186 research outputs found
Clinical Camel: An Open Expert-Level Medical Language Model with Dialogue-Based Knowledge Encoding
We present Clinical Camel, an open large language model (LLM) explicitly
tailored for clinical research. Fine-tuned from LLaMA-2 using QLoRA, Clinical
Camel achieves state-of-the-art performance across medical benchmarks among
openly available medical LLMs. Leveraging efficient single-GPU training,
Clinical Camel surpasses GPT-3.5 in five-shot evaluations on all assessed
benchmarks, including 64.3% on the USMLE Sample Exam (compared to 58.5% for
GPT-3.5), 77.9% on PubMedQA (compared to 60.2%), 60.7% on MedQA (compared to
53.6%), and 54.2% on MedMCQA (compared to 51.0%). In addition to these
benchmarks, Clinical Camel demonstrates its broader capabilities, such as
synthesizing plausible clinical notes. This work introduces dialogue-based
knowledge encoding, a novel method to synthesize conversational data from dense
medical texts. While benchmark results are encouraging, extensive and rigorous
human evaluation across diverse clinical scenarios is imperative to ascertain
safety before implementation. By openly sharing Clinical Camel, we hope to
foster transparent and collaborative research, working towards the safe
integration of LLMs within the healthcare domain. Significant challenges
concerning reliability, bias, and the potential for outdated knowledge persist.
Nonetheless, the transparency provided by an open approach reinforces the
scientific rigor essential for future clinical applications.Comment: for model weights, see https://huggingface.co/wanglab
A Systems Thinking Approach to Redesigning the Patient Experience to Reduce 30 Day Hospital Readmission
INTRODUCTION
The cost of medical care is spiraling out of control, and one of the many reasons is lack of preventative care, poor communication to the patient and primary caregiver(s) both in an inpatient and outpatient setting. There are potentially many reasons for this cost escalation, one of the drivers of this cost is 30 day readmission after a hospitalization and this is what was examined in this analysis.
The purpose of this paper in particular is to share what has been learned using a systems thinking approach to hospital readmissions and the patient experience. It is critical to understand the problems that occurred in the past. In addition, we will explain the methodology utilized and bring awareness to the iterative process. We will also demonstrate a suggested redesigned model
Mott physics and band topology in materials with strong spin-orbit interaction
Recent theory and experiment have revealed that strong spin-orbit coupling
can have dramatic qualitative effects on the band structure of weakly
interacting solids. Indeed, it leads to a distinct phase of matter, the
topological band insulator. In this paper, we consider the combined effects of
spin-orbit coupling and strong electron correlation, and show that the former
has both quantitative and qualitative effects upon the correlation-driven Mott
transition. As a specific example we take Ir-based pyrochlores, where the
subsystem of Ir 5d electrons is known to undergo a Mott transition. At weak
electron-electron interaction, we predict that Ir electrons are in a metallic
phase at weak spin-orbit interaction, and in a topological band insulator phase
at strong spin-orbit interaction. Very generally, we show that with increasing
strength of the electron-electron interaction, the effective spin-orbit
coupling is enhanced, increasing the domain of the topological band insulator.
Furthermore, in our model, we argue that with increasing interactions, the
topological band insulator is transformed into a "topological Mott insulator"
phase, which is characterized by gapless surface spin-only excitations. The
full phase diagram also includes a narrow region of gapless Mott insulator with
a spinon Fermi surface, and a magnetically ordered state at still larger
electron-electron interaction.Comment: 10+ pages including 3+ pages of Supplementary Informatio
Edible crabs “Go West”: migrations and incubation cycle of Cancer pagurus revealed by electronic tags
Crustaceans are key components of marine ecosystems which, like other exploited marine taxa, show seasonable patterns of distribution and activity, with consequences for their availability to capture by targeted fisheries. Despite concerns over the sustainability of crab fisheries worldwide, difficulties in observing crabs’ behaviour over their annual cycles, and the timings and durations of reproduction, remain poorly understood. From the release of 128 mature female edible crabs tagged with electronic data storage tags (DSTs), we demonstrate predominantly westward migration in the English Channel. Eastern Channel crabs migrated further than western Channel crabs, while crabs released outside the Channel showed little or no migration. Individual migrations were punctuated by a 7-month hiatus, when crabs remained stationary, coincident with the main period of crab spawning and egg incubation. Incubation commenced earlier in the west, from late October onwards, and brooding locations, determined using tidal geolocation, occurred throughout the species range. With an overall return rate of 34%, our results demonstrate that previous reluctance to tag crabs with relatively high-cost DSTs for fear of loss following moulting is unfounded, and that DSTs can generate precise information with regards life-history metrics that would be unachievable using other conventional means
Siblings, Stories and the Self: the sociological significance of young people’s sibling relationships
This article explores the significance of intra-generational ties with siblings to sociological understandings of the formation of social identity and sense of self in young people’s lives. Drawing on data from a qualitative study exploring young people’s sense of who they are and who they have the potential to become in the future, it is demonstrated that young people’s identities are often constructed in relation to how they are similar to or different from their sibling(s). Literature expounding the role of stories in the construction of the self is used to suggest that the comparing that is at the heart of the relational construction of sibling identities can occur through the telling and re-telling of family stories within the politics and power dynamics of existing relationships. The article concludes by suggesting that sibling relationships be conceptualized as part of a web of relationships in which young people are embedded
