Feature selection in high-dimensional dataset using MapReduce

This paper describes a distributed MapReduce implementation of the minimum Redundancy Maximum Relevance algorithm, a popular feature selection method in bioinformatics and network inference problems. The proposed approach handles both tall/narrow and wide/short datasets. We further provide an open source implementation based on Hadoop/Spark, and illustrate its scalability on datasets involving millions of observations or features

Malpractice and patient safety descriptors: an innovative grid to evaluate the quality of clinical records

Introduction: The medical record contains all the health information related to the patient’s clinical condition and its evolution during hospitalization. It was defined by the Italian Ministry of Health in 1992 as "The information tool designed to record all relevant demographic and clinical information about a patient during a single episode of hospitalization". The documents and information in a Medical Record must meet the following criteria: traceability, clarity, accuracy, authenticity, pertinence and completeness. The objectives of our study was to develop a tool capable of assessing the quality of the clinical record and pointed the critical point at the Organizational, Technical - Professional, Managerial level. Methods: To evaluate the quality of the medical documentation, we created an assessment grid composed of 4 sections with a total of 92 criteria. This grid was tested on 200 medical records that were randomly selected from 25 (18 medical and 7 surgical) wards of a teaching hospital in Rome. Results: The grid contains 4 sections. The first part regards administrative and clinical data; the second assesses the quality of hospital stay and surgical/invasive procedures; the third part is concerned with the discharge of the patient and the fourth aims to identify the presence of advisory reports given to the patient. This grid has been validated to verify internal consistency with Cronbach's Alpha = 0,743. Conclusions: Medical records were analyzed using a validated tool with grids to identify critical issues in care activities. Weaknesses in the system were identified in order to improve planning. The sample testing also in terms of ‘self-assessment' represents a tool to introduce activities to improve safety and quality of care, greatly reducing the costs of litigation

Prevalence of influenza vaccination among physicians and related enhancing and preventing factors in Italy

Introduction: Several studies proved the convenience of vaccinating health care workers (HCWs), especially physicians, and vaccination is recommended by health authorities in many Countries. Nonetheless in Italy only a small part of HCWs get vaccinated. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among physicians in Italy and to investigate the enhancing/preventing factors associated with this kind of preventive tool.Methods: Relevant articles up to 1st May 2010 have been identified through Scopus, PubMed and Google Scholar; data extraction and quality assessment were performed independently by two researchers.The analysis was performed using StatsDirect 2.7.8.Results: Sixteen studies, performed between 1990 and 2008, reported vaccination rates with pooled prevalence among all HCWs. From nine of them data regarding physicians have been extracted and analysed, finding a pooled proportion of 23.18% (95% CI = 17.85-28.98%). One study allowed an analysis of the reasons encouraging and preventing influenza vaccination. The main ones are on one side self protection, and patients' and family's protection, and on the other side "not caring about influenza," followed by "fear of adverse effects" and "belief that vaccine isn't effective."Discussion: Italy has a good overall influenza vaccination coverage, and national records are available for population aged over 65 years or with chronic illness. Unfortunately there isn't any national record about HCWs or physicians vaccination, and from the data gathered from the studies examined in this analysis vaccination prevalence is low. The reasons brought from physicians are worrying because of their position in the society and in the health care system, in close contact with patients.This shows a great need for well-done information and educational campaigns stressing the importance of prevention

Quality assessment of medical record as a tool for clinical risk management: a three year experience of a teaching hospital Policlinico Umberto I, Rome

Introduction: The medical record was defined by the Italian Ministry of Health in 1992 as "the information tool designed to record all relevant demographic and clinical information on a patient during a single hospitalization episode". Retrospective analysis of medical records is a tool for selecting direct and indirect indicators of critical issues (organizational, management and technical). The project’s aim being the promotion of an evaluation and self-evaluation process of medical records as a Clinical Risk Management tool to improve the quality of care within hospitals. Methods: The Authors have retrospectively analysed, using a validated grid, 1,184 medical records of patients admitted to the Teaching Hospital “Umberto I” in Rome during a three-year period (2013-2015). Statistical analysis was performed using SPSS for Windows © 19:00. All duly filled out criteria (92) were examined. “Strengths” and "Weaknesses" were identified through data analysis and Best and Bad Practice were identified based on established criteria. Conclusion: The data analysis showed marked improvements (statistically significant) in the quality of evaluated clinical documentation and indirectly upon behaviour. However, when examining some sub-criteria, critical issues emerge; these could be subject to future further corrective action

