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Hametner B, Maurer S, Sehnert A, Bachler M, Orter S, Zechner O, Müllner-Rieder M, Penkler M, Wassertheurer S, Sehnert W, Mengden T, Mayer CC. Non-invasive pulse arrival time as a surrogate for oscillometric systolic blood pressure changes during non-pharmacological intervention. Physiol Meas 2024; 45:055015. [PMID: 38688296 DOI: 10.1088/1361-6579/ad45ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/30/2024] [Indexed: 05/02/2024]
Abstract
Background.Non-invasive continuous blood pressure (BP) monitoring is of longstanding interest in various cardiovascular scenarios. In this context, pulse arrival time (PAT), i.e., a surrogate parameter for systolic BP (change), became very popular recently, especially in the context of cuffless BP measurement and dedicated lifestyle interventions. Nevertheless, there is also understandable doubt on its reliability in uncontrolled and mobile settings.Objective.The aim of this work is therefore the investigation whether PAT follows oscillometric systolic BP readings during moderate interventions by physical or mental activity using a medical grade handheld device for non-invasive PAT assessment.Approach.A study was conducted featuring an experimental group performing a physical and a mental task, and a control group. Oscillometric BP and PAT were assessed at baseline and after each intervention. Interventions were selected randomly but then performed sequentially in a counterbalanced order. Multivariate analyses of variance were used to test within-subject and between-subject effects for the dependent variables, followed by univariate analyses for post-hoc testing. Furthermore, correlation analysis was performed to assess the association of intervention effects between BP and PAT.Mainresults.The study included 51 subjects (31 females). Multivariate analysis of variances showed that effects in BP, heart rate, PAT and pulse wave parameters were consistent and significantly different between experimental and control groups. After physical activity, heart rate and systolic BP increased significantly whereas PAT decreased significantly. Mental activity leads to a decrease in systolic BP at stable heart rate. Pulse wave parameters follow accordingly by an increase of PAT and mainly unchanged pulse wave analysis features due to constant heart rate. Finally, also the control group behaviour was accurately registered by the PAT method compared to oscillometric cuff. Correlation analyses revealed significant negative associations between changes of systolic BP and changes of PAT from baseline to the physical task (-0.33 [-0.63, 0.01],p< 0.048), and from physical to mental task (-0.51 [-0.77, -0.14],p= 0.001), but not for baseline to mental task (-0.12 [-0,43,0,20],p= 0.50) in the experimental group.Significance.PAT and the used digital, handheld device proved to register changes in BP and heart rate reliably compared to oscillometric measurements during intervention. Therefore, it might add benefit to future mobile health solutions to support BP management by tracking relative, not absolute, BP changes during non-pharmacological interventions.
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Affiliation(s)
- Bernhard Hametner
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
| | - Severin Maurer
- Institute of Market Research and Methodology, University of Applied Sciences Wiener Neustadt, Wiener Neustadt, Austria
| | - Alina Sehnert
- Institute for Clinical Research Sehnert, Dortmund, Germany
| | - Martin Bachler
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
| | - Stefan Orter
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
| | - Olivia Zechner
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
| | - Markus Müllner-Rieder
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Digital Health Information Systems, Vienna, Austria
| | - Michael Penkler
- Institute of Market Research and Methodology, University of Applied Sciences Wiener Neustadt, Wiener Neustadt, Austria
| | - Siegfried Wassertheurer
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
| | - Walter Sehnert
- Institute for Clinical Research Sehnert, Dortmund, Germany
| | - Thomas Mengden
- Kerckhoff Clinic, Rehabilitation, ESH Excellence Centre, Bad Nauheim, Germany
| | - Christopher C Mayer
- AIT Austrian Institute of Technology, Center for Technology Experience, Experience Business Transformation, Vienna, Austria
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2
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Avoke D, Elshafeey A, Weinstein R, Kim CH, Martin SS. Digital Health in Diabetes and Cardiovascular Disease. Endocr Res 2024:1-13. [PMID: 38605594 DOI: 10.1080/07435800.2024.2341146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Digital health technologies are rapidly evolving and transforming the care of diabetes and cardiovascular disease (CVD). PURPOSE OF THE REVIEW In this review, we discuss emerging approaches incorporating digital health technologies to improve patient outcomes through a more continuous, accessible, proactive, and patient-centered approach. We discuss various mechanisms of potential benefit ranging from early detection to enhanced physiologic monitoring over time to helping shape important management decisions and engaging patients in their care. Furthermore, we discuss the potential for better individualization of management, which is particularly important in diseases with heterogeneous and complex manifestations, such as diabetes and cardiovascular disease. This narrative review explores ways to leverage digital health technology to better extend the reach of clinicians beyond the physical hospital and clinic spaces to address disparities in the diagnosis, treatment, and prevention of diabetes and cardiovascular disease. CONCLUSION We are at the early stages of the shift to digital medicine, which holds substantial promise not only to improve patient outcomes but also to lower the costs of care. The review concludes by recognizing the challenges and limitations that need to be addressed for optimal implementation and impact. We present recommendations on how to navigate these challenges as well as goals and opportunities in utilizing digital health technology in the management of diabetes and prevention of adverse cardiovascular outcomes.
