Implementing a Preoperative Anemia Optimization Protocol for Cardiovascular Surgery Patients: A Quality Improvement Project.

Background: Patients with anemia have poorer outcomes following cardiac surgery than do those without anemia. To improve outcomes, the Enhanced Recovery After Surgery cardiac recommendations include optimizing patients' condition, including treating anemia, before surgery.

Local Problem: Despite implementing Enhanced Recovery After Surgery initiatives, a midwestern cardiothoracic surgery group recognized a care gap in preoperative patients with anemia.

An exploratory study on dialect density estimation for children and adult's African American Englisha).

This paper evaluates an innovative framework for spoken dialect density prediction on children's and adults' African American English. A speaker's dialect density is defined as the frequency with which dialect-specific language characteristics occur in their speech. Rather than treating the presence or absence of a target dialect in a user's speech as a binary decision, instead, a classifier is trained to predict the level of dialect density to provide a higher degree of specificity in downstream tasks.

Generalizing through Forgetting - Domain Generalization for Symptom Event Extraction in Clinical Notes.

Symptom information is primarily documented in free-text clinical notes and is not directly accessible for downstream applications. To address this challenge, information extraction approaches that can handle clinical language variation across different institutions and specialties are needed. In this paper, we present domain generalization for symptom extraction using pretraining and fine-tuning data that differs from the target domain in terms of institution and/or specialty and patient population.

Perceived importance of pandemic interventions for attending cultural events - findings from Germany.

Background: During the first waves of the COVID-19 pandemic, many cultural and sporting events were held without spectators or had to be cancelled. Therefore, several containment strategies to provide requirements for safe events were developed and tested. Nonetheless, every second (50.

Using a Normothermia Bundle With Perioperative Prewarming to Reduce Patient Hypothermia.

Purpose: To determine if implementing a normothermia bundle, which includes preoperative forced-air warming blankets, reduces incidence of inadvertent perioperative hypothermia (IPH).

Design: Intervention study using retrospective chart review.

Methods: Patients received a preoperative forced-air warming blanket and temperature management with the normothermia bundle.

Extracting COVID-19 diagnoses and symptoms from clinical text: A new annotated corpus and neural event extraction framework.

Coronavirus disease 2019 (COVID-19) is a global pandemic. Although much has been learned about the novel coronavirus since its emergence, there are many open questions related to tracking its spread, describing symptomology, predicting the severity of infection, and forecasting healthcare utilization. Free-text clinical notes contain critical information for resolving these questions.

Extracting COVID-19 Diagnoses and Symptoms From Clinical Text: A New Annotated Corpus and Neural Event Extraction Framework.

Coronavirus disease 2019 (COVID-19) is a global pandemic. Although much has been learned about the novel coronavirus since its emergence, there are many open questions related to tracking its spread, describing symptomology, predicting the severity of infection, and forecasting healthcare utilization. Free-text clinical notes contain critical information for resolving these questions.

Annotating social determinants of health using active learning, and characterizing determinants using neural event extraction.

Social determinants of health (SDOH) affect health outcomes, and knowledge of SDOH can inform clinical decision-making. Automatically extracting SDOH information from clinical text requires data-driven information extraction models trained on annotated corpora that are heterogeneous and frequently include critical SDOH. This work presents a new corpus with SDOH annotations, a novel active learning framework, and the first extraction results on the new corpus.

Restrictions on Nursing Students' Electronic Health Information Access.

Background: Restrictions on students' use of electronic health information have been anecdotally reported as a threat to clinical learning, development of informatics competency, and adherence to personal health information privacy laws. However, evidence on which informatics education and policy strategies can be designed is lacking.

Purpose: This study describes the scope of nursing students' access to and use of electronic health information systems as reported by clinical instructors.

Shoulder surgery in beach chair position causing perioperative stroke: Four cases and a review of the literature.

Perioperative stroke is a rare, but serious complication in shoulder-arthroscopy or arthroplasty. Recent literature suggests the beach chair position, widely used during shoulder surgery, might induce severe perioperative hypotension, and with this cerebral desaturation and ultimately perioperative stroke. In this article we report four cases of perioperative stroke in shoulder surgery.

Using Neural Multi-task Learning to Extract Substance Abuse Information from Clinical Notes.

Substance abuse carries many negative health consequences. Detailed information about patients' substance abuse history is usually captured in free-text clinical notes. Automatic extraction of substance abuse information is vital to assess patients' risk for developing certain diseases and adverse outcomes.

Asynchronous Speech Recognition Affects Physician Editing of Notes.

Objective: Clinician progress notes are an important record for care and communication, but there is a perception that electronic notes take too long to write and may not accurately reflect the patient encounter, threatening quality of care. Automatic speech recognition (ASR) has the potential to improve clinical documentation process; however, ASR inaccuracy and editing time are barriers to wider use. We hypothesized that automatic text processing technologies could decrease editing time and improve note quality.

Automatically Detecting Likely Edits in Clinical Notes Created Using Automatic Speech Recognition.

