Laborious Way Research Articles

Closing the loop: automatically identifying abnormal imaging results in scanned documents.

Scanned documents (SDs), while common in electronic health records and potentially rich in clinically relevant information, rarely fit well with clinician workflow. Here, we identify scanned imaging reports requiring follow-up with high recall and practically useful precision. We focused on identifying imaging findings for 3 common causes of malpractice claims: (1) potentially malignant breast (mammography) and (2) lung (chest computed tomography [CT]) lesions and (3) long-bone fracture (X-ray) reports. We train our ClinicalBERT-based pipeline on existing typed/dictated reports classified manually or using ICD-10 codes, evaluate using a test set of manually classified SDs, and compare against string-matching (baseline approach). A total of 393 mammograms, 305 chest CT, and 683 bone X-ray reports were manually reviewed. The string-matching approach had an F1 of 0.667. For mammograms, chest CTs, and bone X-rays, respectively: models trained on manually classified training data and optimized for F1 reached an F1 of 0.900, 0.905, and 0.817, while separate models optimized for recall achieved a recall of 1.000 with precisions of 0.727, 0.518, and 0.275. Models trained on ICD-10-labelled data and optimized for F1 achieved F1 scores of 0.647, 0.830, and 0.643, while those optimized for recall achieved a recall of 1.0 with precisions of 0.407, 0.683, and 0.358. Our pipeline can identify abnormal reports with potentially useful performance and so decrease the manual effort required to screen for abnormal findings that require follow-up. It is possible to automatically identify clinically significant abnormalities in SDs with high recall and practically useful precision in a generalizable and minimally laborious way.

Generation of human liver organoids from pluripotent stem cell-derived hepatic endoderms.

BackgroundThe use of a personalized liver organoid derived from human-induced pluripotent stem cells (HuiPSCs) is advancing the use of in vitro disease models for the design of specific, effective therapies for individuals. Collecting patient peripheral blood cells for HuiPSC generation is preferable because it is less invasive; however, the capability of blood cell-derived HuiPSCs for hepatic differentiation and liver organoid formation remains uncertain. Moreover, the currently available methods for liver organoid formation require a multistep process of cell differentiation or a combination of hepatic endodermal, endothelial and mesenchymal cells, which is a major hurdle for the application of personalized liver organoids in high-throughput testing of drug toxicity and safety. To demonstrate the capability of blood cell-derived HuiPSCs for liver organoid formation without support from endothelial and mesenchymal cells.MethodsThe peripheral blood-derived HuiPSCs first differentiated into hepatic endoderm (HE) in two-dimensional (2D) culture on Matrigel-coated plates under hypoxia for 10 days. The HE was then collected and cultured in 3D culture using 50% Matrigel under ambient oxygen. The maturation of hepatocytes was further induced by adding hepatocyte growth medium containing HGF and oncostatin M on top of the 3D culture and incubating the culture for an additional 12–17 days. The function of the liver organoids was assessed using expression analysis of hepatocyte-specific gene and proteins. Albumin (ALB) synthesis, glycogen and lipid storage, and metabolism of indocyanine were evaluated. The spatial distribution of albumin was examined using immunofluorescence and confocal microscopy.ResultsCD34+ hematopoietic cell-derived HuiPSCs were capable of differentiating into definitive endoderm expressing SOX17 and FOXA2, hepatic endoderm expressing FOXA2, hepatoblasts expressing AFP and hepatocytes expressing ALB. On day 25 of the 2D culture, cells expressed SOX17, FOXA2, AFP and ALB, indicating the presence of cellular heterogeneity. In contrast, the hepatic endoderm spontaneously formed a spherical, hollow structure in a 3D culture of 50% Matrigel, whereas hepatoblasts and hepatocytes could not form. Microscopic observation showed a single layer of polygonal-shaped cells arranged in a 3D structure. The hepatic endoderm-derived organoid synthesis ALB at a higher level than the 2D culture but did not express definitive endoderm-specific SOX17, indicating the greater maturity of the hepatocytes in the liver organoids. Confocal microscopic images and quantitative ELISA confirmed albumin synthesis in the cytoplasm of the liver organoid and its secretion. Overall, 3D culture of the hepatic endoderm is a relatively fast, simple, and less laborious way to generate liver organoids from HuiPSCs that is more physiologically relevant than 2D culture.

