Automatic Detection of Hypoglycemic Events From the Electronic Health Record Notes of Diabetes Patients: Empirical Study

BACKGROUND: Hypoglycemic events are common and potentially dangerous conditions among patients being treated for diabetes. Automatic detection of such events could improve patient care and is valuable in population studies. Electronic health records (EHRs) are valuable resources for the detection of such events. OBJECTIVE: In this study, we aim to develop a deep-learning-based natural language processing (NLP) system to automatically detect hypoglycemic events from EHR notes. Our model is called the High-Performing System for Automatically Detecting Hypoglycemic Events (HYPE). METHODS: Domain experts reviewed 500 EHR notes of diabetes patients to determine whether each sentence contained a hypoglycemic event or not. We used this annotated corpus to train and evaluate HYPE, the high-performance NLP system for hypoglycemia detection. We built and evaluated both a classical machine learning model (ie, support vector machines [SVMs]) and state-of-the-art neural network models. RESULTS: We found that neural network models outperformed the SVM model. The convolutional neural network (CNN) model yielded the highest performance in a 10-fold cross-validation setting: mean precision=0.96 (SD 0.03), mean recall=0.86 (SD 0.03), and mean F1=0.91 (SD 0.03). CONCLUSIONS: Despite the challenges posed by small and highly imbalanced data, our CNN-based HYPE system still achieved a high performance for hypoglycemia detection. HYPE can be used for EHR-based hypoglycemia surveillance and population studies in diabetes patients

Fine-Tuning Bidirectional Encoder Representations From Transformers (BERT)-Based Models on Large-Scale Electronic Health Record Notes: An Empirical Study

BACKGROUND: The bidirectional encoder representations from transformers (BERT) model has achieved great success in many natural language processing (NLP) tasks, such as named entity recognition and question answering. However, little prior work has explored this model to be used for an important task in the biomedical and clinical domains, namely entity normalization. OBJECTIVE: We aim to investigate the effectiveness of BERT-based models for biomedical or clinical entity normalization. In addition, our second objective is to investigate whether the domains of training data influence the performances of BERT-based models as well as the degree of influence. METHODS: Our data was comprised of 1.5 million unlabeled electronic health record (EHR) notes. We first fine-tuned BioBERT on this large collection of unlabeled EHR notes. This generated our BERT-based model trained using 1.5 million electronic health record notes (EhrBERT). We then further fine-tuned EhrBERT, BioBERT, and BERT on three annotated corpora for biomedical and clinical entity normalization: the Medication, Indication, and Adverse Drug Events (MADE) 1.0 corpus, the National Center for Biotechnology Information (NCBI) disease corpus, and the Chemical-Disease Relations (CDR) corpus. We compared our models with two state-of-the-art normalization systems, namely MetaMap and disease name normalization (DNorm). RESULTS: EhrBERT achieved 40.95% F1 in the MADE 1.0 corpus for mapping named entities to the Medical Dictionary for Regulatory Activities and the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), which have about 380,000 terms. In this corpus, EhrBERT outperformed MetaMap by 2.36% in F1. For the NCBI disease corpus and CDR corpus, EhrBERT also outperformed DNorm by improving the F1 scores from 88.37% and 89.92% to 90.35% and 93.82%, respectively. Compared with BioBERT and BERT, EhrBERT outperformed them on the MADE 1.0 corpus and the CDR corpus. CONCLUSIONS: Our work shows that BERT-based models have achieved state-of-the-art performance for biomedical and clinical entity normalization. BERT-based models can be readily fine-tuned to normalize any kind of named entities

An in-situ method for assessing soil aggregate stability in burned landscapes

Due to soil repellency in burned areas, slope runoff and soil erodibility escalates following forest fires, increasing the vulnerability to post-fire debris flows. Soil aggregate stability is a critical determinant of soil infiltration capacity and erosion susceptibility. The prevalent method of assessing soil aggregate stability in burned areas, the counting the number of water drop impacts (CND) method, is time-intensive and impractical for in-situ measurements. In response, this study introduces a novel technique based on the shock and vibration damage (SVD) effect for evaluating soil aggregate stability in burned areas. Thirteen distinct soil aggregate types were meticulously prepared for indoor simulated fire testing, with due consideration to factors such as bulk weight, organic matter content, and water repellency, which influence stability of soil aggregates. Employing a custom-built test apparatus, the mass loss rate (MLR) of soil aggregates was determined through orthogonal experiments using the SVD method and compared against the standard CND technique's quantification of water droplet-induced aggregate destruction. The findings demonstrated that SVD method, employing Test Scheme 6 (testing 20 aggregates, 1-meter impact height, 40% water content, and five impacts), exhibits excellent agreement (Kendall coefficient = 0.797) and correlation (R2 = 0.634) with CND method outcomes. This testing scheme, characterized by rapid determination and effective discrimination, is identified as the optimal testing approach. The SVD testing apparatus is straightforward, portable, and easily disassembled, rendering it suitable for on-site use. It can be used to distinguish the stability level of soil aggregates swiftly and quantitatively under various fire intensities in burned areas in situ, which is an important guiding significance for the study of soil erosion, erosion control, and post-fire debris flow initiation mechanism in burned areas

Orthogonal printing of uniform nanocomposite monolayer and oriented organic semiconductor crystals for high-performance nano-crystal floating gate memory

Inkjet printing is of great interest in the preparation of optoelectronic and microelectronic devices due to its low cost, low process temperature, versatile material compatibility, and ability to precisely manufacture multi-layer devices on demand. However, interlayer solvent erosion is a typical problem that limits the printing of organic semiconductor devices with multi-layer structures. In this study, we proposed a solution to address this erosion problem by designing polystyrene-block-poly(4-vinyl pyridine)-grafted Au nanoparticles (Au@PS-b-P4VP NPs). With a colloidal ink containing the Au@PS-b-P4VP NPs, we obtained a uniform monolayer of Au nano-crystal floating gates (NCFGs) embedded in the PS-b-P4VP tunneling dielectric (TD) layer using direct-ink-writing (DIW). Significantly, PS-b-P4VP has high erosion resistance against the semiconductor ink solvent, which enables multi-layer printing. An active layer of semiconductor crystals with high crystallinity and well-orientation was obtained by DIW. Moreover, we developed a strategy to improve the quality of the TD/semiconductor interface by introducing a polystyrene intermediate layer. We show that the NCFG memory devices exhibit a low threshold voltage (100 cycles), and long-term retention (>10 years). This study provides universal guidance for printing functional coatings and multi-layer devices