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https://www.readbyqxmd.com/read/28729710/learning-a-health-knowledge-graph-from-electronic-medical-records
#1
Maya Rotmensch, Yoni Halpern, Abdulhakim Tlimat, Steven Horng, David Sontag
Demand for clinical decision support systems in medicine and self-diagnostic symptom checkers has substantially increased in recent years. Existing platforms rely on knowledge bases manually compiled through a labor-intensive process or automatically derived using simple pairwise statistics. This study explored an automated process to learn high quality knowledge bases linking diseases and symptoms directly from electronic medical records. Medical concepts were extracted from 273,174 de-identified patient records and maximum likelihood estimation of three probabilistic models was used to automatically construct knowledge graphs: logistic regression, naive Bayes classifier and a Bayesian network using noisy OR gates...
July 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28679454/the-cultural-evolution-of-shamanism
#2
Manvir Singh
Shamans, including medicine-men, mediums, and the prophets of religious movements, recur across human societies. Shamanism also existed among nearly all documented hunter-gatherers, likely characterized the religious lives of many ancestral humans, and is often proposed by anthropologists to be the "first profession", representing the first institutionalized division of labor beyond age and sex. This paper proposes a cultural evolutionary theory to explain why shamanism consistently develops, and in particular, (1) why shamanic traditions exhibit recurrent features around the world, (2) why shamanism professionalizes early, often in the absence of other specialization, and (3) how shifting social conditions affect the form or existence of shamanism...
July 6, 2017: Behavioral and Brain Sciences
https://www.readbyqxmd.com/read/28670545/gestational-weight-gain-and-pregnancy-outcomes-in-relation-to-body-mass-index-in-asian-indian-women
#3
Balaji Bhavadharini, Ranjit Mohan Anjana, Mohan Deepa, Gopal Jayashree, Subramanyam Nrutya, Mahadevan Shobana, Belma Malanda, Arivudainambi Kayal, Anne Belton, Kurian Joseph, Kurian Rekha, Ram Uma, Viswanathan Mohan
AIM: The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories. METHODOLOGY: Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied...
July 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28665523/emotional-labor-and-professional-practice-in-sports-medicine-and-science
#4
Rebecca F Hings, Christopher R D Wagstaff, Richard C Thelwell, Sarah Gilmore, Valerie Anderson
The aim of the present study was to explore how sport medicine and science practitioners manage their emotions through emotional labor when engaging in professional practice in elite sport. To address the research aim a semi-structured interview design was adopted. Specifically, eighteen professional sport medicine and science staff provided interviews. The sample comprised sport and exercise psychologists (n = 6), strength and conditioning coaches (n = 5), physiotherapists (n = 5), one sports doctor and one generic sport scientist...
June 30, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28651841/survey-of-nulliparous-parturients-attitudes-regarding-timing-of-epidural-analgesia-initiation
#5
Ghislaine C Echevarria, Gilbert J Grant, Yousun Chung, Jerome Lax
STUDY OBJECTIVE: At our hospital, although >90% of nulliparous parturients eventually choose epidural analgesia for labor, many delay its initiation, experiencing considerable pain in the interim. This survey probed parturients' views about the timing of initiation of epidural labor analgesia. DESIGN: Single-center, nonrandomized quantitative survey. SETTING: Labor and delivery suite in a large tertiary academic medical center. PATIENTS: Two hundred laboring nulliparous women admitted to the labor and delivery suite...
June 23, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28629455/an-investigation-of-the-relationship-between-autonomy-childbirth-practices-and-obstetric-fistula-among-women-in-rural-lilongwe-district-malawi
#6
Julika Ayla Kaplan, Jonathan Kandodo, Joseph Sclafani, Susan Raine, Jennifer Blumenthal-Barby, Alison Norris, Abigail Norris-Turner, Elly Chemey, John Michael Beckham, Zara Khan, Reginald Chunda
BACKGROUND: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households. We hypothesize that women's limited autonomy may play a role in reinforcing childbirth practices that increase the risk of obstetric fistula in this setting by hindering access to emergency care and further prolonging obstructed labor...
