10,091 research outputs found

    Discovery-led refinement in e-discovery investigations: sensemaking, cognitive ergonomics and system design.

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    Given the very large numbers of documents involved in e-discovery investigations, lawyers face a considerable challenge of collaborative sensemaking. We report findings from three workplace studies which looked at different aspects of how this challenge was met. From a sociotechnical perspective, the studies aimed to understand how investigators collectively and individually worked with information to support sensemaking and decision making. Here, we focus on discovery-led refinement; specifically, how engaging with the materials of the investigations led to discoveries that supported refinement of the problems and new strategies for addressing them. These refinements were essential for tractability. We begin with observations which show how new lines of enquiry were recursively embedded. We then analyse the conceptual structure of a line of enquiry and consider how reflecting this in e-discovery support systems might support scalability and group collaboration. We then focus on the individual activity of manual document review where refinement corresponded with the inductive identification of classes of irrelevant and relevant documents within a collection. Our observations point to the effects of priming on dealing with these efficiently and to issues of cognitive ergonomics at the human–computer interface. We use these observations to introduce visualisations that might enable reviewers to deal with such refinements more efficiently

    Experimental Evaluation and Development of a Silver-Standard for the MIMIC-III Clinical Coding Dataset

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    Clinical coding is currently a labour-intensive, error-prone, but critical administrative process whereby hospital patient episodes are manually assigned codes by qualified staff from large, standardised taxonomic hierarchies of codes. Automating clinical coding has a long history in NLP research and has recently seen novel developments setting new state of the art results. A popular dataset used in this task is MIMIC-III, a large intensive care database that includes clinical free text notes and associated codes. We argue for the reconsideration of the validity MIMIC-III's assigned codes that are often treated as gold-standard, especially when MIMIC-III has not undergone secondary validation. This work presents an open-source, reproducible experimental methodology for assessing the validity of codes derived from EHR discharge summaries. We exemplify the methodology with MIMIC-III discharge summaries and show the most frequently assigned codes in MIMIC-III are under-coded up to 35%

    Historic landmarks in clinical transplantation: Conclusions from the consensus conference at the University of California, Los Angeles

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    The transplantation of organs, cells, and tissues has burgeoned during the last quarter century, with the development of multiple new specialty fields. However, the basic principles that made this possible were established over a three-decade period, beginning during World War II and ending in 1974. At the historical consensus conference held at UCLA in March 1999, 11 early workers in the basic science or clinical practice of transplantation (or both) reached agreement on the most significant contribution of this era that ultimately made transplantation the robust clinical discipline it is today. These discoveries and achievements are summarized here is six tables and annotated with references

    Biocide exposure induces changes in susceptibility, pathogenicity and biofilm formation in Uropathogenic Escherichia coli

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    Background: Uropathogenic Escherichia coli (UPEC) are a frequent cause of catheter associated urinary tract infection (CAUTI). Biocides have been incorporated into catheter-coatings to inhibit bacterial colonisation whilst ideally exhibiting low cytotoxicity and mitigating the selection of resistant bacterial populations. We compared the effects of long-term biocide exposure on susceptibility, biofilm-formation and relative-pathogenicity in eight UPEC isolates.Methods: Minimum inhibitory concentrations (MIC), minimum bactericidal concentrations (MBC), minimum biofilm eradication concentrations (MBEC) and antibiotic susceptibilities were determined before and after long-term exposure to triclosan, polyhexamethylene biguanide (PHMB), benzalkonium chloride (BAC) and silver nitrate. Biofilm-formation was quantified using a crystal violet assay and relative-pathogenicity was assessed via a Galleria mellonella waxworm model. Cytotoxicity and resulting biocompatability index values were determined against an L929 murine fibroblast cell line.Results: Biocide exposure resulted in multiple decreases in biocide susceptibility in planktonic and biofilm associated UPEC. Triclosan exposure induced the largest frequency and magnitude of susceptibility decreases at MIC, MBC and MBEC, which correlated to an increase in biofilm biomass in all isolates. Induction of antibiotic-cross-resistance occurred in 6/84 possible combinations of bacteria, biocide and antibiotic. Relative-pathogenicity significantly decreased after triclosan exposure (5/8 isolates), increased after silver nitrate exposure (2/8 isolates) and varied between isolates for PHMB and BAC. Biocompatibility index ranked antiseptic potential as PHMB>triclosan>BAC>silver nitrate.Conclusion: Biocide exposure in UPEC may lead to reductions in biocide and antibiotic susceptibility, changes in biofilm-formation and alterations relative-pathogenicity. These data indicate the multiple consequences of biocide adaptation that should be considered when selecting an anti-infective catheter-coating agent

    Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics

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    Objective: To investigate the demographic, symptomatic, clinical and structural foot characteristics associated with potential phenotypes of midfoot osteoarthritis (OA). Design: Cross-sectional study of 533 community-dwelling adults aged ≥50 years with foot pain in the past year. Health questionnaires and clinical assessments of symptoms, foot structure and function were undertaken. Potential midfoot OA phenotypes were defined by the pattern of radiographic joint involvement affecting either the medial midfoot (talonavicular, navicular-1 st cuneiform, or cuneiform-1 st metatarsal joint), central midfoot (2 nd cuneiform-metatarsal joint), or both medial and central midfoot joints. Multivariable regression models with generalised estimating equations were used to investigate the associations between patterns of midfoot joint involvement and symptomatic, clinical and structural characteristics compared to those with no or minimal midfoot OA. Results: Of 879 eligible feet, 168 had medial midfoot OA, 103 central midfoot OA, 76 both medial and central midfoot OA and 532 no/minimal OA. Having both medial and central midfoot OA was associated with higher pain scores, dorsally-located midfoot pain (OR 2.54, 95%CI 1.45, 4.45), hallux valgus (OR 1.76, 95%CI 1.02, 3.05), flatter foot posture (β 0.44, 95%CI 0.12, 0.77), lower medial arch height (β 0.02, 95%CI 0.01, 0.03) and less subtalar inversion and 1 st MTPJ dorsiflexion. Isolated medial midfoot OA and central midfoot OA had few distinguishing clinical characteristics. Conclusions: Distinct phenotypes of midfoot OA appear challenging to identify, with substantial overlap in symptoms and clinical characteristics. Phenotypic differences in symptoms, foot posture and function were apparent in this study only when both the medial and central midfoot were involved

    A Hierarchy of Spacetime Symmetries: Holes to Heraclitus

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    We present a hierarchy of symmetry conditions within the context of general relativity. The weakest condition captures a sense in which spacetime is free of symmetry "holes" of a certain type. All standard models of general relativity satisfy the condition but we show that violations can occur if the Hausdorff assumption is dropped. On the other extreme, the strongest condition of the hierarchy is satisfied whenever a model is completely devoid of symmetries. In these "Heraclitus spacetimes," no pair of distinct points can be mapped (even locally) into one another. We prove that such spacetimes exist. We also show a sense in which Heraclitus spacetimes are completely determined by their local properties. We close with a brief comment on the prospect of using the symmetries of a spacetime as a guide to how much "structure" it possesses

    A pentapeptide as minimal antigenic determinant for MHC class I-restricted T lymphocytes

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    Peptides that are antigenic for T lymphocytes are ligands for two receptors, the class I or II glycoproteins that are encoded by genes in the major histocompatibility complex, and the idiotypic / chain T-cell antigen receptor1–9. That a peptide must bind to an MHC molecule to interact with a T-cell antigen receptor is the molecular basis of the MHC restriction of antigen-recognition by T lymphocytes10,11. In such a trimolecular interaction the amino-acid sequence of the peptide must specify the contact with both receptors: agretope residues bind to the MHC receptor and epitope residues bind to the T-cell antigen receptor12,13. From a compilation of known antigenic peptides, two algorithms have been proposed to predict antigenic sites in proteins. One algorithm uses linear motifs in the sequence14, whereas the other considers peptide conformation and predicts antigenicity for amphipathic -helices15,16. We report here that a systematic delimitation of an antigenic site precisely identifies a predicted pentapeptide motif as the minimal antigenic determinant presented by a class I MHC molecule and recognized by a cytolytic T lymphocyte clone
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