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Early warning systems

Su-Han Chang, Chiao-Hsuan Hsieh, Yi-Ming Weng, Ming-Shun Hsieh, Zhong Ning Leonard Goh, Hsien-Yi Chen, Tung Chang, Chip-Jin Ng, Joanna Chen-Yeen Seak, Chen-Ken Seak, Chen-June Seak
Background: Renal abscess is a relatively uncommon yet debilitating and potentially fatal disease. There is no clearly defined, objective risk stratification tool available for emergency physicians' and surgeons' use in the emergency department (ED) to quickly determine the appropriate management strategy for these patients, despite early intervention having a beneficial impact on survival outcomes. Objective: This case control study evaluates the performance of Mortality in Emergency Department Sepsis Score (MEDS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) in predicting risk of mortality in ED adult patients with renal abscess...
2018: BioMed Research International
Nicholas Ballester, Pratik J Parikh, Michael Donlin, Elizabeth K May, Steven R Simon
OBJECTIVES: To develop an early warning discharge disposition prediction tool based on clinical and health services factors for hospitalized patients. Recent study results suggest that early prediction of discharge disposition (ie, whether patients can return home or require placement in a facility) can improve care coordination, expedite care planning, and reduce length of stay. STUDY DESIGN:  Retrospective analysis of inpatient data; development of multiple logistic regression model and an easy-to-use score...
October 1, 2018: American Journal of Managed Care
Eva Turicchia, Marco Abbiati, Michael Sweet, Massimo Ponti
Mediterranean gorgonian forests are species-rich habitats, and like many other marine habitats they are threatened by anthropogenic disturbances and mass mortality events. These mortality events have often been linked to anomalies in the temperature profiles of the Mediterranean region. On 5 September 2017, colonies of the gorgonians Eunicella singularis and Eunicella cavolini exhibited rapid tissue loss, down to a depth of 30 m along the steep cliffs of Montecristo Island, Tuscan Archipelago National Park, Tyrrhenian Sea, Italy...
October 16, 2018: Diseases of Aquatic Organisms
Robbin Bastiaansen, Olfa Jaïbi, Vincent Deblauwe, Maarten B Eppinga, Koen Siteur, Eric Siero, Stéphane Mermoz, Alexandre Bouvet, Arjen Doelman, Max Rietkerk
Spatial self-organization of dryland vegetation constitutes one of the most promising indicators for an ecosystem's proximity to desertification. This insight is based on studies of reaction-diffusion models that reproduce visual characteristics of vegetation patterns observed on aerial photographs. However, until now, the development of reliable early warning systems has been hampered by the lack of more in-depth comparisons between model predictions and real ecosystem patterns. In this paper, we combined topographical data, (remotely sensed) optical data, and in situ biomass measurements from two sites in Somalia to generate a multilevel description of dryland vegetation patterns...
October 15, 2018: Proceedings of the National Academy of Sciences of the United States of America
Joon-Myoung Kwon, Youngnam Lee, Yeha Lee, Seungwoo Lee, Hyunho Park, Jinsik Park
AIM: Triage is important in identifying high-risk patients amongst many less urgent patients as emergency department (ED) overcrowding has become a national crisis recently. This study aims to validate that a Deep-learning-based Triage and Acuity Score (DTAS) identifies high-risk patients more accurately than existing triage and acuity scores using a large national dataset. METHODS: We conducted a retrospective observational cohort study using data from the Korean National Emergency Department Information System (NEDIS), which collected data on visits in real time from 151 EDs...
2018: PloS One
Hannah L Nathan, Nicola Vousden, Elodie Lawley, Annemarie de Greeff, Natasha L Hezelgrave, Nicola Sloan, Nina Tanna, Shivaprasad S Goudar, Muchabayiwa F Gidiri, Jane Sandall, Lucy C Chappell, Andrew H Shennan
Objectives: Haemorrhage, hypertension, sepsis and abortion complications (often from haemorrhage or sepsis) contribute to 60% of all maternal deaths. Each is associated with vital signs (blood pressure (BP) and pulse) abnormalities, and the majority of deaths are preventable through simple and timely intervention. This paper presents the development and evaluation of the CRADLE Vital Signs Alert (VSA), an accurate, low-cost and easy-to-use device measuring BP and pulse with an integrated traffic light early warning system...
