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Hospital Mortality in the United States following Acute Kidney Injury

BIOMED RESEARCH INTERNATIONAL 2016年第0期2016卷 4278579-4278579页

作者： Brown, Jeremiah R. Rezaee, Michael E. Marshall, Emily J. Matheny, Michael E. Geisel Sch Med Dartmouth Inst Hlth Policy & Clin Practice Lebanon NH 03756 USA Dartmouth Hitchcock Med Ctr Dept Med Lebanon NH 03756 USA Dept Community & Family Med Lebanon NH 03756 USA Oakland Univ William Beaumont Sch Med Rochester MI 48309 USA Vet Hlth Adm TVHS GRECC Nashville TN 37232 USA Vanderbilt Univ Dept Med Sch Med Div Gen Internal Med Nashville TN 37232 USA Vanderbilt Univ Dept Biomed Informat Sch Med Nashville TN 37232 USA Vanderbilt Univ Dept Biostat Sch Med Nashville TN 37232 USA

Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths increased almost twofold from 147,943 to 285,768 deaths. We discuss the importance of the 71% reduction in AKI-related mortality among hospitalized patients in the United States and draw on the discussion of whether or not this is a phenomenon of hospital billing (coding) or improvements to the management of AKI.

关键词： ACUTE kidney failure CONFIDENCE intervals PROBABILITY theory FINANCING of research HEALTH insurance reimbursement MULTIPLE regression analysis DISEASE incidence DATA analysis software medical coding DESCRIPTIVE statistics HOSPITAL patients -- Mortality ODDS ratio TREATMENT

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New Trends of Digital Data Storage in DNA

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BIOMED RESEARCH INTERNATIONAL 2016年第0期2016卷 8072463-8072463页

作者： De Silva, Pavani Yashodha Ganegoda, Gamage Upeksha Univ Moratuwa Fac Informat Technol Katubedda Moratuwa Sri Lanka

With the exponential growth in the capacity of information generated and the emerging need for data to be stored for prolonged period of time, there emerges a need for a storage medium with high capacity, high storage density, and possibility to withstand extreme environmental conditions. DNA emerges as the prospective medium for data storage with its striking features. Diverse encoding models for reading and writing data onto DNA, codes for encrypting data which addresses issues of error generation, and approaches for developing codons and storage styles have been developed over the recent past. DNA has been identified as a potential medium for secret writing, which achieves the way towards DNA cryptography and stenography. DNA utilized as an organic memory device along with big data storage and analytics in DNA has paved the way towards DNA computing for solving computational problems. This paper critically analyzes the various methods used for encoding and encrypting data onto DNA while identifying the advantages and capability of every scheme to overcome the drawbacks identified priorly. Cryptography and stenography techniques have been analyzed in a critical approach while identifying the limitations of each method. This paper also identifies the advantages and limitations of DNA as a memory device and memory applications.

关键词： ALGORITHMS COMPUTERS DATABASE management DNA INFORMATION retrieval POLYMERASE chain reaction DATA security medical coding SOFTWARE analytics

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ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration-2014

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2015年第13期72卷 1119-1137页

作者： Pedersen, Craig A. Schneider, Philip J. Scheckelhoff, Douglas J. Confluence Hlth Wenatchee WA 98801 USA Univ Arizona Coll Pharm Phoenix AZ USA Univ Arizona Phoenix AZ USA Amer Soc Hlth Syst Pharmacists Off Practice Adv Bethesda MD USA

Purpose. The results of the 2014 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are described. Methods. A stratified random sample of pharmacy directors at 1435 general and children's medical surgical hospitals in the United States were surveyed by mail. Results. In this national probability sample survey, the response rate was 29.7%. Ninety-seven percent of hospitals used automated dispensing cabinets in their medication distribution systems, 65.7% of which used individually secured lidded pockets as the predominant configuration. Overall, 44.8% of hospitals used some form of machine-readable coding to verify doses before dispensing in the pharmacy. Overall, 65% of hospital pharmacy departments reported having a cleanroom compliant with United States Pharmacopeia chapter 797. Pharmacists reviewed and approved all medication orders before the first dose was administered, either onsite or by remote order view, except in procedure areas and emergency situations, in 81.2% of hospitals. Adoption rates of electronic health information have rapidly increased, with the widespread use of electronic health records, computer prescriber order entry, barcodes, and smart pumps. Overall, 31.4% of hospitals had pharmacists practicing in ambulatory or primary care clinics. Transitions-of-care services offered by the pharmacy department have generally increased since 2012. Discharge prescription services increased from 11.8% of hospitals in 2012 to 21.5% in 2014. Approximately 15% of hospitals outsourced pharmacy management operations to a contract pharmacy services provider, an increase from 8% in 2011. Conclusion. Health-system pharmacists continue to have a positive impact on improving healthcare through programs that improve the efficiency, safety, and clinical outcomes of medication use in health systems.

