Objective: While value-based learning health systems may address challenges associated with the integrative delivery of therapeutic lifestyle management in usual care, the extent to which they have been evaluated in real-world settings have remained limited.
Methods: To explore the feasibility and user-experiences, associated with the first-year implementation of a preventative Learning Health System (LHS), consecutive patients were evaluated following referral from primary and/or specialty care providers from the Halton and Greater Toronto Area in Ontario, Canada, between December 2020 and December 2021. The integration of a LHS into medical care was facilitated using a digital e-learning platform, and consisted of exercise, lifestyle, and disease-management counselling. The dynamic monitoring of user-data allowed patients and providers to modify goals, treatment plans, and care-delivery in real-time in accordance with patient engagement, weekly exercise, and risk-factor targets. All program costs were covered by the public-payer health care system using a physician fee-for-service payment model. Descriptive statistics evaluated attendance to prescheduled visits, drop-out rates, changes in self-reported weekly Metabolic Expenditure Task-Minutes (MET-MINUTES), perceived changes in health knowledge, lifestyle behaviours, health status, satisfaction with care, and programmatic costs.
Results: 378 of 437 patients (86.5%) enrolled in the 6-month program; The average age of patients was 61.2 ± 12.2, 156 (41.3%) of which were female and 140 (37.0%) with established coronary disease. After 1 year, 15.6% dropped out of the program. On average, weekly MET-MINUTES rose by 191.1 throughout the program (95% CI [331.82, 57.96], P=0.007), with increases most prominent among sedentary populations. Participants reported significant improvements in perceived health status and health knowledge, at a total health-care delivery cost of $517.70 per patient for a completed program.
Conclusion: The implementation of an integrative preventative learning health system was feasible, with high patient engagement and favourable user-experiences. Further research is required to compare health outcomes against usual care.
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In the context of Chinese clinical texts, this paper aims to propose a deep learning algorithm based on Bidirectional Encoder Representation from Transformers (BERT) to identify privacy information and to verify the feasibility of our method for privacy protection in the Chinese clinical context. We collected and double-annotated 33,017 discharge summaries from 151 medical institutions on a municipal regional health information platform, developed a BERT-based Bidirectional Long Short-Term Memory Model (BiLSTM) and Conditional Random Field (CRF) model, and tested the performance of privacy identification on the dataset. To explore the performance of different substructures of the neural network, we created five additional baseline models and evaluated the impact of different models on performance.
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June 2025
Current nursing shortages, particularly in complex practice or specialty areas, coupled with high attrition rates of both seasoned and new graduate nurses, have required nursing leaders to consider creative approaches to recruit, prepare and retain nurses in specialty areas. This article describes a collaborative partnership between post-secondary institutions and health authorities in one province to address the need to prepare and retain nurses in high-priority specialized areas, such as the intensive care unit or the emergency department. This partnership allows for a proactive connection that leverages the strengths and resources of both healthcare and educational institutions.
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January 2025
Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, 100084 Beijing, China.
Background: Sports fatigue in soccer athletes has been shown to decrease neural activity, impairing cognitive function and negatively affecting motor performance. Transcranial direct current stimulation (tDCS) can alter cortical excitability, augment synaptic plasticity, and enhance cognitive function. However, its potential to ameliorate cognitive impairment during sports fatigue remains largely unexplored.
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January 2025
Department of Anesthesia, Hangzhou Plastic Surgery Hospital, 310000 Hangzhou, Zhejiang, China.
Introduction: The effects of remimazolam (Re) in combination with andrographolide (AP) on learning, memory, and motor abilities in rats following cardiopulmonary bypass (CPB) surgery were studied.
Methods: We hypothesized that the combination of Re and AP could improve postoperative cognitive dysfunction (POCD) in rats after CPB by modulating nervous system inflammation. Cognitive function was assessed using the Morris Water Maze test, and the concentrations of tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6) in serum were measured by enzyme-linked immunosorbent assay (ELISA).
Mult Scler
January 2025
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Testing for myelin oligodendrocyte glycoprotein immunoglobulin G antibodies (MOG-IgG) is essential to the diagnosis of MOG antibody-associated disease (MOGAD). Due to its central role in the evaluation of suspected inflammatory demyelinating disease, the last 5 years has been marked by an abundance of research into MOG-IgG testing ranging from appropriate patient selection, to assay performance, to utility of serum titers as well as cerebrospinal fluid (CSF) testing. In this review, we synthesize current knowledge pertaining to the "who, what, where, when, why, and how" of MOG-IgG testing, with the aim of facilitating accurate MOGAD diagnosis in clinical practice.
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