ChatCAD+: Towards a Universal and Reliable Interactive CAD using LLMs

The integration of Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) holds great potential in clinical applications, specifically in the roles of digital family doctors and clinic assistants. However, current works in this field are plagued by limitations, specifically a restricted scope of applicable image domains and the provision of unreliable medical advice This restricts their overall processing capabilities. Furthermore, the mismatch in writing style between LLMs and radiologists undermines their practical usefulness. To tackle these challenges, we introduce ChatCAD+, which is designed to be universal and reliable. It is capable of handling medical images from diverse domains and leveraging up-to-date information from reputable medical websites to provide reliable medical advice. Additionally, it incorporates a template retrieval system that improves report generation performance via exemplar reports, enabling seamless integration into existing clinical workflows. The source code is available at https://github.com/zhaozh10/ChatCAD.Comment: Authors Zihao Zhao, Sheng Wang, Jinchen Gu, Yitao Zhu contributed equally to this work and should be considered co-first author

Physiology and Pathology of the Cardiovascular System

The cardiovascular system (CVS) is made up of the heart, blood vessels, and blood. The fundamental function of CVS is to transport substances to and from all parts of the body. The heart is the major pumping organ, pressurizing blood for circulation through the blood vessels; blood is propelled away from the heart in the arteries and returns to the heart through the veins. Cardiovascular disease (CVD) is an umbrella term for a number of inter-linked diseases, generally defined as coronary artery disease, cerebrovascular disease, high blood pressure, peripheral arterial disease, rheumatic and congenital heart diseases, arrhythmia, etc. Globally, CVDs are the leading cause of deaths, and according to the estimation of the World Health Organization (WHO), about 17.9 million people died from CVDs in 2019, accounting for 32% of all global deaths. About 75% of CVD deaths occur in low- and middle-income countries. This burden of CVDs can be decreased by careful risk reduction (such as lifestyle modification, smoking and alcohol cessation, weight optimization, physical exercise), and proper medical treatments, including herbal components. The prevention of CVDs can reduce the occurrence of major cardiovascular events, thereby reducing premature disability, morbidity, and mortality, while prolonging survival and quality of life

Aerospace Medicine and Biology. A continuing bibliography with indexes, supplement 151

This bibliography lists 195 reports, articles, and other documents introduced into the NASA scientific and technical information system in January 1976

The role of psychological factors in chest pain with normal coronary arteries: a controlled study

One hundred and twenty three patients who were awaiting angiography for the investigation of chest pain were contacted by post and invited to participate in the study. Subjects were required to keep a chest pain diary for 14 days, and complete 5 self-report questionnaires examining physical and psychological aspects of their pain. Ofthe total sample of 123 patients who proceeded to angiogram, 72 (58.5%) were subsequently found to have Coronary Artery Disease (CAD) and 51 (41.5%) were found to have Normal Coronary Arteries (NCA). Seventy-two patients agreed to take part, 48 with CAD and 24 with NCA. This represents a return rate of 66.7% for CAD patients and 47% for NCA patients.Comparison ofthe NCA and CAD cohorts using chi-squared and t-tests for independent samples revealed the main factors found to be significantly associated with a finding ofNCA were : age (young), sex (female), non-elevated cholesterol, pain at rest, pain provoked by stress, wakening pain, relief by GTN after more than 5 minutes, and high levels of bodily awareness. Using these factors, a logistic regression was run. From this, factors which were found to be useful in discriminating between CAD and NCA patients were age, sex, somatic awareness and wakening pain. There was also found to be a lesser but consistent association with rest pain, anxiety and depression. These variables were found to correctly classify 85 % of cases. The classification of cases differed between groups with 64% ofNCA cases correctly classified, and 91.5% of CAD cases correctly classified.When the discriminatory power of this predictive equation was tested prospectively on a new sample of 74 patients (phase two) it was found to correctly predict 97.8% ofthe CAD cases and 58.3% of the NCA cases for an overall success rate of 89.5%. The implications of the results for the management of patients with chest pain and Normal Coronary Arteries are discussed. By inquiring routinely about psychological factors when taking a history, cardiologists would stand a better chance of anticipating which patients have an increased likelihood of having NCA. In addition to minimising unnecessary investigations, this could better prepare the patient psychologically for this finding from an early stage and allow more appropriate interventions to be more readily integrated

The relationship between body mass index and disease in non-aboriginal and aboriginal people residing in the Bella Coola Valley.

