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1.
Ann Bot ; 132(7): 1249-1258, 2023 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-37823772

RESUMEN

BACKGROUND AND AIMS: Endoreduplication, the duplication of the nuclear genome without mitosis, is a common process in plants, especially in angiosperms and mosses. Accumulating evidence supports the relationship between endoreduplication and plastic responses to stress factors. Here, we investigated the level of endoreduplication in Ceratodon (Bryophyta), which includes the model organism Ceratodon purpureus. METHODS: We used flow cytometry to estimate the DNA content of 294 samples from 67 localities and found three well-defined cytotypes, two haploids and one diploid, the haploids corresponding to C. purpureus and Ceratodon amazonum, and the diploid to Ceratodon conicus, recombination occurring between the former two. KEY RESULTS: The endoreduplication index (EI) was significantly different for each cytotype, being higher in the two haploids. In addition, the EI of the haploids was higher during the hot and dry periods typical of the Mediterranean summer than during spring, whereas the EI of the diploid cytotype did not differ between seasons. CONCLUSIONS: Endopolyploidy may be essential in haploid mosses to buffer periods of drought and to respond rapidly to desiccation events. Our results also suggest that the EI is closely related to the basic ploidy level, but less so to the nuclear DNA content as previously suggested.


Asunto(s)
Briófitas , Bryopsida , Diploidia , Haploidia , Endorreduplicación/genética , Sequías , ADN
2.
J Med Syst ; 41(2): 33, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28054195

RESUMEN

Multinational health IT benchmarks foster cross-country learning and have been employed at various levels, e.g. OECD and Nordic countries. A bi-national benchmark study conducted in 2007 revealed a significantly higher adoption of health IT in Austria compared to Germany, two countries with comparable healthcare systems. We now investigated whether these differences still persisted. We further studied whether these differences were associated with hospital intrinsic factors, i.e. the innovative power of the organisation and hospital demographics. We thus performed a survey to measure the "perceived IT availability" and the "innovative power of the hospital" of 464 German and 70 Austrian hospitals. The survey was based on a questionnaire with 52 items and was given to the directors of nursing in 2013/2014. Our findings confirmed a significantly greater IT availability in Austria than in Germany. This was visible in the aggregated IT adoption composite score "IT function" as well as in the IT adoption for the individual functions "nursing documentation" (OR = 5.98), "intensive care unit (ICU) documentation" (OR = 2.49), "medication administration documentation" (OR = 2.48), "electronic archive" (OR = 2.27) and "medication" (OR = 2.16). "Innovative power" was the strongest factor to explain the variance of the composite score "IT function". It was effective in hospitals of both countries but significantly more effective in Austria than in Germany. "Hospital size" and "hospital system affiliation" were also significantly associated with the composite score "IT function", but they did not differ between the countries. These findings can be partly associated with the national characteristics. Indicators point to a more favourable financial situation in Austrian hospitals; we thus argue that Austrian hospitals may possess a larger degree of financial freedom to be innovative and to act accordingly. This study is the first to empirically demonstrate the effect of "innovative power" in hospitals on health IT adoption in a bi-national health IT benchmark. We recommend directly including the financial situation into future regression models. On a political level, measures to stimulate the "innovative power" of hospitals should be considered to increase the digitalisation of healthcare.


Asunto(s)
Documentación/estadística & datos numéricos , Administración Hospitalaria/estadística & datos numéricos , Sistemas de Información/estadística & datos numéricos , Innovación Organizacional , Austria , Benchmarking , Registros Electrónicos de Salud/estadística & datos numéricos , Alemania , Capacidad de Camas en Hospitales/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Sistemas de Medicación/estadística & datos numéricos
4.
BMC Med Inform Decis Mak ; 15: 75, 2015 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-26384111

