Subject searching requirements : the HILT II experience

The HILT Phase II project aimed to develop a pilot terminologies server with a view to improving cross-sectoral information retrieval. In order to inform this process, it was first necessary to examine how a representative group of users approached a range of information-related tasks. This paper focuses on exploratory interviews conducted to investigate the proposed ideal and actual strategies of a group of 30 users in relation to eight separate information tasks. In addition, users were asked to give examples of search terms they may employ and to describe how they would formulate search queries in each scenario. The interview process undertaken and the results compiled are outlined, and associated implications for the development of a pilot terminologies server are discussed

Variations in statin prescribing for primary cardiovascular disease prevention: cross-sectional analysis

Background Statins are an important intervention for primary and secondary cardiovascular disease (CVD) prevention. We aimed to establish the variation in primary preventive treatment for CVD with statins in the English population. Methods Cross sectional analyses of 6155 English primary care practices with 40,017,963 patients in 2006/7. Linear regression was used to model prescribing rates of statins for primary CVD prevention as a function of IMD (index of multiple deprivation) quintile, proportion of population from an ethnic minority, and age over 65 years. Defined Daily Doses (DDD) were used to calculate the numbers of patients receiving a statin. Statin prescriptions were allocated to primary and secondary prevention based on the prevalence of CVD and stroke. Results We estimated that 10.5% (s.d.3.7%) of the registered population were dispensed a statin for any indication and that 6.3% (s.d. 3.0%) received a statin for primary CVD prevention. The regression model explained 21.2% of the variation in estimates of prescribing for primary prevention. Practices with higher prevalence of hypertension (β co-efficient 0.299 p <0.001) and diabetes (β co-efficient 0.566 p < 0.001) prescribed more statins for primary prevention. Practices with higher levels of ethnicity (β co-efficient-0.026 p <0.001), greater deprivation (β co-efficient −0.152 p < 0.001) older patients (β co-efficient −0.032 p 0.002), larger lists (β co-efficient −0.085, p < 0.001) and were more rural (β co-efficient −0.121, p0.026) prescribed fewer statins. In a small proportion of practices (0.5%) estimated prescribing rates for statins were so low that insufficient prescriptions were issued to meet the predicted secondary prevention requirements of their registered population. Conclusions Absolute estimated prescribing rates for primary prevention of CVD were 6.3% of the population. There was evidence of social inequalities in statin prescribing for primary prevention. These findings support the recent introduction of a financial incentive for primary prevention of CVD in England

A Modular One-Generation Reproduction Study as a Flexible Testing System for Regulatory Safety Assessment

The European Union’s Registration, Evaluation and Authorisation of Chemicals (REACH) legislation mandates testing and evaluation of approximately 30,000 existing substances within a short period of time, beginning with the most widely used “high production volume” (HPV) chemicals. REACH testing requirements for the roughly 3000 HPV chemicals specify three separate tests for reproductive toxicity: two developmental toxicity studies on different animal species (OECD Test Guideline 414) and a two-generation reproduction toxicity study (OECD TG 416). These studies are highly costly in both economic and animal welfare terms. OECD TG 416 is a fertility study intended to evaluate reproductive performance of animals in the P and F1-generations following repeated exposure to a test substance. It can also be used to detect adverse effects on structural and functional development. Thus, it has conventionally been preferred to the one-generation study (OECD TG 415). Recently, the Agricultural Chemical Safety Assessment (ACSA) Technical Committee of the ILSI Health and Environmental Sciences Institute (HESI) proposed that routine two-generation studies could in most cases be replaced with an “enhanced” one-generation study (Reuter et al. [1]). The flexible design proposed by HESI-ACSA allows for the addition of one or more specialised modules, if triggered (e.g. production of a second generation or the investigation of classical developmental toxicity or developmental neuro- or immunotoxicity). Significantly, however, the HESI-ACSA proposal was designed for use in the safety assessment of pesticidal, as opposed to industrial, chemicals. Thus for the purposes of REACH, a streamlined one-generation study that also examines structural development would be the most efficient means of addressing current information requirements for HPV chemicals. This study represents a flexible testing system that can be modified to meet regulatory needs in a variety of sectors