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Affiliation(s)
- Dorothy Avoke
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Robert Weinstein
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chang H Kim
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S Martin
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Ortner VK, Kilov K, Mondragón AC, Fredman G, Omland SH, Manole I, Laugesen CAP, Havsager S, Johansen B, Duvold T, Isberg AP, Andersen AD, Zibert JR, Hædersdal M. Mobile health technologies in an interventional hybrid study on actinic keratosis: Results from an early phase randomized controlled trial investigating the safety and efficacy of a cytosolic phospholipase A2 inhibitor gel in photodamaged skin. Exp Dermatol 2024; 33:e15068. [PMID: 38610094 DOI: 10.1111/exd.15068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
Hybrid trials are a new trend in dermatological research that leverage mobile health technologies to decentralize a subset of clinical trial elements and thereby reduce the number of in-clinic visits. In a Phase I/IIa randomized controlled hybrid trial, the safety and efficacy of an anti-proliferative and anti-inflammatory drug inhibiting cytosolic phospholipase A2 (AVX001) was tested using 1%, 3% or vehicle gel in 60 patients with actinic keratosis (AK) and assessed in-clinic as well as remotely. Over the course of 12 weeks, patients were assessed in-clinic at baseline, end of treatment (EOT) and end of study (EOS), as well as 9 times remotely on a weekly to biweekly basis. Safety outcomes comprising local skin reactions (LSR; 0-5), adverse events (AE) and cosmesis, were graded in-clinic and remotely using patient-obtained smartphone photographs (PSPs) and questionnaires; efficacy was assessed in-clinic based on clinically visible clearance of AK target area of >50%. A total of 55 participants (91.7%) completed the treatment course. The average submission rate of PSPs was high (≥85%), of which 93% were of sufficient quality. No serious AE were reported and only two experienced temporary LSR >2 (scale 0-4) and cosmesis remained stable throughout the study. Based on the mild AE and LSR profile, daily application of AVX001 gel for 1 month appears safe, tolerable, and cosmetically acceptable for use in patients with AK. At EOT, AVX001 achieved a subtle treatment response with clearance of AK target area of >50% in 18% of patients. Remote and in-clinic assessments of LSRs were in high agreement, suggesting that the use of mobile health technologies in early-phase hybrid studies of AK does not compromise patient safety.