关键词： BAR codes CLINICAL medicine DRUG delivery systems HAZARDOUS substances HOSPITAL pharmacies HOSPITALS INFORMATION storage & retrieval systems -- medical care QUESTIONNAIRES DATA analysis software medical coding DESCRIPTIVE statistics MEDICATION reconciliation

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Error-Correcting Output Codes in Classification of Human Induced Pluripotent Stem Cell Colony Images

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BIOMED RESEARCH INTERNATIONAL 2016年第0期2016卷 3025057-3025057页

作者： Joutsijoki, Henry Haponen, Markus Rasku, Jyrki Aalto-Setala, Katriina Juhola, Martti Univ Tampere Sch Informat Sci Kanslerinrinne 1 Tampere 33014 Finland Univ Tampere BioMediTech Biokatu 12 Tampere 33520 Finland Univ Tampere Sch Med Biokatu 12 Tampere 33520 Finland

The purpose of this paper is to examine how well the human induced pluripotent stem cell (hiPSC) colony images can be classified using error-correcting output codes (ECOC). Our image dataset includes hiPSC colony images from three classes (bad, semigood, and good) which makes our classification task a multiclass problem. ECOC is a general framework to model multiclass classification problems. We focus on four different coding designs of ECOC and apply to each one of them k-Nearest Neighbor (k-NN) searching, naive Bayes, classification tree, and discriminant analysis variants classifiers. We use Scaled Invariant Feature Transformation (SIFT) based features in classification. The best accuracy (62.4%) is obtained with ternary complete ECOC coding design and k-NN classifier (standardized Euclidean distance measure and inverse weighting). The best result is comparable with our earlier research. The quality identification of hiPSC colony images is an essential problem to be solved before hiPSCs can be used in practice in large-scale. ECOC methods examined are promising techniques for solving this challenging problem.

关键词： ALGORITHMS COMPARATIVE studies DISCRIMINANT analysis MICROSCOPY PROBABILITY theory RESEARCH -- Evaluation FINANCING of research STEM cells medical coding DESCRIPTIVE statistics

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On the discovery of hospital admission patterns-a clarification

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BIOINFORMATICS 2016年第13期32卷 2078-2078页

作者： Arandjelovic, Ognjen Univ St Andrews Sch Comp Sci St Andrews Fife Scotland

Contact: ***{at}***

关键词： Routine diagnostic tests Electronic records medical coding

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Navigating the Alcohol Treatment Pathway: A Qualitative Study from the Service Users' Perspective

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ALCOHOL AND ALCOHOLISM 2015年第4期50卷 444-450页

作者： Gilburt, Helen Drummond, Colin Sinclair, Julia Kings Coll London Addict Dept Inst Psychiat Psychol & Neurosci London SE5 8AB England Univ Southampton Fac Med Univ Dept Psychiat Clin & Expt Sci Southampton SO9 5NH Hants England

Provision of effective treatment for dependent drinkers has been identified as a priority in England yet evidence suggests that access is problematic and there are low levels of retention. This qualitative study explores how the alcohol treatment system is experienced by service users, identifying barriers and facilitators that influence treatment outcomes. A total of 20 semi-structured face-to-face interviews were conducted with patients from community alcohol treatment services in three London boroughs in 2012. Interviews were undertaken one year after initially entering treatment. A thematic analysis was conducted, with the results further abstracted to relate them to specific aspects of the treatment journey. Patients journeys were characterized by a perceived lack of control leading to help-seeking, with treatment outcomes influenced by an individuals' self-efficacy and the capabilities and skills of staff in actively engaging and supporting patients on the journey. A focus of services on the detoxification process and fragmented care pathways impacted negatively on engagement. Current alcohol care pathways require significant levels of motivation and self-efficacy to navigate that few patients possess. Pathways need to better reflect the capacity and capabilities of patients to be successful in supporting recovery.

关键词： ALCOHOLICS -- Rehabilitation ALCOHOLISM -- Psychological aspects CONCEPTUAL structures (Information theory) HELP-seeking behavior INTERVIEWING RESEARCH -- Methodology NATIONAL health services QUESTIONNAIRES RESEARCH -- Evaluation RESEARCH -- Finance SELF-efficacy QUALITATIVE research TREATMENT programs THEMATIC analysis TREATMENT effectiveness DATA analysis -- Software PATIENTS -- Attitudes medical coding

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Practical use of medical terminology in curriculum mapping

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COMPUTERS IN BIOLOGY AND MEDICINE 2015年 63卷 74-82页

