University Scholars Day

This paper discusses research on the geography of cerebrovascular disease (CVD) in Texas

AfroLM: A Self-Active Learning-based Multilingual Pretrained Language Model for 23 African Languages

In recent years, multilingual pre-trained language models have gained prominence due to their remarkable performance on numerous downstream Natural Language Processing tasks (NLP). However, pre-training these large multilingual language models requires a lot of training data, which is not available for African Languages. Active learning is a semi-supervised learning algorithm, in which a model consistently and dynamically learns to identify the most beneficial samples to train itself on, in order to achieve better optimization and performance on downstream tasks. Furthermore, active learning effectively and practically addresses real-world data scarcity. Despite all its benefits, active learning, in the context of NLP and especially multilingual language models pretraining, has received little consideration. In this paper, we present AfroLM, a multilingual language model pretrained from scratch on 23 African languages (the largest effort to date) using our novel self-active learning framework. Pretrained on a dataset significantly (14x) smaller than existing baselines, AfroLM outperforms many multilingual pretrained language models (AfriBERTa, XLMR-base, mBERT) on various NLP downstream tasks (NER, text classification, and sentiment analysis). Additional out-of-domain sentiment analysis experiments show that \textbf{AfroLM} is able to generalize well across various domains. We release the code source, and our datasets used in our framework at https://github.com/bonaventuredossou/MLM_AL.Comment: Third Workshop on Simple and Efficient Natural Language Processing, EMNLP 202

SNP and Haplotype Regional Heritability Mapping (SNHap-RHM):Joint Mapping of Common and Rare Variation Affecting Complex Traits

We describe a genome-wide analytical approach, SNP and Haplotype Regional Heritability Mapping (SNHap-RHM), that provides regional estimates of the heritability across locally defined regions in the genome. This approach utilises relationship matrices that are based on sharing of SNP and haplotype alleles at local haplotype blocks delimited by recombination boundaries in the genome. We implemented the approach on simulated data and show that the haplotype-based regional GRMs capture variation that is complementary to that captured by SNP-based regional GRMs, and thus justifying the fitting of the two GRMs jointly in a single analysis (SNHap-RHM). SNHap-RHM captures regions in the genome contributing to the phenotypic variation that existing genome-wide analysis methods may fail to capture. We further demonstrate that there are real benefits to be gained from this approach by applying it to real data from about 20,000 individuals from the Generation Scotland: Scottish Family Health Study. We analysed height and major depressive disorder (MDD). We identified seven genomic regions that are genome-wide significant for height, and three regions significant at a suggestive threshold (p-value < 1 × 10(−5)) for MDD. These significant regions have genes mapped to within 400 kb of them. The genes mapped for height have been reported to be associated with height in humans. Similarly, those mapped for MDD have been reported to be associated with major depressive disorder and other psychiatry phenotypes. The results show that SNHap-RHM presents an exciting new opportunity to analyse complex traits by allowing the joint mapping of novel genomic regions tagged by either SNPs or haplotypes, potentially leading to the recovery of some of the “missing” heritability

Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resourceâ limited setting: the AFRICA trial