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Affiliation(s)
- Vinzent Kevin Ortner
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | | | - Gabriella Fredman
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Silje Haukali Omland
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Ionela Manole
- Studies&Me A/S, Copenhagen, Denmark
- 2nd Department of Dermatology, Colentina Clinical Hospital, Bucharest, Romania
| | | | | | - Berit Johansen
- Coegin Pharma AB, Lund, Sweden
- Department of Biology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | | | | | | - John R Zibert
- Studies&Me A/S, Copenhagen, Denmark
- Coegin Pharma AB, Lund, Sweden
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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4
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Chimatapu SN, Mittelman SD, Habib M, Osuna-Garcia A, Vidmar AP. Wearable Devices Beyond Activity Trackers in Youth With Obesity: Summary of Options. Child Obes 2024; 20:208-218. [PMID: 37023409 PMCID: PMC10979694 DOI: 10.1089/chi.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Background: Current treatment protocols to prevent and treat pediatric obesity focus on prescriptive lifestyle interventions. However, treatment outcomes are modest due to poor adherence and heterogeneity in responses. Wearable technologies offer a unique solution as they provide real-time biofeedback that could improve adherence to and sustainability of lifestyle interventions. To date, all reviews on wearable devices in pediatric obesity cohorts have only explored biofeedback from physical activity trackers. Hence, we conducted a scoping review to (1) catalog other biofeedback wearable devices available in this cohort, (2) document various metrics collected from these devices, and (3) assess safety and adherence to these devices. Methods: This scoping review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Fifteen eligible studies examined the use of biofeedback wearable devices beyond activity trackers in pediatric cohorts, with an emphasis on feasibility of these devices. Results: Included studies varied in sample sizes (15-203) and in ages 6-21 years. Wearable devices are being used to capture various metrics of multicomponent weight loss interventions to provide more insights about glycemic variability, cardiometabolic function, sleep, nutrition, and body fat percentage. High safety and adherence rates were reported among these devices. Conclusions: Available evidence suggests that wearable devices have several applications aside from activity tracking, which could modify health behaviors through real-time biofeedback. Overall, these devices appear to be safe and feasible so as to be employed in various settings in the pediatric age group to prevent and treat obesity.
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Affiliation(s)
- Sri Nikhita Chimatapu
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven D. Mittelman
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Manal Habib
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Antonia Osuna-Garcia
- Department of Health and Life Sciences Librarian, Nursing, Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
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Trirongjitmoah S, Promking A, Kaewdang K, Phansiri N, Treeprapin K. Assessing heart rate and blood pressure estimation from image photoplethysmography using a digital blood pressure meter. Heliyon 2024; 10:e27113. [PMID: 38439889 PMCID: PMC10909774 DOI: 10.1016/j.heliyon.2024.e27113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
This study presents a non-contact approach to measuring heart rate and blood pressure using an image photoplethysmography (iPPG) signal, and compares the results to those from an oscillometric blood pressure meter. Facial videos of 100 subjects were recorded via a webcam under ambient lighting conditions to extract iPPG signals. The results revealed a strong correlation between the heart rate derived from iPPG and that obtained from an oscillometric blood pressure meter. In addition, a continuous wavelet transform images with a 6-s duration were used as input for a custom convolutional neural network model, providing the most accurate blood pressure estimation. The proposed method received a grade A for diastolic and grade B for systolic blood pressure based on the British Hypertension Society's criteria. It also met the standards set by the Association for the Advancement of Medical Instrumentation. This non-contact framework shows promising potential for efficient screening purposes.
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Affiliation(s)
- Suchin Trirongjitmoah
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Ubon Ratchathani University, 85 Sathonlamark, Warinchamrab, Ubon Ratchathani 34190, Thailand
| | - Arphorn Promking
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Ubon Ratchathani University, 85 Sathonlamark, Warinchamrab, Ubon Ratchathani 34190, Thailand
| | - Khanittha Kaewdang
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Ubon Ratchathani University, 85 Sathonlamark, Warinchamrab, Ubon Ratchathani 34190, Thailand
| | - Nisarut Phansiri
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Ubon Ratchathani University, 85 Sathonlamark, Warinchamrab, Ubon Ratchathani 34190, Thailand
| | - Kriengsak Treeprapin
- Department of Mathematics, Statistics and Computers, Faculty of Science, Ubon Ratchathani University, 85 Sathonlamark, Warinchamrab, Ubon Ratchathani 34190, Thailand
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Chato L, Regentova E. Survey of Transfer Learning Approaches in the Machine Learning of Digital Health Sensing Data. J Pers Med 2023; 13:1703. [PMID: 38138930 PMCID: PMC10744730 DOI: 10.3390/jpm13121703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Machine learning and digital health sensing data have led to numerous research achievements aimed at improving digital health technology. However, using machine learning in digital health poses challenges related to data availability, such as incomplete, unstructured, and fragmented data, as well as issues related to data privacy, security, and data format standardization. Furthermore, there is a risk of bias and discrimination in machine learning models. Thus, developing an accurate prediction model from scratch can be an expensive and complicated task that often requires extensive experiments and complex computations. Transfer learning methods have emerged as a feasible solution to address these issues by transferring knowledge from a previously trained task to develop high-performance prediction models for a new task. This survey paper provides a comprehensive study of the effectiveness of transfer learning for digital health applications to enhance the accuracy and efficiency of diagnoses and prognoses, as well as to improve healthcare services. The first part of this survey paper presents and discusses the most common digital health sensing technologies as valuable data resources for machine learning applications, including transfer learning. The second part discusses the meaning of transfer learning, clarifying the categories and types of knowledge transfer. It also explains transfer learning methods and strategies, and their role in addressing the challenges in developing accurate machine learning models, specifically on digital health sensing data. These methods include feature extraction, fine-tuning, domain adaptation, multitask learning, federated learning, and few-/single-/zero-shot learning. This survey paper highlights the key features of each transfer learning method and strategy, and discusses the limitations and challenges of using transfer learning for digital health applications. Overall, this paper is a comprehensive survey of transfer learning methods on digital health sensing data which aims to inspire researchers to gain knowledge of transfer learning approaches and their applications in digital health, enhance the current transfer learning approaches in digital health, develop new transfer learning strategies to overcome the current limitations, and apply them to a variety of digital health technologies.
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Affiliation(s)
- Lina Chato
- Department of Electrical and Computer Engineering, University of Nevada, Las Vegas, NV 89154, USA;
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7
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Abdullah S, Kristoffersson A. Machine learning approaches for cardiovascular hypertension stage estimation using photoplethysmography and clinical features. Front Cardiovasc Med 2023; 10:1285066. [PMID: 38111893 PMCID: PMC10725938 DOI: 10.3389/fcvm.2023.1285066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Cardiovascular diseases (CVDs) are a leading cause of death worldwide, with hypertension emerging as a significant risk factor. Early detection and treatment of hypertension can significantly reduce the risk of developing CVDs and related complications. This work proposes a novel approach employing features extracted from the acceleration photoplethysmography (APG) waveform, alongside clinical parameters, to estimate different stages of hypertension. The current study used a publicly available dataset and a novel feature extraction algorithm to extract APG waveform features. Three distinct supervised machine learning algorithms were employed in the classification task, namely: Decision Tree (DT), Linear Discriminant Analysis (LDA), and Linear Support Vector Machine (LSVM). Results indicate that the DT model achieved exceptional training accuracy of 100% during cross-validation and maintained a high accuracy of 96.87% on the test dataset. The LDA model demonstrated competitive performance, yielding 85.02% accuracy during cross-validation and 84.37% on the test dataset. Meanwhile, the LSVM model exhibited robust accuracy, achieving 88.77% during cross-validation and 93.75% on the test dataset. These findings underscore the potential of APG analysis as a valuable tool for clinicians in estimating hypertension stages, supporting the need for early detection and intervention. This investigation not only advances hypertension risk assessment but also advocates for enhanced cardiovascular healthcare outcomes.
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Affiliation(s)
- Saad Abdullah
- School of Innovation, Design and Engineering, Mälardalen University, Västerås, Sweden
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8
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Tang W, Sun Q, Wang ZL. Self-Powered Sensing in Wearable Electronics─A Paradigm Shift Technology. Chem Rev 2023; 123:12105-12134. [PMID: 37871288 PMCID: PMC10636741 DOI: 10.1021/acs.chemrev.3c00305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/25/2023]
Abstract
With the advancements in materials science and micro/nanoengineering, the field of wearable electronics has experienced a rapid growth and significantly impacted and transformed various aspects of daily human life. These devices enable individuals to conveniently access health assessments without visiting hospitals and provide continuous, detailed monitoring to create comprehensive health data sets for physicians to analyze and diagnose. Nonetheless, several challenges continue to hinder the practical application of wearable electronics, such as skin compliance, biocompatibility, stability, and power supply. In this review, we address the power supply issue and examine recent innovative self-powered technologies for wearable electronics. Specifically, we explore self-powered sensors and self-powered systems, the two primary strategies employed in this field. The former emphasizes the integration of nanogenerator devices as sensing units, thereby reducing overall system power consumption, while the latter focuses on utilizing nanogenerator devices as power sources to drive the entire sensing system. Finally, we present the future challenges and perspectives for self-powered wearable electronics.
