Publications by authors named "J Stirnemann"

Introduction: Healthcare practices providing minimal or no benefit to recipients have been estimated to represent 20% of healthcare costs. However, defining, measuring and monitoring low-value care (LVC) and its downstream consequences remain a major challenge. The purpose of the National Data Stream (LUCID NDS) is to identify and monitor LVC in medical inpatients using routinely collected hospital data.

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Fetal death is defined as the spontaneous cessation of cardiac activity after 14 weeks gestational age (GA). Regarding prevention of fetal death in the general population, it is not recommended to counsel or prescribe rest, aspirin, vitamin A, vitamin D, or micronutrient supplementation; systematically look for nuchal cord during prenatal screening ultrasound; or perform systematic antepartum monitoring by cardiotocography for the sole purpose of reducing the risk of fetal death. It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2.

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Introduction: Sickle cell disease (SCD) is one of the most common genetic diseases in the world, annually affecting approximately 310 000 births and causing >100 000 deaths. Vaso-occlusive crisis (VOC) is the most frequent complication of SCD, leading to bone pain, thoracic pain (acute chest syndrome) and/or abdominal spasms. It is the main cause of mortality in patients with SCD, reducing life expectancy.

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Cardiotocography (CTG) is the main tool available to detect neonatal acidemia during delivery. Presently, obstetricians and midwives primarily rely on visual interpretation, leading to a significant intra-observer variability. In this paper, we build and evaluate a convolutional neural network to detect neonatal acidemia from the CTG signals during delivery on a multicenter database with 27662 cases in five centers, including 3457 and 464 cases of moderate and severe neonatal acidemia respectively (defined by a fetal pH at birth between 7.

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It is common to routinely prescribe gastric ulcer prophylaxis with proton pump inhibitors (PPIs) when administering high-dose glucocorticoids (GC) (> 30 mg/day of prednisone equivalent) or during prolonged time (> 15 days). This routine is due to a risk profile considered safe for PPIs in comparison to the possible severe consequences of developing a gastric ulcer. Given the numerous adverse effects associated with PPIs, it is preferable to question the risk-benefit balance when prescribing them.

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