Towards Automatic Generation of Shareable Synthetic Clinical Notes Using Neural Language Models

Large-scale clinical data is invaluable to driving many computational scientific advances today. However, understandable concerns regarding patient privacy hinder the open dissemination of such data and give rise to suboptimal siloed research. De-identification methods attempt to address these concerns but were shown to be susceptible to adversarial attacks. In this work, we focus on the vast amounts of unstructured natural language data stored in clinical notes and propose to automatically generate synthetic clinical notes that are more amenable to sharing using generative models trained on real de-identified records. To evaluate the merit of such notes, we measure both their privacy preservation properties as well as utility in training clinical NLP models. Experiments using neural language models yield notes whose utility is close to that of the real ones in some clinical NLP tasks, yet leave ample room for future improvements.Comment: Clinical NLP Workshop 201

Anion Exchange Extraction & Separation of Pd(II) & Pt(IV) from Other Platinum Group Metals

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Emergency obstretic hysterectomy: a retrospective study in a tertiary care center

Background: Obstetric hysterectomy remains a necessity in preventing maternal mortality in catastrophic rupture of the uterus or intractable postpartum hemorrhage when all the conservative management options fail. Uterine atony followed by abnormal placentation remains the primary indication of emergency obstratic hysterectomy worldwide. In majority of cases, anticipation, prompt resuscitation and earlier surgical intervention by skilled operator will reduce patient’s morbidity and mortality. The first successful operation was performed in 1876. The main objective of the study was to study frequency, indications and fetomaternal outcome of emergency obstetric hysterectomy in tertiary care center.Methods: Observational, retrospective and analytical study was done over 2 years from January 2017 to January 2019. A total of 11 cases of emergency obstretic hysterectomy (EOH) were recorded.Results: The overall incidence was 1.47 per 1000 deliveries. Atonic postpartum hemorrhage (54%) was the most common indication followed by placenta previa (18%) and placenta accreta (9%). Second gravida were mostly involved (45%) with previous LSCS (45%) as a common risk factor in commonest age group of 20-25 years (46%) amongst them. The most frequent squeal was disseminated intravascular coagulation (45%). Maternal mortality was nil while neonatal mortality being 9%. The decision of performing total or subtotal hysterectomy along with bilateral internal iliac ligation was influenced by patient’s condition.Conclusions: Emergency obstretic hysterectomy is the most demanding obstretic surgery performed in circumstances of life threatening hemorrhages where conservative surgical modalities fail and interventional radiology is not immediately available. Antenatal anticipation of the risk factors, involvement of experienced obstetrician at the early stage of management and prompt hystrectomy after adequate rescuitation will reduce fetomaternal mortality and morbidity

Genetic variation and diversity for grain iron, zinc, protein and agronomic traits in advanced breeding lines of pearl millet [Pennisetum glaucum (L.) R. Br.] for biofortification breeding

Genetic improvements of iron (Fe) and zinc (Zn) content in pearl millet [Pennisetum glaucum (L.) R. Br.] may reduce the problems of anemia and stunted growth among millet dependent staple food consumers. The availability of variation in diversebreeding lines is essential to improve grain micronutrients in high-yielding cultivars. This study aimed to determine the extent of variability, heritability and diversity for grain Fe, Zn and protein, along with key agronomic traits, in 281 advanced breeding lines bred at ICRISAT and evaluated across two seasons (environments). A pooled analysis of variance displayed significant variation for all these traits. Highest variability was recorded for Fe (35–116 mg kg-1), Zn (21–80 mg kg-1), and protein (6–18%), and a three-fold variation was observed for panicle length, panicle girth and 1000-grain-weight (TGW). Diversity analysis showed 10 clusters. Cluster-III had maximum lines (25%) and Cluster-V showed the highest mean values for Fe, Zn, protein and TGW. These results highlight the success of breeding program that aimed both the maintenance and creation of genetic variability and diversity. A significant positive correlation among Fe, Zn, protein and TGW indicated the potential for simultaneous improvement. Grain yield had a non-significant association with Fe and Zn, while protein showed a negative correlation. These results suggest that significant variability exists in elite-breeding lines, thus highlighting an opportunity to breed for biofortified varieties without compromising on the grain yield. The lines with high Fe, Zn and protein content can be used as hybrid parents and may also help in further genetic investigations

Diagnosis-Specific Readmission Risk Prediction Using Electronic Health Data: a Retrospective Cohort Study

Background: Readmissions after hospital discharge are a common occurrence and are costly for both hospitals and patients. Previous attempts to create universal risk prediction models for readmission have not met with success. In this study we leveraged a comprehensive electronic health record to create readmission-risk models that were institution- and patient- specific in an attempt to improve our ability to predict readmission. Methods: This is a retrospective cohort study performed at a large midwestern tertiary care medical center. All patients with a primary discharge diagnosis of congestive heart failure, acute myocardial infarction or pneumonia over a two-year time period were included in the analysis. The main outcome was 30-day readmission. Demographic, comorbidity, laboratory, and medication data were collected on all patients from a comprehensive information warehouse. Using multivariable analysis with stepwise removal we created three risk disease-specific risk prediction models and a combined model. These models were then validated on separate cohorts. Results: 3572 patients were included in the derivation cohort. Overall there was a 16.2% readmission rate. The acute myocardial infarction and pneumonia readmission-risk models performed well on a random sample validation cohort (AUC range 0.73 to 0.76) but less well on a historical validation cohort (AUC 0.66 for both). The congestive heart failure model performed poorly on both validation cohorts (AUC 0.63 and 0.64). Conclusions: The readmission-risk models for acute myocardial infarction and pneumonia validated well on a contemporary cohort, but not as well on a historical cohort, suggesting that models such as these need to be continuously trained and adjusted to respond to local trends. The poor performance of the congestive heart failure model may suggest that for chronic disease conditions social and behavioral variables are of greater importance and improved documentation of these variables within the electronic health record should be encouraged

Terminal drought and a d 2 dwarfing gene affecting grain iron and zinc density in pearl millet

Pearl millet, predominantly a rainfed dryland crop, often encounters terminal drought in crop season. Grain hybrids grown in India are of medium to tall height, and majority of them are based on d2 dwarf seed-parents. Eight pairs of tall and d2 dwarf isogenic-lines, developed from two diverse composites, were evaluated under irrigated control and imposed terminal drought for two-years to examine the effect of d2 dwarfing gene and terminal drought on grain iron (Fe) and zinc (Zn) density. In general, terminal drought had a significant effect on increasing the Fe and Zn density, the d2 dwarfing gene or the linked gene block significantly decreased both micronutrients, with the magnitude of increase or decrease, respectively, dependent on the environment and genetic background of the isolines. Terminal drought has severe adverse impact on grain yield, but grains produced from such environments are likely to be more nutritious with respect to Fe and Zn density. The d2 dwarf hybrids are likely to be less nutritious than non-d2 hybrids with respect to Fe and Zn density. Whether the d2 dwarf seed parents with reduced Fe and Zn density presumably may adversely affect grain yield and micronutrient levels of even non-d2 hybrids developed on them, and this aspect merits further investigation