Background: Acute deterioration of patients in general wards often leads to major adverse events (MAEs), including unplanned intensive care unit transfers, cardiac arrest, or death. Traditional early warning scores (EWSs) have shown limited predictive accuracy, with frequent false positives. We conducted a prospective observational external validation study of an artificial intelligence (AI)-based EWS, the VitalCare - Major Adverse Event Score (VC-MAES), at a tertiary medical center in the Republic of Korea. Methods: Adult patients from general wards, including internal medicine (IM) and obstetrics and gynecology (OBGYN)—the latter were rarely investigated in prior AI-based EWS studies—were included. The VC-MAES predictions were compared with National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) predictions using the area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), and logistic regression for baseline EWS values. False-positives per true positive (FPpTP) were assessed based on the power threshold. Results: Of 6,039 encounters, 217 (3.6%) had MAEs (IM: 9.5%, OBGYN: 0.26%). Six hours prior to MAEs, the VC-MAES achieved an AUROC of 0.918 and an AUPRC of 0.352, including the OBGYN subgroup (AUROC, 0.964; AUPRC, 0.388), outperforming the NEWS (0.797 and 0.124) and MEWS (0.722 and 0.079). The FPpTP was reduced by up to 71%. Baseline VC-MAES was strongly associated with MAEs (P<0.001). Conclusions The VC-MAES significantly outperformed traditional EWSs in predicting adverse events in general ward patients. The robust performance and lower FPpTP suggest that broader adoption of the VC-MAES may improve clinical efficiency and resource allocation in general wards.

Cases of simultaneously occurring medullary thyroid carcinoma (MTC) and lymphoma are extremely rare. An 84-year-old woman visited the hospital due to dyspnea, resulting from rapidly aggravated enlarged neck mass. Ultrasonography revealed two lesions in the thyroid and they were diagnosed as concurrent medullary thyroid carcinoma and diffuse large B cell lymphoma after total thyroidectomy. A few cases simultaneously diagnosed with MTC and systemic lymphoma have been reported. However, the coexistence of MTC and primary thyroid lymphoma is extremely rare.
Aged, 80 and over ; Carcinoma, Medullary ; Dyspnea ; Female ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Neck ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Ultrasonography

PURPOSE: The purposes of this study were to compare confidence in practice of intermittent gavage tube feeding and participants' satisfaction by three types of feedback; professor verbal feedback, professor feedback with smartphone video, and peer feedback with smartphone video. In addition, frequently failed items in the intermittent gavage tube feeding procedure were analyzed. METHODS: Data were collected from a convenience sample of 78 nursing college students in November 2014. Students were randomly assigned to the control group, experimental group I (smartphone video with professor feedback) or group II (smartphone video with peer feedback). Data were analyzed using descriptive statistics including chi-square test, ANOVA, and Scheffe test with SPSS 21.0. RESULTS: Confidence in practice of intermittent gavage tube feeding and satisfaction with feedback were highest in experimental group I that had professor feedback with smartphone video. For the procedure, the most frequently failed item was giving an explanation to patients about the purpose and the procedure of tube feeding. CONCLUSION: The results indicate that professor verbal feedback with smartphone video is the most benefit to the nursing students in acquiring core nursing practice skills.
Enteral Nutrition* ; Humans ; Nursing* ; Students, Nursing*