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https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#1
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27921161/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#2
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
INTRODUCTION AND HYPOTHESIS: There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. METHODS: This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees...
December 5, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#3
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27919375/software-intelligent-system-for-effective-solutions-for-hearing-impaired-subjects
#4
Rajkumar S, Muttan S, Sapthagirivasan V, Jaya V, Vignesh S S
PURPOSE: The anatomy and physiology of the ear is complex in nature, which makes it a challenge for audiologists to prescribe solutions for varied hearing-impaired subjects. There is a need to increase the satisfaction level of hearing-aid users by adopting better strategies that involve modern technological advancements. AIM: To design and develop a decision support Software Intelligent System (SIS) that performs audiological investigations to assess the degree of hearing loss and to suggest appropriate hearing-aid gain values...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#5
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27918122/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#6
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
Introduction and hypothesis There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. Methods This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus)...
December 5, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27918098/functional-outcomes-after-transurethral-resection-of-the-prostate-in-nursing-home-residents
#7
Anne M Suskind, Louise C Walter, Shoujun Zhao, Emily Finlayson
OBJECTIVES: To understand outcomes of transurethral resection of the prostate (TURP) or transurethral laser incision of the prostate (TULIP) for the treatment of bladder outlet obstruction in men with high levels of functional dependence, which are poorly understood. DESIGN: Retrospective cohort study. SETTING: U.S. nursing homes (NHs). PARTICIPANTS: Male NH residents aged 65 and older who underwent TURP or TULIP in the United States between 2005 and 2008 (N = 2,869)...
December 5, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27916948/a-robust-and-device-free-system-for-the-recognition-and-classification-of-elderly-activities
#8
Fangmin Li, Mohammed Abdulaziz Aide Al-Qaness, Yong Zhang, Bihai Zhao, Xidao Luan
Human activity recognition, tracking and classification is an essential trend in assisted living systems that can help support elderly people with their daily activities. Traditional activity recognition approaches depend on vision-based or sensor-based techniques. Nowadays, a novel promising technique has obtained more attention, namely device-free human activity recognition that neither requires the target object to wear or carry a device nor install cameras in a perceived area. The device-free technique for activity recognition uses only the signals of common wireless local area network (WLAN) devices available everywhere...
December 1, 2016: Sensors
https://www.readbyqxmd.com/read/27915463/the-our-hope-approach-for-ethics-and-communication-about-neonatal-neurological-injury
#9
REVIEW
Eric Racine, Emily Bell, Barbara Farlow, Steven Miller, Antoine Payot, Lisa Anne Rasmussen, Michael I Shevell, Donna Thomson, Pia Wintermark
Predicting neurological outcomes of neonates with acute brain injury is an essential component of shared decision-making, in order to guide the development of treatment goals and appropriate care plans. It can aid parents in imagining the child's future, and guide timely and ongoing treatment decisions, including shifting treatment goals and focusing on comfort care. However, numerous challenges have been reported with respect to evidence-based practices for prognostication such as biases about prognosis among clinicians...
December 4, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27913528/mutations-in-mpns-prognostic-implications-window-to-biology-and-impact-on-treatment-decisions
#10
Jamile M Shammo, Brady L Stein
The last decade has witnessed tremendous scientific advances, ushered in by the JAK2 V617F discovery, contributing to enhanced diagnostic capability and understanding of the biology of myeloproliferative neoplasms (MPNs). Discovery of the calreticulin mutations filled a diagnostic gap; more recent work sheds light on its contribution to disease pathogenesis, and prognosis. Recent studies have also identified novel JAK2 and MPL mutations in patients with essential thrombocythemia and myelofibrosis (MF). Especially in MF, the driver mutational profile has prognostic implications, with additive contributions from the acquisition of additional somatic mutations...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#11
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912043/palliative-care-interventions-for-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#12
Michelle S Diop, James L Rudolph, Kristin M Zimmerman, Mary A Richter, L Michal Skarf
OBJECTIVE: To systematically characterize interventions and effectiveness of palliative care for advanced heart failure (HF) patients. BACKGROUND: Patients with advanced heart failure experience a high burden of distressing symptoms and diminished quality of life. Palliative care expertise with symptom management and healthcare decision-making benefits HF patients. METHODS: A systematic PubMed search was conducted from inception to June 2016 for studies of palliative care interventions for HF patients...
