EPICS Database Research Articles

PMS9 EVALUATING THE PERFORMANCE OF THREE ELECTRONIC PATIENT-REPORTED OUTCOMES (EPRO) MEASURES IN TOTAL KNEE ARTHROPLASTY (TKA)

Patient-reported functioning and symptoms are an important component of evaluating orthopedic surgery outcomes. Most joint replacement registries suggest collecting joint-specific and general symptoms, functioning, and health-related quality of life PRO measures. Orthopedic-focused researchers have begun to incorporate PROMIS modules, which presents an opportunity to evaluate the performance of “legacy” joint-specific PROs. Beginning in June 2018, all patients scheduled for total knee arthroplasty (TKA) were sent the Knee Injury and Osteoarthritis Outcomes Score – short form (KOOS Jr), PROMIS-Global Health Physical subscale (GH-P), and PROMIS-Physical Functioning (PF) questionnaires through the MyChart website portal at the time of scheduling (i.e., pre-operative) and then at pre-defined post-operative timepoints. Patient responses were collated and reviewed through an Epic database. Pre-operative and post-operative scores were evaluated for distributions, correlations, and change scores within and between measures. One hundred fourteen TKA patients activated on MyChart who answered all pre-operative questionnaires were included in the analysis. Score distributions were generally parametric, with the KOOS Jr showing slightly higher tailedness than the two PROMIS modules. Mean pre-op scores for the KOOS Jr, GH-P, and PF were 51.2 (SD: 12.43), 39.2 (5.02), and 42.7 (6.22), respectively. Correlations between all three measures were good, ranging from r = 0.628 to 0.678. Mean score changes were 15.1 (SD: 14.04) for the KOOS Jr, 2.0 (8.87) for the GH-P, and 1.5 (5.32) for the PF at an average of 94.0 days post-operation. Two patients reported maximum scores of 100 on the KOOS Jr. Correlations and score changes recorded by TKA patients on three PRO measures were similar to recently published results. While the range of pre-op and post-op KOOS Jr scores are much higher and indicative of a ceiling effect, analyses suggest the legacy joint-specific questionnaire is assessing TKA-related impacts on functioning in a manner similar to two PROMIS modules.

195 Acne keloidalis nuchae: A population-based epidemiologic study in central and northeastern Pennsylvania

Acne keloidalis nuchae (AKN) is reported to mainly occur in adult men of African descent. However, it has been our clinical observation that a large portion of our patients with AKN is not African-American (AA). This study is the largest analysis of demographic and epidemiologic data in non-AA patients with AKN. A retrospective search of the Geisinger Health System EPIC database was performed to identify patients with AKN between 2011-2018. 110 patients were identified and their demographic and epidemiologic data were obtained and analyzed. Comparisons between AA and non-AA groups were performed using the Chi-square or Fisher’s exact test, and two-sample T-test or Wilcoxon rank sum test. Mean age at diagnosis was 36.1 years old, most patients were male (88.2%), Caucasian (59.1%), and had an average BMI of 33.5 kg/m2 (32.9 vs. 33.8 for AA and non-AA respectively, p=0.62). A subset of patients had diabetes (10% vs. 5.9% for AA and non-AA respectively, p=0.46), hyperlipidemia (10% vs. 20.6% for AA and non-AA respectively, p=0.15), were current or former smokers (31.6% vs. 34.3% for AA and non-AA respectively, p=0.66) and took anticonvulsants (10% and 19.1% of AA and non-AA respectively, p=0.21). The most common treatments used for AKN were oral tetracyclines (54.1%), topical corticosteroids (61.2%) and topical antibiotics (41.2%), with non-AAs more likely to be treated with topical antibiotics (p=0.0004). Most patients with AKN in central and northeastern Pennsylvania are Caucasian males. This study identifies similarities and differences between AAs and non-AAs with AKN. Our results serve as a reminder that AKN should be on the differential for chronic scarring folliculitis and perifolliculitis of the posterior scalp and neck in Caucasians and highlight the potential association between obesity and AKN.

ALBAYZIN Query-by-example Spoken Term Detection 2016 evaluation

Query-by-example Spoken Term Detection (QbE STD) aims to retrieve data from a speech repository given an acoustic (spoken) query containing the term of interest as the input. This paper presents the systems submitted to the ALBAYZIN QbE STD 2016 Evaluation held as a part of the ALBAYZIN 2016 Evaluation Campaign at the IberSPEECH 2016 conference. Special attention was given to the evaluation design so that a thorough post-analysis of the main results could be carried out. Two different Spanish speech databases, which cover different acoustic and language domains, were used in the evaluation: the MAVIR database, which consists of a set of talks from workshops, and the EPIC database, which consists of a set of European Parliament sessions in Spanish. We present the evaluation design, both databases, the evaluation metric, the systems submitted to the evaluation, the results, and a thorough analysis and discussion. Four different research groups participated in the evaluation, and a total of eight template matching-based systems were submitted. We compare the systems submitted to the evaluation and make an in-depth analysis based on some properties of the spoken queries, such as query length, single-word/multi-word queries, and in-language/out-of-language queries.

ALBAYZIN 2016 spoken term detection evaluation: an international open competitive evaluation in Spanish

Within search-on-speech, Spoken Term Detection (STD) aims to retrieve data from a speech repository given a textual representation of a search term. This paper presents an international open evaluation for search-on-speech based on STD in Spanish and an analysis of the results. The evaluation has been designed carefully so that several analyses of the main results can be carried out. The evaluation consists in retrieving the speech files that contain the search terms, providing their start and end times, and a score value that reflects the confidence given to the detection. Two different Spanish speech databases have been employed in the evaluation: MAVIR database, which comprises a set of talks from workshops, and EPIC database, which comprises a set of European Parliament sessions in Spanish. We present the evaluation itself, both databases, the evaluation metric, the systems submitted to the evaluation, the results, and a detailed discussion. Five different research groups took part in the evaluation, and ten different systems were submitted in total. We compare the systems submitted to the evaluation and make a deep analysis based on some search term properties (term length, within-vocabulary/out-of-vocabulary terms, single-word/multi-word terms, and native (Spanish)/foreign terms).

Hospital Outcomes for Cirrhotic Patients Admitted With Hyponatremia

Introduction: Hyponatremia (HN) is an indicator of poor prognosis for cirrhotic patients and is associated with severe portal hypertension, hepatic encephalopathy (HE), and increased length of stay for hospitalized patients. In this study, we aim to assess hospital outcomes and readmission rates for patients admitted with HN. Methods: The EPIC database was searched for cirrhotic patients admitted with HN (serum Na < 130 mEq/L).Medical charts were reviewed for diagnoses, hospital-acquired complications, laboratory results, admission and discharge medications, HN treatment, and readmission within 30 days of discharge. Hospital outcome (discharge alive without renal failure [RF], development of RF, receipt of liver transplantation [LT], and hospital mortality [M]) was also recorded. Factors associated with discharge alive without RF and readmission within 30 days of discharge were assessed. Results: 91 patients were admitted with HN. 65 (71.4%) patients were discharged without RF, T, or M whereas 22 (24.2%) developed RF (18, 81.8%), underwent LT (3, 13.6%), or had M (18, 19.8%). Factors associated with discharge alive without RF or T include lower admission BUN (25.1 vs 55.6 mg/dl), Cr (1.3 vs 2.8 mg/dl), MELD (18 vs 26), and MELD-Na (25 vs 31); p < 0.000, lower incidence of prior AKI (32% vs 59%; p = 0.022) and infection other than SBP (30% vs 59%; p = 0.016), as well as decreased rate of hospital associated complications: ascites (35% vs 64%), SBP (3% vs 23%), other infection (13% vs 41%), overt HE (16% vs 45%), and gastrointestinal bleeding (0% vs. 27%); p < 0.005. Of the 65 patients discharged alive without RF, 22 (37%) were readmitted within 30 days. Patients who were not readmitted within 30 days had lower incidence of AKI (21% vs 55%, p = 0.009) prior to initial admission compared to those readmitted. Conclusion: Only 71.4% of cirrhotic patients hospitalized with HN were discharged alive without RF. Factors associated with RF, LT, or hospital death include elevated BUN, Cr, MELD, and MELD-Na, history of AKI and infection prior to admission, and increased rate of hospital associated complications. Re-admission rate for patients discharged without RF was 37% at 30 days. History of AKI prior to admission was associated with re-admission. Prognosis for cirrhotic patients admitted with HN is extremely poor. It is associated with a very high frequency of renal failure, hospital mortality, and a high 30-day readmission rate after hospital discharge.

Biomarkers of Oxidative Stress and Risk of Colorectal Cancer: A Cohort-Nested Case-Control Study in the EPIC Database

Biomarkers of Oxidative Stress and Risk of Colorectal Cancer: A Cohort-Nested Case-Control Study in the EPIC Database

Recent GRBs Observed with the 1.23 m CAHA Telescope and the Status of Its Upgrade

We report on optical observations of Gamma‐Ray Bursts (GRBs) followed up by our collaboration with the 1.23 m telescope located at the Calar Alto observatory. The 1.23 m telescope is an old facility, currently undergoing upgrades to enable fully autonomous response to GRB alerts. We discuss the current status of the control system upgrade of the 1.23 m telescope. The upgrade is being done by our group based on the Remote Telescope System, 2nd Version (RTS2), which controls the available instruments and interacts with the EPICS database of Calar Alto. (Our group is called ARAE (Robotic Astronomy &amp; High‐Energy Astrophysics) and is based on members of IAA (Instituto de Astrofísica de Andalucía). Currently the ARAE group is responsible to develop the BOOTES network of robotic telescopes (Jelínek et al. 2009).) Currently the telescope can run fully autonomously or under observer supervision using RTS2. The fast reaction response mode for GRB reaction (typically with response times below 3 minutes from the GRB onset) still needs some development and testing. The telescope is usually operated in legacy interactive mode, with periods of supervised autonomous runs under RTS2. We show the preliminary results of several GRBs followed up with observer intervention during the testing phase of the 1.23 m control software upgrade.

Issues and practices in the use of effects data from FREDERICA in the ERICA Integrated Approach

The ERICA Integrated Approach requires that a risk assessment screening dose rate is defined for the risk characterisation within Tiers 1 and 2. At Tier 3, no numerical screening dose rate is used, and the risk characterisation is driven by methods that can evaluate the possible effects of ionising radiation on reproduction, mortality and morbidity. Species sensitivity distribution has been used to derive the ERICA risk assessment predicted no-effect dose rate (PNEDR). The method used was based on the mathematical processing of data from FRED (FASSET radiation effects database merged with the EPIC database to form FREDERICA) and resulted in a PNEDR of 10 μGy/h. This rate was assumed to ascribe sufficient protection of all ecosystems from detrimental effects on structure and function under chronic exposure. The value was weighed against a number of points of comparison: (i) PNEDR values obtained by application of the safety factor method, (ii) background levels, (iii) dose rates triggering effects on radioactively contaminated sites and (iv) former guidelines from literature reviews. In Tier 3, the effects analysis must be driven by the problem formulation and is thus highly case specific. Instead of specific recommendations on numeric values, guidance on the sorts of methods that may be applied for refined effect analysis is provided and illustrated.

The Benefits of a Photograph and Image Cataloguing Database for Research and Archival Purposes, Illustrated by an Example from Canadian Archaeology

The practice of using photography, whether in digital, slide, or print form, is a fundamental method of documenting and preserving finds and information in archaeology and most other museum-related disciplines. Images play an important role in the communication and preservation of information and can be regarded as archival collections in their own right. However, in many situations it is difficult to store and search efficiently through this vital resource. With the advent of desktop databases and interconnectivity, images can be readily organized into a searchable database. This approach becomes especially useful when dealing with the huge numbers of photographs accumulated through large projects. The EPIC database is a good example of the solution to this problem. EPIC was created to deal with images generated through one research centre of a large archaeological project (SCAPE: Study of Cultural Adaptations in the Canadian Prairie Ecozone). Built around off-the-shelf software, EPIC allows users to view a small thumbnail of an image with associated information, and has been designed to facilitate multiple search pathways. It also has the ability to link to related Museum databases. EPIC has proved beneficial not only to the SCAPE research community, but also to others who have used the information generated through the project.

Mathematical simulation of dose–effect relationships for fish eggs exposed chronically to ionizing radiation

A mathematical model which simulates the observed dose-effect relationships for fish eggs exposed to chronic irradiation is presented. The model assumes that the exposed fish eggs may exist in one of the following states: normally developing, reversibly damaged, and lethally damaged. Reversible damages may be recovered by repairing mechanisms which are spent for the repairing processes. The model was applied to describe the observed differences in effects of chronic exposure for quickly (2 weeks) and slowly (up to 20 weeks) developing fish eggs. Calculations were performed for dose rates of chronic irradiation ranging from 10 to 300 mGy/day. Two types of radiation effects were considered-the effect on eggs survival (percentage of survived eggs at time t), and the depletion of the repairing pool (in percentage of its maximal value). The model predictions have been compared with the experimental data from the EPIC database. This comparison showed that the model adequately describes the radiation effects in fish eggs of different species, within a wide range of chronic radiation exposures.

A system of dose-effects relationships for the northern wildlife: Radiation protection criteria

The key issue in the assessment system for radiation protection of wildlife is the establishment of dose-effects relationships for reference representatives of natural biota. Within the frame of the EC Project EPIC Environmental Protection from Ionizing Contaminants (2000-2003), a database has been created, which includes about 1600 records from 440 publications in Russian on the dose-effects relationships in wildlife from northern-temperate climatic zones. The EPIC database Radiation effects on biota is based on Russian/FSU experimental and field studies; chronic/lifetime exposures are the focus of the data collection. The database information covers a very wide range of radiation dose rates to biota: from below 1E(-5) Gy d -1 up to more than 1 Gy d -1 . A great variety of radiation effects are registered in the EPIC database, from stimulation at low doses up to death from acute radiation syndrome at high doses. The paper presents the dose-effects relationships for northern wildlife in the conditions of low-LET chronic irradiation. The system of dose-effects relationships forms the scale of severity of radiation effects at increasing levels of chronic radiation exposure. The system can be used as a basis for establishing criteria for radiation protection of the Northern wildlife.

One-way data transfer for PLC to VME status reporting at the Advanced Photon Source

The Personnel Safety System for the experimental beamlines at the Advanced Photon Source will use a large number of Allen Bradley Programmable Logic Controllers (PLC) to replace conventional relay logic. PLCs allow for the design of a very advanced safety system that can handle a large number of I/O points. Certain situations require monitoring of the safety system from various locations around the storage ring via the EPICS OPI (operator interface) consoles. This presentation covers the chosen method for transferring data from the Personnel Safety System into an EPICS database. Specifications on PLC ladder design, EPICS database design and hardware selection are also discussed.