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Ensuring Access to Safe and Nutritious Food for All Through the Transformation of Food Systems
A scoping review of natural language processing of radiology reports in breast cancer
Various natural language processing (NLP) algorithms have been applied in the literature to analyze radiology reports pertaining to the diagnosis and subsequent care of cancer patients. Applications of this technology include cohort selection for clinical trials, population of large-scale data registries, and quality improvement in radiology workflows including mammography screening. This scoping review is the first to examine such applications in the specific context of breast cancer. Out of 210 identified articles initially, 44 met our inclusion criteria for this review. Extracted data elements included both clinical and technical details of studies that developed or evaluated NLP algorithms applied to free-text radiology reports of breast cancer. Our review illustrates an emphasis on applications in diagnostic and screening processes over treatment or therapeutic applications and describes growth in deep learning and transfer learning approaches in recent years, although rule-based approaches continue to be useful. Furthermore, we observe increased efforts in code and software sharing but not with data sharing
Computertomographie-basierte Bestimmung von Aortenklappenkalk und seine Assoziation mit Komplikationen nach interventioneller Aortenklappenimplantation (TAVI)
Background: Severe aortic valve calcification (AVC) has generally been recognized as a key factor in the occurrence of adverse events after transcatheter aortic valve implantation (TAVI). To date, however, a consensus on a standardized calcium detection threshold for aortic valve calcium quantification in contrast-enhanced computed tomography angiography (CTA) is still lacking. The present thesis aimed at comparing two different approaches for quantifying AVC in CTA scans based on their predictive power for adverse events and survival after a TAVI procedure.
Methods: The extensive dataset of this study included 198 characteristics for each of the 965 prospectively included patients who had undergone TAVI between November 2012 and December 2019 at the German Heart Center Berlin (DHZB). AVC quantification in CTA scans was performed at a fixed Hounsfield Unit (HU) threshold of 850 HU (HU 850 approach) and at a patient-specific threshold, where the HU threshold was set by multiplying the mean luminal attenuation of the ascending aorta by 2 (+100 % HUAorta approach). The primary endpoint of this study consisted of a combination of post-TAVI outcomes (paravalvular leak ≥ mild, implant-related conduction disturbances, 30-day mortality, post-procedural stroke, annulus rupture, and device migration). The Akaike information criterion was used to select variables for the multivariable regression model. Multivariable analysis was carried out to determine the predictive power of the investigated approaches.
Results: Multivariable analyses showed that a fixed threshold of 850 HU (calcium volume cut-off 146 mm3) was unable to predict the composite clinical endpoint post-TAVI (OR=1.13, 95 % CI 0.87 to 1.48, p=0.35). In contrast, the +100 % HUAorta approach (calcium volume cut-off 1421 mm3) enabled independent prediction of the composite clinical endpoint post-TAVI (OR=2, 95 % CI 1.52 to 2.64, p=9.2x10-7). No significant difference in the Kaplan-Meier survival analysis was observed for either of the approaches.
Conclusions: The patient-specific calcium detection threshold +100 % HUAorta is more predictive of post-TAVI adverse events included in the combined clinical endpoint than the fixed HU 850 approach. For the +100 % HUAorta approach, a calcium volume cut-off of 1421 mm3 of the aortic valve had the highest predictive value.Hintergrund: Ein wichtiger Auslöser von Komplikationen nach einer Transkatheter-Aortenklappen-Implantation (TAVI) sind ausgeprägte Kalkablagerung an der Aortenklappe. Dennoch erfolgte bisher keine Einigung auf ein standardisiertes Messverfahren zur Quantifizierung der Kalklast der Aortenklappe in einer kontrastverstärkten dynamischen computertomographischen Angiographie (CTA). Die vorliegende Dissertation untersucht, inwieweit die Wahl des Analyseverfahrens zur Quantifizierung von Kalkablagerungen in der Aortenklappe die Prognose von Komplikationen und der Überlebensdauer nach einer TAVI beeinflusst.