Gender Differences in Publication Output: Towards an Unbiased Metric of Research Performance
We examined the publication records of a cohort of 168 life scientists in the field of ecology and evolutionary biology to assess gender differences in research performance. Clear discrepancies in publication rate between men and women appear very early in their careers and this has consequences for the subsequent citation of their work. We show that a recently proposed index designed to rank scientists fairly is in fact strongly biased against female researchers, and advocate a modified index to assess men and women on a more equitable basis
Diagnostic potential of the plasma lipidome in infectious disease: application to acute SARS-CoV-2 infection
Improved methods are required for investigating the systemic metabolic effects of SARS-CoV-2 infection and patient stratification for precision treatment. We aimed to develop an effective method using lipid profiles for discriminating between SARS-CoV-2 infection, healthy controls, and non-SARS-CoV-2 respiratory infections. Targeted liquid chromatography–mass spectrometry lipid profiling was performed on discovery (20 SARS-CoV-2-positive; 37 healthy controls; 22 COVID-19 symptoms but SARS-CoV-2negative) and validation (312 SARS-CoV-2-positive; 100 healthy controls) cohorts. Orthogonal projection to latent structure-discriminant analysis (OPLS-DA) and Kruskal–Wallis tests were applied to establish discriminant lipids, significance, and effect size, followed by logistic regression to evaluate classification performance. OPLS-DA reported separation of SARS-CoV-2 infection from healthy controls in the discovery cohort, with an area under the curve (AUC) of 1.000. A refined panel of discriminant features consisted of six lipids from different subclasses (PE, PC, LPC, HCER, CER, and DCER). Logistic regression in the discovery cohort returned a training ROC AUC of 1.000 (sensitivity = 1.000, specificity = 1.000) and a test ROC AUC of 1.000. The validation cohort produced a training ROC AUC of 0.977 (sensitivity = 0.855, specificity = 0.948) and a test ROC AUC of 0.978 (sensitivity = 0.948, specificity = 0.922). The lipid panel was also able to differentiate SARS-CoV-2-positive individuals from SARS-CoV-2-negative individuals with COVID-19-like symptoms (specificity = 0.818). Lipid profiling and multivariate modelling revealed a signature offering mechanistic insights into SARS-CoV-2, with strong predictive power, and the potential to facilitate effective diagnosis and clinical management
Diagnostic potential of the plasma lipidome in infectious disease: application to acute SARS-CoV-2 infection
Improved methods are required for investigating the systemic metabolic effects of SARS-CoV-2 infection and patient stratification for precision treatment. We aimed to develop an effective method using lipid profiles for discriminating between SARS-CoV-2 infection, healthy controls, and non-SARS-CoV-2 respiratory infections. Targeted liquid chromatography–mass spectrometry lipid profiling was performed on discovery (20 SARS-CoV-2-positive; 37 healthy controls; 22 COVID-19 symptoms but SARS-CoV-2negative) and validation (312 SARS-CoV-2-positive; 100 healthy controls) cohorts. Orthogonal projection to latent structure-discriminant analysis (OPLS-DA) and Kruskal–Wallis tests were applied to establish discriminant lipids, significance, and effect size, followed by logistic regression to evaluate classification performance. OPLS-DA reported separation of SARS-CoV-2 infection from healthy controls in the discovery cohort, with an area under the curve (AUC) of 1.000. A refined panel of discriminant features consisted of six lipids from different subclasses (PE, PC, LPC, HCER, CER, and DCER). Logistic regression in the discovery cohort returned a training ROC AUC of 1.000 (sensitivity = 1.000, specificity = 1.000) and a test ROC AUC of 1.000. The validation cohort produced a training ROC AUC of 0.977 (sensitivity = 0.855, specificity = 0.948) and a test ROC AUC of 0.978 (sensitivity = 0.948, specificity = 0.922). The lipid panel was also able to differentiate SARS-CoV-2-positive individuals from SARS-CoV-2-negative individuals with COVID-19-like symptoms (specificity = 0.818). Lipid profiling and multivariate modelling revealed a signature offering mechanistic insights into SARS-CoV-2, with strong predictive power, and the potential to facilitate effective diagnosis and clinical management
Performance and Consistency of Indicator Groups in Two Biodiversity Hotspots
In a world limited by data availability and limited funds for conservation, scientists and practitioners must use indicator groups to define spatial conservation priorities. Several studies have evaluated the effectiveness of indicator groups, but still little is known about the consistency in performance of these groups in different regions, which would allow their a priori selection.We systematically examined the effectiveness and the consistency of nine indicator groups in representing mammal species in two top-ranked Biodiversity Hotspots (BH): the Brazilian Cerrado and the Atlantic Forest. To test for group effectiveness we first found the best sets of sites able to maximize the representation of each indicator group in the BH and then calculated the average representation of different target species by the indicator groups in the BH. We considered consistent indicator groups whose representation of target species was not statistically different between BH. We called effective those groups that outperformed the target-species representation achieved by random sets of species. Effective indicator groups required the selection of less than 2% of the BH area for representing target species. Restricted-range species were the most effective indicators for the representation of all mammal diversity as well as target species. It was also the only group with high consistency.We show that several indicator groups could be applied as shortcuts for representing mammal species in the Cerrado and the Atlantic Forest to develop conservation plans, however, only restricted-range species consistently held as the most effective indicator group for such a task. This group is of particular importance in conservation planning as it captures high diversity of endemic and endangered species
Chronic effects of an anti-angiogenic thrombospondin-1 mimetic peptide, ABT-898, on female mouse reproductive outcomes
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