作者： Komenda, Martin Schwarz, Daniel Svancara, Jan Vaitsis, Christos Zary, Nabil Dusek, Ladislav Masaryk Univ Fac Med Inst Biostat & Anal CS-60177 Brno Czech Republic Karolinska Inst Dept Learning Informat Management & Eth S-10401 Stockholm Sweden

Background: Various information systems for medical curriculum mapping and harmonization have been developed and successfully applied to date. However, the methods for exploiting the datasets captured inside the systems are rather lacking. Method: We reviewed the existing medical terminologies, nomenclatures, coding and classification systems in order to select the most suitable one and apply it in delivering visual analytic tools and reports for the benefit of medical curriculum designers and innovators. Results: A formal description of a particular curriculum of general medicine is based on 1347 learning units covering 7075 learning outcomes. Two data-analytical reports have been developed and discussed, showing how the curriculum is consistent with the MeSH thesaurus and how the MeSH thesaurus can be used to demonstrate interconnectivity of the curriculum through association analysis. Conclusion: Although the MeSH thesaurus is designed mainly to index medical literature and support searching through bibliographic databases, we have proved its use in medical curriculum mapping as being beneficial for curriculum designers and innovators. The presented approach can be followed wherever needed to identify all the mandatory components used for transparent and comprehensive overview of medical curriculum data. (C) 2015 Elsevier Ltd. All rights reserved.

关键词： medical informatics medical coding MeSH medical education Curriculum management Visual analytics Association analysis

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Dose-Response Relationships of Balance Training in Healthy Young Adults: A Systematic Review and Meta-Analysis

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SPORTS MEDICINE 2015年第4期45卷 557-576页

作者： Lesinski, Melanie Hortobagyi, Tibor Muehlbauer, Thomas Gollhofer, Albert Granacher, Urs Univ Potsdam Div Training & Movement Sci Res Focus Cognit Sci D-14469 Potsdam Germany Univ Groningen Univ Med Ctr Groningen Ctr Human Movement Sci NL-9713 AV Groningen Netherlands Univ Freiburg Inst Sport & Sport Sci D-79106 Freiburg Germany

Background Balance training (BT) has been used for the promotion of balance and sports-related skills as well as for prevention and rehabilitation of lower extremity sport injuries. However, evidence-based dose-response relationships in BT parameters have not yet been established. Objective The objective of this systematic literature review and meta-analysis was to determine dose-response relationships in BT parameters that lead to improvements in balance in young healthy adults with different training status. Data Sources A computerized systematic literature search was performed in the electronic databases PubMed, Web of Knowledge, and SPORTDiscus from January 1984 up to May 2014 to capture all articles related to BT in young healthy adults. Study Eligibility Criteria A systematic approach was used to evaluate the 596 articles identified for initial review. Only randomized controlled studies were included if they investigated BT in young healthy adults (16-40 years) and tested at least one behavioral balance performance outcome. In total, 25 studies met the inclusion criteria for review. Study Appraisal and Synthesis Methods Studies were evaluated using the physiotherapy evidence database (PEDro) scale. Within-subject effect sizes (ESdw) and between-subject effect sizes (ESdb) were calculated. The included studies were coded for the following criteria: training status (elite athletes, sub-elite athletes, recreational athletes, untrained subjects), training modalities (training period, frequency, volume, etc.), and balance outcome (test for the assessment of steady-state, proactive, and reactive balance). Results Mean ESdb demonstrated that BT is an effective means to improve steady-state (ESdb = 0.73) and proactive balance (ESdb = 0.92) in healthy young adults. Studies including elite athletes showed the largest effects (ESdb = 1.29) on measures of steady-state balance as compared with studies analyzing sub-elite athletes (ESdb = 0.32), recreational athletes (ESdb

关键词： RESEARCH methodology evaluation CONFIDENCE intervals DOSE-response relationship (Biochemistry) EQUILIBRIUM (Physiology) EXERCISE physiology EXPERIMENTAL design INFORMATION storage & retrieval systems MEDLINE META-analysis ONLINE information services PHYSICAL fitness SPORTS THERAPEUTICS TIME SYSTEMATIC reviews (medical research) EVIDENCE-based medicine EFFECT sizes (Statistics) ELITE athletes EXERCISE intensity medical coding EVALUATION

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Patients' Use of a Home-Based Virtual Reality System to Provide Rehabilitation of the Upper Limb Following Stroke

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PHYSICAL THERAPY 2015年第3期95卷 350-359页