October 2018: BMJ Innovations
David McCutcheon, Mohan Raghavan, Jessamine Soderstrom, Francois Oosthuizen, Bianca Douglas, Ellen MacDonald, Daniel Fatovich
OBJECTIVE: An ever-increasing number of novel psychoactive substances are being detected worldwide. These emerging drugs have been demonstrated to cause toxicity in clusters, and deaths have been reported. We urgently need to learn more about their effects. We report the protocol for the Western Australian Illicit Substance Evaluation (WISE) study, a research project investigating illicit drug use in the ED. METHODS: Patients can be enrolled if the treating clinician strongly suspects they are currently intoxicated with a stimulant, hallucinogenic or cannabinoid drug; and an i...
October 14, 2018: Emergency Medicine Australasia: EMA
Gregory Levitin, Liudong Xing, Hong-Zhong Huang
Empowered by virtualization technology, service requests from cloud users can be honored through creating and running virtual machines. Virtual machines established for different users may be allocated to the same physical server, making the cloud vulnerable to co-residence attacks where a malicious attacker can steal a user's data through co-residing their virtual machines on the same server. For protecting data against the theft, the data partition technique is applied to divide the user's data into multiple blocks with each being handled by a separate virtual machine...
October 12, 2018: Risk Analysis: An Official Publication of the Society for Risk Analysis
Danny J Avalos, Irene Sarosiek, Priyadarshini Loganathan, Richard W McCallum
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States...
2018: Clinical and Experimental Gastroenterology
Aline Taoum, Farah Mourad-Chehade, Hassan Amoud
Acute respiratory distress syndrome (ARDS) is a critical condition that disturbs the respiratory system and may lead to death. Early identification of this syndrome is crucial for the implementation of preventive measures. The present paper focuses on the prediction of the onset of this syndrome using physiological records of patients. Heart rate, respiratory rate, peripheral arterial oxygen saturation and mean airway blood pressure were considered. The method proposed in this paper uses first distance-based novelty detection that allows detecting deviations from normal states for each signal...
October 4, 2018: Computers in Biology and Medicine
Bettina Siewert, Mary Hochman, Ronald L Eisenberg, Suzanne Swedeen, Olga R Brook
Ensuring the safety of patients and staff is a core effort of all health care organizations. Many regulatory agencies, from The Joint Commission to the Occupational Safety and Health Administration, provide policies and guidelines, with relevant metrics to be achieved. Data on safety can be obtained through a variety of mechanisms, including gemba walks, team discussion during safety huddles, audits, and individual employee entries in safety reporting systems. Data can be organized on a scorecard that provides an at-a-glance view of progress and early warning signs of practice drift...
October 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Bin Li, Shengfan Zhang, Stephen Hoover, Ryan Arnold, Muge Capan
While physiological warning signs prior to deterioration events during hospitalization have been widely studied, evaluating clinical interventions, such as Rapid Response Team (RRT) activations, based on scoring systems remains an understudied area. Simulation of physiological deterioration patterns represented by scoring systems can facilitate testing different RRT policies without disturbing care processes. Christiana Care Early Warning System (CEWS) is a scoring system developed at the study hospital to detect the physiological warning signs and inform RRT activations...
October 4, 2018: IEEE Journal of Biomedical and Health Informatics
A R Davies, L Homolova, C N B Grey, M A Bellis
Background: Mass unemployment events are not uncommon yet the impact on health is not well recognised. There is a need for a preparedness and response framework, as exists for other events that threaten population health. Methods: Framework informed by a narrative review of the impact of mass unemployment on health (studies published in English from 1990 to 2016), and qualitative data from 23 semi-structured interviews with individuals connected to historical national and international events, addressing gaps in published literature on lessons learnt from past responses...
October 5, 2018: Journal of Public Health
Luke E Hodgson, Jo Congleton, Richard Venn, Lui G Forni, Paul J Roderick
The Royal College of Physicians (RCP) recently published the National Early Warning Score 2 (NEWS2), aiming to improve safety for patients with hypercapnic respiratory failure by suggesting a separate oxygen saturation (SpO2 ) parameter scoring system for such patients. A previously published study of patients (n=2,361 admissions) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) demonstrated alternative scoring systems at admission did not outperform the original NEWS. Applying NEWS2 SpO2 parameters to this previously described cohort would have resulted in 44% (n=27/62) of patients who scored ≥7 points on the original NEWS and subsequently died being placed in a lower call-out threshold...
