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81. Human Intelligence & Artificial Intelligence in Medicine: A day with the Stanford Presence Center

& Environmental Sciences Multi-disciplinary Sciences Medicine & Health Research Analysis & Scientific Policy Post navigation in Uncategorized post-i Last week, PLOS Medicine and PLOS ONE editors Linda Nevin and Meghan Byrne attended Human Intelligence & Artificial Intelligence (HIAI) in Medicine, a Stanford Presence Center symposium. HIAI brought together thought leaders in medicine, computer science and policy to envisage an inclusive, equitable and humane experience in medicine with AI solutions. A few (...) Presence Center was founded by Stanford’s Vice Chair for the Theory and Practice of Medicine, Abraham Verghese, a leader at Stanford in advocating for and teaching fully engaged physical exams. HIAI commenced the development of a shared agenda to steer AI toward its most beneficial implementation. Can AI be developed to augment the physician’s intelligence, rather than attempt to replace it? Luminaries from medicine, computer science and policy shared their concerns and aspirations. In the 1960s, Dr

2018 PLOS Blogs Network

82. A single-center, open-label positron emission tomography study to evaluate brivaracetam and levetiracetam synaptic vesicle glycoprotein 2A binding in healthy volunteers. (PubMed)

A single-center, open-label positron emission tomography study to evaluate brivaracetam and levetiracetam synaptic vesicle glycoprotein 2A binding in healthy volunteers. Brivaracetam (BRV) and levetiracetam (LEV) are antiepileptic drugs that bind synaptic vesicle glycoprotein 2A (SV2A). In vitro and in vivo animal studies suggest faster brain penetration and SV2A occupancy (SO) after dosing with BRV than LEV. We evaluated human brain penetration and SO time course of BRV and LEV (...)  mg) and 4 hours postdose of LEV (250-600 mg). Half-time of 11 C-UCB-J signal change was computed from displacement measurements. Half-saturation concentrations (IC50 ) were determined from calculated SO.Observed tracer displacement half-times were 18 ± 6 minutes for BRV (100 mg, n = 4), 9.7 and 10.1 minutes for BRV (200 mg, n = 2), and 28 ± 6 minutes for LEV (1500 mg, n = 6). Estimated corrected half-times were 8 minutes shorter. The SO was 66%-70% for 100 mg intravenous BRV, 84%-85% for 200 mg

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2019 Epilepsia

83. Microcomputed Assessment of Transportation, Centering Ratio, Canal Area, and Volume Increase after Single-file Rotary and Reciprocating Glide Path Instrumentation in Curved Root Canals: A Laboratory Study. (PubMed)

the root canal preparation, changes in the root canals regarding the volume, surface area, SMI, transportation made by the files, and the change of their centering ability in the apical, middle, and coronal third were analyzed by micro-CT imaging. The data were statistically evaluated using 1-way analysis of variance and the Kruskal-Wallis test with a significance level set at 5% (P < .05).The WOGG and RP file systems showed better centering abilities at all thirds compared with the PG file system (P (...) Microcomputed Assessment of Transportation, Centering Ratio, Canal Area, and Volume Increase after Single-file Rotary and Reciprocating Glide Path Instrumentation in Curved Root Canals: A Laboratory Study. The aim of this study was to compare the transportation and centering abilities of the ProGlider (PG; Dentsply-Sirona, Ballaigues, Switzerland), WaveOne Gold Glider (WOGG; Dentsply-Sirona), and R-Pilot (RP; VDW, Munich, Germany) file systems and the changes in the structure model index (SMI

