Decreased heart rate variability (HRV) is a marker of autonomic dysfunction and has been associated with future cardiac morbidity and mortality. HRV has been inconsistently associated with exposure to particulate matter (PM) air pollution. Fewer studies have examined whether air pollution exposure is a risk factor for cardiac arrhythmias. We aimed in this study to evaluate the relationships of heart rate variability and cardiac arrhythmias to PM exposures. Heart rate variability and arrhythmias were measured with ambulatory electrocardiographs using available raw data collected in a cohort panel study the National Institutes of Health, National Institute of Environmental Health Sciences (funded by NIH NIEHS R01 ES-012243). Electrocardiograph data (8,952 person-hours) were collected in 50 nonsmokers with coronary artery disease age 71 years and older living in four retirement communities in the Los Angeles air basin. Exposures included hourly markers of traffic-related PM and secondary organic aerosols, daily size-fractionated particle mass, and hourly outdoor criteria gases. Subjects were genotyped for the glutathione S-transferase M1 and T1 null (risk) alleles. Repeated measures regression analyses were adjusted for actigraph-derived physical activity and heart rate, temperature, day of week, season, and community location.

关键词：空气污染影响;老年人;气溶胶;环境暴露;气体;健康影响;心率;发病率;死亡率;微粒;危险因素;可变性

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In parallel with the implementation of information and communications systems, health care organizations are beginning to amass large-scale repositories of clinical and administrative data. Many nations seek to leverage so-called Big Data repositories to support improvements in health outcomes, drug safety, health surveillance, and care delivery processes. An unsupported assumption is that electronic health care data are of sufficient quality to enable the varied use cases envisioned by health ministries. The reality is that many electronic health data sources are of suboptimal quality and unfit for particular uses. To more systematically define, characterize and improve electronic health data quality, we propose a novel framework for health data stewardship. The framework is adapted from prior data quality research outside of health, but it has been reshaped to apply a systems approach to data quality with an emphasis on health outcomes. The proposed framework is a beginning, not an end. We invite the biomedical informatics community to use and adapt the framework to improve health data quality and outcomes for populations in nations around the world.

关键词：医疗记录系统;计算机;质量控制;质量改进;信息存储和检索;医学信息学

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Currently, no automated means of detecting abnormal mammograms exist. While knowledge discovery capabilities through data mining and data analytics tools are widespread in many industries, the healthcare industry as a whole lags far behind. Providers are only just beginning to recognize the value of data mining as a tool to analyze patient care and clinical outcomes. The research conducted by the authors investigates the use of genetic algorithms for classification of unstructured mammography reports, which can be later correlated to the images for extraction and testing. In mammography, much effort has been expended to characterize findings in the radiology reports. Various computer-assisted technologies have been developed to assist radiologists in detecting cancer; however, the algorithms still lack high degrees of sensitivity and specificity, and must undergo machine learning against a training set with known pathologies in order to further refine the algorithms with higher validity of truth. In a large database of reports and corresponding images, automated tools are needed just to determine which data to include in the training set. Validation of these data is another issue. Radiologists disagree with each other over the characteristics and features of what constitutes a normal mammogram and the terminology to use in the associated radiology report. Abnormal reports follow the lexicon established by the American College of radiology Breast Imaging Reporting and Data System (Bi-RADS), but even within these reports, there is a high degree of text variability and interpretation of semantics. The focus has been on classifying abnormal or suspicious reports, but even this process needs further layers of clustering and gradation, so that individual lesions can be more effectively classified. The tools that are needed will not only help further identify problem areas but also support risk assessment and other knowledge discovery applications

关键词：乳腺;采样;算法;分类;诊断(医学);教育设施;基因;学习;肿瘤;优化;患者;放射学;风险评估;采样;灵敏度;测试;验证

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No abstract available.

关键词：减压病;缺氧;微重力;宇航员;风险;舱外活动;低比重的大气层;对策

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The VA Office of Inspector General Office of Healthcare Inspections conducted a review to assess how Veterans Health Administration (VHA) medical facilities manage prevention of Legionnaires Disease (LD) at the request of the VA Secretary, Senator Robert P. Casey, Jr., Congressman Tim Murphy, and the Chairmen and Ranking Members of the House Committee on Veterans Affairs and the Senate Committee on Veterans Affairs.

关键词：退伍军人(军人);医疗检查;传染病;预防医学;细菌;肺炎;依从性

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No abstract available.

关键词：骨软化,微重力;对策;骨质疏松;药物;体育锻炼;宇航员;风险;骨头;断层;有限元法;压裂;脊柱;航空航天医学

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The VA Office of Inspector General (OIG) Office of Healthcare Inspections conducted a review in response to an allegation that a patient of the Amarillo VA Health Care System, Amarillo, TX (system) received negligent care resulting in permanent kidney damage, which in turn, led to multiple other medical problems. The purpose of the review was to determine whether the allegation had merit.

关键词：卫生保健,检查,预防医学,肾脏疾病;退伍军人(军人);患者;指控;过失;急性肾功能衰竭;弗吉尼亚州阿马里洛卫生保健系统(Texaas);肾脏受损

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No abstract available.

关键词：眼睛视力;考试;国际空间站;眼压;超声波;眼科;航空航天医学

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Space radiation effects mitigation has been identified as one of the highest priority technology development areas for human space flight in the NASA Strategic Space Technology Investment Plan (Dec. 2012). In this paper we review the special features of space radiation that lead to severe constraints on long-term (more than 180 days) human flight operations outside Earth's magnetosphere. We then quantify the impacts of human space radiation dose limits on spacecraft engineering design and development, flight program architecture, as well as flight program schedule and cost. A new Deep Space Habitat (DSH) concept, the hybrid inflatable habitat, is presented and shown to enable a flexible, affordable approach to long term manned interplanetary flight today.

关键词：电离辐射;宇航员;辐射剂量;辐射危害;外星辐射;深太空;行星际飞行;对策

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Data, when entered correctly, help tell the story of HIV at the national, community, and individual levels, allowing us to identify and understand disproportionate disease burden and trends as well as inform public health decisions and activities. In fact, the story of HIV/AIDS has always been told through numbersfrom the five young, previously healthy gay men in Los Angeles diagnosed with a mysterious disease in 19811 to the now nearly 1.2 million people living with HIV/AIDS (PLWHA) nationwide.2 Since the early days of the epidemic, the Health Resources and Services Administration (HRSA) has used data to best target efforts and funds. This was true with the HRSA-led AIDS Service Demonstration Grants of 1986, and it remains true today. Adequate attention to data collection and submission requirements, particularly client-level data, is critical to curtailing HIV/AIDS in the United States and to improving care access to those in need. Quality data reports that track client demographics, core medical and social services provided, and client outcomes allow Ryan White HIV/AIDS Program providers to pinpoint patients falling out of care, chart a clients response to a new treatment regimen, and examine the associated costs. Data that are not entered correctly, however, do not represent a reliable picture of services being provided to Ryan White.

关键词：艾滋病,预防医学,人类免疫缺陷病毒(HIV),疾病控制,人口控制;公共卫生护理

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