Early Prediction of Hypertensive Disorders of Pregnancy Using Machine Learning and Medical Records from the First and Second Trimesters.

Hypertensive disorders of pregnancy (HDPs) remain a major challenge in maternal health. Early prediction of HDPs is crucial for timely intervention. Most existing predictive machine learning (ML) models rely on costly methods like blood, urine, genetic tests, and ultrasound, often extracting features from data gathered throughout pregnancy, delaying intervention.

Rural Versus Urban Health Disparities in the COVID-19 Era Among Veterans With COPD.

Individuals living in rural areas in the United States experienced disparities in COVID-19 incidence and mortality rates, and people with chronic obstructive pulmonary disease (COPD) are at high risk of poor outcomes. We sought to determine whether veterans with COPD living in rural areas experienced different perceptions and practices of COVID-19 mitigation strategies, access to care, and health disparities during the COVID-19 pandemic, compared to their urban-living counterparts. We performed a one-time survey of veterans with COPD, collecting COVID-19-related information including individual perceptions and practice of mitigation strategies, COVID-19 vaccination status, access to care, and respiratory symptoms stratified by rural-urban status.

Depression: an individual-level early warning indicator of virologic failure in HIV patients in South Africa.

Objective: To identify individual-level early warning indicators of virologic failure in HIV patients receiving antiretroviral therapy (ART) in South Africa.

Design: A matched case-control study of individuals with and without virologic failure (VF) (>5 months on ART and HIV-1 plasma viral load >1,000 copies/mL) was conducted between June 2014 and June 2018. Of the 1,000 participants enrolled in the parent cohort, 96 experienced VF, and 199 additional controls were identified from the parent cohort and matched 1:2 (some matched 1:3) for sex, age, ART duration, and site.

Fake Xanax: Designer Emerging Benzodiazepine Epidemic Linked to Morbidity and Mortality a Narrative Review.

Etizolam is a thienodiazepine derivative which produces an anxiolytic effect similar to benzodiazepines such as alprazolam (Xanax). Like classic benzodiazepines, etizolam has a high affinity towards the GABA receptor, and allosterically potentiates the effects of GABA resulting in neuronal hyperpolarization related to chloride influx. When taken in therapeutic doses, etizolam produces a similar effect to Xanax.

Lung Cancer Screening Outreach Program in an Urban Native American Clinic.

Objectives: To evaluate uptake of lung cancer screening in an urban Native American clinic using 2 culturally targeted promotion strategies.

Methods: Patients eligible for lung cancer screening from July 2019 to July 2021 were randomized to receive either a single culturally-targeted mailer from the clinic regarding possible eligibility for screening, or the same mailer plus a follow-up text message and additional mailing.

Results: Overall, there were low rates of shared decision-making visit scheduling (8.

Using Trajectories of Bedside Vital Signs to Identify COVID-19 Subphenotypes.

Background: Trajectories of bedside vital signs have been used to identify sepsis subphenotypes with distinct outcomes and treatment responses. The objective of this study was to validate the vitals trajectory model in a multicenter cohort of patients hospitalized with COVID-19 and to evaluate the clinical characteristics and outcomes of the resulting subphenotypes.

Research Question: Can the trajectory of routine bedside vital signs identify COVID-19 subphenotypes with distinct clinical characteristics and outcomes?

Study Design And Methods: The study included adult patients admitted with COVID-19 to four academic hospitals in the Emory Healthcare system between March 1, 2020, and May 31, 2022.

Sociodemographic and Geographic Risk Factors for All-Cause Mortality in Patients with COPD.

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide. Identifying both individual and community risk factors associated with higher mortality is essential to improve outcomes. Few population-based studies of mortality in COPD include both individual characteristics and community risk factors.

Food Insecurity Is Associated With Low Tenofovir Diphosphate in Dried Blood Spots in South African Persons With HIV.

Background: Food insecurity has been linked to suboptimal antiretroviral therapy (ART) adherence in persons with HIV (PWH). This association has not been evaluated using tenofovir diphosphate (TFV-DP) in dried blood spots (DBSs), a biomarker of cumulative ART adherence and exposure.

Methods: Within a prospective South African cohort of treatment-naive PWH initiating ART, a subset of participants with measured TFV-DP in DBS values was assessed for food insecurity status.

Use of Natural Language Processing of Patient-Initiated Electronic Health Record Messages to Identify Patients With COVID-19 Infection.

Importance: Natural language processing (NLP) has the potential to enable faster treatment access by reducing clinician response time and improving electronic health record (EHR) efficiency.

Objective: To develop an NLP model that can accurately classify patient-initiated EHR messages and triage COVID-19 cases to reduce clinician response time and improve access to antiviral treatment.