2019 Journal of Endodontics

84. Noncaseating granulomatous diseases in germ cell cancer patients-A single-center experience. (PubMed)

Noncaseating granulomatous diseases in germ cell cancer patients-A single-center experience. In patients with testicular Germ Cell Tumors (GCT) noncaseating granulomatous diseases such as Sarcoid Like Lesions (SLL) or Sarcoidosis can mimic metastasis due to hilar or mediastinal lymphadenopathy. Due to the clinical and prognostic impact, exclusion of malignant diseases is mandatory.Retrospectively, data from 636 GCT patients, who were seen in the course of tumor surveillance/follow-up were (...) -nine patients suffered from suspected tumor relapse. Whereas thoracic relapses were suspected in 15 patients on chest computed tomography, thoracic relapse was confirmed in 5 cases by open surgery. In 2 cases open surgery yielded reactive lymphadenitis, and in 8 cases SLL was diagnosed either via EBUS-TBNA (n = 7) or thoracoscopic wedge resection plus lymphadenectomy (n = 1). With focus on overall survival, no relevant difference was found between all tested subgroups (P = 0.265; logrank test

2019 Urologic oncology

85. Experience of the management of coronary artery bypass graft only on moderate ischemic mitral regurgitation: A single-center retrospective study. (PubMed)

surgery. The statistical data were processed by SPSS 19 software with computer; statistical significant difference with P < .05.Overall in-hospital mortality was 2.75% (3 patients). Patients had lower mean LVEF in the postoperative compared with the preoperative period, but all the patients had higher LVEF since 6 months than preoperative period (P < .001). Compared with the preoperative dates, postoperative valvular regurgitation, left ventricular and atrial size and LVEDV postoperative 10 days (...) Experience of the management of coronary artery bypass graft only on moderate ischemic mitral regurgitation: A single-center retrospective study. To summary the impact of off-pump coronary artery bypass grafting (CABG) only on patients with moderate ischemic mitral regurgitation and survival.We retrospectively analyzed 109 patients with coronary artery disease (CAD) complicated by moderate mitral regurgitation, from January, 2008 to December, 2014, in the Department of Cardiovascular Surgery

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2019 Medicine

86. Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. (PubMed)

orthopedic traumatic injury in the first 12 months postinjury using data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, and, using clinical computed tomographic (CT) scans, examine whether the presence (CT+) or absence (CT-) of acute intracranial findings in the mTBI group was associated with outcomes.TRACK-TBI, a cohort study of patients with mTBI presenting to US level I trauma centers, enrolled patients from February 26, 2014, to August 8, 2018 (...) Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. Most traumatic brain injuries (TBIs) are classified as mild (mTBI) based on admission Glasgow Coma Scale (GCS) scores of 13 to 15. The prevalence of persistent functional limitations for these patients is unclear.To characterize the natural history of recovery of daily function following mTBI vs peripheral

2019 JAMA neurology

87. The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study. (PubMed)

at higher rates than computed tomography or x-ray studies (P<.001). Approximately half of all the diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9904/18,573, 53.32% and radiology reports: 971/2019, 48.1%). On the other extreme, 19.9% (3701/18,573) of laboratory results and 31.6% (639/2019) of radiology reports were viewed more than 2 weeks after availability in the portal.The data highlight the relatively low use (...) The Use of an Electronic Health Record Patient Portal to Access Diagnostic Test Results by Emergency Patients at an Academic Medical Center: Retrospective Study. Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients.The study aimed to assess patient portal utilization by ED patients at an academic medical center using account

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2019 Journal of medical Internet research

88. Assessing variability in surgical decision making among attending neurosurgeons at an academic center. (PubMed)

Assessing variability in surgical decision making among attending neurosurgeons at an academic center. OBJECTIVEAlthough it is known that intersurgeon variability in offering elective surgery can have major consequences for patient morbidity and healthcare spending, data addressing variability within neurosurgery are scarce. The authors performed a prospective peer review study of randomly selected neurosurgery cases in order to assess the extent of consensus regarding the decision to offer (...) of each type randomly selected for review). The selected cases were scored by attending neurosurgeons using a need for surgery (NFS) score based on clinical data (patient demographics, preoperative notes, radiology reports, and operative notes; n = 616 independent case reviews). Attending neurosurgeon reviewers were blinded as to performing provider and surgical outcome. Aggregate NFS scores across various categories were measured. The authors employed a repeated-measures mixed ANOVA model

