Designing Clinical Data Presentation Using Cognitive Task Analysis Methods

Despite the many decades of research on effective use of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practicing dentists in the United States. One critical reason is the poor usability of clinical systems, which makes it difficult for providers to navigate through the system and obtain an integrated view of patient data during patient care. Cognitive science methods have shown significant promise to meaningfully inform and formulate the design, development and assessment of clinical information systems. Most of these methods were applied to evaluate the design of systems after they have been developed. Very few studies, on the other hand, have used cognitive engineering methods to inform the design process for a system itself. It is this gap in knowledge – how cognitive engineering methods can be optimally applied to inform the system design process – that this research seeks to address through this project proposal. This project examined the cognitive processes and information management strategies used by dentists during a typical patient exam and used the results to inform the design of an electronic dental record interface. The resulting 'proof of concept' was evaluated to determine the effectiveness and efficiency of such a cognitively engineered and application flow design. The results of this study contribute to designing clinical systems that provide clinicians with better cognitive support during patient care. Such a system will contribute to enhancing the quality and safety of patient care, and potentially to reducing healthcare costs

Leveraging Electronic Dental Record Data to Classify Patients Based on Their Smoking Intensity

Background Smoking is an established risk factor for oral diseases and, therefore, dental clinicians routinely assess and record their patients' detailed smoking status. Researchers have successfully extracted smoking history from electronic health records (EHRs) using text mining methods. However, they could not retrieve patients' smoking intensity due to its limited availability in the EHR. The presence of detailed smoking information in the electronic dental record (EDR) often under a separate section allows retrieving this information with less preprocessing. Objective To determine patients' detailed smoking status based on smoking intensity from the EDR. Methods First, the authors created a reference standard of 3,296 unique patients’ smoking histories from the EDR that classified patients based on their smoking intensity. Next, they trained three machine learning classifiers (support vector machine, random forest, and naïve Bayes) using the training set (2,176) and evaluated performances on test set (1,120) using precision (P), recall (R), and F-measure (F). Finally, they applied the best classifier to classify smoking status from an additional 3,114 patients’ smoking histories. Results Support vector machine performed best to classify patients into smokers, nonsmokers, and unknowns (P, R, F: 98%); intermittent smoker (P: 95%, R: 98%, F: 96%); past smoker (P, R, F: 89%); light smoker (P, R, F: 87%); smokers with unknown intensity (P: 76%, R: 86%, F: 81%), and intermediate smoker (P: 90%, R: 88%, F: 89%). It performed moderately to differentiate heavy smokers (P: 90%, R: 44%, F: 60%). EDR could be a valuable source for obtaining patients’ detailed smoking information. Conclusion EDR data could serve as a valuable source for obtaining patients' detailed smoking information based on their smoking intensity that may not be readily available in the EHR

Review of Remote Sensing Techniques for the Visualization of Mangroves, Reefs, Fishing Grounds, and Molluscan Settling Areas in Tropical Waters

Globally there has been tremendous progress in space technology especially in the field of satellite remote sensing applications during the past five decades. Satellite based sensors provide a repetitive and synoptic coverage of inaccessible / larger areas which generated a time series database useful in identification and mapping of environment and resources. These databases form a scientific tool for various stakeholders to device suitable strategies for management of coastal and marine resources. This chapter analyses the various applications of satellite remote sensing and numerical modelling on identification and mapping of mangroves, coral reefs, fishing and molluscan grounds in the coastal marine ecosystems with relevant case studies and illustrations. The mapping methods for mangroves explains the classification protocols, advantages in using different remote sensing techniques and the comparison of different mapping techniques. In case of reef mapping, the vulnerability mapping of reefs due to extreme events is also discussed. Fish movement in a dynamic environment and the mapping of these movements with the help of proxy indicators are also detailed. Molluscan mapping is done based on the biomass differences during different seasons and their physical attributes

Ecosystem Responses in the Distribution of Black Clam (Villorita cyprinoides) Beds in Vembanad Estuary during Environmental Changes Using GIS and RS

