The Impact of Big Data on Chronic Disease Management

Introduction: Population health management – and specifically chronic disease management – depend on the ability of providers to identify patients at high risk of developing costly and harmful conditions such as diabetes, heart failure, and chronic kidney disease (CKD). The advent of big data analytics could help identify high-risk patients which is really beneficial to healthcare practitioners and patients to make informed decisions in a timelier manner with much more evidence in hand. It would allow doctors to extend effective treatment but also reduces the costs of extending improved care to patients. Purpose: The purpose of this study was to identify current applications of big data analytics in healthcare for chronic disease management and to determine its real-world effectiveness in improving patient outcomes and lessening financial burdens. Methodology: The methodology for this study was a literature review. Six electronic databases were utilized and a total of 49 articles were referenced for this research. Results: Improvement in diagnostic accuracy and risk prediction and reduction of hospital readmissions has resulted in significant decrease in health care cost. Big data analytic studies regarding care management and wellness programs have been largely positive. Also, Big data analytics guided better treatment leading to improved patient outcomes. Discussion/Conclusion: Big data analytics shows initial positive impact on quality of care, patient outcomes and finances, and could be successfully implemented in chronic disease management

Mobile Health Interventions for Adult Obesity in the United States: Analysis of Effectiveness and Efficacy

The Unites States continues to struggle with the negative health effects associated with increasing population obesity, a problem which has been historically difficult, if not impossible, to solve. Mobile health applications represent a potential partial solution to this problem. We examine the existing literature on the effects of mobile health applications on body weight, waist circumference, BMI, and lifestyle, examining both physical findings as well as adherence, satisfaction and cost effectiveness. The use of mobile for weight reduction looks promising, but evidence is mixed, which is not surprising given the rapidly evolving nature of the mobile application field

Ransomware in Healthcare Facilities: A Harbinger of the Future?

Cybercriminals have begun to target the healthcare industry with ransomware, malware that encrypts an infected device and any attached devices or network drives. After encryption, cybercriminals demand a ransom before releasing the devices from encoding. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. We examined the extent of recent ransomware infections in healthcare settings, the risk liabilities and costs associated with such infections, and possible risk mitigation tactics. The methodology of this study was a literature review. The review was limited to sources published in English from 2005 to 2017. Of the 118 sources found, 74 were used in the results section. We also performed two semistructured interviews, one with an expert in health care law and the other with a chief information officer from a local teaching hospital who was an expert in healthcare information technology. Financial costs associated with business recovery after ransomware attacks on healthcare facilities are significant and are growing in both magnitude and scope. Other risks are a loss of future business and reputation damage. Research has suggested that the best plan of action is to have a proper business continuity and disaster plan with adequate data backups and to be vigilant in educating employees about the sources of ransomware to prevent potential attacks

Understanding Emergency Room Visits for Nontraumatic Oral Health Conditions in a Hospital Serving Rural Appalachia: Dental Informatics Study

BackgroundIn the Appalachian region, a variety of factors will impact the ability of patients to maintain good oral health, which is essential for overall health and well-being. Oral health issues have led to high costs within the Appalachian hospital system. Dental informatics examines preventable dental conditions to understand the problem and suggest cost containment. ObjectiveWe aimed to demonstrate the value of dental informatics in dental health care in rural Appalachia by presenting a research study that measured emergency room (ER) use for nontraumatic dental conditions (NTDCs) and the associated economic impact in a hospital system that primarily serves rural Appalachia. MethodsThe Appalachian Clinical and Translational Science Institute’s oral health data mart with relevant data on patients (n=8372) with ER encounters for NTDC between 2010 and 2018 was created using Appalachian Clinical and Translational Science Institute’s research data warehouse. Exploratory analysis was then performed by developing an interactive Tableau dashboard. Dental Informatics provided the platform whereby the overall burden of these encounters, along with disparities in burden by age groups, gender, and primary payer, was assessed. ResultsDental informatics was essential in understanding the overall problem and provided an interactive and easily comprehensible visualization of the situation. We found that ER visits for NTDCs declined by 40% from 2010 to 2018, but a higher percentage of visits required inpatient care and surgical intervention. ConclusionsDental informatics can provide the necessary tools and support to health care systems and state health departments across Appalachia to address serious dental problems. In this case, informatics helped identify that although inappropriate ER use for NTDCs diminished due to ER diversion efforts, they remain a significant burden. Through its visualization and data extraction techniques, dental informatics can help produce policy changes by promoting models that improve access to preventive care

