Machine learning based natural language processing of radiology reports in orthopaedic trauma

OBJECTIVES: To compare different Machine Learning (ML) Natural Language Processing (NLP) methods to classify radiology reports in orthopaedic trauma for the presence of injuries. Assessing NLP performance is a prerequisite for downstream tasks and therefore of importance from a clinical perspective (avoiding missed injuries, quality check, insight in diagnostic yield) as well as from a research perspective (identification of patient cohorts, annotation of radiographs). METHODS: Datasets of Dutch radiology reports of injured extremities (n = 2469, 33% fractures) and chest radiographs (n = 799, 20% pneumothorax) were collected in two different hospitals and labeled by radiologists and trauma surgeons for the presence or absence of injuries. NLP classification was applied and optimized by testing different preprocessing steps and different classifiers (Rule-based, ML, and Bidirectional Encoder Representations from Transformers (BERT)). Performance was assessed by F1-score, AUC, sensitivity, specificity and accuracy. RESULTS: The deep learning based BERT model outperforms all other classification methods which were assessed. The model achieved an F1-score of (95 ± 2)% and accuracy of (96 ± 1)% on a dataset of simple reports (n= 2469), and an F1 of (83 ± 7)% with accuracy (93 ± 2)% on a dataset of complex reports (n= 799). CONCLUSION: BERT NLP outperforms traditional ML and rule-base classifiers when applied to Dutch radiology reports in orthopaedic trauma

Exploring social patterns of participation in university-entrance level mathematics in England

In recent years in England there has been considerable attention given to a range of apparent crises in mathematics education, one of which has been the long term decline of participation in university-entrance level (Advanced or A) mathematics. Given the negative impact upon mathematics participation of Curriculum 2000, together with the government’s emphasis on Science Technology Engineering and Mathematics (STEM) subjects, the political intent to increase participation in Advanced level mathematics is clear. This paper uses the National Pupil Database (NPD) to develop a descriptive statistical account of how completion of Advanced level mathematics varies along the social axes of SES, ethnicity and gender. The process of working with the NPD is discussed in some depth in order to clarify the processes involved in this type of quantitative analysis and to illustrate how this analysis can be used to raise questions about who is doing what mathematics in the post-16 age-range

Agro-materials : a bibliographic review

Facing the problems of plastic recycling and fossil resources exhaustion, the use of biomass to conceive new materials appears like a reasonable solution. Two axes of research are nowadays developed : on the one hand the synthesis of biodegradable plastics, whichever the methods may be, on the other hand the utilization of raw biopolymers, which is the object of this paper. From this perspective, the “plastic” properties of natural polymers, the caracteristics of the different classes of polymers, the use of charge in vegetable matrix and the possible means of improving the durability of these agro-materials are reviewed

Acceptability of the internet-based Chlamydia screening implementation in the Netherlands and insights into nonresponse.

BACKGROUND: The study assessed the acceptability of internet-based Chlamydia screening using home-testing kits among 16- to 29-year-old participants and nonparticipants in the first year of a Chlamydia Screening Implementation program in the Netherlands. METHODS: Questionnaire surveys were administered to randomly selected participants (acceptability survey) and nonparticipants (nonresponse survey) in 3 regions of the Netherlands where screening was offered. Participants received email invitations to an online survey; nonparticipants received postal questionnaires. Both surveys enquired into opinions on the screening design, reasons for (non-) participation and future willingness to be tested. RESULTS: The response rate was 63% (3499/5569) in the acceptability survey and 15% (2053/13,724) in the nonresponse survey. Primary motivation for participating in the screening was "for my health" (63%). The main reason for nonresponse given by sexually active nonparticipants was "no perceived risk of infection" (40%). Only 2% reported nonparticipation due to no internet access. Participants found the internet (93%) and home-testing (97%) advantages of the program, regardless of test results. Two-thirds of participants would test again, 92% via the screening program. Half of nonparticipants were appreciative of the program design, while about 1 in 5 did not like internet usage, home-testing, or posting samples. CONCLUSIONS: The screening method was highly acceptable to participants. Nonparticipants in this survey were generally appreciative of the program design. Both groups made informed choices about participation and surveyed low-risk nonparticipants accurately perceived their low-risk status. Although many nonparticipants were not reached by the nonresponse survey, current insights on acceptability and nonresponse are undoubtedly valuable for evaluation of the current program

The political dimension: added value for cross-cultural analysis:Nozawa and Smits, two CEO's and their public statements

Work-related cultural differences, which were familiarized by scholars such as Hall and Hofstede, offer important concepts to help us understand various forms of cooperation and communication. However, the predominant focus of cultural analysis on collectivistic harmony prevents us from gaining an understanding of strategy and conflict. In an attempt to grasp how conflicts are handled, a political analysis can provide new insights. This is illustrated by a comparative study of two CEOs who gave public statements concerning management failure: Shouhei Nozawa of Yamaichi and Paul Smits of KPN. Their statements were strikingly different in several ways, but the classical insights of cross-cultural analysis can only partly explain the differences. This is where political analysis comes in, focusing on interest relationships, responsibilities and virtues, tactics and strategy

Competing risks survival analysis applied to data from the Australian Orthopaedic Association National Joint Replacement Registry