The goal of this project was to examine the prevalence of obesity and its associations with various diseases, in both the First Nation and non-First Nation populations in the isolated coastal community of the Bella Coola Valley on the West coast of British Columbia, Canada. 1. Are BMIs for Nuxalk in the Bella Coola Valley higher than non-aboriginals in the Bella Coola Valley? 2. Are diseases associated with higher BMIs in the Bella Coola Valley? 3. Are diseases more prevalent for Nuxalk or non-aboriginals in the Bella Coola Valley? --P.6.The original print copy of this thesis may be available here: http://wizard.unbc.ca/record=b132603

Spartan Daily, March 25, 1985

Volume 84, Issue 39https://scholarworks.sjsu.edu/spartandaily/7292/thumbnail.jp

“An interval of comfort”: postamputation pain & long-term consequences of amputation in British First World War veterans, 1914-1985

The First World War resulted in the largest amputee cohort in history, with 41,208 amputees in the UK alone; the majority injured as young men and surviving into the late 20th century. Recent studies have estimated that significant residual limb pain affects up to 85% of military amputees: applying this figure to the First World War amputee cohort raises the possibility that up to 35,000 British veterans may have experienced chronic postamputation pain. Despite this and the fact that 13% of injuries in this conflict resulted in amputation, there has been little research into the long-term impact on veterans’ health and quality of life. Recently catalogued historical medical and pension files held at The National Archives offer the opportunity to follow up this type of injury in a large group of veterans for the first time. This thesis will use these files to document and explore long-term outcomes of amputation and chronic postamputation pain, developments made in the treatment of this condition, the impact of aging on amputee veterans and their likelihood of developing a concomitant condition from 1914 to 1985. It will examine these issues from three perspectives: that of the injured servicemen, the civil servants attempting to value and compensate those injuries, and from the clinicians’ responsible for the veterans’ medical care and rehabilitation. This research has been based on a unique model of interdisciplinary collaboration, incorporating research methods from history and clinical medicine, and will present its findings from historical material with recommendations for current practice. Given the similarities in injury patterns and prevalence of chronic residual limb, phantom and neuropathic pain between the First World War cohort and contemporary casualties, it is anticipated that the findings of the project will assist in the strategic assessment and planning for long-term pain conditions by medical staff and care providers for today’s and future blast injury amputee cohorts.Open Acces

The heart of epilepsy: Cardiac comorbidity and sudden death

The research described in this thesis aims to increase understanding of cardiac comorbidities and sudden unexpected death in epilepsy (SUDEP). People with epilepsy have a three-fold increased risk of dying prematurely compared to the general population. Common contributors to this are cardiovascular comorbidities, of which I provide an overview. Cardiovascular conditions and epilepsy can both lead to transient loss of consciousness (TLOC) with overlapping semiology. Particularly, myoclonic jerks which are commonly observed during syncope can be mistaken for signs of epilepsy. A misdiagnosis with detrimental consequences. I provide evidence that a careful analysis of motor phenomena can distinguish the two conditions. SUDEP is the commonest direct epilepsy-related premature death (UK >500 people/year). It typically occurs following convulsive seizures (CS). Most victims are found prone and some suggested people should sleep supine. I assessed video-EEG recordings of 180 CS and demonstrated peri-ictal positions often change, and most ending prone turned during CS. Sleeping supine is thus unlikely to prevent a postictal prone position and reduce risk of SUDEP. Pathomechanisms underlying SUDEP are likely a combination of interacting cardiorespiratory and autonomic factors. People with Dravet syndrome (DS) have a particular high SUDEP risk. I show that 49% of reported deaths in DS are SUDEP cases, most <10 years (78%). In DS, SCN1A mutations are mostly found, encoding a sodium channel expressed in brain and heart. DS mouse models suggest a key role for peri-ictal cardiac arrhythmias in SUDEP. I conducted a multicentre observational study and recorded 547 seizures in 45 DS participants. No major peri-ictal arrhythmias were found. Peri-ictal QTc-lengthening was, however, more common in DS than controls. This may reflect unstable repolarisation and increased propensity for arrhythmias. Prospective data to determine whether these peri-ictal variables can predict SUDEP risk is warranted

