Machine Learning Approaches to Predict Asthma Exacerbations: A Narrative Review.

The implementation of artificial intelligence (AI) and machine learning (ML) techniques in healthcare has garnered significant attention in recent years, especially as a result of their potential to revolutionize personalized medicine. Despite advances in the treatment and management of asthma, a significant proportion of patients continue to suffer acute exacerbations, irrespective of disease severity and therapeutic regimen. The situation is further complicated by the constellation of factors that influence disease activity in a patient with asthma, such as medical history, biomarker phenotype, pulmonary function, level of healthcare access, treatment compliance, comorbidities, personal habits, and environmental conditions.

Retrospective comparison of traditional and artificial intelligence-based heart failure phenotyping in a US health system to enable real-world evidence.

Objective: Quantitatively evaluate the quality of data underlying real-world evidence (RWE) in heart failure (HF).

Design: Retrospective comparison of accuracy in identifying patients with HF and phenotypic information was made using traditional (ie, structured query language applied to structured electronic health record (EHR) data) and advanced (ie, artificial intelligence (AI) applied to unstructured EHR data) RWE approaches. The performance of each approach was measured by the harmonic mean of precision and recall (F score) using manual annotation of medical records as a reference standard.

Using artificial intelligence to identify patients with migraine and associated symptoms and conditions within electronic health records.

Background: Real-world evidence (RWE)-based on information obtained from sources such as electronic health records (EHRs), claims and billing databases, product and disease registries, and personal devices and health applications-is increasingly used to support healthcare decision making. There is variability in the collection of EHR data, which includes "structured data" in predefined fields (e.g.

Development and validation of a novel model for characterizing migraine outcomes within real-world data.

Background: In disease areas with 'soft' outcomes (i.e., the subjective aspects of a medical condition or its management) such as migraine or depression, extraction and validation of real-world evidence (RWE) from electronic health records (EHRs) and other routinely collected data can be challenging due to how the data are collected and recorded.

The crouching of the shrew: Mechanical consequences of limb posture in small mammals.

An important trend in the early evolution of mammals was the shift from a sprawling stance, whereby the legs are held in a more abducted position, to a parasagittal one, in which the legs extend more downward. After that transition, many mammals shifted from a crouching stance to a more upright one. It is hypothesized that one consequence of these transitions was a decrease in the total mechanical power required for locomotion, because side-to-side accelerations of the body have become smaller, and thus less costly with changes in limb orientation.

Falling with Style: Bats Perform Complex Aerial Rotations by Adjusting Wing Inertia.

The remarkable maneuverability of flying animals results from precise movements of their highly specialized wings. Bats have evolved an impressive capacity to control their flight, in large part due to their ability to modulate wing shape, area, and angle of attack through many independently controlled joints. Bat wings, however, also contain many bones and relatively large muscles, and thus the ratio of bats' wing mass to their body mass is larger than it is for all other extant flyers.

Re-examining health IT policy: what will it take to derive value from our investment?

Despite substantial investments in health information technology (HIT), the nation's goals of reducing cost and improving outcomes through HIT remain elusive. This period of transition, with new Office of National Coordinator for HIT leadership, upcoming Meaningful Use Stage III definitions, and increasing congressional oversight, is opportune to consider needed course corrections in HIT strategy. This article describes current problems and recommended changes in HIT policy, including approaches to usability, interoperability, and quality measurement.

Hindlimb motion during steady flight of the lesser dog-faced fruit bat, Cynopterus brachyotis.

In bats, the wing membrane is anchored not only to the body and forelimb, but also to the hindlimb. This attachment configuration gives bats the potential to modulate wing shape by moving the hindlimb, such as by joint movement at the hip or knee. Such movements could modulate lift, drag, or the pitching moment.

Glide performance and aerodynamics of non-equilibrium glides in northern flying squirrels (Glaucomys sabrinus).

Gliding is an efficient form of travel found in every major group of terrestrial vertebrates. Gliding is often modelled in equilibrium, where aerodynamic forces exactly balance body weight resulting in constant velocity. Although the equilibrium model is relevant for long-distance gliding, such as soaring by birds, it may not be realistic for shorter distances between trees.

Kinematic plasticity during flight in fruit bats: individual variability in response to loading.

All bats experience daily and seasonal fluctuation in body mass. An increase in mass requires changes in flight kinematics to produce the extra lift necessary to compensate for increased weight. How bats modify their kinematics to increase lift, however, is not well understood.

Upstroke wing flexion and the inertial cost of bat flight.

