Abstract:
:Early admission to the neurosciences intensive care unit (NSICU) is associated with improved patient outcomes. Natural language processing offers new possibilities for mining free text in electronic health record data. We sought to develop a machine learning model using both tabular and free text data to identify patients requiring NSICU admission shortly after arrival to the emergency department (ED). We conducted a single-center, retrospective cohort study of adult patients at the Mount Sinai Hospital, an academic medical center in New York City. All patients presenting to our institutional ED between January 2014 and December 2018 were included. Structured (tabular) demographic, clinical, bed movement record data, and free text data from triage notes were extracted from our institutional data warehouse. A machine learning model was trained to predict likelihood of NSICU admission at 30 min from arrival to the ED. We identified 412,858 patients presenting to the ED over the study period, of whom 1900 (0.5%) were admitted to the NSICU. The daily median number of ED presentations was 231 (IQR 200-256) and the median time from ED presentation to the decision for NSICU admission was 169 min (IQR 80-324). A model trained only with text data had an area under the receiver-operating curve (AUC) of 0.90 (95% confidence interval (CI) 0.87-0.91). A structured data-only model had an AUC of 0.92 (95% CI 0.91-0.94). A combined model trained on structured and text data had an AUC of 0.93 (95% CI 0.92-0.95). At a false positive rate of 1:100 (99% specificity), the combined model was 58% sensitive for identifying NSICU admission. A machine learning model using structured and free text data can predict NSICU admission soon after ED arrival. This may potentially improve ED and NSICU resource allocation. Further studies should validate our findings.
journal_name
Sci Repjournal_title
Scientific reportsauthors
Klang E,Kummer BR,Dangayach NS,Zhong A,Kia MA,Timsina P,Cossentino I,Costa AB,Levin MA,Oermann EKdoi
10.1038/s41598-021-80985-3subject
Has Abstractpub_date
2021-01-14 00:00:00pages
1381issue
1issn
2045-2322pii
10.1038/s41598-021-80985-3journal_volume
11pub_type
杂志文章abstract::SHH Medulloblastoma (SHH-MB) is a pediatric brain tumor characterized by an inappropriate activation of the developmental Hedgehog (Hh) signaling. SHH-MB patients treated with the FDA-approved vismodegib, an Hh inhibitor that targets the transmembrane activator Smoothened (Smo), have shown the rapid development of dru...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep44079
更新日期:2017-03-09 00:00:00
abstract::To elude the strength-electrical conductivity trade-off dilemma, a nanostructuring strategy was achieved in microalloyed Al-0.1wt.% Zr conductor by optimizing the processing route, leading to enhanced strength and simultaneously improved electrical conductivity. The nanostructural design involved ultrafine grains with...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-018-24527-4
更新日期:2018-04-18 00:00:00
abstract::Neural connectivity requires neuronal differentiation, axon growth, and precise target innervation. Midbrain dopaminergic neurons project via the nigrostriatal pathway to the striatum to regulate voluntary movement. While the specification and differentiation of these neurons have been extensively studied, the molecul...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-08900-3
更新日期:2017-08-17 00:00:00
abstract::The process, how lipids are removed from the circulation and transferred from high density lipoprotein (HDL) - a main carrier of cholesterol in the blood stream - to cells, is highly complex. HDL particles are captured from the blood stream by the scavenger receptor, class B, type I (SR-BI), the so-called HDL receptor...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-15949-7
更新日期:2017-11-21 00:00:00
abstract::G-protein-coupled receptors (GPCRs) are important drug targets with diverse therapeutic applications. However, there are still more than a hundred orphan GPCRs, whose protein functions and biochemical features remain unidentified. Gpr176 encodes a class-A orphan GPCR that has a role in circadian clock regulation in mo...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-020-61370-y
更新日期:2020-03-10 00:00:00
abstract::The bilateral controlled NOT (CNOT) operation plays a key role in standard entanglement purification process, but the CNOT operation may not be the optimal joint operation in the sense that the output entanglement is maximized. In this paper, the CNOT operations in both the Schmidt-projection based entanglement concen...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep25958
更新日期:2016-05-18 00:00:00
abstract::An amendment to this paper has been published and can be accessed via a link at the top of the paper. ...
