Hasil untuk "Computer applications to medicine. Medical informatics"

Synne Krekling Lien, Bjørn Ludvigsen, Harald Taxt Walnum et al.

This article describes a dataset of hourly sub-metered energy use data from 48 school buildings located in Oslo, owned and managed by Oslobygg KF. The dataset consists of 1 comma-delimited file per building, each containing meta data about the building, time series data containing energy use measurements and local weather data. The length of the dataset varies by building, covering between 1 and 11 years of raw data. Raw data for each building was downloaded in 2023 from Oslobygg KF’s energy management system, “Energinet.” Only buildings with sufficiently reliable sub-metered heating data were included. This process included manual selection, quality-control, relabelling and cleaning to ensure consistency and accuracy. The dataset includes buildings with both electric heating (electric boilers and/or heat pumps) and district heating. All buildings have sub-metered heating data, and some also include sub-meters for domestic hot water heating and photovoltaic electricity generation. The data set can be used for several research and engineering purposes, including benchmarking and validation of building simulations, heating disaggregation, energy use time series classification, forecasting of energy loads and flexibility, grid planning and other modelling activities.

Valeria Rosalia Vergara, Chiara Bara, Andrea Zaccaro et al.

<italic>Goal:</italic> Brain-heart interactions have been linked to physiological and pathological states and are typically studied through the use of electroencephalographic (EEG) signal and heart rate variability (HRV) time series. However, there are still major challenges to overcome, particularly in establishing a robust methodology to assess these complex multi-scale interactions and to extract meaningful information. To this end, we explore the time scale-dependent nature of brain-heart interactions by exploiting information-theoretic measures. <italic>Methods:</italic> We analyze cardiac vagal activity and EEG brain wave amplitudes at two time scales&#x2014;heart rhythm (<inline-formula><tex-math notation="LaTeX">$\sim$</tex-math></inline-formula>1 s) and longer (<inline-formula><tex-math notation="LaTeX">$\sim$</tex-math></inline-formula>1 min)&#x2014;in two groups of healthy subjects monitored during wakefulness and sleep, respectively. Different entropy-based measures are then employed to evaluate the regularity of each system&#x0027;s dynamics, as well as their static and dynamic coupling. <italic>Results:</italic> Different time-scales are involved in different physiological coupling mechanisms. While overall coupling strength values are low, longer time-scales show a stronger presence of coupling in terms of statistically validated brain-heart connections compared to shorter time-scales. <italic>Conclusions:</italic> This study shows that the presence and the strength of brain-heart interactions are highly dependent on the time-scale, which in turn is affected by the underlying physiological processes.

Lars Masanneck, Sven G. Meuth, Marc Pawlitzki

Abstract Effectively managing evidence-based information is increasingly challenging. This study tested large language models (LLMs), including document- and online-enabled retrieval-augmented generation (RAG) systems, using 13 recent neurology guidelines across 130 questions. Results showed substantial variability. RAG improved accuracy compared to base models but still produced potentially harmful answers. RAG-based systems performed worse on case-based than knowledge-based questions. Further refinement and improved regulation is needed for safe clinical integration of RAG-enhanced LLMs.

João A. Leite, Olesya Razuvayevskaya, Kalina Bontcheva et al.

Abstract Credibility signals represent a wide range of heuristics typically used by journalists and fact-checkers to assess the veracity of online content. Automating the extraction of credibility signals presents significant challenges due to the necessity of training high-accuracy, signal-specific extractors, coupled with the lack of sufficiently large annotated datasets. This paper introduces Pastel (Prompted weAk Supervision wiTh crEdibility signaLs), a weakly supervised approach that leverages large language models (LLMs) to extract credibility signals from web content, and subsequently combines them to predict the veracity of content without relying on human supervision. We validate our approach using four article-level misinformation detection datasets, demonstrating that Pastel outperforms zero-shot veracity detection by 38.3% and achieves 86.7% of the performance of the state-of-the-art system trained with human supervision. Moreover, in cross-domain settings where training and testing datasets originate from different domains, Pastel significantly outperforms the state-of-the-art supervised model by 63%. We further study the association between credibility signals and veracity, and perform an ablation study showing the impact of each signal on model performance. Our findings reveal that 12 out of the 19 proposed signals exhibit strong associations with veracity across all datasets, while some signals show domain-specific strengths.

Patricia A. Braun, Kimberly T. Wiggins, Cherith Flowerday et al.

Objective: Evaluate healthcare providers’ and staffs’ knowledge, self-reported abilities, activities, and barriers to providing preventive oral health services (POHS) at primary care medical visits before and after participation in the Rocky Mountain Network of Oral Health (RoMoNOH) project. Methods: The RoMoNOH project integrated POHS into primary care medical visits of young children at 22 community health centers (CHCs) in Arizona, Colorado, Montana, and Wyoming by medical team members and/or by embedded dental hygienists (DHs). Twelve CHCs embedded DHs onto their teams. In an observational pre/post evaluation, a convenience sample of healthcare providers’ characteristics were surveyed at baseline and 3 years across 4 oral health domains: knowledge, self-reported abilities, behaviors, and barriers. Each domain was scored from 0% to 100%, with 100% being optimal. Differences between pre- and post-project domain scores were assessed using chi-square, t-tests, and linear and logistic regression adjusting for providers’ age. Results: Embedding DHs into CHCs and staff turnover impacted pre/post survey participants. The final analytic cohort included 213 (pre-survey response rate: 71%) and 165 (post-survey response rate: 52%) healthcare providers who worked with children < age 3. Participants were female (pre: 81%, post: 81%) and aged >35 years (pre: 39%, post: 41%). Unadjusted mean differences across surveys improved across all oral health domains (pre/post): knowledge: 65%/81%, P  < .001; self-reported ability: 52%/71%, P  < .001; activities: 32%/57%, P  < .001; barriers: 27%/21%, P  = .011. After adjustment for age, these improvements remained significant (all P  ≤ .011). Conclusions: Healthcare providers’ oral health practices improved over a multi-year oral health integration project aimed at increasing delivery of POHS at medical visits.

Andrés Anaya-Isaza, Leonel Mera-Jiménez, Martha Zequera-Diaz

Nivine Hanach, Roba Saqan, Hadia Radwan et al.

BackgroundThe postpartum period is a critical phase in a woman's life, marked by various physical, psychological, and social challenges. In light of the rapid proliferation and uptake of digital technologies, particularly in the United Arab Emirates (UAE), mothers increasingly seek informational and emotional support from digital resources. No previous study has thoroughly explored the usage of various digital resources beyond telehealth services in the UAE. This literature gap is particularly relevant for the postpartum period, which remains largely understudied in the UAE. ObjectiveThis study aims to delve into the digital experiences of postpartum women in the UAE by exploring the types of resources they navigate and the purposes those resources serve. In addition, it seeks to identify their perspectives and needs regarding digital resources that support their postpartum journey. MethodsFour focus groups were conducted synchronously on the web, involving a total of 27 multicultural mothers (mean age 32.47, SD 4.56 years), between 2 and 12 months post partum and living in the UAE. Descriptive interpretive thematic analysis was used to analyze the data. ResultsSixteen out of 27 women exhibited severe depressive symptoms at the time of the discussions (Edinburgh Postnatal Depression Scale score of >12). Two main themes were generated from the analysis: (1) Mothers’ Experiences with Digital Resources: Participants valued digital resources for providing immediate information, convenience, and support. They primarily used these resources to seek information on infant health, parenting advice, and emotional support through web-based communities. However, the abundance of conflicting information and the pressure to conform to health recommendations often created stress and anxiety. (2) The Perceived Need for Digital Resources: Despite their extensive use of digital resources, mothers articulated the need for a reliable UAE government digital platform tailored specifically to postpartum care, offering trusted information on infant health and postpartum mental well-being. They also emphasized the need for tailored postpartum telemedicine services and moderated web-based discussion forums to foster peer support among mothers. ConclusionsThis study reveals the multifaceted role of digital resources in supporting mothers during the postpartum period, highlighting unmet needs that present opportunities for advancing postpartum care in the UAE. It demonstrates the importance of developing reliable digital solutions for postpartum women, especially regarding mental health and to enhance access to care through tailored telemedicine services. Collaborative efforts are required to ensure the implementation of user-centered digital platforms. Future research should focus on the diverse needs of postpartum women, including cultural sensitivity, the feasibility of telemedicine services, and the integration of partner support in digital interventions to improve maternal health outcomes.

Kristofer Vernmark, Moncia Buhrman, Per Carlbring et al.

This narrative historical review examines the development of internet-based cognitive behavioral therapy (ICBT) in Sweden, describing its progression within both academic and routine care settings. The review encompasses key publications, significant scientific findings, and contextual factors in real-world settings. Over 25 years ago, Sweden emerged as a pioneering force in internet-delivered treatment research for mental health. Since then, Swedish universities, in collaboration with research partners, have produced substantial research demonstrating the efficacy of ICBT across various psychological problems, including social anxiety disorder, panic disorder, generalized anxiety disorder, and depression. Although research conducted in clinical settings has been less frequent than in academic contexts, it has confirmed the effectiveness of therapist-supported ICBT programs for mild-to-moderate mental health problems in routine care. Early on, ICBT was provided as an option for patients at both the primary care level and in specialized clinics, using treatment programs developed by both public and private providers. The development of a national platform for delivering internet-based treatment and the use of procurement in selecting ICBT programs and providers are factors that have shaped the current routine care landscape. However, gaps persist in understanding how to optimize the integration of digital treatment in routine care, warranting further research and the use of specific implementation frameworks and outcomes. This historical perspective on the research and delivery of ICBT in Sweden over two decades offers insights for the international community into the development and broad dissemination of a specific digital mental health intervention within a national context.

Mahnaz Samadbeik, Nasim Aslani, Masoumeh Maleki et al.

Rachael Lear, Sophia Ellis, Tiffany Ollivierre-Harris et al.

BackgroundVideo recordings of patients may offer advantages to supplement patient assessment and clinical decision-making. However, little is known about the practice of video recording patients for direct care purposes. ObjectiveWe aimed to synthesize empirical studies published internationally to explore the extent to which video recording patients is acceptable and effective in supporting direct care and, for the United Kingdom, to summarize the relevant guidance of professional and regulatory bodies. MethodsFive electronic databases (MEDLINE, Embase, APA PsycINFO, CENTRAL, and HMIC) were searched from 2012 to 2022. Eligible studies evaluated an intervention involving video recording of adult patients (≥18 years) to support diagnosis, care, or treatment. All study designs and countries of publication were included. Websites of UK professional and regulatory bodies were searched to identify relevant guidance. The acceptability of video recording patients was evaluated using study recruitment and retention rates and a framework synthesis of patients’ and clinical staff’s perspectives based on the Theoretical Framework of Acceptability by Sekhon. Clinically relevant measures of impact were extracted and tabulated according to the study design. The framework approach was used to synthesize the reported ethico-legal considerations, and recommendations of professional and regulatory bodies were extracted and tabulated. ResultsOf the 14,221 abstracts screened, 27 studies met the inclusion criteria. Overall, 13 guidance documents were retrieved, of which 7 were retained for review. The views of patients and clinical staff (16 studies) were predominantly positive, although concerns were expressed about privacy, technical considerations, and integrating video recording into clinical workflows; some patients were anxious about their physical appearance. The mean recruitment rate was 68.2% (SD 22.5%; range 34.2%-100%; 12 studies), and the mean retention rate was 73.3% (SD 28.6%; range 16.7%-100%; 17 studies). Regarding effectiveness (10 studies), patients and clinical staff considered video recordings to be valuable in supporting assessment, care, and treatment; in promoting patient engagement; and in enhancing communication and recall of information. Observational studies (n=5) favored video recording, but randomized controlled trials (n=5) did not demonstrate that video recording was superior to the controls. UK guidelines are consistent in their recommendations around consent, privacy, and storage of recordings but lack detailed guidance on how to operationalize these recommendations in clinical practice. ConclusionsVideo recording patients for direct care purposes appears to be acceptable, despite concerns about privacy, technical considerations, and how to incorporate recording into clinical workflows. Methodological quality prevents firm conclusions from being drawn; therefore, pragmatic trials (particularly in older adult care and the movement disorders field) should evaluate the impact of video recording on diagnosis, treatment monitoring, patient-clinician communication, and patient safety. Professional and regulatory documents should signpost to practical guidance on the implementation of video recording in routine practice. Trial RegistrationPROSPERO CRD42022331825: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331825

Antonela Miccoli, Joanne Song, Magdalena Romanowicz et al.

Adverse childhood experiences (ACEs) are potentially traumatic events that can cause lifelong suffering, with 1 out of 2 children in the United States experiencing at least 1 ACEs. The intergenerational effect of ACEs has been described, but there’s still paucity of knowledge of its impact on child development and behavior in children enrolled in Early Head Start (EHS) home visiting programs. A retrospective observational study was performed with 71 parents and 92 children participating in the EHS Home Visiting Program in Olmsted County from 2014 to 2019. Parents reported their own ACEs using a 10-item questionnaire. Children’s social-emotional status was evaluated with Devereux Early Childhood Assessment Second Edition (DECA) and development was evaluated using the Brigance Early Childhood Screens III. Referrals of children by EHS staff to community agencies were recorded. The association between parental ACEs score, developmental outcomes and referrals was analyzed. Parental ACEs score of 4 or more was associated with failing at least 1 domain on the Brigance screen ( P  = .02) especially adaptive/cognitive domain ( P  = .05), and increased risk of referral to community resources ( P  < .001). However, there was no association between ACEs scores and failing DECA screens. We identified an intergenerational association between parental exposure to ACEs and risk for childhood developmental delay and referrals to community services. Parental adverse childhood experiences (ACEs) have intergenerational effects on offspring. In our study, parental ACEs are associated with offspring developmental delays and referral to community resources. Screening for parental adverse childhood experiences, a key social determinant of health, is imperative and should be incorporated into primary care and early childhood settings to identify children at risk for developmental delay.

