Miracle-dz/UniFAR-FTUs huggingface dataset:
Qualifying Certainty in Radiology Reports through Deep Learning–Based Natural Language Processing

BACKGROUND AND PURPOSE: Communication gaps exist between radiologists and referring physicians in conveying diagnostic certainty. We aimed to explore deep learning–based bidirectional contextual language models for automatically assessing diagnostic certainty expressed in the radiology reports to facilitate the precision of communication. MATERIALS AND METHODS: We randomly sampled 594 head MR imaging reports from an academic medical center. We asked 3 board-certified radiologists to read sentences from the Impression section and assign each sentence 1 of the 4 certainty categories: “Non-Definitive,” “Definitive-Mild,” “Definitive-Strong,” “Other. ” Using the annotated 2352 sentences, we developed and validated a natural language-processing system based on the start-of-the-art bidirectional encoder representations from transformers (BERT), which can capture contextual uncertainty semantics beyond the lexicon level. Finally, we evaluated 3 BERT variant models and reported standard metrics including sensitivity, specificity, and area under the curve. RESULTS: A κ score of 0.74 was achieved for interannotator agreement on uncertainty interpretations among 3 radiologists. For the 3 BERT variant models, the biomedical variant (BioBERT) achieved the best macro-average area under the curve of 0.931 (compared with 0.928 for the BERT-base and 0.925 for the clinical variant [ClinicalBERT]) on the validation data. All 3 models yielded high macro-average specificity (93.13%–93.65%), while the BERT-base obtained the highest macro-average sensitivity of 79.46% (compared with 79.08% for BioBERT and 78.52% for ClinicalBERT). The BioBERT model showed great generalizability on the heldout test data with a macro-average sensitivity of 77.29%, specificity of 92.89%, and area under the curve of 0.93. CONCLUSIONS: A deep transfer learning model can be developed to reliably assess the level of uncertainty communicated in a radiology report.
Personalizing interventions using real-world interactions: Improving symptoms and social functioning in schizophrenia with tailored metacognitive therapy.

OBJECTIVE When clients' lives are not reflected in therapy, they struggle to apply the skills learned in treatment to everyday situations. In this pilot study, we determined if using clients' real-world interactions in therapy could effectively target metacognitive capacity-yielding improved symptoms and social functioning-by tailoring treatment to focus on issues faced by clients in daily life. METHOD Using a randomized controlled trial design, schizophrenia subjects with metacognitive deficits completed 24 sessions of: (a) Standard Metacognitive Reflection and Insight Therapy (MERIT); or (b) Tailored MERIT. Real-world interactions were captured via the Electronically Activated Recorder (EAR), a smartphone application that passively records audio in daily life. All subjects wore the EAR; however, real-world interactions were only used to personalize sessions in Tailored MERIT. RESULTS Feasibility and acceptability were shown; those in Tailored MERIT wore the EAR 84% of their waking hours and reported minimal burden. When compared to Standard MERIT, Tailored MERIT participants showed large pre-post reductions in negative metacognitive beliefs and disorganized symptoms. Small, but nonsignificant, improvements in social functioning were also observed. CONCLUSIONS Compared to an evidence-based benchmark, we observed that real-world interactions can be used to tailor metacognitive therapy and improve outcomes in schizophrenia. Tailored MERIT has the potential to impact practice by personalizing treatment to account for individual variations in environment and lifestyle-aligning with the Precision Medicine Initiative-in a way that is not possible with current therapy. This is particularly salient in schizophrenia, where limited insight and cognitive deficits often make subjective reporting unreliable. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Evaluation of mobile phone‐based Positive Deviance/Hearth child undernutrition program in Cambodia

