Papers by Robert Hernandez
Cureus, 2020
The practice of interdisciplinary medicine is one of the most effective and cooperative forms of ... more The practice of interdisciplinary medicine is one of the most effective and cooperative forms of medical management, which optimizes clinical care and outcomes for a patient. This model of care affords the patient the benefit of receiving the best available therapeutic options from specialists who are experts in their respective disciplines, which would otherwise be limited when compared with the clinical expertise from a single provider managing multiple comorbidities. However, poor communication between each specialized team managing a patient's care can result in redundancies and superfluous treatment that can have deleterious clinical outcomes that impede the physician-patient relationship and question the bioethical principles of clinical practice. Having a medical provider like an internist who is the primary medical provider for a patient anchors reinforces the physician-patient relationship through familiarity and continuous involvement in the gross clinical course of a patient. Specialty care provides a very focused and limiting scope of practice. However, whether practicing specialty care or being a generalist, utilizing clinical tools, such as the biopsychosocial model and routinely using bioethical principles during clinical encounters, not only help extract pertinent information from the patient's medical history but also furthers the continuity of clinical care by understanding the global context of the patient's medical history. This is a case analysis that exemplifies sub-optimal outcomes in patient care due to undermining the critical role of an internist in patient care and clinical management in addition to challenging several bioethical principles of clinical care. It also highlights the importance of how using the biopsychosocial model of care can avoid clinical errors, improve interdisciplinary and patient communication, and, ultimately, optimize the patient-physician relationship and clinical care.
Supporting clinical trial data curation from literature with table mining
Journal for ImmunoTherapy of Cancer, 2021
BackgroundOne of the pharmacodynamic measures of biologic compounds is an assessment of target re... more BackgroundOne of the pharmacodynamic measures of biologic compounds is an assessment of target receptor/ligand occupancy (RO). If the primary mechanism for drug clearance is through target binding, drug exposure may increase once RO is saturated. SL-172154 (SIRPα-Fc-CD40L) and SL-279252 (PD1-Fc-OX40L) are two bi-functional fusion proteins in phase I clinical trials (NCT04406623 and NCT03894618). The binding interaction between a biologic compound and its targets (CD47 or PD-L1) typically does not stimulate migration from the blood, allowing direct measurement of drug and target. Evaluation of RO for immune agonists (CD40 and OX40) is challenging because agonists can stimulate lymphocytes to rapidly extravasate from the peripheral blood following infusion, thus precluding direct RO measurement as target cells are no longer present in the blood (figure 1a).MethodsTo assess full receptor engagement of CD40 or OX40, the formula shown in figure 1b was derived. The formula captures cells ...
Macromolecular Rapid Communications, 2021
Meredith Leach Sanders. I would also like to extend my thanks to Fan Zhang, Xiaorong Zhang and my... more Meredith Leach Sanders. I would also like to extend my thanks to Fan Zhang, Xiaorong Zhang and my other friends and colleagues. A special thank you goes out to the NUWC Code 852 "Think Tank" (Jason Kane, Matt Seaton, and Will Simoneau) for proof reading my papers, making recommendations, but more importantly for ALWAYS being there when I needed them most.
Therapeutic Drug Monitoring, 2019
Background: Solithromycin is a fourth-generation macrolide antibiotic with potential efficacy in ... more Background: Solithromycin is a fourth-generation macrolide antibiotic with potential efficacy in pediatric community-acquired bacterial pneumonia. Pharmacokinetic (PK) studies of solithromycin in pediatric subjects are limited, therefore application of minimally invasive drug sampling techniques, such as dried blood spots (DBS), may enhance PK study enrollment in children. The objectives of this study were to compare solithromycin concentrations in DBS with those in liquid plasma samples (LPS) and to quantify the effects of modeling DBS concentrations on the results of a population PK model. Methods: Comparability analysis was performed on matched DBS and LPS solithromycin concentrations collected from two different phase 1 clinical trials of solithromycin treatment in children (clinicaltrials.gov # and #). Comparability of solithromycin concentrations was evaluated based on DBS-LPS ratio, median percentage prediction error (MPPE), and median absolute percentage prediction error (MAPE). The effect of correcting DBS concentrations for both hematocrit and protein binding was investigated. Additionally, a previously published population PK model (NONMEM®) was leveraged to compare parameter estimates resulting from either DBS or LPS concentrations. Results: A total of 672 paired DBS-LPS concentrations were available from 95 subjects (age: 0-17 years of age. The median (range) LPS and DBS solithromycin concentrations were 0.3 (0.01-12) μg/mL and 0.32 (0.01-14) μg/mL, respectively. MPPE and MAPE of raw DBS to LPS solithromycin concentrations were 5.26% and 22.95%, respectively. Additionally, the majority of
International Journal on Document Analysis and Recognition (IJDAR), 2019
The scientific literature is growing exponentially, and professionals are no more able to cope wi... more The scientific literature is growing exponentially, and professionals are no more able to cope with the current amount of publications. Text mining provided in the past methods to retrieve and extract information from text; however, most of these approaches ignored tables and figures. The research done in mining table data still does not have an integrated approach for mining that would consider all complexities and challenges of a table. Our research is examining the methods for extracting numerical (number of patients, age, gender distribution) and textual (adverse reactions) information from tables in the clinical literature. We present a requirement analysis template and an integral methodology for information extraction from tables in clinical domain that contains 7 steps: (1) table detection, (2) functional processing, (3) structural processing, (4) semantic tagging, (5) pragmatic processing, (6) cell selection and (7) syntactic processing and extraction. Our approach performed with the F-measure ranged between 82 and 92%, depending on the variable, task and its complexity.
