Olivine alteration and the loss of Mars' early atmospheric carbon.

The early Martian atmosphere had 0.25 to 4 bar of CO but thinned rapidly around 3.5 billion years ago.

Developing and Validating a Prediction Model For Death or Critical Illness in Hospitalized Adults, an Opportunity for Human-Computer Collaboration.

Unlabelled: Hospital early warning systems that use machine learning (ML) to predict clinical deterioration are increasingly being used to aid clinical decision-making. However, it is not known how ML predictions complement physician and nurse judgment. Our objective was to train and validate a ML model to predict patient deterioration and compare model predictions with real-world physician and nurse predictions.

From compute to care: Lessons learned from deploying an early warning system into clinical practice.

Background: Deploying safe and effective machine learning models is essential to realize the promise of artificial intelligence for improved healthcare. Yet, there remains a large gap between the number of high-performing ML models trained on healthcare data and the actual of these models. Here, we describe the deployment of CHARTwatch, an artificial intelligence-based early warning system designed to predict patient risk of clinical deterioration.

Harnessing the full potential of hospital-based data to support surgical quality improvement.

Surgical departments commonly rely on third-party quality improvement registries. As electronic health data become increasingly integrated and accessible within an institution, alternatives to these platforms arise. We present the conceptualization and implementation of an in-house quality improvement platform that provides real-time reports, is less onerous on clinicians and is tailored to an institution's priorities of care.

Cohort profile: St. Michael's Hospital Tuberculosis Database (SMH-TB), a retrospective cohort of electronic health record data and variables extracted using natural language processing.

Background: Tuberculosis (TB) is a major cause of death worldwide. TB research draws heavily on clinical cohorts which can be generated using electronic health records (EHR), but granular information extracted from unstructured EHR data is limited. The St.

Nursing resource team capacity planning using forecasting and optimization methods: A case study.

Aim: To estimate the cost-minimizing size and skill mix of a nursing resource team (NRT).

Background: Nurse absences can be filled by an NRT at lower hourly cost than staffing agencies or nurses working overtime, but an NRT must be appropriately sized to minimize total cost.

Methods: Using all registered nurse (RN) absences at an academic teaching hospital from 1 October 2014 to 31 March 2018, we developed a generalized additive model (GAM) to forecast the weekly frequency of each of ten types of absence over 52 weeks.

Extracting Clinical Features From Dictated Ambulatory Consult Notes Using a Commercially Available Natural Language Processing Tool: Pilot, Retrospective, Cross-Sectional Validation Study.

Background: The increasing adoption of electronic health records (EHRs) in clinical practice holds the promise of improving care and advancing research by serving as a rich source of data, but most EHRs allow clinicians to enter data in a text format without much structure. Natural language processing (NLP) may reduce reliance on manual abstraction of these text data by extracting clinical features directly from unstructured clinical digital text data and converting them into structured data.

Objective: This study aimed to assess the performance of a commercially available NLP tool for extracting clinical features from free-text consult notes.

Characterizing the impact of snowfall on patient attendance at an urban emergency department in Toronto, Canada.

Objectives: We sought to determine whether addition of a snowfall variable improves emergency department (ED) patient volume forecasting. Our secondary objective was to characterize the magnitude of effect of snowfall on ED volume.

Methods: We used daily historical patient volume data and local snowfall records from April 1st, 2011 to March 31st, 2018 (2542 days) to fit a series of four generalized linear models: a baseline model which included calendar variables and three different snowfall models with an indicator variable for either any snowfall (>0 cm), moderate snowfall (≥1 cm), or large snowfall (≥5 cm).

Physician recruitment and retention in New Brunswick: a medical student perspective.

Background: Physician recruitment and retention is a priority for many Canadian provinces. Each province is unique in terms of recruitment strategies and packages offered; however, little is known about how medical students evaluate these programs. The purpose of the current study was to determine which factors matter most to New Brunswick (NB) medical students when considering their location of future practice.

Efficacy of intraoperative cell salvage in decreasing perioperative blood transfusion rates in first-time cardiac surgery patients: a retrospective study.

