Implicações da prática profissional no acolhimento institucional de crianças: perspectiva de cuidadoras / Implications of professional practice in children's institutional sheltering: caregivers' perspective / Implicaciones de la práctica profesional en el alojamiento institucional de niños: perspectiva de cuidadoras

Este estudo qualitativo teve como objetivo compreender, a partir da teoria de bioecológica de desenvolvimento, as implicações da prática profissional no processo de acolhimento de crianças em uma casa-abrigo, na perspectiva de cuidadoras. As participantes foram 10 profissionais de uma casa-abrigo localizada na região sul do Brasil. Utilizou-se a entrevista semiestruturada e a organização e análise dos dados sustentou-se na Grounded Theory, com auxílio do software Atlas.ti 8.4.14. Os resultados evidenciaram uma centralização das ações de acolhimento e atenção em torno dos cuidados físicos das crianças. As ações para promover suporte e cuidados emocionais dentro da casa-abrigo eram delegadas às profissionais da equipe técnica da instituição. Observou-se que as dificuldades encontradas pelas cuidadoras diziam respeito à falta de segurança e preparação para responder e acolher as demandas emocionais das crianças, as quais estão presentes em diversos momentos do processo de acolhimento. Percebeu-se que as práticas institucionais afetaram decisivamente tanto as ações de acolhimento das participantes e o suporte emocional oferecido às crianças na passagem pela casa-abrigo quanto as cuidadoras, no sentido de vivenciarem no trabalho sentimentos de insegurança. Os resultados tensionam ecologicamente a interação nos processos proximais presentes no desenvolvimento humano. Advoga-se pela reflexão sobre as implicações das práticas institucionais de uma casa-abrigo e o desenvolvimento infantil, visando o cuidado integral dos acolhidos.(AU)

Based on the developmental bioecological theory, this study analyzes the implications of professional practice in children's user embracement at a shelter from the caregivers' perspective. Semi-structured interviews were conducted with 10 professionals from a shelter located in southern Brazil. Data organization and analysis was performed based on Grounded Theory using the Atlas.ti 8.4.14 software. Results showed that embracement and attention focus on the physical care of children. Support and emotional care activities were delegated to the institution's technical team. Caregivers faced difficulties regarding the lack of security and preparation to respond to and accept the children's emotional demands, which arise at different moments in the embracement process. The institutional practices decisively affected both user embracement actions and the emotional support offered to the children, as well as the caregivers, in the sense of experiencing feelings of insecurity. These findings ecologically tension the interaction in the proximal processes present in human development. Further reflections on the implications of institutional shelter-based practices for child development are needed to provide comprehensive care.(AU)

Este estudio cualitativo tuvo como objetivo comprender, desde la perspectiva de la teoría bioecológica del desarrollo, las implicaciones de la práctica profesional en el proceso de acogida de niños en una institución infantil desde la perspectiva de las cuidadoras. Las participantes fueron 10 profesionales de una institución de acogida infantil ubicada en la región Sur de Brasil. Se utilizó la entrevista semiestructurada, y para la organización y análisis de datos se aplicó Grounded Theory, con el uso del software Atlas.ti 8.4.14. Los resultados mostraron que las acciones de recepción y atención se centran en el cuidado físico de los niños. Las acciones de promoción de apoyo y cuidado emocional dentro del alojamiento se asignaron a los profesionales del equipo técnico de la institución. Se observó que las dificultades encontradas por las cuidadoras estaban relacionadas con la falta de seguridad y preparación para responder y aceptar las demandas emocionales de los niños, las cuales se encuentran presentes en diferentes momentos del proceso de acogida. Se notó que las prácticas institucionales afectaron decisivamente tanto las acciones de acogida de las participantes como el apoyo emocional que la institución brinda a los niños durante su paso, así como a las cuidadoras en el sentido de experimentar sentimientos de inseguridad en el trabajo. Estos resultados tensan ecológicamente la interacción en los procesos proximales presentes en el desarrollo humano. Se aboga por reflexionar sobre las implicaciones de las prácticas institucionales en los alojamientos institucionales y el desarrollo infantil, apuntando a la atención integral de los acogidos.(AU)

Recent-Onset Altered Mental Status: Evaluation and Management.

