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Bells Corners, Canada

Dankar F.K.,IBM | Dankar F.K.,Sidra Medical and Research Center | El Emam K.,Children Hospital of Eastern Ontario | Matwin S.,Polish Academy of Sciences | Matwin S.,Dalhousie University
Procedia Computer Science

Knowledge of patients' location information (postal/zip codes) is critical in public health research. However, the inclusion of location information makes it easier to determine the identity of the individuals in the data sets. An efficient way to anonymize location information is through aggregation. In order to aggregate the locations efficiently, the data holder needs to know the locations' adjacency information. A location adjacency matrix is big, and requires constant updates, thus it cannot be stored at the data holder's end. A possible solution would be to have the adjacency matrix stored on a cloud server, the data holder can then query the required adjacency records. However, queries reveal information on patients' locations, thus, we need to privately query the cloud server's database. Existing private information retrieval protocols are inefficient for our context, therefore, in this paper, we present an efficient protocol to privately query the server's database for adjacency information and thus preserving patients' privacy. © 2014 The Authors. Source

Hellmann J.,Hospital for Sick Children | Hellmann J.,University of Toronto | Knighton R.,Hospital for Sick Children | Lee S.K.,University of Toronto | And 16 more authors.
Archives of Disease in Childhood: Fetal and Neonatal Edition

Objective: To determine the causes and process of death in neonates in Canada. Design: Prospective observational study. Setting: Nineteen tertiary level neonatal units in Canada. Participants: 942 neonatal deaths (215 full-term and 727 preterm). Exposure and outcome: Explored the causes and process of death using data on: (1) the rates of withdrawal of life-sustaining treatment (WLST); (2) the reasons for raising the issue of WLST; (3) the extent of consensus with parents; (4) the consensual decision-making process both with parents and the multidisciplinary team; (5) the elements of WLST; and (6) the age at death and time between WLST and actual death. Results: The main reasons for deaths in preterm infants were extreme immaturity, intraventricular haemorrhage and pulmonary causes; in full-term infants asphyxia, chromosomal anomalies and syndromic malformations. In 84% of deaths there was discussion regarding WLST. WLST was agreed to by parents with relative ease in the majority of cases. Physicians mainly offered WLST for the purpose of avoiding pain and suffering in imminent death or survival with a predicted poor quality of life. Consensus with multidisciplinary team members was relatively easily obtained. There was marked variation between centres in offering WLST for severe neurological injury in preterm (10%-86%) and severe hypoxic-ischaemic encephalopathy in full-term infants (5%-100%). Conclusions and relevance: In Canada, the majority of physicians offered WLST to avoid pain and suffering or survival with a poor quality of life. Variation between units in offering WLST for similar diagnoses requires further exploration. Source

Aziz K.,University of Alberta | Chinnery H.,Stollery Childrens Hospital | Lacaze-Masmonteil T.,Children Hospital of Eastern Ontario
Advances in Neonatal Care

OBJECTIVE: To describe the implementation and outcomes of delayed cord clamping (DCC) in preterm babies. STUDY DESIGN: Following staff orientation, a policy of DCC for 45 seconds was instituted for all eligible babies born between 28 and 32 weeks' gestational age, and later to all those younger than 33 weeks. RESULTS: Of 480 babies, 349 (73%) were eligible for DCC. Of these, 236 (68%) received DCC. Monthly compliance rates to DCC protocol in eligible babies ranged from 18% to 93%. There was no significant difference in demographic measures or rates of delivery room ventilation between eligible babies who did or did not receive DCC. Delayed cord clamping was associated with less hypothermia, higher initial hemoglobin levels, and less necrotizing enterocolitis, with a trend toward lower 1-minute Apgar scores and less blood pressure support. CONCLUSIONS: The DCC protocol is feasible in preterm babies with reinforcement and education. It appears practical, safe, and applicable, and has minimal impact on immediate neonatal transition, with possible early neonatal benefits. Copyright © 2012 by The National Association of Neonatal Nurses. Source

Hing M.M.,University of Ottawa | Michalowski M.,Adventium Labs | Wilk S.,Poznan University of Technology | Michalowski W.,University of Ottawa | Farion K.,Children Hospital of Eastern Ontario
2010 IEEE International Conference on Bioinformatics and Biomedicine Workshops, BIBMW 2010

This paper describes a methodological approach to identifying inconsistencies when reconciling multiple clinical practice guidelines. The need to address these inconsistencies arises when a patient with co-morbidity has to be managed according to different treatment regimens. Starting with a well-known flowchart representation we discuss how to create a formal guideline model that allows for easy manipulations of its components. For this model we present how to identify conflicting actions that are manifested by treatment-treatment and treatment-disease interactions, and how to reconcile these conflicting actions. ©2010 IEEE. Source

Michalowski M.,Adventium Labs | Mainegra Hing M.,University of Ottawa | Wilk S.,Poznan University of Technology | Michalowski W.,University of Ottawa | Farion K.,Children Hospital of Eastern Ontario
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)

This paper describes a novel methodological approach to identifying inconsistencies when concurrently using multiple clinical practice guidelines. We discuss how to construct a formal guideline model using Constraint Logic Programming, chosen for its ability to handle relationships between patient information, diagnoses, and treatment suggestions. We present methods to identify inconsistencies that are manifested by treatment-treatment and treatment-disease interactions associated with comorbidity. Using an open source constraint programming system (ECLiPSe), we demonstrate the ability of our approach to find treatment given incomplete patient data and to identify possible inconsistencies. © 2011 Springer-Verlag. Source

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