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https://www.readbyqxmd.com/read/28537812/perspectives-of-patients-with-cancer-on-the-ethics-of-rapid-learning-health-systems
#1
Reshma Jagsi, Kent A Griffith, Aaron Sabolch, Rochelle Jones, Rebecca Spence, Raymond De Vries, David Grande, Angela R Bradbury
Purpose To inform the evolving implementation of CancerLinQ and other rapid-learning systems for oncology care, we sought to evaluate perspectives of patients with cancer regarding ethical issues. Methods Using the GfK Group online research panel, representative of the US population, we surveyed 875 patients with cancer; 621 (71%) responded. We evaluated perceptions of appropriateness (scored from 1 to 10; 10, very appropriate) using scenarios and compared responses by age, race, and education. We constructed a scaled measure of comfort with secondary use of deidentified medical information and evaluated its correlates in a multivariable model...
May 24, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28487512/rapid-learning-curve-assessment-in-an-ex-vivo-training-system-for-microincisional-glaucoma-surgery
#2
Yalong Dang, Susannah Waxman, Chao Wang, Hardik A Parikh, Igor I Bussel, Ralitsa T Loewen, Xiaobo Xia, Kira L Lathrop, Richard A Bilonick, Nils A Loewen
Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63)...
May 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28451755/the-interpretation-of-compact-polysomnography-polygraphy-in-sleep-breathing-disorders-patients-a-validation-s-study
#3
Marcello Bosi, Andrea De Vito, Chiara Bellini, Giovanni D'Agostino, Elisabetta Firinu, Riccardo Gobbi, Alessandro Pacella, Giulio Filograna Pignatelli, Ermelinda Zeccardo, Venerino Poletti, Claudio Vicini
The Otorhinolaryngologist (ENT) frequently has to deal with OSA or suspicious OSA patients and undergone polysomnography (PSG) or portable monitoring (PM) and should be confident about the quality and consistency of the polysomnographic diagnosis. The main polysomnographic traces compressed in a unique epoch, defined as compact PSG/PM (CP), could represent an efficient tool to confirm the quality of PSG/PM Sleep Breathing Disorders diagnosis. This is a validation's study of a CP interpretation's method, analyzing the learning curve, the level of diagnostic accuracy, and the inter-operator agreement in interpreting the CP pattern between a group of ENT specialists not skilled in PSG/PM scoring, but managing SBD patients during daily practice...
April 27, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28411303/comparative-approaches-to-same-different-abstract-concept-learning
#4
A A Wright, D M Kelly
Martinho and Kacelnik (2016) imprinted newly hatched ducklings (Anas platyrhynchos domestica) with a moving pair of either same or different objects, and following only one session, the ducklings accurately transferred the same/different relationship to novel object pairs that maintained the training relationship. This rapid learning and transfer of the concepts same and different far outstrips the more gradual learning of these basic concepts by animals in associative-learning tasks in which reinforcement is given for correct responses...
April 14, 2017: Learning & Behavior
https://www.readbyqxmd.com/read/28405951/posterior-retroperitonoscopic-adrenalectomy-a-back-door-access-with-an-unusually-rapid-learning-curve
#5
Sohail Bakkar, Gabriele Materazzi, Lorenzo Fregoli, Piermarco Papini, Paolo Miccoli
Posterior retroperitonoscopic adrenalectomy (PRA) has become a standard approach to the adrenal gland. The aim of this study was to report an initial experience with the procedure following a proper preparatory phase highlighting the rapidity, safety and effectiveness by which it could be introduced into a surgeon's practice. Between May 2015 and July 2016, 14 PRAs were performed in 14 patients (9 females and 5 males). The average age was 46 years, BMI: 25.5 kg/m(2), and ASA score: 2. Indications included: incidenatloma (n = 5), Conn's adenoma (n = 5), and Cushing's adenoma (n = 4)...
April 12, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28374206/free-flying-honeybees-extrapolate-relational-size-rules-to-sort-successively-visited-artificial-flowers-in-a-realistic-foraging-situation
#6
Scarlett R Howard, Aurore Avarguès-Weber, Jair Garcia, Adrian G Dyer
Learning and applying relational concepts to solve novel tasks is considered an indicator of cognitive-like ability. It requires the abstraction of relational concepts to different objects independent to the physical nature of the individual objects. Recent research has revealed the honeybee's ability to rapidly learn and manipulate relations between visual stimuli such as 'same/different', 'above/below', or 'larger/smaller' despite having a miniature-sized brain. While honeybees can solve problems using rule-based relative size comparison, it remains unresolved as to whether bees can apply size rules when stimuli are encountered successively, which requires reliance on working memory for stimuli comparison...
