Identifying high-impact sub-structures for convolution kernels in document-level sentiment classification

Convolution kernels support the modeling of complex syntactic information in machine-learning tasks. However, such models are highly sensitive to the type and size of syntactic structure used. It is therefore an important challenge to automatically identify high impact sub-structures relevant to a given task. In this paper we present a systematic study investigating (combinations of) sequence and convolution kernels using different types of substructures in document-level sentiment classification. We show that minimal sub-structures extracted from constituency and dependency trees guided by a polarity lexicon show 1.45 point absolute improvement in accuracy over a bag-of-words classifier on a widely used sentiment corpus

A quantitative comparison between the essential medicines for rheumatic diseases in children and young people in Africa and the WHO model list

\ua9 The Author(s) 2024.Background: The World Health Organisation Essential Medicines List (WHO EML) guides National Essential Medicines Lists and Standard Treatment Guidelines for clearly identified disease priorities especially in low- and middle-income countries. This study compares the degree to which the basket of medicines recommended for rheumatic diseases in children and young people in National Essential Medicines Lists of countries in the WHO Africa region, corresponds to the 2021 WHO EML and WHO EML for children, as a proxy of availability. Methods: An online search of the WHO medicines and health technology portal, the Health Ministry websites of the 54 African countries, PUBMED and Google Scholar, with search terms for ‘National Essential Medicines List’, AND/OR ‘standard treatment guidelines’ AND/OR ‘Lista Nacional de Medicamentos Essenciais’ AND/ OR ‘Liste Nationale de Medicaments Essentiels’ AND Africa AND/OR < Name of African country > was conducted. The number of medicines on the national lists were compared according to a predefined template of medicines; and the percentage similarity calculated. Descriptive statistics were derived using STATA. Results: Forty-seven countries in the WHO Africa region have developed a National Essential Medicines List. Eleven countries do not have any medicines listed for rheumatic diseases. The majority of countries had less than or equal to 50% similarity with the WHO EML for rheumatic disease in children and young people, median 3 medicines (IQR 1— 4). The most common medicines on the national lists from Africa were methotrexate, sulfasalazine and azathioprine, with etanercept available in 6 countries. Seven countries had only one medicine, acetylsalicylic acid listed in the section ‘Juvenile Joint diseases’. A multiple linear regression model for the predictors of the number of medicines on the national lists established that 20% of the variability was predicted by health expenditure per capita, socio-demographic index and the availability of rheumatology services (adult and/or paediatric) p = 0.006, with socio-demographic index (p = 0.035, 95% CI 0.64—16.16) and the availability of rheumatology services (p = 0.033, 95% CI 0.13 – 2.90) significant. Conclusion: Four countries (8.5%) in Africa have updated their National Essential Medicines Lists to reflect adequate care for children and young people with rheumatic diseases. Moving forward, efforts should focus on aligning available medicines with the WHO EML, and strengthening healthcare policy for rheumatology and pharmaceutical services, for affordable access to care and medicines

Beyond pGALS: the need for a multifaceted musculoskeletal decision-making tool (\u27pGALSplus\u27) in community-based clinical practice

\ua9 The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. Musculoskeletal (MSK) problems in children are common, and health-care professionals must identify those requiring onward referral. Paediatric gait, arms, legs and spine (pGALS) is an MSK assessment to discern abnormal joints. We aimed to identify MSK assessments to add to pGALS (pGALSplus) to facilitate decision-making in the context of exemplar conditions representing a spectrum of MSK presentations, namely JIA, mucopolysaccharidoses, muscular dystrophy and developmental co-ordination disorder. A literature review identified 35 relevant articles that focused on clinical assessments [including questionnaire(s), physical examination and functional tests] used by health-care professionals in the context of the exemplar conditions. We provide a description of these assessments and the rationale regarding how they, or components of such tools, might be useful within pGALSplus. This process provides a foundation for further work to develop and validate pGALSplus

Unifying Theories of Reactive Design Contracts

Design-by-contract is an important technique for model-based design in which a composite system is specified by a collection of contracts that specify the behavioural assumptions and guarantees of each component. In this paper, we describe a unifying theory for reactive design contracts that provides the basis for modelling and verification of reactive systems. We provide a language for expression and composition of contracts that is supported by a rich calculational theory. In contrast with other semantic models in the literature, our theory of contracts allow us to specify both the evolution of state variables and the permissible interactions with the environment. Moreover, our model of interaction is abstract, and supports, for instance, discrete time, continuous time, and hybrid computational models. Being based in Unifying Theories of Programming (UTP), our theory can be composed with further computational theories to support semantics for multi-paradigm languages. Practical reasoning support is provided via our proof framework, Isabelle/UTP, including a proof tactic that reduces a conjecture about a reactive program to three predicates, symbolically characterising its assumptions and guarantees about intermediate and final observations. This allows us to verify programs with a large or infinite state space. Our work advances the state-of-the-art in semantics for reactive languages, description of their contractual specifications, and compositional verification

