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      Prediction Model of Ischemic Stroke Recurrence Using PSO-LSTM in Mobile Medical Monitoring System

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          Abstract

          Aiming at the problems of low prediction accuracy and low sensitivity of traditional ischemic stroke recurrence prediction methods, which limits its application range, by introducing an adaptive particle swarm optimization (PSO) algorithm into the Long and Short-Term Memory (LSTM) model, a prediction model of ischemic stroke recurrence using deep learning in mobile medical monitoring system is proposed. First, based on the clustering idea, the particles are divided into local optimal particles and ordinary particles according to the characteristic information and distribution of different particles. By updating the particles with different strategies, the diversity of the population is improved and the problem of local optimal solution is eliminated. Then, by introducing the adaptive PSO algorithm into the LSTM, the PSO-LSTM prediction model is constructed. The optimal super parameters of the model are determined quickly and accurately, and the model is trained combined with the patient's clinical data. Finally, by using SMOTE method to process the original data, the imbalance of positive and negative sample data is eliminated. Under the same conditions, the proposed PSO-LSTM prediction model is compared with two traditional LSTM models. The results show that the prediction accuracy of PSO-LSTM model is 92.0%, which is better than two comparison models. The effective prediction of ischemic stroke recurrence is realized.

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          Most cited references27

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          Recurrent ischemic stroke: Incidence, predictors, and impact on mortality

          Background and purpose Recurrent ischemic stroke (IS) or TIA is frequent with a considerable variation in incidence and mortality across populations. Current data on stroke recurrence and mortality are useful to examine trends, risk factors, and treatment effects. In this study, we calculated the incidence of recurrent IS or TIA in a hospital‐based stroke population in Western Norway, investigated recurrence factors, and estimated the effect of recurrence on all‐cause mortality. Methods This prospective cohort study registered recurrence and mortality among 1872 IS and TIA survivors admitted to the stroke unit at Haukeland University Hospital between July 2007 and December 2013. Recurrence and death until September 1, 2016, were identified by medical chart review. Cumulative incidences of recurrence were estimated with a competing risks Cox model. Multivariate Cox models were used to examine recurrence factors and mortality. Results During follow‐up, 220 patients had 277 recurrent IS or TIAs. The cumulative recurrence rate was 5.4% at 1 year, 11.3% at 5 years, and 14.2% at the end of follow‐up. Hypertension (HR = 1.65, 95% CI 1.21‐2.25), prior symptomatic stroke (HR = 1.63, 95% CI 1.18‐2.24), chronic infarcts on MRI (HR = 1.48, 95% CI 1.10‐1.99), and age (HR 1.02/year, 95% CI 1.00‐1.03) were independently associated with recurrence. A total of 668 (35.7%) patients died during follow‐up. Recurrence significantly increased the all‐cause mortality (HR = 2.55, 95% CI 2.04‐3.18). Conclusions The risk of recurrent IS stroke or TIA was modest in our population and was associated with previously established risk factors. Recurrence more than doubled the all‐cause mortality.
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            Risk Factors Associated With Cerebrovascular Recurrence in Symptomatic Carotid Disease: A Comparative Study of Carotid Plaque Morphology, Microemboli Assessment and the European Carotid Surgery Trial Risk Model

            Background The European Carotid Surgery Trial (ECST) risk model is a validated tool for predicting cerebrovascular risk in patients with symptomatic carotid disease. Carotid plaque hemorrhage as detected by MRI (MRIPH) and microembolic signals (MES) detected by transcranial Doppler (TCD) are 2 emerging modalities in assessing instability of the carotid plaque. The aim of this study was to assess the strength of association of MES and MRIPH with cerebrovascular recurrence in patients with symptomatic carotid artery disease in comparison with the ECST risk prediction model. Methods and Results One hundred and thirty‐four prospectively recruited patients (mean [SD]: age 72 [9.8] years, 33% female) with symptomatic severe (50% to 99%) carotid stenosis underwent preoperative TCD, MRI of the carotid arteries to assess MES, PH, and the ECST risk model. Patients were followed up until carotid endarterectomy, recurrent cerebral event, death, or study end. Event‐free survival analysis was done using backward conditional Cox regression analysis. Of the 123 patients who had both TCD and MRI, 82 (66.7%) demonstrated PH and 46 (37.4%) had MES. 37 (30.1%) cerebrovascular events (21 transient ischemic attacks, 6 amaurosis fugax, and 10 strokes) were observed. Both carotid PH (HR=8.68; 95% CI 2.66 to 28.40, P<0.001) as well as MES (HR=3.28; 95% CI 1.68 to 6.42, P=0.001) were associated with cerebrovascular event recurrence. Combining MES and MRIPH improved the strength of association (HR=0.74, 95% CI 0.65 to 0.83; P<0.001). The ECST risk model was not associated with recurrence (HR=0.86; 95% CI 0.45 to 1.65; P=0.65). Conclusions The presence of carotid plaque hemorrhage is better associated with recurrent cerebrovascular events in patients with symptomatic severe carotid stenosis than the presence of microembolic signals; combining MES and MRIPH, further improves the association while the ECST risk score was insignificant.
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              Sex differences in acute ischaemic stroke patients: clinical presentation, causes and outcomes.

              The aim was to investigate sex differences in the causes, clinical presentation, outcome and stroke recurrences in a large cohort of consecutive acute ischaemic stroke patients.

                Author and article information

                Contributors
                Journal
                Comput Intell Neurosci
                Comput Intell Neurosci
                cin
                Computational Intelligence and Neuroscience
                Hindawi
                1687-5265
                1687-5273
                2022
                24 March 2022
                : 2022
                : 8936103
                Affiliations
                1School of Medical Technology, Qiqihar Medical University, Qiqihar, Heilongjiang 161000, China
                2School of Public Health, Qiqihar Medical University, Qiqihar, Heilongjiang 161000, China
                3Clinical Teaching Center, Qiqihar Medical University, Qiqihar, Heilongjiang 161000, China
                4School of General Practice and Continuing, Qiqihar Medical University, Qiqihar, Heilongjiang 161000, China
                Author notes

                Academic Editor: Deepika Koundal

                Author information
                https://orcid.org/0000-0002-7749-2782
                https://orcid.org/0000-0001-9519-4263
                https://orcid.org/0000-0001-6332-9346
                https://orcid.org/0000-0001-9333-6803
                https://orcid.org/0000-0001-6828-7253
                Article
                10.1155/2022/8936103
                8970909
                35371252
                f614e5a4-e434-4142-b3de-ac55d2cc3671
                Copyright © 2022 Qingjiang Li et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 December 2021
                : 13 January 2022
                : 25 January 2022
                Funding
                Funded by: science and technology research project of Heilongjiang Provincial Department of Education
                Award ID: 2018-KYYWF-0104
                Categories
                Research Article

                Neurosciences
                Neurosciences

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