SemEHR:A general-purpose semantic search system to surface semantic data from clinical notes for tailored care, trial recruitment, and clinical research

OBJECTIVE: Unlocking the data contained within both structured and unstructured components of electronic health records (EHRs) has the potential to provide a step change in data available for secondary research use, generation of actionable medical insights, hospital management, and trial recruitment. To achieve this, we implemented SemEHR, an open source semantic search and analytics tool for EHRs. METHODS: SemEHR implements a generic information extraction (IE) and retrieval infrastructure by identifying contextualized mentions of a wide range of biomedical concepts within EHRs. Natural language processing annotations are further assembled at the patient level and extended with EHR-specific knowledge to generate a timeline for each patient. The semantic data are serviced via ontology-based search and analytics interfaces. RESULTS: SemEHR has been deployed at a number of UK hospitals, including the Clinical Record Interactive Search, an anonymized replica of the EHR of the UK South London and Maudsley National Health Service Foundation Trust, one of Europe's largest providers of mental health services. In 2 Clinical Record Interactive Search-based studies, SemEHR achieved 93% (hepatitis C) and 99% (HIV) F-measure results in identifying true positive patients. At King's College Hospital in London, as part of the CogStack program (github.com/cogstack), SemEHR is being used to recruit patients into the UK Department of Health 100 000 Genomes Project (genomicsengland.co.uk). The validation study suggests that the tool can validate previously recruited cases and is very fast at searching phenotypes; time for recruitment criteria checking was reduced from days to minutes. Validated on open intensive care EHR data, Medical Information Mart for Intensive Care III, the vital signs extracted by SemEHR can achieve around 97% accuracy. CONCLUSION: Results from the multiple case studies demonstrate SemEHR's efficiency: weeks or months of work can be done within hours or minutes in some cases. SemEHR provides a more comprehensive view of patients, bringing in more and unexpected insight compared to study-oriented bespoke IE systems. SemEHR is open source, available at https://github.com/CogStack/SemEHR

Common concerns, barriers to care, and the lived experience of individuals with hepatitis B: a qualitative study.

BACKGROUND: An estimated between 257 and 292 million people live with chronic HBV globally. While much is known about the causes, and epidemiology of HBV, little is understood about the quality of life and impact of HBV on those living with the infection. METHODS: A random sample of HBV-related email queries sent to the Hepatitis B Foundation, a U.S.-based non-profit organization, over a 12-month period in 2018-2019 were retrieved, tabulated, and analyzed qualitatively to highlight information needs and explore the experiences of people living with HBV and their families and loved ones. Codebook development was informed by the literature and through line-by-line reading of a sub-sample of queries. Data analysis was facilitated by NVivo12 software. Data were coded independently by two members of the research team and intercoder reliability was assessed to assure coding accuracy throughout the coding phase. RESULTS: A total of 338 queries from people around the globe were identified and analyzed. The analysis revealed three thematic groups: 1) health-specific challenges associated with diagnosis and treatment, 2) emotional needs related to experiences with HBV stigma, discrimination, fear, social isolation, and distress and 3) informational needs related to HBV prevention and transmission, and interpretation of laboratory tests. CONCLUSIONS: People living with HBV are in need of information to manage their disease and prevent its spread. Analysis of queries uncovered significant misconceptions about HBV transmission and treatment. Additionally, the emotional and psychological impact of an HBV diagnosis on those living with the infection is significant. There is a clear need for patient and community education to expand knowledge and awareness of HBV globally to achieve 2030 WHO HBV elimination goals

Indication of endovascular treatment of type B aortic dissection -Literature review Indicação do tratamento endovascular na dissecção de aorta do tipo B -Revisão da literatura

Indication of endovascular treatment of type B aortic dissection -Literature review Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery, vol. 29, núm. 3, julio-septiembre, 2014, pp. 396-401 Sociedade Brasileira de Cirurgia Cardiovascular São José do Rio Preto, Brasil REVIEW ARTICLE Abstract Aortic dissection is a cardiovascular event of high mortality if not early diagnosed and properly treated. In Stanford type A aortic dissection, there is the involvement of the ascending aorta, whereas in type B the ascending aorta is not affected. The treatment of type A aortic dissection is mainly surgical. The hospital mortality of type B aortic dissection surgical treatment is approximately 20%, while medical therapy is 10%. However, half the patients who are discharged from hospital after medical treatment, progress to aortic complications in the following years, and the mortality in three to five years may reach 25-50%. In addition, the surgical treatment of aortic complications after medical treatment, has also a significant mortality. This way, the endovascular treatment comes up as an interesting alternative of a less invasive treatment for this disease. They presented a mortality rate lower than 10% with more than 80% success rate of occlusion and thrombosis of the false lumen. The INSTEAD TRIAL, which randomized patients with uncomplicated type B aortic dissection for optimal medical therapy and endovascular treatment in addition to optimal medical therapy, showed that after three years of follow up, patients who underwent endovascular treatment had lower mortality and aorta-related complications. Therefore, there is a current tendency to recommend the endovascular treatment as a standard for the treatment of type B aortic dissection for false lumen thrombosis. Nienaber et al. [8