Potential precipitating factors for the recent onset of altered mental status (AMS) include primary central nervous system insults, systemic infections, metabolic disturbances, toxin exposure, medications, chronic systemic diseases, and psychiatric conditions. Delirium is also an important manifestation of AMS, especially in older people who are hospitalized. Clinicians should identify and treat reversible causes of the AMS, some of which require urgent intervention to minimize morbidity and mortality. A history and physical examination guide diagnostic testing. Laboratory testing, chest radiography, and electrocardiography help diagnose infections, metabolic disturbances, toxins, and systemic conditions. Neuroimaging with computed tomography or magnetic resonance imaging should be performed when the initial evaluation does not identify a cause or raises concern for intracranial pathology. Lumbar puncture and electroencephalography are also important diagnostic tests in the evaluation of AMS. Patients at increased risk of AMS benefit from preventive measures. The underlying etiology determines the definitive treatment. When intervention is needed to control patient behaviors that threaten themselves or others, nonpharmacologic interventions are preferred to medications. Physical restraints should rarely be used and only for the shortest time possible. Medications should be used only when nonpharmacologic treatments are ineffective.

Development of a risk prediction nomogram for disposition of acute toxic exposure patients to intensive care unit.

Early risk stratification of acutely poisoned patients is essential to identify patients at high risk of intensive care unit (ICU) admission. We aimed to develop a prognostic model and risk-stratification nomogram based on the readily accessible clinical and laboratory predictors on admission for the probability of ICU admission in acutely poisoned patients. This retrospective cohort study included adult patients with acute toxic exposure to a drug or a chemical substance. Patients' demographic, toxicologic, clinical and laboratory data were collected. Among the 1260 eligible patients, 180 (14.3%) were admitted to the ICU. We developed a generalized prognostic model for predicting ICU admission in patients with acute poisoning. The predictors included the Glasgow coma scale, oxygen saturation, diastolic blood pressure, respiratory rate and blood bicarbonate concentration. The model displayed excellent discrimination and calibration (optimistic-adjusted area under the curve = 0.924 and optimistic-adjusted Hosmer and Lemeshow test = 0.922, respectively) when internally validated. Additionally, we developed prognostic models that determine ICU admission in patients with specific poisonings. Furthermore, we constructed risk-stratification nomograms that rank the probability of ICU admission in these patients. The developed risk-stratification nomograms help decision-making regarding ICU admission in acute poisonings. Future external validation in independent cohorts is necessary before clinical application.

Feasibility of physiologically based pharmacokinetic simulations for assessing pediatric patients after accidental drug ingestion: A case study of a 1.4-year-old girl who ingested alprazolam.

The accidental ingestion of drugs is a common concern, especially in the case of young children. A physiologically based pharmacokinetic (PBPK) model that implements the age-dependent size growth and ontogeny of organ functions can be used to predict the concentration-time profiles of drugs in the pediatric population. In this study, the feasibility of using a PBPK model for predicting the amount of drug accidentally swallowed by a child was assessed based on a case study in an infant. Alprazolam was the drug involved in the current case. The developed PBPK model of alprazolam was first evaluated using pharmacokinetic data obtained in healthy adult male volunteers. Then, it was adapted for application to virtual Japanese pediatric subjects having the same demographic information as the infant of interest. The pharmacokinetic data observed in the infant fell within the range of the 5th and 95th percentiles of the pharmacokinetic simulations after administration of 0.4 mg alprazolam (equivalent to one tablet) in the panel of virtual infants. PBPK simulations could provide estimates of the amount accidentally ingested by a child and also give mechanistic insights into the observed drug concentrations. The current study demonstrates the potential clinical utility of PBPK modeling.

Health risk estimation of metals bioaccumulated in commercial fish from coastal areas and rivers in Bangladesh.

Metal contaminations in commercial fish have become a great public health concern worldwide including Bangladesh. The current study was conducted to provide preliminary evidence of nine metals in three commercially significant fish namely Pampus argenteus, Sardinella longiceps and Tenualosa ilisha collected from four coastal stations- Kuakata, Pathorghata, Cox's Bazar, and Pirojpur, and eight stations of five rivers- Padma, Meghna, Jamuna, Katcha, and Nobogonga in Bangladesh. High magnitudes of Pb (0.74-4.59 mg/kg ww), Cd (0.07-0.24 mg/kg ww), and Mn (0.45-2.03 mg/kg ww) were recorded in the sampling stations that exceeded the maximum permissible limits (MPL) proposed by different recognized organizations. Significant mean differences of metal concentrations were observed (p < 0.05) between species and stations. In fish samples, excessive metals accumulations were recorded from Kuakata (St.1) at the coastal area, and Nobogonga (St. 12) among the rivers. The health risk assessment (HRA) was carried out comprehensively via the estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), and target cancer risk (TR) calculations. The outcomes of EDI, THQ, and HI suggest that chronic exposure to towering Pb content might pose potential health threats to inhabitants particularly living in highly polluted stations of the coastal area. In addition, the massive TR values of Cd intake through fish consumption from the coastal area might create cancer risks. Accordingly, the ingestion of metals contaminated fish portends chronic as well as acute health risks to Bangladeshi people living both at home and abroad.