Optical device and methodology for optical sensing of hemolysis in hypotonic media

Identifying abnormalities in red blood cells can provide important medical clues for the diagnosis, prognosis, and treatment of some health disorders. A common test used to examine the conditions of erythrocytes in humans is osmotic fragility. The standard technique to determine the osmotic fragility of red blood cells is laborious and time-consuming, and provides only approximate values with a few experimental data. In this work, we propose and investigate a way to measure the osmotic fragility of erythrocytes, rapidly and in a straightforward, more quantitative and less laborious way, with an optical sensor. The basic idea is monitoring in real time the refractive index of a suspension of erythrocytes to follow the kinetics of their lysis as the hemoglobin-rich cytosol is released from the erythrocytes in the surrounding hypotonic solution during hemolysis, resulting in an increase of the refractive index. We propose a device to measure in real time the refractive index and demonstrate the feasibility of monitoring the hemolysis process with high resolution. Our results show that the release of hemoglobin-rich cytosol during the progress of the hemolysis of erythrocytes in hypotonic media is generally an exponential-like function of time. We provide a mathematical model that reproduces experimental curves effectively. We show results for erythrocytes obtained from human blood stored in a blood bank and from volunteers diagnosed with two different types of anemia: hemolytic and drepanocytic. We define times, measurable from the kinetics of the refractive index signal, to quantify the progress of hemolysis as a possible new method of measuring osmotic fragility.

Braking Efficiency and Stability of Chassis Braking System of Combine Harvester: The Theoretical Derivation and Virtual Prototype Simulation

With the advancement of agricultural mechanization, the safety of agricultural vehicles has aroused extensive concern. However, conventional methods evaluate the performance of the combine harvesters in a laborious and inaccurate filed-test way. It is still a challenge to evaluate their performance in a theoretical derivation-based simulation way. Here, we accurately derive the braking model of the combine harvester, which provides a guidance for further braking simulation. Firstly, a four-wheel braking system was designed and theoretically checked. Secondly, the virtual prototype of the chassis braking system was established in ADAMS, in consideration of the complicated contact characteristics between the tire and the road and between the friction pad and the brake disk. Finally, simulation experiments of braking efficiency and directional stability were carried out under different braking conditions. By this means, we find a novel effective yet simple way to optimize the braking efficiency as well as the sufficient braking stability of combine harvesters. The results show that braking efficiency would be improved with stronger braking force, lower initial braking velocity, and lighter weight of the combine harvester. Compared with straight-line braking, steering braking shows lower braking efficiency and less inclination of rear wheel bounce under the same braking conditions. As for braking directional stability, the lateral slippage would be increased with the locking of rear wheels, higher driving speed, or lower road adhesion coefficient. In addition, the simulation results are in agreement with the theoretical results, proving the validity of the virtual prototype simulation. Overall, other than traditional filed-test methods, our method provides an effective yet simple way for designing and evaluating the chassis braking system of combine harvesters.

About the size of measuring instruments sample in the conformity assessment of them with technical regulations on the module F

The principles of measuring instruments sampling in the conformity assessment with technical regulations on the module F and the reliability of using the sample are considered in this paper. According to the technical regulation of the legislatively regulated measuring instruments and the technical regulation of measuring instruments, in the compliance assessment according to the module F, sampling control is possible with a confidence level of 0.95. In order to verify the fulfillment of the requirement to ensure a confidence probability of 0.95, the simplest but very laborious way is to take a sufficiently large batch size and verify that the amount of measuring instruments with an error not exceeding its normalized value is not less than 95 % of the batch size. Another way that requires a much smaller batch size is to find the root mean square deviation of errors (with their signs) for each measuring instrument, then based on the Student’s distribution, to find the deviation corresponding to the probability of 0.95. The test result can be considered positive if the deviation obtained does not exceed the normalized error. Confidence intervals for the root mean square deviation are about 22 % for 20 instruments and about 9 % for 100 instruments. There may be some additional reduction in sample size, if each instrument from a batch is tested at several points of the range and there are grounds for considering the results at these points to be independent. Then, not the maximum error in the range is taken, but the errors (with signs) at all points of the range are used for each instrument. In this case, the equivalent number of instruments is reduced in the number of measurement points of the range.