Antimicrobial agents and chemotherapy, Jan 11, 2018
Solithromycin is a novel fluoroketolide antibiotic, which was under investigation for the treatme... more Solithromycin is a novel fluoroketolide antibiotic, which was under investigation for the treatment of community-acquired bacterial pneumonia (CABP). A phase 1 study was performed to characterize the pharmacokinetics (PK) and safety of solithromycin in children. Eighty-four subjects (median age 6 years [range 4 days - 17 years]) were administered intravenous (IV) or oral (capsules or suspension) solithromycin (IV 6-8 mg/kg; capsules/suspension 14-16 mg/kg on Day 1 and 7-15 mg/kg on Days 2-5). PK samples were collected after first and multi-dose administration. Data from 83 subjects (662 samples) were combined with previously collected adolescent PK data (N=13, median [range] age 16 years (12-17)) following capsule administration to perform a population PK analysis. A 2-compartment PK model characterized the data well, and post-menstrual age was the only significant covariate after accounting for body size differences. Dosing simulations suggested that 8 mg/kg IV daily and oral dosin...
Media session framework using a control module to direct and manage application and service servers
Proceedings of the 9th International Joint Conference on Biomedical Engineering Systems and Technologies, 2016
Current biomedical text mining efforts are mostly focused on extracting information from the body... more Current biomedical text mining efforts are mostly focused on extracting information from the body of research articles. However, tables contain important information such as key characteristics of clinical trials. Here, we examine the feasibility of information extraction from tables. We focus on extracting data about clinical trial participants. We propose a rule-based method that decomposes tables into cell level structures and then extracts information from these structures. Our method performed with a F-measure of 83.3% for extraction of number of patients, 83.7% for extraction of patient's body mass index and 57.75% for patient's weight. These results are promising and show that information extraction from tables in biomedical literature is feasible.
Lecture Notes in Computer Science, 2016
Within the scientific literature, tables are commonly used to present factual and statistical inf... more Within the scientific literature, tables are commonly used to present factual and statistical information in a compact way, which is easy to digest by readers. The ability to "understand" the structure of tables is key for information extraction in many domains. However, the complexity and variety of presentation layouts and value formats makes it difficult to automatically extract roles and relationships of table cells. In this paper, we present a model that structures tables in a machine readable way and a methodology to automatically disentangle and transform tables into the modelled data structure. The method was tested in the domain of clinical trials: it achieved an F-score of 94.26% for cell function identification and 94.84% for identification of inter-cell relationships.
System And Method For Detecting Anomalies In Market Data
Implementation and Challenges of a SIL 3 Subsea HIPPS
Offshore Technology Conference, 2016
A subsea HIPPS (High Integrity Pressure Protection System) is an effective tool to reduce the ove... more A subsea HIPPS (High Integrity Pressure Protection System) is an effective tool to reduce the overall CAPEX of a system by limiting the pressure downstream equipment may experience. While there are challenges associated with implementing this system, proper HIPPS design focuses on the safety and reliability of the entire system from reservoir to topsides. A HIPPS can allow the integration of high pressure wells into low pressure systems, thus expanding the capabilities and life of equipment that may already exist. In order to ensure the safety and reliability of the HIPPS, rigorous testing and compliance with regulatory bodies are necessary. This paper presents a summary of the design criteria of a subsea HIPPS, the benefits of proper HIPPS implementation, and the challenges that must be met. Despite these challenges, it is both plausible and feasible to integrate future high-pressure systems into low-pressure systems by implementing a HIPPS to protect against the overpressure of lo...