October 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Marco A F Pimentel, Oliver C Redfern, Stephen Gerry, Gary S Collins, James Malycha, David Prytherch, Paul E Schmidt, Gary B Smith, Peter J Watkinson
AIMS: To compare the ability of the National Early Warning Score (NEWS) and the National Early Warning Score 2 (NEWS2) to identify patients at risk of in-hospital mortality and other adverse outcomes. METHODS: We undertook a multi-centre retrospective observational study at five acute hospitals from two UK NHS Trusts. Data were obtained from completed adult admissions who were not fit enough to be discharged alive on the day of admission. Diagnostic coding and oxygen prescriptions were used to identify patients with type II respiratory failure (T2RF)...
October 1, 2018: Resuscitation
Juan P Argañaraz, Marcos A Landi, Carlos Marcelo Scavuzzo, Laura M Bellis
Fuel moisture content (FMC) is an important fuel property for assessing wildfire hazard, since it influences fuel flammability and fire behavior. The relationship between FMC and fire activity differs among land covers and seems to be a property of each ecosystem. Our objectives were to analyze pre-fire FMC among different land covers and to propose a wildfire hazard classification for the Sierras Chicas in the Chaco Serrano subregion (Argentina), by analyzing pre-fire FMC distributions observed for grasslands, shrublands and forests and using percentiles to establish thresholds...
2018: PloS One
Xiuping Yang, Xun Niu, Ying Xiao, Kun Lin, Xiong Chen
BACKGROUND: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is prone to being complicated with various cardiovascular, cerebrovascular and metabolic conditions. OSAHS, due to its multifactorial nature, entails individualized and comprehensive treatment. So far, no well-established diagnostic criteria for the disease are available. In recent years, miRNA has been shown to be a sensitive biomarker suggestive of the progression and prognosis of many diseases. In this study, we examined some serum miRNAs in healthy OSAHS (OSAHS patients without complication) and OSAHS with arterial hypertension, with an attempt to understand the potential effects on the disease, improve the diagnosis of OSAHS and find OSAHS-related diagnostic markers...
October 2, 2018: Respiratory Research
Peter J Lillitos, Mark D Lyttle, Damian Roland, Colin Ve Powell, Julian Sandell, Andrew G Rowland, Susan M Chapman, Ian K Maconochie
BACKGROUND: Clarifying whether paediatric early warning scores (PEWS) accurately predict significant illness is a research priority for UK and Ireland paediatric emergency medicine (EM). However, a standardised list of significant conditions to benchmark these scores does not exist. OBJECTIVES: To establish standardised significant illness endpoints for use in determining the performance accuracy of PEWS and safety systems in emergency departments (ED), using a consensus of expert opinion in the UK and Ireland...
October 3, 2018: Emergency Medicine Journal: EMJ
U Stöhlker, M Bleher, H Doll, H Dombrowski, W Harms, I Hellmann, R Luff, B Prommer, S Seifert, F Weiler
Environmental radiation monitoring networks have been established in Europe and world-wide for the purpose of protecting population and environment against ionizing radiation. Some of these networks had been established during the cold war period and were improved after the Chernobyl accident in 1986. Today, the German Federal Office for Radiation Protection (BfS) operates an early warning network with roughly 1800 ambient dose equivalent rate (ADER) stations equally distributed over the German territory. The hardware and software of all network components are developed in-house allowing the continuous optimization of all relevant components...
October 1, 2018: Radiation Protection Dosimetry
Adrian M Tompkins, Madeleine C Thomson
In this study, experiments are conducted to gauge the relative importance of model, initial condition, and driving climate uncertainty for simulations of malaria transmission at a highland plantation in Kericho, Kenya. A genetic algorithm calibrates each of these three factors within their assessed prior uncertainty in turn to see which allows the best fit to a timeseries of confirmed cases. It is shown that for high altitude locations close to the threshold for transmission, the spatial representativeness uncertainty for climate, in particular temperature, dominates the uncertainty due to model parameter settings...
2018: PloS One
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