Extracting clinical knowledge from electronic medical records

As the adoption of Electronic Medical Records (EMRs) rises in the healthcare institutions, these resources' importance increases because of the clinical information they contain about patients. However, the unstructured information in the form of clinical narratives present in those records, makes it hard to extract and structure useful clinical knowledge. This unstructured information limits the potential of the EMRs, because the clinical information these records contain can be used to perform important tasks inside healthcare institutions such as searching, summarization, decision support and statistical analysis, as well as be used to support management decisions or serve for research. These tasks can only be done if the unstructured clinical information from the narratives is properly extracted, structured and transformed in clinical knowledge. Usually, this extraction is made manually by healthcare practitioners, which is not efficient and is error-prone. This research uses Natural Language Processing (NLP) and Information Extraction (IE) techniques, in order to develop a pipeline system that can extract clinical knowledge from unstructured clinical information present in Portuguese EMRs, in an automated way, in order to help EMRs to fulfil their potential.info:eu-repo/semantics/publishedVersio

Intravenous ibandronate in men with osteoporosis: An open pilot study over 2 years

In the treatment of osteoporosis, the tolerance of oral bisphosphonates is often low. The high potency of ibandronate allows iv bolus injections that can be repeated every 2 to 3 months. However, the best dose and time interval of the treatment with iv ibandronate is still debated. Efficacy of 2-mg ibandronate injected every 3 months was tested in men with osteoporosis over 2 yr, in a prospective, open study. Fourteen men with primary osteoporosis, mean age 57±12 yr (range: 40-73), received 2-mg ibandronate iv every 3 months over 2 yr. All got 1 g/day calcium and 880 UI/day vitamin D for 2 yr. Bone mineral density (BMD) increased after 2 yr by 6.7±1.5% (mean change±SEM) at lumbar spine (p<0.001), by 3.2±08% at trochanter (p<0.001) and by 1.4±1.1% at femoral neck (ns). Serum ß-crosslaps and osteocalcin decreased significantly by 30-45 and 30%, respectively, during the 2 yr of treatment. Serum calcium increased from the lower to the middle tertile of the normal range during the 2 yr of the study. The observed decrease of bone remodelling and the increase of BMD are of the same magnitude as those described with oral bisphosphonates. The increase of plasma calcium confirms the positive effect of the supplementation with calcium and vitamin D. These results suggest that 3 months are a good interval between two doses of iv ibandronate, when 2 mg are give

Extracting clinical information from electronic medical records

As the adoption of Electronic Medical Records (EMRs) rises in the healthcare institutions, these resources are each day more important because of the clinical data they contain about patients. However, the unstructured textual data in the form of narrative present in those records, makes it hard to extract and structure useful clinical information. This unstructured text limits the potential of the EMRs, because the clinical data these records contain, can be used to perform important operations inside healthcare institutions such as searching, summarization, decision support and statistical analysis, as well as be used to support management decisions or serve for research. These operations can only be done if the clinical data from the narratives is properly extracted and structured. Usually this extraction is made manually by healthcare practitioners, what is not efficient and is error-prone. The present work uses Natural Language Processing (NLP) and Information Extraction(IE) techniques in order to develop a pipeline system that can extract clinical information directly from unstructured texts present in Portuguese EMRs, in an automated way, in order to help EMRs to fulfil their potential.info:eu-repo/semantics/acceptedVersio

Normal subgroups in the Cremona group (long version)

Let k be an algebraically closed field. We show that the Cremona group of all birational transformations of the projective plane P^2 over k is not a simple group. The strategy makes use of hyperbolic geometry, geometric group theory, and algebraic geometry to produce elements in the Cremona group that generate non trivial normal subgroups.Comment: With an appendix by Yves de Cornulier. Numerous but minors corrections were made, regarding proofs, references and terminology. This long version contains detailled proofs of several technical lemmas about hyperbolic space

Characterization of the Subsurface of 67P/Churyumov-Gerasimenko's Abydos Site

We investigate the structure of the subsurface of the Abydos site using a cometary nucleus model with parameters adapted to comet 67P/Churyumov-Gerasimenko and the Abydos landing site. We aim to compare the production rates derived from our model with those of the main molecules measured by Ptolemy. This will allow us to retrieve the depths at which the different molecules still exist in solid form

'I-V Characteristic and Crystal Structural Of a-As/c-Si Heterojunctions

In this research the a-As flims have been prepared by thermal evaporation with thickness 250 nm and rata of deposition r_d(1.04nm/sec) as function to annealing temperature (373 and 473K), from XRD analysis we can see that the degree of crystalline increase with T_a, and I-V characteristic for dark and illumination shows that forward bias current varieties approximately exponentially with voltage bias. Also we found that the quality factor and saturation current dependence on annealing temperatures

