Optimizing critical illness outcomes through the family experience-A theoretical review

An estimated six to eight million patients are admitted to the intensive care unit (ICU) in the United States every year [1, 2]. It is possible that new and innovative medical therapies have provided patients with treatment options that enhance survival of a critical illness and allow them go home with more medical support than previously available in earlier years. This may explain why there are now millions of ICU survivors are a result of declining mortality rates (8-19%) even though there are increased ICU admissions [3, 4]. This also indicates a change in direction of the attitudes and beliefs of the family unit today and their desire for the family member to return home after critical illness instead of moving to a tertiary facility for care

NLP meets psychotherapy: Using predicted client emotions and self-reported client emotions to measure emotional coherence

Emotions are experienced and expressed through various response systems. Coherence between emotional experience and emotional expression is considered important to clients' well being. To date, emotional coherence (EC) has been studied at a single time point using lab-based tasks with relatively small datasets. No study has examined EC between the subjective experience of emotions and emotion expression in therapy or whether this coherence is associated with clients' well being. Natural language Processing (NLP) approaches have been applied to identify emotions from psychotherapy dialogue, which can be implemented to study emotional processes on a larger scale. However, these methods have yet to be used to study coherence between emotional experience and emotional expression over the course of therapy and whether it relates to clients' well-being. This work presents an end-to-end approach where we use emotion predictions from our transformer based emotion recognition model to study emotional coherence and its diagnostic potential in psychotherapy research. We first employ our transformer based approach on a Hebrew psychotherapy dataset to automatically label clients' emotions at utterance level in psychotherapy dialogues. We subsequently investigate the emotional coherence between clients' self-reported emotional states and our model-based emotion predictions. We also examine the association between emotional coherence and clients' well being. Our findings indicate a significant correlation between clients' self-reported emotions and positive and negative emotions expressed verbally during psychotherapy sessions. Coherence in positive emotions was also highly correlated with clients well-being. These results illustrate how NLP can be applied to identify important emotional processes in psychotherapy to improve diagnosis and treatment for clients suffering from mental-health problems.Comment: Accepted at Empowering Communities: A Participatory Approach to AI for Mental Health, NeurIPS 2022 VIRTUAL Worksho

Do Ask, Do Tell: High Levels of Acceptability by Patients of Routine Collection of Sexual Orientation and Gender Identity Data in Four Diverse American Community Health Centers

Background: The Institute of Medicine and The Joint Commission have recommended asking sexual orientation and gender identity (SOGI) questions in clinical settings and including such data in Electronic Health Records (EHRs). This is increasingly viewed as a critical step toward systematically documenting and addressing health disparities affecting lesbian, gay, bisexual, and transgender (LGBT) people. The U.S. government is currently considering whether to include SOGI data collection in the Stage 3 guidelines for the incentive program promoting meaningful use of EHR. However, some have questioned whether acceptable standard measures to collect SOGI data in clinical settings exist. Methods: In order to better understand how a diverse group of patients would respond if SOGI questions were asked in primary care settings, 301 randomly selected patients receiving primary care at four health centers across the U.S. were asked SOGI questions and then asked follow-up questions. This sample was mainly heterosexual, racially diverse, and geographically and regionally broad. Results: There was a strong consensus among patients surveyed about the importance of asking SOGI questions. Most of the LGBT respondents thought that the questions presented on the survey allowed them to accurately document their SOGI. Most respondents—heterosexual and LGBT—answered the questions, and said that they would answer such questions in the future. While there were some age-related differences, respondents of all ages overwhelmingly expressed support for asking SOGI questions and understood the importance of providers' knowing their patients' SOGI. Conclusions: Given current deliberations within national health care regulatory bodies and the government's increased attention to LGBT health disparities, the finding that patients can and will answer SOGI questions has important implications for public policy. This study provides evidence that integrating SOGI data collection into the meaningful use requirements is both acceptable to diverse samples of patients, including heterosexuals, and feasible

HUD feedback to minimize the risk of cellular phone use and number entry while driving

There has been considerable public debate as to whether people should be allowed to use cell phones while driving. In several countries, this debate has led to restrictions on cell phone use while driving. Japanese data suggests that answering a call might be the most dangerous task, followed by dialing. Several questions were therefore selected for further investigation. 1. How does the dialing device and its location affect task time, errors, driving performance, and ratings of workload? 2. How does the location of the display (especially head-up displays) affect those same measures? 3. For various control-display combinations, how are those measures affected by driving workload? The experiment will be comprised of two distinct portions. In the first portion, subjects will drive a simulator on straight roads (implying controlled workload) while dialing a 10-digit telephone number using 6 device configurations with various displays. During the second test portion, participants will drive a simulator on roads with curves of different radii while entering phone numbers for 3 different device combinations. The following device/location configurations will be examined: (1) 10-key keypad on the steering wheel spoke, (2) 10-key keypad on the center console, (3) joystick on the steering wheel spoke, (4) joystick mounted on the center console, (5) hand held 10- key keypad, (6) a cross key on the touch screen, and (7) a 10 key keypad on the touch screen. These devices will be used for 3 display conditions: (1) head up display, (2) monitor mounted in the center console, or (3) no display.Nissan Research Centerhttp://deepblue.lib.umich.edu/bitstream/2027.42/92345/1/102881.pd

Lelek's problem is not a metric problem

We show that Lelek's problem on the chainability of continua with span zero is not a metric problem: from a non-metric counterexample one can construct a metric one.Comment: Final version as sent to edito

The dose–response effect of insulin sensitivity on albuminuria in children according to diabetes type

Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases

Experiences from treating seven adult 5q spinal muscular atrophy patients with Nusinersen

Background: The antisense oligonucleotide Nusinersen recently became the first approved drug against spinal muscular atrophy (SMA). It was approved for all ages, albeit the clinical trials were conducted exclusively on children. Hence, clinical data on adults being treated with Nusinersen is scarce. In this case series, we report on drug application, organizational demands, and preliminary effects during the first 10 months of treatment with Nusinersen in seven adult patients. Methods: All patients received intrathecal injections with Nusinersen. In cases with severe spinal deformities, we performed computed tomography (CT)-guided applications. We conducted a total of 40 administrations of Nusinersen. We evaluated the patients with motor, pulmonary, and laboratory assessments, and tracked patient-reported outcome. Results: Intrathecal administration of Nusinersen was successful in most patients, even though access to the lumbar intrathecal space in adults with SMA is often challenging. No severe adverse events occurred. Six of the seven patients reported stabilization of motor function or reduction in symptom severity. The changes in the assessed scores did not reach a significant level within this short time period. Conclusions: Treating adult SMA patients with Nusinersen is feasible and most patients consider it beneficial. It demands a complex organizational and interdisciplinary effort. Due to the slowly decreasing motor functions in adult SMA patients, long observation phases for this recently approved treatment are needed to allow conclusions about effectiveness of Nusinersen in adults