Methodik: Der Untersuchung liegt ein umfangreicher Datensatz von 965 Patienten mit 198 Merkmalen pro Patienten zugrunde, welche sich zwischen 2012 und 2019 am Deutschen Herzzentrum Berlin einer TAVI unterzogen haben. Die Quantifizierung der Kalkablagerung an der Aortenklappe mittels CTA wurde einerseits mit einem starren Grenzwert von 850 Hounsfield Einheiten (HU) (HU 850 Verfahren) und andererseits anhand eines individuellen Grenzwertes bemessen. Letzterer ergibt sich aus der HU-Dämpfung in dem Lumen der Aorta ascendens multipliziert mit 2 (+100 % HUAorta Verfahren). Der primäre klinische Endpunkt dieser Dissertation besteht aus einem aus sechs Variablen zusammengesetzten klinischen Endpunkt, welcher ungewünschte Ereignisse nach einer TAVI abbildet (paravalvuläre Leckage ≥mild, Herzrhythmusstörungen nach einer TAVI, Tod innerhalb von 30 Tagen, post-TAVI Schlaganfall, Ruptur des Annulus und Prothesendislokation). Mögliche Störfaktoren, die auf das Eintreten der Komplikationen nach TAVI Einfluss haben, wurden durch den Einsatz des Akaike Informationskriterium ermittelt. Um die Vorhersagekraft von Komplikationen nach einer TAVI durch beide Verfahren zu ermitteln, wurde eine multivariate Regressionsanalyse durchgeführt.
Ergebnisse: Die multivariaten logistischen Regressionen zeigen, dass die Messung der Kalkablagerungen anhand der HU 850 Messung (Kalklast Grenzwert von 146 mm3) die Komplikationen und die Überlebensdauer nicht vorhersagen konnten (OR=1.13, 95 % CI 0.87 bis 1.48, p=0.35). Die nach dem +100 % HUAorta Verfahren (Kalklast Grenzwert von 1421 mm3) individualisierte Kalkmessung erwies sich hingegen als sehr aussagekräftig, da hiermit Komplikationen nach einer TAVI signifikant vorhergesagt werden konnten (OR=2, 95 % CI 1.52 bis 2.64, p=9.2x10-7). In Hinblick auf die postoperative Kaplan-Meier Überlebenszeitanalyse kann auch mit dem +100 % HUAorta Verfahren keine Vorhersage getroffen werden.
Fazit: Aus der Dissertation ergibt sich die Empfehlung, die Messung von Kalkablagerungen nach dem +100 % HUAorta Verfahren vorzunehmen, da Komplikationen wesentlich besser und zuverlässiger als nach der gängigen HU 850 Messmethode vorhergesagt werden können. Für das +100 % HUAorta Verfahren lag der optimale Kalklast Grenzwert bei 1421 mm3
Data-to-text generation with neural planning
In this thesis, we consider the task of data-to-text generation, which takes non-linguistic
structures as input and produces textual output. The inputs can take the form of
database tables, spreadsheets, charts, and so on. The main application of data-to-text
generation is to present information in a textual format which makes it accessible to
a layperson who may otherwise find it problematic to understand numerical figures.
The task can also automate routine document generation jobs, thus improving human
efficiency. We focus on generating long-form text, i.e., documents with multiple paragraphs. Recent approaches to data-to-text generation have adopted the very successful
encoder-decoder architecture or its variants. These models generate fluent (but often
imprecise) text and perform quite poorly at selecting appropriate content and ordering
it coherently. This thesis focuses on overcoming these issues by integrating content
planning with neural models. We hypothesize data-to-text generation will benefit from
explicit planning, which manifests itself in (a) micro planning, (b) latent entity planning, and (c) macro planning. Throughout this thesis, we assume the input to our
generator are tables (with records) in the sports domain. And the output are summaries
describing what happened in the game (e.g., who won/lost, ..., scored, etc.).
We first describe our work on integrating fine-grained or micro plans with data-to-text generation. As part of this, we generate a micro plan highlighting which records
should be mentioned and in which order, and then generate the document while taking
the micro plan into account.
We then show how data-to-text generation can benefit from higher level latent entity planning. Here, we make use of entity-specific representations which are dynam ically updated. The text is generated conditioned on entity representations and the
records corresponding to the entities by using hierarchical attention at each time step.
We then combine planning with the high level organization of entities, events, and
their interactions. Such coarse-grained macro plans are learnt from data and given
as input to the generator. Finally, we present work on making macro plans latent
while incrementally generating a document paragraph by paragraph. We infer latent
plans sequentially with a structured variational model while interleaving the steps of
planning and generation. Text is generated by conditioning on previous variational
decisions and previously generated text.
Overall our results show that planning makes data-to-text generation more interpretable, improves the factuality and coherence of the generated documents and re duces redundancy in the output document
Theorising Christian Anarchism A Political Commentary on the Gospel
This thesis argues that there is a tradition in political theology and in political theory that deserves to be called "Christian anarchism." The various thinkers that contribute to this tradition have never before been considered to be part of a theoretical movement or tradition, and the originality of this thesis is to weave these thinkers together and present a generic theory of Christian anarchism. . Taken together, thinkers like Tolstoy, Ellul, Elliott and Andrews put forward a comprehensive exegesis of Jesus' teaching and example as implying a critique of the state and a vision of a stateless society. Based on this understanding of the Gospel, they accuse both the state and the church of contradicting, betraying and corrupting the essence of Christianity. Some Christian anarchists - Eller in particular - even see Romans 13 and the "render unto Caesar" passage as not discrediting but indeed confirming their interpretation, and although more activist Christian anarchists sometimes disagree on the potential role of civil disobedience, they do all stress that what matters above all is obedience to God Moreover, they all call for the "true" church to lead the Christian anarchist revolution by example, despite the very demanding sacrifices which this involves. They point to numerous examples of similar witness ever since the early church, and themselves strive to emulate such examples in their own lives - the Catholic Worker movement being perhaps the most notable example in this regard Thus, Christian anarchist thinkers' critique of the current order and appeal to follow God's radical commandments echoes the voices of the prophets of old, calling society to return to God's covenant. By weaving their scattered voices together - by theorising Christian anarchism - this thesis provides a political commentary on the Gospel which contributes as much to political theory as it does to political theology
The applied psychology of addictive orientations : studies in a 12-step treatment context.
The clinical data for the studies was collected at The PROMIS Recovery Centre, a Minnesota Model treatmentc entre for addictions,w hich encouragesth e membership and use of the 12 step Anonymous Fellowships, and is abstinence based. The area of addiction is contextualised in a review chapter which focuses on research relating to the phenomenon of cross addiction. A study examining the concept of "addictive orientations" in male and female addicts is described, which develops a study conductedb y StephensonM, aggi, Lefever, & Morojele (1995). This presents study found a four factor solution which appeared to be subdivisions of the previously found Hedonism and Nurturance factors. Self orientated nurturance (both food dimensions, shopping and caffeine), Other orientated nurturance (both compulsive helping dimensions and work), Sensation seeking hedonism (Drugs, prescription drugs, nicotine and marginally alcohol), and Power related hedonism (Both relationship dimensions, sex and gambling. This concept of "addictive orientations" is further explored in a non-clinical population, where again a four factor solution was found, very similar to that in the clinical population. This was thought to indicate that in terms of addictive orientation a pattern already exists in this non-clinical population and that consideration should be given to why this is the case. These orientations are examined in terms of gender differences. It is suggested that the differences between genders reflect power-related role relationships between the sexes. In order to further elaborate the significance and meaning behind these orientations, the next two chapters look at the contribution of personality variables and how addictive orientations relate to psychiatric symptomatology. Personality variables were differentially, and to a considerable extent predictably involved with the four factors for both males and females.Conscientiousness as positively associated with "Other orientated Nurturance" and negatively associated with "Sensation seeking hedonism" (particularly for men). Neuroticism had a particularly strong association with the "Self orientated Nurturance" factor in the female population. More than twice the symptomatology variance was explained by the factor scores for females than it was for males. The most important factorial predictors for psychiatric symptomatology were the "Power related hedonism" factor for males, and "Self oriented nurturance" for females. The results are discussed from theoretical and treatment perspectives
Understanding the adoption and implementation of Sector Skills Councils in Chile
Technical and Vocational Education and Training (TVET) policies have gained increased interest in global agendas, being a particular concern in ensuring that youths have the skills needed to enter the labour market. In this line, international organisations and cooperation agencies have widely promoted sector skills bodies. This policy seeks to involve employers in skills formation and foster collaboration among different stakeholders to ensure that the skills developed through TVET meet labour market needs. However, academic research about this specific policy is limited. Moreover, even when several countries have adopted these bodies, little is known about them from a policy transfer perspective (i.e. studying the travel of an education policy from one place to another). This thesis addresses this gap by examining the adoption and implementation of private-led Sector Skills Councils (SSCs) in Chile. Thus, two main research questions guided this study: Why and how private actors in Chile have adopted SSCs? How have different employers and TVET providers implemented SSCs’ initiatives in Chile?
