Opportunities for the informatics community to advance learning health systems.

Objectives: There is rapidly growing interest in learning health systems (LHSs) nationally and globally. While the critical role of informatics is recognized, the informatics community has been relatively slow to formalize LHS as a priority area.

Materials And Methods: We compiled results from a short survey of LHS leaders and American Medical Informatics Association (AMIA) members, discussion from an LHS reception at the AMIA annual meeting, and a follow-up survey to inform priorities at the intersection of LHS and informatics.

Selection and Implementation of Virtual Scribe Solutions to Reduce Documentation Burden: A Mixed Methods Pilot.

Electronic health record (EHR) documentation is a leading reason for clinician burnout. While technology-enabled solutions like virtual and digital scribes aim to improve this, there is limited evidence of their effectiveness and minimal guidance for healthcare systems around solution selection and implementation. A transdisciplinary approach, informed by clinician interviews and other considerations, was used to evaluate and select a virtual scribe solution to pilot in a rapid iterative sprint over 12 weeks.

Machine vision situations: Tracing distributed agency.

This article proposes a new method for tracing and examining agency in heterogeneous assemblages, focusing on the role of machine vision technologies in creative works. We introduce the concept of the "machine vision situation" and define it as the moment in which machine vision technologies come into play and make a difference to the course of events. By taking situations as the unit of analysis, we identify moments at which machine vision technologies take part in actions without reducing them to either tools or protagonists, instead allowing for more complex agential entanglements between human and non-human actors.

Development and Usability Evaluation of an Opioid Management App.

We describe the development and usability evaluation of a novel patient engagement tool (OPY) in its early stage from perspectives of both experts and end-users. The tool is aimed at engaging patients in positive behaviors surrounding the use, weaning, and disposal of opioid medications in the post-surgical setting. The messaging and design of the application were created through a behavioral economics lens.

Advanced Care Planning Content Encoding with Natural Language Processing.

While advanced care planning (ACP) is an essential practice for ensuring patient-centered care, its adoption remains poor and the completeness of its documentation variable. Natural language processing (NLP) approaches hold promise for supporting ACP, including its use for decision support to improve ACP gaps at the point of care. ACP themes were annotated on palliative care notes across four annotators (Fleiss kappa = 0.

The Differential Impact of COVID-19 on Labour Market Outcomes of Immigrants in Canada.

Based on Canadian Labour Force Survey data, we estimate the differential effect of the COVID-19 pandemic on seven labour market outcomes, and separate between recent and established immigrants relative to domestic-born Canadians. We also use Recentered Influence Function (RIF) unconditional quantile regressions to estimate the differential effects across the distribution of outcomes. We find that the pandemic had an adverse effect on the labour market outcomes for all workers, and that the adverse effects were generally larger for immigrants and especially recent immigrants as well as for immigrants at the bottom of the outcome distributions.

Crowdsourcing Electronic Health Record Improvements at Scale across an Integrated Health Care Delivery System.

Background And Objective: Despite widespread adoption of electronic health records (EHRs), these systems have significant room for improved efficiency and efficacy. While the idea of crowdsourcing EHR improvement ideas has been reported, little is known about how this might work across an integrated health care delivery system in practice.

Methods: Our program solicited EHR improvement submissions during two timeframes across 10 hospitals and 60 clinics in an upper-Midwest integrated health care delivery system.

A Pilot Systematic Review and Meta-analysis of Neuroprotective Studies in Female Rodent Models of Ischemic Stroke.

Most ischemic stroke (IS) patients go untreated due to limited treatment windows, restrictive eligibility criteria, and poor availability of current clinical therapies. Neuroprotective treatments targeting protracted neurodegeneration are needed yet keep failing in clinical trials. Over half of IS patients are female, and the scarcity of neuroprotective studies using female animals hinders translational success.

Emergency Interhospital Transfer of Patients With ST-Segment-Elevation Myocardial Infarction: Call 9-1-1-The American Heart Association Mission: Lifeline Program.

The American Heart Association Mission: Lifeline program objectives are to improve the quality of care and outcomes for patients with ST-segment-elevation myocardial infarction. Every minute of delay in treatment adversely affects 1-year mortality. Transfer of patients safely and timely to hospitals with primary percutaneous coronary intervention capability is needed to improve outcomes.

Representations of machine vision technologies in artworks, games and narratives: A dataset.

This data paper documents a dataset that captures cultural attitudes towards machine vision technologies as they are expressed in art, games and narratives. The dataset includes records of 500 creative works (including 77 digital games, 190 digital artworks and 233 movies, novels and other narratives) that use or represent machine vision technologies like facial recognition, deepfakes, and augmented reality. The dataset is divided into three main tables, relating to the works, to specific situations in each work involving machine vision technologies, and to the characters that interact with the technologies.

Effects of selenium treatment on endogenous antioxidant capacity in signal crayfish (Pacifastacus leniusculus).

Selenium is an essential element that plays a role in numerous physiological processes and is critical for the maintenance of a strong endogenous antioxidant system. Previous work by our research group reported that the organophosphate pesticide dimethoate decreased glutathione S-transferase activity (GST) in signal crayfish (Pacifastacus leniusculus) collected from the Boise River (Idaho, USA). The goals of this study were to examine whether: 1) sodium selenite modulated the endogenous antioxidants glutathione (GSH), metallothionein (MT), and glutathione S-transferase (GST), thus suggesting a mechanism of antioxidant activity, 2) dimethoate exposure (pro-oxidant stressor) decreased GST activity in a localized population of signal crayfish collected from the Snake River (Idaho, USA), and 3) investigate whether selenium cotreatment ameliorated the adverse effects of dimethoate on GST activity due to the antioxidant properties associated with selenium.

