Neural Network-Based Prediction of Perceived Sleep Quality Through Wearable Device Data

BACKGROUND This study focuses on the development of a neural network model to predict perceived sleep quality using data from wearable devices. We collected various physiological metrics from 18 participants over four weeks, including heart rate, physical activity, and both device-measured and self-reported sleep quality. OBJECTIVES The primary objective was to correlate wearable device data with subjective sleep quality perceptions. METHODS Our approach used data processing, feature engineering, and optimizing a Multi-Layer Perceptron classifier. RESULTS Despite comprehensive data analysis and model experimentation, the predictive accuracy for perceived sleep quality was moderate (59%), highlighting the complexities in accurately quantifying subjective sleep experiences through wearable data. Applying a tolerance of 1 grade (on a scale from 1-5), increased accuracy to 92%. DISCUSSION More in-depth analysis is required to fully comprehend how wearables and artificial intelligence might assist in understanding sleep behavior

Arterial remodeling and hemodynamics in carotid stents: a prospective duplex ultrasound study over 2 years

AbstractObjectiveThis study was undertaken to study negative and positive arterial remodeling processes within self-expanding carotid stents, their interaction, and the resulting changes in hemodynamics over 2 years, with duplex ultrasound scanning.Subjects and methodsOne hundred twelve consecutive patients with 121 successfully stented carotid arteries were examined with color-coded duplex ultrasound scanning the day after the stent procedure and at 3, 6, 12, and 24 months of follow-up. The stent diameters at the proximal, middle, and distal regions, and the maximal neointimal thickness (B-mode) and hemodynamic parameters were recorded. Pre-interventional plaques were assigned to three types: soft, fibrous, and largely calcified.ResultsThe diameters of the self-expanding stents steadily increased over 2 years (positive arterial remodeling), from (mean ± SD) 5.80 ± 0.89 mm to 6.77 ± 0.98 mm in the proximal stent area, from 3.51 ± 0.76 mm to 4.92 ± 0.89 mm in the middle stent area, and from 3.7 ± 0.5 mm to 4.68 ± 0.61 mm in the distal stent area (P < .001). Stent expansion was most marked in the middle stent area, depending on the type of pre-interventional plaque. The extent in stent expansion was more in soft than in fibrous and calcified plaques (P < .001). Neointimal thickness increased up to 12 months, and stabilized thereafter. The mean (± SD) neointimal thickness at 3, 6, 12, and 24 months was 0.61 ± 0.28 mm, 0.97 ± 0.39 mm, 1.06 ± 0.36 mm, and 1.12 ± 0.38 mm, respectively. These complex interactions resulted in the dominance of negative remodeling secondary to neointimal proliferation, with an increased flow ratio during the first year, from 1.16 ± 0.37 at day 1 to 1.23 ± 0.46 at 3 months, 1.67 ± 1.37 at 6 months, and 1.57 ± 0.70 at 12 months (P < .001), followed by a tendency to decrease as a result of stent expansion thereafter (flow ratio at 24 months, 1.49 ± 0.70). Two of 121 stents (1.6%) had recurrent stenosis that required a secondary procedure.ConclusionsNeointimal proliferation or negative arterial remodeling prevails up to 12 months, and may give rise to rare stent recurrent stenosis. Stent expansion reduces this effect in the first year, and dominates in the second year. This might contribute to the good mid-term outcome of carotid stenting. Poor stent expansion in heavily calcified plaques calls for primary surgical management

Heme Oxygenase-1 Gene Promoter Microsatellite Polymorphism is Associated with Restenosis after Percutaneous Transluminal Angioplasty

Purpose:To determine if an association exists between postdilation restenosis and heme oxygenase-1 (HO-1), which is induced by balloon injury and inhibits neointimal formation through the action of endogenous carbon monoxide. A dinucleotide repeat in the promoter region of the HO-1 gene shows a length polymorphism that modulates the level of gene transcription.Methods:This cohort study included 96 consecutive patients (64 men; median age 69 years, interquartile range 60–75) who underwent successful balloon dilation in the femoropopliteal segment. Six-month patency was evaluated using oscillography, ankle-brachial index, and duplex sonography. The association of patency and the length of (GT) repeats in the HO-1 gene promoter was assessed in univariate and multivariate analyses.Results:Restenosis was found in 23 (24%) patients within the first 6 months. Patients with short (&lt;25 GT) dinucleotide repeats in the HO-1 gene promoter on either allele had restenosis significantly less often than patients with longer (≥25 GT) dinucleotide repeats (p = 0.01). Multivariate analysis revealed a significantly reduced risk for restenosis in these patients compared to patients without the short allele (odds ratio 0.2, 95% CI 0.06 to 0.70, p = 0.007).Conclusions:Genetic risk factors for restenosis after percutaneous transluminal angioplasty have not been investigated. In this patient population, short repeat alleles of the heme oxygenase-1 gene promoter polymorphism were associated with reduced postdilation restenosis at 6 months. Upregulation of HO-1 may be an important protective factor after balloon angioplasty by inhibition of vascular smooth muscle cell proliferation.</jats:sec

Angioplasty and Elective Stenting of De Novo versus Recurrent Femoropopliteal Lesions: 1-Year Follow-up

Purpose: To investigate patency rates after percutaneous transluminal angioplasty (PTA) and PTA plus elective stenting in de novo versus recurrent femoropopliteal lesions. Methods: The data were collected from a prospective registry including 533 consecutive patients (284 men; median age 71 years, interquartile range [IQR] 72–78) with severe claudication (n=387) or critical limb ischemia (n = 146) who underwent femoropopliteal percutaneous interventions during a 36-month period. PTA was used to treat 357 de novo and 99 recurrent lesions; PTA plus elective stent implantation was performed in 58 de novo and 19 recurrent lesions. Patients were followed for a median 12 months (IQR 7–14) using color duplex sonography. Rates of restenosis (≥50%) were compared by multivariate analysis. Results: Overall primary technical success was achieved in 517 (97%) patients; 31 (6%) periprocedural complications were encountered. Restenosis occurred in 213 (40%) patients after a median 6 months (IQR 4–7). Twelve-month patency after PTA was 61% in de novo and 33% in recurrent lesions (p&lt;0.0001). Patients with recurrent lesions had a 2.3-fold increased adjusted risk for restenosis after PTA (95% confidence interval 1.7 to 3.2). Twelve-month patency after stenting was 58% in de novo and 52% in recurrent lesions (p=0.9). In patients with de novo lesions, patency rates after PTA and stent were similar (p=0.8); however, in patients with recurrent lesions, elective stenting performed better (p=0.05). Conclusions: Recurrent stenosis after prior femoropopliteal balloon angioplasty is an independent risk factor for restenosis; these lesions exhibit disappointing patency after repeated PTA. Stent implantation may improve intermediate-term results in these patients. </jats:sec