Flying vertebrates change the shapes of their wings during the upstroke, thereby decreasing wing surface area and bringing the wings closer to the body than during downstroke. These, and other wing deformations, might reduce the inertial cost of the upstroke compared with what it would be if the wings remained fully extended. However, wing deformations themselves entail energetic costs that could exceed any inertial energy savings.

Whole-body kinematics of a fruit bat reveal the influence of wing inertia on body accelerations.

The center of mass (COM) of a flying animal accelerates through space because of aerodynamic and gravitational forces. For vertebrates, changes in the position of a landmark on the body have been widely used to estimate net aerodynamic forces. The flapping of relatively massive wings, however, might induce inertial forces that cause markers on the body to move independently of the COM, thus making them unreliable indicators of aerodynamic force.

Climbing flight performance and load carrying in lesser dog-faced fruit bats (Cynopterus brachyotis).

The metabolic cost of flight increases with mass, so animals that fly tend to exhibit morphological traits that reduce body weight. However, all flying animals must sometimes fly while carrying loads. Load carrying is especially relevant for bats, which experience nightly and seasonal fluctuations in body mass of 40% or more.

The effect of body size on the wing movements of pteropodid bats, with insights into thrust and lift production.

In this study we compared the wing kinematics of 27 bats representing six pteropodid species ranging more than 40 times in body mass (M(b)=0.0278-1.152 kg), to determine whether wing posture and overall wing kinematics scaled as predicted according to theory.

Wake structure and wing kinematics: the flight of the lesser dog-faced fruit bat, Cynopterus brachyotis.

We investigated the detailed kinematics and wake structure of lesser dog-faced fruit bats (Cynopterus brachyotis) flying in a wind tunnel. High speed recordings of the kinematics were conducted to obtain three-dimensional reconstructions of wing movements. Simultaneously, the flow structure in the spanwise plane perpendicular to the flow stream was visualized using time-resolved particle image velocimetry.

Echolocation call production during aerial and terrestrial locomotion by New Zealand's enigmatic lesser short-tailed bat, Mystacina tuberculata.

Linkage of echolocation call production with contraction of flight muscles has been suggested to reduce the energetic cost of flight with echolocation, such that the overall cost is approximately equal to that of flight alone. However, the pattern of call production with limb movement in terrestrially agile bats has never been investigated. We used synchronised high-speed video and audio recordings to determine patterns of association between echolocation call production and limb motion by Mystacina tuberculata Gray 1843 as individuals walked and flew, respectively.

Massive transfusion protocols: the role of aggressive resuscitation versus product ratio in mortality reduction.

Background: Exsanguinating hemorrhage necessitating massive blood product transfusion is associated with high mortality rates. Recent data suggest that altering the fresh frozen plasma to packed red blood cell ratio (FFP:PRBC) results in significant mortality reductions. Our purpose was to evaluate mortality and blood product use in the context of a newly initiated massive transfusion protocol (MTP).

Bats go head-under-heels: the biomechanics of landing on a ceiling.

Bats typically roost head-under-heels but they cannot hover in this position, thus, landing on a ceiling presents a biomechanical challenge. To land, a bat must perform an acrobatic flip that brings the claws of the toes in contact with the ceiling and do so gently enough as to avoid injury to its slender hindlimbs. In the present study, we sought to determine how bats land, to seek a link between landing kinematics and ceiling impact forces, and to determine whether landing strategies vary among bat species.

Quantifying the complexity of bat wing kinematics.

Body motions (kinematics) of animals can be dimensionally complex, especially when flexible parts of the body interact with a surrounding fluid. In these systems, tracking motion completely can be difficult, and result in a large number of correlated measurements, with unclear contributions of each parameter to performance. Workers typically get around this by deciding a priori which variables are important (wing camber, stroke amplitude, etc.

Ultrasonic sound as an indicator of acute pain in laboratory mice.

In response to pain, mice may vocalize at frequencies above the range of human hearing (greater than 20 kHz). To determine whether an ultrasonic recording system is a reliable tool for assessing acute pain, we measured audible and ultrasonic vocalization in mice subjected to either nonpainful or potentially painful procedures performed routinely in animal facilities. Data were collected from 109 weanling mice (Mus musculus; B6, 129S6-Stab 5b) scheduled for 2 potentially painful procedures: DNA testing by tail snip and identification by ear notching.

A county hospital surgical practice: a model for acute care surgery.

Background: Trauma surgery has changed significantly over the past decade. Nonoperative evidence-based algorithms have become common and surgical trauma volume has become increasingly difficult to maintain. The acute care surgery (ACS) model, which integrates trauma, critical care, and emergency surgery, has been proposed as a future model of trauma practice.