This qualitative research utilised a multiple-case study design for which data was collected through semi-structured interviews and documents analysis. First, based on a Cultural Political Economy approach, the adoption of SSCs was investigated by examining the main factors that could account for the mechanisms involved in the process. Second, the implementation of SSCs was studied by considering a policy enactment focus and the principles of the Realist Evaluation approach to understand how two main actors affected by the policy, employers and TVET providers, have fulfilled the policy expectations.
The findings of this thesis show the crucial role of ideational factors (i.e. the influence of policy entrepreneur) to trigger policy change and the specific economic, institutional, political and educational conditions at the national and sectoral levels that may explain the adoption of SSCs. As a result, it advances our understanding of the different roles played by ideational and material factors in adopting SSCs as a TVET policy. Likewise, given the unusual private-led adoption of these bodies, this study provides an empirical demonstration of this uncommon situation. Simultaneously, it offers potential new insights about the assessments made by employers and their business associations when deciding to involve in skill formation policies. Moreover, by investigating the implementation of SSCs from the perspective of the main actors expected to enact the policy, this thesis provides an initial understanding of the varied contextual and stakeholder conditions affecting these actors’ responses to SSCs. In doing so, this thesis also offers an empirical demonstration of the limitations of SSCs adopted and implemented with a skills supply orthodoxy rhetoric
Feathers and Thorns: the politics of participation in mental health services
A key development in mental health service planning and delivery in the UK over the last fifteen years has been the introduction of user participation. Alongside this development has been the growth and expansion of the service user/survivor movement. Research in Canada and Australia has documented the 'unsettling relations' created by these demands for participation and power sharing. Research in the UK has also raised questions about the ability of user participation to create the cultural change some believe is required to prevent services from being disempowering. Feathers and Thorns explores the 'unsettling relations' and the conflict and power dynamics of user participation in mental health services, in a UK context, to address the lack of systematic research in this area. The study uses qualitative methods to investigate user participation in two statutory mental health settings in England, between 1997 and 1999. Feathers and Thorns found that the uncritical adoption of the consumerist approach has led to a 'business as usual' model of participation and a consequent lack of discernible organisational and cultural change. The influence of user groups within statutory mental health services rarely extends to setting agendas, with the 'rules of the game' of participation still firmly controlled by statutory partners. There was evidence of professional and organisational resistance, as user participation destabilised the roles of both users and professionals and boundaries became increasingly blurred. It is suggested
that this destabilising of traditional roles provides evidence of a shift in power relations, despite continued organisational and professional resilience to change. Although user participation was considered to be an effective strategy to legitimate existing power relationships and give the illusion of change: there was evidence that user groups and individuals have also gained from these processes, particularly in terms of raised consciousness, increased activism and self-assurance
Listening to Rivers: Using sound to monitor rivers
From a babbling brook to a thunderous torrent, a rivers' soundscape can be described by many onomatopoeic words. Using sound produced sub-aerially by a river to calculate its stage is an entirely novel idea, designed to be used in an environment that is seldom monitored, headwater catchments. In these environments it is difficult to use traditional methods of automatic stage gauging, such as pressure transducers and ultrasonic depth monitors. I propose a cost-effective, simple to install sound monitor which can be simply placed beside a river that is making a noise. I develop a method of how to take the tempest that is river sound and filter it to a usable component using data collected from around the North East of England during Storm Ciara and Dennis, 2020. Understanding where river sound is generated from and the mechanisms behind it are key to developing sound monitoring which is why I use an experiment at a white water course to investigate the link between sound and river topography. Using an artificial channel and obstacles I investigate the link between obstacle height and configuration on the production of sound. To use river sound as a proxy for river stage, there has to be a process of how to setup and calibrate sound. I present a method of how one may go about setting up a sound monitor and the usage it may have in water resource management. Finally, I apply the method of sound filtering, river placement, and calibration at a catchment scale to determine its validity in river monitoring. Although novel, using sound to monitor a rivers' stage is practical and deployable
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