Simon Pinzek, Alex Gustschin, Tobias Neuwirth et al.

Grating-based phase-contrast and dark-field imaging systems create intensity modulations that are usually modeled with sinusoidal functions to extract transmission, differential-phase shift, and scatter information. Under certain system-related conditions, the modulations become non-sinusoidal and cause artifacts in conventional processing. To account for that, we introduce a piecewise-defined periodic polynomial function that resembles the physical signal formation process, modeling convolutions of binary periodic functions. Additionally, we extend the model with an iterative expectation-maximization algorithm that can account for imprecise grating positions during phase-stepping. We show that this approach can process a higher variety of simulated and experimentally acquired data, avoiding most artifacts.

Alexander Tingulstad, Maurits W. Van Tulder, Tarjei Rysstad et al.

Abstract Background The Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed generic questionnaire that consists of 14 items assessing health status in people with musculoskeletal disorders. The objective was to translate and cross-culturally adapt the MSK-HQ into Norwegian and to examine its construct validity and reliability in people on sick leave with musculoskeletal disorders. Methods A prospective cohort study was carried out in Norway on people between 18 and 67 years of age and sick leave due to a musculoskeletal disorder. The participants were recruited through the Norwegian Labour and Welfare Administration during November 2018–January 2019 and responded to the MSK-HQ at inclusion and after four weeks. Internal consistency was assessed by Cronbach’s alpha, and structural validity with a factor analysis. Construct validity was assessed by eight “a priori” defined hypotheses regarding correlations between the MSK-HQ and other reference scales. Correlations were analyzed by Spearman’s- or Pearson’s correlation coefficient and interpreted as high with values ≥ 0.50, moderate between 0.30–0.49, and low < 0.29. Reliability was tested with test–retest, standard error of measurement (SEM) and smallest detectable change (SDC). Results A total of 549 patients, mean age (SD) 48.6 (10.7), 309 women (56.3%), were included. The mean (SD) MSK-HQ sum scores (min–max 3–56) were 27.7 (8.2). Internal consistency was 0.86 and a three-factor structure was determined by factor analysis. Construct validity was supported by the confirmation of all hypotheses; high correlation with HRQOL, psychosocial risk profile, and self-perceived health; moderate correlation with physical activity, self-perceived work ability, and work presenteeism; and low correlation with the number of sick days. The test–retest reliability was good with an intraclass correlation coefficient of 0.83 (95% CI, 0.74–0.89), SEM was 2.3 and SDC 6.5. Conclusions The Norwegian version of the MSK-HQ demonstrated high internal consistency, a three-factor structure, good construct validity and good test–retest reliability when used among people on sick leave due to musculoskeletal disorders.

Hyder, Maryam A, Razzak, Junaid

Telemedicine refers to the delivery of medical care and provision of general health services from a distance. Telemedicine has been practiced for decades with increasing evidence proving its potential for enhanced quality of care for patients, reduction in hospital readmissions, and increase in savings for both patients and providers. The COVID-19 pandemic has resulted in a significant increase in the reliance on telemedicine and telehealth for provision of health care services. Developments in telemedicine should be structured as complements to current health care procedures, not with the goal of completely digitizing the entire health care system, but rather to use the power of technology to enhance areas that may not be working at their full potential. At the same time, it is also clear that further research is needed on the effectiveness of telemedicine in terms of both financial and patient benefits. We discuss the current and rapidly increasing knowledge about the use of telemedicine in the United States, and identify the gaps in knowledge and opportunities for further research. Beginning with telemedicine’s origins in the United States to its widespread use during the COVID-19 pandemic, we highlight recent developments in legislation, accessibility, and acceptance of telemedicine.

Jumana Antoun, Ghassan Hamadeh, Maya Romani

Ludovica Montanucci, Emidio Capriotti, Yotam Frank et al.