July 2017: Animal Cognition
https://www.readbyqxmd.com/read/28373977/learning-curve-analysis-of-different-stages-of-robotic-assisted-laparoscopic-hysterectomy
#7
Feng-Hsiang Tang, Eing-Mei Tsai
Objective. To analyze the learning curves of the different stages of robotic-assisted laparoscopic hysterectomy. Design. Retrospective analysis. Design Classification. Canadian Task Force classification II-2. Setting. Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Patient Intervention. Women receiving robotic-assisted total and subtotal laparoscopic hysterectomies for benign conditions from May 1, 2013, to August 31, 2015. Measurements and Main Results. The mean age, body mass index (BMI), and uterine weight were 46...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28362608/tmagic-a-model-free-3d-tracker
#8
Karel Lebeda, Simon Hadfield, Richard Bowden
Significant effort has been devoted within the visual tracking community to rapid learning of object properties on the fly. However, state-of-the-art approaches still often fail in cases such as rapid out-of-plane rotation, when the appearance changes suddenly. One of the major contributions of this work is a radical rethinking of the traditional wisdom of modelling 3D motion as appearance change during tracking. Instead, 3D motion is modelled as 3D motion. This intuitive but previously unexplored approach provides new possibilities in visual tracking research...
March 1, 2017: IEEE Transactions on Image Processing: a Publication of the IEEE Signal Processing Society
https://www.readbyqxmd.com/read/28318904/dual-memory-neural-networks-for-modeling-cognitive-activities-of-humans-via-wearable-sensors
#9
Sang-Woo Lee, Chung-Yeon Lee, Dong-Hyun Kwak, Jung-Woo Ha, Jeonghee Kim, Byoung-Tak Zhang
Wearable devices, such as smart glasses and watches, allow for continuous recording of everyday life in a real world over an extended period of time or lifelong. This possibility helps better understand the cognitive behavior of humans in real life as well as build human-aware intelligent agents for practical purposes. However, modeling the human cognitive activity from wearable-sensor data stream is challenging because learning new information often results in loss of previously acquired information, causing a problem known as catastrophic forgetting...
August 2017: Neural Networks: the Official Journal of the International Neural Network Society
https://www.readbyqxmd.com/read/28314871/-evidence-based-lichtenstein-technique
#10
W Reinpold, D Chen
Lichtenstein hernioplasty is the number one technique worldwide for open, mesh-based inguinal hernia repair. The principle of Lichtenstein hernioplasty is the tension-free reinforcement of the abdominal wall by covering the transversalis fascia and the oblique muscles with an artificial patch of mesh. The Lichtenstein technique has been modified since its inception. The technique has the benefits of low costs and a rapid learning curve and can be performed with the patient under local anesthesia. The recurrence rates after the Lichtenstein operation are significantly lower compared to open suture repair and equal to laparoendoscopic techniques...
April 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28245500/rapid-learning-of-visual-ensembles
#11
Andrey Chetverikov, Gianluca Campana, Árni Kristjánsson
We recently demonstrated that observers are capable of encoding not only summary statistics, such as mean and variance of stimulus ensembles, but also the shape of the ensembles. Here, for the first time, we show the learning dynamics of this process, investigate the possible priors for the distribution shape, and demonstrate that observers are able to learn more complex distributions, such as bimodal ones. We used speeding and slowing of response times between trials (intertrial priming) in visual search for an oddly oriented line to assess internal models of distractor distributions...
February 1, 2017: Journal of Vision
https://www.readbyqxmd.com/read/28231470/rapid-integration-of-artificial-sensory-feedback-during-operant-conditioning-of-motor-cortex-neurons
#12
Mario Prsa, Gregorio L Galiñanes, Daniel Huber
Neuronal motor commands, whether generating real or neuroprosthetic movements, are shaped by ongoing sensory feedback from the displacement being produced. Here we asked if cortical stimulation could provide artificial feedback during operant conditioning of cortical neurons. Simultaneous two-photon imaging and real-time optogenetic stimulation were used to train mice to activate a single neuron in motor cortex (M1), while continuous feedback of its activity level was provided by proportionally stimulating somatosensory cortex...
February 22, 2017: Neuron
https://www.readbyqxmd.com/read/28220025/management-of-cancer-in-the-older-age-person-an-approach-to-complex-medical-decisions
#13
REVIEW
María Vallet-Regí, Miguel Manzano, Leocadio Rodriguez-Mañas, Marta Checa López, Matti Aapro, Lodovico Balducci
The management of cancer in older aged people is becoming a common problem due to the aging of the population. There are many variables determining the complex situation that are interconnected. Some of them can be assessed, such as risk of mortality and risk of treatment complications, but many others are still unknown, such as the course of disease, the host-related factors that influence cancer aggressiveness, and the phenotype heralding risk of permanent treatment-related damage.This article presents a dynamic and personalized approach to older people with cancer based on our experience on aging, cancer, and their biological interactions...