作者： Standen, Penny. Threapleton, Kate Connell, Louise Richardson, Andy Brown, David J. Battersby, Steven Sutton, Catherine Jane Platts, Fran Univ Nottingham Sch Med QMC Nottingham NG7 2UH England Univ Nottingham Sch Hlth Sci Nottingham NG7 2UH England Univ Cent Lancashire Sch Hlth Preston PR1 2HE Lancs England Derbyshire Community Hlth Serv Belper Derby England Nottingham Trent Univ Sch Sci & Technol Comp & Technol Team Nottingham England Univ Nottingham Div Rehabil & Ageing Nottingham NG7 2UH England Sherwood Forest Hosp NHS Fdn Trust Ashfield Notts England

Background. A low-cost virtual reality system that translates movements of the hand, fingers, and thumb into game play was designed to provide a flexible and motivating approach to increasing adherence to home-based rehabilitation. Objective. Effectiveness depends on adherence, so did patients use the intervention to the recommended level? If not, what reasons did they give? The purpose of this study was to investigate these and related questions. Design. A prospective cohort study, plus qualitative analysis of interviews, was conducted. Methods. Seventeen patients recovering from stroke recruited to the intervention arm of a feasibility trial had the equipment left in their homes for 8 weeks and were advised to use it 3 times a day for periods of no more than 20 minutes. Frequency and duration of use were automatically recorded. At the end of the intervention, participants were interviewed to determine barriers to using it in the recommended way. Results. Duration of use and how many days they used the equipment are presented for the 13 participants who successfully started the intervention. These figures were highly variable and could fall far short of our recommendations. There was a weak positive correlation between duration and baseline reported activities of daily living. Participants reported lack of familiarity with technology and competing commitments as barriers to use, although they appreciated the flexibility of the intervention and found it motivating. Limitations. The small sample size limits the conclusions that can be drawn. Conclusions. Level of use is variable and can fall far short of recommendations. Competing commitments were a barrier to use of the equipment, but participants reported that the intervention was flexible and motivating. It will not suit everyone, but some participants recorded high levels of use. Implications for practice are discussed.

关键词： ARM -- Physiology ACTIVITIES of daily living EVALUATION REHABILITATION METHODOLOGY HOME care services CLINICAL trials CONFIDENCE GAMES HEALTH status indicators INTERVIEWING LIFE skills LONGITUDINAL method COMPUTERS in medicine MOTIVATION (Psychology) PATIENT compliance PROBABILITY theory RESEARCH -- Evaluation RESEARCH -- Finance SAMPLING (Statistics) TECHNOLOGY THERAPEUTICS TIME TIME management VIRTUAL reality QUALITATIVE research PILOT projects PRODUCT design QUANTITATIVE research SOCIAL support THEMATIC analysis RANDOMIZED controlled trials TREATMENT effectiveness PRE-tests & post-tests DATA analysis -- Software medical coding STROKE -- Patients -- Rehabilitation DESCRIPTIVE statistics

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Problem-based learning in undergraduate medical education in Saudi Arabia: Time has come to reflect on the experience

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medical TEACHER 2015年第Sup1期37卷 S61-S66页

作者： AlHaqwi, Ali Ibrahim Mohamed, Tariq Awad Al Kabba, Abdulaziz F. Alotaibi, Sultan S. Al Shehri, Ali M. Abdulghani, Hamza M. Badri, Motasim King Saud bin Abdulaziz Univ Hlth Sci Riyadh 11547 Saudi Arabia King Saud Univ Riyadh 11451 Saudi Arabia

Background: Problem-based learning (PBL) is being increasingly used in many undergraduate medical schools worldwide due to its recognized advantages. Objectives: To explore views of medical students in the Kingdom of Saudi Arabia (KSA) about the appropriateness of the PBL concepts and process. Differences in students' views were examined as well. Methods: This is a cross-sectional, questionnaire-based study conducted in two medical colleges in Riyadh, Saudi Arabia, during the period from April to June 2012. Results: One hundred seventy four undergraduate medical students participated in the study. Majority of the participants supported the concept of PBL and thought it is a beneficial learning strategy. However, only about half of them consider the problems used in tutorials are relevant for the local setting. Significant differences have been identified between the gender, schools, and study level of participants and their views on the process of PBL tutorials. About 35% of participants either undecided or will not recommend medical schools that adopt PBL curriculums for their friends. Conclusions: The majority of participants were satisfied with PBL approach and valued its importance in their learning process. Specific concerns have been expressed about relevance of some aspects of PBL. Underlying factors should be further explored in order to improve the outcomes of PBL curriculum in the local Saudi setting.

关键词： Problem-based learning medical education Teaching methods -- Research Chi-squared test Correlation (Statistics) Experimental design Research -- Methodology Medicine -- Study & teaching Questionnaires Research -- Evaluation Research -- Finance Sex distribution (Demography) Statistical hypothesis testing Students -- Attitudes Pilot projects Undergraduates -- Psychology Cross-sectional method Data analysis -- Software medical coding Descriptive statistics Higher education -- Saudi Arabia medical students -- Attitudes

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