preventive strategies and avoidance of peri-operative pro-delirium factors are crucial for comprehensive geriatric care.Recommendations are a key component of radiology reports. Automatic extraction of recommendations would facilitate tasks such as recommendation tracking, quality improvement, and large-scale descriptive studies. Existing report-parsing systems are frequently limited to recommendations for follow-up imaging studies, operate at the sentence or document level rather than the individual recommendation level, and do not extract important contextualizing information. We present a neural network architecture capable of extracting fully contextualized recommendations from any type of radiology report.  https://www.selleckchem.com/products/oxidopamine-hydrobromide.html  We identified six major "questions" necessary to capture the majority of context associated with a recommendation recommendation, time period, reason, conditionality, strength, and negation. We developed a unified task representation by allowing questions to refer to answers to other questions. Our representation allows for a single system to perform named entity recognition (NER) and classification tasks. We annotated 2272 radiology reports from all specialties, imaging modalities, and multiple hospitals across our institution. We evaluated the performance of a long short-term memory (LSTM) architecture on the six-question task. The single-task LSTM model achieves a token-level performance of 89.2% at recommendation extraction, and token-level performances between 85 and 95% F1 on extracting modifying features. Our model extracts all types of recommendations, including follow-up imaging, tissue biopsies, and clinical correlation, and can operate in real time. It is feasible to extract complete contextualized recommendations of all types from arbitrary radiology reports. The approach is likely generalizable to other clinical entities referenced in radiology reports, such as radiologic findings or diagnoses.
  During the peak of the COVID-19 pandemic in spring 2020, the entire emergency rescue system was confronted with major challenges. Starting on 15 March, all tourists were asked to leave the State of Tyrol, Austria. The main goal of the efforts was to ensure the usual quality of emergency medical care while reducing the physical contact during emergency interventions on site.
 
  The Austrian Emergency Medical Service is physician-based, meaning that in addition to an ambulance team, an emergency physician (EP) is dispatched to every potential life-threatening emergency call. In Tyrol and starting on 17March 2020, 413 types of emergency call dispatches, which were addressed with an ambulance crew as well as an EP crew before COVID-19, were now dispatched only with an ambulance crew. This procedure of dispatching differently as well as the general development of emergency calls during this period were analyzed from 15 March to 15 May 2020 and compared to the data from the same time period from 2017 to 2019.
 
  Defore keeping these reductions of the dispatching order regarding. EPs for the routine operation, adaptions in these reductions as well as deeper evaluations under consideration of the data from hospitals and GPs would be necessary. Also, different options to reduce physical contact should be evaluated, e.g. building an EMT-led scout team to evaluate the patient's status while the EP team is waiting outside.
  Despite recent improvements in cancer treatment in Germany, a marked difference in cancer survival based on socioeconomic factors persists. We aim to quantify the effect of socioeconomic inequality on head and neck cancer (HNC) survival.
 
  Information on 20,821 HNC patients diagnosed in 2009-2013 was routinely collected by German population-based cancer registries. Socioeconomic inequality was defined by the German Index of Socioeconomic Deprivation. The Cox proportional regression and relative survival analysis measured the survival disparity according to level of socioeconomic deprivation with respective confidence intervals (CI). A causal mediation analysis was conducted to quantify the effect of socioeconomic deprivation mediated through medical care, stage at diagnosis, and treatment on HNC survival.
 
  The most socioeconomically deprived patients were found to have the highest hazard of dying when compared to the most affluent (Hazard Ratio 1.25, 95% CI 1.17-1.34). The most deprived patients also had the worst 5-year age-adjusted relative survival (50.8%, 95% CI 48.5-53.0). Our mediation analysis showed that most of the effect of deprivation on survival was mediated through differential stage at diagnosis during the first 6months after HNC diagnosis. As follow-up time increased, medical care, stage at diagnosis, and treatment played no role in mediating the effect of deprivation on survival.
 
  This study confirms the survival disparity between affluent and deprived HNC patients in Germany. Considering data limitations, our results suggest that, within six months after HNC diagnosis, the elimination of differences in stage at diagnosis could reduce survival inequalities.
 This study confirms the survival disparity between affluent and deprived HNC patients in Germany. Considering data limitations, our results suggest that, within six months after HNC diagnosis, the elimination of differences in stage at diagnosis could reduce survival inequalities.
  This study aimed to reveal additional factors potentially contributing to the multifactorial ethiopathogenesis of spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) for descending thoracic aortic aneurysm (TAA).
 
  The medical records of 293 patients who underwent TEVAR without debranching procedures for descending TAA between 2011 and 2018 were retrospectively reviewed. We excluded the following cases from the study 72 patients with aortic dissection; 15 with rupture; 14 with anastomotic pseudoaneurysm; 22 with re-TEVAR; 34 without evaluation of the artery of Adamkiewicz (AKA). Sufficient data were available for 136 patients (79% men; mean age of 76 ± 7.4years). We conducted univariable and multivariable analyzes using the logistic regression analysis to assess the relationship between pre-/intraoperative factors and postoperative SCI.
 
  SCI was observed in nine patients (6.8%). Severe intraluminal atheroma [odds ratio (OR), 6.23; p = 0.014] and iliac artery access (OR 4.65; p = 0.