Plos One
-
Observational Study
Combining patient visual timelines with deep learning to predict mortality.
Deep learning algorithms have achieved human-equivalent performance in image recognition. However, the majority of clinical data within electronic health records is inherently in a non-image format. Therefore, creating visual representations of clinical data could facilitate using cutting-edge deep learning models for predicting outcomes such as in-hospital mortality, while enabling clinician interpretability. The objective of this study was to develop a framework that first transforms longitudinal patient data into visual timelines and then utilizes deep learning to predict in-hospital mortality. ⋯ We converted longitudinal patient data into visual timelines and applied a deep neural network for predicting in-hospital mortality more accurately than current standard clinical models, while allowing for interpretation. Our framework holds promise for predicting several important outcomes in clinical medicine.
-
Population trends of disease prevalence and incidence over time measure burden of disease and inform healthcare planning. Neuromuscular disorders (NMD) affect muscle and nerve function with varying degrees of severity and disease progression. ⋯ In both adults and children, NMD prevalence is rising and mortality rates are declining. In adults incidence is decreasing while in children it remains stable. This confirms on a population-based level the increased survival of children and adults with NMD.
-
Observational Study
Prevalence of frailty in a tertiary hospital: A point prevalence observational study.
Frailty is an important concept in modern healthcare due to its association with adverse outcomes. Its prevalence varies in the literature and there is a paucity of literature looking at the prevalence of frailty in an inpatient setting. Its significance lies on its impact on resource utilisation and costs. ⋯ Frailty is highly prevalent in the hospital setting with 48.8% of all inpatients classified as frail. This high number of frail patients has significant resource implications and an increased understanding of the burden of frailty in this population may aid targeting of interventions towards this vulnerable population.
-
Clinical Trial
How the service delivery works in the Iranian specialised burns hospitals? A qualitative approach.
As burn injuries are a major cause of death and infirmity, successful service delivery is vital in health systems. In Iran, a few specialised burns hospitals (SBHs) located in big provinces provide burn services in which burn patients with more severe conditions are referred to. However, SBHs are faced with several challenges for delivering due treatment for burn patients. ⋯ Themes and (subthemes) including burn care continuum (preventive care, pre-hospital care, hospital care, follow-up, and home care), regionalisation of burning services (access to other specialties and medical services, access to specialized care in provinces without a SBH, standardised regionalisation system for burn related services (BRSs), costs of providing BRSs (expensive services and supplies and long hospitalisation), and non-compliance with standardised care (guidelines to provide burn care and physical space to provide BRSs). Results suggest that improving BRSs delivery in Iran may be reached by strengthening burn care continuum, regionalising burn care, allocating sufficient budgets to burn services and formulating burn care guidelines. These policy actions can be better addressed via intra-sectoral collaborations.
-
Cardiovascular adaptations to exercise, particularly at the individual level, remain poorly understood. Previous group level research suggests the relationship between cardiac output and oxygen consumption ([Formula: see text]-[Formula: see text]) is unaffected by training as submaximal [Formula: see text] is unchanged. We recently identified substantial inter-individual variation in the exercise [Formula: see text]-[Formula: see text] relationship that was correlated to stroke volume (SV) as opposed to arterial oxygen content. ⋯ Quadriceps muscle oxygenation and RPE were not different between groups (all P>0.1). In contrast to [Formula: see text], [Formula: see text] responders are capable of improving submaximal [Formula: see text]-[Formula: see text] in response to SIT via increased SV. However, the increased submaximal exercise [Formula: see text] does not benefit exercising muscle oxygenation.