Inpatient Burden and Mortality of Methanol Intoxication in the United States.

BACKGROUND: This study aimed to assess inpatient prevalence, characteristics, outcomes, and resource utilization of hospitalization for methanol intoxication in the United States. MATERIALS AND METHODS: A total of 603 hospitalized patients with a primary diagnosis of methanol intoxication from 2003 to 2014 were identified in the National Inpatient Sample database. The inpatient prevalence, clinical characteristics, treatments, outcomes, resource utilization, were investigated. Multivariable logistic regression was performed to identify factors independently associated with in-hospital mortality. RESULTS: The overall inpatient prevalence of methanol intoxication among hospitalized patients was 6.4 cases per 1,000,000 admissions in the United States. The mean age was 38±18 (range 0-86) years. 44% used methanol for suicidal attempts. 20% of admissions required mechanical ventilation, and 40% required renal replacement therapy. The three most common complications were metabolic acidosis (44%), hypokalemia (18%), and visual impairment or optic neuritis (8%). The three most common end-organ failures were renal failure (22%), respiratory failure (21%), and neurological failure (17%). 6.5% died in the hospital. Factors associated with increased in-hospital mortality included alcohol drinking, hypernatremia, renal failure, respiratory failure, circulatory failure, and neurological failure. The mean length of hospital stay was 4.0 days. The mean hospitalization cost per patient was $43,222 CONCLUSION: The inpatient prevalence of methanol intoxication in the United States was 6.4 cases per 1,000,000 admissions. The risk of in-hospital mortality mainly depended on the number of end-organ failures.

Antimalarial and cytotoxic drugs on COVID-19 and the cardiovascular burden: Literature review and lessons to be learned.

BACKGROUND: The world is witnessing an unprecedented crisis with Coronavirus disease 2019 (COVID-19). It is important to accurately analyze the available evidence to provide correct clinical guidance for optimal patient care. We aim to discuss current clinical evidence regarding chloroquine, hydroxychloroquine, azithromycin, remdesivir, and the cardiovascular burden of COVID-19. METHODS: A literature review was performed using PubMed and Google Scholar. Additional clinical trials were identified through the "TrialsTracker" project. RESULTS: We found conflicting evidence of chloroquine, hydroxychloroquine plus azithromycin, and remdesivir in COVID-19 despite promising early reports of in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2. Some of the current studies have demonstrated adverse drug reactions to chloroquine and hydroxychloroquine + azithromycin. Widespread systemic inflammation and procoagulant/hypercoagulable state, including thrombotic microangiopathy, endothelial dysfunction, bleeding disorder, and thrombosis are increasingly being witnessed in COVID-19. Evidence of cardiac injury and stroke is mostly reported in hospitalized patients; however, large specialized studies that focus on cardiac or neuropathology are lacking. DISCUSSION: There is no convincing clinical evidence of chloroquine, hydroxychloroquine with or without azithromycin, and remdesivir use in COVID-19. As evidence of systemic inflammation is rapidly unfolding, there is a dire need to maximize our resources to find the best possible solutions to the current crisis while conclusive evidence from clinical trials emerges.

Research Participants' Attitudes towards Receiving Information on Genetic Susceptibility to Arsenic Toxicity in Rural Bangladesh.

BACKGROUND: In human genetics research, it has become common practice for researchers to consider returning genetic information to participants who wish to receive it. Research participants in lower-resource settings may have barriers or competing interests that reduce the benefit or relevance of such information. Thus, the decision to return genetic information in these settings may involve special considerations of participants' interests and preferences. In this project, our goal was to assess Bangladeshi research participants' attitudes towards receiving information regarding genetic susceptibility to the effects of consuming arsenic-contaminated drinking water, a serious environmental health concern in Bangladesh and other countries. METHODS: We administered a short questionnaire to 200 individuals participating in the Health Effects of Arsenic Longitudinal Study. Associations between survey responses and participant characteristics were estimated using logistic regression. RESULTS: Overall, 100% of our participants were interested in receiving information regarding their genetic susceptibility to arsenic toxicities, and 91% indicated that being at increased genetic risk would motivate them to make efforts to reduce their exposure. Lower levels of education showed evidence of association with less concern regarding the health effects of arsenic and lower levels of motivation to reduce exposure in response to genetic information. CONCLUSIONS: Research participants in this low-resource setting appeared interested in receiving information on their genetic susceptibility to arsenic toxicity and motivated to reduce exposure in response to such information. Additional research is needed to understand how best to communicate genetic information in this population and to assess the impact of such information on individuals' behaviors and health.