journal_title:Scientific reports
pub_type: 已发布勘误
doi:10.1038/s41598-020-77348-9
更新日期:2020-11-18 00:00:00
abstract::Living organisms dynamically and flexibly operate a great number of components. As one of such redundant control mechanisms, low-dimensional coordinative structures among multiple components have been investigated. However, structures extracted from the conventional statistical dimensionality reduction methods do not ...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-019-53187-1
更新日期:2019-11-14 00:00:00
abstract::Multiple infections of avian influenza viruses (AIVs) in poultry or wild birds contribute to the continued evolution of H5 subtype viruses in nature and provide potential recombination of AIVs of different origins. In this study, we carried out surveillance of AIVs in ducks, geese and the environment of a community in...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep25549
更新日期:2016-05-06 00:00:00
abstract::Liraglutide, a glucagon-like peptide-1 receptor (GLP-1R) agonist, is widely used to treat diabetes. However, its effect on pulmonary arterial hypertension (PAH) is unknown. In this study, we investigated its effects on rats with monocrotaline (MCT)-induced PAH and mechanisms on rat pulmonary artery smooth muscle cells...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep31788
更新日期:2016-09-01 00:00:00
abstract::Methylation of histone H3 lysine 4 (H3K4) is catalyzed by the multi-component COMPASS or COMPASS-like complex, which is highly conserved from yeast to human, and plays essential roles in gene expression and transcription, cell cycle progression, and DNA repair. Here we present a cryo-EM map of the complete S. cerevisi...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-018-35609-8
更新日期:2018-11-27 00:00:00
abstract::Clinical practice guides recommend delayed clamping of the umbilical cord. If this is not possible, some authors suggest milking as an alternative. The objective of this study was to determine the variability in professional practice in the management of umbilical cord clamping and milking and to identify factors or c...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-020-58641-z
更新日期:2020-02-03 00:00:00
abstract::The exovesicles (EVs) are involved in pathologic host-parasite immune associations and have been recently used as biomarkers for diagnosis of infectious diseases. The release of EVs by Trypanosoma cruzi, the causative agent of Chagas disease, has recently been described, with different protein cargoes including the MA...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep44451
更新日期:2017-03-15 00:00:00
abstract::Blood transfusion is fundamental in managing hematologic malignancies. We sought to evaluate the need and availability of blood products for patients with hematological malignancies at Uganda Cancer Institute. We prospectively studied the demand and supply of blood for patients with thrombocytopenia (platelet count ≤5...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-020-59773-y
更新日期:2020-02-18 00:00:00
abstract::Run-and-tumble motility is widely used by swimming microorganisms including numerous prokaryotic and eukaryotic organisms. Here, we experimentally investigate the run-and-tumble dynamics of the bacterium E. coli in polymeric solutions. We find that even small amounts of polymer in solution can drastically change E. co...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep15761
更新日期:2015-10-28 00:00:00
abstract::It is challenging task to detect and measure genuine multipartite entanglement. We investigate the problem by considering the average based positive partial transposition(PPT) criterion and the realignment criterion. Sufficient conditions for detecting genuine tripartite entanglement are presented. We also derive lowe...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-17585-7
更新日期:2017-12-08 00:00:00
abstract::Self-assembly of a nucleoside on Au(111) was studied to ascertain whether polymerization on well-defined substrates constitutes a promising approach for making sequence-controlled polymers. Scanning tunneling microscopy and density functional theory were used to investigate the self-assembly on Au(111) of (RS)-N(9)-(2...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep18891
更新日期:2016-01-04 00:00:00
abstract::Nicotine is the psychoactive agent involved in nicotine dependence. However, nicotine as a drug, and its effects on human psychology are largely under-investigated in genetic studies. In this study, we recruited 208 current non-smokers to evaluate the effect of nicotine and its relationship to genetic risks to nicotin...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep09521
更新日期:2015-03-31 00:00:00
abstract::In this study, we aimed to investigate the protective effects and underlying mechanism of Lycium barbarum polysaccharide (LBP) on high-fat-induced nonalcoholic fatty liver disease (NAFLD). Recently, sirtuin 1 (SIRT1) has been shown to play an important role in the regulation of hepatocellular lipid metabolism. Here, w...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep36209
更新日期:2016-11-08 00:00:00
abstract::Systemic lipopolysaccharide (LPS) is implicated in increasing mortality in patients with alcoholic hepatitis but the underlying mechanisms are not well characterised. The objective of this study was to characterise neutrophil function, LPS and cytokine concentrations within the splanchnic circulation of alcoholic cirr...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep40157
更新日期:2017-01-04 00:00:00
abstract::Nanoscale real-time molecular sensing requires large signal enhancement, small background, short detection time and high spectral resolution. We demonstrate a new vibrational spectroscopic technique which satisfies all of these conditions. This time-resolved surface-enhanced coherent anti-Stokes Raman scattering (tr-S...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/srep00891
更新日期:2012-01-01 00:00:00
abstract::A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper. ...
