Interrater Reliability in Toxicity Identification: Limitations of Current Standards.

PurposeThe National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v5.0 is the standard for oncology toxicity encoding and grading, despite limited validation. We assessed interrater reliability (IRR) in multireviewer toxicity identification.Methods and materialsTwo reviewers independently reviewed 100 randomly selected notes for weekly on-treatment visits during radiation therapy from the electronic health record. Discrepancies were adjudicated by a third reviewer for consensus. Term harmonization was performed to account for overlapping symptoms in CTCAE. IRR was assessed based on unweighted and weighted Cohen's kappa coefficients.ResultsBetween reviewers, the unweighted kappa was 0.68 (95% confidence interval, 0.65-0.71) and the weighted kappa was 0.59 (0.22-1.00). IRR was consistent between symptoms noted as present or absent with a kappa of 0.6 (0.66-0.71) and 0.6 (0.65-0.69), respectively.ConclusionsSignificant discordance suggests toxicity identification, particularly retrospectively, is a complex and error-prone task. Strategies to minimize IRR, including training and simplification of the CTCAE criteria, should be considered in trial design and future terminologies

Research in interactive scene analysis

An interactive scene interpretation system (ISIS) was developed as a tool for constructing and experimenting with man-machine and automatic scene analysis methods tailored for particular image domains. A recently developed region analysis subsystem based on the paradigm of Brice and Fennema is described. Using this subsystem a series of experiments was conducted to determine good criteria for initially partitioning a scene into atomic regions and for merging these regions into a final partition of the scene along object boundaries. Semantic (problem-dependent) knowledge is essential for complete, correct partitions of complex real-world scenes. An interactive approach to semantic scene segmentation was developed and demonstrated on both landscape and indoor scenes. This approach provides a reasonable methodology for segmenting scenes that cannot be processed completely automatically, and is a promising basis for a future automatic system. A program is described that can automatically generate strategies for finding specific objects in a scene based on manually designated pictorial examples

Cylindrical gravitational waves in expanding universes: Models for waves from compact sources

New boundary conditions are imposed on the familiar cylindrical gravitational wave vacuum spacetimes. The new spacetime family represents cylindrical waves in a flat expanding (Kasner) universe. Space sections are flat and nonconical where the waves have not reached and wave amplitudes fall off more rapidly than they do in Einstein-Rosen solutions, permitting a more regular null inifinity.Comment: Minor corrections to references. A note added in proo

An Examination of the Challenges Experienced by Canadian Ice-Hockey Players in the National Hockey League

Semistructured interviews were used in this study to learn about the challenges experienced by four groups of National Hockey League (NHL) players (N=11): prospects (n=3), rookies (n=3), veterans (n=2), and retirees (n=3). The database is comprised of 757 meaning units grouped into 11 contextual challenges pertaining to scouting demands, training camp, increased athletic demands, team expectations, and earning team trust. The veterans spoke mostly of challenges including scouting demands, athletic demands, and team expectations. Retirees considered mostly challenges pertaining to team expectations, athletic demands, lifestyle, media demands, transactions, cross-cultural encounters, and playoffs. An expert panel ensured that the interview guide, data analysis, and the findings represented the participants’ experiences in the NHL. Recommendations for practitioners and researchers working with NHL players are proposed

Social and Discourse Contributions to the Determination of Reference in Cross-Situational Word Learning

How do children infer the meanings of their first words? Even in infant-directed speech, object nouns are often used in complex contexts with many possible referents and in sentences with many other words. Previous work has argued that children can learn word meanings via cross-situational observation of correlations between words and their referents. While cross-situational associations can sometimes be informative, social cues to what a speaker is talking about can provide a powerful shortcut to word meaning. The current study takes steps toward quantifying the informativeness of cues that signal speakers' chosen referent, including their eye-gaze, the position of their hands, and the referents of their previous utterances. We present results based on a hand-annotated corpus of 24 videos of child-caregiver play sessions with children from 6 to 18 months old, which we make available to researchers interested in similar issues. Our analyses suggest that although they can be more useful than cross-situational information in some contexts, social and discourse information must also be combined probabilistically to be effective in determining reference.National Science Foundation (U.S.) (NSF #DDRIG #0746251)United States. Department of Education (Jacob K. Javits Graduate Fellowship

The Effect of Symmetrical, Hand-held Load Carriage on Thoracic Rotation during Gait: An Observational Study