BACKGROUND AND PURPOSE: The Kaplan-Meier (KM) method is often used in the analysis of arthroplasty registry data to estimate the probability of revision after a primary procedure. In the presence of a competing risk such as death, KM is known to overestimate the probability of revision. We investigated the degree to which the risk of revision is overestimated in registry data. PATIENTS AND METHODS: We compared KM estimates of risk of revision with the cumulative incidence function (CIF), which takes account of death as a competing risk. We considered revision by (1) prosthesis type in subjects aged 75–84 years with fractured neck of femur (FNOF), (2) cement use in monoblock prostheses for FNOF, and (3) age group in patients undergoing total hip arthroplasty (THA) for osteoarthritis (OA). RESULTS: In 5,802 subjects aged 75–84 years with a monoblock prosthesis for FNOF, the estimated risk of revision at 5 years was 6.3% by KM and 4.3% by CIF, a relative difference (RD) of 46%. In 9,821 subjects of all ages receiving an Austin Moore (non-cemented) prosthesis for FNOF, the RD at 5 years was 52% and for 3,116 subjects with a Thompson (cemented) prosthesis, the RD was 79%. In 44,365 subjects with a THA for OA who were less than 70 years old, the RD was just 1.4%; for 47,430 subjects > 70 years of age, the RD was 4.6% at 5 years. INTERPRETATION: The Kaplan-Meier method substantially overestimated the risk of revision compared to estimates using competing risk methods when the risk of death was high. The bias increased with time as the incidence of the competing risk of death increased. Registries should adopt methods of analysis appropriate to the nature of their data.Marianne H. Gillam, Philip Ryan, Stephen E. Graves, Lisa N. Miller, Richard N. de Steiger and Amy Salte

Making Sense Through Participation

In this chapter we discuss the issue of social differences in relation to learning. In theories on co-operative learning or collaborative learning social differences are treated as characteristics of individual learners. The focus on learning as a social process is primarily elaborated in terms of interaction between pupils and the combined construction of knowledge. Sociocultural theory (Vygotsky, Lave & Wenger), however, understands ‘social’ not only in terms of knowledge/meaning being constructed in interaction with others, but also in terms of the cultural practices/activities informing these interaction processes. Learning can be understood as increasing participating in communities of practice. As social differences are an intrinsic part of the culture in which students are learning to participate, these are also an inherent aspect of learning processes in schools. Students learn to participate in practices in different ways, depending on their social position, and thus develop distinguished cultural identities. In this chapter we elaborate on this tenet, using examples from various empirical research projects on learning in secondary education. We not only show how social differences in the cultural practices that underpin learning influence what is learned by whom, but also explore the consequences of this perspective for the pedagogical space of the school

Different competing risks models applied to data from the Australian Orthopaedic Association National Joint Replacement Registry

Purpose: Here we describe some available statistical models and illustrate their use for analysis of arthroplasty registry data in the presence of the competing risk of death, when the influence of covariates on the revision rate may be different to the influence on the probability (that is, risk) of the occurrence of revision. Patients and methods: Records of 12,525 patients aged 75–84 years who had received hemiarthroplasty for fractured neck of femur were obtained from the Australian Orthopaedic Association National Joint Replacement Registry. The covariates whose effects we investigated were: age, sex, type of prosthesis, and type of fixation (cementless or cemented). Extensions of competing risk regression models were implemented, allowing the effects of some covariates to vary with time. Results: The revision rate was significantly higher for patients with unipolar than bipolar prostheses (HR = 1.38, 95% CI: 1.01–1.89) or with monoblock than bipolar prostheses (HR = 1.45, 95% CI: 1.08–1.94). It was significantly higher for the younger age group (75–79 years) than for the older one (80–84 years) (HR = 1.28, 95% CI: 1.05–1.56) and higher for males than for females (HR = 1.37, 95% CI: 1.09–1.71). The probability of revision, after correction for the competing risk of death, was only significantly higher for unipolar prostheses than for bipolar prostheses, and higher for the younger age group. The effect of fixation type varied with time; initially, there was a higher probability of revision for cementless prostheses than for cemented prostheses, which disappeared after approximately 1.5 years. Interpretation: When accounting for the competing risk of death, the covariates type of prosthesis and sex influenced the rate of revision differently to the probability of revision. We advocate the use of appropriate analysis tools in the presence of competing risks and when covariates have time-dependent effects.Marianne H Gillam, Amy Salter, Philip Ryan, and Stephen E Grave

Parent perceptions and attributions for children's math achievement

From junior high school on, girls report lower estimations of their math ability and express more negative attitudes about math than do boys, despite equivalent performance in grades. Parents show this same sex-typed bias. This paper examines the role that attributions may play in explaining these sex differences in parents' perceptions of their children's math ability. Mothers and fathers of 48 junior high school boys and girls of high, average, and low math ability completed questionnaires about their perceptions of their child's ability and effort in math, and their causal attributions for their child's successful and unsuccessful math performances. Parents' math-related perceptions and attributions varied with their child's level of math ability and gender. Parents credited daughters with more effort than sons, and sons with more talent than daughters for successful math performances. These attributional patterns predicted sex-linked variations in parents' ratings of their child's effort and talent. No sex of child effects emerged for failure attributions; instead, lack of effort was seen as the most important, and lack of ability as the least important, cause of unsuccessful math performances for both boys and girls. Implications of these attributions for parents' influence on children's developing self-concept of math ability, future expectancies, and subsequent achievement behaviors are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45585/1/11199_2004_Article_BF00289840.pd

Cortical Thinning in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure

Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD