A cost minimisation analysis of a telepaediatric otolaryngology service

Background: Paediatric ENT services in regional areas can be provided through telemedicine (tele-ENT) using videoconferencing or with a conventional outpatient department ENT service (OPD-ENT) in which patients travel to see the specialist. The objective of this study was to identify the least-cost approach to providing ENT services for paediatric outpatients

Influence of water chemical and environmental parameters on larval mosquito dynamics in tires

The community structure of mosquito larvae (Diptera: Culicidae) in discarded tires from an 8-ha tire yard was examined in relation to environmental and water chemical parameters. Shaded tires contained over three times as many larvae as sun-exposed tires. Sun-exposed tires were dominated by Aedes atropalpus (Coquillett) (52%). Aedes triseriatus (Say) (24%), and Culex restuans Theobald (18%), whereas A. triseriatus alone accounted for 89% of the total larvae is shaded tires. The oviposition rate of A. triseriatus was 30 times higher in shaded areas than in exposed areas. Significants differences were found between exposed and shaded tires for 12 of 14 environmental variables. Densities of three mosquito species were significantly correlated with levels of ammonia, color and tubidity of water in tires. Oviposition preferences, the spacial distribution of tires, and water quality regulate larval mosquito dynamics in tire yards

An Intelligent Listening Framework for Capturing Encounter Notes from a Doctor-Patient Dialog

Background: Capturing accurate and machine-interpretable primary data from clinical encounters is a challenging task, yet critical to the integrity of the practice of medicine. We explore the intriguing possibility that technology can help accurately capture structured data from the clinical encounter using a combination of automated speech recognition (ASR) systems and tools for extraction of clinical meaning from narrative medical text. Our goal is to produce a displayed evolving encounter note, visible and editable (using speech) during the encounter. Results: This is very ambitious, and so far we have taken only the most preliminary steps. We report a simple proof-of-concept system and the design of the more comprehensive one we are building, discussing both the engineering design and challenges encountered. Without a formal evaluation, we were encouraged by our initial results. The proof-of-concept, despite a few false positives, correctly recognized the proper category of single-and multi-word phrases in uncorrected ASR output. The more comprehensive system captures and transcribes speech and stores alternative phrase interpretations in an XML-based format used by a text-engineering framework. It does not yet use the framework to perform the language processing present in the proof-of-concept. Conclusion: The work here encouraged us that the goal is reachable, so we conclude with proposed next steps. Some challenging steps include acquiring a corpus of doctor-patient conversations, exploring a workable microphone setup, performing user interface research, and developing a multi-speaker version of our tools.National Library of Medicine (U.S.) (grant T15 LM07117)National Library of Medicine (U.S.) (grant R01 LM009723-01A1