2019 Journal of Neurosurgery

89. An in vitro evaluation of marginal fit zirconia crowns fabricated by a CAD-CAM dental laboratory and a milling center. (PubMed)

the marginal discrepancy (MD) and absolute marginal discrepancy (AMD) of computer-aided design, and computer-aided manufacturing (CAD-CAM) used in a dental laboratory and a milling center for producing monolithic zirconia crowns.The marginal fit of 30 zirconia crowns cemented to typodont teeth was evaluated by means of a sectioning technique. Fifteen crowns were fabricated with a CEREC inLAB MC X5 from IPS e.max ZirCAD blocks. Fifteen crowns were fabricated using a LAVA milling center from LAVA Plus (...) Zirconia Blocks. The 30 crowns were sectioned with a precision saw, and MD and AMD were subsequently measured using a light microscope. Data were analyzed using the one-way ANOVA technique to investigate significant differences in the marginal fit between the two fabrication systems (α = .05).The AMD dimension of the CEREC inLAB system was significantly smaller (P < .05). Mean AMD values for zirconia crowns fabricated by the CEREC inLAB were 85 μm, and for the LAVA milling center 133 μm

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2019 BMC Oral Health

90. Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia. (PubMed)

was conducted on all adult drug resistant tuberculosis patients who initiated treatment from September 2010 to December 2017. Data were collected from patient charts, registration books, and computer databases using abstraction sheets. The data were entered using Epi-info version 7 and exported to SPSS version 20 for analysis. Summary statistics, like means, medians, and proportions were used to present it. Binary logistic regression was fitted; Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI (...) Treatment delay and associated factors among adults with drug resistant tuberculosis at treatment initiating centers in the Amhara regional state, Ethiopia. A delayed initiation of tuberculosis treatment results in high morbidity, mortality, and increased person-to-person transmissions. The aim of this study was to assess treatment delay and its associated factors among adult drug resistant tuberculosis patients in the Amhara Regional State, Ethiopia.An institution based cross-sectional study

2019 BMC Infectious Diseases

91. Are We Doing Enough to Reduce Ionizing Radiation Exposure in Children?: An Analysis of Current Approaches to Pediatric Appendicitis Imaging at a Major Urban Medical Center. (PubMed)

Are We Doing Enough to Reduce Ionizing Radiation Exposure in Children?: An Analysis of Current Approaches to Pediatric Appendicitis Imaging at a Major Urban Medical Center. The aim of this study was to evaluate current imaging approaches in children with suspected appendicitis (AP) in the pediatric emergency department (ED) of a major urban medical center.Children aged 6 to 18 years who presented to a pediatric ED in 2016 with possible AP were identified by a keyword search. Charts were (...) reviewed for the following: age, sex, time of evaluation, imaging study, results of imaging study, disposition, and outcome.We calculated mean values and SD for continuous data. Initially, 503 charts were identified. Of these 503, 292 children were identified as having possible AP. Mean age was 10.7 years (SD, 2.7); 50.6% presented between 5:00 PM and 8:00 AM the next morning. Of the 287 US studies performed, 114 (39.7%) were definitively positive or negative. Of these, 46 (16.0%) were negative for AP

2019 Pediatric Emergency Care

92. Effects of Student Physical Therapists on Clinical Instructor Productivity Across Settings in an Academic Medical Center. (PubMed)

center before, during, and after clinical education experiences (CEEs), determine if there are differences in productivity during CEEs across settings, and compare CI productivity to that of therapists who did not have a student during the same time frames.A retrospective design examined productivity across 3 years in acute care (AC), inpatient rehabilitation (IPR), outpatient orthopedics (OPO), and outpatient neurology (OPN). Mean daily productivity was computed, normalized to an 8-hour day (...) Effects of Student Physical Therapists on Clinical Instructor Productivity Across Settings in an Academic Medical Center. Clinical education is an integral component of physical therapy education. Both benefits and barriers exist in clinical education, but 1 commonly stated barrier includes the perception that students have a negative impact on clinical instructor (CI) productivity.The purposes of this study were to evaluate the productivity of physical therapist CIs in an academic medical

