scholarly journals Use of an EHR to inform an administrative data algorithm to categorize inpatient COVID-19 severity

2021 ◽  
Author(s):  
Elizabeth M Garry ◽  
Andrew R Weckstein ◽  
Kenneth Quinto ◽  
Tamar Lasky ◽  
Aloka Chakravarty ◽  
...  
Keyword(s):  
Administrative Data ◽  
Invasive Mechanical Ventilation ◽  
Supplemental Oxygen ◽  
Real World Data ◽  
Severity Level ◽  
Differential Misclassification ◽  
Initial Procedure ◽  
The Impact ◽  
Selection Of

Importance: Algorithms for classification of inpatient COVID-19 severity are necessary for confounding control in studies using real-world data (RWD). Objective: To explore use of electronic health record (EHR) data to inform an administrative data algorithm for classification of supplemental oxygen or noninvasive ventilation (O2/NIV) and invasive mechanical ventilation (IMV) to assess disease severity in hospitalized COVID-19 patients. Design: In this retrospective cohort study, we developed an initial procedure-based algorithm to identify O2/NIV, IMV, and NEITHER O2/NIV nor IMV in two inpatient RWD sources. We then expanded the algorithm to explore the impact of adding diagnoses indicative of clinical need for O2/NIV (hypoxia, hypoxemia) or IMV (acute respiratory distress syndrome) and O2-related patient vitals available in the EHR. Observed changes in severity categorization were used to augment the administrative algorithm. Setting: Optum de-identified COVID-19 EHR data and HealthVerity claims and chargemaster data (March - August 2020). Participants: Among patients hospitalized with COVID-19 in each RWD source, our motivating example selected dexamethasone (DEX+) initiators and a random selection of patients who were non-initiators of a corticosteroid of interest (CSI-) matched on date of DEX initiation, age, sex, baseline comorbidity score, days since admission, and COVID-19 severity level (NEITHER, O2/NIV, IMV) on treatment index. Main Outcome and Measures: Inpatient COVID-19 severity was defined using the algorithms developed to classify respiratory support requirements among hospitalized COVID-19 patients (NEITHER, O2/NIV, IMV). Measures were reported as the treatment-specific distributions of patients in each severity level, and as observed changes in severity categorization between the initial procedure-based and expanded algorithms. Results: In the administrative data cohort with 5,524 DEX+ and CSI- patient pairs matched using the initial procedure-based algorithm, 30% were categorized as O2/NIV, 5% as IMV, and 65% as NEITHER. Among patients assigned NEITHER via the initial algorithm, use of an expanded algorithm informed by the EHR-based algorithm shifted 54% DEX+ and 28% CSI- to O2/NIV, and 2% DEX+ and 1% CSI- to IMV. Among patients initially assigned O2/NIV, 7% DEX+ and 3% CSI- shifted to IMV. Conclusions and Relevance: Application of learnings from an EHR-based exploration to our administrative algorithm minimized treatment-differential misclassification of COVID-19 severity.

scholarly journals Clinical and Pregnancy Outcomes of COVID-19 Among Hospitalized Pregnant Women in the United States

2021 ◽  
Author(s):  
Christina M Ackerman ◽  
Jennifer L Nguyen ◽  
Swapna Ambati ◽  
Maya Reimbaeva ◽  
Birol Emir ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Negative Impact ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
The United States ◽  
Supplemental Oxygen ◽  
Healthcare Database ◽  
The Impact

Abstract Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clinical and pregnancy outcomes was greater among pregnant women with COVID-19 compared with pregnant women without a COVID-19 diagnosis in 2020; the risk of poor clinical and pregnancy outcomes increased with increasing age. Hispanic and Black non-Hispanic women were consistently observed to have the highest relative risk of experiencing poor clinical or pregnancy outcomes across all age groups. Conclusions Overall, COVID-19 had a significant negative impact on maternal health and pregnancy outcomes. These data help inform clinical practice and counselling to pregnant women regarding the risks of COVID-19. Clinical studies evaluating the safety and efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 in pregnant women are urgently needed.

scholarly journals Provissional Access For Improving Classification Accuracy On Diabetes Dataset

2019 ◽  
Vol 8 (6) ◽  
pp. 5245-5248
Keyword(s):  
Data Mining ◽  
Experimental System ◽  
Classification Algorithms ◽  
Data Mining Technique ◽  
Real World Data ◽  
Mining Technique ◽  
Complete Set ◽  
The Impact ◽  
Speed And Accuracy

Data mining helps to solve many problems in the area of medical diagnosis using real-world data. However, much of the data is unrealizable as it does not have desirable features and contains a lot of gaps and errors. A complete set of data is a prerequisite for precise grouping and classification of a dataset. Preprocessing is a data mining technique that transforms the unrefined dataset into reliable and useful data. It is used for resolving the issues and changes raw data for next level processing. Discretization is a necessary step for data preprocessing task. It reduces the large chunks of numeric values to a group of well-organized values. It offers remarkable improvements in speed and accuracy in classification. This paper investigates the impact of preprocessing on the classification process. This work implements three techniques such as NaiveBayes, Logistic Regression, and SVM to classify Diabetes dataset. The experimental system is validated using discretize techniques and various classification algorithms.

Wired and Cable Networks of Fire-hazardous Zones

2021 ◽  
pp. 63-68
Author(s):  
G.I. Smelkov ◽  
◽  
V.A. Pekhotikov ◽  
A.I. Ryabikov ◽  
A.A. Nazarov ◽  
...  
Keyword(s):  
Fire Protection ◽  
Fire Hazard ◽  
Correct Selection ◽  
Federal State ◽  
Normative Documents ◽  
Electric Equipment ◽  
Civil Defence ◽  
The Impact ◽  
Selection Of

The urgency of the issue to be considered is conditioned by the high fire hazard of electric cables of the voltage up to 1000 V. As a result of fires associated with this type of products at the industrial and storage units in 2020 in Russia, the volume of direct loss exceeded 68 % comparing to the fires caused by all other types of cable lines occurred at enterprises. The high fire hazard of industrial facilities is mainly associated with numerous fire-hazardous premises containing combustible media capable of inflammation under the impact of ignition sources. In order to reduce their fire hazard, two independent and mutually reinforcing systems of fire-hazardous premise classification applied at designing such units are developed: Identification of fire-hazardous zone’s class to ensure correct selection of electric equipment and level of its fire-protection. Categorization of buildings and premises as fire-hazardous to ensure fire protection for both for buildings and attending employees. The main regulatory document where the requirements to fire-hazardous zone classification and selection of relevant fire-protected equipment were initially stipulated is the Rules for electric installations (1980). In 2008, the updated version of the Rules was incorporated into the text of the Federal Law of June 22, 2008 № 123-FZ «The technical regulation on fire safety requirements». The studies conducted by the experts of The Federal State Budgetary Establishment «All-Russian Research Institute for Fire Protection of the Ministry of the Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters» of Russia serves as a basis to develop normative documents regulating categorization of fire-hazardous premises and classification of fire-hazardous zones as well as the recommendations on the scope of application of some electric equipment in fire-hazardous zones. The adopted classification of fire-hazardous zones is unique and has no analogues in global practices.

scholarly journals SUBSTANTIATION OF EFFECTIVE INSTRUMENTS OF REGULATION OF FINANCIAL IMBALANCES OF ENDOGENOUS-ORIENTED DEVELOPMENT OF THE REGIONS OF UKRAINE

2019 ◽  
Vol 6 (3-4) ◽  
pp. 46-54
Author(s):  
TARAS KLOBA ◽  
SOLOMIIA KLOBA
Keyword(s):  
Regional Development ◽  
Self Regulation ◽  
Economic Cycle ◽  
Basic Principles ◽  
Systemic Mechanism ◽  
Crisis Conditions ◽  
External Borrowing ◽  
The Impact ◽  
Selection Of

The article deals with instruments recommended for regulating financial imbalances of endogenous-oriented development of the regions of Ukraine as an integral part of the regional economy management mechanism, and also explored the ways of regulating regional socioeconomic processes in crisis conditions. The basic principles of selection of instruments for the regulation of financial imbalances of endogenous-oriented development of regions are determined. The classification of instruments of regulation of financial imbalances of endogenous-oriented development is considered. The basic tools used to support the development of regions and municipalities are analyzed: legal; related to the development of appropriate strategies and programs; based on the implementation of inter-municipal cooperation; financial. The three main directions of financial imbalance regulation tools for endogenous-oriented development of the regions are investigated, which are used to analyze the impact on the effectiveness of regional development at different stages of the economic cycle. The system of specially organized measures of regulation of financial imbalances of endogenously oriented development of regions is substantiated. In modern conditions, great attention is paid to the problems of regulation of financial imbalances of endogenously oriented development of regions of Ukraine, the implementation of which requires special instruments. A holistic presentation of the systemic mechanism of regulation of financial imbalances of endogenously oriented development of regions is offered. After all, ensuring endogenous-oriented development of regions in the current conditions of functioning of the economy of Ukraine requires the implementation of strategies of socioeconomic transformation, which will be aimed at changing the financial imbalances of development of regions and mechanisms for their implementation. Endogenously oriented regional development means increasing the level of overcoming adverse social, economic and environmental risks and trends, with the ability of regions to provide financial imbalances, self-regulation, self-improvement with maximum use of internal as well as external borrowing resources to meet the needs of the population of the regions. The endogenous-oriented development of the regions is conditioned by the identification of instruments for regulating the financial imbalances of the regions and the identification of conditions for their achievement, which are derivatives for ensuring the endogenously-oriented development of the regions as a whole.

scholarly journals TAKING INTO ACCOUNT THE PARAMETERS OF AEROSOL EMISSIONS IN THE DEVELOPMENT TECHNOLOGICAL SOLUTIONS TO REDUCE THE IMPACT ON THE ENVIRONMENT

2021 ◽  
pp. 3-10
Author(s):  
Ivan Koziy ◽  
Leonid Plyatsuk ◽  
Larysa Hurets ◽  
Inna Trunova
Keyword(s):  
High Efficiency ◽  
Selection Process ◽  
Morphological Characteristics ◽  
Literary Sources ◽  
Reasonable Choice ◽  
Aerosol Emissions ◽  
Physical And Chemical ◽  
The Impact ◽  
Selection Of

The article discusses the issues of studying the parameters of various origins aerosol emissions in order to make a reasonable choice of appropriate technological solutions to reduce the impact on the environment. Based on the analysis of literary sources, a classical approach to the existing classification of aerosols considered: by the nature of the formation; by dispersion; by the state of aggregation of the dispersed phase; by morphological characteristics of particles; by particle concentration; by the nature of the impact on a person. Refinement of existing classifications was conducted based on the most important physical and chemical characteristics such as cohesiveness of particles, hygroscopicity, and ability to absorb additional substances from the environment which in turn is an important factor in the selection process of environmental solutions. Based on the analysis of aerosols classifications concluded possible solutions of the problem of selection of high-efficiency and reliable equipment capable for trapping fine dust with various physical and physicochemical parameters

Methods for Restricting Maximum Exposure Rate in Computerized Adaptative Testing

Methodology ◽  
2007 ◽  
Vol 3 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Juan Ramon Barrada ◽  
Julio Olea ◽  
Vicente Ponsoda
Keyword(s):  
Measurement Accuracy ◽  
Computerized Adaptive Testing ◽  
Computation Time ◽  
Adaptive Testing ◽  
Exposure Rate ◽  
Control Parameters ◽  
The Impact ◽  
Two Alternatives ◽  
Selection Of ◽  
Maximum Exposure

Abstract. The Sympson-Hetter (1985) method provides a means of controlling maximum exposure rate of items in Computerized Adaptive Testing. Through a series of simulations, control parameters are set that mark the probability of administration of an item on being selected. This method presents two main problems: it requires a long computation time for calculating the parameters and the maximum exposure rate is slightly above the fixed limit. Van der Linden (2003) presented two alternatives which appear to solve both of the problems. The impact of these methods in the measurement accuracy has not been tested yet. We show how these methods over-restrict the exposure of some highly discriminating items and, thus, the accuracy is decreased. It also shown that, when the desired maximum exposure rate is near the minimum possible value, these methods offer an empirical maximum exposure rate clearly above the goal. A new method, based on the initial estimation of the probability of administration and the probability of selection of the items with the restricted method ( Revuelta & Ponsoda, 1998 ), is presented in this paper. It can be used with the Sympson-Hetter method and with the two van der Linden's methods. This option, when used with Sympson-Hetter, speeds the convergence of the control parameters without decreasing the accuracy.