Ionization Quenching Factor Measurement of Helium 4

The ionization quenching factor (IQF) is defined as the fraction of energy released by a recoil in a medium through ionization compared with its total kinetic energy. At low energies, in the range of a few keV, the ionization produced in a medium falls rapidly and systematic measurements are needed. We report measurements carried out at such low energies as a function of the pressure in He4 at 350, 700, 1000 and 1300 mbar. In order to produce a nucleus moving with a controlled energy in the detection volume, we have developed an Electron Cyclotron Resonance Ion Source (ECRIS) coupled to an ionization chamber by a differential pumping. The quenching factor of He4 has been measured for the first time down to 1 keV recoil energies. An important deviation with respect to the phenomenological calculations has been found allowing an estimation of the scintillation produced in He4 as a function of pressure. The variation of the IQF as a function of the percentage of isobutane, used as quencher, is also presented

Oral health and nutritional characteristics of adults with morbid obesity: a multivariate analysis.

The relationship between oral health and nutritional aspects are complex, especially in individuals with chronic diseases and comorbidities, such as morbid obesity. Thus, the aim of the present study was to identify oral health and nutritional-related patterns in 113 individuals, aged 19–68 years (92 females), seeking treatment for morbid obesity. Sociodemographic variables and medical records were examined, in addition to the consumption of fruit, vegetables, candies, and processed foods. Measures of body mass index, neck, waist and hip, caries experience (DMFT index), Community Periodontal Index (CPI index), and salivary physicochemical aspects were gathered. Aspects of oral health-related quality of life and symptoms of dry mouth were evaluated by means of Oral Health Impact Profile (OHIP-14) and Xerostomia Inventory-XI questionnaires. K-means cluster analysis and, subsequently, comparisons between clusters (one-way ANOVA) were performed (α = 5%). Three clusters were generated: Cluster 1 (labeled “Young”; n = 77) was characterized by younger participants with higher BMI, who reported the use of distractors while eating, the smallest number of meals/day, and who consumed sweetened drinks and processed food the day before. Cluster 2 (labeled “Diabetic individuals”; n = 12) was characterized by older participants with the highest proportion of diabetic participants (100% were diabetic; 73% insulin users), lower BMI, higher DMFT index and OHIP-14 and xerostomia scores, and who reported having consumed fruit and vegetables the day before. Finally, Cluster 3 (labeled “Poor periodontal health”; n = 24) was characterized by participants with the worse periodontal condition (higher CPI), and lower salivary flow, pH, and buffer capacity. Cluster 1 and 2 were the groups that showed higher demand for nutritional and dietetic counseling, because of the poor eating behavior and higher serum glucose levels, respectively. On the other hand, Cluster 2 and 3 showed the higher demand for oral rehabilitation and dental treatment because of the loss of teeth and worse periodontal condition, respectively, besides the need for dietetic counseling. This sample of individuals with morbid obesity showed very unique oral-health and nutritional characteristics and special needs patterns that should be identified to adjust or change unhealthy habits, thus improving the assistance of this condition

An evaluation of 14C age relationships between co-occurring foraminifera, alkenones, and total organic carbon in continental margin sediments

Author Posting. © American Geophysical Union, 2005. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography 20 (2005): PA1016, doi:10.1029/2004PA001103.Radiocarbon age relationships between co-occurring planktic foraminifera, alkenones and total organic carbon in sediments from the continental margins of Southern Chile, Northwest Africa and the South China Sea were compared with published results from the Namibian margin. Age relationships between the sediment components are site-specific and relatively constant over time. Similar to the Namibian slope, where alkenones have been reported to be 1000 to 4500 years older than co-occurring foraminifera, alkenones were significantly (~1000 yrs) older than co-occurring foraminifera in the Chilean margin sediments. In contrast, alkenones and foraminifera were of similar age (within 2σ error or better) in the NW African and South China Sea sediments. Total-organic-matter and alkenone ages were similar off Namibia (age difference TOC-alkenones: 200-700 years), Chile (100-450 years), and NW Africa (360-770 years), suggesting minor contributions of pre-aged terrigenous material. In the South China Sea total organic carbon is significantly (2000-3000 yrs) older due to greater inputs of pre-aged terrigenous material. Age offsets between alkenones and planktic foraminifera are attributed to lateral advection of organic matter. Physical characteristics of the depositional setting, such as sea-floor morphology, shelf width, and sediment composition, may control the age of co-occurring 2 sediment components. In particular, offsets between alkenones and foraminifera appear to be greatest in deposition centers in morphologic depressions. Aging of organic matter is promoted by transport. Age offsets are correlated with organic richness, suggesting that formation of organic aggregate is a key process.GM and MK acknowledge financial support from the WHOI postdoctoral scholarship program. This work was funded by NSF grant OCE-0327405