Population-Based Utility of van Herick Grading for Angle-Closure Detection

Primary angle-closure glaucoma accounts for half of glaucoma-related blindness worldwide with a disproportionate burden of disease found in Asian populations. The clinical reference standard for diagnosis of angle closure is gonioscopy, but van Herick (VH) grading of limbal anterior chamber depth (LACD) has been used as a screening tool, with varying sensitivities and specificities on classifying gonioscopically occludable angles reported in Chinese and other East Asian populations. A cutoff of VH grade ≤1 (modified grade ≤15%) has been found to have sensitivities ranging from 19% to 84% and specificities from 86% to 100%, whereas a higher cutoff VH grade ≤2 (modified grade ≤25%) has had sensitivities ranging from 54% to 99% and specificities from 65% to 96%. However, the efficacy of using the VH test as a screening tool in community-based screening programs to identify gonioscopically occludable angle has not been investigated. The purpose of this study was to determine the sensitivity and specificity of modified VH grading of LACD in detecting gonioscopically defined primary angle-closure suspects (PACS) among subjects screened for participation in the Zhongshan Angle Closure Prevention (ZAP) Trial in southern China

The development of pGALSplus: evaluating feasibility and acceptability of an assessment to facilitate the identification and triage of children with musculoskeletal presentations

\ua9 2024 The Author(s). Objectives: Healthcare professionals (HCPs) need to identify potentially serious musculoskeletal (MSK) presentations in children and refer them to specialists appropriately. Our aim was to develop \u27pGALSplus\u27 (paediatric gait, arms, legs and spine plus) to support clinical assessment, aid decision-making and assess feasibility and acceptability in exemplar MSK pathologies. Methods: We used a three-phase mixed methods approach: phase 1, preliminary stakeholder engagement and scoping review to propose pGALSplus; phase 2, iterative development of pGALSplus involving an expert working group; and phase 3, testing the feasibility of pGALSplus in exemplar MSK conditions [JIA, mucopolysaccharidoses (MPS), muscular dystrophy (MD), developmental coordination disorder (DCD) and healthy controls (HCs)]. The final pGALSplus was derived from analysis of phase 3 data and feedback from HCPs, families and expert consensus input from an international e-survey (n = 22) and virtual event (n = 13). Results: Feasibility was tested in 45 children (JIA, n = 10; MPS, n = 6; MD, n = 9; DCD, n = 10; HCs, n = 10). Overall the assessment was achievable in the target age range (2-10 years) and quick to complete [median 12 min (range 8-20)], with high acceptability from families. Expert feedback deemed pGALSplus to be very useful and of particular use to non-specialists in MSK paediatrics. The final pGALSplus comprises 26 clinical observations/skills with a colour-coding approach to aid decision-making and identification of more serious MSK presentations and additional resources to support its use in clinical practice. Conclusions: pGALSplus is a novel evidence- and consensus-based assessment building on pGALS, with high acceptability and feasibility. As community-based MSK assessment in children becomes more established, we propose that pGALSplus will facilitate and inform decision-making to promote access to specialist care

Iris volume change with physiologic mydriasis to identify development of angle closure: the Zhongshan Angle Closure Prevention Trial

AIMS: To assess dynamic change of iris area (Iarea) and volume (VOL) with physiologic pupil dilation for progression of primary angle closure suspects. METHODS: Participants underwent baseline examinations including gonioscopy and anterior segment OCT (AS-OCT) as part of the Zhongshan Angle Closure Prevention Trial. The AS-OCT images were obtained both in the dark and light. Progression was defined as development of primary angle closure or an acute angle closure attack. Static ocular biometrics and dynamic changes were compared between progressors and non-progressors and multivariable logistic regression was developed to assess risk factors for progression. RESULTS: A mean 16.8% decrease in Iarea and a mean 6.26% decrease in VOL occurred with pupil dilation, while 22.96% non-progressors and 40% progressors presented VOL increases with pupil dilation. Iarea in light and dark and VOL in light were significantly smaller in progressors. In a multivariable logistic model, older age (p=0.008), narrower horizontal angle opening distance (AOD) 250 µm from the scleral spur (AOD250, p=0.001), flatter iris curvature (IC, p=0.006) and lower loss of iris volume (ΔVOL, p=0.04) were significantly associated with progression. With receiver operating characteristic analysis, the area under the curve for ΔVOL alone was 0.621, while that for the combined index (age, AOD250, IC and ΔVOL) was 0.824. Eyes with elevated intraocular pressure had less VOL loss compared with progressors developing peripheral anterior synechiae alone (p=0.055 for ΔVOL adjusted for pupil enlargement). CONCLUSION: A smaller change in ΔVOL is an additive risk factor to identify eyes more likely to develop angle closure disease. TRIAL REGISTRATION NUMBER: ISRCTN45213099