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Affiliation(s)
- Wei Tang
- CAS
Center for Excellence in Nanoscience, Beijing Institute of Nanoenergy
and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- School
of Nanoscience and Technology, University
of Chinese Academy of Sciences, Beijing 100049, China
- Institute
of Applied Nanotechnology, Jiaxing, Zhejiang 314031, P.R. China
| | - Qijun Sun
- CAS
Center for Excellence in Nanoscience, Beijing Institute of Nanoenergy
and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- School
of Nanoscience and Technology, University
of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhong Lin Wang
- CAS
Center for Excellence in Nanoscience, Beijing Institute of Nanoenergy
and Nanosystems, Chinese Academy of Sciences, Beijing 100083, China
- Yonsei
Frontier Lab, Yonsei University, Seoul 03722, Republic of Korea
- Georgia
Institute of Technology, Atlanta, Georgia 30332-0245, United States
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9
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Gerónimo JF, Alastruey J, Keramat A. Signatures of obstructions and expansions in the arterial frequency response. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107628. [PMID: 37336151 DOI: 10.1016/j.cmpb.2023.107628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND AND OBJECTIVE The blood pressure and flow waveforms carry valuable information about the condition of the cardiovascular system and a patient's health. Waveform analysis in health and pathological conditions can be performed in the time or frequency domains; the information to be emphasised defines the use of either domain. However, physicians are more familiar with the time domain, and the changes in the waveforms due to cardiovascular diseases and ageing are better characterised in such domain. On the other hand, the analysis of the vascular and geometrical variables determining the signatures in the frequency response of local vascular anomalies, such as aneurysms and stenoses, has not been thoroughly explored. This paper aims to characterise the signatures of obstructions (stenoses) and expansions (aneurysms) in the frequency response of tapered arteries. METHODS The first step in our methodology was to incorporate the viscous response of the arterial wall into a one-dimensional elastic formulation that solves the governing equations in the frequency domain. As a second step, we imposed a volumetric flow excitation in arteries simulating the aorta with increasing geometry complexity: from straight to tapered arteries with local expansions or obstructions; and we assessed the frequency response. RESULTS We found that the obstructions and expansions cause characteristic signatures in an artery's frequency response that are distinguishable from a health condition. The signatures of obstruction and expansions differ; the obstructions increase the magnitude of fundamental frequency and work as a close boundary condition. On the other hand, the expansions diminish the fundamental frequency and work as an open boundary condition. Furthermore, such signatures correlate to the distance between the artery's inlet and the anomaly's starting point and have the potential to pinpoint abnormalities non-invasively. CONCLUSIONS We found that the obstructions and expansions cause characteristic signatures in an artery's frequency response that have the potential to detect and follow up on the development of vascular abnormalities. For the latter purpose, constant monitoring may be required; despite this not being a common clinical practice, the new wearable technology offers the possibility of continuous monitoring of biophysical markers such as the pressure waveform.
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Affiliation(s)
- Joaquín Flores Gerónimo
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Alireza Keramat
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR
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10
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Qureshi FM, Golan R, Ghomeshi A, Ramasamy R. An Update on the Use of Wearable Devices in Men's Health. World J Mens Health 2023; 41:785-795. [PMID: 36792091 PMCID: PMC10523121 DOI: 10.5534/wjmh.220205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 02/01/2023] Open
Abstract
Men's health represents an often-overlooked aspect of public health. Men have higher mortality rates worldwide and are more negatively affected by chronic conditions such as obesity and heart disease, as well as addiction to alcohol and tobacco. Men also have health issues such as prostate cancer and male sexual dysfunction which only affect them. Because of the skewed burden of morbidity and mortality on men, it is imperative from a public health perspective to make a concerted effort to specifically improve men's health. The use of wearable devices in medical practice presents a novel avenue to invest in men's health in a safe, easily scalable, and economic fashion. Wearable devices are now ubiquitous in society, and their use in the healthcare setting is only increasing with time. There are commercially available devices such as smart watches which are available to lay people and healthcare professionals alike to improve overall health and wellness, and there are also purpose-built wearable devices which are used to track or treat a specific disease. In our review of the literature, we found that while research in the field of wearable devices is still in its early stages, there is ample evidence that wearable devices can greatly improve men's health in the long-term.
