123 research outputs found
Development and Validation of eRADAR: A Tool Using EHR Data to Detect Unrecognized Dementia.
ObjectivesEarly recognition of dementia would allow patients and their families to receive care earlier in the disease process, potentially improving care management and patient outcomes, yet nearly half of patients with dementia are undiagnosed. Our aim was to develop and validate an electronic health record (EHR)-based tool to help detect patients with unrecognized dementia (EHR Risk of Alzheimer's and Dementia Assessment Rule [eRADAR]).DesignRetrospective cohort study.SettingKaiser Permanente Washington (KPWA), an integrated healthcare delivery system.ParticipantsA total of 16 665 visits among 4330 participants in the Adult Changes in Thought (ACT) study, who undergo a comprehensive process to detect and diagnose dementia every 2 years and have linked KPWA EHR data, divided into development (70%) and validation (30%) samples.MeasurementsEHR predictors included demographics, medical diagnoses, vital signs, healthcare utilization, and medications within the previous 2 years. Unrecognized dementia was defined as detection in ACT before documentation in the KPWA EHR (ie, lack of dementia or memory loss diagnosis codes or dementia medication fills).ResultsOverall, 1015 ACT visits resulted in a diagnosis of incident dementia, of which 498 (49%) were unrecognized in the KPWA EHR. The final 31-predictor model included markers of dementia-related symptoms (eg, psychosis diagnoses, antidepressant fills), healthcare utilization pattern (eg, emergency department visits), and dementia risk factors (eg, cerebrovascular disease, diabetes). Discrimination was good in the development (C statistic = .78; 95% confidence interval [CI] = .76-.81) and validation (C statistic = .81; 95% CI = .78-.84) samples, and calibration was good based on plots of predicted vs observed risk. If patients with scores in the top 5% were flagged for additional evaluation, we estimate that 1 in 6 would have dementia.ConclusionThe eRADAR tool uses existing EHR data to detect patients with good accuracy who may have unrecognized dementia. J Am Geriatr Soc 68:103-111, 2019
Vascular Flora of Hooper Branch Savanna Nature Preserve, Iroquois County, Illinois
INHS Technical Report prepared for Illinois Department of Natural Resources, Division of
Natural Heritag
The Relationship of Age to Personal Network Size, Relational Multiplexity, and Proximity to Alters in the Western United States
Objectives. This study examines the association of age and other sociodemographic variables with properties of personal networks; using samples of individuals residing in the rural western United States and the City of Los Angeles, we evaluate the degree to which these associations vary with geographical context. For both samples, we test the hypothesis that age is negatively associated with network size (i.e., degree) and positively associated with network multiplexity (the extent of overlap) on 6 different relations: core discussion members, social activity participants, emergency contacts, neighborhood safety contacts, job informants, and kin. We also examine the relationship between age and spatial proximity to alters. Method. Our data consist of a large-scale, spatially stratified egocentric network survey containing information about respondents and those to whom they are tied. We use Poisson regression to test our hypothesis regarding degree while adjusting for covariates, including education, gender, race, and self-reported sense of neighborhood belonging. We use multiple linear regression to test our hypotheses on multiplexity and distance to alters. Results. For both rural and urban populations, we find a nonmonotone association between age and numbers of core discussants and emergency contacts, with rural populations also showing nonmonotone associations for social activity partners and kin. These nonmonotone relationships show a peak in expected degree at midlife, followed by an eventual decline. We find a decline in degree among the elderly for all relations in both populations. Age is positively associated with distance to nonhousehold alters for the rural population, although residential tenure is associated with shorter ego-alter distances in both rural and urban settings. Additionally, age is negatively associated with network multiplexity for both populations. Discussion. Although personal network size ultimately declines with age, we find that increases for some relations extend well into late-midlife and most elders still maintain numerous contacts across diverse relations. The evidence we present suggests that older people tap into an wider variety of different network members for different types of relations than do younger people. This is true even for populations in rural settings, for whom immediate access to potential alters is more limited
Extragalactic magnetism with SOFIA (SALSA Legacy Program) -- V: First results on the magnetic field orientation of galaxies
We present the analysis of the magnetic field (-field) structure of
galaxies measured with far-infrared (FIR) and radio (3 and 6 cm) polarimetric
observations. We use the first data release of the Survey on extragALactic
magnetiSm with SOFIA (SALSA) of 14 nearby ( Mpc) galaxies with resolved (5
