Dictionary-based Data Generation for Fine-Tuning Bert for Adverbial Paraphrasing Tasks

Recent advances in natural language processing technology have led to the emergence of large and deep pre-trained neural networks. The use and focus of these networks are on transfer learning. More specifically, retraining or fine-tuning such pre-trained networks to achieve state of the art performance in a variety of challenging natural language processing/understanding (NLP/NLU) tasks. In this thesis, we focus on identifying paraphrases at the sentence level using the network Bidirectional Encoder Representations from Transformers (BERT). It is well understood that in deep learning the volume and quality of training data is a determining factor of performance. The objective of this thesis is to develop a methodology for algorithmic generation of high-quality training data for paraphrasing task, an important NLU task, as well as the evaluation of the resulting training data on fine-tuning BERT to identify paraphrases. Here we will focus on elementary adverbial paraphrases, but the methodology extends to the general case. In this work, training data for adverbial paraphrasing was generated utilizing an Oxfordiii synonym dictionary, and we used the generated data to re-train BERT for the paraphrasing task with strong results, achieving a validation accuracy of 96.875%

Redesigning College Algebra for Success: An Analysis of Student Performance

A section of College Algebra was redesigned to consist of best practices in instruction and assessment, a lower enrollment, and a required lab component in an effort to improve student performance. This pilot course consisted of instructional methods such as whole class instruction, small group instruction, and student presentations. Additional course revisions included a writing component using personal reflections, an additional lab component, a software package aligned with the adopted textbook, and bi-weekly progress reports. There was a statistically significant increase from pretest to posttest, as determined by a T-test. Other comparative analyses showed the course had the highest passing rate in the department. This class had the highest average on the departmental final exam. The faculty member teaching the course also had a higher passing rate when compared to courses she taught during previous semesters. According to these results based on student performance, this course was deemed successful

What impact does nursing care left undone have on patient outcomes? Review of the literature

AIMS AND OBJECTIVES: Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes. BACKGROUND: A considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear. DESIGN: Systematic review. METHODS: We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses' aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review. RESULTS: Fourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged. CONCLUSIONS: The review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self-reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required. RELEVANCE TO CLINICAL PRACTICE: Although nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses' reports of missed care and consider routine monitoring as a quality and safety indicator

The association between nurse staffing and omissions in nursing care: A systematic review.

AIMS: To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing. BACKGROUND: Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. DESIGN: Systematic review. DATA SOURCES: We searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. REVIEW METHODS: Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. RESULTS: Eighteen studies gave subjective reports of missed care. Seventy-five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. CONCLUSIONS: Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated

Representation of Gender in Middle Grades Mathematics Textbooks Used in Southwest Georgia

