scholarly journals Guiding Principles for a Pediatric Neurology ICU (neuroPICU) Bedside Multimodal Monitor

2016 ◽  
Vol 07 (02) ◽  
pp. 380-398 ◽  
Author(s):  
Yonina Eldar ◽  
Daniel Gopher ◽  
Amihai Gottlieb ◽  
Rotem Lammfromm ◽  
Halinder Mangat ◽  
...  
Keyword(s):  
Time Series ◽  
Medical Information ◽  
Rapid Review ◽  
Current Status ◽  
Patient Specific ◽  
Multiple Sources ◽  
Pediatric Neurology ◽  
Information Strategies ◽  
Clinical Scenarios ◽  
Guiding Principles

SummaryPhysicians caring for children with serious acute neurologic disease must process overwhelming amounts of physiological and medical information. Strategies to optimize real time display of this information are understudied.Our goal was to engage clinical and engineering experts to develop guiding principles for creating a pediatric neurology intensive care unit (neuroPICU) monitor that integrates and displays data from multiple sources in an intuitive and informative manner.To accomplish this goal, an international group of physicians and engineers communicated regularly for one year. We integrated findings from clinical observations, interviews, a survey, signal processing, and visualization exercises to develop a concept for a neuroPICU display.Key conclusions from our efforts include: (1) A neuroPICU display should support (a) rapid review of retrospective time series (i.e. cardiac, pulmonary, and neurologic physiology data), (b) rapidly modifiable formats for viewing that data according to the specialty of the reviewer, and (c) communication of the degree of risk of clinical decline. (2) Specialized visualizations of physiologic parameters can highlight abnormalities in multivariable temporal data. Examples include 3-D stacked spider plots and color coded time series plots. (3) Visual summaries of EEG with spectral tools (i.e. hemispheric asymmetry and median power) can highlight seizures via patient-specific “fingerprints.” (4) Intuitive displays should emphasize subsets of physiology and processed EEG data to provide a rapid gestalt of the current status and medical stability of a patient.A well-designed neuroPICU display must present multiple datasets in dynamic, flexible, and informative views to accommodate clinicians from multiple disciplines in a variety of clinical scenarios.

Current Status of a Medical Information System

1970 ◽  
Vol 09 (03) ◽  
pp. 149-160 ◽  
Author(s):  
E. Van Brunt ◽  
L. S. Davis ◽  
J. F. Terdiman ◽  
S. Singer ◽  
E. Besag ◽  
...  
Keyword(s):  
Information System ◽  
Medical Records ◽  
Medical Information ◽  
Clinical Laboratory ◽  
Development Program ◽  
Medical Data ◽  
Direct Access ◽  
Medical Information System ◽  
Current Status ◽  
Central System

A pilot medical information system is being implemented and currently is providing services for limited categories of patient data. In one year, physicians’ diagnoses for 500,000 office visits, 300,000 drug prescriptions for outpatients, one million clinical laboratory tests, and 60,000 multiphasic screening examinations are being stored in and retrieved from integrated, direct access, patient computer medical records.This medical information system is a part of a long-term research and development program. Its major objective is the development of a multifacility computer-based system which will support eventually the medical data requirements of a population of one million persons and one thousand physicians. The strategy employed provides for modular development. The central system, the computer-stored medical records which are therein maintained, and a satellite pilot medical data system in one medical facility are described.

Overview Statement on Medical Records

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 329-329 ◽  
Author(s):  
Hugh C. Thompson ◽  
Stanton J. Barron ◽  
John P. Connelly ◽  
Andrew Margileth ◽  
Richard Olmsted ◽  
...  
Keyword(s):  
Medical Record ◽  
Medical Records ◽  
Medical Information ◽  
Third Party ◽  
Specific Information ◽  
Multiple Sources ◽  
Chart Audit ◽  
Working Together ◽  
The One ◽  
The Individual

Historically, medical records have been maintamed by individual physicians to record specific information concerning patients. This information was often understandable only to the writer. The data were of outstanding events. This was thought to be sufficient documentation for patient care. Records are now read by others than the individual physicians. Groups of physicians working together often share the same patients and their records. Patients may have multiple sources of care. Our population has become more mobile which makes it necessary to transfer vast amounts of medical information. The medical record many times is the one instrument which gives a complete and continuous documentation of the patient's medical history. Third-party payers are requesting access to medical records to document services provided. Chart audit is being tested as a mechanism for evaluating physician performance. Records must reflect what the physician does in order to be useful in such an appraisal. Much clinical research on the delivery of health care depends on accurately kept records which are easily interpreted. A chart is also a legal document for the protection of the physician as well as the patient. Thus, records will be used in other than traditional ways. Proper confidentiality must be maintained when such uses are necessary. Physicians generally agree as to the essential content of a medical record. However, there is little unanimity as to the structure of the chart. No one system of keeping records is now appropriate for all situations. The maintenance of adequate charts requires additional cost in both time and money.

