Use of troponins in the classification of myocardial infarction from electronic health records. The Atherosclerosis Risk in Communities (ARIC) Study.

Objective: Electronic health record (EHR) data are underutilized for abstracting classification criteria for heart disease. We compared extraction of EHR data on troponin I and T levels with human abstraction.

Methods: Using EHR for hospitalizations identified through the Atherosclerosis Risk in Communities (ARIC) Study in four US hospitals, we compared blood levels of troponins I and T extracted from EHR structured data elements with levels obtained through data abstraction by human abstractors to 3 decimal places.

Ascertaining Framingham heart failure phenotype from inpatient electronic health record data using natural language processing: a multicentre Atherosclerosis Risk in Communities (ARIC) validation study.

Objectives: Using free-text clinical notes and reports from hospitalised patients, determine the performance of natural language processing (NLP) ascertainment of Framingham heart failure (HF) criteria and phenotype.

Study Design: A retrospective observational study design of patients hospitalised in 2015 from four hospitals participating in the Atherosclerosis Risk in Communities (ARIC) study was used to determine NLP performance in the ascertainment of Framingham HF criteria and phenotype.

Setting: Four ARIC study hospitals, each representing an ARIC study region in the USA.

Shrubs as magnets for pollination: A test of facilitation and reciprocity in a shrub-annual facilitation system.

The magnet species hypothesis proposes that flowering plants that are attractive to pollinators can increase the relative pollination rates of neighbouring plants by acting as 'magnets.' Here, we test the hypothesis that insect-pollinated shrub species and wind-pollinated shrub species act as magnets for the pollinator visitation of understory annual plant species in an arid ecosystem. As an extension to the magnet species hypothesis, we propose the double magnet species hypothesis in which we further test for reciprocity by the floral island created in the understory of the benefactor shrubs as an additional pollinator magnet for the shrub itself.

A systematic review of the direct and indirect effects of herbivory on plant reproduction mediated by pollination.

Background: Plant reproduction is influenced by the net outcome of plant-herbivore and plant-pollinator interactions. While both herbivore impacts and pollinator impacts on plant reproduction have been widely studied, few studies examine them in concert.

Methodology: Here, we review the contemporary literature that examines the net outcomes of herbivory and pollination on plant reproduction and the impacts of herbivores on pollination through damage to shared host plants using systematic review tools.

Emergency Medical Text Classifier: New system improves processing and classification of triage notes.

Objective: Automated syndrome classification aims to aid near real-time syndromic surveillance to serve as an early warning system for disease outbreaks, using Emergency Department (ED) data. We present a system that improves the automatic classification of an ED record with triage note into one or more syndrome categories using the vector space model coupled with a 'learning' module that employs a pseudo-relevance feedback mechanism.

Materials And Methods: Terms from standard syndrome definitions are used to construct an initial reference dictionary for generating the syndrome and triage note vectors.

Implementation of Emergency Medical Text Classifier for syndromic surveillance.

Public health officials use syndromic surveillance systems to facilitate early detection and response to infectious disease outbreaks. Emergency department clinical notes are becoming more available for surveillance but present the challenge of accurately extracting concepts from these text data. The purpose of this study was to implement a new system, Emergency Medical Text Classifier (EMT-C), into daily production for syndromic surveillance and evaluate system performance and user satisfaction.

Integration of syndromic surveillance data into public health practice at state and local levels in North Carolina.

Objectives: We sought to describe the integration of syndromic surveillance data into daily surveillance practice at local health departments (LHDs) and make recommendations for the effective integration of syndromic and reportable disease data for public health use.

Methods: Structured interviews were conducted with local health directors and communicable disease nursing staff from a stratified random sample of LHDs from May through September 2009. Interviews captured information on direct access to the North Carolina syndromic surveillance system and on the use of syndromic surveillance information for outbreak management, program management, and the creation of reports.

A case of intrathoracic stomach and spleen after aortic repair: an unusual complication.

Unlabelled: A patient is described who presented with an intrathoracic stomach and spleen two weeks after aortic repair for an aortoduodenal fistula. At an urgent laparotomy the stomach was repositioned and the spleen removed. The patient recovered fully.

TN-TIES: A system for extracting temporal information from emergency department triage notes.

The triage note field of the Emergency Department (ED) patient record describes the reason for the patient's visit, including specific symptoms and incidents. Here we present the Triage Note Temporal Information Extraction System (TN-TIES), which systematically processes triage note text and outputs a human and machine readable interpretation of the timing of the events leading up to the ED visit. TN-TIES consists of chunking, classification, and interpretation processing stages.

Toward vocabulary control for chief complaint.

The chief complaint (CC) is the data element that documents the patient's reason for visiting the emergency department (ED). The need for a CC vocabulary has been acknowledged at national meetings and in multiple publications, but to our knowledge no groups have specifically focused on the requirements and development plans for a CC vocabulary. The national consensus meeting "Towards Vocabulary Control for Chief Complaint" was convened to identify the potential uses for ED CC and to develop the framework for CC vocabulary control.

AID-dependent activation of a MYC transgene induces multiple myeloma in a conditional mouse model of post-germinal center malignancies.

By misdirecting the activity of Activation-Induced Deaminase (AID) to a conditional MYC transgene, we have achieved sporadic, AID-dependent MYC activation in germinal center B cells of Vk*MYC mice. Whereas control C57BL/6 mice develop benign monoclonal gammopathy with age, all Vk*MYC mice progress to an indolent multiple myeloma associated with the biological and clinical features highly characteristic of the human disease. Furthermore, antigen-dependent myeloma could be induced by immunization with a T-dependent antigen.

Unified medical language system coverage of emergency-medicine chief complaints.

Background: Emergency department (ED) chief-complaint (CC) data increasingly are important for clinical-care and secondary uses such as syndromic surveillance. There is no widely used ED CC vocabulary, but experts have suggested evaluation of existing health-care vocabularies for ED CC.

Objectives: To evaluate the ED CC coverage in existing biomedical vocabularies from the Unified Medical Language System (UMLS).

Evaluation of emergency medical text processor, a system for cleaning chief complaint text data.

Objectives: Emergency Medical Text Processor (EMT-P) version 1, a natural language processing system that cleans emergency department text (e.g., chst pn, chest pai), was developed to maximize extraction of standard terms (e.

Emergency Department data for bioterrorism surveillance: electronic data availability, timeliness, sources and standards.

Emergency Department (ED) data are a key component of bioterrorism surveillance systems. Little research has been done to examine differences in ED data capture and entry across hospitals, regions and states. The purpose of this study was to describe the current state of ED data for use in bioterrorism surveillance in 2 regions of the country.

Diagnosis clusters for emergency medicine.

Objectives: Aggregated emergency department (ED) data are useful for research, ED operations, and public health surveillance. Diagnosis data are widely available as The International Classification of Diseases, version, 9, Clinical Modification (ICD-9-CM) codes; however, there are over 24,000 ICD-9-CM code-descriptor pairs. Standardized groupings (clusters) of ICD-9-CM codes have been developed by other disciplines, including family medicine (FM), internal medicine (IM), inpatient care (Agency for Healthcare Research and Quality [AHRQ]), and vital statistics (NCHS).

Using nurses' natural language entries to build a concept-oriented terminology for patients' chief complaints in the emergency department.

Information about the chief complaint (CC), also known as the patient's reason for seeking emergency care, is critical for patient prioritization for treatment and determination of patient flow through the emergency department (ED). Triage nurses document the CC at the start of the ED visit, and the data are increasingly available in electronic form. Despite the clinical and operational significance of the CC to the ED, there is no standard CC terminology.