ObjectiveTo assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resourceâ limited setting.MethodsApproximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress. Patients were assigned to the intervention group if their treating physician had completed the CPUS training. The physician’s initial diagnostic impression was recorded immediately after the history and physical examination in the control group, and after an added CPUS examination in the intervention group. This was compared to a standardised final diagnosis derived from post hoc chart review of the patient’s care at 24 h by two blinded, independent reviewers using a clearly defined and systematic process. Secondary outcomes were 24â h mortality and use of IV fluids, diuretics, vasopressors and bronchodilators.ResultsOf 890 patients presenting during the study period, 502 were assessed for eligibility, and 180 patients were enrolled. Diagnostic accuracy was higher for patients who received the CPUS examination (71.9% vs. 57.1%, Î 14.8% [CI 0.5%, 28.4%]). This effect was particularly pronounced for patients with a â cardiacâ diagnosis, such as cardiogenic shock, congestive heart failure or acute valvular disease (94.7% vs. 40.0%, Î 54.7% [CI 8.9%, 86.4%]). Secondary outcomes were not different between groups.ConclusionsIn an urban ED in Ghana, a CPUS examination improved the accuracy of the treating physician’s initial diagnostic impression. There were no differences in 24â h mortality and a number of patient care interventions.ObjectifEvaluer les effets de l’examen échographique cardioâ pulmonaire (CPUS) sur la précision du diagnostic chez les patients gravement malades dans un cadre à ressource limitée.MéthodesEnviron la moitié des médecins résidents en médecine d’urgence à la Komfo Anokye Teaching Hôpital (KATH) à Kumasi, au Ghana ont été formés pour un protocole de CPUS. Les patients adultes triés dans l’unité de ressuscitation des soins intensifs ont été inscrits s’ils présentaient des signes ou des symptômes de choc ou d’une détresse respiratoire. Les patients ont été assignés au groupe d’intervention si leur médecin traitant avait suivi la formation CPUS. Le diagnostic initial du médecin a été enregistré immédiatement après l’anamnèse et l’examen physique dans le groupe témoin, et après un examen CPUS ultérieur dans le groupe d’intervention. Cela a été comparé à un diagnostic final standard dérivé de l’analyse postâ hoc en aveugle des dossiers de soins du patient à 24 heures par deux examinateurs indépendants, au moyen d’un processus clairement défini et systématique. Les résultats secondaires étaient la mortalité de 24 heures et l’utilisation de fluides en IV, de diurétiques, de vasopresseurs et de bronchodilatateurs.RésultatsSur 890 patients présentés au cours de la période dâ étude, 502 ont été évalués pour lâ éligibilité et 180 patients ont été inscrits. La précision du diagnostic était plus élevée chez les patients ayant reçu l’examen CPUS (71,9% contre 57,1%, Î 14,8% [IC: 0,5% à 28.4%]). Cet effet était particulièrement marquée pour les patients avec un diagnostic «cardiaque», tel que le choc cardiogénique, l’insuffisance cardiaque congestive ou une maladie aiguë valvulaire (94,7% contre 40,0%, Î 54,7% [IC: 8,9% à 86,4%]). Les résultats secondaires nâ étaient pas différents entre les groupes.ConclusionsDans un service de soins intensifs urbain au Ghana, un examen CPUS améliorait la précision du diagnostic initial du médecin traitant. Il n’y avait aucune différence dans la mortalité de 24 heures et dans le nombre des interventions de soins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/1/tmi12992.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/2/tmi12992_am.pd

Update of the international HerniaSurge guidelines for groin hernia management

Background: Groin hernia repair is one of the most common operations performed globally, with more than 20 million procedures per year. The last guidelines on groin hernia management were published in 2018 by the HerniaSurge Group. The aim of this project was to assess new evidence and update the guidelines. The guideline is intended for general and abdominal wall surgeons treating adult patients with groin hernias. Method: A working group of 30 international groin hernia experts and all involved stakeholders was formed and examined all new literature on groin hernia management, available until April 2022. Articles were screened for eligibility and assessed according to GRADE methodologies. New evidence was included, and chapters were rewritten. Statements and recommendations were updated or newly formulated as necessary. Results: Ten chapters of the original HerniaSurge inguinal hernia guidelines were updated. In total, 39 new statements and 32 recommendations were formulated (16 strong recommendations). A modified Delphi method was used to reach consensus on all statements and recommendations among the groin hernia experts and at the European Hernia Society meeting in Manchester on October 21, 2022. Conclusion: The HerniaSurge Collaboration has updated the international guidelines for groin hernia management. The updated guidelines provide an overview of the best available evidence on groin hernia management and include evidence-based statements and recommendations for daily practice. Future guideline development will change according to emerging guideline methodology

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Implementing the NICE osteoarthritis guidelines: A mixed methods study and cluster randomised trial of a model osteoarthritis consultation in primary care - the Management of OsteoArthritis In Consultations (MOSAICS) study protocol