Design, Setting, And Participants: This retrospective cohort study assessed development of a novel NLP framework to classify patient-initiated EHR messages and subsequently evaluate the model's accuracy.

Supervised Text Classification System Detects Fontan Patients in Electronic Records With Higher Accuracy Than Codes.

Background The Fontan operation is associated with significant morbidity and premature mortality. Fontan cases cannot always be identified by () codes, making it challenging to create large Fontan patient cohorts. We sought to develop natural language processing-based machine learning models to automatically detect Fontan cases from free texts in electronic health records, and compare their performances with code-based classification.

Development and validation of novel sepsis subphenotypes using trajectories of vital signs.

Purpose: Sepsis is a heterogeneous syndrome and identification of sub-phenotypes is essential. This study used trajectories of vital signs to develop and validate sub-phenotypes and investigated the interaction of sub-phenotypes with treatment using randomized controlled trial data.

Methods: All patients with suspected infection admitted to four academic hospitals in Emory Healthcare between 2014-2017 (training cohort) and 2018-2019 (validation cohort) were included.

Determinates of infection (CDI) testing practices among inpatients with diarrhea at selected acute-care hospitals in Rochester, New York, and Atlanta, Georgia, 2020-2021.

Objective: We evaluated the impact of test-order frequency per diarrheal episodes on difficile infection (CDI) incidence estimates in a sample of hospitals at 2 CDC Emerging Infections Program (EIP) sites.

Design: Observational survey.

Setting: Inpatients at 5 acute-care hospitals in Rochester, New York, and Atlanta, Georgia, during two 10-workday periods in 2020 and 2021.

Nucleocapsid Antigenemia Is a Marker of Acute SARS-CoV-2 Infection.

Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is essential for diagnosis, treatment, and infection control. Polymerase chain reaction (PCR) fails to distinguish acute from resolved infections, as RNA is frequently detected after infectiousness. We hypothesized that nucleocapsid in blood marks acute infection with the potential to enhance isolation and treatment strategies.

Issues in the automated classification of multilead ecgs using heterogeneous labels and populations.

The standard twelve-lead electrocardiogram (ECG) is a widely used tool for monitoring cardiac function and diagnosing cardiac disorders. The development of smaller, lower-cost, and easier-to-use ECG devices may improve access to cardiac care in lower-resource environments, but the diagnostic potential of these devices is unclear. This work explores these issues through a public competition: the 2021 PhysioNet Challenge.

Troponin is unrelated to outcomes in heart failure patients discharged from the emergency department.

Background: Prior data has demonstrated increased mortality in hospitalized patients with acute heart failure (AHF) and troponin elevation. No data has specifically examined the prognostic significance of troponin elevation in patients with AHF discharged after emergency department (ED) management.

Objective: Evaluate the relationship between troponin elevation and outcomes in patients with AHF who are treated and released from the ED.

Ethics Education for Nurses: Foundations for an Integrated Curriculum.

Background: Complexity in health care environments causes practice problems. Nurses bear responsibility for recognizing, addressing, and preventing ethical problems. Inadequacies in ethics education are partly to blame and contribute to nurse moral distress, attrition, and suboptimal care.

Tools to enhance nursing students' confidence and skills in medication administration.

Nursing students experience high levels of stress and anxiety, which can be evident in tasks like administering medications in the clinical setting. This article shares tools to help decrease student stress during medication administration and foster a culture of safety.

Coronavirus Disease 2019 Temperature Trajectories Correlate With Hyperinflammatory and Hypercoagulable Subphenotypes.

Objectives: Body temperature trajectories of infected patients are associated with specific immune profiles and survival. We determined the association between temperature trajectories and distinct manifestations of coronavirus disease 2019.

Design: Retrospective observational study.

Raspberry Pi-Based Data Archival System for Electroencephalogram Signals From the SedLine Root Device.

Background: The retrospective analysis of electroencephalogram (EEG) signals acquired from patients under general anesthesia is crucial in understanding the patient's unconscious brain's state. However, the creation of such database is often tedious and cumbersome and involves human labor. Hence, we developed a Raspberry Pi-based system for archiving EEG signals recorded from patients under anesthesia in operating rooms (ORs) with minimal human involvement.

Trends in ICU Mortality From Coronavirus Disease 2019: A Tale of Three Surges.

Objectives: To determine the association between time period of hospitalization and hospital mortality among critically ill adults with coronavirus disease 2019.

Design: Observational cohort study from March 6, 2020, to January 31, 2021.

Setting: ICUs at four hospitals within an academic health center network in Atlanta, GA.