Characterization of Listeria monocytogenes isolated from wildlife in central New York.

Background: Listeria monocytogenes (Lm) present in farming soil and food-processing facilities threatens food safety, but little is known about the carriage of Lm by wildlife.

Objectives: We estimated the prevalence of faecal Lm shedding among wildlife admitted to a veterinary medical teaching hospital in central New York and characterized a subset of the Lm isolates.

Methods: Wildlife samples were collected between May 2018 and December 2019.

Modulation of endogenous antioxidants by zinc and copper in signal crayfish (Pacifastacus leniusculus).

Metal pollution is a long-standing concern and bioindicators are commonly used in ecotoxicological studies to monitor impacted wildlife populations for evidence of sublethal effects. Significant variation in the response of common biomarkers to metals is reported across taxa, thus necessitating careful characterization in model organisms. In this study, we describe the regulation of glutathione S-transferase (GST), glutathione (GSH), and metallothionein (MT) by zinc chloride (0.

Playbook for Labour Policies for Novel Shocks Such as COVID-19.

This article outlines a playbook for labour policies to deal with novel shocks such as COVID-19. The labour-related characteristics of such shocks are outlined, with special attention to whether and how they require labour market policy responses that are different from the conventional policies. Elements of a playbook for dealing with the crisis, as well as coming out of it, are outlined.

NEMSMA Position Statement and White Paper: Process and Outcomes Data Sharing between EMS and Receiving Hospitals.

Emergency Medical Services provider agencies and programs for systems of care for time-sensitive conditions in many communities and regions struggle with hospitals to obtain feedback data regarding patient outcomes and hospital processes relevant to EMS quality programs. EMS provider agencies also have issues in providing information to hospitals at the time of patient transfer to support continuity of care. The paper presents a position statement and supporting rationale from the National EMS Management Association on the bi-lateral exchange of data between EMS and hospitals.

The Effect of Implementation of the American Heart Association Mission Lifeline PreAct Algorithm for Prehospital Cardiac Catheterization Laboratory Activation on the Rate of "False Positive" Activations.

Hypothesis: Emergency Medical Services (EMS) systems have developed protocols for prehospital activation of the cardiac catheterization laboratory for patients with suspected ST-elevation myocardial infarction (STEMI) to decrease first-medical-contact-to-balloon time (FMC2B). The rate of "false positive" prehospital activations is high. In order to decrease this rate and expedite care for patients with true STEMI, the American Heart Association (AHA; Dallas, Texas USA) developed the Mission Lifeline PreAct STEMI algorithm, which was implemented in Los Angeles County (LAC; California USA) in 2015.

Observation of persistent species temperature separation in inertial confinement fusion mixtures.

The injection and mixing of contaminant mass into the fuel in inertial confinement fusion (ICF) implosions is a primary factor preventing ignition. ICF experiments have recently achieved an alpha-heating regime, in which fusion self-heating is the dominant source of yield, by reducing the susceptibility of implosions to instabilities that inject this mass. We report the results of unique separated reactants implosion experiments studying pre-mixed contaminant as well as detailed high-resolution three-dimensional simulations that are in good agreement with experiments.

Risk Factors for Concomitant Collateral Ligament Injuries in Children and Adolescents With Anterior Cruciate Ligament Tears.

Background: Risk factors for concomitant ligament injuries (CLIs) of the lateral collateral ligament (LCL) and medial collateral ligament (MCL) in children and adolescents with anterior cruciate ligament (ACL) tears are unknown.

Purpose: To determine whether body mass index (BMI), sex, age, and injury mechanism are associated with CLIs in children and adolescents with ACL tears and whether CLIs are associated with meniscal and chondral injuries and a delay to surgery.

Study Design: Cohort study; Level of evidence, 3.

Obesity and recovery of muscle strength after anterior cruciate ligament reconstruction in pediatric patients.

Purpose:: To explore factors influencing muscle strength after anterior cruciate ligament (ACL) reconstruction (ACLR) in pediatric patients. We hypothesized that obesity/overweight, autograft hamstring tendon, and concomitant injuries would be associated with slower muscle recovery.

Methods:: We retrospectively reviewed the records of pediatric ACLR patients during a 3-year period.

A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting.

A significant percentage of patients with psychiatric disorders are exclusively seen for health-care services by primary care physicians. To address the mental health needs of such patients, collaborative models of care were developed including the embedded psychiatry consult model which places a consultant psychiatrist on-site to assist the primary care physician to recognize psychiatric disorders, prescribe psychiatric medication, and develop management strategies. Outcome studies have produced ambiguous and inconsistent findings regarding the impact of this model.

Response of phase I and II detoxification enzymes, glutathione, metallothionein and acetylcholine esterase to mercury and dimethoate in signal crayfish (Pacifastacus leniusculus).

Metals and pesticides are common pollutants and the modulation of biomarkers can indicate sub-lethal influences on the physiology of organisms inhabiting impacted aquatic systems. We examined the effects of mercury and the organophosphate pesticide dimethoate on EROD, MROD, glutathione S-transferase (GST), acetylcholine esterase (AChE), metallothionein (MT) and glutathione (GSH) in the signal crayfish (Pacifastacus leniusculus). Crayfish were injected with mercury chloride or dimethoate (0.

National Assessment of Quality Programs in Emergency Medical Services.

Objective: This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS.

Methods: A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement.