62 research outputs found
Detecting of a Patient's Condition From Clinical Narratives Using Natural Language Representation
The rapid progress in clinical data management systems and artificial
intelligence approaches enable the era of personalized medicine. Intensive care
units (ICUs) are the ideal clinical research environment for such development
because they collect many clinical data and are highly computerized
environments. We designed a retrospective clinical study on a prospective ICU
database using clinical natural language to help in the early diagnosis of
heart failure in critically ill children. The methodology consisted of
empirical experiments of a learning algorithm to learn the hidden
interpretation and presentation of the French clinical note data. This study
included 1386 patients' clinical notes with 5444 single lines of notes. There
were 1941 positive cases (36 % of total) and 3503 negative cases classified by
two independent physicians using a standardized approach. The multilayer
perceptron neural network outperforms other discriminative and generative
classifiers. Consequently, the proposed framework yields an overall
classification performance with 89 % accuracy, 88 % recall, and 89 % precision.
Furthermore, a generative autoencoder learning algorithm was proposed to
leverage the sparsity reduction that achieved 91% accuracy, 91% recall, and 91%
precision. This study successfully applied learning representation and machine
learning algorithms to detect heart failure from clinical natural language in a
single French institution. Further work is needed to use the same methodology
in other institutions and other languages.Comment: Submitting to IEEE Transactions on Biomedical Engineering. arXiv
admin note: text overlap with arXiv:2104.0393
Head and thorax elevation prevents the rise of intracranial pressure during extracorporeal resuscitation in swine
Aim: Head and thorax elevation during cardiopulmonary resuscitation improves cerebral hemodynamics
and ultimate neurological outcome after cardiac arrest. Its effect during extracorporeal cardiopulmonary resuscitation
(E-CPR) is unknown. We tested whether this procedure could improve hemodynamics in swine treated by E-CPR.
Methods and Results: Pigs were anesthetized and submitted to 15 minutes of untreated ventricular fibrillation followed
by E-CPR. Animals randomly remained in flat position (flat group) or underwent head and thorax elevation since E-CPR
institution (head-up group). Electric shocks were delivered after 30 minutes until the return of spontaneous circulation (ROSC).
They were followed during 120 minutes after ROSC. After 30 minutes of E-CPR, ROSC was achieved in all animals, with no difference regarding blood pressure, heart rate, and extracorporeal membrane of oxygenation flow among groups. The head-up
group had an attenuated increase in ICP as compared with the flat group after cardiac arrest (13 ± 1 vs. 26 ± 2 mm Hg at the
end of the follow-up, respectively). Cerebral perfusion pressure tended to be higher in the head-up versus flat group despite
not achieving statistical difference (66 ± 1 vs 46 ± 1 mm Hg at the end of the follow-up). Carotid blood flow and cerebral oxygen
saturation were not significantly different among groups. Conclusion: During E-CPR, head and thorax elevation prevents ICP
increase. Whether it could improve the ultimate neurological outcome in this situation deserves further investigation.The study was supported by grants LIVE-RESP and AREG-SHOCK from Agence Nationale pour la Recherche. Y. Levy was supported by ADEREMVeterinari
Executive Summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2)
OBJECTIVES: We sought to update our 2015 work in the Second Pediatric Acute Lung Injury Consensus Conference (PALICC-2) guidelines for the diagnosis and management of pediatric acute respiratory distress syndrome (PARDS), considering new evidence and topic areas that were not previously addressed. DESIGN: International consensus conference series involving 52 multidisciplinary international content experts in PARDS and four methodology experts from 15 countries, using consensus conference methodology, and implementation science. SETTING: Not applicable. PATIENTS: Patients with or at risk for PARDS. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eleven subgroups conducted systematic or scoping reviews addressing 11 topic areas: 1) definition, incidence, and epidemiology; 2) pathobiology, severity, and risk stratification; 3) ventilatory support; 4) pulmonary-specific ancillary treatment; 5) nonpulmonary treatment; 6) monitoring; 7) noninvasive respiratory support; 8) extracorporeal support; 9) morbidity and long-term outcomes; 10) clinical informatics and data science; and 11) resource-limited settings. The search included MEDLINE, EMBASE, and CINAHL Complete (EBSCOhost) and was updated in March 2022. Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to summarize evidence and develop the recommendations, which were discussed and voted on by all PALICC-2 experts. There were 146 recommendations and statements, including: 34 recommendations for clinical practice; 112 consensus-based statements with 18 on PARDS definition, 55 on good practice, seven on policy, and 32 on research. All recommendations and statements had agreement greater than 80%. CONCLUSIONS: PALICC-2 recommendations and consensus-based statements should facilitate the implementation and adherence to the best clinical practice in patients with PARDS. These results will also inform the development of future programs of research that are crucially needed to provide stronger evidence to guide the pediatric critical care teams managing these patients.</p
Detection of nitrogen flow condensation onset in a hypersonic wind tunnel using a static pressure probe
info:eu-repo/semantics/publishe
Experimental Characterization of Hypersonic Nozzle Boundary Layers and Free-Stream Noise Levels
info:eu-repo/semantics/publishe
Design of static pressure probes for improved free-stream characterization in hypersonic wind tunnels
info:eu-repo/semantics/publishe
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