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Affiliation(s)
- Farhan M Qureshi
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
- Medical Scientist Training Program, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Roei Golan
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Armin Ghomeshi
- Department of Urology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
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11
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Tsioufis PA, Iliakis P, Konstantinidis D, Dimitriadis K, Tsioufis K. 7-day Aktiia bracelet vs 24 h ABPM study: more questions than answers? Hypertens Res 2023; 46:2251-2253. [PMID: 37443260 DOI: 10.1038/s41440-023-01344-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 07/15/2023]
Affiliation(s)
| | - Panagiotis Iliakis
- First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Kyriakos Dimitriadis
- First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
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12
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Karamchandani K, Dave S, Hoffmann U, Khanna AK, Saugel B. Intraoperative arterial pressure management: knowns and unknowns. Br J Anaesth 2023; 131:445-451. [PMID: 37419749 DOI: 10.1016/j.bja.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/16/2023] [Accepted: 05/29/2023] [Indexed: 07/09/2023] Open
Abstract
Preventing postoperative organ dysfunction is integral to the practice of anaesthesia. Although intraoperative hypotension is associated with postoperative end organ dysfunction, there remains ambiguity with regards to its definition, targets, thresholds for initiating treatment, and ideal treatment modalities.
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Affiliation(s)
- Kunal Karamchandani
- Department of Anesthesiology and Pain Management, Division of Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Siddharth Dave
- Department of Anesthesiology and Pain Management, Division of Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ulrike Hoffmann
- Department of Anesthesiology and Pain Management, Division of Neuroanesthesia, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ashish K Khanna
- Department of Anesthesiology, Section on Critical Care Medicine, Perioperative Outcomes and Informatics Collaborative (POIC), Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA; Outcomes Research Consortium, Cleveland, OH, USA
| | - Bernd Saugel
- Outcomes Research Consortium, Cleveland, OH, USA; Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Seesaard T, Wongchoosuk C. Flexible and Stretchable Pressure Sensors: From Basic Principles to State-of-the-Art Applications. MICROMACHINES 2023; 14:1638. [PMID: 37630177 PMCID: PMC10456594 DOI: 10.3390/mi14081638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Flexible and stretchable electronics have emerged as highly promising technologies for the next generation of electronic devices. These advancements offer numerous advantages, such as flexibility, biocompatibility, bio-integrated circuits, and light weight, enabling new possibilities in diverse applications, including e-textiles, smart lenses, healthcare technologies, smart manufacturing, consumer electronics, and smart wearable devices. In recent years, significant attention has been devoted to flexible and stretchable pressure sensors due to their potential integration with medical and healthcare devices for monitoring human activity and biological signals, such as heartbeat, respiratory rate, blood pressure, blood oxygen saturation, and muscle activity. This review comprehensively covers all aspects of recent developments in flexible and stretchable pressure sensors. It encompasses fundamental principles, force/pressure-sensitive materials, fabrication techniques for low-cost and high-performance pressure sensors, investigations of sensing mechanisms (piezoresistivity, capacitance, piezoelectricity), and state-of-the-art applications.
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Affiliation(s)
- Thara Seesaard
- Department of Physics, Faculty of Science and Technology, Kanchanaburi Rajabhat University, Kanchanaburi 71190, Thailand;
| | - Chatchawal Wongchoosuk
- Department of Physics, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
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Karam S, Cohen DL, Jaoude PA, Dionne J, Ding FL, Garg A, Tannor EK, Chanchlani R. Approach to Diagnosis and Management of Hypertension: A Comprehensive and Combined Pediatric and Adult Perspective. Semin Nephrol 2023; 43:151438. [PMID: 37951795 DOI: 10.1016/j.semnephrol.2023.151438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
The global prevalence of primary hypertension has been increasing both in children and in the adolescent and adult populations and can be attributed to changes in lifestyle factors with an obesity epidemic, increased salt consumption, and sedentary lifestyles. Childhood blood pressure is the strongest predictor of adult hypertension. Although hypertension in adults is associated strongly with an increased risk for cardiovascular disease, chronic kidney disease, and mortality, outcomes in children are defined less clearly. In adults, major guidelines agree on a threshold of less than 120/80 mm Hg as the optimal blood pressure (BP) and recommend a target of less than 130/80 mm Hg for treatment in most cases. In children, international pediatric guidelines recommend using thresholds based on the normative distribution of BP in healthy normal-weight children. Out-of-office BP assessment is extremely useful for confirming the diagnosis of hypertension and monitoring response to treatment. Lifestyle modifications are instrumental whether coupled or not with pharmacologic management. New agents such as nonsteroidal mineralocorticoid-receptor antagonists, aminopeptidase A inhibitors, aldosterone synthase inhibitors, and dual endothelin antagonists hold significant promise for resistant hypertension. The transition from pediatric to adult care can be challenging and requires careful planning and effective coordination within a multidisciplinary team that includes patients and their families, and pediatric and adult providers.