RESUMEN

BACKGROUND: An Austrian Nursing Minimum Data Set (NMDS-AT) has been developed to describe the diversity of patient populations and variability of nursing care based on nursing diagnoses, nursing interventions, and nursing outcomes. The aim of this study is to test the feasibility of using this NMDS-AT by assessing the availability of data needed for the NMDS-AT in routine nursing documentation, and to assess its reliability and usefulness. METHODS: Data were collected in a general hospital from patient records of 20 patients representing 457 patient days. Availability of needed data was assessed by two raters in a chart review based on an NMDS-AT form. The interrater reliability (n=20) and intrarater reliability (n=5) was assessed using Cohen's kappa coefficient and intraclass correlation coefficient (ICC). Usefulness was assessed by verifying whether typical analysis questions can be answered by the documented NMDS-AT data. RESULTS: In the 20 patient records, thirteen nursing diagnoses, 50 nursing interventions, and five nursing outcomes occurred, representing 68 (58.6%) of the overall 116 data elements of the NMDS-AT. The data were found at different data sources (e.g., electronic nursing record or paper-based fever chart) and in various forms (e.g., standardized or free text). The interrater reliability of the thirteen nursing diagnoses showed kappa values (percentage of agreement) ranging from 0.35 (85%) to 1.00 (100%). The 50 nursing interventions showed ICCs ranging from 0.03 to 1.00. All nursing outcomes showed an ICC of 1.00. The intrarater reliability showed 100% agreement. Performing typical analysis questions showed that the extracted NMDS-AT data are able to answer questions of clinical management, of policy makers, and of nursing science. CONCLUSIONS: The NMDS-AT was found to be feasible: needed data was available in the analysed patient records, data extraction showed good reliability, and typical analysis could be performed and showed interesting results. Before the NMDS-AT can be introduced in healthcare institutions, the following challenges need to be addressed: 1. improve the quality of nursing documentation; 2. reduce fragmentation of documentation; 3. use a standardized nursing classification system; and 4. establish mappings between nursing classification systems and the NMDS-AT.


Asunto(s)
Bases de Datos Factuales/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Hospitales/estadística & datos numéricos , Personal de Enfermería en Hospital/estadística & datos numéricos , Enfermería/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Austria , Bases de Datos Factuales/normas , Estudios de Factibilidad , Femenino , Humanos , Masculino , Enfermería/normas , Personal de Enfermería en Hospital/normas
5.
Acta Anaesthesiol Scand ; 58(7): 820-5, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24903522

RESUMEN

BACKGROUND: Bolus injections of intravenous propofol and remifentanil can be used in the tracheal intubation of infants and children, but relatively large doses are needed. We hypothesised that addition of a small bolus of rocuronium would ensure good intubation conditions when modest propofol and remifentanil doses were used. METHODS: Seventy infants between 3 weeks and 4 months of age were randomised to receive either placebo or rocuronium. Anaesthesia was induced with IV propofol, 3 (3-5) mg/kg [median (range)]. Rocuronium (0.2 mg/kg) or placebo was then injected, followed 15 s later by 2 µg/kg remifentanil. One anaesthetist attempted tracheal intubation 1 min after the rocuronium/placebo injection and used the 'Copenhagen scoring system' to assess intubation conditions. The neuromuscular effect of 0.2 mg/kg rocuronium was recorded in another eight, already intubated, infants using thumb accelerometry during train-of-four stimulation of the ulnar nerve. RESULTS: Intubation conditions were classified as 'poor' in 14 of 34 (41%) patients given placebo and in 10 of 36 (28%) patients given rocuronium (P = 0.32). There were four failed first attempts at intubation in the placebo group and none in the rocuronium group (P = 0.051). Maximum neuromuscular depression occurred 4 (3-8) after injection of 0.2 mg/kg rocuronium. CONCLUSIONS: Intubation conditions were poor in almost one third of the patients receiving propofol-remifentanil. Adding a low-dose rocuronium did not significantly improve intubation conditions.


Asunto(s)
Androstanoles/administración & dosificación , Anestesia Intravenosa , Anestésicos Intravenosos/administración & dosificación , Intubación Intratraqueal/métodos , Fármacos Neuromusculares no Despolarizantes/administración & dosificación , Piperidinas/administración & dosificación , Propofol/administración & dosificación , Periodo de Recuperación de la Anestesia , Tos/etiología , Sinergismo Farmacológico , Femenino , Humanos , Hipnóticos y Sedantes/administración & dosificación , Lactante , Recién Nacido , Intubación Intratraqueal/efectos adversos , Laringoscopía , Lidocaína/administración & dosificación , Masculino , Midazolam/administración & dosificación , Piperidinas/farmacología , Medicación Preanestésica , Propofol/farmacología , Remifentanilo , Rocuronio , Insuficiencia del Tratamiento , Pliegues Vocales/fisiología
6.
Stud Health Technol Inform ; 313: 198-202, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38682530

RESUMEN

Secondary use of clinical health data implies a prior integration of mostly heterogenous and multidimensional data sets. A clinical data warehouse addresses the technological and organizational framework conditions required for this, by making any data available for analysis. However, users of a data warehouse often do not have a comprehensive overview of all available data and only know about their own data in their own systems - a situation which is also referred to as 'data siloed state'. This problem can be addressed and ultimately solved by implementation of a data catalog. Its core function is a search engine, which allows for searching the metadata collected from different data sources and thereby accessing all data there is. With this in mind, we conducted an explorative online market survey followed by vendor comparison as a pre-requisite for system selection of a data catalog. Assessment of vendor performance was based on seven predetermined and weighted selection criteria. Although three vendors achieved the highest score, results were lying closely together. Detailed investigations and test installations are needed for further narrowing down the selection process.


Asunto(s)
Data Warehousing , Registros Electrónicos de Salud , Motor de Búsqueda , Humanos , Almacenamiento y Recuperación de la Información/métodos , Metadatos
7.
Stud Health Technol Inform ; 313: 209-214, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38682532

RESUMEN

The Covid-19 pandemic spurred an unprecedented shift towards digitalization, prompting a surge in telehealth practices. This paper explores the impact of the pandemic on telemedicine through a comprehensive analysis of scientific publications. Utilizing a bibliometric approach, the study examines trends in telemedicine research before and after the onset of Covid-19. The systematic search in PubMed yielded 8,454 pre-Covid-19 publications (2016-2019) and 16,633 post-Covid-19 publications (2020-2023). A total of 21,989 distinct keywords were extracted. Co-occurrence maps reveal evolving thematic clusters, with "mhealth" and "ehealth" dominating pre-Covid-19, while "Covid-19" emerges as a top keyword post-pandemic. The Top-10 keywords shift post-Covid-19, reflecting dynamic research priorities. The bibliometric approach illuminates a heightened exploration of telehealth solutions post-pandemic, emphasizing the enduring impact of the crisis on academic discourse. Changes in key terms and shifts in key term ranking indicate dynamic research priorities and a broader consideration of multidimensional healthcare challenges. Acknowledging study limitations, the analysis offers a high-level perspective, focusing on authors' keywords. Despite challenges, the study provides a systematic overview, revealing the emergence of new telemedicine application domains and the need for further in-depth analyses. Future research directions may explore the ecological impact of telemedicine applications and other intriguing aspects, contributing to a comprehensive understanding of telemedicine's scholarly trajectory.


Asunto(s)
Bibliometría , COVID-19 , Pandemias , Telemedicina , COVID-19/epidemiología , Humanos , SARS-CoV-2
8.
Stud Health Technol Inform ; 316: 1709-1713, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39176539

RESUMEN

The increasing volume of unstructured textual data in healthcare, particularly in nursing care reports, presents both challenges and opportunities for enhancing patient care and operational efficiency. This study explores the application of Latent Dirichlet Allocation (LDA) topic modeling to analyze free-text nursing narratives from inpatient stays in three different clinics, aiming to uncover the latent thematic structures within. Utilizing the R programming environment and the visualization tool LDAvis, we identified three main themes: "Patient Well-being," "Patient Mobility and Care Activities," and "Treatment and Pain Management," the latter combining two closely related but initially distinct topics due to their overlapping content. Our findings demonstrate the potential of LDA topic modeling in extracting meaningful insights from nursing narratives, which could inform patient care strategies and healthcare practices. However, the study also highlights significant challenges associated with the method, including the sensitivity to parameter settings, the lack of updates for key software packages, and concerns about reproducibility. These issues highlight the need for meticulous parameter validation and the exploration of alternative text analysis methodologies for future research. By addressing these methodological challenges and emphasizing the importance of comparative method analysis, this study contributes to the advancement of text analytics in healthcare. It opens avenues for further research aimed at developing more robust, efficient, and accessible tools for analyzing free-text data, thereby enhancing the ability of healthcare professionals to use unstructured data to improve decision making and patient outcomes.


Asunto(s)
Narración , Humanos , Procesamiento de Lenguaje Natural , Registros de Enfermería , Atención de Enfermería , Minería de Datos/métodos
9.
Stud Health Technol Inform ; 313: 173-178, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38682526

RESUMEN

BACKGROUND: The integration of Information Technology (IT) into private medical practice is crucial in modern healthcare. Physicians managing office-related IT without proper knowledge risk operational inefficiencies and security. OBJECTIVES: This study determines the relevance of specific IT topics in medical practice and identifies the training needs of physicians for enhancing IT competencies in healthcare. METHODS: In March 2023 a cross-sectional online survey was conducted with physicians comprising nine IT-related topics in Tyrol, Austria. RESULTS: The survey results highlighted a strong perceived relevance and high demand for IT education among physicians working in their medical practice, especially in areas of core medical IT and security. The majority of responses indicated high relevance (76.7%) and high demand (69.7%) for IT topics in medical practice. CONCLUSION: The findings underscore a significant need for targeted IT training and support in medical practices, particularly in areas related to the medical practice and security. Addressing these needs could lead to improved healthcare delivery and better management of technological resources in the healthcare sector.


Asunto(s)
Práctica Privada , Estudios Transversales , Austria , Humanos , Encuestas y Cuestionarios , Informática Médica/educación
10.
Stud Health Technol Inform ; 313: 203-208, 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38682531

RESUMEN

This study scrutinizes free AI tools tailored for supporting literature review and analysis in academic research, emphasizing their response to direct inquiries. Through a targeted keyword search, we cataloged relevant AI tools and evaluated their output variation and source validity. Our results reveal a spectrum of response qualities, with some tools integrating non-academic sources and others depending on outdated information. Notably, most tools showed a lack of transparency in source selection. Our study highlights two key limitations: the exclusion of commercial AI tools and the focus solely on tools that accept direct research queries. This raises questions about the potential capabilities of paid tools and the efficacy of combining various AI tools for enhanced research outcomes. Future research should explore the integration of diverse AI tools, assess the impact of commercial tools, and investigate the algorithms behind response variability. This study contributes to a better understanding of AI's role in academic research, emphasizing the importance of careful selection and critical evaluation of these tools in academic endeavors.


Asunto(s)
Inteligencia Artificial , Estudiantes , Humanos , Investigadores , Literatura de Revisión como Asunto
11.
Nat Commun ; 15(1): 3102, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38600072

RESUMEN

Several studies have suggested the imprinting of SARS-CoV-2 immunity by original immune challenge without addressing the formation of the de novo response to successive antigen exposures. As this is crucial for the development of the original antigenic sin, we assessed the immune response against the mutated epitopes of omicron SARS-CoV-2 after vaccine breakthrough. Our data demonstrate a robust humoral response in thrice-vaccinated individuals following omicron breakthrough which is a recall of vaccine-induced memory. The humoral and memory B cell responses against the altered regions of the omicron surface proteins are impaired. The T cell responses to mutated epitopes of the omicron spike protein are present due to the high cross-reactivity of vaccine-induced T cells rather than the formation of a de novo response. Our findings, therefore, underpin the speculation that the imprinting of SARS-CoV-2 immunity by vaccination may lead to the development of original antigenic sin if future variants overcome the vaccine-induced immunity.


Asunto(s)
Infección Irruptiva , Vacunas , Humanos , Vacunación , Epítopos , SARS-CoV-2 , Inmunidad , Anticuerpos Antivirales , Anticuerpos Neutralizantes
12.
Br J Clin Pharmacol ; 76 Suppl 1: 78-90, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24007454

RESUMEN

AIMS: The prevention of adverse drug events (ADEs) demands co-ordination of different health care professionals. ADE scorecards are a novel approach to raise the team awareness regarding ADE risks and causes. It makes information on numbers and on possible causes of possible ADE cases available to the clinical team. The aim of the study was to investigate the usage and acceptance of ADE scorecards by healthcare professionals and their impact on rates of possible ADEs. METHODS: ADE scorecards were introduced in three departments of a French hospital. A controlled time series analysis of ADE data was conducted to assess the impact of the ADE scorecards. In addition, qualitative interviews and a standardized survey with all participating staff members were performed. RESULTS: Physicians, nurses and pharmacists found ADE scorecards effective to increase medication safety and recommended future usage. The time-series analysis did not show changes in rates of possible ADEs. CONCLUSION: ADE scorecards appear to be useful to raise awareness of ADE-related issues among professionals. Although the evaluation did not show significant reductions of ADE rates, the participating physicians, nurses and pharmacists believed that the ADE scorecards could contribute to increased patient safety and to a reduction in ADE rates. Strategies need to be designed to integrate ADE scorecards better into the clinical routine and to increase the precision of ADE detection.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Administración de la Seguridad , Sistemas de Apoyo a Decisiones Clínicas , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/prevención & control , Femenino , Humanos , Masculino , Errores de Medicación/prevención & control , Seguridad del Paciente
13.
Crit Care ; 17(3): R88, 2013 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-23663770

