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141. Integration of genomic and clinical data augments surveillance of healthcare-acquired infections. (PubMed)

Integration of genomic and clinical data augments surveillance of healthcare-acquired infections. Determining infectious cross-transmission events in healthcare settings involves manual surveillance of case clusters by infection control personnel, followed by strain typing of clinical/environmental isolates suspected in said clusters. Recent advances in genomic sequencing and cloud computing now allow for the rapid molecular typing of infecting isolates.To facilitate rapid recognition (...) -computing platform was used for whole-genome sequence analysis and cluster identification.Most strains of the 4 studied pathogens were unrelated, and 34 potential transmission clusters were present. The characteristics of the potential clusters were complex and likely not identifiable by traditional surveillance alone. Notably, only 1 cluster had been suspected by routine manual surveillance.Our work supports the assertion that integration of genomic and clinical epidemiologic data can augment infection

2019 Infection control and hospital epidemiology

142. A systematic review of natural language processing and text mining of symptoms from electronic patient-authored text data. (PubMed)

-measure for symptom-specific research questions.NLP and text mining have been used to extract and analyze patient-authored symptom data in a wide variety of online communities. Though there are computational challenges with accessing ePAT, the depth of information provided directly from patients offers new horizons for precision medicine, characterization of sub-clinical symptoms, and the creation of personal health libraries as outlined by the National Library of Medicine.Future research should (...) A systematic review of natural language processing and text mining of symptoms from electronic patient-authored text data. In this systematic review, we aim to synthesize the literature on the use of natural language processing (NLP) and text mining as they apply to symptom extraction and processing in electronic patient-authored text (ePAT).A comprehensive literature search of 1964 articles from PubMed and EMBASE was narrowed to 21 eligible articles. Data related to purpose, text source

2019 International journal of medical informatics

143. Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers? (PubMed)

Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers? The main aim is to examine whether patients' viewing time on information about colorectal cancer (CRC) screening before a primary care physician (PCP) visit is associated with discussion of screening options during the visit. We analyzed data from a multi-center randomized controlled trial of a tailored interactive multimedia computer program

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2018 Health education research

144. Adaptive responses of sterically confined intramolecular chalcogen bonds †Electronic supplementary information (ESI) available: Computational details and coordinates. See DOI: 10.1039/c8sc01943f (PubMed)

Adaptive responses of sterically confined intramolecular chalcogen bonds †Electronic supplementary information (ESI) available: Computational details and coordinates. See DOI: 10.1039/c8sc01943f The responsive behavior of an entity towards its immediate surrounding is referred to as an adaptive response. The adaptive responses of a noncovalent interaction at the molecular scale are reflected from its structural and functional roles. Intramolecular chalcogen bonding (IChB), an attractive (...) interaction between a heavy chalcogen E (E = Se or Te) centered sigma hole and an ortho-heteroatom Lewis base donor D (D = O or N), plays an adaptive role in defining the structure and reactivity of arylchalcogen compounds. In this perspective, we describe the adaptive roles of a chalcogen centered Lewis acid sigma hole and a proximal Lewis base (O or N) in accommodating built-in steric stress in 2,6-disubstituted arylchalcogen compounds. From our perspective, the IChB components (a sigma hole

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2018 Chemical Science

145. Blunt Trauma Abdominal and Pelvic Computed Tomography Has Low Yield for Injuries in More Than One Anatomic Region (PubMed)

Blunt Trauma Abdominal and Pelvic Computed Tomography Has Low Yield for Injuries in More Than One Anatomic Region Most trauma centers order abdominal and pelvic computed tomography (CT) as an automatically paired CT for adult blunt trauma evaluation. However, excessive CT utilization adds risks of excessive exposure to ionizing radiation, the need to work up incidental findings (leading to unnecessary and invasive tests), and greater costs. Examining a cohort of adult blunt trauma patients (...) assessments at an urban Level I trauma center from April through October 2014. Categorization of CSI was determined according to an a priori, expert panel-derived classification scheme.The median age of the 689 patients who had A/P CT was 48 years old; 68.1% were male; 64.0% were admitted, and hospital mortality was 3.6%. CSI yields were as follows: abdomen 2.2% (95% confidence interval [CI] [1.3-3.6%]); pelvis 2.9% (95% CI [1.9-4.4%]); lumbosacral spine 0.6% (95% CI [0.2-1.5%]); both abdomen and pelvis

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2018 Western Journal of Emergency Medicine

146. Cost-effectiveness of Magnetic Resonance Imaging in Cervical Clearance of Obtunded Blunt Trauma After a Normal Computed Tomographic Finding. (PubMed)