2019 Physical therapy

93. Health-resource use and quality of life in children with bronchiectasis: a multi-center pilot cohort study. (PubMed)

with bronchiectasis.We undertook a prospective cohort study of 85 children aged < 18-years with high-resolution chest computed-tomography confirmed bronchiectasis undergoing management in three pediatric respiratory medical clinics in Darwin and Brisbane, Australia and Auckland, New Zealand. Children with cystic fibrosis or receiving cancer treatment were excluded. Data collected included the frequency of healthcare attendances (general practice, specialists, hospital and/or emergency departments, and other (...) Health-resource use and quality of life in children with bronchiectasis: a multi-center pilot cohort study. Bronchiectasis in children is an important, but under-researched, chronic pulmonary disorder that has negative impacts on health-related quality of life. Despite this, it does not receive the same attention as other chronic pulmonary conditions in children such as cystic fibrosis. We measured health resource use and health-related quality of life over a 12-month period in children

2019 BMC health services research

94. Prevalence and characterization of chronic rhinosinusitis in patients with non-cystic fibrosis bronchiectasis at a tertiary care center in the United States. (PubMed)

are associated with the presence of CRS in patients with bronchiectasis.This was a retrospective cohort study in which data were obtained from a large database warehouse at a tertiary care center. Patients with bronchiectasis were identified from 2007 to 2017 using diagnosis codes from the the ninth and tenth revisions of the International Classification of Diseases (ICD-9/10) and confirmed by radiographic evidence of bronchiectasis on chest computed tomography (CT) scans. Patients were divided into cohorts (...) Prevalence and characterization of chronic rhinosinusitis in patients with non-cystic fibrosis bronchiectasis at a tertiary care center in the United States. Chronic rhinosinusitis (CRS) is associated with bronchiectasis; however, this relationship has not been well studied in the United States (US) population. In this work we aimed to determine the prevalence of CRS among patients with bronchiectasis affiliated with a US tertiary medical center and identify which comorbid diseases

2019 International forum of allergy & rhinology

95. Perceived pain for orthodontic patients with conventional brackets or self-ligating brackets over 1 month period: A single-center, randomized controlled clinical trial. (PubMed)

whose age between 12 to 40 years and suitable for orthodontic fixed appliance treatment. The main outcome was pain intensity measured by visual analog scale (VAS) with all patients followed at 4 h, 24 h, 3 days, 1 week and 1 month. Randomization was accomplished with a computer-generated list of random numbers. Blinding was applicable for outcome assessment only. Data were analyzed using multi-level nonlinear mixed effect model, Friedman's test and Wilcoxon signed rank test with the Bonferroni (...) Perceived pain for orthodontic patients with conventional brackets or self-ligating brackets over 1 month period: A single-center, randomized controlled clinical trial. The objective of this 2-arm parallel trial was to test the superiority of self-ligating brackets (SLB) over conventional brackets (CB) in terms of perceived pain for orthodontic patients.Patients about to undergo treatment were included to fixed appliance placed with CB or SLB. Eligibility criteria included malocclusion patients

2019 Journal of the Formosan Medical Association = Taiwan yi zhi Controlled trial quality: uncertain

96. A Single-Center, Randomized, Controlled Comparison of the Transradial vs Transfemoral Approach for Cerebral Angiography: A Learning Curve Analysis. (PubMed)

(mean age 68 years; 41 men) to TRA using a computer-generated random table. The patients' demographic and angiographic data were recorded and analyzed. The learning curve of a novice interventionist was analyzed for procedure time, puncture time, fluoroscopy time, and contrast volume as markers of technical proficiency with TFA compared with TRA. Median values are given with the interquartile range (IQR). Results: Procedure time [35 (IQR 30, 47.5) vs 31.0 (IQR 25.0, 48.9) minutes, p=0.16 (...) A Single-Center, Randomized, Controlled Comparison of the Transradial vs Transfemoral Approach for Cerebral Angiography: A Learning Curve Analysis. Purpose: To compare the characteristics and learning curve of the transfemoral approach (TFA) vs the transradial approach (TRA) for cerebral angiography. Materials and Methods: Between February 2016 and April 2017, 101 patients undergoing cerebral angiography were enrolled. Fifty-one patients (mean age 67 years; 40 men) were randomized to TFA and 50