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Affiliation(s)
- Sabine Karam
- Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, MN.
| | - Debbie L Cohen
- Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Pauline Abou Jaoude
- Division of Pediatric Nephrology, Hotel-Dieu de France-University Medical Center, Beirut, Lebanon
| | - Janis Dionne
- Division of Nephrology, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - FangChao Linda Ding
- Division of Nephrology, Department of Pediatrics, University of British Columbia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Anika Garg
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Elliot Koranteng Tannor
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana; Renal Unit, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Alawieh H, Weiss N. A Novel Form Factor For PPG-based Blood Pressure Monitoring. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-6. [PMID: 38083075 DOI: 10.1109/embc40787.2023.10341192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Blood pressure (BP) is one of the four main vital signs in medicine and may be a useful signal for wellness tracking and for user-aware interfaces in human-computer interaction. The current standard for BP measurement uses cuff-based devices that block an artery temporarily to get a single, discrete measurement of BP. Recently, there have been significant efforts to measure correlates of BP continuously and non-invasively from relevant signals like photoplethysmography (PPG), which responds to volumetric changes in arteries due to blood pulsations. In this paper, we explore a novel setup with two points of instrumentation, one on the head and a second on the wrist, for recording PPG and estimating the pulse wave velocity, which is a major correlate of BP, along with other waveform-related features. We prospectively tested the device on 10 subjects who followed a protocol for the deliberate variation of BP while ground truth measurements were taken using a reference cuff-device. Generic absolute BP models, which use the collected data for leave-one-subject-out cross-validation, yielded an error of -0.14 ± 7.3 mmHg for systolic BP (SBP) and -0.21±6.7 mmHg for diastolic BP (DBP), which are within the regulatory limits of 5 ± 8 mmHg. Notably, the correlation between the predicted BPs and the ground truth BPs was higher for SBP (r = 0.74, p < 0.001) than for DBP (r = 0.34, p < 0.001). The results show that the proposed form factor can extract BP-related features that could be used for continuous, cuff-less BP monitoring.
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Barteit S, Sié A, Zabré P, Traoré I, Ouédraogo WA, Boudo V, Munga S, Khagayi S, Obor D, Muok E, Franke J, Schwarz M, Blass K, Su TT, Bärnighausen T, Sankoh O, Sauerborn R. Widening the lens of population-based health research to climate change impacts and adaptation: the climate change and health evaluation and response system (CHEERS). Front Public Health 2023; 11:1153559. [PMID: 37304117 PMCID: PMC10248881 DOI: 10.3389/fpubh.2023.1153559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Climate change significantly impacts health in low-and middle-income countries (LMICs), exacerbating vulnerabilities. Comprehensive data for evidence-based research and decision-making is crucial but scarce. Health and Demographic Surveillance Sites (HDSSs) in Africa and Asia provide a robust infrastructure with longitudinal population cohort data, yet they lack climate-health specific data. Acquiring this information is essential for understanding the burden of climate-sensitive diseases on populations and guiding targeted policies and interventions in LMICs to enhance mitigation and adaptation capacities. Objective The objective of this research is to develop and implement the Change and Health Evaluation and Response System (CHEERS) as a methodological framework, designed to facilitate the generation and ongoing monitoring of climate change and health-related data within existing Health and Demographic Surveillance Sites (HDSSs) and comparable research infrastructures. Methods CHEERS uses a multi-tiered approach to assess health and environmental exposures at the individual, household, and community levels, utilizing digital tools such as wearable devices, indoor temperature and humidity measurements, remotely sensed satellite data, and 3D-printed weather stations. The CHEERS framework utilizes a graph database to efficiently manage and analyze diverse data types, leveraging graph algorithms to understand the complex interplay between health and environmental exposures. Results The Nouna CHEERS site, established in 2022, has yielded significant preliminary findings. By using remotely-sensed data, the site has been able to predict crop yield at a household level in Nouna and explore the relationships between yield, socioeconomic factors, and health outcomes. The