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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/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#2
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28726971/an-environment-for-guideline-based-decision-support-systems-for%C3%A2-outpatients-monitoring
#3
Elisa M Zini, Giordano Lanzola, Paolo Bossi, Silvana Quaglini
OBJECTIVES: We propose an architecture for monitoring outpatients that relies on mobile technologies for acquiring data. The goal is to better control the onset of possible side effects between the scheduled visits at the clinic. METHODS: We analyze the architectural components required to ensure a high level of abstraction from data. Clinical practice guidelines were formalized with Alium, an authoring tool based on the PROforma language, using SNOMED-CT as a terminology standard...
July 19, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28726600/age-and-sex-associated-differences-in-phenotypic-and-functional-characteristics-of-peripheral-blood-lymphocytes-in-chimpanzees-pan-troglodytes
#4
Pramod Nehete, Elizabeth Magden, Bharti Nehete, Lawrence Williams, Christian Abee, K Sastry
Chimpanzees are the closest phylogenetic relatives to humans, sharing more than 98% genetic sequence identity. Thesegenetic similarities prompted the belief that chimpanzees can serve as an ideal model for human disease conditions andvaccine development. However, in light of the recent NIH decision to phase out biomedical research in chimpanzees and retire NIH-supported chimpanzees, data from the present study will continue to provide value for the care of aged and sick chimpanzees located in zoos, sanctuaries, and primate centers...
July 19, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28724368/utilizing-patient-data-from-the-veterans-administration-electronic-health-record-to-support-web-based-clinical-decision-support-informatics-challenges-and-issues-from-three-clinical-domains
#5
Nallakkandi Rajeevan, Kristina M Niehoff, Peter Charpentier, Forrest L Levin, Amy Justice, Cynthia A Brandt, Terri R Fried, Perry L Miller
BACKGROUND: The US Veterans Administration (VA) has developed a robust and mature computational infrastructure in support of its electronic health record (EHR). Web technology offers a powerful set of tools for structuring clinical decision support (CDS) around clinical care. This paper describes informatics challenges and design issues that were confronted in the process of building three Web-based CDS systems in the context of the VA EHR. METHODS: Over the course of several years, we implemented three Web-based CDS systems that extract patient data from the VA EHR environment to provide patient-specific CDS...
July 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28724005/human-resources-for-health-global-crisis-and-international-cooperation
#6
Gustavo Zoio Portela, Amanda Cavada Fehn, Regina Lucia Sarmento Ungerer, Mario Roberto Dal Poz
From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28722548/the-change-makers-of-west-africa
#7
EDITORIAL
Sue Godt, Sharmila Mhatre, Anne-Marie Schryer-Roy
West Africa was the focus of global attention during the Ebola virus disease outbreak, when systemic health system weaknesses compounded a serious emergency and complicated response efforts. Following the crisis, calls were made to strengthen health systems, but investments to date have fallen short of delivering the support needed to build strong health systems able to prevent and manage future outbreaks.In part, this reality serves to highlight the shortcomings of the solutions being repeatedly prioritised by external funders and experts, solutions that often fail to consider the wealth of West African evidence and actors actively working to strengthen the leadership and health systems needed to drive and sustainably improve national health outcomes...
July 12, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28721199/evidence-informed-capacity-building-for-setting-health-priorities-in-low-and-middle-income-countries-a-framework-and-recommendations-for-further-research
#8
Ryan Li, Francis Ruiz, Anthony J Culyer, Kalipso Chalkidou, Karen J Hofman
Priority-setting in health is risky and challenging, particularly in resource-constrained settings. It is not simply a narrow technical exercise, and involves the mobilisation of a wide range of capacities among stakeholders - not only the technical capacity to "do" research in economic evaluations. Using the Individuals, Nodes, Networks and Environment (INNE) framework, we identify those stakeholders, whose capacity needs will vary along the evidence-to-policy continuum. Policymakers and healthcare managers require the capacity to commission and use relevant evidence (including evidence of clinical and cost-effectiveness, and of social values); academics need to understand and respond to decision-makers' needs to produce relevant research...
2017: F1000Research
https://www.readbyqxmd.com/read/28718779/a-review-and-experimental-study-on-application-of-classifiers-and-evolutionary-algorithms-in-eeg-based-brain-machine-interface-systems
#9
Farajollah Tahernezhad-Javazm, Vahid Azimirad, Maryam Shoaran
OBJECTIVE: Considering the importance and the near future development of noninvasive Brain-Machine Interface (BMI) systems, this paper presents a comprehensive theoretical-experimental survey on the classification and evolutionary methods for BMI-based systems in which EEG signals are used. APPROACH: The paper is divided into two main parts. In the first part a wide range of different types of the base and combinatorial classifiers including boosting and bagging classifiers and also evolutionary algorithms are reviewed and investigated...
July 18, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28717902/fusion-of-heart-rate-variability-and-pulse-rate-variability-for-emotion-recognition-using-lagged-poincare-plots
#10
Atefeh Goshvarpour, Ataollah Abbasi, Ateke Goshvarpour
Designing an efficient automatic emotion recognition system based on physiological signals has attracted great interests within the research of human-machine interactions. This study was aimed to classify emotional responses by means of a simple dynamic signal processing technique and fusion frameworks. The electrocardiogram and finger pulse activity of 35 participants were recorded during rest condition and when subjects were listening to music intended to stimulate certain emotions. Four emotion categories, including happiness, sadness, peacefulness, and fear were chosen...