Rethinking Knowledge and Pedagogy in Dental Education

Dentistry as a profession has often been considered both art and science. Traditional dental education has attempted to address both; however, in many places only the science of dentistry is emphasized. The move toward competency-based curricula in dental education requires an expansion of what constitutes meaningful knowledge in the curriculum and what pedagogies best support that curriculum. The scientific and technical knowledge considered foundational to clinical practice is not sufficient to teach competencies associated with the art of dentistry. Habermas, a social scientist, offers a way of looking beyond technical knowledge to consider two other forms of knowledge: practical and emancipatory. Pedagogy that supports development of practical and emancipatory knowledge includes problem-based learning and case methods, heuristics, reflective practica, journals, storytelling, and performance-based assessment methods. These important teaching strategies are being integrated into various dental curricula including a new competency-based dental curriculum at Marquette University\u27s School of Dentistry. It will be critical for dental educators to continue developing these methods to provide efficient and effective education for future practitioners in both the art and science of dentistry

Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE): epidemiologic correlates for 2016 surveillance isolates

Background: The Centers for Disease Control and Prevention advocate data collection and monitoring as one facet of a comprehensive approach to combat antimicrobial resistance in the United States. However, a paucity of such data exists at the local/state level for common disease-causing organisms. Methods: To begin to characterize epidemiologic correlates of antibacterial resistance in Wisconsin, data analyses were performed with respect to isolates in the Surveillance of Wisconsin Organisms for Trends in Antimicrobial Resistance and Epidemiology (SWOTARE) 2016 collection. In addition to submitting isolates of Escherichia coli, Proteus mirabilis, Pseudomonas aeruginosa, and Streptococcus pneumoniae, participating laboratories were also requested to submit data regarding patient age, specimen source, and location of patient service. Results: Fifty-five percent of isolates were of outpatient origin (including emergency department). In general, isolates derived from inpatients were more likely to demonstrate higher resistance rates than those from outpatient locations. Upon further stratification, isolates from emergency department encounters generally exhibited higher susceptibility rates than those from outpatient clinics. Sixty-seven percent of isolates emanated from skin and soft tissue or invasive sites. Delineation of specimen source played a minimal role in prediction of antimicrobial resistance. Older patients were more likely to generate isolates of E coli and P mirabilis exhibiting resistance to agents such as fluoroquinolones and trimethoprim-sulfamethoxazole. Conclusions: SWOTARE facilitates epidemiologic investigations into resistance at the local/ state level. Investigations are warranted to further delineate differences in isolates derived from emergency department and outpatient clinic visits. Characterizations at the demographic level could impact local empiric treatment guidelines and antimicrobial stewardship throughout Wisconsin

Computational depth of anesthesia via multiple vital signs based on artificial neural networks

This study evaluated the depth of anesthesia (DoA) index using artificial neural networks (ANN) which is performed as the modeling technique. Totally 63-patient data is addressed, for both modeling and testing of 17 and 46 patients, respectively. The empirical mode decomposition (EMD) is utilized to purify between the electroencephalography (EEG) signal and the noise. The filtered EEG signal is subsequently extracted to achieve a sample entropy index by every 5-second signal. Then, it is combined with other mean values of vital signs, that is, electromyography (EMG), heart rate (HR), pulse, systolic blood pressure (SBP), diastolic blood pressure (DBP), and signal quality index (SQI) to evaluate the DoA index as the input. The 5 doctor scores are averaged to obtain an output index. The mean absolute error (MAE) is utilized as the performance evaluation. 10-fold cross-validation is performed in order to generalize the model. The ANN model is compared with the bispectral index (BIS). The results show that the ANN is able to produce lower MAE than BIS. For the correlation coefficient, ANN also has higher value than BIS tested on the 46-patient testing data. Sensitivity analysis and cross-validation method are applied in advance. The results state that EMG has the most effecting parameter, significantly.This research is financially supported by the Ministry of Science and Technology (MOST) of Taiwan. This research is also supported by the Centre for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is also sponsored by MOST (MOST103-2911-I-008-001). Also, it is supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302)