Using Artificial Intelligence and Big Data-Based Documents to Optimize Medical Coding

Clinical information systems (CISs) in some hospitals streamline the data management from data warehouses. These warehouses contain heterogeneous information from all medical specialties that offer patient care services. It is increasingly difficult to manage large volumes of data in a specific clinical context such as quality coding of medical services. The document-based not only SQL (NoSQL) model can provide an accessible, extensive, and robust coding data management framework while maintaining certain flexibility. This paper focuses on the design and implementation of a big data-coding warehouse, and it also defines the rules to convert a conceptual model of coding into a document-oriented logical model. Using that model, we implemented and analyzed a big data-coding warehouse via the MongoDB database and evaluated it using data research mono- and multi-criteria and then calculated the precision of our model

Smart-EEG: a Tele-medicine System for EEG Exams

National audienceThis paper presents Smart-EEG, a telemedicine project aiming to improve remote diagnosis of brain diseases. Those exams are commonly done by acquiring EEG, ECG, EOG, EMG and a video of the scene. Nowadays, systems uses video acquisition limited to standard frame-rate (30 fps) and unreliable synchronization mechanism. Those current limitations may lead to wrong diagnosis of a patient. To get around those limitation, the system architecture is centered around a hardware acquisition system handling synchronization and compression and a self contained EEG exam file to permit remote diagnosis. This device aims at providing reliable synchronization and high frame-rate video recordin

Exposure to Maternal Diabetes Induces Salt-Sensitive Hypertension and Impairs Renal Function in Adult Rat Offspring

OBJECTIVE—Epidemiological and experimental studies have led to the hypothesis of fetal origin of adult diseases, suggesting that some adult diseases might be determined before birth by altered fetal development. We have previously demonstrated in the rat that in utero exposure to maternal diabetes impairs renal development leading to a reduction in nephron number. Little is known on the long-term consequences of in utero exposure to maternal diabetes. The aim of the study was to assess, in the rat, long-term effects of in utero exposure to maternal diabetes on blood pressure and renal function in adulthood

The US etonogestrel implant mandatory clinical training and active monitoring programs: 6-year experience

ObjectiveThe objective was to monitor the effectiveness of the etonogestrel implant clinical training program through a voluntary active monitoring program (AMP).Study designUS health care providers underwent mandatory training by the manufacturer on etonogestrel implant insertion, localization and removal. After training, health care providers could enroll in a voluntary AMP to provide outcome data to meet a postmarketing commitment of the manufacturer with the US Food and Drug Administration (FDA). Those who volunteered completed and faxed forms to the manufacturer after implant insertion and removal detailing the procedure and device-related outcomes, including insertion-, localization- or removal-associated events. Experts reviewed outcome data quarterly, which the Sponsor then reported to the FDA.ResultsAmong 42,337 health care providers completing the training program, 4294 (10.1%) volunteered to participate in the AMP. The 26,198 forms submitted over 6.4 years included more insertion (n=20,497) forms than removal forms (n=5701). The volunteers reported 646 events on 566 (2.2%) forms related to insertion (n=197), localization (n=34), removal (n=357) and "other" (n=58). Clinically important events included noninsertion (n=4), serum etonogestrel positive but implant not found (n=1), and possible nerve (n=66) or vascular (n=5) injury. The reports did not include any insertion-, localization- or removal-associated hospitalizations. Eight (0.14%) removal reports described referral for surgical implant removal.ConclusionEvents related to insertion, localization or removal of the etonogestrel implant are uncommon among US providers who received mandatory training in the use of the implant.ImplicationsThis report presents results from the first mandatory US contraceptive training program. Health care providers volunteered to report information about etonogestrel implant insertion, localization and removal. Although the data do not demonstrate whether a mandatory program improves outcomes, they elucidate the utility and real-life experience that clinical training programs can provide

Understanding the Lived School Experience of a Young Boy with ODD and Symptoms of Anxiety through Interpretive Phenomenological Analysis: Child, Parent, and Teacher Perspectives

Oppositional defiant disorder (ODD) and anxiety disorders are among the most common mental health problems affecting children and adolescents today. Youth struggling with externalizing disorders such as ODD or internalizing disorders such as anxiety are at a higher risk of experiencing multiple challenges during their school years and well into adulthood. Despite the array of concerning outcomes frequently associated with each of these disorders there is minimal research that explores the presentation and implications when these disorders co-occur. Furthermore, a clear understanding of the experiential component of children and adolescents with ODD and anxiety is profoundly lacking. Further complicating the matter, some research has shown that even subthreshold anxiety, in which an individual demonstrates fewer symptoms than required for a diagnosis of anxiety, can lead to impairments comparable to those seen among individuals who meet full diagnostic criteria for an anxiety disorder. The lack of understanding of the experience of co-occurring ODD and sub-threshold anxiety in the educational setting and the implications associated with co-occurring ODD and sub-threshold anxiety are concerning because children and adolescents spend the majority of their time in school. My research aims to make a novel and meaningful contribution to the limited research on ODD and anxiety by exploring the lived school experience of a boy with ODD and subthreshold symptoms of anxiety. The participants in this study included an adolescent boy (Joshua), his mother (Jacquie), his grade 4 teacher (Diane), and his school behaviour support teacher (Marlene). Each participant engaged in two virtual interviews of approximately 60 minutes in length. An interpretive phenomenological analysis methodology was employed to authentically capture Joshua’s lived experience of school through interviews with Joshua, his mother, and two of his former school teachers. Findings illuminated that despite Joshua’s positive attributes, which included being a smart, funny, and curious boy, he displayed a tremendous amount of anger, along with some anxiety. He experienced ineffective exclusionary discipline measures that remained in place until he met a teacher who changed his trajectory. Joshua’s lived experience of school during his elementary years, as described by Joshua, his mother, and two of his former teachers, was tumultuous until two caring educators built a warm, patient, understanding, and supportive relationship with him. Based on findings from this study, possibilities for practice are provided for consideration for school-based teams and school psychologists who may encounter other students like Joshua. Additional areas of research within the greater context of ODD and anxiety in the educational setting are also offered for consideration

Analyse des risques associés à la mise en oeuvre d'un Système d'Information Hospitalier (à propos de l'Hôpital Européen Georges Pompidou)

PARIS6-Bibl. St Antoine CHU (751122104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Lossy Digital Medical Images: How far compression goes?

National audienc