journal_title:Scientific reports
pub_type: 已发布勘误
doi:10.1038/s41598-019-46785-6
更新日期:2019-07-17 00:00:00
abstract::Pyrazinamide (PZA) is an important first-line drug in all existing and new tuberculosis (TB) treatment regimens. PZA-resistance in M. tuberculosis is increasing, especially among M/XDR cases. Noted issues with PZA Drug Susceptibility Testing (DST) have driven the search for alternative tests. This study provides a com...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-03452-y
更新日期:2017-06-19 00:00:00
abstract::CEST-MRI of the rNOE signal has been demonstrated in vitro to be closely linked to the protein conformational state. As the detectability of denaturation and aggregation processes on a physiologically relevant scale in living organisms has yet to be verified, the aim of this study was to perform heat-shock experiments...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-020-68022-1
更新日期:2020-07-06 00:00:00
abstract::Olive oil pomace (OOP) is a bio-waste rich in highly soluble polyphenols. OOP has been proposed as an additive in ruminant feeding to modulate rumen fermentations. Three groups of ewes were fed the following different diets: a control diet and two diets supplemented with OOP, obtained with a two-phase (OOP2) or three-...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-018-26713-w
更新日期:2018-05-31 00:00:00
abstract::Risk of malaria in infants can be influenced by prenatal factors. In this study, the potential for placental parasitemia at delivery in predicting susceptibility of infants to Plasmodium falciparum (Pf) infections was evaluated. Seventy-two newborns of mothers who were placental malaria negative (PM-) and of mothers w...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-18574-6
更新日期:2018-01-09 00:00:00
abstract::On standard electrocardiogram (ECG) PQ interval is known to be moderately heart rate dependent, but no physiologic details of this dependency have been established. At the same time, PQ dynamics is a clear candidate for non-invasive assessment of atrial abnormalities including the risk of atrial fibrillation. We studi...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-020-59480-8
更新日期:2020-02-13 00:00:00
abstract::In this study, we aimed to elucidate the origin of domestic chickens and their evolutionary history over the course of their domestication. We conducted a large-scale genetic study using mitochondrial DNA D-loop sequences and 28 microsatellite DNA markers to investigate the diversity of 298 wild progenitor red junglef...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-021-81589-7
更新日期:2021-01-21 00:00:00
abstract::Trophic variation in food web structure occurs among and within ecosystems. The magnitude of variation, however, differs from system to system. In ephemeral pond ecosystems, temporal dynamics are relatively more important than in many systems given that hydroperiod is the ultimate factor determining the presence of an...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-017-08026-6
更新日期:2017-08-08 00:00:00
abstract::Inter-specific emotion recognition is especially adaptive when species spend a long time in close association, like dogs and humans. Here, we comprehensively studied the human ability to recognize facial expressions associated with dog emotions (hereafter, emotions). Participants were presented with pictures of dogs, ...
journal_title:Scientific reports
pub_type: 杂志文章
doi:10.1038/s41598-019-52938-4
更新日期:2019-11-11 00:00:00