Reliability of the telephone-administered International Physical Activity Questionnaire in an Italian pilot sample

Background: the International Physical Activity Questionnaire (IPAQ) is an instrument for crossnational monitoring of physical activity and inactivity. The aim of the study was the reliability evaluation of the Italian telephone-administered IPAQ version in Rome. Methods: the IPAQ short form (IPAQ-SF), consisting of 7 items, was administered. The responses, used to compute Metabolic Equivalent Task (MET in minutes per week), were processed to analyze the internal consistency. Standardized Cronbach’s alpha was used for reliability estimation. Results: a total of 133 adults (51 males and 82 females) participated in the study, with a mean age of 51 years (SD=19). The mean MET was 4 130, corresponding to good physical activity levels. The standardized Cronbach’s alpha on 6 items, concerning time spent on vigorous and moderate activity and walking, was 0.614. Conclusions: according to the findings from other countries, the Italian IPAQ-SF has acceptable measurement properties, as good as other established self-reports. The IPAQ-SF has a questionable reliability as previously reported, but the results of the present pilot study are promising and suggest that these instruments can be used to compare population estimates of physical activity

Hybrid Approach to Atrial Fibrillation Ablation

Sequential surgical thoracoscopic and electrophysiological (EP) ablation is gaining popularity as a novel approach for the treatment of patients with stand-alone, persistent and long standing persistent atrial fibrillation (AF)

Health status and public health in Asia

[No abstract available

Durable staged hybrid ablation with thoracoscopic and percutaneous approach for treatment of long-standing atrial fibrillation: A 30-month assessment with continuous monitoring

Objectives: Electrophysiologic and surgical procedures to treat stand-alone atrial fibrillation (AF) have recently evolved, but disappointing results in patients with long-standing persistent (LSP) AF have challenged the durability of these procedures. Methods: Lone AF patients (n = 36) with either LSP-AF (n = 28) or persistent AF (n = 8) were prospectively enrolled in the study and consecutively treated by thoracoscopic ablation followed by electrophysiologic evaluation 30 days afterward. Mean left atrial dimension was 50.3 ± 5.5 mm, and average AF duration was 72.8 months (range, 7-240 months). The thoracoscopic procedure was a right monolateral approach to create a box lesion using a temperature-controlled radiofrequency device with suction adherence. A continuous rhythm monitoring device was implanted at the end of the operation. Results: Thoracoscopic ablation was successfully completed without morbidity or mortality and without any intensive care unit stay. Intraoperative exit and entrance block was achieved in 100% and 88.8% (32/36) of patients, respectively. At 33 ± 2 days after the operation, an electrophysiologic study confirmed entry-exit block in 83.3% (30/36) whereas pulmonary vein reconnections were observed in 16.7% (6/36) of patients. Additional transcatheter lesions were performed in 61.1% (22/36) of patients. At a mean follow-up of 30 months (range, 1-58 months), 91.6% (33/36) of patients are in sinus rhythm with 77.7% (28/36) of these patients off antiarrhythmic drugs and 88.8% (32/36) free of warfarin. Long-term incidence of left atrial flutter was 0%. Conclusions: The combination of a surgical box lesion and transcatheter ablation in a hybrid approach provided excellent durable clinical outcomes in patients with LSP-AF. Copyright © 2012 by The American Association for Thoracic Surgery

Multi-Hazard Assessment of Bridges in Case of Hazard Chain: State of Play and Application to Vehicle-Pier Collision Followed by Fire

This study focuses on multi-hazard analysis for bridges, following a two-tier approach. First, it identifies relevant open issues and recent literature developments in the field, presenting data in a meaningful manner, with specific focus on the issues related with the analysis of hazard chain scenario treated as low probability–high consequence events. Second, it describes a practically useful and sufficiently generic approach for efficient computational investigation of hazard chain scenarios in highway bridges. Following that, the applicability of the approach is exemplified in an appealing and commonly encountered in real-life hazard chain scenario, in which a multilevel modeling strategy is adopted to assess the structural response under hazard chain scenarios of a highway viaduct. Among the considered scenarios is the impact of a heavy vehicle (tank truck) on the bridge pier, and the fire spread following the collision due to the presence of inflammable materials. The bridge structure is a typical 189-m-long multi-span composite highway viaduct. The impact is modeled with a non-linear transient dynamic analysis that accounts the inertial effect of the global structure, while the fire modeling is performed with non-linear quasi static dynamic analysis focusing on local behavior with a substructured model. Then different impact and fire scenarios are considered, including different impact velocities of the truck.JRC.C.4-Sustainable Transpor