feasibility and acceptability of wearable technology have been confirmed in rural Burkina Faso for obtaining individual-level data, despite the presence of technical challenges. The use of wearables to study the impact of extreme weather on health has shown significant effects of heat exposure on sleep and daily activity, highlighting the urgent need for interventions to mitigate adverse health consequences. Conclusion Implementing the CHEERS in research infrastructures can advance climate change and health research, as large and longitudinal datasets have been scarce for LMICs. This data can inform health priorities, guide resource allocation to address climate change and health exposures, and protect vulnerable communities in LMICs from these exposures.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Pascal Zabré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - I Traoré
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | - Valentin Boudo
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | | | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Erick Muok
- Kenya Medical Research Institute, Kisumu, Kenya
| | | | | | - Klaus Blass
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Tin Tin Su
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
- Harvard Center for Population and Development Studies, Cambridge, MA, United States
| | - Osman Sankoh
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Statistics Sierra Leone, Freetown, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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Zhang M, Shi Y, Zhou B, Huang Z, Zhao Z, Li C, Zhang X, Han G, Peng K, Li X, Wang Y, Ezzati M, Wang L, Li Y. Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey. BMJ 2023; 380:e071952. [PMID: 36631148 PMCID: PMC10498511 DOI: 10.1136/bmj-2022-071952] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To assess the recent trends in prevalence and management of hypertension in China, nationally and by population subgroups. DESIGN Six rounds of a national survey, China. SETTING China Chronic Disease and Risk Factors Surveillance, 2004-18. PARTICIPANTS 642 523 community dwelling adults aged 18-69 years (30 501 in 2004, 47 353 in 2007, 90 491 in 2010, 156 836 in 2013, 162 293 in 2015, and 155 049 in 2018). MAIN OUTCOME MEASURES Hypertension was defined as a blood pressure of ≥140/90 mm Hg or taking antihypertensive drugs. The main outcome measures were hypertension prevalence and proportion of people with hypertension who were aware of their hypertension, who were treated for hypertension, and whose blood pressure was controlled below 140/90 mm Hg. RESULTS The standardised prevalence of hypertension in adults aged 18-69 years in China increased from 20.8% (95% confidence interval 19.0% to 22.5%) in 2004 to 29.6% (27.8% to 31.3%) in 2010, then decreased to 24.7% (23.2% to 26.1%) in 2018. During 2010-18, the absolute annual decline in prevalence of hypertension among women was more than twice that among men (-0.83 percentage points (95% confidence interval -1.13 to -0.52) v -0.40 percentage points (-0.73 to -0.07)). Despite modest improvements in the awareness, treatment, and control of hypertension since 2004, rates remained low in 2018, at 38.3% (36.3% to 40.4%), 34.6% (32.6% to 36.7%), and 12.0% (10.6% to 13.4%). Of 274 million (95% confidence interval 238 to 311 million) adults aged 18-69 years with hypertension in 2018, control was inadequate in an estimated 240 million (215 to 264 million). Across all surveys, women with low educational attainment had higher prevalence of hypertension than those with higher education, but the finding was mixed for men. The gap in hypertension control between urban and rural areas persisted, despite larger improvements in diagnosis and control in rural than in urban areas. CONCLUSIONS The prevalence of hypertension in China has slightly declined since 2010, but treatment and control remain low. The findings highlight the need for improving detection and treatment of hypertension through the strengthening of primary care in China, especially in rural areas.
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Affiliation(s)
- Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yu Shi
- National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
| | - Bin Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guiyuan Han
- National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
| | - Ke Peng
- National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
| | - Xinhua Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- People's Medical Publishing House, Beijing, China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yichong Li
- National Clinical Research Center for Cardiovascular Diseases, Heart Failure Ward, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Guangdong Province, China
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