Random forest machine learning method outperforms prehospital National Early Warning Score for predicting one-day mortality : A retrospective study

Aim of the study: The National Early Warning Score (NEWS) is a validated method for predicting clinical deterioration in hospital wards, but its performance in prehospital settings remains controversial. Modern machine learning models may outperform traditional statistical analyses for predicting short-term mortality. Thus, we aimed to compare the mortality prediction accuracy of NEWS and random forest machine learning using prehospital vital signs. Methods: In this retrospective study, all electronic ambulance mission reports between 2008 and 2015 in a single EMS system were collected. Adult patients (>= 18 years) were included in the analysis. Random forest models with and without blood glucose were compared to the traditional NEWS for predicting one-day mortality. A ten-fold cross-validation method was applied to train and validate the random forest models. Results: A total of 26,458 patients were included in the study of whom 278 (1.0%) died within one day of ambulance mission. The area under the receiver operating characteristic curve for one-day mortality was 0.836 (95% CI, 0.810-0.860) for NEWS, 0.858 (95% CI, 0.832-0.883) for a random forest trained with NEWS variables only and 0.868 (0.843-0.892) for a random forest trained with NEWS variables and blood glucose. Conclusion: A random forest algorithm trained with NEWS variables was superior to traditional NEWS for predicting one-day mortality in adult prehospital patients, although the risk of selection bias must be acknowledged. The inclusion of blood glucose in the model further improved its predictive performance.Peer reviewe

Treatment Patterns and Outcomes in a Cohort of Finnish NSCLC Patients with ALK Rearrangement Reflect Rapid Evolution in Treatment Practices

Background: In Finland approximately 2,500 people are diagnosed with lung cancer annually. A small proportion of non-small cell lung cancer (NSCLC) patients (3–7%) have tumorigenic rearrangement of the anaplastic lymphoma kinase (ALK) gene (ALK-positive). ALK tyrosine kinase inhibitors (TKI) are the standard of care for these patients, showing superior efficacy compared to traditional chemotherapy (CT). Due to the rapid development of novel next-generation ALK TKIs, treatment practices have undergone substantial changes. In Finnish real-life clinical practice the choice of treatment is largely determined by the reimbursement status of available drugs. We set out to assess the prevailing treatment practices and outcomes for NSCLC patients harbouring ALK rearrangement. Materials and methods: This was a retrospective, non-interventional, two-centre study. Adult NSCLC patients from the Hospital District of Southwest Finland and ALK-positive NSCLC patients from the Hospital District of Helsinki and Uusimaa diagnosed between 2013–2017 were included. Patients were followed until death or until the end of study period (May 2018). Data were extracted retrospectively from electronic health records from University Hospital data lakes. Results: A total of 1,260 patients were included, of which 60 were ALK-positive. ALK TKI regimens were mainly received in second and later lines of treatment. Median time-to-next treatment (TTNT) during ALK TKI treatment was 11.0 months (95% CI; 5.0–35.0) and during CT treatment 7.0 months (5.0–11.0) when assessed irrespective of treatment line (p=0.08). Patients who received at least one ALK TKI treatment regimen during the follow-up had median overall survival (OS) of 33.6 months (16.9–NR) from diagnosis vs. 11.5 months (4.6–NR) in patients who were treated with CT regimens only (p=0.054). Conclusions: ALK-positive patients benefit from treatment with ALK targeting agents in real-world clinical practice. </p

The added impact of parenting education in early childhood education programs: A meta-analysis

Many early childhood education (ECE) programs seek to enhance parents’ capacities to support their children's development. Using a meta-analytic database of 46 studies of ECE programs that served children age three to five-years-old, we examine the benefits to children's cognitive and pre-academic skills of adding parenting education to ECE programs for children and consider the differential impacts of: 1) parenting education programs of any type; 2) parenting education programs that provided parents with modeling of or opportunities to practice stimulating behaviors and 3) parenting education programs that were delivered through intensive home visiting. The results of the study call into question some general longstanding assertions regarding the benefits of including parenting education in early childhood programs. We find no differences in program impacts between ECE programs that did and did not provide some form of parenting education. We find some suggestive evidence that among ECE programs that provided parenting education, those that provided parents with opportunities to practice parenting skills were associated with greater short-term impacts on children's pre-academic skills. Among ECE programs that provided parenting education, those that did so through one or more home visits a month yielded effect sizes for cognitive outcomes that were significantly larger than programs that provided lower dosages of home visits

Kuurojen herätyskello : Bluetooth-ohjattu relekytkentä

Laitteemme toiminta perustuu releeseen, joka toimii kytkimen lailla. Sitä ohjataan Bluetooth-vastaanottimella ja tekemällämme Android-sovelluksella, joka tässä tapauksessa on herätyskello. Kuurojen herätyskelloissa on yleensä kaksi osaa, joista toinen vilkuttaa valoja ja toinen on tärinähälytin. Laitteemme tarkoitus on sopia mihin tahansa kytkimeen, esimerkiksi pöytälamppuun tai kattovalaisimeen, ja tärinähälyttimenä käytämme ohjaavan kännykän tärinähälytystä. Opinnäytetyömme on jaettu kahteen pääalueeseen: tietoliikenne- sekä ohjelmistopuoleen. Tietoliikenneosassa käsitellään eri komponentit ja niiden toiminta keskenään. Ohjelmistopuolella käsittelemme tekemämme Android-sovelluksen sekä muita pienempiä ohjelmia, joita laitteen käyttö tarvitsee.Our equipment is based on the relay, which acts as a switch. It is operated via a Bluetooth receiver and Android application which we made, which in this case is an alarm clock. Alarm clocks for deaf people usually contain two parts: flashing lights and a vibrating alarm. Our switch equipment is designed to fit inside existing switch, for example on a table lamb or ceiling lamp and the mobile phone is acting as a vibrating alarm. The thesis is divided into two main areas: telecommunications, as well as the software side. The telecommunication part explains the various components and how they work with each other. Software part explains our Android app, as well as other smaller programs which are needed to operate the device