-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice. The analysis used a Markov decision model over a lifetime horizon from a societal perspective with variables from systematic reviews and meta-analyses and reimbursement rates from the Centers for Medicare & Medicaid Services, National Spinal Cord Injury Database, and other large published studies. Data were collected from the most recent literature available.No follow-up vs MRI follow-up after (...) Cost-effectiveness of Magnetic Resonance Imaging in Cervical Clearance of Obtunded Blunt Trauma After a Normal Computed Tomographic Finding. Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding.To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma.This cost

2018 JAMA surgery

147. Computer-based Training (Retraining) for People With Gambling Problems

1: Computer-based training program (retraining), condition 2: Wait-list control group (access to the training after the post-assessment). Two assessments-points, the intervention period (pre-post) is eight weeks. Sociodemographic and pathological data are obtained with an internet survey on Unipark®. Masking: None (Open Label) Primary Purpose: Treatment Official Title: Computer-based Training (Retraining) for People With Gambling Problems Actual Study Start Date : January 18, 2018 Estimated (...) Computer-based Training (Retraining) for People With Gambling Problems Computer-based Training (Retraining) for People With Gambling Problems - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Computer-based

2018 Clinical Trials

148. Quantitative Estimation of Thrombus Burden in Patients With STEMI Using Micro-Computed Tomography (QUEST-STEMI)

Quantitative Estimation of Thrombus Burden in Patients With STEMI Using Micro-Computed Tomography (QUEST-STEMI) Quantitative Estimation of Thrombus Burden in Patients With STEMI Using Micro-Computed Tomography (QUEST-STEMI) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved (...) studies (100). Please remove one or more studies before adding more. Quantitative Estimation of Thrombus Burden in Patients With STEMI Using Micro-Computed Tomography (QUEST-STEMI) (QUEST-STEMI) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2018 Clinical Trials

149. Computer Scan Based Analysing System on Improving Stroke Management Quality Evaluation

and improving the defects of the traditional working mode, our center developed the medical records data acquisition and KPI statistics system based on computer scan. This method guarantee the authenticity of the data, It computes the KPI of the corresponding medical institutions in the corresponding period and gives feedback on a regular basis. This study aims to explore whether this new working mode can continuously improve the overall KPI of all hospitals in Zhejiang province, and thus reflect (...) patients by medical records scanning system since that month into the group. Quality control platform of Cerebral apoplexy in Zhejiang province extracts and analyze the data through the computer and calculates the corresponding monthly KPI. The hospitals will receive their own monthly KPI and the monthly highest KPI of all hospitals included in the study. Based on the compare of the monthly KPI of all hospitals, Quality control platform will give corresponding suggestions to all hospitals

2018 Clinical Trials

150. Root Canal Shaping Using Nickel Titanium, M-Wire, and Gold Wire: A Micro-computed Tomographic Comparative Study of One Shape, ProTaper Next, and WaveOne Gold Instruments in Maxillary First Molars. (PubMed)

and after shaping to compare centering ratio and canal transportation values at the apical, midroot, and coronal levels and the overall changes in canal volume. Data sets were statistically analyzed (analysis of variance and Kruskal-Wallis H tests).The centering ratios for all groups were statistically similar at all levels. Apical canal transportation was significantly high for K/OS and K/PTN (P = .003). Midroot canal transportation was significantly high for K/PTN, K/OS, and OG/OS (P = .0003). Coronal (...) Root Canal Shaping Using Nickel Titanium, M-Wire, and Gold Wire: A Micro-computed Tomographic Comparative Study of One Shape, ProTaper Next, and WaveOne Gold Instruments in Maxillary First Molars. The aim of this study was to evaluate the root canal shaping effect of instruments manufactured from nickel titanium, M-Wire, and Gold wire with different glide path preparation techniques.One hundred thirty-five mesiobuccal canals of extracted human maxillary molars were randomly divided into 3 equal

2018 Journal of Endodontics

151. Quantitative Lesion Water Uptake in Acute Stroke Computed Tomography Is a Predictor of Malignant Infarction. (PubMed)

predict development of malignant edema. The aim was to compare NWU in acute brain infarct against other common predictors of malignant edema. Methods- After consecutive screening of single-center registry data, 153 patients with acute proximal middle cerebral artery occlusion fulfilled the inclusion criteria. A total of 29 (18.2%) patients developed malignant edema defined as end point in follow-up imaging leading to decompressive surgery and death as a direct implication of mass effect. Early infarct (...) Quantitative Lesion Water Uptake in Acute Stroke Computed Tomography Is a Predictor of Malignant Infarction. Background and Purpose- Early selection of patients with acute middle cerebral artery infarction at risk for malignant edema is critical to initiate timely decompressive surgery. Net water uptake (NWU) per brain volume is a quantitative imaging biomarker of space-occupying ischemic edema which can be measured in computed tomography. We hypothesize that NWU in early infarct lesions can