March 2017: Oncologist
https://www.readbyqxmd.com/read/28152757/lung-cancer-diagnosis-transformation-aligning-the-people-processes-and-technology-sides-of-the-learning-system
#14
Donna E Maziak, Jason R Pantarotto, Jennifer Smylie, Leanne Taylor, Thomas Timlin, Tiziana Cacciotti, Patrick James Villeneuve, Carole Dennie, Chantal Bornais, Jose Aquino, Paul Wheatley-Price, David J Stewart
50 Background: The Ottawa Hospital, serving a population of 1.2 million across a large geographic area, redesigned its regional lung cancer diagnosis and patient intake process using a systems approach. Although having a strong record of excellent coordinated care, recent challenges had created strains on delivery metrics. Prior to the implementation of the project (October 2014), it took patients a range of 15 - 225 days to get from a referral with a suspicion of lung cancer to initial treatment, with a 90(th) percentile of 117 days...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152753/data-driven-quality-improvement-in-an-oncology-patient-centered-medical-home
#15
Maureen Lowry, Brian Flounders, Susan Higman Tofani
54 Background: In a 2012 abstract, Data driven transformation for an Oncology Patient-Centered Medical Home, Consultants in Medical Oncology (CMOH) demonstrated that standardized processes and enhanced IT capabilities (IRIS software app) provided a rapid learning system for the practice. Iris aggregated data became the basis for Quality Improvement Projects (QIPs) allowing CMOH to continue to improve in quality and cost measures. Deviation from performance trend is readily identifiable, providing operational direction...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28123082/amygdala-contributions-to-stimulus-reward-encoding-in-the-macaque-medial-and-orbital-frontal-cortex-during-learning
#16
Peter H Rudebeck, Joshua A Ripple, Andrew R Mitz, Bruno B Averbeck, Elisabeth A Murray
Orbitofrontal cortex (OFC), medial frontal cortex (MFC), and amygdala mediate stimulus-reward learning, but the mechanisms through which they interact are unclear. Here, we investigated how neurons in macaque OFC and MFC signaled rewards and the stimuli that predicted them during learning with and without amygdala input. Macaques performed a task that required them to evaluate two stimuli and then choose one to receive the reward associated with that option. Four main findings emerged. First, amygdala lesions slowed the acquisition and use of stimulus-reward associations...
February 22, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28118109/perspectives-on-the-implementation-of-an-ethical-rapid-learning-health-system
#17
Peter Paul Yu
No abstract text is available yet for this article.
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28118107/patient-perspectives-on-the-ethical-implementation-of-a-rapid-learning-system-for-oncology-care
#18
Rochelle D Jones, Aaron N Sabolch, Erin Aakhus, Rebecca A Spence, Angela R Bradbury, Reshma Jagsi
INTRODUCTION: A rapid learning system (RLS) of health care harnesses data generated from routine patient care to create a virtuous cycle of data collection and analysis for quality improvement and research. The success of such systems depends on understanding patient perspectives regarding the ethical issues that arise from the ongoing implementation of this transformative concept. METHODS: An interview guide was designed to evaluate patient perspectives to inform the ethical implementation of an oncology RLS...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28118106/qualitative-study-of-oncologists-views-on-the-cancerlinq-rapid-learning-system
#19
Rachel M Mayo, Julie F Summey, Joel E Williams, Rebecca A Spence, Shally Kim, Reshma Jagsi
INTRODUCTION: ASCO is actively developing CancerLinQ (CLQ), a rapid learning system for oncology care. The purpose of this study was to explore providers' opinions and concerns related to implementation of CLQ, including ethical issues. METHODS: Twenty key informant oncologists were recruited for individual in-depth interviews through ASCO contacts, purposively selected to represent a wide variety of cancer specialties as well as different levels of familiarity with CLQ (familiar v unfamiliar)...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28043438/surgical-experience-and-long-term-results-of-baroreflex-activation-therapy-for-heart-failure-with-reduced-ejection-fraction
#20
RANDOMIZED CONTROLLED TRIAL
Fred A Weaver, William T Abraham, William C Little, Christian Butter, Anique Ducharme, Marcel Halbach, Didier Klug, Eric G Lovett, Navid Madershahian, Jochen Müller-Ehmsen, Jill E Schafer, Michele Senni, Vijay Swarup, Rolf Wachter, Michael R Zile
The purpose of this publication is to describe the intraoperative experience along with long-term safety and efficacy of the second-generation baroreflex activation therapy (BAT) system in patients with heart failure (HF) and reduced ejection fraction HF (HFrEF). In a randomized trial of New York Heart Association Class III HFrEF, 140 patients were assigned 1:1 to receive BAT plus medical therapy or medical therapy alone. Procedural information along with safety and efficacy data were collected and analyzed over 12 months...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
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