Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters

OBJECTIVES: The secondary use of medical data contained in electronic medical records, such as hospital discharge letters, is a valuable resource for the improvement of clinical care (e.g. in terms of medication safety) or for research purposes. However, the automated processing and analysis of medical free text still poses a huge challenge to available natural language processing (NLP) systems. The aim of this study was to implement a knowledge-based best of breed approach, combining a terminology server with integrated ontology, a NLP pipeline and a rules engine. METHODS: We tested the performance of this approach in a use case. The clinical event of interest was the particular drug-disease interaction "proton-pump inhibitor [PPI] use and osteoporosis". Cases were to be identified based on free text digital discharge letters as source of information. Automated detection was validated against a gold standard. RESULTS: Precision of recognition of osteoporosis was 94.19%, and recall was 97.45%. PPIs were detected with 100% precision and 97.97% recall. The F-score for the detection of the given drug-disease-interaction was 96,13%. CONCLUSION: We could show that our approach of combining a NLP pipeline, a terminology server, and a rules engine for the purpose of automated detection of clinical events such as drug-disease interactions from free text digital hospital discharge letters was effective. There is huge potential for the implementation in clinical and research contexts, as this approach enables analyses of very high numbers of medical free text documents within a short time period

Practical report: Supporting the communication and cooperation between educational science and educational practice with meta-projects

In diesem Beitrag werden die Tätigkeiten eines Metavorhabens, das etwa 50 vom Bundesministerium für Bildung und Forschung (BMBF) geförderte Forschungsprojekte begleitet, dahingehend dargestellt, wie sie zur Förderung und Reflexion der Kommunikation und Kooperation zwischen Bildungsforschung und -praxis beitragen. Ausgehend von einer Evaluation dieser Tätigkeiten werden Ansatzpunkte für mögliche zukünftige Tätigkeiten des Metavorhabens präsentiert. (DIPF/Orig.)In this article, the activities of a meta-project, which accompanies around 50 research projects funded by the German Federal Ministry of Education and Science (BMBF), are presented in terms of how they contribute to promoting and reflecting the communication and cooperation between educational research and educational practice. Based on an evaluation of the activities with quantitative data, possible prospective activities of the meta-project and for future research are being presented. (DIPF/Orig.

Marchenko-type focusing functions: Generalisation, modelling and imaging

Imaging is a field of mathematics and physics that aims to retrieve information about the internal structure of an object that can only be accessed on its boundary. Many imaging methods are based on the following principle: a source outside of the object emits a wave. The wave propagates through the object. Wherever the physical structure of the object changes, scattered waves are induced. These scattered waves are measured by receivers outside of the object, and these scattered data are used to invert for the interior composition of the medium under investigation. The Marchenko integral was originally introduced for one-dimensional inverse scattering problems in the context of quantum mechanics. It can be related to Green's functions and so-called focusing functions - fields that produce a focus when injected into a medium from a single side. About ten years ago, the Marchenko integral was extended to two and three dimensions. This paved the way for, e.g., the elimination of imaging artefacts due to multiple scattering and Green's function retrieval for virtual source locations. However, many questions about the full potential as well as the accuracy of the Marchenko equation in two and three dimensions remain unanswered. In this thesis we present a new derivation for the multidimensional Marchenko integral. Our derivation is based on a generalised framework for wavefield focusing and circumvents the limiting assumptions of the previous extension. As we use partial differential equations rather than integral equations to define focusing functions, it allows for new physical insights. For instance, our approach indicates that it is possible to model Marchenko-type focusing functions with a conventional wave equation. Ultimately, this enables us to study Marchenko-type focusing in different 2D and 3D media and learn about the accuracy of the concept. We present a straightforward modelling approach for 1D as well as a least-squares modelling approach for 2D and 3D. The latter suggests that the Marchenko integral might be inherently approximative in multiple dimensions. We also discuss Green's function retrieval with our newly derived Marchenko integral, i.e. without wavefield decomposition. This method allows for estimating Green's functions for virtual sources inside of the medium. While it requires single-sided scattering data and an estimate of the first arrival of the desired Green's function there is no need to have an actual source or receiver inside of the medium. Our results demonstrate that we can retrieve good estimates of the full-spectrum Green's functions, involving evanescent and refracted waves, which were believed to not be retrievable with the previously derived Marchenko integral. Ultimately, we discuss imaging with these Marchenko-based Green's functions. Being able to include measurements for virtual sources inside of the medium allows for a natural linearisation of the imaging problem. Thus, we use the Marchenko integral to linearise state-of-the-art imaging approaches, similar to full waveform inversion or least-squares reverse time migration, and estimate the scattering potential. Our Marchenko-based linearisation accounts for all orders of scattering and performs slightly better than a single-scattering approximation

School Networks and Digitalisation: (How) can Cooperative School Development Contribute to the Digital Transformation?