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2018 Stroke

152. Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism. (PubMed)

of surgical outcomes. Patient data were obtained from 18 internationally distributed centers and retrospectively analyzed for clinical and biochemical outcomes of adrenalectomy of patients with surgical management based on CT (n=235 patients, diagnosed from 1994-2016) or AVS (526 patients, diagnosed from 1994-2015) using the standardized PASO (Primary Aldosteronism Surgical Outcome) criteria. Biochemical outcomes were highly different according to surgical management approach with a smaller proportion (...) Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism. Unilateral primary aldosteronism is the most common surgically correctable form of endocrine hypertension and is usually differentiated from bilateral forms by adrenal venous sampling (AVS) or computed tomography (CT). Our objective was to compare clinical and biochemical postsurgical outcomes of patients with unilateral primary aldosteronism diagnosed by CT or AVS and identify predictors

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2018 Hypertension

153. Diagnostic Accuracy of a Machine-Learning Approach to Coronary Computed Tomographic Angiography-Based Fractional Flow Reserve: Result From the MACHINE Consortium. (PubMed)

centers in Europe, Asia, and the United States, 351 patients, including 525 vessels with invasive FFR comparison, were included. ML-based and CFD-based CT-FFR were performed on the CTA data, and diagnostic performance was evaluated using invasive FFR as reference. Correlation between ML-based and CFD-based CT-FFR was excellent (R=0.997). ML-based (area under curve, 0.84) and CFD-based CT-FFR (0.84) outperformed visual CTA (0.69; P<0.0001). On a per-vessel basis, diagnostic accuracy improved from 58 (...) Diagnostic Accuracy of a Machine-Learning Approach to Coronary Computed Tomographic Angiography-Based Fractional Flow Reserve: Result From the MACHINE Consortium. Coronary computed tomographic angiography (CTA) is a reliable modality to detect coronary artery disease. However, CTA generally overestimates stenosis severity compared with invasive angiography, and angiographic stenosis does not necessarily imply hemodynamic relevance when fractional flow reserve (FFR) is used as reference. CTA

2018 Circulation. Cardiovascular imaging

154. Coronary CT Angiography-derived Fractional Flow Reserve: Machine Learning Algorithm versus Computational Fluid Dynamics Modeling. (PubMed)

angiography and quantitative coronary angiography (QCA). Materials and Methods A total of 85 patients (mean age, 62 years ± 11 [standard deviation]; 62% men) who had undergone coronary CT angiography followed by invasive FFR were included in this single-center retrospective study. FFR values were derived on-site from coronary CT angiography data sets by using both FFRCFD and FFRML. The performance of both techniques for detecting lesion-specific ischemia was compared against visual stenosis grading (...) Coronary CT Angiography-derived Fractional Flow Reserve: Machine Learning Algorithm versus Computational Fluid Dynamics Modeling. Purpose To compare two technical approaches for determination of coronary computed tomography (CT) angiography-derived fractional flow reserve (FFR)-FFR derived from coronary CT angiography based on computational fluid dynamics (hereafter, FFRCFD) and FFR derived from coronary CT angiography based on machine learning algorithm (hereafter, FFRML)-against coronary CT

2018 Radiology

155. Development of a congenital cardiovascular computed tomography imaging registry: Rationale and implementation. (PubMed)

of cardiac CT 2) establish best practice guidelines designed to optimize diagnostic image quality with appropriate use of radiation and anesthesia exposure 3) provide institution specific feedback compared with the group norm across participating centers 4) improve the level of evidence for the use of CT in CHD through the collection of prospective and multi-institutional data.Prospective multi-institutional data is needed to inform risk estimates of CT in CHD using current generation scanners (...) Development of a congenital cardiovascular computed tomography imaging registry: Rationale and implementation. The cumulative exposure and risk of anesthesia, vascular access, contrast agents and radiation is emerging as a significant lifelong burden in patients with congenital heart disease (CHD). Latest generation computerized tomographic (CT) scanners are increasingly used for high resolution cardiovascular imaging and have both hardware and post processing radiation dose reduction