Yoga – a laborious way to well-being: patients’ experiences of yoga as a treatment for hypertension in primary care

Objective: The aim of the study was to describe patients’ experience of yoga as a treatment for hypertension, as well as their experience of living with hypertension.Design: Qualitative interview studyMethod and materials: In 2013–2014, in southern Sweden, patients with hypertension from three health care centres were invited to participate in a randomised controlled trial on yoga for hypertension. After completion of the study, eight women and five men (aged 35–79), who had practiced the yoga intervention, were interviewed about their experiences. We used a semi-structured interview guide according to Kvale. Qualitative analysis was conducted by systematic text condensation inspired by Malterud.Results: Two main themes emerged during the analysis process: Yoga – a laborious way to well-being and hypertension – a silent disease. The positive experiences of doing yoga were described in terms of tranquillity and increased agility. The drawbacks were mainly linked to the time required to perform the exercises.Living with high blood pressure and having to take medication can imply a stigma and cause concerns for future cardiovascular events. Most patients that we interviewed expressed a wish to find alternative ways to treat their high blood pressure. Participating in the yoga study was seen as a good possibility to try such an alternative way.Conclusions: Many patients with hypertension in Swedish primary care seem to be interested in trying alternative treatments to control blood pressure. The patients in our study experienced several benefits from doing yoga, but they also pointed out difficulties in implementing yoga as a regular and permanent lifestyle change.

On the approximation by three consecutive continued fraction convergents

Denote by pn/qn,n=1,2,3,…, the sequence of continued fraction convergents of the real irrational number x. Define the sequence of approximation coefficients by θn:=qn|qnx−pn|,n=1,2,3,…. A laborious way of determining the mean value of the sequence |θn+1−θn−1|,n=2,3,…, is simplified. The method involved also serves for showing that for almost all x the pattern θn−1<θn<θn+1 occurs with the same asymptotic frequency as the pattern θn+1<θn<θn−1, namely 0.12109⋯. All the four other patterns have the same asymptotic frequency 0.18945⋯. The constants are explicitly given.

The changing face of allergy/immunology fellowship programs

Fellowship training in allergy/immunology (A/I) has evolved through the decades. Up until a few years ago, the application process was much simpler, with just a submission of a completed application form and letter of interest and that all-important interview. Since then, the requirements and documentation necessary to start and successfully complete an A/I fellowship have stockpiled. Are these changes really molding fellows to be better clinicians, researchers, and clinician-educators, or is this just a more laborious way of documenting their training because the medical environment has been increasingly susceptible to litigious investigation, and because of demands made by the public, the Institute of Medicine, and the federal government? The changes have been made across the board for the different specialties and subspecialties in medicine, and it has been particularly challenging to keep up with accreditation. In the last 5 to 10 years, some of the changes have included the application process, the level of supervision and necessary documentation needed for evaluation of the fellows, and advances in technology and the process of adult learning.

In vitro modification of substituted cysteines as tool to study receptor functionality and structure–activity relationships

Mutagenic investigations of expressed membrane proteins are routine, but the variety of modifications is limited by the twenty canonical amino acids. We describe an easy and effective cysteine substitution mutagenesis method to modify and investigate distinct amino acids in vitro. The approach combines the substituted cysteine accessibility method (SCAM) with a functional signal transduction readout system using different thiol-specific reagents. We applied this approach to the prolactin-releasing peptide receptor (PrRPR) to facilitate biochemical structure–activity relationship studies of eight crucial positions. Especially for D6.59C, the treatment with the positively charged methanethiosulfonate (MTS) ethylammonium led to an induced basal activity, whereas the coupling of the negatively charged MTS ethylsulfonate nearly reconstituted full activity, obviously by mimicking the wild-type charged side chain. At E5.26C, W5.28C, Y5.38C, and Q7.35C, accessibility was observed but hindered transfer into the active receptor conformation. Accordingly, the combination of SCAM and signaling assay is feasible and can be adapted to other G-protein-coupled receptors (GPCRs). This method circumvents the laborious way of inserting non-proteinogenic amino acids to investigate activity and ligand binding, with rising numbers of MTS reagents allowing selective side chain modification. This method pinpoints to residues being accessible but also presents potential molecular positions to investigate the global conformation.

A Novel Technique for Data Extraction from Hidden Web Databases

The large amount of information on web is stored in backend databases which are not indexed by traditional search engines. Such databases are referred to as Hidden web databases and extraction of this hidden web content is a potential research area as the pages are dynamically created through search query interfaces. However, direct query through this search interface is laborious way to search. Hence, there has been increased interest in retrieval and integration of hidden web data with a view to give high quality information to the web user. This paper proposes a novel approach that identifies Web page templates and the tag structures of a document in order to extract structured data from hidden web sources as the results returned in response to a user query are typically presented using template generated Web pages.

Murder Afloat (review)

Reviewed by: Murder Afloat Elizabeth Bush Conly, Jane Leslie. Murder Afloat. Disney/Hyperion, 2010. [176p.] ISBN 978-1-4231-0416-2 $17.99 Reviewed from galleys R Gr. 5-8. Many, many unfortunate fictional boys have found themselves under the thumb of a ruthless sea captain, generally after either being kidnapped or impressed. Ben Orville, age fourteen, falls into the kidnapped category, rounded up with a bunch of German immigrants near the docks in 1882 Baltimore to toil on the oyster dredger Ella Daw under drunken, vicious Captain Henry Steele. The first and second mates, Plum and Hawk, seem nearly as terrifying as the captain, but as Ben is forcibly taught his new trade, he begins to realize that Plum and Hawk are the only hope for order aboard the ship. A group of the Germans make an escape one night, and they take Ben with them; he and a young man named Rolfe are the only survivors among the escapees, and as they rely on the kindness of strangers to make their laborious way back toward Baltimore, Rolfe is picked up by bounty hunters and Ben hastily finds employment on Captain John Mayer's happier Disciple. He also, though, is eventually captured while ashore and returned to the now desperately undermanned Ella Daw, with its deranged captain and two very angry mates. Although Ben's misadventures closely resemble those of other young literary seafarers, Conly individuates her protagonist's story with well-drawn, scandal-infused details of the oyster industry, a distinctive narrative voice for Ben that recalls the tone of nineteenth-century adventure tales, and a taut plot thread that implicates Ben directly in a murder. Brevity—a boon to many reluctant or time-constrained readers—will make this easy to promote as a satisfying middle-school quick pick. Copyright © 2010 The Board of Trustees of the University of Illinois

Right to Specific Performance: Is There a Divergence between Civil- and Common-Law Systems and, If So, How Has It Been Bridged in the DCFR?

ABSTRACT: Civil- and common-law systems are asserted to treat the right of a party to a contract to specific performance in quite different ways: in civil-law systems, this right seems to be a fundamental right of a creditor, emanating from the adagium ‘pacta sunt servanda’ itself; common-law systems, on the contrary, are supposed to grant this action to the creditors only in the exceptional case that their usual remedy, damages, would not achieve appropriate justice. One might expect that this well-known divergence between the before-said law systems has posed quite a problem to the draughtsmen of the Draft Common Frame of Reference (DCFR); since it is to serve as an international instrument, unitary rules were needed, and therefore, it might be expected that its draughtsmen have reached a laborious compromise between the before-said law systems in a laborious way. The following questions will be addressed: does this divergence between civil- and common-law systems exist realiter and, if so, how has it been bridged in the DCFR? In order to answer these questions, rights of a party to a contract of monetary obligations have been distinguished from rights to non-monetary ones. It will turn out with respect to each of these types of obligations that the beforesaid divergence between civil- and common-law systems is not as wide as might have been expected. The remaining divergences between the law systems have been bridged by the draughtsmen of the DCFR in different ways, dependent on the type of obligation at stake. With respect to monetary obligations, they have chosen for the common-law solution, that is, damages instead of a right to specific performance. With respect to non-monetary obligations, the civil-law solution that these draughtsmen have, on the contrary, chosen for the civil-law solution as the basic rule is the right to specific performance; their task to include the rights that the European Union confers on consumers in the DCFR may account for this latter choice.

The Navajo, Psychosis, Lacan, and Derrida

����� ��� The effective violence of disseminating writing. An infraction marking the “symbolic.” Would every possibility of disorder and disorganization in the symbolic, from the vantage of a certain outside force, would everything that forces the symbolic, derive from the specular (or the “imaginary”), that is, from a “real” determined as the “impossible”? From schizophrenia or psychosis? In this case, what are the conclusions to be drawn? —Jacques Derrida, Positions So psychoanalysis “recognizes itself” when it is confronted with those very psychoses which nevertheless (or rather, for that very reason) it has scarcely any means of reaching: as if the psychosis were displaying in a savage illumination, and offering in a mode not too distant but just too close, that towards which analysis must make its laborious way.

Human-centered concepts for exploration and understanding of Earth observation images

The progress in information retrieval, computer vision, and image analysis makes it possible to establish very complete bases of algorithms and operators. A specialist in remote sensing or image processing now has the tools that allow him, at least in theory, to configure applications solving complex problems of image understanding. However, in reality, earth observation (EO) data analysis is still performed in a very laborious way at the end of repeated cycles of trial and error. To overcome this, we proposed a novel advanced remote sensing information processing system knowledge-driven information mining (KIM). KIM is based on human-centered concepts (HCCs), which implements new features and functions allowing improved feature extraction, search on a semantic level, the availability of collected knowledge, interactive knowledge discovery, and new visual user interfaces. We assess the HCC methodology for solving several difficult tasks in EO image interpretation, using a broad variety of sensor data, from meter-resolution synthetic aperture radar and optical images to hyperspectral data.

Immunosuppressive drug monitoring - what to use in clinical practice today to improve renal graft outcome

Therapeutic drug monitoring (TDM) of immunosuppressive therapy is becoming an increasingly complex matter as the number of compounds and their respective combinations are continuously expanding. Unfortunately, in clinical practice, monitoring predose trough blood concentrations is often not sufficient for guiding optimal long-term dosing of these drugs. The excellent short-term results obtained nowadays in renal transplantation confer a misleading feeling of safety despite the fact that long-term results have not substantially improved, definitely not to a point where longer graft survival could counteract the increasing need for transplant organs and less toxicity and side-effects could ameliorate patient survival. It is therefore a challenging task to try to tailor immunosuppressive drug therapy to the individual patient profile and this in a time-dependent manner. For the majority of currently used immunosuppressive drugs, measurement of total drug exposure by determination of the dose-interval area under the concentration curve (AUC) seems to provide more useful information for clinicians in terms of concentration-exposure and exposure-response as well as reproducibility. To simplify this laborious way of measuring drug exposure, several validated abbreviated AUC profiles, accurately predicting the dose-interval AUC, have been put forward. Together with an increasing knowledge of the time-related pharmacokinetic behaviour of immunosuppressive drug and their metabolites, studies are focusing on how to apply abbreviated AUC sampling methods in clinical transplantation, taking into account the numerous factors affecting drug pharmacokinetics. Eventually, TDM using abbreviated AUC profiles has to be prospectively tested against classic methods of drug monitoring in terms of cost-effectiveness, feasibility and clinical relevance with the ultimate goal of improving patient and graft survival.

McRAPD as a new approach to rapid and accurate identification of pathogenic yeasts

Despite advances in antifungal prophylaxis and therapy, morbidity and mortality incurred by yeasts remain a significant burden. As pathogenic yeast species vary in their susceptibilities to antifungal agents, clinical microbiology laboratories face an important challenge to identify them rapidly and accurately. Although a vast array of phenotyping and genotyping methods has been developed, these are either unable to cover the whole spectrum of potential yeast pathogens or can do this only in a rather costly or laborious way. Random amplified polymorphic DNA (RAPD) fingerprinting was repeatedly demonstrated to be a convenient tool for species identification in pathogenic yeasts. However, its wider acceptance has been limited mainly due to special expertise and software needed for analysis and comparison of the resulting banding patterns. Based on a pilot study, we demonstrate here that a simple and rapid melting curve analysis of RAPD products can provide data for identification of five of the most medically important Candida species. We have termed this new approach melting curve of random amplified polymorphic DNA (McRAPD) to emphasize its rapidity and potential for automation, highly desirable features for a routine laboratory test.