2015 IEEE 23rd Annual International Symposium on Field-Programmable Custom Computing Machines, 2015
Design, Automation & Test in Europe Conference & Exhibition (DATE), 2015, 2015
This paper presents a novel architecture of a lower limb neural machine interface (NMI) for deter... more This paper presents a novel architecture of a lower limb neural machine interface (NMI) for determination of user intent. Our new design and implementation paves the way for future bionic legs that require high speed real-time deterministic response, high accuracy, easy portability, and low power consumption. A working FPGA-based prototype has been built, and experiments have shown that it achieves average performance gains of around 8x that of the equivalent software algorithm running on an Intel Core i7 2670QM, or 24x that of an Intel Atom Z530 with no perceivable loss in accuracy. Furthermore, our fully pipelined and parallel non-linear support vector machine-based FPGA implementation led to a 6.4x speedup over an equivalent GPU-based design. In this paper, we also characterize our achieved timing margin to show that our design is capable of supporting real-time wireless communications. With additional refinement, such a wireless personal area network (PAN) system will provide improved flexibility on an individual basis for electromyography (EMG) sensor placement.
2015 Annual IEEE Systems Conference (SysCon) Proceedings, 2015
This paper presents a rapid prototype approach for the development of a real-time capable neural-... more This paper presents a rapid prototype approach for the development of a real-time capable neural-machine-interface (NMI) for control of artificial legs based on mobile processor technology (Intel Atom TM Z530 Processor.) By effectively exploiting the architectural features of a mobile embedded CPU, we implemented a decision-making algorithm, based on neuromuscular-mechanical fusion and gait phase-dependent support vector machines (SVM) classification to meet the demanding performance constraints. To demonstrate the feasibility of a real-time mobile computing based NMI, real-time experiments were performed on an able bodied subject with window increments of 50ms. The experiments showed that the mobile computing based NMI provided fast and accurate classifications of four major human locomotion tasks (levelground walking, stair ascent, stair descent, and standing) and a 46X speedup over an equivalent MATLAB implementation. The testing yielded accuracies of 96.31% with low power consumption. An offline analysis showed the accuracy could be increased to 98.87% with minor modifications to the application.
Design and implementation of a low power mobile CPU based embedded system for artificial leg control
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2013
This paper presents the design and implementation of a new neural-machine-interface (NMI) for con... more This paper presents the design and implementation of a new neural-machine-interface (NMI) for control of artificial legs. The requirements of high accuracy, real-time processing, low power consumption, and mobility of the NMI place great challenges on the computation engine of the system. By utilizing the architectural features of a mobile embedded CPU, we are able to implement our decision-making algorithm, based on neuromuscular phase-dependant support vector machines (SVM), with exceptional accuracy and processing speed. To demonstrate the superiority of our NMI, real-time experiments were performed on an able bodied subject with a 20 ms window increment. The 20 ms testing yielded accuracies of 99.94% while executing our algorithm efficiently with less than 11% processor loads.
<title>Inexpensive semi-autonomous ground vehicles for defusing IEDs</title>
Sensors, and Command, Control, Communications, and Intelligence (C3I) Technologies for Homeland Security and Homeland Defense VII, 2008
Improvised explosive devices (IEDs) are an important concern to coalition forces during the confl... more Improvised explosive devices (IEDs) are an important concern to coalition forces during the conflicts in the Middle East. These devices are responsible for many casualties to American armed forces in the Middle East. These explosives are particularly dangerous because they are improvised with materials readily available to the designer, and there is no systematic way of explosive ordinance disposal. IEDs
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference, 2012
This paper presents the design and implementation of a low power embedded system using mobile pro... more This paper presents the design and implementation of a low power embedded system using mobile processor technology (Intel Atom™ Z530 Processor) specifically tailored for a neural-machine interface (NMI) for artificial limbs. This embedded system effectively performs our previously developed NMI algorithm based on neuromuscular-mechanical fusion and phase-dependent pattern classification. The analysis shows that NMI embedded system can meet real-time constraints with high accuracies for recognizing the user's locomotion mode. Our implementation utilizes the mobile processor efficiently to allow a power consumption of 2.2 watts and low CPU utilization (less than 4.3%) while executing the complex NMI algorithm. Our experiments have shown that the highly optimized C program implementation on the embedded system has superb advantages over existing PC implementations on MATLAB. The study results suggest that mobile-CPU-based embedded system is promising for implementing advanced contr...
Tobacco Cessation Objective Structured Clinical Examination (OSCE)
MedEdPORTAL Publications, 2009
Abstract This objective structured clinical examination (OSCE) station was developed to evaluate ... more Abstract This objective structured clinical examination (OSCE) station was developed to evaluate the motivational interviewing and counseling skills of medical students at the end of the third year...
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Papers by Robert Hernandez