RESUMEN

INTRODUCTION: Diclofenac, a nonsteroidal antiinflammatory drug, is commonly used as antipyretic therapy in intensive care. The purpose of this study was to investigate the effects of parenteral diclofenac infusion on brain homeostasis, including brain-tissue oxygen tension (PbtO2) and brain metabolism after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We conducted a prospective, observational study with retrospective analysis of 21 consecutive aSAH patients with multimodal neuromonitoring. Cerebral perfusion pressure (CPP), mean arterial pressure (MAP), intracranial pressure (ICP), body temperature, and PbtO2 were analyzed after parenteral diclofenac infusion administered over a 34-minute period (20 to 45 IQR). Data are given as mean ± standard error of mean and median with interquartile range (IQR), as appropriate. Time-series data were analyzed by using a general linear model extended by generalized estimation equations (GEEs). RESULTS: One-hundred twenty-three interventions were analyzed. Body temperature decreased from 38.3°C ± 0.05°C by 0.8°C ± 0.06°C (P < 0.001). A 10% decrease in MAP and CPP (P < 0.001) necessitated an increase of vasopressors in 26% (n = 32), colloids in 33% (n = 41), and crystalloids in 5% (n = 7) of interventions. PbtO2 decreased by 13% from a baseline value of 28.1 ± 2.2 mm Hg, resulting in brain-tissue hypoxia (PbtO2 <20 mm Hg) in 38% (n = 8) of patients and 35% (n = 43) of interventions. PbtO2 <30 mm Hg before intervention was associated with brain-tissue hypoxia after parenteral diclofenac infusion (likelihood ratio, 40; AUC, 93%; 95% confidence interval (CI), 87% to 99%; P < 0.001). Cerebral metabolism showed no significant changes after parenteral diclofenac infusion. CONCLUSIONS: Parenteral diclofenac infusion after aSAH effectively reduces body temperature, but may lead to CPP decrease and brain-tissue hypoxia, which were both associated with poor outcome after aSAH.


Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Encéfalo/metabolismo , Diclofenaco/uso terapéutico , Oxígeno/metabolismo , Hemorragia Subaracnoidea/tratamiento farmacológico , Hemorragia Subaracnoidea/metabolismo , Antiinflamatorios no Esteroideos/administración & dosificación , Presión Sanguínea/efectos de los fármacos , Temperatura Corporal/efectos de los fármacos , Circulación Cerebrovascular/efectos de los fármacos , Diclofenaco/administración & dosificación , Humanos , Infusiones Parenterales , Presión Intracraneal/efectos de los fármacos , Monitoreo Fisiológico , Estudios Prospectivos , Estudios Retrospectivos
14.
Int J Hyperthermia ; 29(7): 620-8, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24001114

RESUMEN

PURPOSE: This paper outlines a theoretical approach for optimisation of the coagulation zone for thermal ablation procedures and considerations for its practical application. METHODS: The theoretical approach is outlined in the Cartesian coordinate system. Considerations for practical application are implemented. The optimised coagulation zone is defined as the bare coverage of tumour mass plus a safety margin. The eccentricity of coagulation centre (ECC) is defined as the distance between the coagulation centre and the tumour centre. The direction of the applicator shaft is determined based on the x-axis direction. The tumour centre and coagulation centre are defined within the x/y-plane. The distance between coagulation margin (applicator tip) and tumour margin is called parallel offset (PAO). RESULTS: For spherical coagulation shapes, a linear relationship exists between optimised coagulation diameter and ECC. An exponential relationship exists between optimised coagulation volume and ECC. A complex relationship was found between PAO and determinants of ECC, which are ex and ey. PAO is an extremely important parameter, which allows for determination of the optimal applicator tip position in relation to the tumour margin. It can be calculated in such a manner that the optimised coagulation zone is minimised by neutralising dislocation of the coagulation centre in applicator shaft direction. The latter can be realised by withdrawing or further inserting the applicator shaft. CONCLUSIONS: The presented concept can be used to optimise the extent of the coagulation zone for thermal ablation procedures after positioning of the applicator. Its inherent advantage is the simple adjustment of the applicator shaft, which obviates the need for a repuncture.


