On the Ground Validation of Online Diagnosis with Twitter and Medical Records

Social media has been considered as a data source for tracking disease. However, most analyses are based on models that prioritize strong correlation with population-level disease rates over determining whether or not specific individual users are actually sick. Taking a different approach, we develop a novel system for social-media based disease detection at the individual level using a sample of professionally diagnosed individuals. Specifically, we develop a system for making an accurate influenza diagnosis based on an individual's publicly available Twitter data. We find that about half (17/35 = 48.57%) of the users in our sample that were sick explicitly discuss their disease on Twitter. By developing a meta classifier that combines text analysis, anomaly detection, and social network analysis, we are able to diagnose an individual with greater than 99% accuracy even if she does not discuss her health.Comment: Presented at of WWW2014. WWW'14 Companion, April 7-11, 2014, Seoul, Kore

Introduction: performing the self: women's lives in historical perspective

Katie Barclay and Sarah Richardso

Artificial neural network prediction of weld distortion rectification using a travelling induction coil

An experimental investigation has been carried out to determine the applicability of an induction heating process with a travelling induction coil for the rectification of angular welding distortion. The results obtained from experimentation have been used to create artificial neural network models with the ability to predict the welding induced distortion and the distortion rectification achieved using a travelling induction coil. The experimental results have shown the ability to reduce the angular distortion for 8 mm and 10 mm thick DH36 steel plate and effectively eliminate the distortion on 6 mm thick plate. Results for 6 mm plate also show the existence of a critical induction coil travel speed at which maximum corrective bending occurs. Artificial neural networks have demonstrated the ability to predict the final distortion of the plate after both welding and induction heating. The models have also been used as a tool to determine the optimum speed to minimise the resulting distortion of steel plate after being subjected to both welding and induction heating processes

Rayleigh scattering, mode coupling, and optical loss in silicon microdisks

High refractive index contrast optical microdisk resonators fabricated from silicon-on-insulator wafers are studied using an external silica fiber taper waveguide as a wafer-scale optical probe. Measurements performed in the 1500 nm wavelength band show that these silicon microdisks can support whispering-gallery modes with quality factors as high as 5.2 x 10^5, limited by Rayleigh scattering from fabrication induced surface roughness. Microdisks with radii as small as 2.5 microns are studied, with measured quality factors as high as 4.7 x 10^5 for an optical mode volume of 5.3 cubic wavelengths in the material.Comment: 4 pages, 2 figures; contains minor correction to doublet splitting theor

A new paradigm evaluating cost per cure of HCV infection in the UK

Background: New interferon (IFN)-free treatments for hepatitis C are more effective, safer but more expensive than current IFN-based therapies. Comparative data of these, versus current first generation protease inhibitors (PI) with regard to costs and treatment outcomes are needed. We investigated the real-world effectiveness, safety and cost per cure of 1st generation PI-based therapies in the UK. Methods: Medical records review of patients within the HCV Research UK database. Patients had received treatment with telaprevir or boceprevir and pegylated interferon and ribavirin (PR). Data on treatment outcome, healthcare utilisation and adverse events (AEs) requiring intervention were collected and analysed overall and by subgroups. Costs of visits, tests, therapies, adverse events and hospitalisations were estimated at the patient level. Total cost per cure was calculated as total median cost divided by SVR rate. Results: 154 patients from 35 centres were analysed. Overall median total cost per cure was £44,852 (subgroup range,: £35,492 to £107,288). Total treatment costs were accounted for by PI: 68.3 %, PR: 26.3 %, AE management: 5.4 %. Overall SVR was 62.3 % (range 25 % to 86.2 %). 36 % of patients experienced treatment-related AEs requiring intervention, 10 % required treatment-related hospitalisation. Conclusions: This is the first UK multicentre study of outcomes and costs of PI-based HCV treatments in clinical practice. There was substantial variation in total cost per cure among patient subgroups and high rates of treatment-related discontinuations, AEs and hospitalisations. Real world safety, effectiveness and total cost per cure for the new IFN free combinations should be compared against this baseline

Mucosal delivery of tuberculosis vaccines: a review of current approaches and challenges.

Introduction: Tuberculosis (TB) remains a major health threat and it is now clear that the current vaccine, BCG, is unable to arrest the global TB epidemic. A new vaccine is needed to either replace or boost BCG so that a better level of protection could be achieved. The route of entry of Mycobacterium tuberculosis, the causative organism, is via inhalation making TB primarily a respiratory disease. There is therefore good reason to hypothesize that a mucosally delivered vaccine against TB could be more effective than one delivered via the systemic route.Areas covered: This review summarizes the progress that has been made in the area of TB mucosal vaccines in the last few years. It highlights some of the strengths and shortcomings of the published evidence and aims to discuss immunological and practical considerations in the development of mucosal vaccines.Expert opinion: There is a growing body of evidence that the mucosal approach to vaccination against TB is feasible and should be pursued. However, further key studies are necessary to both improve our understanding of the protective immune mechanisms operating in the mucosa and the technical aspects of aerosolized delivery, before such a vaccine could become a feasible, deployable strategy

Withdrawal of anticancer therapy in advanced disease: a systematic literature review

Abstract Background Current guidelines set out when to start anticancer treatments, but not when to stop as the end of life approaches. Conventional cytotoxic agents are administered intravenously and have major life-threatening toxicities. Newer drugs include molecular targeted agents (MTAs), in particular, small molecule kinase-inhibitors (KIs), which are administered orally. These have fewer life-threatening toxicities, and are increasingly used to palliate advanced cancer, generally offering additional months of survival benefit. MTAs are substantially more expensive, between £2-8 K per month, and perceived as easier to start than stop. Methods A systematic review of decision-making concerning the withdrawal of anticancer drugs towards the end of life within clinical practice, with a particular focus on MTAs. Nine electronic databases searched. PRISMA guidelines followed. Results Forty-two studies included. How are decisions made? Decision-making was shared and ongoing, including stopping, starting and trying different treatments. Oncologists often experienced ‘professional role dissonance’ between their self-perception as ‘treaters’, and talking about end of life care. Why are decisions made? Clinical factors: disease progression, worsening functional status, treatment side-effects. Non-clinical factors: physicians’ personal experience, values, emotions. Some patients continued treatment to maintain ‘hope’, often reflecting limited understanding of palliative goals. When are decisions made? Limited evidence reveals patients’ decisions based upon quality of life benefits. Clinicians found timing withdrawal particularly challenging. Who makes the decisions? Decisions were based within physician-patient interaction. Conclusions Oncologists report that decisions around stopping chemotherapy treatment are challenging, with limited evidence-based guidance outside of clinical trial protocols. The increasing availability of oral MTAs is transforming the management of incurable cancer; blurring boundaries between active treatment and palliative care. No studies specifically addressing decision-making around stopping MTAs in clinical practice were identified. There is a need to develop an evidence base to support physicians and patients with decision-making around the withdrawal of these high cost treatments