June 19, 2017: BMC International Health and Human Rights
https://www.readbyqxmd.com/read/28629273/the-association-between-maternal-race-and-adverse-outcomes-in-twin-pregnancies-with-similar-healthcare-access
#7
Marti D Soffer, Mariam Naqvi, Stephanie Melka, Aren Gottlieb, Julie Romero, Nathan S Fox
OBJECTIVE: To compare twin pregnancy outcomes between white and nonwhite women with similar access to healthcare. METHODS: Retrospective cohort study of all twin pregnancies delivered by a single maternal-fetal medicine practice from 2005-2016. All patients had private health insurance and equal access to physician care. Outcomes were compared between white and nonwhite women using logistic regression to adjust for differences at baseline. RESULTS: Of the 858 women included, 730 (85...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28629247/obstetric-practice-patterns-in-pregnancies-complicated-by-fetal-trisomy-13-or-18
#8
Sarah K Dotters-Katz, Marcela C Smid, Cora Mcelwain, Jeffrey A Kuller, Jay Schulkin
PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13(T13) or 18(T18), and compare these between maternal-fetal-medicine (MFM) and non-MFM providers. MATERIALS AND METHODS: We conducted an electronic survey using the American College of Obstetricians and Gynecologists database. Using simple statistics, we describe demographics and practice patterns among respondents, and compare those of MFM practitioners with non-MFM providers...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28625302/pharmacogenetics-in-obstetric-anesthesia
#9
REVIEW
Ruth Landau, Richard Smiley
The 21st century has been billed as the era of "precision/personalized medicine." Genetic investigation of clinical syndromes may guide therapy as well as reveal previously unknown biological or pharmacological pathways that may result in novel drug therapies. Several clinical issues in obstetrics and obstetric anesthesiology have been targets for genetic investigations. These include evaluation of the genetic effects on preterm labor and the progression of labor, spinal anesthesia-induced hypotension and the response to medications used to treat hypotension, and the effect of gene variants on pain and analgesic responses...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28600029/racial-and-ethnic-disparities-in-obstetric-anesthesia
#10
Elizabeth M S Lange, Suman Rao, Paloma Toledo
Racial and ethnic disparities are prevalent within healthcare and have persisted despite advances in medicine and public health. Disparities have been described in the use of neuraxial labor analgesia, with minority women being less likely to use neuraxial labor analgesia than non-minority white women. Minority women are also more likely to have a general anesthetic for cesarean delivery than non-minority women. The origins of these disparities are likely multi-factorial, with patient-, provider-, and systems-level contributors...
June 6, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28594650/impact-of-an-obstetrical-hospitalist-program-on-the-safety-events-in-a-mid-sized-obstetrical-unit
#11
Julie Z Decesare, Suzanne Y Bush, Ashley N Morton
OBJECTIVE: Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit. METHODS: From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor...
June 8, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28592770/dic-an-update-on-diagnosis-and-treatment
#12
Hideo Wada, Kei Hasegawa, Maki Watanabe
Disseminated intravascular coagulation (DIC) was considered to be a fatal disease. However, it has recently been suggested that very early DIC protects the host against microthrombosis and infection localization. Therefore, early treatment of DIC may be contraindicated in patients with sepsis. These factors suggest that the diagnosis and treatment of DIC will gain further importance. The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG2016), which include details regarding the management of DIC, have been recently published...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28592704/the-added-value-of-exhaled-breath-temperature-in-respiratory-medicine
#13
Todor A Popov, Tanya Kralimarkova, Marina Labor, Davor Plavec
Recognition of the huge economic burden chronic respiratory diseases pose for society motivated fundamental and clinical research leading to insight into the role of airway inflammation in various disease entities and their phenotypes. However, no easy, cheap and patient-friendly methods to assess it have found a place in routine clinical practice. Measurement of exhaled breath temperature (EBT) has been suggested as a non-invasive method to detect inflammatory processes in the airways as a result of increased blood flow within the airway walls...