IMPACTO DE LOS RECURSOS INSTRUCCIONALES APOYADOS EN REALIDAD AUMENTADA PARA EL APRENDIZAJE DE CIENCIAS NATURALES DEL TERCER GRADO DE EDUCACIÓN PRIMARIA

Esta investigación se realizó en el Grupo Escolar “La Frontera”. El objetivo de este trabajo investigación fue analizar el impacto que genera los recursos instruccionales apoyados con la tecnología de realidad aumentada para el aprendizaje de Ciencias Naturales del tercer grado de Educación Primaria, con la intensión de verificar la utilidad que tiene el mismo en el logro del proceso de aprendizajes de los estudiantes con el tema de los sentidos del cuerpo humano de las ciencias naturales.  Por tal motivo el estudio se enmarca dentro del paradigma cuantitativo bajo un estudio explicativo pre-experimental. La población objeto de este estudio estará representada por (32) estudiantes pertenecientes al tercer grado sección única. En cuanto a la muestra fue censal, por cuanto se tomó la totalidad de la población.  Para la recolección de los datos se aplicó la técnica de la observación directa y participativa aplicado a un solo grupo mediante un instrumento de recolección de datos como lo es la escala de estimación con criterios de evaluación que permitió registrar la observación de los distintos criterios en términos de presencia – ausencia, además de grado de intensidad – frecuencia con la cual se manifiestan estos criterios y sus niveles de desempeño.  El instrumento fue validado por una prueba Piloto de la cual determinaran la congruencia de los ítems. Por su parte el análisis de los resultados arrojo lo siguiente:  a) Se logo establecer una relación didáctica y tecnología mediante la práctica y el uso del recurso instruccional en el tema de los sentidos del cuerpo humano. b) Se logró percibir que los estudiantes poseen ciertos conocimientos previos en relación a los órganos de los sentidos del cuerpo humano mediante el uso del recurso instruccional

INSTRUCTIONAL DESIGN AND ASESSMENT The Development, Implementation, And Evaluation Of A Self-Assessment Instrument For Use In A Pharmacy Student Competition

Objectives. The purpose of this research was to develop, implement, and evaluate a 10-item assessment instrument for pharmacy students participating in a local Academy of Managed Care Pharmacy, Pharmacy and Therapeutics Committee competition. The instrument was designed to measure and document student perceived-learning processes and outcomes. Methods. The study used a single group posttest design with a retrospective pretest component. The self-assessment instrument was comprised of 10 assessment items and 5 open-ended questions. The Rasch rating scale model was used to evaluate data provided by the instrument. Results. The perceived outcomes from the competition in terms of student growth through participation and completion of the assessment instrument were favorable for all items. However, 3 of the 6 items administered in a retrospective pretest-posttest format became more difficult for students to endorse. Conclusions. The Competition Student Assessment Instrument provided valuable, meaningful, and reliable information about processes and learning outcomes of the competition. Student-driven competitions represent an innovation in applying student-directed activities outside the curriculum that is consistent with expected learning outcomes of the formal curriculum. It is anticipated that this assessment instrument would be useful for assessing student competitions at other schools and colleges of pharmacy

Association between sex and survival after out‐of‐hospital cardiac arrest: A systematic review and meta‐analysis

Abstract The current literature on sex differences in 30‐day survival following out‐of‐hospital cardiac arrest (OHCA) is conflicting, with 3 recent systematic reviews reporting opposing results. To address these contradictions, this systematic literature review and meta‐analysis aimed to synthesize the literature on sex differences in survival after OHCA by including only population‐based studies and through separate meta‐analyses of crude and adjusted effect estimates. MEDLINE and Embase databases were systematically searched from inception to March 23, 2022 to identify observational studies reporting sex‐specific 30‐day survival or survival until hospital discharge after OHCA. Two meta‐analyses were conducted. The first included unadjusted effect estimates of the association between sex and survival (comparing males vs females), whereas the second included effect estimates adjusted for possible mediating and/or confounding variables. The PROSPERO registration number was CRD42021237887, and the search identified 6712 articles. After the screening, 164 potentially relevant articles were identified, of which 26 were included. The pooled estimate for crude effect estimates (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.22–1.66) indicated that males have a higher chance of survival after OHCA than females. However, the pooled estimate for adjusted effect estimates shows no difference in survival after OHCA between males and females (OR, 0.93; 95% CI, 0.84–1.03). Both meta‐analyses involved high statistical heterogeneity between studies: crude pooled estimate I2 = 95.7%, adjusted pooled estimate I2 = 91.3%. There does not appear to be a difference in survival between males and females when effect estimates are adjusted for possible confounding and/or mediating variables in non‐selected populations