Die Zusammenarbeit von Schulen, Schulträgern und weiteren Akteuren in Netzwerken kann dazu beitragen, Schulentwicklungs-, Innovations- und Transformationsprozesse zu initiieren und zu unterstützen (Endberg et al. 2020). Der vorliegende Beitrag geht der Frage nach, inwiefern solche Netzwerkkooperationen die digitale Transformation an Schulen unterstützen können. Im Mittelpunkt des Beitrags stehen Schulnetzwerke, die in unterschiedlichen Kontexten gegründet und deren Konzepte sukzessive weiterentwickelt und ausgebaut wurden. Die betrachteten Schulnetzwerke wurden in Regionen oder Kommunen gebildet, in denen sich Schulen und andere Akteure zum Thema «Bildung im digitalen Wandel» zusammengefunden haben, um gemeinsam Schritte der Integration digitaler Medien in den Schulalltag zu entwickeln und zu erproben. Der Beitrag analysiert, was die Netzwerkarbeit zur (kooperativen) Schulentwicklung im Kontext von Digitalisierung beitragen kann und wie sie zu organisieren ist, damit Zusammenarbeit – auch über die eigene Schule hinaus – gelingen kann. Der Beitrag erläutert dazu die Anlage von Netzwerken sowie die Arbeit in den Netzwerken aus Sicht der Moderation. Es wird speziell darauf eingegangen, welches Potenzial die Netzwerkarbeit hat, um kooperative Arbeitsformen im Sinne einer Ko-Konstruktion (Gräsel et al. 2006) zu fördern, welche über den reinen Austausch von Information oder Material hinausgehen und welche Inhalte, angelegt an die Schulentwicklungsdimensionen (Rolff 2016; Schulz-Zander 2001; Eickelmann und Gerick 2017) sich für die Zusammenarbeit anbieten.The cooperation of schools, school authorities and other actors in networks can contribute to initiate and support school development, innovation and transformation processes (Endberg et al. 2020). This article explores the question of how such network cooperations can support the digital transformation at schools. The focus of the article is on school networks that were founded in different contexts and whose concepts were successively developed and expanded. The school networks considered were formed in regions or municipalities in which schools and other stakeholders have come together on the topic of «education in the digital transformation» in order to jointly develop and test steps for integrating digital media into everyday school life. The article analyzes what networking can contribute to (cooperative) school development in the context of digitization and how it is to be organized so that this cooperation – also beyond the own school – can succeed. The article explains the creation of networks and the work in the networks from the perspective of the moderator. The potential of networking to promote cooperative forms of work in the sense of co-construction (Gräsel et al. 2006), which go beyond the mere exchange of information or material, and which contents, applied to the school development dimensions (Rolff 2016; Schulz-Zander 2001; Eickelmann und Gerick 2017) are suitable for cooperation, will be specifically addressed

Multidimensional Construction Planning and Agile Organized Project Execution?The 5D-PROMPT Method

Although tremendous technological and strategic advances have been developed and implemented in the construction sector in recent years, there is substantial room for improvement in the areas of productivity growth, project performance, and schedule reliability. Thus, the present paper seeks to discover why the currently applied scheduling tools and the latest agile-based project organization approaches have not yet achieved their full potential. A missing interlinkage between the project?s design, cost, and time aspects within the project design phase and its sparse utilization throughout project execution were indicated as the driving contributors responsible for the slow progress in development. To fundamentally change this situation, an extensive and coherent project organization solution is proposed. The key process of this solution utilizes a 5D Building Information Model comprising tight concatenations between the individual model objects and the corresponding construction cost and time effort values. The key dates of a waterfall-based construction process simulation, set during the project planning phase, provide particular information to create a structure for agile organized project execution. The implementation of information feedback loops allows target/actual comparisons and contributes to continual improvements in future planning. A comparative case study was conducted with auspicious results on improvements in the overall project performance, and schedule and cost reliabilityThis research was supported by Heinrich Schmid GmbH&Co.KG regarding the cooperative conduction of two construction projects used for the case-study; RIB Software SE, who provided the BIM software platform iTWO Baseline and the site management software OnSite, and Contelos GmbH for the provision of the 3D Building Information Model