scholarly journals Islamic Ethos: Examining Sources of Authority

Humanities ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 170 ◽  
Author(s):  
Lana Oweidat
Keyword(s):  
Historical Narrative ◽  
Careful Examination ◽  
Islamic State ◽  
Religious Leaders ◽  
Multiple Sources ◽  
Islamic Period ◽  
Sources Of Authority ◽  
Guiding Principles ◽  
Racist Discourse ◽  
Early Islamic Period

This paper investigates the construction of Islamic ethos in the early Islamic period, highlighting what constitutes the guiding principles of its authority. As a religion that is currently subject to many ugly charges, a careful examination of its core historic values provides a counternarrative to the distorted ideology perpetuated by extremists such as The Islamic State of Iraq and Syria (ISIS), as well as to the Islamophobic and anti-Muslim racist discourse circulating in the West. The counternarrative presented here serves scholars of ethos whose expertise lies elsewhere than in religious studies. While providing this historical narrative, I highlight how Islamic ethos is derived from multiple sources of religious and cultural/communal authority, mainly from The Qur’an (the holy book of Muslims); the Sunnah (the Prophet Muḥammad’s example, deeds, and customs); and ijtihad (the interpretations and deductions of Muslim religious leaders). Tracing the construction of Islamic ethos through the creation of the Muslim community (Ummah) in 622 CE and the establishment of the Caliphate in 632 CE reveals guiding principles of conduct that are, in contrast to the discourses mentioned above, realistic, practical, and adaptable to current global needs and exigencies.

scholarly journals Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Biomolecules ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1577
Author(s):  
Zhonghua Sun
Keyword(s):  
Cardiovascular Disease ◽  
3D Printing ◽  
Current Status ◽  
Patient Specific ◽  
Future Research ◽  
Junior Doctors ◽  
Imaging Data ◽  
Training Tool ◽  
Complex Anatomy ◽  
3D Printed

Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.

Update on Palliative Care for Pediatric Neurology

2018 ◽  
Vol 36 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Ariel M. Lyons-Warren
Keyword(s):  
Palliative Care ◽  
American Academy ◽  
Palliative Medicine ◽  
Symptom Burden ◽  
Current Status ◽  
Care Model ◽  
Pediatric Neurology ◽  
Neurological Conditions ◽  
American Academy Of Neurology

It has long been recognized that patients with neurological conditions, and particularly pediatric neurology patients, are well suited for palliative care because they frequently have a high symptom burden and variable prognoses. In 1996, the American Academy of neurology formally recognized a need for neurologists to “understand and apply the principles of palliative medicine.” Subsequently, some reviews have proposed a simultaneous care model in which palliative care is integrated for all neurology patients from the time of diagnosis. This article will review the current status of palliative care in pediatric neurology and discuss barriers to its integration.

scholarly journals Research on Teaching Model of Medical Information Retrieval

2018 ◽  
Vol 227 ◽  
pp. 03003
Author(s):  
Yongrui Zhang ◽  
Jialin Gao
Keyword(s):  
Information Retrieval ◽  
Evaluation System ◽  
Medical Information ◽  
Classroom Interaction ◽  
Teaching Quality ◽  
Current Status ◽  
The Internet ◽  
Teaching Model ◽  
Traditional Teaching ◽  
Medical Information Retrieval

With the advent of the Internet era, traditional teaching forms, teaching methods and teaching concepts have undergone tremendous changes, and the teaching of medical information retrieval courses has also undergone good changes. This paper will explore the new teaching model of medical information retrieval under the Internet era from the teaching modes of PICOS, MOOC, SPOC, etc., in order to change the current status of poor classroom interaction and lack of high-quality teaching resources in college medical information retrieval courses, and improve the teaching quality of medical information retrieval courses and graduate students’ information literacy; and effectively change the traditional teaching evaluation system, give full play to the advantages of the network environment, and better innovate and rectify the teaching mode of medical information retrieval courses.

Appropriateness of adjuvant systemic therapy for axillary node-negative breast cancer: a physician opinion survey.

1995 ◽  
Vol 13 (6) ◽  
pp. 1459-1469 ◽  
Author(s):  
C A Sawka ◽  
A M O'Connor ◽  
H A Llewellyn-Thomas ◽  
T To ◽  
S P Pinfold ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Combination Chemotherapy ◽  
Current Knowledge ◽  
Menopausal Status ◽  
Specific Treatment ◽  
Patient Specific ◽  
Node Negative ◽  
Node Negative Breast Cancer ◽  
Clinical Scenarios

PURPOSE To examine variations in physicians' recommendations for systemic adjuvant therapy in the treatment of women with node-negative breast cancer (NNBC) and to determine factors used in making specific recommendations. MATERIALS AND METHODS A questionnaire was sent by mail to all 149 Ontario physicians who actively treated breast cancer in 1993. The questionnaire described 48 clinical scenarios of women with NNBC, which included all possible combinations of the following factors: menopausal status, tumor size, hormone receptor status, histologic and nuclear grade, and lymphatic and/or vascular invasion. Respondents rated the appropriateness of administering tamoxifen, combination chemotherapy, or both tamoxifen and combination chemotherapy on a nine-point scale from extremely inappropriate to extremely appropriate. Respondent agreement and disagreement were tabulated for each scenario, and factors associated with specific treatment ratings were analyzed by logistic regression. RESULTS The response rate was 87%. Agreement for the appropriateness of specific therapies was most evident where clinical trials have demonstrated efficacy, whereas disagreement was observed in scenarios in which support for a specific treatment is not available in the current literature. Relevant tumor- and patient-specific factors were used in decision-making; personal characteristics of the respondents had no statistically significant impact on appropriateness ratings. CONCLUSION The physicians surveyed had good knowledge of NNBC prognostic factors, but had a range of opinion on optimal therapy for many clinical scenarios, which reflects current knowledge of the benefits of adjuvant therapy for NNBC.

Exploring signatures-based calibration of hydrological models for prediction in ungauged basins.

2020 ◽  
Author(s):  
Marco Dal Molin ◽  
Dmitri Kavetski ◽  
Mario Schirmer ◽  
Fabrizio Fenicia
Keyword(s):  
Time Series ◽  
Accurate Estimation ◽  
Ungauged Basins ◽  
Rainfall Runoff ◽  
Multiple Sources ◽  
Important Challenge ◽  
Rainfall Runoff Model ◽  
Approximate Bayesian ◽  
Correct Estimation ◽  
Runoff Model

<p>One of the open challenges in catchment hydrology is prediction in ungauged basins (PUB), i.e. being able to predict catchment responses (typically streamflow) when measurements are not available. One of the possible approaches to this problem consists in calibrating a model using catchment response statistics (called signatures) that can be estimated at the ungauged site.<br>An important challenge of any approach to PUB is to produce reliable and precise predictions of catchment response, with an accurate estimation of the uncertainty. In the context of PUB through calibration on regionalized streamflow signatures, there are multiple sources of uncertainty that affect streamflow predictions, which relate to:</p><ul><li>The use streamflow signatures, which, by synthetizing the underlying time series, reduce the information available for model calibration;</li> <li>The regionalization of streamflow signatures, which are not observed, but estimated through some signature regionalization model;</li> <li>The use of a rainfall-runoff model, which carries uncertainties related to input data, parameter values, and model structure.</li> </ul><p>This study proposes an approach that separately accounts for the uncertainty related to the regionalization of the signatures from the other types; the implementation uses Approximate Bayesian Computation (ABC) to infer the parameters of the rainfall-runoff model using stochastic streamflow signatures. <br>The methodology is tested in six sub-catchments of the Thur catchment in Switzerland; results show that the regionalized model produces streamflow time series that are similar to the ones obtained by the classical time-domain calibration, with slightly higher uncertainty but similar fit to the observed data. These results support the proposed approach as a viable method for PUB, with a focus on the correct estimation of the uncertainty.</p>

scholarly journals Factors associated with the consumption of chlorine dioxide to prevent and treat COVID-19 in the Peruvian population: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David R. Soriano-Moreno ◽  
Daniel Fernandez-Guzman ◽  
Fabricio Ccami-Bernal ◽  
Cristhian Rojas-Miliano ◽  
Wendy Nieto-Gutierrez
Keyword(s):  
Chlorine Dioxide ◽  
Medical Information ◽  
Cross Sectional Study ◽  
Consumption Pattern ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Information Strategies ◽  
The Family ◽  
History Of

Abstract Background Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population. Methods Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method. Results Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09–1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35–0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02–1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40–0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01–1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45–0.74), using medications (aPR: 1.59; 95% CI: 1.25–2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21–2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18–0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16–0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33–0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12–0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07–0.32). Conclusions The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.

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