July 17, 2017: Australasian Physical & Engineering Sciences in Medicine
https://www.readbyqxmd.com/read/28717717/management-and-care-of-women-with-invasive-cervical-cancer-american-society-of-clinical-oncology-resource-stratified-clinical-practice-guideline
#11
Linus T Chuang, Sarah Temin, Rolando Camacho, Alfonso Dueñas-Gonzalez, Sarah Feldman, Murat Gultekin, Vandana Gupta, Susan Horton, Graciela Jacob, Elizabeth A Kidd, Kennedy Lishimpi, Carolyn Nakisige, Joo-Hyun Nam, Hextan Yuen Sheung Ngan, William Small, Gillian Thomas, Jonathan S Berek
PURPOSE: To provide evidence-based, resource-stratified global recommendations to clinicians and policymakers on the management and palliative care of women diagnosed with invasive cervical cancer. METHODS: ASCO convened a multidisciplinary, multinational panel of cancer control, medical and radiation oncology, health economic, obstetric and gynecologic, and palliative care experts to produce recommendations reflecting resource-tiered settings. A systematic review of literature from 1966 to 2015 failed to yield sufficiently strong quality evidence to support basic- and limited-resource setting recommendations; a formal consensus-based process was used to develop recommendations...
October 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716166/invited-review-helping-dairy-farmers-to-improve-economic-performance-utilizing-data-driving-decision-support-tools
#12
V E Cabrera
The objective of this review paper is to describe the development and application of a suite of more than 40 computerized dairy farm decision support tools contained at the University of Wisconsin-Madison (UW) Dairy Management website http://DairyMGT.info. These data-driven decision support tools are aimed to help dairy farmers improve their decision-making, environmental stewardship and economic performance. Dairy farm systems are highly dynamic in which changing market conditions and prices, evolving policies and environmental restrictions together with every time more variable climate conditions determine performance...
July 18, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/28716132/a-patient-safety-and-professional-perspective-on-non-conveyance-in-ambulance-care-a-systematic-review
#13
REVIEW
Remco H A Ebben, Lilian C M Vloet, Renate F Speijers, Nico W Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen, Sivera A A Berben
BACKGROUND: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. METHODS: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#14
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28713265/a-comparison-of-reimbursement-recommendations-by-european-hta-agencies-is-there-opportunity-for-further-alignment
#15
Nicola Allen, Lawrence Liberti, Stuart R Walker, Sam Salek
Introduction: In Europe and beyond, the rising costs of healthcare and limited healthcare resources have resulted in the implementation of health technology assessment (HTA) to inform health policy and reimbursement decision-making. European legislation has provided a harmonized route for the regulatory process with the European Medicines Agency, but reimbursement decision-making still remains the responsibility of each country. There is a recognized need to move toward a more objective and collaborative reimbursement environment for new medicines in Europe...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28712356/discontinuing-psychiatric-medications-a-survey-of-long-term-users
#16
Laysha Ostrow, Lauren Jessell, Manton Hurd, Sabrina M Darrow, David Cohen
OBJECTIVE: Individuals undergoing long-term psychiatric treatment frequently choose to stop taking psychiatric medications. To enhance service user choice and prevent undesirable outcomes, this first U.S. survey of a large sample of longer-term users sought to increase knowledge about users' experience of medication discontinuation. METHODS: A sample of 250 U.S. adults with a diagnosis of serious mental illness and a recent goal to stop up to two prescribed psychiatric medications, which they had taken for at least nine months, completed a web-based survey about experiences, strategies, and supports during discontinuation...
July 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28712078/effects-based-spatial-assessment-of-contaminated-estuarine-sediments-from-bear-creek-baltimore-harbor-md-usa
#17
Sharon E Hartzell, Michael A Unger, Beth L McGee, Lance T Yonkos
Estuarine sediments in regions with prolonged histories of industrial activity are often laden to significant depths with complex contaminant mixtures, including trace metals and persistent organic pollutants. Given the complexity of assessing risks from multi-contaminant exposures, the direct measurement of impacts to biological receptors is central to characterizing contaminated sediment sites. Though biological consequences are less commonly assessed at depth, laboratory-based toxicity testing of subsurface sediments can be used to delineate the scope of contamination at impacted sites...
July 15, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#18
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28707188/hemodynamic-benefits-of-counterpulsation-implantable-percutaneous-and-intraaortic-rotary-blood-pumps-an-in-silico-and-in-vitro-study
#19
Yu Wang, Steven C Koenig, Michael A Sobieski, Mark S Slaughter, Guruprasad A Giridharan
Mechanical circulatory support (MCS) devices have become a standard therapy for heart failure (HF) patients. MCS device designs may differ by level of support, inflow and/or outflow cannulation sites, and mechanism(s) of cardiac unloading and blood flow delivery. Investigation and direct comparison of hemodynamic parameters that help characterize performance of MCS devices has been limited. We quantified cardiac and vascular hemodynamic responses for different types of MCS devices. Continuous flow (CF) left ventricular (LV) assist devices (LVAD) with LV or left atrial (LA) inlet, counterpulsation devices, percutaneous CF LVAD, and intra-aortic rotary blood pumps (IARBP) were quantified using established computer simulation and mock flow loop models...
July 13, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28706871/tricuspid-valve-regurgitation-after-heart-transplantation
#20
Murray H Kwon, Richard J Shemin
Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure...
May 2017: Annals of Cardiothoracic Surgery
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