A corpus-based discourse analysis of representations of people with schizophrenia in the British press between 2000 and 2015

Roughly one in a hundred people experience symptoms of schizophrenia during their lifetime, symptoms which include experiencing delusions and hallucinations, such as hearing voices (Johnstone and Frith, 2004). The frequency and intensity of symptoms is exacerbated by widespread negative attitudes and increases the likelihood that an individual will comply with command hallucinations (Harrison and Gill, 2010; Goldstone et al., 2012). In spite of this, the mass media continues to represent people with schizophrenia in an inaccurate and stereotypical way (Clement and Foster, 2008; Chopra and Doody, 2007). This fosters widespread misunderstandings and negative assumptions around the disorder. These misunderstandings gain traction because schizophrenia is widely misunderstood by the public at large (Jensen et al., 2016), and because people are unlikely to have first-hand experiences with people with schizophrenia. Despite the harmful nature of media representations, no study to date has seriously considered how misconceptions of schizophrenia and people with schizophrenia are mediated linguistically in the media. This is curious given that scholars in fields outside of Linguistics are increasingly recognising that the manner in which mental illness is represented plays an important role in reproducing stereotypical and prejudiced attitudes (Goulden et al., 2011, Kalucy et al., 2011). With these considerations in mind, this thesis draws on theories and methods from the field of Corpus Assisted Discourse Studies (CADS) to examine representations of people with schizophrenia in articles published in the British press between 2000 and 2015. This thesis uses a combination of corpus toolkits (Wordswmith 5.0, Sketch Engine) to examine repetitive lexicogrammatical patterns in articles published in the press that refer to schizophrenia and people with schizophrenia. It takes a particular interest in ‘non-obvious meaning’ (Partington, 2012:11), meanings that are only visible when examining how lexicogrammatical patterns converge around broader semantic and evaluative structures in large repositories of text. Do these patterns, working cumulatively over hundreds and thousands of texts suggest certain ways of understanding or viewing schizophrenia that would not be discernible to the naked eye? The root of the problem revealed in the analysis was a tension between reporting schizophrenia accurately and the press’ interest in reporting on schizophrenia in a way that is newsworthy in accordance with news values (Galtung and Ruge, 1965; Jewkes, 2015). In particular, there was a tendency to report on exceptional cases of people with schizophrenia (e.g. worst cases where people experience florid symptoms, people with schizophrenia who have succeeded creatively) that do not represent the majority of people diagnosed with the disorder. In the same vein, there was also a tendency for the press to repackage hard news as entertainment, for instance, by interdiscursively drawing on language and tropes associated with horror fiction. Salient language patterns converged around two main discourses: (1) that people with schizophrenia pose a risk to others, and (2) that people with schizophrenia who kill are intentional immoral agents. The analysis also identified a problematic metaphorical usage, which potentially reproduced the widespread misassumption that schizophrenia refers to a ‘split personality disorder’ (e.g. Jensen et al., 2015). I conclude by supporting a suggestion made in the academic literature (e.g. Ellison et al., 2018) that the diagnostic term ‘schizophrenia’ should be relabelled so that individuals diagnosed with the disorder do not carry the additional burden of negative stereotypes and misassumptions associated with the label

Patient-Specific Implants in Musculoskeletal (Orthopedic) Surgery

Most of the treatments in medicine are patient specific, aren’t they? So why should we bother with individualizing implants if we adapt our therapy to patients anyway? Looking at the neighboring field of oncologic treatment, you would not question the fact that individualization of tumor therapy with personalized antibodies has led to the thriving of this field in terms of success in patient survival and positive responses to alternatives for conventional treatments. Regarding the latest cutting-edge developments in orthopedic surgery and biotechnology, including new imaging techniques and 3D-printing of bone substitutes as well as implants, we do have an armamentarium available to stimulate the race for innovation in medicine. This Special Issue of Journal of Personalized Medicine will gather all relevant new and developed techniques already in clinical practice. Examples include the developments in revision arthroplasty and tumor (pelvic replacement) surgery to recreate individual defects, individualized implants for primary arthroplasty to establish physiological joint kinematics, and personalized implants in fracture treatment, to name but a few