Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting

Quantitative infrared thermography resolved leakage current problem in cathodic protection system

Leakage current problem can happen in Cathodic Protection (CP) system installation. It could affect the performance of underground facilities such as piping, building structure, and earthing system. Worse can happen is rapid corrosion where disturbance to plant operation plus expensive maintenance cost. Occasionally, if it seems, tracing its root cause could be tedious. The traditional method called line current measurement is still valid effective. It involves isolating one by one of the affected underground structures. The recent methods are Close Interval Potential Survey and Pipeline Current Mapper were better and faster. On top of the mentioned method, there is a need to enhance further by synthesizing with the latest visual methods. Therefore, this paper describes research works on Infrared Thermography Quantitative (IRTQ) method as resolution of leakage current problem in CP system. The scope of study merely focuses on tracing the root cause of leakage current occurring at the CP system lube base oil plant. The results of experiment adherence to the hypothesis drawn. Consequently, res

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.Comment: Under revie

A Heuristic Neural Network Structure Relying on Fuzzy Logic for Images Scoring

Traditional deep learning methods are sub-optimal in classifying ambiguity features, which often arise in noisy and hard to predict categories, especially, to distinguish semantic scoring. Semantic scoring, depending on semantic logic to implement evaluation, inevitably contains fuzzy description and misses some concepts, for example, the ambiguous relationship between normal and probably normal always presents unclear boundaries (normal − more likely normal - probably normal). Thus, human error is common when annotating images. Differing from existing methods that focus on modifying kernel structure of neural networks, this study proposes a dominant fuzzy fully connected layer (FFCL) for Breast Imaging Reporting and Data System (BI-RADS) scoring and validates the universality of this proposed structure. This proposed model aims to develop complementary properties of scoring for semantic paradigms, while constructing fuzzy rules based on analyzing human thought patterns, and to particularly reduce the influence of semantic conglutination. Specifically, this semantic-sensitive defuzzier layer projects features occupied by relative categories into semantic space, and a fuzzy decoder modifies probabilities of the last output layer referring to the global trend. Moreover, the ambiguous semantic space between two relative categories shrinks during the learning phases, as the positive and negative growth trends of one category appearing among its relatives were considered. We first used the Euclidean Distance (ED) to zoom in the distance between the real scores and the predicted scores, and then employed two sample t test method to evidence the advantage of the FFCL architecture. Extensive experimental results performed on the CBIS-DDSM dataset show that our FFCL structure can achieve superior performances for both triple and multiclass classification in BI-RADS scoring, outperforming the state-of-the-art methods

How safe are clinical systems?

Th is study was commissioned by the Health Foundation to examine the extent, type and causes of failures in reliability in different healthcare systems: failures which have the potential to create risk or cause patient harm

A probabilistic model for information and sensor validation

This paper develops a new theory and model for information and sensor validation. The model represents relationships between variables using Bayesian networks and utilizes probabilistic propagation to estimate the expected values of variables. If the estimated value of a variable differs from the actual value, an apparent fault is detected. The fault is only apparent since it may be that the estimated value is itself based on faulty data. The theory extends our understanding of when it is possible to isolate real faults from potential faults and supports the development of an algorithm that is capable of isolating real faults without deferring the problem to the use of expert provided domain-specific rules. To enable practical adoption for real-time processes, an any time version of the algorithm is developed, that, unlike most other algorithms, is capable of returning improving assessments of the validity of the sensors as it accumulates more evidence with time. The developed model is tested by applying it to the validation of temperature sensors during the start-up phase of a gas turbine when conditions are not stable; a problem that is known to be challenging. The paper concludes with a discussion of the practical applicability and scalability of the model

End of Life Care Practices for Patients Who Die in Intensive Care Units (ICU)

Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. The results highlight the inadequate treatment of EOL discomforts. No patients received palliative care or POLST designation, and only one patient received hospice care. Also, the highest mortality happened within the first 6 days of the hospital stay, indicating the time sensitive nature of ICU admissions. Therefore, early planning of the comfort care for end-of-life patient and better communication with the inter-professional team is recommended