Title: The Effect of Symmetrical, Hand-held Load Carriage on Thoracic Rotation during Gait: An Observational Study Authors: Danny J. McMillian, PT, DSc, OCS, CSCS ; Robert C. Bennett, SPT ; Claire E. Tenenbaum, SPT ; Daniel C. Winnwalker, SPT Affiliation: Physical Therapy Program, University of Puget Sound Purpose: During unloaded ambulation arm, trunk and leg motion produces reciprocal, anti-phase rotation between the pelvis and thoracic spine. Anti-phase rotation allows for efficient, stable gait patterns and promotes balanced segmental forces. Research demonstrates that several common factors cause in-phase thoracic spine and pelvic rotation resulting in decreased gait efficiency. Factors include load carriage, slow gait velocity, and locomotor pathologies that promote protective spinal stabilization such as low back pain and pregnancy-related pelvic girdle pain. Since painful spinal and pelvic conditions are frequently treated with physical therapy interventions that promote stabilization, clinicians should be cognizant of the degree to which such exercises may alter normal gait mechanics.A previous, as yet unpublished study from our lab has shown that gait mechanics transition from anti-phase to in-phase rotation with as little as 5% of an individual’s body weight carried as a asymmetrical hand-held load. The purpose of the current study was to establish if altered gait kinematics, specifically thoracic spinal rotation relative to the pelvis, occurs with symmetrical hand-held loads. Subjects: Adult volunteers, 18-30 years old, with no gait or health complications. Materials & Methods: Each subject walked at a cadence of 100 beats per minute for a distance of 48 feet and repeated seven different conditions three times in randomized order. The conditions were: 1) no load, 2) holding an empty canvas bag in each hand, 3) holding 2% of body weight (BW), 4) holding 4% BW, 5) holding 6% BW, 6) holding 8% BW, and 7) holding 10% BW. Each percentage of BW was carried bilaterally and subjects were blinded to conditions 2-7. Ten Bonita cameras recorded each condition at 120 hertz, and gait kinematics were analyzed with VICON Nexus 1.8.4 motion analysis system. In order to compare the average thoracic rotation relative to the pelvis for each condition a repeated measures ANOVA with Bonferroni adjustment was performed with alpha value p\u3c0.05. Results: Compared to condition 1 (unloaded walking), condition 2-7 demonstrated significant decrease in rotational angles of the thoracic spine relative to the pelvis (p\u3c0.001). Furthermore, condition 2 demonstrated a significant decrease in thoracic rotation as compared to conditions 5 (p\u3c0.004) and 7 (p\u3c0.034). Conclusion: Thoracic spine rotation decreases when walking with unloaded bags in each hand. Diminished rotation was likely due to decreasing arm swing. Consistent with the effects of muscular stabilization, increased load generally decreased rotation further. Clinical Relevance: This information is clinically applicable when working with individuals who have some degree of in-phase gait kinematics and need rehabilitation in order to return to activities that necessitate gait with hand-held loads. In these cases, clinicians should consider first reestablishing optimal transverse plane kinematics, then incorporating only the minimally necessary amount of hand-held load

A Bayesian framework for cross-situational word-learning

For infants, early word learning is a chicken-and-egg problem. One way to learn a word is to observe that it co-occurs with a particular referent across different situations. Another way is to use the social context of an utterance to infer the intended referent of a word. Here we present a Bayesian model of cross-situational word learning, and an extension of this model that also learns which social cues are relevant to determining reference. We test our model on a small corpus of mother-infant interaction and find it performs better than competing models. Finally, we show that our model accounts for experimental phenomena including mutual exclusivity, fast-mapping, and generalization from social cues

Explaining human multiple object tracking as resource-constrained approximate inference in a dynamic probabilistic model

Multiple object tracking is a task commonly used to investigate the architecture of human visual attention. Human participants show a distinctive pattern of successes and failures in tracking experiments that is often attributed to limits on an object system, a tracking module, or other specialized cognitive structures. Here we use a computational analysis of the task of object tracking to ask which human failures arise from cognitive limitations and which are consequences of inevitable perceptual uncertainty in the tracking task. We find that many human performance phenomena, measured through novel behavioral experiments, are naturally produced by the operation of our ideal observer model (a Rao-Blackwelized particle filter). The tradeoff between the speed and number of objects being tracked, however, can only arise from the allocation of a flexible cognitive resource, which can be formalized as either memory or attention

Generative Invertible Networks (GIN): Pathophysiology-Interpretable Feature Mapping and Virtual Patient Generation

Machine learning methods play increasingly important roles in pre-procedural planning for complex surgeries and interventions. Very often, however, researchers find the historical records of emerging surgical techniques, such as the transcatheter aortic valve replacement (TAVR), are highly scarce in quantity. In this paper, we address this challenge by proposing novel generative invertible networks (GIN) to select features and generate high-quality virtual patients that may potentially serve as an additional data source for machine learning. Combining a convolutional neural network (CNN) and generative adversarial networks (GAN), GIN discovers the pathophysiologic meaning of the feature space. Moreover, a test of predicting the surgical outcome directly using the selected features results in a high accuracy of 81.55%, which suggests little pathophysiologic information has been lost while conducting the feature selection. This demonstrates GIN can generate virtual patients not only visually authentic but also pathophysiologically interpretable