Genomics of Detoxification: How Genomics can be Used for Targeting Potential Intervention and Prevention Strategies Including Nutrition for Environmentally Acquired Illness.

Due to their genomic variants, some individuals are more highly affected by toxicants than others. Toxicant metabolizing and activating variants have been linked with a wide variety of health issues including an increased risk of miscarriages, birth defects, Alzheimer's, benzene toxicity, mercury toxicity and cancer. The study of genomics allows a clinician to identify pathways that are less effective and then gives the clinician the opportunity to counsel their patients about diet, supplements and lifestyle modifications that can improve the function of these pathways or compensate to some extent for their deficits. This article will review a few of these critical pathways relating to phase I and phase 2 detox such as GSTP1, GPX1, GSTT1 deletions, PON1 and some of the CYP 450 system as examples of how an individual's genomic vulnerabilities to toxicants can be addressed by upregulating or downregulating specific pathways via genomically targeted use of foods, supplements and lifestyle changes.

How to interpret urine toxicology tests.

A 13-year-old girl presents to the emergency department for the second time with an unresponsive episode. She has a GCS (Glasgow Coma Scale) score of 11 on arrival and all other observations are normal. The story is unclear, but there are ongoing safeguarding concerns and the family are known to social services. All investigations are normal. After a period of observation on the ward, her GCS returns to normal and she appears well. Both on the first presentation and this presentation ingestion of a toxin was suspected. However, this was denied by the patient and urine toxicology screen was negative. Does this rule out toxin ingestion? Will this change your management?

Análisis de las notificaciones de eventos adversos en un hospital privado / Análise das notificações de eventos adversos em um hospital privado / Analysis of notifications of adverse events in a private hospital

Introducción: la seguridad del paciente, en el contexto actual, pasó a ser investigada en los diversos campos de la salud, con el objetivo de reducir la incidencia de daños y eventos adversos a los pacientes. Objetivo: identificar y analizar los eventos adversos que comprometen la seguridad del paciente durante la asistencia de enfermería en un hospital privado. Métodos: investigación exploratoria, documental y retrospectiva. El instrumento de recolección de datos fue el informe de notificación de eventos adversos utilizado por el hospital compuesto por cuestiones abiertas y cerradas. Resultados: se analizaron 262 informes de notificación de eventos adversos / incidentes que ocurrieron en el período de 2015 a 2016. Se demuestra que los factores contribuyentes para la ocurrencia de los eventos adversos fueron causados por fallo humano. Del total de formularios analizados, 161 (61,83%) indicaron descuido y distracción. La omisión se destacó con 11 (4,20%) casos. La falta de atención con el paciente propició 116 (44,27%) errores en la administración de medicamentos, 46 (17,56%) fallos durante la digitación y transcripción de la prescripción médica y 35 (13,36%) fallos en la asistencia. Conclusión: se percibe que los incidentes son causados por factores humanos y de posible reversión. Cuando son investigados, pueden ser minimizados, lo que contribuye a la calidad y seguridad en el cuidado al paciente

Introdução: a segurança do paciente, no contexto atual, passou a ser investigada nos diversos campos da saúde, com o objetivo de reduzir a incidência de danos e eventos adversos aos pacientes. Objetivo: identificar e analisar os eventos adversos que comprometem a segurança do paciente durante a assistência de enfermagem em um hospital privado. Métodos: pesquisa exploratória, documental e retrospectiva. O instrumento de coleta de dados foi o relatório de notificação de eventos adversos utilizado pelo hospital composto por questões abertas e fechadas. Resultados: analisaram-se 262 relatórios de notificação de eventos adversos/incidentes que ocorreram no período de 2015 a 2016. Demonstra-se que o fatores contribuintes para a ocorrência dos eventos adversos foram causados por falha humana. Do total de formulários analisados, 161 (61,83%) apontaram descuido e distração. A omissão se destacou com 11 (4,20%) casos. A falta de atenção com o paciente propiciou 116 (44,27%) erros na administração de medicamentos, 46 (17,56%) falhas durante a digitação e transcrição da prescrição médica e 35 (13,36%) falhas na assistência. Conclusão: percebe-se que os incidentes são causados por fatores humanos e de possível reversão. Quando investigados, podem ser minimizados, o que contribui para a qualidade e segurança no cuidado ao paciente

