ARDSFlag: an NLP/machine learning algorithm to visualize and detect high-probability ARDS admissions independent of provider recognition and billing codes.

BACKGROUND: Despite the significance and prevalence of acute respiratory distress syndrome (ARDS), its detection remains highly variable and inconsistent. In this work, we aim to develop an algorithm (ARDSFlag) to automate the diagnosis of ARDS based on the Berlin definition. We also aim to develop a visualization tool that helps clinicians efficiently assess ARDS criteria. METHODS: ARDSFlag applies machine learning (ML) and natural language processing (NLP) techniques to evaluate Berlin criteria by incorporating structured and unstructured data in an electronic health record (EHR) system. The study cohort includes 19,534 ICU admissions in the Medical Information Mart for Intensive Care III (MIMIC-III) database. The output is the ARDS diagnosis, onset time, and severity. RESULTS: ARDSFlag includes separate text classifiers trained using large training sets to find evidence of bilateral infiltrates in radiology reports (accuracy of 91.9%±0.5%) and heart failure/fluid overload in radiology reports (accuracy 86.1%±0.5%) and echocardiogram notes (accuracy 98.4%±0.3%). A test set of 300 cases, which was blindly and independently labeled for ARDS by two groups of clinicians, shows that ARDSFlag generates an overall accuracy of 89.0% (specificity = 91.7%, recall = 80.3%, and precision = 75.0%) in detecting ARDS cases. CONCLUSION: To our best knowledge, this is the first study to focus on developing a method to automate the detection of ARDS. Some studies have developed and used other methods to answer other research questions. Expectedly, ARDSFlag generates a significantly higher performance in all accuracy measures compared to those methods.

Behavior of Solid Electrolyte in Li-Polymer Battery with NMC Cathode via in-Situ Scanning Electron Microscopy.

We present the first results of in situ scanning electron microscopy (SEM) of an all-solid Li battery with a nickel-manganese-cobalt-oxide (NMC-622) cathode at 50 °C and an operating voltage of 2.7-4.3 V. Experiments were conducted under a constant current at several C rates (nC rate: cycling in 1/n h): C/12, C/6, and C/3. The microstructure evolution during cycling was monitored by continuous secondary electron imaging. We found that the chemical degradation of the solid polymer electrolyte (SPE) was the main mechanism for battery failure. This degradation was observed in the form of a gradual thinning of the SPE as a function of cycling time, resulting in gas generation from the cell. We also present various dynamic electrochemical and mechanical phenomena, as observed by SEM images, and compare the performance of this battery with that of an all-solid Li battery with a LiFePO4 cathode.

Stabilization of lithium anode with ceramic-rich interlayer for all solid-state batteries.

The deposition of thin layers of polymer/ceramic on a lithium surface to produce a strong barrier against dendrites was demonstrated. Different forms (needle, sphere, rod) and types of ceramic (Al2O3, Mg2B2O5) were tested and polymer/ceramic interlayers of a few micrometers (4 µm minimum) between the lithium and the PEO-based solid polymer electrolyte (SPE) were deposited. Interlayers with high amounts of ceramic up to 85 wt% were successfully coated on the surface of lithium foil. Compact "polymer in ceramic" layers were observed when Al2O3 spheres were used for instance, providing a strong barrier against the progression of dendrites as well as a buffer layer to alleviate the lithium deformation during stripping/plating cycles. The electrochemical performance of the lithium anodes was assessed in symmetrical Li/SPE/Li cells and in full all-solid-state LiFePO4 (LFP)/SPE/Li batteries. It was observed for all the cells that the charge transfer resistance was significantly reduced after the deposition of the polymer/ceramic layers on the lithium surface. In addition, the symmetrical cells were able to cycle at higher C-rates and the durability at C/4 was even improved by a factor of 8. Microscopic observations of Li/SPE/Li stacks after cycling revealed that the polymer/ceramic interlayer reduces the deformation of lithium upon cycling and avoids the formation of dendrites. Finally, LFP/SPE/Li batteries were cycled and better coulombic efficiencies as well as capacity retentions were obtained with the modified lithium electrodes. This work is patent-pending (WO2021/159209A1).

On high-temperature evolution of passivation layer in Li-10 wt % Mg alloy via in situ SEM-EBSD.

Li-10 wt % Mg alloy (Li-10 Mg) is used as an anode material for a solid-state battery with excellent electrochemical performance and no evidence of dendrite formation during cycling. Thermal treatment of Li metal during manufacturing improves the interfacial contact between a Li metal electrode and solid electrolyte to achieve an all solid-state battery with increased performance. To understand the properties of the alloy passivation layer, this paper presents the first direct observation of its evolution at elevated temperatures (up to 325°C) by in situ scanning electron microscopy. We found that the morphology of the surface passivation layer was unchanged above the alloy melting point, while the bulk of the material below the surface was melted at the expected melting point, as confirmed by in situ electron backscatter diffraction. In situ heat treatment of Li-based materials could be a key method to improve battery performance.

"My body's a 50 year-old but my brain is definitely an 85 year-old": exploring the experiences of men ageing with HIV-associated neurocognitive challenges.

INTRODUCTION: Research investigating HIV, neurocognition and ageing is well developed using neuropsychometric or other quantitative approaches; however, little is known about individuals' subjective experiences. The purpose of this article is to explore the experiences of men aged 50 and older who self-identify as having HIV-associated neurocognitive challenges. In particular, this study uses the Episodic Disability Framework (EDF) to explore participants' perceptions regarding: 1) symptoms/impairments, difficulties with day-to-day activities, challenges with social inclusion and uncertainty; 2) ageing as related to their HIV-associated neurocognitive challenges, and 3) the episodic nature of their HIV-associated neurocognitive challenges. METHODS: This qualitative, interpretive study involved in-depth, semi-structured interviews with 12 men aged 50 years and older who self-identified as having HIV-associated neurocognitive challenges. Participants were recruited from a neurobehavioural research unit (NBRU) at a large hospital in Toronto, Canada. Data were analyzed thematically and with reference to the EDF. RESULTS: Participants' experiences reflected all concepts within the EDF to some extent. Difficulties with daily activities were diverse but were addressed using similar living strategies. Participants described challenges with work and social relationships resulting from neurocognitive challenges. Participants downplayed the significance of uncertainty in their lives, which they attributed to effective living strategies. Most men reported confusion regarding the link between their neurocognitive challenges and ageing. Others discussed ageing as an asset that helped with coping. CONCLUSIONS: This is the first study to use a disability framework to examine the subjective experiences of men ageing with HIV-associated neurocognitive challenges. Findings reframe the episodic disability experienced by these individuals as being predictably linked to certain triggers. As such, support for managing neurocognitive challenges could focus on triggers that exacerbate the condition in addition to the impairments themselves. The study also describes ageing as not only a source of problems but also as an asset among men growing older with HIV.