Significant growth in Electronic Health Records (EHR) over the last decade has provided an abundance of clinical text that is mostly unstructured and untapped. This huge amount of clinical text data has motivated the development of new information extraction and text mining techniques. Named Entity Recognition (NER) and Relationship Extraction (RE) are key components of information extraction tasks in the clinical domain. In this paper, we highlight the present status of clinical NER and RE techniques in detail by discussing the existing proposed NLP models for the two tasks and their performances and discuss the current challenges. Our comprehensive survey on clinical NER and RE encompass current challenges, state-of-the-art practices, and future directions in information extraction from clinical text. This is the first attempt to discuss both of these interrelated topics together in the clinical context. We identified many research articles published based on different approaches and looked at applications of these tasks. We also discuss the evaluation metrics that are used in the literature to measure the effectiveness of the two these NLP methods and future research directions.

COVID-19 is a global health crisis that has altered human life and still promises to create ripples of death and destruction in its wake. The sea of scientific literature published over a short time-span to understand and mitigate this global phenomenon necessitates concerted efforts to organize our findings and focus on the unexplored facets of the disease. In this work, we applied natural language processing (NLP) based approaches on scientific literature published on COVID-19 to infer significant keywords that have contributed to our social, economic, demographic, psychological, epidemiological, clinical, and medical understanding of this pandemic. We identify key terms appearing in COVID literature that vary in representation when compared to other virus-borne diseases such as MERS, Ebola, and Influenza. We also identify countries, topics, and research articles that demonstrate that the scientific community is still reacting to the short-term threats such as transmissibility, health risks, treatment plans, and public policies, underpinning the need for collective international efforts towards long-term immunization and drug-related challenges. Furthermore, our study highlights several long-term research directions that are urgently needed for COVID-19 such as: global collaboration to create international open-access data repositories, policymaking to curb future outbreaks, psychological repercussions of COVID-19, vaccine development for SARS-CoV-2 variants and their long-term efficacy studies, and mental health issues in both children and elderly.

Rigorous radiotherapy quality surveillance and comprehensive outcome assessment require electronic capture and automatic abstraction of clinical, radiation treatment planning, and delivery data. We present the design and implementation framework of an integrated data abstraction, aggregation, and storage, curation, and analytics software: the Health Information Gateway and Exchange (HINGE), which collates data for cancer patients receiving radiotherapy. The HINGE software abstracts structured DICOM-RT data from the treatment planning system (TPS), treatment data from the treatment management system (TMS), and clinical data from the electronic health records (EHRs). HINGE software has disease site-specific "Smart" templates that facilitate the entry of relevant clinical information by physicians and clinical staff in a discrete manner as part of the routine clinical documentation.Radiotherapy data abstracted from these disparate sources and the smart templates are processed for quality and outcome assessment. The predictive data analyses are done on using well-defined clinical and dosimetry quality measures defined by disease site experts in radiation oncology. HINGE application software connects seamlessly to the local IT/medical infrastructure via interfaces and cloud services and performs data extraction and aggregation functions without human intervention. It provides tools to assess variations in radiation oncology practices and outcomes and determines gaps in radiotherapy quality delivered by each provider. K E Y W O R D S big data in radiation oncology, quality surveillance 1 | INTRODUCTION Advanced technologies in health care are bringing a sharper focus on clinical outcome assessment and the assessment of health care quality. Manual abstraction, collation, and subsequent analysis of health care quality from patient treatment and outcome data are onerous, expensive, and impractical. Advances in computer storage, computing power, and the ability to electronically mine data from disparate sources (e.g., demographics, genetics, imaging, treatment, clinical decisions, and outcomes) have enabled big data research in medicine. The evolution of several initiatives in the realm of interconnectivity of health care data sources and the availability of advanced computing frameworks have opened doors for answering a broad array of questions related to quality, safety, and outcomes of

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A major hallmark of Alzheimer's disease (AD) is the accumulation of extracellular aggregates of amyloid-β (Aβ). Structural polymorphism observed among Aβ fibrils in AD brains seem to correlate with the clinical subtypes suggesting a link between fibril polymorphism and pathology. Since fibrils emerge from a templated growth of low-molecular-weight oligomers, understanding the factors affecting oligomer generation is important. Membrane lipids are key factors to influence early stages of Aβ aggregation and oligomer generation, which cause membrane disruption. We have previously demonstrated that conformationally discrete Aβ oligomers can be generated by modulating the charge, composition, and chain length of lipids and surfactants. Here, we extend our studies into liposomal models by investigating Aβ oligomerization on large unilamellar vesicles (LUVs) of total brain extracts (TBE), reconstituted lipid rafts (LRs), or 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC). Varying the vesicle composition by specifically increasing the amount of GM1 gangliosides as a constituent, we found that only GM1-enriched liposomes induce the formation of toxic, low-molecular-weight oligomers. Furthermore, we found that the aggregation on liposome surface and membrane disruption are highly cooperative and sensitive to membrane surface characteristics. Numerical simulations confirm such a cooperativity and reveal that GM1-enriched liposomes form twice as many pores as those formed in the absence GM1. Overall, this study uncovers mechanisms of cooperativity between oligomerization and membrane disruption under controlled lipid compositional bias, and refocuses the significance of the early stages of Aβ aggregation in polymorphism, propagation, and toxicity in AD.

Physicians often label anatomical structure sets in Digital Imaging and Communications in Medicine (DICOM) images with nonstandard names. As these names vary widely, the standardization of the nonstandard names in the Organs at Risk (OARs), Planning Target Volumes (PTVs), and 'Other' organs inside the area of interest is a vital problem. Prior works considered traditional machine learning approaches on structure sets with moderate success. This paper presents integrated deep learning methods applied to structure sets by integrating the multimodal data compiled from the radiotherapy centers administered by the US Veterans Health Administration (VHA) and the Department of Radiation Oncology at Virginia Commonwealth University (VCU). The de-identified radiation oncology data collected from VHA and VCU radiotherapy centers have 16,290 prostate structures. Our method integrates the heterogeneous (textual and imaging) multimodal data with Convolutional Neural Network (CNN)-based deep learning approaches like CNN, Visual Geometry Group (VGG) network, and Residual Network (ResNet). Our model presents improved results in prostate (RT) structure name standardization. Evaluation of our methods with macro-averaged F1 Score shows that our deep learning model with single-modal textual data usually performs better than the previous studies. We also experimented with various combinations of multimodal data (masked images, masked dose) besides textual data. The models perform well on the textual data alone, while the addition of imaging data shows that deep neural networks can achieve improved performance using information present in the other modalities. Additionally, using masked images and masked doses along with text leads to an overall performance improvement with the various CNN-based architectures than using all the modalities together. Undersampling the majority class leads to further performance enhancement. The VGG network on the masked image-dose data combined with CNNs on the text data performs the best and establishes the state-of-the-art in this domain.

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