December 2, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#13
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27910703/co-calibration-of-two-self-reported-measures-of-adherence-to-antiretroviral-therapy
#14
Robin M Nance, J A Chris Delaney, Carol E Golin, Wendee M Wechsberg, Chinazo Cunningham, Frederick Altice, Katerina Christopoulos, Kevin Knight, Vu Quan, Michael S Gordon, Sandra Springer, Jeremy Young, Paul K Crane, Kenneth H Mayer, Michael J Mugavero, Carlos Del Rio, Richard A Kronmal, Heidi M Crane
Adherence to antiretroviral therapy (ART) is an important determinant of clinical success assessed in many HIV studies. Harmonizing adherence data from studies that use different measures is difficult without a co-calibration equation to convert between validated instruments. Our purpose was to co-calibrate two commonly used adherence measures: the AIDS Clinical Trials Group (ACTG) questionnaire and the Visual Analog Scale (VAS). We used robust linear regression to develop a co-calibration equation in a clinical care cohort...
December 2, 2016: AIDS Care
https://www.readbyqxmd.com/read/27909393/a-comparison-of-multiple-behavior-models-in-a-simulation-of-the-aftermath-of-an-improvised-nuclear-detonation
#15
Nidhi Parikh, Harshal G Hayatnagarkar, Richard J Beckman, Madhav V Marathe, Samarth Swarup
We describe a large-scale simulation of the aftermath of a hypothetical 10kT improvised nuclear detonation at ground level, near the White House in Washington DC. We take a synthetic information approach, where multiple data sets are combined to construct a synthesized representation of the population of the region with accurate demographics, as well as four infrastructures: transportation, healthcare, communication, and power. In this article, we focus on the model of agents and their behavior, which is represented using the options framework...
November 2016: Autonomous Agents and Multi-agent Systems
https://www.readbyqxmd.com/read/27908577/the-use-of-predictive-models-to-optimize-risk-of-decisions
#16
József Baranyi, Nathália Buss da Silva
The purpose of this paper is to set up a mathematical framework that risk assessors and regulators could use to quantify the "riskiness" of a particular recommendation (choice/decision). The mathematical theory introduced here can be used for decision support systems. We point out that efficient use of predictive models in decision making for food microbiology needs to consider three major points: (1) the uncertainty and variability of the used information based on which the decision is to be made; (2) the validity of the predictive models aiding the assessor; and (3) the cost generated by the difference between the a-priory choice and the a-posteriori outcome...
January 2, 2017: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/27908167/computer-aided-prognosis-for-cell-death-categorization-and-prediction-in-vivo-using-quantitative-ultrasound-and-machine-learning-techniques
#17
M J Gangeh, A Hashim, A Giles, L Sannachi, G J Czarnota
PURPOSE: At present, a one-size-fits-all approach is typically used for cancer therapy in patients. This is mainly because there is no current imaging-based clinical standard for the early assessment and monitoring of cancer treatment response. Here, the authors have developed, for the first time, a complete computer-aided-prognosis (CAP) system based on multiparametric quantitative ultrasound (QUS) spectroscopy methods in association with texture descriptors and advanced machine learning techniques...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27907968/palliative-care-practice-in-neurocritical-care
#18
Andrea K Knies, David Y Hwang
Many neurocritically ill patients and their families have high amounts of palliative care needs. Multiple professional societies relevant to neurocritical care have released consensus statements on meeting palliative care needs in neuroscience intensive care units. In this review, the authors discuss the ongoing debate regarding what model of palliative care delivery is optimal, focus on the process of shared decision making during goals-of-care discussions, and briefly comment on transitions from intensive care to comfort care...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27905172/recommendations-for-pathologic-staging-ptnm-of-cancer-of-the-esophagus-and-esophagogastric-junction-for-the-8th-edition-ajcc-uicc-staging-manuals
#19
T W Rice, H Ishwaran, W L Hofstetter, D P Kelsen, C Apperson-Hansen, E H Blackstone
We report analytic and consensus processes that produced recommendations for pathologic stage groups (pTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 13,300 without preoperative therapy had pathologic assessment after esophagectomy or endoscopic treatment. Risk-adjusted survival for each patient was developed using random survival forest analysis to identify data-driven pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups...
November 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27904166/iris-an-internet-based-intervention-as-a-suitable-path-to-addictive-substance-use-prevention-and-counselling-in-pregnancy-beneficiary-profiles-and-user-satisfaction
#20
A Stiegler, H Abele, A Batra
Alcohol or tobacco consumption in pregnancy can harm the unborn child. Counselling on this subject is therefore of major importance. The aim of the presented study was not only to develop an internet based, professionally e-mail accompanied platform for alcohol or tobacco consuming pregnant women ("IRIS Platform") but also to analyse the beneficiary profiles and investigate the practicability and acceptance of the platform among women and referring gynaecologists. The offer comprised three 12-week counselling programmes (alcohol, tobacco, combined consumption)...
November 2016: Geburtshilfe und Frauenheilkunde
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