Abstract Background Predicting the effect of single point variations on protein stability constitutes a crucial step toward understanding the relationship between protein structure and function. To this end, several methods have been developed to predict changes in the Gibbs free energy of unfolding (∆∆G) between wild type and variant proteins, using sequence and structure information. Most of the available methods however do not exhibit the anti-symmetric prediction property, which guarantees that the predicted ∆∆G value for a variation is the exact opposite of that predicted for the reverse variation, i.e., ∆∆G(A → B) = −∆∆G(B → A), where A and B are amino acids. Results Here we introduce simple anti-symmetric features, based on evolutionary information, which are combined to define an untrained method, DDGun (DDG untrained). DDGun is a simple approach based on evolutionary information that predicts the ∆∆G for single and multiple variations from sequence and structure information (DDGun3D). Our method achieves remarkable performance without any training on the experimental datasets, reaching Pearson correlation coefficients between predicted and measured ∆∆G values of ~ 0.5 and ~ 0.4 for single and multiple site variations, respectively. Surprisingly, DDGun performances are comparable with those of state of the art methods. DDGun also naturally predicts multiple site variations, thereby defining a benchmark method for both single site and multiple site predictors. DDGun is anti-symmetric by construction predicting the value of the ∆∆G of a reciprocal variation as almost equal (depending on the sequence profile) to -∆∆G of the direct variation. This is a valuable property that is missing in the majority of the methods. Conclusions Evolutionary information alone combined in an untrained method can achieve remarkably high performances in the prediction of ∆∆G upon protein mutation. Non-trained approaches like DDGun represent a valid benchmark both for scoring the predictive power of the individual features and for assessing the learning capability of supervised methods.

Muhammad Hassan Khan, Julien Helsper, Muhammad Shahid Farid et al.

Kathrin Cresswell, Ann Slee, Aziz Sheikh

Background: There is currently limited guidance for hospitals to implement ePrescribing systems. We have developed an ePrescribing Toolkit designed to support ongoing implementation, adoption and optimisation of efforts. Aim: To investigate the perceived usefulness, reported use and areas for further development of the Toolkit by ePrescribing implementers in English hospitals. Methods: Questionnaire-based survey of hospitals that have or are interested in implementing ePrescribing systems. Results: We received responses from a total of 78 individuals representing 49 English NHS Trusts (out of 82 different Trusts who were emailed the survey, 60% response rate). The overwhelming majority of respondents (92%) were familiar with the ePrescribing Toolkit and 66% reported using it to guide their ongoing implementation efforts. The majority of ePrescribing Toolkit users (85%) viewed it as a helpful resource. Implementers particularly valued the case studies describing lessons learnt from hospitals that had already implemented ePrescribing systems. Suggestions for improvement included more information in relation to the progress of hospitals implementing systems, the names of key contacts in these sites, a list of available systems and the contact details of ePrescribing vendors. Respondents also highlighted the need for more information on optimisation and specialist prescribing. Conclusions: Interactive elements and learning lessons from early adopter sites that had accumulated experiences of implementing systems was viewed as the most helpful aspect of the ePrescribing Toolkit. The Toolkit now needs to be further developed to facilitate the continuing implementation/optimisation of ePrescribing and other health information technology across the NHS.

P Kuppusamy, B Divya

The colour retinal photography is one of the most essential features to identify the confirmation of various eye diseases. The iris is primary attribute to authenticate the human. This research work presents the survey and comparison of various blood vessel related feature identification, segmentation, extraction and enhancement methods. Additionally, this study is observed the various databases performance for storing the images and testing in minimal time. This paper is also provides the better performance techniques based on the survey.

Ryan B. Kochanski, MD, Robert Dawe, PhD, Daniel B. Eddelman, MD et al.

Background: Deep brain stimulation (DBS) via anatomical targeting of white matter tracts defined by diffusion tensor imaging (DTI) may be a useful tool in the treatment of pathologic neurophysiologic circuits implicated in certain disease states like treatment resistant depression (TRD). We sought to determine if DTI could be used to define the stria medullaris thalami (SM), the major afferent white matter pathway to the lateral habenula (LHb), a thalamic nucleus implicated in the pathophysiology of TRD. Methods: Probabilistic DTI was performed on ten cerebral hemispheres in five patients who underwent preoperative MRI for DBS surgery. Manual identification of the LHb on axial T1 weighted MRI was used for the initial seed region for tractography. Variations in tractography depending on chosen axial slice of the LHb and chosen voxel within the LHb were also assessed. Results: In all hemispheres the SM was reliably visualized. Variations in chosen axial seed slice as well as variations in single seed placement did not lead to significant changes in SM tractography. Conclusions: Probabilistic DTI can be used to visualize the SM which may ultimately provide utility for direct anatomic targeting in DBS surgery.