Asunto(s)
Coagulación Sanguínea , Hipertermia Inducida , Neoplasias/terapia , Modelos Teóricos , Neoplasias/sangre
15.
Stud Health Technol Inform ; 301: 220-224, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37172184

RESUMEN

The Clinical Information Systems (CIS) section of the IMIA Yearbook of Medical Informatics systematically screens about 2,500 publications from more than 1,000 journals annually to find the best CIS publications. The editors of the CIS section have noticed a trend toward patient-centered care supported by AI and machine learning and increased research in cross-institutional data sharing, particularly in telemedicine. As a result, they adjusted their search query to include the MeSH term "telemedicine." As a preliminary step and to get a sense of the historical development of telemedicine research activity, they performed a bibliometric analysis of all previously published papers in PubMed indexed with the tag "Telemedicine" as MeSH Major Topic. They retrieved 29,289 publications from 1976 to 2022 and used their titles and abstracts to create a bibliometric network that visualizes the most relevant terms, their frequency and relationship to each other, and the chronological sequence of their publication. The development over time also shows a clear move toward patient-centeredness. Interestingly, the term "Covid," which has only recently come into use, takes on a central role in the network.


Asunto(s)
COVID-19 , Informática Médica , Telemedicina , Humanos , Aprendizaje Automático , Bibliometría
16.
Yearb Med Inform ; 32(1): 127-137, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38147856

RESUMEN

OBJECTIVE: In this synopsis, the editors of the Clinical Information Systems (CIS) section of the IMIA Yearbook of Medical Informatics overview recent research and propose a selection of best papers published in 2022 in the CIS field. METHODS: The editors follow a systematic approach to gather relevant articles and select the best papers for the section. This year, they updated the query to incorporate the topic of telemedicine and removed search terms related to geographic information systems. The revised query resulted in a larger number of identified papers, necessitating the appointment of a third section editor to handle the increased workload. The editors narrowed the initial pool of articles to 15 candidate papers through a multi-stage selection process. At least seven independent reviews were collected for each candidate paper, and a selection meeting with the IMIA Yearbook editorial board led to the final selection of the best papers for the CIS section. RESULTS: The query was carried out in mid-January 2023 and retrieved a deduplicated result set of 5,206 articles from 1,500 journals. This year, 15 papers were nominated as candidates, and four were finally selected as the best papers in the CIS section.Including telemedicine in the query resulted in a substantial increase in the number of papers found. The analysis highlights the growing convergence between clinical information systems and telemedicine, with mobile health (mHealth) technologies and data science applications gaining prominence. The selected candidate papers emphasize the practical impact of research efforts, focusing on patient-centric outcomes and benefits, including intelligent mobile health monitoring systems and AI-assisted decision-making in healthcare. CONCLUSIONS: Looking ahead, the field of CIS is expected to continue evolving, driven by advances in telemedicine, mHealth technologies, data science, and AI integration, leading to more efficient, patient-oriented, and intelligent healthcare systems and overall improvement of global healthcare outcomes.


Asunto(s)
Informática Médica , Telemedicina , Humanos , Inteligencia Artificial , Ciencia de los Datos , Sistemas de Información , Poder Psicológico
17.
Front Pharmacol ; 14: 1143974, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37180719

RESUMEN

Introduction: After six years of medication errors' (MEs) collection and analysis in a pediatric unit of a French University Hospital, the number of MEs was no longer decreasing. We then decided to set up pharmaceutical training and tools and evaluate their impact on the occurrence of ME. Materials and methods: This monocentric prospective study was carried out in the form of audits of prescriptions, preparations, and administrations before and after intervention (A1 and A2). After the analysis of A1 results, feedback was given to the teams, some tools for the proper use of medication (PUM) were distributed, and A2 was conducted. Finally, A1 and A2 results were compared. Results: Each audit included 202 observations. A total of 120 MEs were identified during A1 and 54 for A2 (p < 0.0001). The observation rate with at least 1 ME decreased from 39.11% to 21.29% (p < 0.0001), and no observation had more than two MEs during A2 in contrast to A1 (n = 12). Human factors were responsible for the majority of MEs. The audit feedback allowed professionals to feel concerned about ME. The PUM tools received an average satisfaction rating of 9/10. The staff had never participated in this type of training, and all felt it was useful to apply PUM. Conclusion: This study showed a significant impact of pharmaceutical training and tools on the pediatric PUM. Clinical pharmaceutic actions allowed us to reach our objectives and satisfied all the staff. They must, therefore, be continued to limit human factors' impact and thus contribute to the safety of drug management in pediatrics.