Background: Evidence regarding the safety and efficacy of intraoperative cell salvage (ICS) in transfusion reduction during cardiac surgery remains conflicting. We sought to evaluate the impact of routine ICS on outcomes following cardiac surgery.

Methods: We conducted a retrospective analysis of patients who underwent nonemergent, first-time cardiac surgery 18 months before and 18 months after the implementation of routine ICS.

Increased Distance From the Tertiary Cardiac Center Is Associated With Worse 30-Day Outcomes After Cardiac Operations.

Background: Numerous studies have examined the effect of geographic place of residence on access to cardiovascular care, but few have examined their effect on outcomes after cardiac operations. This study examined the effect of geographic place of residence on in-hospital and 30-day outcomes after cardiac operations.

Methods: We performed a retrospective analysis of all patients undergoing nonemergency cardiac operations at a single institution between April 2004 and March 2011.

Application of the Beers Criteria to Alternate Level of Care Patients in Hospital Inpatient Units.

Background: The Beers criteria were developed to help in identifying potentially inappropriate medications (PIMs) for elderly patients. These medications are often associated with adverse events and limited effectiveness in older adults. Patients awaiting an alternate level of care (ALC patients) are those who no longer require acute care hospital services and are waiting for placement elsewhere.

Mammographic microcalcifications and breast cancer tumorigenesis: a radiologic-pathologic analysis.

Background: Microcalcifications (MCs) are tiny deposits of calcium in breast soft tissue. Approximately 30% of early invasive breast cancers have fine, granular MCs detectable on mammography; however, their significance in breast tumorigenesis is controversial. This study had two objectives: (1) to find associations between mammographic MCs and tumor pathology, and (2) to compare the diagnostic value of mammograms and breast biopsies in identifying malignant MCs.

Incidence of febrile neutropenia in early stage breast cancer patients receiving adjuvant FEC-D treatment.

Purpose: The purpose of this study is to determine the incidence of febrile neutropenia (FN) among women receiving FEC-D (flurouracil 500 mg/m(2), epirubicin 100 mg/m(2), and cyclophosphamide 500 mg/m(2) every 3 weeks for three cycles followed by docetaxel 100 mg/m(2) every 3 weeks for three cycles) chemotherapy for early stage breast cancer (ESBC) and the impact of primary granulocyte colony-stimulating factor (G-CSF) prophylaxis in a non-clinical trial setting.

Patients And Methods: A retrospective chart review of women referred for ESBC to The Moncton Hospital between 2005 and 2010 evaluated patient and disease characteristics, adjuvant chemotherapy receipt, G-CSF usage, FN incidence, hospital admission rates, and length of stay. Association of variables with FN was examined, and exploratory multivariable logistic regression modeling examined the impact of baseline variables on risk of FN.

Emergency department use: is frequent use associated with a lack of primary care provider?

Objective: To determine if having a primary care provider is an important factor in frequency of emergency department (ED) use.

Design: Analysis of a central computerized health network database.

Setting: Three EDs in southern New Brunswick.

Factors related to dropout from treatment in two outpatient treatments for borderline personality disorder.

Patients with borderline personality disorder frequently drop out prematurely from psychotherapy. This study examined factors related to treatment attrition in 180 patients enrolled in a randomized controlled trial comparing 1 year of Dialectical Behavior Therapy (DBT) to General Psychiatric Management (GPM). Completers and dropouts were compared on a range of variables, including demographics, Axis I and Axis II disorders, anger and impulsivity, therapeutic alliance, and treatment condition.

Gender roles in persistent sex differences in health-related quality-of-life outcomes of patients with coronary artery disease.

Background: The increased recognition of significant sex/gender differences in health status outcomes, and the implications for clinical practice and service delivery, has led to calls for more gender sensitivity and specificity in research endeavors as well as within clinical practice. Previous investigations by our research group have consistently identified important sex differences in both changes in health status from baseline to 1 year and in health status outcomes of patients treated for coronary artery disease (CAD), with women reporting poorer health-related quality of life (HRQoL) compared with men.

Objective: The objective of this study was to examine whether persistent sex differences in the health status of patients with CAD may be attributed to social factors such as gender roles.