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81.
Progestin‐primed ovarian stimulation with or without clomiphene citrate supplementation in normal ovulatory women undergoing in vitro fertilization/intracytoplasmic sperm injection: A prospective randomized controlled trial 下载免费PDF全文
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Right ventricular systolic function in hypoplastic left heart syndrome: A comparison of manual and automated software to measure fractional area change 下载免费PDF全文
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Elizabeth McNeer Cole Beck Hannah L Weeks Michael L Williams Nathan T James Cosmin A Bejan Leena Choi 《J Am Med Inform Assoc》2021,28(4):782
ObjectiveTo develop an algorithm for building longitudinal medication dose datasets using information extracted from clinical notes in electronic health records (EHRs).Materials and MethodsWe developed an algorithm that converts medication information extracted using natural language processing (NLP) into a usable format and builds longitudinal medication dose datasets. We evaluated the algorithm on 2 medications extracted from clinical notes of Vanderbilt’s EHR and externally validated the algorithm using clinical notes from the MIMIC-III clinical care database.ResultsFor the evaluation using Vanderbilt’s EHR data, the performance of our algorithm was excellent; F1-measures were ≥0.98 for both dose intake and daily dose. For the external validation using MIMIC-III, the algorithm achieved F1-measures ≥0.85 for dose intake and ≥0.82 for daily dose.DiscussionOur algorithm addresses the challenge of building longitudinal medication dose data using information extracted from clinical notes. Overall performance was excellent, but the algorithm can perform poorly when incorrect information is extracted by NLP systems. Although it performed reasonably well when applied to the external data source, its performance was worse due to differences in the way the drug information was written. The algorithm is implemented in the R package, “EHR,” and the extracted data from Vanderbilt’s EHRs along with the gold standards are provided so that users can reproduce the results and help improve the algorithm.ConclusionOur algorithm for building longitudinal dose data provides a straightforward way to use EHR data for medication-based studies. The external validation results suggest its potential for applicability to other systems. 相似文献
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Abstract: Background: The media both creates and reflects public opinion. The way in which health professionals are depicted in the media is likely to influence views held by and about different health professions. The aim of this study was to examine how midwives and obstetricians are reported in English language web-based news reports from around the world. Methods: News alerts from the Internet search engine Google were created to search for the terms “midwife,”“midwives,”“midwifery,”“obstetrics,” and “obstetricians.” These alerts were received over a 12-month period (May 1, 2006–April 31, 2007), downloaded, and analyzed using quantitative content analysis. Results: A total of 522 web-based news reports for midwifery and 564 for obstetrics (n = 1,086) were found. Dominant categories for midwives were: “mainstreaming midwives” (models of care/rise of midwifery) (28%); “the Cinderella of the maternity care” (workforce/industrial) (27%); “delivering the baby with your hands tied” (funding, insurance, and legislation) (21%); “ask the expert” (education, research, and health advice) (8%), “recognizing midwives” (awards and announcements) (7%), “unsafe midwives” (litigation) (6%); and “the art of birth” (books, film, and photographs) (2%). Dominant categories for obstetricians were: “ask the expert” (research and advice) (26%); “doctors are heroes amongst us” (awards and announcements) (19%); “obstetric workforce woes” (workforce/industrial) (19%); “new frontiers” (trends in care and new technology) (17%); “the disappearing obstetrician” (insurance and litigation) (10%); and “human-interest news reports” (9%). Obstetricians were more likely to be recognized as experts on pregnancy and birth and receive public recognition compared with midwives. Midwives were more likely to be depicted as struggling to be a mainstream option while being hampered by lack of funding, insurance, and legislative barriers. Conclusions: Although midwives have rising acceptance, they still struggle with recognition. Obstetricians have both acceptance and recognition. Countries where midwifery is a mainstream option have more news reports related to midwifery than obstetrics. Different issues appear more dominant in some countries, such as work force in the United Kingdom and funding, insurance, and legislation in the United States. (BIRTH 39:1 March 2012) 相似文献
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Lukas Frase Peter Selhausen Lukas Krone Sulamith Tsodor Friederike Jahn Bernd Feige Jonathan G. Maier Florian Mainberger Hannah Piosczyk Marion Kuhn Stefan Klöppel Annette Sterr Chiara Baglioni Kai Spiegelhalder Dieter Riemann Michael A. Nitsche Christoph Nissen 《Brain stimulation》2019,12(3):674-683
Background
Arousal and sleep represent basic domains of behavior, and alterations are of high clinical importance.Objective/hypothesis
The aim of this study was to further elucidate the neurobiology of insomnia disorder (ID) and the potential for new treatment developments, based on the modulation of cortical activity through the non-invasive brain stimulation technique transcranial direct current stimulation (tDCS). Specifically, we tested the hypotheses that bi-frontal anodal tDCS shortens and cathodal tDCS prolongs total sleep time in patients with ID, compared to sham stimulation. Furthermore, we tested for differences in indices of arousal between ID patients and healthy controls and explored their potential impact on tDCS effects.Methods
Nineteen ID patients underwent a within-subject repeated-measures sleep laboratory study with adaptation, baseline and three experimental nights. Bifrontal anodal, cathodal and sham tDCS was delivered in a counterbalanced order immediately prior to sleep. Wake EEG was recorded prior to and after tDCS as well as on the following morning. Subsequently, we compared patients with ID to a healthy control group from an earlier dataset.Results
Against our hypothesis, we did not observe any tDCS effects on sleep continuity or sleep architecture in patients with ID. Further analyses of nights without stimulation demonstrated significantly increased levels of arousal in ID patients compared to healthy controls, as indexed by subjective reports, reduced total sleep time, increased wake after sleep onset and increased high frequency EEG power during wakefulness and NREM sleep. Of note, indices of increased arousal predicted the lack of effect of tDCS in ID patients.Conclusions
Our study characterizes for the first time differential effects of tDCS on sleep in patients with ID and healthy controls, presumably related to persistent hyperarousal in ID. These findings suggest that adapted tDCS protocols need to be developed to modulate arousal and sleep dependent on baseline arousal levels. 相似文献89.
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Indian Journal of Pediatrics - Bone marrow failure has many different etiologies, including genetic defects which manifest with specific syndromes, as well as acquired conditions as a result of... 相似文献