The biomass and distribution of black clam (Villorita cyprinoides) in Vembanad, a tropical estuary located along the southwest coast of India varied significantly. Sampling was done in freshwater-dominated zone in the south (distal) and brackish water zone in the north (proximal), during pre and post monsoon seasons. Clam biomass was estimated from samples, collected from different stations during the study period. Water transparency and temperature were measured at the sample sites. Water samples were collected and analysed for salinity, dissolved oxygen (DO), pH and hardness. There was a significant difference in the clam biomass during the two seasons in the distal zone, and those collected from the distal and proximal zones during premonsoon season. The data were further analysed to determine the factors affecting the clam biomass distribution in the two zones and seasons. Factor analyses, comparing the distal zone during two seasons and zonal variations were similar to earlier observations. Step wise regression analyses found that dissolved oxygen (adjusted R2 = 0.3) is the only variable affecting clam survival during pre-monsoon period in the distal and proximal zones. A geographic map of the region obtained from the Indian satellite sensor LISS (Linear Image Self Scanner) was used along with in situ data to map the results using inverse distance weightage model

Can Salivary Innate Immune Molecules Provide Clue on Taste Dysfunction in COVID-19?

Emerging concerns following the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) pandemic are the long-term effects of coronavirus disease (COVID)-19. Dysgeusia in COVID-19 is supported by the abundant expression of the entry receptor, angiotensin-converting enzyme-2 (ACE2), in the oral mucosa. The invading virus perturbs the commensal biofilm and regulates the host responses that permit or suppress viral infection. We correlated the microbial recognition receptors and soluble ACE2 (sACE2) with the SARS-CoV2 measures in the saliva of COVID-19 patients. Data indicate that the toll-like receptor-4, peptidoglycan recognition protein, and sACE2 are elevated in COVID-19 saliva and correlate moderately with the viral load

Evaluation of Ecosystem services of Villorita cyprinoides in Vembanad

Vembanad Lake, a wetland of international importance, famous for waterfowl habitat was designated a Ramsar site, for conservation and sustainable utilisation of the ecosystem. Millennium ecosystem assessment (2005) emphasises that the various services provided by the ecosystem benefitting human population needs to be identified and evaluated for judicious utilisation of the resources. Villorita cyprinoides is a major species contributing to the molluscan fishery of Vembanad lake. The study involving Villorita sp. was taken up with the objectives of development of a conceptual framework encompassing the different ecosystem services provided by the clam resources, estimation of the values of selected ecosystem services using appropriate proxies and analysis of the trade-offs between anthropogenic activities like dredging vis-a-vis clam resources utilizations following the principles of MEA (2005). The study identified that the clam fisheries in the lake is most acknowledged for its provisioning ecosystem services. Apart from the regulating services such as water quality maintenance and carbon sequestration, the cultural and the linking services provided by clam fisheries to human are also identified. In spite of the identification of the various services, the non-realisation of the value of the services provided by clam fisheries has prompted the destruction of the resource knowingly or unknowingly by our activities. One of the anthropogenic activities affecting the clam fisheries is the dredging of sub fossil deposits of clamshell or white clams which are good sources of calcium carbonate for cement manufacturers. Identifying the lacunae of non-realisation of the services of clam resources, the paper has judiciously attempted not only to evaluate the services of the ecosystem service provider but also to externalize the internalities in the ecosystem services evaluation process by considering the various social costs and benefits associated with the resource

Identification and evaluation of ecosystem services provided by clam (Villorita cyprinoides) fisheries in wetland

Black clam (Villorita cyprinoides), constitute a major molluscan based subsistence level fishery in Vembanadlake providing a variety of ecosystem services to the dependent populations of the ecosystem. The non-realization of the values of the services provided by clams coupled with the anthropogenic activities like dredging aggravated the non-sustainable harvest of the resource. The paper attempts to evaluate the provisioning and cultural services provided by clams in-order to highlight the importance of the management of this ecosystem service provider and various tradeoffs between anthropogenic activities and clam resource utilizations

Length-weight relationship and condition factor of Dawkinsia filamentosa (Valenciennes, 1844) in different aquatic habitats

The growth rate of a species in any aquatic environment is an indicator of the water quality of the system. In the current study, the Length-weight relationship (LWR) and the condition factor of Dawkinsia filamentosa from various aquatic ecosystems especially lotic, lentic and brackish lentic systems were compared. It was observed that growth rate of the fish was more in brackish lentic systems. The study showed that already reported growth rate (b) of the species in brackish lentic systems is around 3.273 indicating proximity towards the isometric growth pattern as compared to the growth rate in reservoirs (2.3184) and that in lentic systems (3.116) obtained from present study. Similar studies supplemented with environmental variables can be used to study the health status of the ecosystem. The best system suitable for the adaptive growth of the species can be ascertained only after a holistic approach involving environmental variables

HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's Disease

Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.This article is freely available via Open Access. Click on Publisher URL to access the full-text