2018 Journal of cardiovascular computed tomography

156. Access to primary care and computed tomography use in the emergency department. (PubMed)

. We set out to determine if there is an association between CT utilization in the ED and patient access to primary care.We performed a cross-sectional study of all ED visits in which a CT scan was obtained between 2003 and 2012 at an academic, tertiary-care center. Data were abstracted from the electronic medical record and administrative databases and included type of CT obtained, demographics, comorbidities, and access to a local primary care provider (PCP). CT utilization rates were determined (...) Access to primary care and computed tomography use in the emergency department. The decision to obtain a computed tomography CT scan in the emergency department (ED) is complex, including a consideration of the risk posed by the test itself weighed against the importance of obtaining the result. In patients with limited access to primary care follow up the consequences of not making a diagnosis may be greater than for patients with ready access to primary care, impacting diagnostic reasoning

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2018 BMC health services research

157. Reliability of a Condensed Computer-based Patient Outcomes Scoring Tool in Orthopaedic Trauma Patients. (PubMed)

Reliability of a Condensed Computer-based Patient Outcomes Scoring Tool in Orthopaedic Trauma Patients. To determine the reliability of a condensed computer-based patient-centered outcome score system versus multiple standard uncondensed validated outcome scores used in orthopaedic trauma.Prospective.Level I Trauma Center.One hundred patients older than 18 years with various orthopaedic injuries were evaluated at a Level I Trauma Clinic.Study participants were randomly assigned to complete (...) to 0.05.Because patient-centered outcomes drive the direction of orthopaedic care, it is critical to collect patient data efficiently while minimizing responder burden. This condensed web-based adaptive outcome tool reliably produced similar scores when compared with individual paper scores, and it decreased responder burden and error.

2018 Journal of Orthopaedic Trauma

158. Root Canal Shaping Effect of Instruments with Offset Mass of Rotation in the Mandibular First Molar: A Micro-computed Tomographic Study. (PubMed)

Root Canal Shaping Effect of Instruments with Offset Mass of Rotation in the Mandibular First Molar: A Micro-computed Tomographic Study. The aim of this study was to evaluate the root canal shaping effect of 2 nickel-titanium rotary instruments with offset mass of rotation compared with an instrument with a conventional centered mass of rotation.Thirty-six extracted human mandibular first molars with 2 independent mesial canals and 1 oval distal canal were selected and divided equally into 3 (...) (Bruker micro-CT, Kontich, Belgium) at 10-μm isotropic resolution. Changes in the canal area, volume, structure model index (SMI), and untouched canal area were evaluated. Canal transportation and centering ratio were measured at 1, 3, 5, and 7 mm from the apical foramen. Data were statistically analyzed using 1-way analysis of variance with the Tukey post hoc test.The PTN and RS systems showed significantly less transportation and better centering ability compared with the PTU system at 1 mm from

2018 Journal of Endodontics

159. Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis.

increasingly in the emergency department for evaluating this, but its added value remains controversial.We retrospectively collected data on the diagnostic yield of CTA in patients with acute severe headache, normal neurological examination, and normal NCCT who received additional CTA in the acute phase in 2 secondary referral centers for vascular neurology. We combined data of our patients with those from the literature and performed a meta-analysis.We included 88 patients from our hospital files and 641 (...) Yield of Computed Tomography (CT) Angiography in Patients with Acute Headache, Normal Neurological Examination, and Normal Non Contrast CT: A Meta-Analysis. Patients with acute severe headache, normal neurological examination, and a normal noncontrast head computed tomography (NCCT) may still have subarachnoid hemorrhage, cerebral venous thrombosis (CVT), cervical arterial dissection, or reversible cerebral vasoconstriction syndrome (RCVS). Computed tomography angiography (CTA) is used

2018 Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

160. Computers are the modern stethoscope

forward, there is a step backward. As a family doc, I spent the first 19 years of my practice in a care center, away from the main clinic. I didn’t have access to the same chart as the specialist. I hungered for the electronic record. But the day it arrived, it brought its own challenges. Remember back to 1990: We didn’t have sleek flat screens in the rooms, we had big bulky monitors. The exam rooms themselves weren’t built with a doc and a computer in mind. I found myself swirling on my stool to talk (...) to the patient. Of course, initially, nothing was in the computer to help me, and I found myself playing physician data entry person. Now I have an office designed with the EHR in mind. The screens can be turned so the patients can see. For an established patient, much background data is there. I have learned navigation tools and tricks, so there is less typing. But, what have I lost? Scroll back to 1964, age five. I followed my daddy on hospital rounds. Nothing made me happier than to hear people ask if I

2018 KevinMD blog

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