Incremental Learning from Scratch for Task-Oriented Dialogue Systems

Clarifying user needs is essential for existing task-oriented dialogue systems. However, in real-world applications, developers can never guarantee that all possible user demands are taken into account in the design phase. Consequently, existing systems will break down when encountering unconsidered user needs. To address this problem, we propose a novel incremental learning framework to design task-oriented dialogue systems, or for short Incremental Dialogue System (IDS), without pre-defining the exhaustive list of user needs. Specifically, we introduce an uncertainty estimation module to evaluate the confidence of giving correct responses. If there is high confidence, IDS will provide responses to users. Otherwise, humans will be involved in the dialogue process, and IDS can learn from human intervention through an online learning module. To evaluate our method, we propose a new dataset which simulates unanticipated user needs in the deployment stage. Experiments show that IDS is robust to unconsidered user actions, and can update itself online by smartly selecting only the most effective training data, and hence attains better performance with less annotation cost.Comment: ACL201

Multi-Teacher Knowledge Distillation For Text Image Machine Translation

Text image machine translation (TIMT) has been widely used in various real-world applications, which translates source language texts in images into another target language sentence. Existing methods on TIMT are mainly divided into two categories: the recognition-then-translation pipeline model and the end-to-end model. However, how to transfer knowledge from the pipeline model into the end-to-end model remains an unsolved problem. In this paper, we propose a novel Multi-Teacher Knowledge Distillation (MTKD) method to effectively distillate knowledge into the end-to-end TIMT model from the pipeline model. Specifically, three teachers are utilized to improve the performance of the end-to-end TIMT model. The image encoder in the end-to-end TIMT model is optimized with the knowledge distillation guidance from the recognition teacher encoder, while the sequential encoder and decoder are improved by transferring knowledge from the translation sequential and decoder teacher models. Furthermore, both token and sentence-level knowledge distillations are incorporated to better boost the translation performance. Extensive experimental results show that our proposed MTKD effectively improves the text image translation performance and outperforms existing end-to-end and pipeline models with fewer parameters and less decoding time, illustrating that MTKD can take advantage of both pipeline and end-to-end models.Comment: Accepted at The 17th International Conference on Document Analysis and Recognition (ICDAR 2023

Multidrug-resistant tuberculosis in middle ear: A case report

Background: Tuberculosis (TB) continues to be a common disease in developing countries, among which middle ear TB is rare. Furthermore, it is relatively difficult to make an early diagnosis and provide follow-up treatment for middle ear TB. So, it is necessary to report this case for reference and further discussion. Case presentation: We reported 1 case of multidrug-resistant tuberculosis otitis media. TB otitis media is rare in tuberculosis; multidrug-resistant TB otitis media is even more rare. Our paper analyzes the possible causes, imaging, molecular biology, pathology, and clinical manifestations of multidrug-resistant TB otitis media. Conclusion: PCR and DNA molecular biology techniques are highly recommended for the early diagnosis of multidrug-resistant TB otitis media. Early, effective anti-tuberculosis treatment is the guarantee for further recovery for patients with multidrug-resistant TB otitis media

E2TIMT: Efficient and Effective Modal Adapter for Text Image Machine Translation

Text image machine translation (TIMT) aims to translate texts embedded in images from one source language to another target language. Existing methods, both two-stage cascade and one-stage end-to-end architectures, suffer from different issues. The cascade models can benefit from the large-scale optical character recognition (OCR) and MT datasets but the two-stage architecture is redundant. The end-to-end models are efficient but suffer from training data deficiency. To this end, in our paper, we propose an end-to-end TIMT model fully making use of the knowledge from existing OCR and MT datasets to pursue both an effective and efficient framework. More specifically, we build a novel modal adapter effectively bridging the OCR encoder and MT decoder. End-to-end TIMT loss and cross-modal contrastive loss are utilized jointly to align the feature distribution of the OCR and MT tasks. Extensive experiments show that the proposed method outperforms the existing two-stage cascade models and one-stage end-to-end models with a lighter and faster architecture. Furthermore, the ablation studies verify the generalization of our method, where the proposed modal adapter is effective to bridge various OCR and MT models.Comment: Accepted at The 17th International Conference on Document Analysis and Recognition (ICDAR 2023

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society