Kanglamont9097

To validate the use of electronic algorithms based on International Classification of Diseases (ICD)-10 codes to identify outpatient visits for urinary tract infections (UTI), one of the most common reasons for antibiotic prescriptions.

ICD-10 symptom codes (e.g., dysuria) alone or in addition to UTI diagnosis codes plus prescription of a UTI-relevant antibiotic were used to identify outpatient UTI visits. Chart review (gold standard) was performed by two reviewers to confirm diagnosis of UTI. The positive predictive value (PPV) that the visit was for UTI (based on chart review) was calculated for three different ICD-10 code algorithms using (1) symptoms only, (2) diagnosis only, or (3) both.

Of the 1087 visits analyzed, symptom codes only had the lowest PPV for UTI (PPV = 55.4%; 95%CI 49.3-61.5%). Diagnosis codes alone resulted in a PPV of 85% (PPV = 84.9%; 95%CI 81.1-88.2%). The highest PPV was obtained by using both symptom and diagnosis codes together to identify visits with UTI (PPV = 96.3%; 95%CI 94.5-97.9%).

ICD-10 diagnosis codes with or without symptom codes reliably identify UTI visits; symptom codes alone are not reliable. ICD-10 based algorithms are a valid method to study UTIs in primary care settings.

ICD-10 diagnosis codes with or without symptom codes reliably identify UTI visits; symptom codes alone are not reliable. ICD-10 based algorithms are a valid method to study UTIs in primary care settings.A nutritional growth retardation study, which closely resembles the nutritional observations in children who consumed insufficient total energy to maintain normal growth, was conducted. In this study, a nutritional stress in weanling rats placed on restricted balanced diet for 4 weeks is produced, followed by a food recovery period of 4 weeks using two enriched diets that differ mainly in the slow (SDC) or fast (RDC) digestibility and complexity of their carbohydrates. After re-feeding with the RDC diet, animals showed the negative effects of an early caloric restriction an increase in adiposity combined with poorer muscle performance, insulin resistance and, metabolic inflexibility. ZM447439 These effects were avoided by the SDC diet, as was evidenced by a lower adiposity associated with a decrease in fatty acid synthase expression in adipose tissue. The improved muscle performance of the SDC group was based on an increase in myocyte enhancer factor 2D (MEF2D) and creatine kinase as markers of muscle differentiation as well as better insulin sensitivity, enhanced glucose uptake, and increased metabolic flexibility. In the liver, the SDC diet promoted glycogen storage and decreased fatty acid synthesis. Therefore, the SDC diet prevents the catch-up fat phenotype through synergistic metabolic adaptations in adipose tissue, muscle, and liver. These coordinated adaptations lead to better muscle performance and a decrease in the fat/lean ratio in animals, which could prevent long-term negative metabolic alterations such as obesity, insulin resistance, dyslipidemia, and liver fat deposits later in life.Current methods for estimating heat vulnerability of young athletes use a heat index (HI) or a wet bulb globe thermometer (WBGT), neither of which fully include the environmental or physiological characteristics that can affect a person's heat budget, particularly where activity occurs on a synthetic surface. This study analyzed and compared the standard methods, HI and WBGT, with a novel and more comprehensive method termed COMFA-Kid (CK) which is based on an energy budget model explicitly designed for youth. The COMFA model was presented at the same time to demonstrate the difference between a child and an adult during activity. Micrometeorological measurements were taken at a synthetic-surfaced football field during mid-day in hot environmental conditions. Standard methods (HI and WBGT) indicated that conditions on the field were relatively safe for youth to engage in activities related to football practice or games, whereas the CK method indicated that conditions were dangerously hot and could lead to exertional heat illness. Estimates using the CK method also indicated that coaches and staff standing on the sidelines, and parents sitting in the stands, would not only be safe from heat but would be thermally comfortable. The difference in thermal comfort experienced by coaches and staff off the field, versus that experienced by young players on the field, could affect decision making regarding the duration and intensity of practices and time in the game. The CK method, which is easy to use and available for modification for specific conditions, would lead to more accurate estimates of heat safety on outdoor synthetic surfaces in particular, and in sports with a high prevalence of heat illness such as football, and should be considered as a complementary or alternative preventive measure against heat.Control moment gyroscopes (CMG) are crucial components in spacecrafts. Since the anomaly of bearing temperature of the CMG shows apparent correlation with nearly all critical fault modes, temperature prediction is of great importance for health management of CMGs. However, due to the complicity of thermal environment on orbit, the temperature signal of the CMG has strong intrinsic nonlinearity and chaotic characteristics. Therefore, it is crucial to study temperature prediction under the framework of chaos time series theory. There are also several other challenges including poor data quality, large individual differences and difficulty in processing streaming data. To overcome these issues, we propose a new method named Chaotic Ensemble of Online Recurrent Extreme Learning Machine (CE-ORELM) for temperature prediction of control moment gyroscopes. By means of the CE-ORELM model, this proposed method is capable of dynamic prediction of temperature. The performance of the method was tested by real temperature data acquired from actual CMGs. Experimental results show that this method has high prediction accuracy and strong adaptability to the on-orbital temperature data with sudden variations. These superiorities indicate that the proposed method can be used for temperature prediction of control moment gyroscopes.