Irony and the Eucharist

In one region of our lives, we have no problem in understanding how a thing can change its substance while apparently remaining itself. The process is known as metaphor. ‘Fire’ can mean anger or amorousness rather than literal flame, but the word ‘fire’ remains unaltered in this exchange, rather as the bread and wine of the eucharist still look and behave like bread and wine. Since the meaning of a word is its being, we can say that the being or ‘substance’ of the word has changed with this metaphorical transaction. Flame has transubstantiated into fury.Moreover, ‘fire’ can act as a metaphor of passion only because there are real resemblances between the two. The relation between the two signs is not iconic (they don’t look much like each other), but it is not arbitrary either. Maybe Seamus Heaney could get ‘carburetter’ to mean erotic passion, but for most of us ‘fire’ is a less laborious way of doing it. In a similar way, the bread and wine of the eucharist, as signs of our human solidarity which need to be destroyed (consumed) if they are to yield life, have natural affinities with the body of Christ. As Herbert McCabe once remarked, you couldn’t consecrate Coke and burgers because they aren’t food and drink.The notion of metaphor will only get us so far in understanding the eucharist, since a change of being which leaves a thing apparently intact is more mysterious than a change of meaning which does so. But a semiotics of the eucharist can be pressed further.

Glacier mass balance: the first 50 years of international monitoring

The paper reviews measurements of glacier mass balance in the period 1946-95. There are data for 246 glaciers but most records are quite short. The available mass-balance data are biased to Western Europe, North America and the former USSR with too few measurements from other parts of the world. The data are also biased towards wetter conditions with too few data from the dry-cold glaciers that are typical of many regions. There is no sign of any recent global trend towards increased glacier melting, and the data mainly reflect variations within and between regions. The ‘direct method’ of measuring glacier mass balance is with stakes and snowpits but it is a very laborious way of measuring long-term glacier changes. Stake/snowpit measurements should be more integrated in future with geodetic and remote sensing methods, especially laser profiling, and with modelling.

Evaluating commercial maize hybrids for resistance to gibberella ear rot

An integral component of breeding maize for resistance to Fusarium graminearum ear rot is the identification of resistant genotypes. Since natural infection is not consistent from year to year, maize researchers must use manual techniques to inoculate the plant material with fungal spores. Information is presented here on site resistance of commercial maize hybrids to F. graminearum over three years and at two locations. Additionally, results of an investigation on the two predominant techniques of inoculating maize, the silk channel and kernel inoculation methods, are reported. Of 61 commercial hybrids tested, only two were ranked as moderately resistant to the fungus by both inoculation methods. These two hybrids also had a stable response to the F. graminearum infection across seven environments when the silk channel inoculation method was used. The majority of the hybrids were ranked as either susceptible or highly susceptible and less than 10% of the hybrids had a stable response to fungal infection. In the investigation of methodology, it was concluded that silk browning would be the least laborious way to identify the ideal time to complete silk channel inoculations. It was found that kernel inoculations using the pin inoculation method should take place between 11 and 15 days after 50% silking to achieve proper hybrid discrimination. Mist irrigation increased mold severity ratings and resulted in greater discrimination between hybrids with varying levels of resistance to F. graminearum infection.

English as she should be taught

Recently the BBC launched a campaign to help the two million adults in this country who are unable to read. Everyone of good will wishes the BBC great success, but one must wonder how so many people who, we are told, are of normal intelligence came to fail so lamentably in a basic skill like simple reading. The excuses are legend — large classes, sickness, absence from school for one reason or another; but the stark fact remains that two million of our fellow citizens cannot read at all. How many more are inadequate readers is, perhaps fortunately, not known; but if the performance of people observed in trains, buses and public libraries is anything to judge by, the total could be in excess of eighty per cent of the adult population. The slow, inefficient, laborious way in which ordinary men and women spell their way through the popular newspapers has to be seen to be believed. Most take at least five or six times as long to read the simple prose of our newspapers as a skilled reader, and probably retain much less.