Background & aims: Accurate diagnosis of sarcopenia requires evaluation of muscle quality, which refers to the amount of fat infiltration in muscle tissue. In this study, we aim to investigate whether we can independently predict mortality risk in transcatheter aortic valve implantation (TAVI) patients, using automatic deep learning algorithms to assess muscle quality on procedural computed tomography (CT) scans. Methods: This study included 1199 patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) between January 2010 and January 2020. A procedural CT scan was performed as part of the preprocedural-TAVI evaluation, and the scans were analyzed using deep-learning-based software to automatically determine skeletal muscle density (SMD) and intermuscular adipose tissue (IMAT). The association of SMD and IMAT with all-cause mortality was analyzed using a Cox regression model, adjusted for other known mortality predictors, including muscle mass. Results: The mean age of the participants was 80 ± 7 years, 53% were female. The median observation time was 1084 days, and the overall mortality rate was 39%. We found that the lowest tertile of muscle quality, as determined by SMD, was associated with an increased risk of mortality (HR 1.40 [95%CI: 1.15–1.70], p < 0.01). Similarly, low muscle quality as defined by high IMAT in the lowest tertile was also associated with increased mortality risk (HR 1.24 [95%CI: 1.01–1.52], p = 0.04). Conclusions: Our findings suggest that deep learning-assessed low muscle quality, as indicated by fat infiltration in muscle tissue, is a practical, useful and independent predictor of mortality after TAVI.
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Many organizations use business process management to manage and model their processes. Currently, flow-based process formalisms, such as BPMN, are considered the standard for modeling processes. However, recent literature describes several limitations of this type of formalism that can be solved by adopting a constraint-based formalism. To preserve economic investments in existing process models, transformation activities needed to be limited. This paper presents a methodical approach for performing the tedious parts of process model transformation. Executing the method results in correctly transformed process models and reduces the effort required for converting the process models.
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Physical rehabilitation programs revolve around the repetitive execution of exercises since it has been proven to lead to better rehabilitation results. Although beginning the motor (re)learning process early is paramount to obtain good recovery outcomes, patients do not normally see/experience any short-term improvement, which has a toll on their motivation. Therefore, patients find it difficult to stay engaged in seemingly mundane exercises, not only in terms of adhering to the rehabilitation program, but also in terms of proper execution of the movements. One way in which this motivation problem has been tackled is to employ games in the rehabilitation process. These games are designed to reward patients for performing the exercises correctly or regularly. The rewards can take many forms, for instance providing an experience that is engaging (fun), one that is aesthetically pleasing (appealing visual and aural feedback), or one that employs gamification elements such as points, badges, or achievements. However, even though some of these serious game systems are designed together with physiotherapists and with the patients’ needs in mind, many of them end up not being used consistently during physical rehabilitation past the first few sessions (i.e. novelty effect). Thus, in this project, we aim to 1) Identify, by means of literature reviews, focus groups, and interviews with the involved stakeholders, why this is happening, 2) Develop a set of guidelines for the successful deployment of serious games for rehabilitation, and 3) Develop an initial implementation process and ideas for potential serious games. In a follow-up application, we intend to build on this knowledge and apply it in the design of a (set of) serious game for rehabilitation to be deployed at one of the partners centers and conduct a longitudinal evaluation to measure the success of the application of the deployment guidelines.
The Hereon team has expressed interest in the use of the PO platform for the virtualization of the (hydro)dynamic behavior of offshore wind farms, in particular regarding turbidity around wind turbines. BUas has developed the Procedural Ocean (PO) platform. The platform uses procedural content generation (AI) for data-driven 3D virtualization of complex marine and maritime environments, with elements such as geo-environment (bathymery, etc.), geo-physics (weather conditions, waves), wind farms, aquaculture, shipping, ecology, and more. The virtual and immersive environment in the game engine Unreal supports advanced (game-like) user interaction for policy-oriented learning (marine spatial planning), ocean management, and decision making. We therefore propose a joint pilot Research and Development (R&D) project to explore, demonstrate and validate how a gridded dataset provided by Hereon can show the dynmics around wind farm monopiles. Furthermore, we can explore interactivity with the engineering and design of the turbine and the multiplication of the turbine design to compose a wind farm. Client: Hereon (The Helmholtz-Zentrum Hereon is a non-profit making research institute )
