Automatic Extraction of Disease Risk Factors from Medical Publications

We present a novel approach to automating the identification of risk factors for diseases from medical literature, leveraging pre-trained models in the bio-medical domain, while tuning them for the specific task. Faced with the challenges of the diverse and unstructured nature of medical articles, our study introduces a multi-step system to first identify relevant articles, then classify them based on the presence of risk factor discussions and, finally, extract specific risk factor information for a disease through a question-answering model. Our contributions include the development of a comprehensive pipeline for the automated extraction of risk factors and the compilation of several datasets, which can serve as valuable resources for further research in this area. These datasets encompass a wide range of diseases, as well as their associated risk factors, meticulously identified and validated through a fine-grained evaluation scheme. We conducted both automatic and thorough manual evaluation, demonstrating encouraging results. We also highlight the importance of improving models and expanding dataset comprehensiveness to keep pace with the rapidly evolving field of medical research.Comment: BioNLP@ACL2024, 12 page

Mode of delivery in a subsequent pregnancy following previous instrumental delivery

Abstract Objective: To assess mode of subsequent delivery in women with previous instrumental vaginal delivery. Study design: In this retrospective longitudinal study we followed women who underwent instrumental delivery. The study group included all consecutive parturient women who underwent an instrumental vaginal delivery during a 24-month period (1996–1999). We then identified women who had a subsequent delivery in our center until the end of the year 2010. The control group included women who had a spontaneous vaginal delivery from the same time. Results: During the index period we had 349 consecutive successful instrumental vaginal deliveries. Of those, 125 women had a subsequent delivery in our center (35.8%). In subsequent pregnancies, the spontaneous vaginal delivery rate was 76.8% and 90.4%; the instrumental delivery rate was 8.8% and 1.6%; and the cesarean rate was 14.4% and 8.0%, in the instrumental delivery, and spontaneous vaginal delivery groups, respectively (P&lt;0.05). The odds ratio for a woman to undergo either an instrumental delivery or a cesarean after having an instrumental delivery in a previous pregnancy was 2.8 (95% confidence interval 1.4–5.9, P&lt;0.05). Conclusion: Women with a previous instrumental delivery are at an increased risk of requiring either an instrumental delivery or a cesarean section in a subsequent pregnancy compared with women with a previous spontaneous vaginal delivery.</jats:p

Routine Ankle-Brachial Index (ABI) measurement: a window into atherosclerosis and early left ventricular dysfunction in patients diagnosed with cancer

Abstract Background Cancer therapy is considered to cause accelerated ischemia. Ankle-Brachial Index (ABI) measurement is an inexpensive, simple, available test for the early diagnosis of peripheral artery disease (PAD); however, it is not performed routinely. We aimed to evaluate the role of routine ABI measurement for the diagnosis of PAD among patients diagnosed with cancer and whether it correlates with left ventricular (LV) dysfunction. Methods A retrospective, single-center study including patients diagnosed with cancer at Tel Aviv Sourasky Medical Center. The cohort included patients performing routine ABI and LV global longitudinal strain (GLS) echocardiography. The primary endpoint was the prevalence of PAD and whether it correlates with LV dysfunction, defined by LV GLS absolute value < 19%. The secondary composite endpoint evaluated the association between reduced ABI to LV dysfunction and all-cause mortality. Results Among 226 patients, PAD was diagnosed in 14 patients (6%). We revealed a positive correlation between ABI and LV GLS (r = 0.22, p < 0.01) with a reduced mean ABI score among patients with reduced LV GLS. A reduced mean ABI was observed among the positive composite endpoint group; however, it was not statistically significant (p = 0.35). Conclusions We report, for the first time to our knowledge, the routine use of ABI testing among patients diagnosed with cancer. ABI showed a significant correlation to LV GLS, implying a potential tool in the early diagnosis of atherosclerosis and cardiotoxicity. Considering its low cost and availability, future prospective trials are needed to integrate its role in routine assessment

Safety and efficacy of immune checkpoint inhibitors in patients with pre-treatment reduced left ventricular function

Abstract Aims Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment outcomes. However, the response varies across different populations, and their use may lead to life-threatening cardiovascular (CV) events. While pre-treatment reduced left ventricular ejection fraction (LVEF) is considered a marker for high-risk cardiotoxicity and a contraindication for anthracycline and HER2-targeted therapies, there is limited evidence on the safety and efficacy of ICIs therapy in patients presenting with pre-treatment reduced LVEF. The study aims to evaluate the safety and efficacy of ICIs therapy in patients with pre-treatment reduced LVEF. Methods Retrospective single center cohort of patients treated with ICIs therapy, who performed pre-treatment LVEF assessment. The primary endpoint was to evaluate the safety of ICIs among this population, assessed by CV events (composite of myocarditis, acute coronary syndrome, heart failure, and arrhythmias). The secondary endpoint was to evaluate the efficacy of ICIs, assessed by all-cause mortality and progression-free survival (PFS). Results The cohort included 307 patients, with 30 (10%) presenting with pre-treatment reduced LVEF, with a mean LVEF of 39 ± 7%. While a significantly higher incidence of CV events was observed in the reduced LVEF group (37% vs. 14%, p = 0.004), following a multivariate Cox regression analysis including baseline CV diseases and risk factors, pre-treatment reduced LVEF did not remain a significant independent predictor (p = 0.358). No significant differences were observed between the groups regarding all-cause mortality and PFS. Conclusions Pre-treatment reduced LVEF was not identified as an independent marker for clinical outcomes in patients treated with ICIs therapy

Trajectories of Key Physiological Parameters in COVID-19 Patients Using Continuous Remote Monitoring and Health AI

Abstract Coronavirus disease 2019 (COVID-19) exerts deleterious effects on the cardiorespiratory system, leading to worse prognosis in the most effected. The aim of this retrospective multi-center study was to describe the variability of key cardiopulmonary vitals amongst hospitalized COVID-19 patients, measured every 15 minutes using a novel wearable chest-monitor. A total of 492 patients were included, with &gt;3 million measurements collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. We show differential trajectories of these vital signs, apparent within the first 24hrs of monitoring. Importantly, we show for the first time that cardiovascular deterioration appears early after admission and in parallel with changes in the respiratory parameters, and identify sub-populations at high risk. Combining frequent monitoring using wearable technology with advanced big data and AI analysis tools may aid early detection of deterioration of COVID-19 patients.</jats:p

Continuous Remote Patient Monitoring Shows Early Cardiovascular Changes in COVID-19 Patients

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units. A total of 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 min. More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk. Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring

Continuous Remote Patient Monitoring Shows Early Cardiovascular Changes in COVID-19 Patients

COVID-19 exerts deleterious cardiopulmonary effects, leading to a worse prognosis in the most affected. This retrospective multi-center observational cohort study aimed to analyze the trajectories of key vitals amongst hospitalized COVID-19 patients using a chest-patch wearable providing continuous remote patient monitoring of numerous vital signs. The study was conducted in five COVID-19 isolation units. A total of 492 COVID-19 patients were included in the final analysis. Physiological parameters were measured every 15 min. More than 3 million measurements were collected including heart rate, systolic and diastolic blood pressure, cardiac output, cardiac index, systemic vascular resistance, respiratory rate, blood oxygen saturation, and body temperature. Cardiovascular deterioration appeared early after admission and in parallel with changes in the respiratory parameters, showing a significant difference in trajectories within sub-populations at high risk. Early detection of cardiovascular deterioration of COVID-19 patients is achievable when using frequent remote patient monitoring.</jats:p