scholarly journals Temporal prediction of in-hospital falls using tensor factorisation

2018 ◽  
Vol 4 (2) ◽  
pp. 75-83 ◽  
Author(s):  
Haolin Wang ◽  
Qingpeng Zhang ◽  
Hing-Yu So ◽  
Angela Kwok ◽  
Zoie Shui-Yee Wong

In-hospital fall incidence is a critical indicator of healthcare outcome. Predictive models for fall incidents could facilitate optimal resource planning and allocation for healthcare providers. In this paper, we proposed a tensor factorisation-based framework to capture the latent features for fall incidents prediction over time. Experiments with real-world data from local hospitals in Hong Kong demonstrated that the proposed method could predict the fall incidents reasonably well (with an area under the curve score around 0.9). As compared with the baseline time series models, the proposed tensor based models were able to successfully identify high-risk locations without records of fall incidents during the past few months.

Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 798-798
Author(s):  
Lama Assi ◽  
Ahmed Shakarchi ◽  
Bonnielin Swenor ◽  
Nicholas Reed

Abstract Sensory impairment is a barrier to patient-provider communication and access to care, which may impact satisfaction with care. Satisfaction with the quality of care received in the past year was assessed in the 2017 Medicare Current Beneficiary Survey (weighted sample=53,905,182 Medicare beneficiaries). Self-reported sensory impairment was categorized as no sensory impairment, hearing impairment (HI)-only, vision impairment (VI)-only, and dual sensory impairment (DSI) – concurrent HI and VI. In a model adjusted for sociodemographic characteristics and health determinants, having DSI was associated with higher odds of dissatisfaction with the quality of care received (Odds Ratio [OR]=1.53, 95%Confidence Interval [CI]=1.14-2.06) relative to no sensory impairment; however, having HI-only or VI-only were not (OR=1.33, 95%CI=1.94-1.89, and OR=1.32, 95%CI=0.95-1.93, respectively). These findings have implications for healthcare providers as Medicare shifts to value-based reimbursement. Moreover, previous work that singularly focused on HI or VI alone may have failed to recognize the compounded effect of DSI.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 611-612
Author(s):  
Taylor Patskanick ◽  
Julie Miller

Abstract Medication management is an ongoing consideration for adults ages 85 and older, their caregivers, and healthcare providers. When asked about their attitudes and behaviors regarding medication management, over 73% of the Lifestyle Leaders reported taking 3+ prescription medications daily and managing their own medication regimes. 61.9% of participants had taken over-the-counter, non-prescription medication for pain over the past five years. When asked why some participants didn’t currently take prescription medications to manage pain, the most frequently-reported responses were: “I don’t feel that my pain warrants a prescription medication,” (19%, n=8), “I don’t want to deal with the side effects,” and “I don’t trust drug companies,” (9.5%, n=4, respectively). The Lifestyle Leaders reported they would be most likely to go to the internet (over their local pharmacist) to ask for advice about their medication(s). Meanwhile, 39% of Lifestyle Leaders would trust a robot to manage their medication(s) for them.


Author(s):  
Tulika Chatterjee ◽  
Johnathon Stephens ◽  
Moni Roy

Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement.


2021 ◽  
Author(s):  
Johannes Marian Landmann ◽  
Matthias Huss ◽  
Hans Rudolf Künsch ◽  
Christophe Ogier ◽  
Lea Geibel ◽  
...  

&lt;p&gt;As glaciers shrink, high interest in their near real-time mass balance arises. This is mainly for two reasons: first, there are concerns about water availability and short-term water resource planning, and second, glaciers are one of the most prominent indicators of climate change, resulting in a high interest of the broader public.&lt;/p&gt;&lt;p&gt;To satisfy both interests regarding information on near real-time mass balance, we are running the project CRAMPON &amp;#8211; &amp;#8220;Cryospheric Monitoring and Prediction Online&amp;#8221;. Within this project, we set up an operational assimilation platform where it is possible to query daily mass balance estimates in near real-time, i.e. updated with a lag of max. 24 hours. During the operational alpha phase, we increase the amount of modelled glaciers and assimilated observations steadily. We start with about 15 glaciers from the Glacier Monitoring Switzerland (GLAMOS) program, for which time series of seasonal mass balances from the glaciological method are available. After that, we expand our set of modelled glaciers to about 50 glaciers that have frequent geodetic mass balances in the past, and finally to all glaciers in Switzerland. The assimilated observations reach from the operational GLAMOS seasonal mass balance observations via daily point mass balances from nine in situ cameras providing instantaneous ablation rates to satellite-derived albedo and snow distribution on the glacier.&lt;br&gt;As basis for the platform, we run an ensemble of three temperature index and one simplified energy balance melt models. This ensemble takes gridded temperature, precipitation and radiation as input and aims at quantifying uncertainties of the produced daily mass balances. To determine uncertainties in the model prediction of a current mass budget year correctly, we run the models with parameter distributions we have fitted on individual parameter sets calibrated in the past. Since a purely model-based prediction can reveal high uncertainties though, we choose a sequential data assimilation approach in the form of a Particle Filter to constrain this uncertainty with observations, whenever available. We have customized the standard Particle Filter to (1) use a resampling method that is able to keep models in the ensemble despite a temporary bad performance, and (2) allow parameter and model probability evolution over time.&lt;/p&gt;&lt;p&gt;In this contribution, we focus on giving a holistic overview over the already existing platform features and discuss the future developments. We plan to make the calculated mass balances publicly available in summer 2021, and to extend this platform to the global scale at a later stage.&lt;/p&gt;


Author(s):  
William S ENNS-BRAY ◽  
Kim ROCHAT

The rapid evolution of information technology over the past 50 years is transforming our healthcare institutions from paper-based organizations into smart hospitals, a term now used by European Union Agency for Cybersecurity (ENISA). These changes are also associated with the systematic reliance on medical devices by both patients and healthcare providers. While these devices have the potential to advance personalized health solutions and improving the quality and efficacy of care, they nevertheless present significant security risks and challenges throughout the healthcare sector.


2021 ◽  
pp. 99-124
Author(s):  
Michael J. Saks ◽  
Stephan Landsman

“Defensive Medicine: A Response to the Legal Response?” discusses the origins, meaning, purposes, and uncertain existence of defensive medicine. The concept has been most useful for those promoting changes in the law to economically benefit the healthcare industry. In the span of several decades, healthcare providers reversed their stance on whether or not they practice defensively. Why would providers commit defensive medicine? Why would they admit to practices that are universally seen as unethical, illegal (fraud), and unsound medical practice? Different types of empirical research have tried to determine whether defensive medicine occurs and, if so, its extent, cost, and effects on patients: physician self-report surveys, clinical scenario surveys, and multivariate analyses of real-world data. The chapter explores the possibility that defensive practices mostly occur in those situations where considerable uncertainty about diagnosis exists and the risk of serious harm is great if the patient is not treated correctly.


2017 ◽  
Vol 6 (3) ◽  
pp. 279-289 ◽  
Author(s):  
Yuan Yang ◽  
Zhen Qin ◽  
Wei Zeng ◽  
Ting Yang ◽  
Yubin Cao ◽  
...  

AbstractIn the past decades, much attention has been paid to toxicity assessment of nanoparticles prior to clinical and biological applications. Whilein vitrostudies have been increasing constantly,in vivostudies of nanoparticles have not established a unified system until now. Predictive models and validated standard methods are imperative. This review summarizes the current progress in approaches assessing nanotoxicity in main systems, including the hepatic and renal, gastrointestinal, pulmonary, cardiovascular, nervous, and immune systems. Histopathological studies and specific functional examinations in each system are elucidated. Related injury mechanisms are also discussed.


2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Monira Alwhaibi ◽  
Yazed AlRuthia ◽  
Abdulkarim M. Meraya

Objective. To examine the association between sex and the use of complementary and alternative medicine (CAM) among adults with arthritis. Methods. Data from the 2012 National Health Interview Survey on CAM use for adults with arthritis were analyzed. Five different multivariable regression models were used to examine the association between sex and CAM use after adjusting for demographics, socioeconomics, perceived health status, functional limitations, comorbid chronic conditions, body mass index, and personal health practices. Results. The number of subjects who met the eligibility criteria and were eventually included in the study was 7,919 adults with arthritis. Around half of the study sample reported ever using CAM (n = 4,055), and about 27% (n = 2,016) reported using CAM in the past 12 months. Women have a significantly higher rate of ever utilization of CAM compared to their male counterparts (62.2% vs. 37.8%) as well as CAM use over the past 12 months (66.1% vs. 33.9%). After controlling for other covariates that can potentially affect the use of CAM, women had higher odds of ever using CAM (AOR = 1.68, 95% CI = 1.55–1.81) as well as the CAM use in the past 12 months (AOR = 1.63, 95% CI = 1.49–1.78) compared to men. Functional limitation and multiple comorbidities were associated with CAM use among women. Conclusions. The utilization rate of CAM among women with arthritis is significantly higher compared to their male counterparts, which highlights the need to screen adults with arthritis, particularly women, for potential drug-CAM interactions. Also, practicing patient-centered care is important, which should allow the patients to discuss the potential benefits and risks of CAM use with their healthcare providers.


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