There is as yet no evidence on the feasibility of implementing recommendations from the National Institute of Health and Care Excellence (NICE) osteoarthritis (OA) guidelines in primary care, or of the effect these recommendations have on the condition. The primary aim of this study is to determine the clinical and cost effectiveness of a model OA consultation (MOAC), implementing the core recommendations from the NICE OA guidelines in primary care. Secondary aims are to investigate the impact, feasibility and acceptability of the MOAC intervention; to develop and evaluate a training package for management of OA by general practitioners (GPs) and practice nurses; test the feasibility of deriving 'quality markers' of OA management using a new consultation template and medical record review; and describe the uptake of core NICE OA recommendations in participants aged 45 years and over with joint pain.Design: A mixed methods study with a nested cluster randomised controlled trial.Method: This study was developed according to a defined theoretical framework (the Whole System Informing Self-management Engagement). An overarching model (the Normalisation Process Theory) will be employed to undertake a comprehensive 'whole-system' evaluation of the processes and outcomes of implementing the MOAC intervention. The primary outcome is general physical health (Short Form-12 Physical component score [PCS]) (Ware 1996). The impact, acceptability and feasibility of the MOAC intervention at practice level will be assessed by comparing intervention and control practices using a Quality Indicators template and medical record review. Impact and acceptability of the intervention for patients will be assessed via self-completed outcome measures and semi-structured interviews. The impact, acceptability and feasibility of the MOAC intervention and training for GPs and practice nurses will be evaluated using a variety of methods including questionnaires, semi-structured interviews, and observations.Discussion: The main output from the study will be to determine whether the MOAC intervention is clinically and cost effective. Additional outputs will be the development of the MOAC for patients consulting with joint pain in primary care, training and educational materials, and resources for patients and professionals regarding supported self-management and uptake of NICE guidance. Trial registration: ISRCTN number: ISRCTN06984617

Profile of persons with vehicular related trauma presenting at Komfo Anokye Teaching Hospital Emergency Centre

Vehicular Related Trauma (VRT) is a major cause of morbidity and mortality. Worldwide, an estimated 1.2 million people die yearly from VRT whilst about 50 million people sustain non-fatal injuries. WHO predicts Road Traffic Accident as the third leading cause of death worldwide by 2020. Ghana has been experiencing an increasing number of VRT which imposes a high clinical and economic burden. In the year 2010 out of 16,904 casualties 1986 were killed in Ghana (National Road Safety Commission). This study was conducted to assess the morbidity and mortality resulting from VRT, the severity of presentation and the injury types. Methods: The study was cross-sectional. Patients fulfilling inclusion criteria at the Komfo Anokye Teaching Hospital (KATH) Emergency Centre (EC) were recruited on admission. Written informed consent was obtained. Patients were triaged using the five-tier South Africa Triage system. Data were collected over a six-week period between July and August 2011. Results: Out of the total sample of 1004, approximately 41% had some form of injury; of these almost half (49.6%) had injuries from Vehicular Related Trauma. A further look at VRT cases indicated that the principal presentations were caused by car crash (41.6%), pedestrian injuries (25.8%), and motorcycle related injuries (19.6%). Mini buses and bicycles accounted for 9.8% and 2.2%, respectively. 6.8% of the patients were triaged to “red”, 33.4% to “orange”, and 59.3% to “yellow”. Thirty-four and a half percent of the patients presented with lower extremity injuries and fractures, followed by head injuries (26.1%). Mortality rate (24 h mortality) at the Emergency department during the period in respect with trauma is as follows: 15.78% for “red”, 1.27% for “orange” and none at “yellow”. None of the patients involved in bicycle accidents wore a helmet and only 5.3% of those riding motorcycles wore a crash helmet. Discussion: This study confirms that injuries resulting from Vehicular Related Trauma contribute a significant cause of all injuries presenting at the KATH EC and therefore could have a significant economic burden on Ghana. Policy makers should make road safety a priority and implement cost effective measures to improve it