Use of photodynamic therapy for photodamage skin (review of literature)

2019 ◽  
Vol 1 (7) ◽  
pp. 19-23
Author(s):  
S. I. Surkichin ◽  
N. V. Gryazeva ◽  
L. S. Kholupova ◽  
N. V. Bochkova
Keyword(s):  
Photodynamic Therapy ◽  
Comparative Evaluation ◽  
Clinical Manifestations ◽  
Light Sources ◽  
Review Of Literature ◽  
Photosensitizing Agents ◽  
Selection Of

The article provides an overview of the use of photodynamic therapy for photodamage of the skin. The causes, pathogenesis and clinical manifestations of skin photodamage are considered. The definition, principle of action of photodynamic therapy, including the sources of light used, the classification of photosensitizers and their main characteristics are given. Analyzed studies that show the effectiveness and comparative evaluation in the selection of various light sources and photosensitizing agents for photodynamic therapy in patients with clinical manifestations of photodamage.

Philosophcal review of h. white̕s tropological theory in the context of the new philosophy of history

2020 ◽  
Vol 3 (152) ◽  
pp. 92-99
Author(s):  
S. M. Geiko ◽  
◽  
O. D. Lauta
Keyword(s):  
Modern Science ◽  
Historical Knowledge ◽  
Text Organization ◽  
The Social ◽  
History Of ◽  
Actual Material ◽  
The Common ◽  
Historical Nature ◽  
Selection Of

The article provides a philosophical analysis of the tropological theory of the history of H. White. The researcher claims that history is a specific kind of literature, and the historical works is the connection of a certain set of research and narrative operations. The first type of operation answers the question of why the event happened this way and not the other. The second operation is the social description, the narrative of events, the intellectual act of organizing the actual material. According to H. White, this is where the set of ideas and preferences of the researcher begin to work, mainly of a literary and historical nature. Explanations are the main mechanism that becomes the common thread of the narrative. The are implemented through using plot (romantic, satire, comic and tragic) and trope systems – the main stylistic forms of text organization (metaphor, metonymy, synecdoche, irony). The latter decisively influenced for result of the work historians. Historiographical style follows the tropological model, the selection of which is determined by the historian’s individual language practice. When the choice is made, the imagination is ready to create a narrative. Therefore, the historical understanding, according to H. White, can only be tropological. H. White proposes a new methodology for historical research. During the discourse, adequate speech is created to analyze historical phenomena, which the philosopher defines as prefigurative tropological movement. This is how history is revealed through the art of anthropology. Thus, H. White’s tropical history theory offers modern science f meaningful and metatheoretically significant. The structure of concepts on which the classification of historiographical styles can be based and the predictive function of philosophy regarding historical knowledge can be refined.

ON THE CLASSIFICATION OF DIGITAL TECHNOLOGIES IN CIVIL PROCESS

2019 ◽  
pp. 27-35
Author(s):  
Alexandr Neznamov
Keyword(s):  
Information Processing ◽  
Scientific Community ◽  
Digital Technologies ◽  
Significant Feature ◽  
Legal Proceedings ◽  
Civil Process ◽  
Civil Proceedings ◽  
Processing Information ◽  
The Impact

Digital technologies are no longer the future but are the present of civil proceedings. That is why any research in this direction seems to be relevant. At the same time, some of the fundamental problems remain unattended by the scientific community. One of these problems is the problem of classification of digital technologies in civil proceedings. On the basis of instrumental and genetic approaches to the understanding of digital technologies, it is concluded that their most significant feature is the ability to mediate the interaction of participants in legal proceedings with information; their differentiating feature is the function performed by a particular technology in the interaction with information. On this basis, it is proposed to distinguish the following groups of digital technologies in civil proceedings: a) technologies of recording, storing and displaying (reproducing) information, b) technologies of transferring information, c) technologies of processing information. A brief description is given to each of the groups. Presented classification could serve as a basis for a more systematic discussion of the impact of digital technologies on the essence of civil proceedings. Particularly, it is pointed out that issues of recording, storing, reproducing and transferring information are traditionally more «technological» for civil process, while issues of information processing are more conceptual.

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