Abstract Child undernutrition in Cambodia is a persistent public health problem requiring low‐cost and scalable solutions. Rising cellphone use in low‐resource settings represents an opportunity to replace in‐person counselling visits with phone calls; however, questions remain on relative effectiveness. Our objective was to evaluate the impact of two options for delivering a World Vision infant and young child feeding (IYCF) counselling programme: (1) traditional Positive Deviance/Hearth (PDH) programme with in‐person visits or (2) PDH with Interactive Voice Calling (PDH‐IVC) which integrates phone calls to replace 62.5% of face‐to‐face interaction between caregivers and volunteers, compared to the standard of care (SOC). We conducted a longitudinal cluster‐randomised controlled trial in 361 children 6–23 months. We used an adjusted difference‐in‐difference approach using baseline, midline (3 months) and endline (12 months) surveys to evaluate the impact on child growth among the three groups. At baseline, nearly a third of children were underweight, and over half were food insecure. At midline the PDH group and the PDH‐IVC groups had improved weight‐for‐age z‐scores (0.13 DID, p = 0.011; 0.13 DID, p = 0.02, respectively) and weight‐for‐height z‐score (0.16 DID, p = 0.038; 0.24 DID, p = 0.002), relative to SOC. There were no differences in child height‐for‐age z‐scores. At endline, the impact was sustained only in the PDH‐IVC group for weight‐for‐age z‐score (0.14 DID, p = 0.049), and the prevalence of underweight declined by 12.8 percentage points (p = 0.036), relative to SOC. Integration of phone‐based IYCF counselling is a potentially promising solution to reduce the burden of in‐person visits; however, the modest improvements suggest the need to combine it with other strategies to improve child nutrition.
Nurses' experience of handoffs on four Canadian medical and surgical units: A shared accountability for knowing and safeguarding the patient.

AIMS To explore nurses' experience and describe how they manage various contextual factors affecting the nurse-to-nurse handoff at change of shift. DESIGN Qualitative descriptive study. METHODS A convenience sample of 51 nurses from four medical and surgical care units at a university-affiliated hospital in Montreal, Canada, participated in one of the 19 focus group interviews from November 2017 to January 2018. Data were analysed through a continuous and iterative process of thematic analysis. RESULTS Analysis of the data generated a core theme of 'sharing accountability for knowing and safeguarding the patient' that is achieved through actions related to nurses' role in the exchange. Specifically, the outgoing nurse takes actions to ensure continuity of care when letting go, and the incoming nurse takes actions to provide seamless care when taking over. In both roles, nurses navigate each handoff juncture by mutually adjusting, ensuring attentiveness, managing judgements, keeping on track, and venting and debriefing. Handoff is also shaped by contextual conditions related to handoff norms and practices, the nursing environment, individual nurse attributes and patient characteristics. CONCLUSIONS This study generated a conceptualization of nurses' roles and experience that details the relationship among the elements and conditions that shape nurse-to-nurse handoffs. IMPACT Nursing handoff involves the communication of patient information and relational behaviours that support the exchange. Although many factors are known to influence handoffs, little was known about nurses' experience of dealing with these at the point of care. This study contributed a comprehensive conceptualization of nursing handoff that could be useful in identifying areas for quality improvement and guiding future educational efforts.
Intracardiac echocardiography‐ versus transesophageal echocardiography‐guided left atrial appendage occlusion with Watchman FLX

Watchman FLX has been recently approved for left atrial appendage occlusion (LAAO) in the US. Intracardiac echocardiography (ICE) ‐ which is already commonly used to guide trans‐septal access ‐ can serve as an alternative to TEE, simplifying the procedure and reducing associated costs. Herein, we report our experience with ICE‐guided LAAO with Watchman FLX.
Effectiveness of autogenic relaxation training in addition to usual physiotherapy on emotional state and functional independence of stroke survivors