The Adipocyte Na/K-ATPase Oxidant Amplification Loop is the Central Regulator of Western Diet-Induced Obesity and Associated Comorbidities

Obesity has become a worldwide epidemic. We have previously reported that systemic administration of pNaKtide which targets the Na/K-ATPase oxidant amplification loop (NKAL) was able to decrease systemic oxidative stress and adiposity in mice fed a high fat and fructose supplemented western diet (WD). As adipocytes are believed to play a central role in the development of obesity and its related comorbidities, we examined whether lentiviral-mediated adipocyte-specific expression of NaKtide, a peptide derived from the N domain of the alpha1 Na/K-ATPase subunit, could ameliorate the effects of the WD. C57BL6 mice were fed a WD, which activated Na/K-ATPase signaling in the adipocytes and induced an obese phenotype and caused an increase in plasma levels of leptin, IL-6 and TNFalpha. WD also decreased locomotor activity, expression of the D2 receptor and tyrosine hydroxylase in brain tissue, while markers of neurodegeneration and neuronal apoptosis were increased following the WD. Selective adipocyte expression of NaKtide in these mice fed a WD attenuated all of these changes including the brain biochemical alterations and behavioral adaptations. These data suggest that adipocyte derived cytokines play an essential role in the development of obesity induced by a WD and that targeting the adipocyte NKAL loop may serve as an effective therapeutic strategy

Measurement of the branching fractions for Cabibbo-suppressed decays D+→K+K−π+π0D^{+}\to K^{+} K^{-}\pi^{+}\pi^{0} and D(s)+→K+π−π+π0D_{(s)}^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0} at Belle

International audienceWe present measurements of the branching fractions for the singly Cabibbo-suppressed decays $D^+\to K^{+}K^{-}\pi^{+}\pi^{0}$ and $D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}$, and the doubly Cabibbo-suppressed decay $D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}$, based on 980 ${\rm fb}^{-1}$ of data recorded by the Belle experiment at the KEKB $e^{+}e^{-}$ collider. We measure these modes relative to the Cabibbo-favored modes $D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}$ and $D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0}$. Our results for the ratios of branching fractions are $B(D^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})/B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}) = (11.32 \pm 0.13 \pm 0.26)\%$, $B(D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})/B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0}) = (1.68 \pm 0.11\pm 0.03)\%$, and $B(D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})/B(D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0}) = (17.13 \pm 0.62 \pm 0.51)\%$, where the uncertainties are statistical and systematic, respectively. The second value corresponds to $(5.83\pm 0.42)\times\tan^4\theta_C$, where $\theta_C$ is the Cabibbo angle; this value is larger than other measured ratios of branching fractions for a doubly Cabibbo-suppressed charm decay to a Cabibbo-favored decay. Multiplying these results by world average values for $B(D^{+}\to K^{-}\pi^{+}\pi^{+}\pi^{0})$ and $B(D_s^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})$ yields $B(D^{+}\to K^{+}K^{-}\pi^{+}\pi^{0})= (7.08\pm 0.08\pm 0.16\pm 0.20)\times10^{-3}$, $B(D^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0})= (1.05\pm 0.07\pm 0.02\pm 0.03)\times10^{-3}$, and $B(D_s^{+}\to K^{+}\pi^{-}\pi^{+}\pi^{0}) = (9.44\pm 0.34\pm 0.28\pm 0.32)\times10^{-3}$, where the third uncertainty is due to the branching fraction of the normalization mode. The first two results are consistent with, but more precise than, the current world averages. The last result is the first measurement of this branching fraction