Empirical research has shown gender-related differences in educational materials contribute to females and males performance in mathematics. The purpose of this study was to investigate the degree of representation of females and males in middle grades mathematics textbooks used in southwest Georgia. The most frequently used sixth and seventh grade mathematics textbooks, identified by school system personnel in southwest Georgia, were selected for this study. Content analysis methodologies used were illustration analysis and textual analysis. Chi square was used to test for significant differences between variables. Coding rules and instruments were developed to collect the data of interest systematically and consistently for illustrations and text of middle grades mathematics textbooks. There were relatively even frequency counts of females and males represented in both illustrations and text of middle grades mathematics textbooks used in southwest Georgia. However, patterns emerged which indicated the use of more gender-neutral language and some stereotyping of females and males when analyzing the other gender roles. In both illustration analysis and textual analysis, females and males were portrayed in more gender-neutral roles than any other role. In illustrations and text, males were depicted in more traditional roles than females; and females were portrayed in more nontraditional roles than males.ii TABLE OF CONTENTS INTRODUCTION..............................................................................................................1 Statement of the Problem........................................................................................4 Purpose of the Study...............................................................................................6 Research Question...................................................................................................6 Significance of the Study........................................................................................7 Definitions...............................................................................................................8 REVIEW OF LITERATURE...........................................................................................10 Concerns of Gender Inequalities...........................................................................10 Defining Gender Language Forms........................................................................12 Georgia Textbook Selection..................................................................................14 Instructional Materials..........................................................................................15 Middle School.......................................................................................................17 Adolescence..........................................................................................................17 Adolescents and Identity.......................................................................................19 Mathematics Achievement....................................................................................21 Stereotyping of Mathematics................................................................................23 Gender Bias in Other Educational Materials........................................................25 Gender Bias in Mathematics Textbooks...............................................................26 Career Choices......................................................................................................31 Summary...............................................................................................................32 METHOD..........................................................................................................................34 Scope of the Study................................................................................................34 iii Research Questions...............................................................................................36 Description of Study Variables.............................................................................37 Sampling Procedures.............................................................................................37 Design and Procedures..........................................................................................41 Krippendorffs Procedures in Content Analysis...................................................43 Data Collection.....................................................................................................47 Data Analysis........................................................................................................57 Summary...............................................................................................................58 RESULTS.........................................................................................................................60 Content Analysis for Illustrations.........................................................................61 Research Questions for Illustrations.....................................................................61 Content Analysis for Text.....................................................................................64 Research Questions for Text.................................................................................64 Summary...............................................................................................................67 DISCUSSION...................................................................................................................69 Recommendations.................................................................................................75 Implications...........................................................................................................75 Future Research.....................................................................................................77 Conclusion............................................................................................................77 REFERENCES.................................................................................................................79 APPENDICES..................................................................................................................87 Appendix A: Mathematics Textbooks Recommended by Georgia......................88 Appendix B: Coding Instrument for Illustrations.................................................89 Appendix C: Coding Rules for Illustrations.........................................................90 Appendix D: Coding Instrument for Text.............................................................91 Appendix E: Coding Rules for Text .....................................................................92 Appendix F: IRB Approval...................................................................................93 Appendix G: Permission of Sage Publications, Inc..............................................94Brovey, Andrew J.Lowney, KathleenThomas, GeorgeStanley, Barbara K.Ed.D.Educatio

Care processes and racial/ethnic differences in family reports of end‐of‐life care among Veterans: A mediation analysis

BACKGROUND: Bereaved family members of racial/ethnic minority Veterans are less likely than families of White Veterans to provide favorable overall ratings of end-of-life (EOL) care quality; however, the underlying mechanisms for these differences have not been explored. The objective of this study was to examine whether a set of EOL care process measures mediated the association between Veteran race/ethnicity and bereaved families' overall rating of the quality of EOL care in VA medical centers (VAMCs). METHODS: A retrospective, cross-sectional analysis of linked Bereaved Family Survey (BFS), administrative and clinical data was conducted. The sample included 17,911 Veterans (mean age: 73.7; SD: 11.6) who died on an acute or intensive care unit across 121 VAMCs between October 2010 and September 2015. Mediation analyses were used to assess whether five care processes (potentially burdensome transitions, high-intensity EOL treatment, and the BFS factors of Care and Communication, Emotional and Spiritual Support, and Death Benefits) significantly affected the association between Veteran race/ethnicity and a poor/fair BFS overall rating. RESULTS: Potentially burdensome transitions, high-intensity EOL treatment, and the three BFS factors of Care and Communication, Emotional and Spiritual Support, and Death Benefits did not substantially mediate the relationship between Veteran race/ethnicity and poor/fair overall ratings of quality of EOL care by bereaved family members. CONCLUSIONS: The reasons underlying poorer ratings of quality of EOL care among bereaved family members of racial/ethnic minority Veterans remain largely unexplained. More research on identifying potential mechanisms, including experiences of racism, and the unique EOL care needs of racial and ethnic minority Veterans and their families is warranted

Safety and efficacy of nivolumab plus ipilimumab in patients with advanced renal cell carcinoma with brain metastases: CheckMate 920.

