Clinical information extraction for preterm birth risk prediction

This paper contributes to the pursuit of leveraging unstructured medical notes to structured clinical decision making. In particular, we present a pipeline for clinical information extraction from medical notes related to preterm birth, and discuss the main challenges as well as its potential for clinical practice. A large collection of medical notes, created by staff during hospitalizations of patients who were at risk of delivering preterm, was gathered and analyzed. Based on an annotated collection of notes, we trained and evaluated information extraction components to discover clinical entities such as symptoms, events, anatomical sites and procedures, as well as attributes linked to these clinical entities. In a retrospective study, we show that these are highly informative for clinical decision support models that are trained to predict whether delivery is likely to occur within specific time windows, in combination with structured information from electronic health records

Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect

The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization ("urban heat islands"), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life-history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations.status: publishe

Data from:Microgeographic differentiation in thermal performance curves between rural and urban populations of an aquatic insect

The rapidly increasing rate of urbanization has a major impact on the ecology and evolution of species. While increased temperatures are a key aspect of urbanization (“urban heat islands”), we have very limited knowledge whether this generates differentiation in thermal responses between rural and urban populations. In a common garden experiment, we compared the thermal performance curves (TPCs) for growth rate and mortality in larvae of the damselfly Coenagrion puella from three urban and three rural populations. TPCs for growth rate shifted vertically, consistent with the faster-slower theoretical model whereby the cold-adapted rural larvae grew faster than the warm-adapted urban larvae across temperatures. In line with costs of rapid growth, rural larvae showed lower survival than urban larvae across temperatures. The relatively lower temperatures, hence expected shorter growing seasons in rural populations compared to the populations in the urban heat islands likely impose stronger time constraints to reach a certain developmental stage before winter, thereby selecting for faster growth rates. In addition, higher predation rates at higher temperature may have contributed to the growth rate differences between urban and rural ponds. A faster-slower differentiation in TPCs may be a widespread pattern along the urbanization gradient. The observed microgeographic differentiation in TPCs supports the view that urbanization may drive life history evolution. Moreover, because of the urban heat island effect, urban environments have the potential to aid in developing predictions on the impact of climate change on rural populations

Prenatale diagnostiek van congenitale afwijkingen: multidisciplinaire aanpak

Prenatale diagnostiek (PND) is een razendsnel evoluerend subspecialisme binnen de verloskunde. Dit heeft geleid tot een aantal evoluties: ouders verwachten een garantie op een „gezond” kind. In een klimaat van verregaande autonomie eist men vaak een soort van „alleenbeslissingsrecht” over het verdere verloop van de zwangerschap. PND komt steeds vaker aan bod in juridische procedures. De toenemende mogelijkheden in het genetische onderzoek kunnen leiden tot vaststellingen die niet het oorspronkelijke doel waren van het onderzoek of waarvan de klinische gevolgen onduidelijk of (vooralsnog) onbehandelbaar zijn. Daarnaast betreft het een zeer gevoelig en emotioneel beladen domein in de geneeskunde. Al deze evoluties hebben ertoe geleid dat een raadpleging in een prenataal diagnostisch centrum op een professionele manier aangepakt moet worden door een prenataal diagnosticus met kennis ter zake, alsook gebaseerd moet zijn op een aantal hoekstenen: multidisciplinariteit (met een continue beschikbaarheid van specialismen zoals medische genetica en neonatologie, alsook de ad-hocbeschikbaarheid van pediatrische orgaanspecialisten), wetenschappelijke expertise (aangepast aan de meest recente evidentie), patiëntcommunicatieve vaardigheden (met aandacht voor de patiënt met inbegrip van de psychologische en de sociale aspecten), een continue paramedische ondersteuning door vroedvrouwen en sociaal assistenten met een specifieke opleiding en tot slot een collegiale samenwerking met de verwijzer

data_Tuzun2017_EVA

Data used for the analysis of growth rate (longitudinal format)

Physiological responses during downhill walking: A new exercise modality for subjects with chronic obstructive pulmonary disease?

Skeletal muscle quadriceps low-frequency fatigue (LFF) during exercise promotes improvements in exercise capacity with exercise training. In healthy subjects, eccentric muscle work induced by downhill walking (DW) generates higher muscular stress, whilst metabolic cost is lower compared to level walking (LW). We investigated quadriceps LFF and metabolic cost of DW in patients with chronic obstructive pulmonary disease. Ten participants (67 ± 7 years, FEV1 51 ± 15% predicted) performed DW, DW carrying a load (DWL) of 10% body weight via vest and LW, in random order. Quadriceps potentiated twitch force (TWqpot) was assessed before and after each walk, and muscle damage was assessed before and 24 hours after each walk via serum creatine kinase (CK) levels. Ventilation (VE) and oxygen consumption (VO2) were measured via breath-by-breath analysis during each walk. DW and DWL resulted in a greater decrease in TWqpot (-30 ± 14 N in DW, p 0.05). CK levels only increased 24 hours following DW and DWL (p < 0.05). DW and DWL showed lower VE and VO2 than LW (p < 0.05). DW is associated with enhanced quadriceps LFF and lower cardiorespiratory costs than LW. The addition of a chest load to DW does not seem to enhance these effects.status: publishe