18.
Stud Health Technol Inform ; 301: 180-185, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37172177

RESUMEN

Data-driven decision-making in health care is becoming increasingly important in daily clinical use. A data warehouse, storing all the clinically relevant information in a highly structured way, is a primary basis for achieving this goal. We are developing a clinical data warehouse where more than 20 years of clinical data can be persisted, and newly generated data from different sources can be integrated. A back room was created to store all hospital information system data in a PostgreSQL database. Due to the enormous number of diverse forms in the hospital information system, a broker service was developed that integrates the individual data sources into the data warehouse as soon as they are released for storage. The front room represents the interface from the infrastructure to the targeted analysis. Database query and visualization tools or business intelligence tools can display and analyze processed and interleaved data. In all areas of business and medicine, structured and quality-adjusted data is of major importance. With the help of a clinical data warehouse system, it is possible to perform patient-centered analyses and thus realize optimal therapy. Furthermore, it is possible to provide staff and management with dashboards for control purposes.


Asunto(s)
Data Warehousing , Sistemas de Información en Hospital , Humanos , Virtudes , Bases de Datos Factuales , Hospitales
19.
Stud Health Technol Inform ; 301: 162-167, 2023 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-37172174

RESUMEN

BACKGROUND: Dashboards provide a good retrospective view of the development of the disease. Yet, current COVID-related dashboards typically lack the capability to predict future trends. However, this is important for health policy makers and health care providers in order to adopt meaningful containment strategies. OBJECTIVES: The aim of this paper is to present the Surviral dashboard, which allows the effective monitoring of infectious disease dynamics. METHODS: The presented dashboard comprises a wide range of information, including retrospective and prognostic data based on an agent-based simulation framework. It served as the basis for informed decision-making and planning of disease control strategies within the federal state of Tyrol. RESULTS: By visualizing the information in an understandable format, the dashboard provided a comprehensive overview of the COVID-19 situation in Tyrol and allowed for the identification of trends and patterns. CONCLUSION: The presented dashboard is a valuable tool for managing pandemics such as COVID-19. It provides a convenient and efficient way to monitor the spread of a disease and identify potential areas for intervention.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Estudios Retrospectivos , Política de Salud , Registros , Personal de Salud
20.
Front Immunol ; 14: 1066123, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36742295

RESUMEN

Background: Worldwide vaccination campaigns significantly reduced mortality caused by SARS-CoV-2 infection and diminished the devastating effects of the pandemic. The first approved vaccines are based on novel mRNA technology and elicit potent immune responses offering high levels of protection from severe disease. Methods: Here we longitudinally assessed adaptive immune responses during a 12-month follow-up period after the initial immunization with 2 doses of mRNA vaccines and after the booster dose in blood and saliva. Results: Our findings demonstrate a rapid waning of the anti-spike IgG titers between months 3 and 6 after the initial vaccination (1.7- and 2.5-fold decrease in plasma and saliva, respectively; P<0.0001). Conversely, the frequency of spike-specific memory B cells increased during this period (2.4-fold increase; P<0.0001) while the frequency of spike-specific CD4+ and CD8+ T cells remained stable for all assessed functions: cytotoxicity, IFNγ, IL-2, and TNFα expression. Booster vaccination significantly improved the antibody response in plasma and saliva, with the most profound changes observed in the neutralization capacity against the currently circulating omicron variant (25.6-fold increase; P<0.0001). The positive effect of booster vaccination was also evident for spike-specific IgG+ memory B cell (2.4-fold increase; P<0.0001) and cytotoxic CD4+ and CD8+ T cell responses (1.7- and 1.9-fold increase respectively; P<0.05). Conclusions: Collectively, our findings offer a detailed insight into the kinetics of adaptive immune response following SARS-CoV-2 vaccination and underline the beneficial effects of a booster vaccination.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Humanos , COVID-19/prevención & control , Vacunas contra la COVID-19/inmunología , Inmunoglobulina G , SARS-CoV-2 , Inmunidad Adaptativa , Inmunización Secundaria
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