The use of automatic speech recognition (ASR) to create clinical notes has the potential to reduce costs associated with note creation for electronic medical records, but at current system accuracy levels, post-editing by practitioners is needed to ensure note quality. Aiming to reduce the time required to edit ASR transcripts, this paper investigates novel methods for automatic detection of edit regions within the transcripts, including both putative ASR errors but also regions that are targets for cleanup or rephrasing. We create detection models using logistic regression and conditional random field models, exploring a variety of text-based features that consider the structure of clinical notes and exploit the medical context.

Quality of research and quality of reporting in elbow surgery trials.

Background: Randomized controlled trials (RCTs) are high in the hierarchy of scientific evidence, but possible sources of bias should be identified or even excluded. This systematic review assessed the methodologic quality and the quality of reporting of the RCTs on the treatment of elbow pathology.

Methods: A systematic review of RCTs was performed on the treatment of elbow pathology.

Cytochrome P450 125 (CYP125) catalyses C26-hydroxylation to initiate sterol side-chain degradation in Rhodococcus jostii RHA1.

The cyp125 gene of Rhodococcus jostii RHA1 was previously found to be highly upregulated during growth on cholesterol and the orthologue in Mycobacterium tuberculosis (rv3545c) has been implicated in pathogenesis. Here we show that cyp125 is essential for R. jostii RHA1 to grow on 3-hydroxysterols such as cholesterol, but not on 3-oxo sterol derivatives, and that CYP125 performs an obligate first step in cholesterol degradation.

Characteristics of speaking style and implications for speech recognition.

Differences in speaking style are associated with more or less spectral variability, as well as different modulation characteristics. The greater variation in some styles (e.g.

Patient-reported outcome in total hip replacement. A comparison of five instruments of health status.

Our aim was to define the minimum set of patient-reported outcome measures which are required to assess health status after total hip replacement (THR). In 114 patients, we compared the pre-operative characteristics and sensitivity to change of the Oxford hip score (OHS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), the SF-36, the SF-12 (derived from the SF-36), and the Euroqol questionnaire (EQ-5D). At one year after operation, very large effect sizes were found for the disease-specific measures, the physical domains of the SF-12, SF-36 and the EQ-5Dindex (1.

Waiting for total hip arthroplasty: avoidable loss in quality time and preventable deterioration.

This study was conducted to determine the effect of waiting times for total hip arthroplasty in terms of loss in quality-adjusted life years and additional burden perceived. A second goal was to study the effect of waiting times and preoperative function scores on postoperative outcome scores. Data were collected prospectively from a cohort of 161 patients waiting for total hip arthroplasty.

[High-frequency ultrasonography applied to disorders of the lacrimal canaliculi (Part 2)].

Introduction: Thirty patients presenting disorders of the lacrimal passages were examined using high-frequency ultrasonography in the hopes that this diagnostic tool would provide better image resolution and better reproduction quality than conventional 8- to 10-MHz ultrasound examination.

Material And Methods: To carry out this examination, we were able to combine a 20-MHz ultrasound probe to the I3 ultrasound diagnostic device. The patient was then positioned and the interior palpebral angle was filled with methylcellulose.

[Imaging the lacrimal canaliculus with 20-MHz ultrasonography: a normal diagnosis (Part 1)].

Introduction: High-frequency ultrasonography is used in ophthalmology with probes at 20, 30 and 50 MHz. The latter are used particularly for examining the anterior segments of the eye. The physical and acoustic parameters of the 20-MHz probes present an ideal compromise between resolution and penetration depth for examination of the lacrimal passages.

The epidemiology of total hip replacement in The Netherlands and Sweden: present status and future needs.

By combining data from the Discharge registers and the census bureaus in The Netherlands and Sweden, we calculated the age-specific incidences of primary total hip replacement (THR), studied the demographic profile of the population receiving THR and predicted demands. In the period 1986-1997, the number of THRs increased by 20% in Sweden to 10,000 operations (113/100,000 inhabitants) and by 68% to 17,400 operations (112/100,000 inhabitants) in The Netherlands. Of this increase 3% and 15% could be explained by changes in the age-profile and size of the population, respectively.

Segmental durations in the vicinity of prosodic phrase boundaries.

Numerous studies have indicated that prosodic phrase boundaries may be marked by a variety of acoustic phenomena including segmental lengthening. It has not been established, however, whether this lengthening is restricted to the immediate vicinity of the boundary, or if it extends over some larger region. In this study, segmental lengthening in the vicinity of prosodic boundaries is examined and found to be restricted to the rhyme of the syllable preceding the boundary.

The use of prosody in syntactic disambiguation.

Prosodic structure and syntactic structure are not identical; neither are they unrelated. Knowing when and how the two correspond could yield better quality speech synthesis, could aid in the disambiguation of competing syntactic hypotheses in speech understanding, and could lead to a more comprehensive view of human speech processing. In a set of experiments involving 35 pairs of phonetically similar sentences representing seven types of structural contrasts, the perceptual evidence shows that some, but not all, of the pairs can be disambiguated on the basis of prosodic differences.