Introduction: patient safety, in the current context, began to be investigated in the different health fields, aiming to reduce the incidence of damages and adverse events to patients. Objective: to identify and analyze adverse events that compromise patient safety during nursing care in a private hospital. Methods: exploratory, documentary and retrospective research. The instrument of data collection was the report of adverse event notification used by the hospital composed of open and closed questions. Results: the researchers analyzed 262 reports of adverse/incident events that occurred in the period 2015 to 2016. The contributing factors for the occurrence of adverse events were caused by human failure. Of the total number of forms analyzed, 161 (61.83%) reported carelessness and distraction. The omission was highlighted with 11 (4.20%) cases. The lack of attention with the patient led to 116 (44.27%) errors in medication administration, 46 (17.56%) failures during the typing and transcription of the medical prescription and 35 (13.36%) failures in care. Conclusion: the incidents are caused by human factors, with possible reversion. When investigated, they can be minimized, which contributes to quality and safety in patient care

Acute kidney injury and the risk of mortality in patients with methanol intoxication.

BACKGROUND: Methanol poisoning is a serious public health issue in developing countries, but few data are available in the literature on acute kidney injury (AKI) after methanol intoxication. METHODS: This study examined the clinical features, spectrum and outcomes of AKI in patients with methanol intoxication and evaluated the predictors of mortality after methanol intoxication. A total of 50 patients with methanol intoxication were seen at Chang Gung Memorial Hospital between 2000 and 2013. Patients were grouped according to the status of renal damage as AKI (n = 33) or non-AKI (n = 19). Demographic, clinical, laboratory, and mortality data were obtained for analysis. RESULTS: Most patients were middle-aged (47.8 ± 14.9 years), predominantly male (74.0%), and habitual alcohol consumers (70.0%). Most incidents were oral exposures (96.0%) and unintentional (66.0%). Two (4.0%) patients attempted suicide by intravenous injection of methanol. Five (10.0%) patients suffered methanol intoxication after ingestion of methomyl pesticide that contained methanol as a solvent. Compared to non-AKI patients, the AKI patients were older (50.9 ± 13.7 versus 41.6 ± 15.6 years, P = 0.034), predominantly male (90.9% versus 42.8%, P = 0.000), more habitual alcohol users (84.8% versus 41.2%, P = 0.001) and had more unintentional exposures (82.8% versus 35.3%, P = 0.001). Furthermore, there was a higher incidence of respiratory failure (63.6% versus 29.4%, P = 0.022) in the AKI group than in the non-AKI group, respectively. The laboratory studies revealed that the AKI patients suffered from more severe metabolic acidosis than the non-AKI patients. By the end of this study, 13 (39.5%) AKI patients and 1 (5.9%) non-AKI patient had died. The overall in-hospital hospital mortality rate was 28%. In a multivariate binary logistic regression model, it was demonstrated that AKI (odds ratio 19.670, confidence interval 1.026-377.008, P = 0.048) and Glasgow coma scale score (odds ratio 1.370, confidence interval 1.079-1.739, P = 0.010) were significant factors associated with mortality. The Kaplan-Meier analysis disclosed that AKI patients suffered lower cumulative survival than non-AKI patients (log-rank test, chi-square = 5.115, P = 0.024). CONCLUSIONS: AKI was common (66.0%) after methanol intoxication and was predictive of in-hospital hospital mortality. The development of AKI was associated with a 19.670-fold higher risk of in-hospital mortality.

DigChem: Identification of disease-gene-chemical relationships from Medline abstracts.

Chemicals interact with genes in the process of disease development and treatment. Although much biomedical research has been performed to understand relationships among genes, chemicals, and diseases, which have been reported in biomedical articles in Medline, there are few studies that extract disease-gene-chemical relationships from biomedical literature at a PubMed scale. In this study, we propose a deep learning model based on bidirectional long short-term memory to identify the evidence sentences of relationships among genes, chemicals, and diseases from Medline abstracts. Then, we develop the search engine DigChem to enable disease-gene-chemical relationship searches for 35,124 genes, 56,382 chemicals, and 5,675 diseases. We show that the identified relationships are reliable by comparing them with manual curation and existing databases. DigChem is available at http://gcancer.org/digchem.