2019 Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Controlled trial quality: uncertain

97. TCGA Expedition: A Data Acquisition and Management System for TCGA Data. (PubMed)

accessible TCGA data are released through public portals, but many challenges exist in navigating and using data obtained from these sites. We developed TCGA Expedition to support the research community focused on computational methods for cancer research. Data obtained, versioned, and archived using TCGA Expedition supports command line access at high-performance computing facilities as well as some functionality with third party tools. For a subset of TCGA data collected at University of Pittsburgh, we (...) , participant- and sample-centered, local TCGA data directory with metadata structures that directly reference the local data files as well as the original data files. The software supports flexible searches of the data via a web portal, user-centric data tracking tools, and data provenance tools. Using this software, we created a collaborative repository, the Pittsburgh Genome Resource Repository (PGRR) that enabled investigators at our institution to work with all TCGA data formats, and to interrogate

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2016 PLoS ONE

98. The center for expanded data annotation and retrieval. (PubMed)

The center for expanded data annotation and retrieval. The Center for Expanded Data Annotation and Retrieval is studying the creation of comprehensive and expressive metadata for biomedical datasets to facilitate data discovery, data interpretation, and data reuse. We take advantage of emerging community-based standard templates for describing different kinds of biomedical datasets, and we investigate the use of computational techniques to help investigators to assemble templates and to fill (...) in their values. We are creating a repository of metadata from which we plan to identify metadata patterns that will drive predictive data entry when filling in metadata templates. The metadata repository not only will capture annotations specified when experimental datasets are initially created, but also will incorporate links to the published literature, including secondary analyses and possible refinements or retractions of experimental interpretations. By working initially with the Human Immunology

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2015 Journal of the American Medical Informatics Association

99. The NIH BD2K center for big data in translational genomics. (PubMed)

The NIH BD2K center for big data in translational genomics. The world's genomics data will never be stored in a single repository - rather, it will be distributed among many sites in many countries. No one site will have enough data to explain genotype to phenotype relationships in rare diseases; therefore, sites must share data. To accomplish this, the genetics community must forge common standards and protocols to make sharing and computing data among many sites a seamless activity. Through (...) the Global Alliance for Genomics and Health, we are pioneering the development of shared application programming interfaces (APIs) to connect the world's genome repositories. In parallel, we are developing an open source software stack (ADAM) that uses these APIs. This combination will create a cohesive genome informatics ecosystem. Using containers, we are facilitating the deployment of this software in a diverse array of environments. Through benchmarking efforts and big data driver projects, we

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2015 Journal of the American Medical Informatics Association

100. Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers. (PubMed)

-observer agreement in gross tumor volume (GTV) and duodenum delineation for pancreatic cancer compared with computer tomography (CT).Two clinical cases of borderline resectable (Case 1) and unresectable (Case 2) pancreatic cancer were selected. In two sequential steps, diagnostic contrast-enhanced CT scan and MRI sequences were sent to the participating centers. CT-GTVs were contoured while blinded to MRI data sets. DICE index was used to evaluate the spatial overlap accuracy.Thirty-one radiation (...) Magnetic resonance imaging (MRI) compared with computed tomography (CT) for interobserver agreement of gross tumor volume delineation in pancreatic cancer: a multi-institutional contouring study on behalf of the AIRO group for gastrointestinal cancers. Due to the high soft tissue resolution, magnetic resonance imaging (MRI) could improve the accuracy of pancreatic tumor delineation in radiation treatment planning. A multi-institutional study was proposed to evaluate the impact of MRI on inter

2019 Acta Oncologica

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