arcsec-18 arcsec; pc-- kpc) imaging polarimetric observations using
HAWC+/SOFIA from to \um. We compute the magnetic pitch angle
() profiles as a function of the galactrocentric radius. We introduce
a new magnetic alignment parameter () to estimate the
disordered-to-ordered -field ratio in spiral -fields. We find FIR and
radio wavelengths to not generally trace the same -field morphology in
galaxies. The profiles tend to be more ordered with galactocentric
radius in radio () than in FIR
(). For spiral galaxies, FIR -fields
are \% more turbulent than the radio -fields. For starburst galaxies,
we find that FIR polarization is a better tracer of the -fields along the
galactic outflows than radio polarization. Our results suggest that the
-fields associated with dense, dusty, turbulent star-forming regions, those
traced at FIR, are less ordered than warmer, less-dense regions, those traced
at radio, of the interstellar medium. The FIR -fields seem to be more
sensitive to the activity of the star-forming regions and the morphology of the
molecular clouds within a vertical height of few hundred pc in the disk of
spiral galaxies than the radio -fields.Comment: 26 pages, 13 figure
Front Pharmacol
Drug misuse may happen when patients do not follow the prescriptions and do actions which lead to potentially harmful situations, such as intakes of incorrect dosage (overuse or underuse) or drug use for indications different from those prescribed. Although such situations are dangerous, patients usually do not report the misuse of drugs to their physicians. Hence, other sources of information are necessary for studying these issues. We assume that online health fora can provide such information and propose to exploit them. The general purpose of our work is the automatic detection and classification of drug misuses by analysing user-generated data in French social media. To this end, we propose a multi-step method, the main steps of which are: (1) indexing of messages with extended vocabulary adapted to social media writing; (2) creation of typology of drug misuses; and (3) automatic classification of messages according to whether they contain drug misuses or not. We present the results obtained at different steps and discuss them. The proposed method permit to detect the misuses with up to 0.773 F-measure
Capabilities, Performance, and Status of the SOFIA Science Instrument Suite
The Stratospheric Observatory for Infrared Astronomy (SOFIA) is an airborne observatory, carrying a 2.5 m telescope onboard a heavily modified Boeing 747SP aircraft. SOFIA is optimized for operation at infrared wavelengths, much of which is obscured for ground-based observatories by atmospheric water vapor. The SOFIA science instrument complement consists of seven instruments: FORCAST (Faint Object InfraRed CAmera for the SOFIA Telescope), GREAT (German Receiver for Astronomy at Terahertz Frequencies), HIPO (High-speed Imaging Photometer for Occultations), FLITECAM (First Light Infrared Test Experiment CAMera), FIFI-LS (Far-Infrared Field-Imaging Line Spectrometer), EXES (Echelon-Cross-Echelle Spectrograph), and HAWC (High-resolution Airborne Wideband Camera). FORCAST is a 540 m imager with grism spectroscopy, developed at Cornell University. GREAT is a heterodyne spectrometer providing high-resolution spectroscopy in several bands from 60240 m, developed at the Max Planck Institute for Radio Astronomy. HIPO is a 0.31.1 m imager, developed at Lowell Observatory. FLITECAM is a 15 m wide-field imager with grism spectroscopy, developed at UCLA. FIFI-LS is a 42210 m integral field imaging grating spectrometer, developed at the University of Stuttgart. EXES is a 528 m high-resolution spectrograph, developed at UC Davis and NASA ARC. HAWC is a 50240 m imager, developed at the University of Chicago, and undergoing an upgrade at JPL to add polarimetry capability and substantially larger GSFC detectors. We describe the capabilities, performance, and status of each instrument, highlighting science results obtained using FORCAST, GREAT, and HIPO during SOFIA Early Science observations conducted in 2011
Explanatory pluralism in the medical sciences: theory and practice
Explanatory pluralism is the view that the best form and level of explanation depends on the kind of question one seeks to answer by the explanation, and that in order to answer all questions in the best way possible, we need more than one form and level of explanation. In the first part of this article, we argue that explanatory pluralism holds for the medical sciences, at least in theory. However, in the second part of the article we show that medical research and practice is actually not fully and truly explanatory pluralist yet. Although the literature demonstrates a slowly growing interest in non-reductive explanations in medicine, the dominant approach in medicine is still methodologically reductionist. This implies that non-reductive explanations often do not get the attention they deserve. We argue that the field of medicine could benefit greatly by reconsidering its reductive tendencies and becoming fully and truly explanatory pluralist. Nonetheless, trying to achieve the right balance in the search for and application of reductive and non-reductive explanations will in any case be a difficult exercise
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