An optimized imaging protocol for [99mTc]Tc-DPD scintigraphy and SPECT/CT quantification in cardiac transthyretin (ATTR) amyloidosis

Background: In [(99)mTc]Tc-DPD scintigraphy for myocardial ATTR amyloidosis, planar images 3 hour p.i. and SPECT/CT acquisition in L-mode are recommended. This study investigated if earlier planar images (1 hour p.i.) are beneficial and if SPECT/CT acquisition should be preferred in H-mode (180 degrees detector angle) or L-mode (90 degrees). Methods: In SPECT/CT phantom measurements (NaI cameras, N = 2; CZT, N = 1), peak contrast recovery (CRpeak) was derived from sphere inserts or myocardial insert (cardiac phantom; signal-to-background ratio [SBR], 10:1 or 5:1). In 25 positive and 38 negative patients reference: endomyocardial biopsy or clinical diagnosis), Perugini scores and heart-to-contralateral (H/CL) count ratios were derived from planar images 1 hour and 3 hour p.i. Results: In phantom measurements, accuracy of myocardial CRpeak at SBR 10:1 (H-mode, 0.95-0.99) and reproducibility at 5:1 (H-mode, 1.02-1.14) was comparable for H-mode and L-mode. However, L-mode showed higher variability of background counts and sphere CRpeak throughout the field of view than H-mode. In patients, sensitivity/specificity were >= 95% for H/CL ratios at both time points and visual scoring 3 hour. At 1 hour, visual scores showed specificity of 89% and reduced reader's confidence. Conclusions: Early DPD images provided no additional value for visual scoring or H/CL ratios. In SPECT/CT, H-mode is preferred over L-mode, especially if quantification is applied apart from the myocardium

Lattice Coulomb Hamiltonian and Static Color-Coulomb Field

The lattice Coulomb-gauge hamiltonian is derived from the transfer matrix of Wilson's Euclidean lattice gauge theory, wherein the lattice form of Gauss's law is satisfied identically. The restriction to a fundamental modular region (no Gribov copies) is implemented in an effective hamiltonian by the addition of a "horizon function" $G$ to the lattice Coulomb-gauge hamiltonian. Its coefficient $\gamma_0$ is a thermodynamic parameter that ultimately sets the scale for hadronic mass, and which is related to the bare coupling constant $g_0$ by a "horizon condition". This condition determines the low-momentum behavior of the (ghost) propagator that transmits the instantaneous longitudinal color-electric field, and thereby provides for a confinement-like feature in leading order in a new weak-coupling expansion.Comment: 110 pages + 1 fig., uuencoded compressed tar-file (190 kb) revised and shortened for readability. Technical derivations relegated to appendices. Concepts clarified in Introduction and Conclusion. One figure adde

Assembling evidence for identifying reservoirs of infection

Many pathogens persist in multihost systems, making the identification of infection reservoirs crucial for devising effective interventions. Here, we present a conceptual framework for classifying patterns of incidence and prevalence, and review recent scientific advances that allow us to study and manage reservoirs simultaneously. We argue that interventions can have a crucial role in enriching our mechanistic understanding of how reservoirs function and should be embedded as quasi-experimental studies in adaptive management frameworks. Single approaches to the study of reservoirs are unlikely to generate conclusive insights whereas the formal integration of data and methodologies, involving interventions, pathogen genetics, and contemporary surveillance techniques, promises to open up new opportunities to advance understanding of complex multihost systems

Taking care of kidney transplant recipients during the COVID-19 pandemic: experience from a medicalized hotel.

The global overload that health systems are undergoing since the start of the COVID-19 pandemic has forced hospitals to explore sustainable alternatives to treat vulnerable patients that require closer monitoring and higher use of resources, such as Kidney Transplant Recipients (KTRs)1,2 .The use of telemedicine and hospital-like infrastructures represent a valid option for most patients with mild-moderate COVID-19, as well as for patients in the recovery phase who cannot be discharged from hospital