BACKGROUND: Nivolumab plus ipilimumab (NIVO + IPI) has demonstrated long-term efficacy and safety in patients with previously untreated, advanced renal cell carcinoma (aRCC). Although most phase 3 clinical trials exclude patients with brain metastases, the ongoing, multicohort phase 3b/4 CheckMate 920 trial (ClincalTrials.gov identifier NCT02982954) evaluated the safety and efficacy of NIVO + IPI in a cohort that included patients with aRCC and brain metastases, as reported here. METHODS: Patients with previously untreated aRCC and asymptomatic brain metastases received NIVO 3 mg/kg plus IPI 1 mg/kg every 3 weeks × 4 followed by NIVO 480 mg every 4 weeks. The primary end point was the incidence of grade ≥3 immune-mediated adverse events (imAEs) within 100 days of the last dose of study drug. Key secondary end points were progression-free survival and the objective response rate according to Response Evaluation Criteria in Solid Tumors, version 1.1 (both determined by the investigator). Exploratory end points included overall survival, among others. RESULTS: After a minimum follow-up of 24.5 months (N = 28), no grade 5 imAEs occurred. The most common grade 3 and 4 imAEs were diarrhea/colitis (n = 2; 7%) and hypophysitis, rash, hepatitis, and diabetes mellitus (n = 1 each; 4%). The objective response rate was 32% (95% CI, 14.9%-53.5%) with a median duration of response of 24.0 months; 4 of 8 responders remained without reported progression. Seven patients (25%) had intracranial progression. The median progression-free survival was 9.0 months (95% CI, 2.9-12.0 months), and the median overall survival was not reached (95% CI, 14.1 months to not estimable). CONCLUSIONS: In patients who had previously untreated aRCC and brain metastases-a population with a high unmet medical need that often is underrepresented in clinical trials-the approved regimen of NIVO + IPI followed by NIVO showed encouraging antitumor activity and no new safety signals

Anti-CTLA4 monoclonal antibodies: the past and the future in clinical application

Recently, two studies using ipilimumab, an anti-CTLA-4 monoclonal antibody (mab) demonstrated improvements in overall survival in the treatment of advanced melanoma. These studies utilized two different schedules of treatment in different patient categories (first and second line of treatment). However, the results were quite similar despite of different dosage used and the combination with dacarbazine in the first line treatment. We reviewed the result of randomized phase II-III clinical studies testing anti-CTLA-4 antibodies (ipilimumab and tremelimumab) for the treatment of melanoma to focus on practical or scientific questions related to the broad utilization of these products in the clinics. These analyses raised some considerations about the future of these compounds, their potential application, dosage, the importance of the schedule (induction/manteinance compared to induction alone) and their role as adjuvants. Anti-CTLA-4 antibody therapy represents the start of a new era in the treatment of advanced melanoma but we are on the steep slope of the learning curve toward the optimization of their utilization either a single agents or in combination

Addressing disparities in cancer clinical trials: a roadmap to more equitable accrual

The Georgia Center for Oncology Research and Education (Georgia CORE) and the Georgia Society of Clinical Oncology (GASCO) held a one-day summit exploring opportunities and evidence-based interventions to address disparities in cancer clinical trials. The purpose of the summit was to identify clear and concise recommendations aimed at decreasing clinical trial accrual disparities in Georgia for rural and minority populations. The summit included expert presentations, panel discussions with leaders from provider organizations throughout Georgia, and breakout sessions to allow participants to critically discuss the information presented. Over 120 participants attended the summit. Recognizing the need for evidence-based interventions to improve clinical trial accrual among rural Georgians and persons of color, summit participants identified four key areas of focus that included: improving clinical trial design, providing navigation for all, enhancing public education and awareness of cancer clinical trials, and identifying potential policy and other opportunities. A comprehensive list of takeaways and action plans was developed in the four key areas of focus with the expectation that implementation of the strategies that emerged from the summit will enhance cancer clinical trial accrual for all Georgians