June 8, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28592330/state-of-play-and-clinical-prospects-of-antibody-gene-transfer
#14
REVIEW
Kevin Hollevoet, Paul J Declerck
Recombinant monoclonal antibodies (mAbs) are one of today's most successful therapeutic classes in inflammatory diseases and oncology. A wider accessibility and implementation, however, is hampered by the high product cost and prolonged need for frequent administration. The surge in more effective mAb combination therapies further adds to the costs and risk of toxicity. To address these issues, antibody gene transfer seeks to administer to patients the mAb-encoding nucleotide sequence, rather than the mAb protein...
June 7, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28587493/a-randomized-controlled-trial-of-a-new-treatment-for-labor-dystocia
#15
Eva Wiberg-Itzel, Susan Wray, Helena Åkerud
OBJECTIVE: Labor dystocia is an intransigent, high-profile issue in obstetric care. Amniotic fluid lactate (AFL) reflects the uterine metabolic status. High levels associate with subsequent need for operative intervention due to dystocia. In sports medicine, it is known that lactic acid can affect muscular performance and can be decreased by bicarbonate given orally before physical activity. MATERIAL AND METHODS: Two hundred dystocic deliveries were included. At the confirmation of dystocia, the AFL-level was analyzed...
June 22, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28562794/cost-of-nursing-most-frequent-procedures-performed-on-severely-burned-patients
#16
Talita de Oliveira Melo, Antônio Fernandes Costa Lima
Objective: to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. Method: exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. Results: a MDC of US$ 0...
May 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28554543/a-method-for-the-isolation-and-characterization-of-functional-murine-monoclonal-antibodies-by-single-b-cell-cloning
#17
Sara Carbonetti, Brian G Oliver, Vladimir Vigdorovich, Nicholas Dambrauskas, Brandon Sack, Emilee Bergl, Stefan H I Kappe, D Noah Sather
Monoclonal antibody technologies have enabled dramatic advances in immunology, the study of infectious disease, and modern medicine over the past 40years. However, many monoclonal antibody discovery procedures are labor- and time-intensive, low efficiency, and expensive. Here we describe an optimized mAb discovery platform for the rapid and efficient isolation, cloning and characterization of monoclonal antibodies in murine systems. In this platform, antigen-binding splenic B cells from immunized mice are isolated by FACS and cocultured with CD40L positive cells to induce proliferation and mAb production...
May 26, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28545266/-analysis-of-misssed-diagnosis-and-misdiagnosis-of-1-212-cases-with-placental-abruption
#18
D Xu, C Liang, J W Xu, J He
Objective: To investigate the risk factors and clinical manifestations of placental abruption, and to analyze the causes of missed diagnosis and misdiagnosis. Methods: A retrospective analysis was conducted in 135 584 women who delivered in Women's Hospital, School of Medicine, Zhejiang University from January 2005 to December 2015. The diagnosis of placental abruption was made in 1 212 cases. According to the consistency of prenatal and postnatal diagnosis, they were divided into 3 groups. (1) The diagnosis was consistent prenatally and postnatally in 715 cases(58...
May 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28541383/the-technology-crisis-in-neuropsychology
#19
Justin B Miller, William B Barr
Neuropsychology has fallen reliant on outdated and labor intensive methods of data collection that are slow, highly inefficient, and expensive, and provide relatively data-poor estimates of human behavior despite rapid technological advance in most other fields of medicine. Here we present a brief historical overview of current testing practices in an effort to frame the current crisis, followed by an overview of different settings in which technology can and should be integrated. Potential benefits of laboratory based assessments, remote assessments, as well as passive and high-frequency data collection tools rooted in technology are discussed, along with several relevant examples and how these technologies might be deployed...
May 24, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28535320/effectiveness-of-a-labor-cervical-exam-model-in-family-medicine-and-ob-gyn-residents
#20
Joshua F Nitsche, Nora F Fino, Jose M Palomo, Abraham Portillo Perdomo, Brian C Brost
BACKGROUND AND OBJECTIVES: Labor cervical exam accuracy is an essential skill for family medicine and OB-GYN residents to master. To determine the effectiveness of simulation on labor cervical exam training, family medicine and OB-GYN residents were trained using a self-constructed PVC pipe-based cervical exam model during a short and intensive simulation workshop or "boot camp." METHODS: A task trainer was constructed that allows for the blind examination of cervical dilation and effacement...
May 2017: Family Medicine
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