the many factors involved and in particular, the high degree of clinical and sub-clinical heterogeneity in disease progression among pwMS. In this paper, we discuss these many different challenges complicating treatment optimization for pwMS as well as how a shift towards a more pro-active, data-driven and personalized medicine approach could potentially improve patient outcomes for pwMS. We describe how the 'Clinical Impact through AI-assisted MS Care' (CLAIMS) project serves as a recent example of how to realize such a shift towards personalized treatment optimization for pwMS through the development of a platform that offers a holistic view of all relevant patient data and biomarkers, and then using this data to enable AI-supported prognostic modelling.