Hydrogen Sulfide Toxicity: Mechanism of Action, Clinical Presentation, and Countermeasure Development.

INTRODUCTION: Hydrogen sulfide (H2S) is found in various settings. Reports of chemical suicide, where individuals have combined readily available household chemicals to produce lethal concentrations of H2S, have demonstrated that H2S is easily produced. Governmental agencies have warned of potential threats of use of H2S for a chemical attack, but currently there are no FDA-approved antidotes for H2S. An ideal antidote would be one that is effective in small volume, readily available, safe, and chemically stable. In this paper we performed a review of the available literature on the mechanism of toxicity, clinical presentation, and development of countermeasures for H2S toxicity. DISCUSSION: In vivo, H2S undergoes an incomplete oxidation after an exposure. The remaining non-oxidized H2S is found in dissolved and combined forms. Dissolved forms such as H2S gas and sulfhydryl anion can diffuse between blood and tissue. The combined non-soluble forms are found as acid-labile sulfides and sulfhydrated proteins, which play a role in toxicity. Recent countermeasure development takes into account the toxicokinetics of H2S. Some countermeasures focus on binding free hydrogen sulfide (hydroxocobalamin, cobinamide); some have direct effects on the mitochondria (methylene blue), while others work by mitigating end organ damage by generating other substances such as nitric oxide (NaNO2). CONCLUSION: H2S exists in two main pools in vivo after exposure. While several countermeasures are being studied for H2S intoxication, a need exists for a small-volume, safe, highly effective antidote with a long shelf life to treat acute toxicity as well as prevent long-term effects of exposure.

Getting to Remission: Differentiating Residual Symptoms From Treatment Side Effects in Major Depressive Disorder.

Despite the availability of effective treatments for MDD, many individuals have difficulty achieving remission. Residual symptoms can be difficult to differentiate from treatment side effects. Through 2 comic-based case presentations, this CME activity depicts common clinical scenarios and provides evidence-based strategies for effectively identifying and managing residual symptoms of MDD.

relSCAN - A system for extracting chemical-induced disease relation from biomedical literature.

This paper proposes an effective and robust approach for Chemical-Induced Disease (CID) relation extraction from PubMed articles. The study was performed on the Chemical Disease Relation (CDR) task of BioCreative V track-3 corpus. The proposed system, named relSCAN, is an efficient CID relation extraction system with two phases to classify relation instances from the Co-occurrence and Non-Co-occurrence mention levels. We describe the case of chemical and disease mentions that occur in the same sentence as 'Co-occurrence', or as 'Non-Co-occurrence' otherwise. In the first phase, the relation instances are constructed on both mention levels. In the second phase, we employ a hybrid feature set to classify the relation instances at both of these mention levels using the combination of two Machine Learning (ML) classifiers (Support Vector Machine (SVM) and J48 Decision tree). This system is entirely corpus dependent and does not rely on information from external resources in order to boost its performance. We achieved good results, which are comparable with the other state-of-the-art CID relation extraction systems on the BioCreative V corpus. Furthermore, our system achieves the best performance on the Non-Co-occurrence mention level.

Chemical-induced disease extraction via recurrent piecewise convolutional neural networks.

BACKGROUND: Extracting relationships between chemicals and diseases from unstructured literature have attracted plenty of attention since the relationships are very useful for a large number of biomedical applications such as drug repositioning and pharmacovigilance. A number of machine learning methods have been proposed for chemical-induced disease (CID) extraction due to some publicly available annotated corpora. Most of them suffer from time-consuming feature engineering except deep learning methods. In this paper, we propose a novel document-level deep learning method, called recurrent piecewise convolutional neural networks (RPCNN), for CID extraction. RESULTS: Experimental results on a benchmark dataset, the CDR (Chemical-induced Disease Relation) dataset of the BioCreative V challenge for CID extraction show that the highest precision, recall and F-score of our RPCNN-based CID extraction system are 65.24, 77.21 and 70.77%, which is competitive with other state-of-the-art systems. CONCLUSIONS: A novel deep learning method is proposed for document-level CID extraction, where domain knowledge, piecewise strategy, attention mechanism, and multi-instance learning are combined together. The effectiveness of the method is proved by experiments conducted on a benchmark dataset.