Abstract Introduction: The occurrence of post-stroke emotional problems is significant during the early post-stroke stage and affects the recovery of functionality among the survivors. Because stroke survivors require active engagement in rehabilitation to optimize the process of neuroplasticity in the initial stage of stroke, there is a need to integrate an intervention, preferably therapists-mediated during rehabilitation, which reduce emotional problems thus improve motivation level among the survivors. One such technique is autogenic relaxation training (ART). ART has been found to reduce anxiety and depression among patients with several medical conditions. However, its usage in stroke survivors during rehabilitation has been limited to date. Therefore, this study is intended to evaluate the effectiveness of ART in addition to usual physiotherapy in improving emotional state and functional level of stroke survivors during rehabilitation. Methods: This is an assessor blinded randomized controlled trial comparing 2 intervention approaches namely ART-added physiotherapy (experimental group) and usual physiotherapy (control group). A total of 70 post-stroke patients will be recruited and allocated into either the ART-added physiotherapy or the usual physiotherapy group. The ART-added physiotherapy group will undergo a 20-minute ART session followed by 40 minutes of usual physiotherapy. While the usual physiotherapy group will receive usual physiotherapy alone for 60 minutes. All participants will be treated once a week and are required to carry out a set of home exercises for 2 times per week during the 12-week intervention. Assessment of emotional status and functional independence will be carried out at pre-intervention and week 13 of the intervention with the use of Hospital anxiety and depression scale, Barthel index, and EuroQol-5 dimensions-5 levels. All data will be analyzed using descriptive and inferential statistics. Discussion: The expected main study outcome is an enhanced evidence-based physiotherapy program that may be used by physiotherapists in the rehabilitation of stroke patients with emotional disturbances. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12619001664134 (last updated on 28/11/2019).
Production of time reference in Turkish Broca’s aphasia: The effect of morphological complexity

ABSTRACT In PWA (people with aphasia) difficulties with sentences that refer to the past compared to non-past time reference have been shown for many languages, including Turkish. However, the impact of morphological complexity on past time reference ability in production has not yet been reported for Turkish-speaking PWA. Turkish, where verb forms have complex inflectional paradigms and exhibit overt and non-overt morphology, facilitates the examination of the effects of morphological complexity. The current study has two objectives: 1) to investigate whether the morphological complexity of the verb form affects time reference production of Turkish-speaking PWA and 2) to provide analysis for the error patterns discovered. Seventeen Turkish individuals with Broca’s aphasia who were matched in age with a control group of 17 neurologically intact Turkish individuals were tested with a picture sentence completion task. Test conditions were present progressive, simple past, past perfect, past progressive, and future tense. The task required the participants to complete each sentence frame with a verb. Our findings show that Turkish-speaking PWA were more successful in producing verb forms referring to non-past than verb forms referring to the past time reference. The current study supports previous findings that past is more difficult than non-past time reference for Turkish-speaking PWA. In terms of morphological complexity, we find that PWA were more impaired when producing morphologically complex verb forms rather than morphologically simple forms. We argue that these impairments lie in the realization of overt morphology.
Recent Progress on Photo‐Electrocatalytic Reduction of Carbon Dioxide

Ever‐increasing carbon dioxide emission has led to serious greenhouse effect and global warming in recent years. Photo‐electrocatalysis is the most significant approach to convert carbon dioxide into hydrocarbon fuels to alleviate the greenhouse effect as well as ensure the global carbon cycling with inexhaustible solar energy resource. There are four typical configurations in the photo‐electrocatalytic (PEC) carbon dioxide reduction system, i.e., photocathode coupling with anode cell, photoanode combining with cathode cell, photocathode integrating photoanode cell, and a photovoltaic‐photo‐electrocatalytic tandem cell. This review briefly summarizes the state‐of‐the‐art progress of above four configurations for photo‐electrocatalytic carbon dioxide reduction with a focus on the rational design of the electrode materials to achieve higher efficiency. In addition, the innovative design of the PEC system for efficient carbon dioxide reduction has also been concisely introduced. Finally, the perspectives on the challenges and future development of photo‐electrocatalytic carbon dioxide reduction based on the discussed configurations are presented.
Association of infant feeding patterns with body fat mass and obesity in the first 2 years of life: a longitudinal twin birth cohort study

