Use of Electronic Medical Records (EMR) in Gerontology: Benefits, Considerations and a Promising Future.

Electronic medical records (EMRs) have many benefits in clinical research in gerontology, enabling data analysis, development of prognostic tools and disease risk prediction. EMRs also offer a range of advantages in clinical practice, such as comprehensive medical records, streamlined communication with healthcare providers, remote data access, and rapid retrieval of test results, ultimately leading to increased efficiency, enhanced patient safety, and improved quality of care in gerontology, which includes benefits like reduced medication use and better patient history taking and physical examination assessments. The use of artificial intelligence (AI) and machine learning (ML) approaches on EMRs can further improve disease diagnosis, symptom classification, and support clinical decision-making. However, there are also challenges related to data quality, data entry errors, as well as the ethics and safety of using AI in healthcare. This article discusses the future of EMRs in gerontology and the application of AI and ML in clinical research. Ethical and legal issues surrounding data sharing and the need for healthcare professionals to critically evaluate and integrate these technologies are also emphasized. The article concludes by discussing the challenges related to the use of EMRs in research as well as in their primary intended use, the daily clinical practice.

Utility of the Comprehensive Trail Making Test in the Assessment of Mild Cognitive Impairment in Older Patients.

INTRODUCTION: The purpose of this study is to determine the usefulness of the CTMT (Comprehensive Trail Making Test) in diagnosing mild cognitive impairment in older patients. The test is used to assess executive functions, of which impairment is already observed in the early stages of the neurodegenerative process. MATERIALS AND METHODS: The study includes 98 patients of a geriatric ward assigned to 2 groups of 49 patients each: patients diagnosed with a mild cognitive impairment and patients without a cognitive impairment, constituting the control group (group K). A set of screening tests was used in the initial study: the MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment), and CDT (Clock Drawing Test), GDS (Geriatric Depression Scale). The second study included the performance of the CTMT; the performance indicator was the time of performance. RESULTS: Statistically significant differences are obtained between patients with mild cognitive impairments and those in cognitive normality in the performance of the CTMT test (p < 0.01). Patients with MCIs took longer to complete all trails of the test. To identify cognitive impairment, cutoff points were proposed for the CTMT total score and the other test trails. The CTMT overall score and CTMT 5 scored the highest AUCs (CTMT overall score = 0.77, CTMT Trail 5 = 0.80). CONCLUSIONS: The Comprehensive Trail Making Test may be useful in diagnosing mild cognitive impairment as a complementary screening tool.

Noninvasive Quantum Measurement of Arbitrary Operator Order by Engineered Non-Markovian Detectors.

The development of solid-state quantum technologies requires the understanding of quantum measurements in interacting, nonisolated quantum systems. In general, a permanent coupling of detectors to a quantum system leads to memory effects that have to be taken into account in interpreting the measurement results. We analyze a generic setup of two detectors coupled to a quantum system and derive a compact formula in the weak-measurement limit that interpolates between an instantaneous (text-book type) and almost continuous-detector dynamics-dependent-measurement. A quantum memory effect that we term "system-mediated detector-detector interaction" is crucial to observe noncommuting observables simultaneously. Finally, we propose a mesoscopic double-dot detector setup in which the memory effect is tunable and that can be used to explore the transition to non-Markovian quantum measurements experimentally.

Spatial and dynamical handwriting analysis in mild cognitive impairment.

Background and Objectives Standard clinical procedure of Mild Cognitive Impairment (MCI) assessment employs time-consuming tests of psychological evaluation and requires the involvement of specialists. The employment of quantitative methods proves to be superior to clinical judgment, yet reliable, fast and inexpensive tests are not available. This study was conducted as a first step towards the development of a diagnostic tool based on handwriting. Methods In this paper the handwriting sample of a group of 37 patients with MCI (mean age 76.1±5.8) and 37 healthy controls (mean age 74.8±5.7) was collected using a Livescribe Echo Pen while completing three tasks: (1) regular writing, (2) all-capital-letters writing, and (3) single letter multiply repeated. Parameters differentiating both groups were selected in each task. Results Subjects with confirmed MCI needed more time to complete task one (median 119.5s, IQR - interquartile range - 38.1 vs. 95.1s, IQR 29.2 in control and MCI group, p-value <0.05) and two (median 84.2s, IQR 49.2 and 53.7s, IQR 30.5 in control and MCI group) as their writing was significantly slower. These results were associated with a longer time to complete a single stroke of written text. The written text was also noticeably larger in the MCI group in all three tasks (e.g. median height of the text block in task 2 being 22.3mm, IQR 12.9 in MCI and 20.2mm, IQR 8.7 in control group). Moreover, the MCI group showed more variation in the dynamics of writing: longer pause between strokes in task 1 and 2. The all-capital-letters task produced most of the discriminating features. Conclusion Proposed handwriting features are significant in distinguishing MCI patients. Inclusion of quantitative handwriting analysis in psychological assessment may be a step forward towards a fast MCI diagnosis.

Nonsymmetrized correlations in quantum noninvasive measurements.

A long-standing problem in quantum mesoscopic physics is which operator order corresponds to noise expressions like , where I(ω) is the measured current at frequency ω. Symmetrized order describes a classical measurement while nonsymmetrized order corresponds to a quantum detector, e.g., one sensitive to either emission or absorption of photons. We show that both order schemes can be embedded in quantum weak-measurement theory taking into account measurements with memory, characterized by a memory function which is independent of a particular experimental detection scheme. We discuss the resulting quasiprobabilities for different detector temperatures and how their negativity can be tested on the level of second-order correlation functions already. Experimentally, this negativity can be related to the squeezing of the many-body state of the transported electrons in an ac-driven tunnel junction.

Quasiprobabilistic interpretation of weak measurements in mesoscopic junctions.

The impossibility of measuring noncommuting quantum mechanical observables is one of the most fascinating consequences of the quantum mechanical postulates. Hence, to date the investigation of quantum measurement and projection is a fundamentally interesting topic. We propose to test the concept of weak measurement of noncommuting observables in mesoscopic transport experiments, using a quasiprobabilistic description. We derive an inequality for current correlators, which is satisfied by every classical probability but violated by high-frequency fourth-order cumulants in the quantum regime for experimentally feasible parameters.

Formulation of time-resolved counting statistics based on a positive-operator-valued measure.

We propose a derivation of the full counting statistics of electronic current based on a positive-operator-valued measure. Our approach justifies the Levitov-Lesovik formula in the long-time limit, but can be generalized to the detection of finite-frequency noise correlations. The combined action of the projection postulate and the quantum formula for current noise at high frequencies imply an additional white noise. Estimates for this additional noise are in accordance with known experiments. We propose an experimental test of our conjecture by a simultaneous measurement of high- and low-frequency noise.

Sutherland formula for a square-well fluid.

We introduce a closed Onsager-symmetric set of linear kinetic equations for smooth interactions. The new formula is an equivalent of the Enskog equation for hard spheres. Corresponding Green-Kubo expressions for transport coefficients are given with high temperature corrections from finite potentials-Sutherland formula, not only for thermal conductivity and shear viscosity, but also bulk viscosity with discussion of the square-well case.

Symmetric linear kinetic theory.

Equilibrium time correlation functions are expressed by two Onsager-symmetric quantumlike operators containing equilibrium distribution function. A model of dissipation for smooth interaction potentials is proposed. Approximations leading to the mode coupling formula are clearly stated and the Green-Kubo prescription for the calculation of the transport coefficients is reformulated.