Abstract Childhood obesity is a major public health problem with no effective intervention. We explored the influence of feeding patterns on infants’ growth indices within the first 2 years in a twin birth cohort. Dietary intake at 12 months was recorded with a food frequency questionnaire, and dietary patterns were identified by principal component analysis. Milk feeding methods in first 6 months were categorised as breastfeeding or exclusive formula feeding. Correlations between feeding patterns and infants’ growth indices were examined via generalised estimating equations. Two dietary patterns were identified and neither of which was related to growth indices. Breastfed infants had a higher body fat mass (BFM) percentage at 12 months, a higher body mass index (BMI) increment from birth to 6 months and a lower BMI increment from 6 to 12 months. Breastfed infants were likely positively correlated with BFM at 12 months; as complementary food was added, the effect of breastfeeding on growth gradually decreased.
A Real-World Efficacy of Nab-Paclitaxel Monotherapy in Metastatic Breast Cancer

Purpose We aimed to assess the real-world efficacy of nab-paclitaxel in metastatic breast cancer patients. Materials and Methods This is a retrospective study performed in two tertiary referral hospitals in Korea. Patients with metastatic breast cancer treated with nab-paclitaxel (Abraxane) between March 2016 and March 2020 were enrolled. Results A total of 102 patients with metastatic breast cancer were included. Patients were heavily pre-treated with a median of four prior lines of chemotherapy (5 lines when including endocrine therapy in hormone-receptor-positive patients), and 66 patients (64.7%) were exposed to taxanes in the metastatic setting. According to St. Gallen molecular subtypes, 36 patients (35.3%) were luminal A, 28 (27.5%) were luminal B, 18 (17.7%) were human epidermal growth factor receptor 2–positive and 20 (19.6%) had triple-negative disease. Fifty patients (49.0%) were treated with a 3-weekly regimen (260 mg/m2 on day 1 every 3 weeks), and 52 (51.0%) were treated with a weekly regimen (100 mg/m2 every week). Objective response rate was 22.9%. After a median follow-up of 22.0 months, median progression-free survival (PFS) was 4.0 months (95% confidence interval [CI], 2.6 to 4.8) and median overall survival was 8.7 months (95% CI, 7.5 to 11.2). Patients treated with weekly regimen had longer PFS compared to 3-weekly regimen (5.5 vs. 2.3 months, p < 0.001). Multivariate analysis revealed the treatment regimen as an independent prognostic factor for PFS. There was no grade 3 or 4 hypersensitivity reaction. Conclusion This real-world data shows that nab-paclitaxel is a reasonable treatment option in heavily pre-treated and/or taxane-exposed metastatic breast cancer patients.
Very preterm birth and trajectories of domain-specific self-concept from childhood into adulthood

Abstract Self-concept refers to individuals’ perceptions of themselves in specific domains and is closely related with their overall self-esteem. Lower self-esteem has been reported in those born preterm (<37 weeks gestation), but the development of self-concept has not been studied in this population. This study investigates whether differences in trajectories of domain-specific self-concepts are explained by premature birth or other risk factors, using the Bavarian Longitudinal Study (N = 460), a population-based study of very preterm (VP; <32 weeks gestation)/very low birth weight (VLBW; <1500 g) cohort and term-born controls. Trajectories of body and social self-concept from 6 to 26 years of age were estimated using latent class growth analysis. Regression models examined the effects of VP/VLBW and other individual, social, and family factors. Two trajectories – one stable and one decreasing – were identified for both self-concepts. VP/VLBW birth was associated with decreasing self-concept in both domains, although the effect of VP/VLBW on social self-concept was weakened in the adjusted analysis. Furthermore, mediated pathways were found from VP/VLBW to decreasing social self-concept via chronic bullying (β = 0.05, 95% CI [0.002, 0.12]) and motor impairments (β = 0.04, 95% CI [0.01, 0.07]), suggesting that negative self-concept in the VP/VLBW population is partially modifiable through improving peer relationships and motor impairments in childhood.
Understanding Infants' In-Home Injuries: Context and Correlates.

RATIONALE Infancy is a time of elevated risk of injury. Past research has focused mostly on the type of injuries, leaving many gaps in knowledge about contextual information that could aid in injury prevention planning. METHODS In this longitudinal study, a participant-event recording method was used in which mothers tracked their infants' home injuries through three motor development stages (sitting up independently, crawling, and walking). A contextual analysis elucidated where injuries occurred, their type and severity, the infant's and parent's behaviors at the time, if the infant had done the risk behavior before and been injured, the level of supervision, and the nature of any safety precautions parents implemented following these injuries. RESULTS Injuries occurred as often in play as in nonplay areas and were due to physically-active nonplay activities more so than play activities; mothers were often doing chores. Bumps and bruises were the most common types of injuries. As infants became more mobile, supervision scores declined and injury severity scores increased. Infants had done the risk behavior leading to injury previously about 60% of the time, with higher scores associated with parents implementing fewer preventive actions in response to injury. When mothers did implement a safety precaution, greater injury severity was associated with more modifications to the environment and increased supervision; teaching about safety was infrequent. CONCLUSION Implications of these results for injury prevention messaging are discussed.
Evaluation of simulators for x-ray speckle-based phase contrast imaging

X-ray phase contrast imaging (PCI) denotes a group of highly sensitive imaging techniques that permits imaging at scales ranging from nanoscopic to the medical. Recently introduced, speckle-based imaging has seen a rapid development because of its experimental simplicity and its capability to retrieve the refraction, the scattering and the absorption of a sample using a conventional x-ray set-up. Precise simulation would permit to optimise the imaging setups for different applications, but until now works on simulation of x-ray speckle-based PCI have been very few. In this work we evaluate different simulation codes, based on Monte-Carlo, analytical ray-tracing and wave-optics Fresnel propagation. The simulation results are compared to both synchrotron and conventional imaging experiments to permits their validation. We obtain a strong similarity between simulated and experimental data. We discuss the validity and applicability of each approach.
Nonlocal topological insulators: Deterministic aperiodic arrays supporting localized topological states protected by nonlocal symmetries

Significance A concept of nonlocal topological phases of DAAs introduced here establishes a different direction in topological physics and offers approaches to emulate higher-dimensional topology in lower-dimensional systems. Our study also unveils opportunities to engineer topologically protected states in aperiodic systems and paves the path to application of resonances associated with such states, whose robustness is ensured by nonlocal symmetries of DAAs. In particular, the possibility to engineer multiple localized resonances via dimensional reduction and their unique features, such as precise spectral properties stemming from their topological nature, offers remarkable opportunities for practical applications, from robust resonators to sensors and aperiodic topological lasers. The properties of topological systems are inherently tied to their dimensionality. Indeed, higher-dimensional periodic systems exhibit topological phases not shared by their lower-dimensional counterparts. On the other hand, aperiodic arrays in lower-dimensional systems (e.g., the Harper model) have been successfully employed to emulate higher-dimensional physics. This raises a general question on the possibility of extended topological classification in lower dimensions, and whether the topological invariants of higher-dimensional periodic systems may assume a different meaning in their lower-dimensional aperiodic counterparts. Here, we demonstrate that, indeed, for a topological system in higher dimensions one can construct a one-dimensional (1D) deterministic aperiodic counterpart which retains its spectrum and topological characteristics. We consider a four-dimensional (4D) quantized hexadecapole higher-order topological insulator (HOTI) which supports topological corner modes. We apply the Lanczos transformation and map it onto an equivalent deterministic aperiodic 1D array (DAA) emulating 4D HOTI in 1D. We observe topological zero-energy zero-dimensional (0D) states of the DAA—the direct counterparts of corner states in 4D HOTI and the hallmark of the multipole topological phase, which is meaningless in lower dimensions. To explain this paradox, we show that higher-dimension invariant, the multipole polarization, retains its quantization in the DAA, yet changes its meaning by becoming a nonlocal correlator in the 1D system. By introducing nonlocal topological phases of DAAs, our discovery opens a direction in topological physics. It also unveils opportunities to engineer topological states in aperiodic systems and paves the path to application of resonances associates with such states protected by nonlocal symmetries.