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Large language models for simplifying radiology reports: a systematic review and meta-analysis of patient, public, and clinician evaluations
Get PDFBACKGROUND: Radiology reports are typically written in language that is difficult for patients to understand. Large language models (LLMs) excel at simplifying text. We aimed to evaluate the ability of LLMs to improve the understanding of radiology reports. METHODS: In this systematic review and meta-analysis, we searched CENTRAL, MEDLINE, and Embase from inception to Nov 11, 2025, without restrictions on language. Full-text articles and preprints were considered for inclusion. Eligible studies applied LLMs to simplify radiology reports and had these reports assessed by members of the public or medical professionals. We excluded studies that focused solely on dialogues with interactive chatbots, preimaging leaflets, educational materials, appointment letters, or summarising findings without simplifying them for patients. Search results were screened independently by two authors and full-text review and data extraction were done by three authors; disagreements were resolved by consensus. The main outcomes were patient, public, and clinician evaluations (Likert scores) and text readability metrics. We assessed study quality with the MAIC-10 tool. This study was registered with PROSPERO (CRD420251027489). FINDINGS: We identified 2385 records, of which 38 studies were eligible. These 38 studies generated 12 922 simplified reports, assessed by 508 evaluators (387 lay people and 121 clinicians). 35 (92%) of 38 studies used OpenAI GPT models and 29 (76%) produced simplified reports in English. Patients perceived LLM-rewritten reports as significantly more understandable than radiologist reports (mean Likert score 4·04 [SD 1·20] for simplified reports vs 2·16 [SD 0·94] for original reports; mean difference 2·00 [95% CI 1·54-2·46]). Clinicians rated LLM-rewritten reports highly for accuracy (mean 4·45 [95% CI 4·27-4·63]; 27 studies) and completeness (mean 4·53 [95% CI 4·30-4·76]; 14 studies). Readability was improved across imaging modalities, with lower Flesch-Kincaid Grade Level for LLM-rewritten reports, including a mean difference of -6·20 (95% CI -6·91 to -5·48) for CT, -5·07 (-5·99 to -4·15) for x-ray, and -5·0 (-6·0 to -4·0) for MRI. The error rate in LLM-rewritten reports was 7·2% (95% CI 5·1%-10·0%; 13 studies) and 0·9% (95% CI 0·6-1·5%; 2 studies) for clinically significant errors. INTERPRETATION: LLM-simplified radiology reports improved patient-perceived understanding and readability and were rated by clinicians as largely accurate and complete, although a small proportion contained clinically significant errors. LLM-based simplification shows promise for making radiology communication more patient-centred, but further evaluation of its effect on patient outcomes and clinical workflows is required. FUNDING: National Institute for Health and Care Research Sheffield Biomedical Research Centre
New insights on the influence of hard transformed regions created on R260 rails using lasers on damage behaviour during rolling-sliding contact tests
Get PDFThis research examines the influence of laser-induced hard transformed regions (consisting of white and likely brown etching layers) on the damage behaviour of R260 rail steel under rolling–sliding contact conditions. The laser-based approach was found to produce very consistent transformed regions across different specimens. The research explores how the transformed regions contribute to crack initiation and propagation, particularly at the interface with the substrate material and within the transformed region itself. Crack formation was consistent in terms of location, angle, and length for regions of the same geometry, while systematic variations in crack position and length were observed when comparing regions of different lengths. Localised material deformation, including unique material flow patterns at the trailing edge, was found to play a key role in crack development. The findings provide deeper insight into rail surface degradation mechanisms and have implications for the design, treatment, and maintenance of railway components. The consistency of the layer-based approach and the possibility to efficiently test many hard transformed regions for the first time has allowed generation of repeatable and consistent data sets that can be used with confidence as inputs for rail damage modelling and for providing a benchmark for comparing against other rail grades
The psychoactive effects of repeated ketamine infusions and their mechanistic role in the treatment of alcohol use disorder: secondary analysis of a randomised controlled trial
Get PDFBackground and aims
Ketamine assisted psychotherapy is a promising new treatment for alcohol use disorder (AUD). The psychoactive effects of repeated intravenous (IV) ketamine infusions in people with AUD and their mechanistic role in treating AUD are largely unknown. This study aimed to (1) quantify the subjective, psychoactive effects of IV ketamine in people with AUD, (2) investigate how these effects change over three dosing sessions and (3) test whether these effects mediate ketamine's therapeutic benefits in reducing alcohol consumption.
Design
Secondary analysis of the randomised, parallel-arm, double-blind, placebo-controlled, phase 2 ‘KARE’ clinical trial.
Setting
Two clinical research facilities in England.
Participants
96 adults (35 women) aged 18–64 years with moderate-to-severe AUD.
Intervention
Three weekly infusions of either ketamine (IV 0.8 mg/kg over 40 minutes) or placebo (saline solution).
Measurements
Psychoactive drug effects experienced were self-reported pre-, during- and post-infusion, every 20 minutes (eight times/infusion) on Likert scales (1–10), for: Effects of Drug, Liking of Drug, Altered Reality, Out of Body Experiences, Visual Distortion, Sound Distortion and Altered Time Perception. For each scale, we calculated area-under-the-curve (AUC) scores for each infusion and the AUC average across three infusions. The clinical outcome was percentage of days abstinent from alcohol in the 6 months after infusions.
Findings
Ketamine produced strong psychoactive effects on every scale, relative to placebo (all P values < 0.001). Ketamine's psychoactive effects were moderated by infusion number (infusion 2 vs. infusion 1) for: Liking of Drug (P = 0.001), Altered Reality (P = 0.030) and Out of Body Experiences (P = 0.033), with small-to-moderate effect sizes. The remaining four psychoactive effects were not statistically significantly changed by repeated dosing. No psychoactive effect statistically significantly mediated the relationship between drug treatment and percentage days abstinent (all P values = 0.075–0.935).
Conclusions
People with alcohol use disorder experience alterations in consciousness from 0.8 mg/kg intravenous ketamine administration. Ketamine's effects appear to be broadly consistent across three repeated infusions. Ketamine-related reductions in alcohol consumption do not appear to be mediated by the acute psychoactive effects of ketamine
Novel symptom subgroups in patients with irritable bowel syndrome are associated with healthcare utilisation in secondary and tertiary care
Get PDFBackground & Aims
Current classification systems for irritable bowel syndrome (IBS) based on bowel habit do not consider psychological impact. We applied a previously validated latent class analysis (LCA) model to a cohort of patients with IBS in secondary and tertiary care to assess whether it predicted levels of healthcare utilisation.
Methods
We applied our LCA model to a referral population with IBS. As described previously, we assigned cluster membership based on gastrointestinal symptom severity and psychological burden. We assessed demographics, symptom severity and quality of life at baseline and levels of healthcare utilisation during 12 months of longitudinal follow-up according to cluster.
Results
We recruited 379 patients, of whom 249 (65.7%) met the Rome IV criteria. Those in the four clusters with higher psychological burden had more severe symptoms on the IBS-SSS and lower quality of life scores (p < 0.001 for both). Rates of discharge were generally lower in clusters with higher psychological burden (p = 0.05). Rates of prescribing a drug for IBS (p = 0.001), the mean number of drugs prescribed for IBS (p < 0.001) and the mean number of different drug types prescribed for IBS (p < 0.001 for trend) were highest in the four clusters with higher psychological burden.
Conclusions
In patients with IBS in secondary and tertiary care, the LCA model identified groups of individuals with more severe symptoms and greater impairments in quality of life at baseline and significantly higher rates of healthcare utilisation during longitudinal follow-up
Mapping low-intensity selective logging across the Peruvian Amazon
Get PDFSelective logging is a major driver of tropical forest degradation and is estimated to span over 400 million hectares of tropical forest. Despite widely available forest monitoring tools that effectively map deforestation, accurate and scalable remote sensing methods to detect selective logging are less advanced. Previous efforts are largely unable to reliably detect the low-intensity selective logging (< 10 m3ha-1) that dominates across much of the Amazon rainforest, the world’s largest remaining stock of tropical timber. Utilising a unique training dataset of high-resolution uninhabited aerial vehicle (UAV) imagery from logged forests across the Peruvian Amazon, we build random forest models trained to detect selective logging using freely available optical satellite images from Sentinel-2 and Landsat. We find the Sentinel-2 model to be highly accurate (F1 score: 0.88, kappa: 0.85, false detection rate: 6.3%), outperforming the Landsat model (F1 score: 0.77, kappa: 0.74, false detection rate: 21.7%). Both models accurately detected 3- to 20-fold more selective logging activity in our validation data than widely available forest monitoring tools (TMF, GLAD-S2 Alerts, RADD Alerts). We demonstrate novel uses for these logging-detection models in the monitoring of legal timber harvesting inside forest concessions and illegal harvesting of wood inside Protected Areas. These results have the potential to transform our understanding of low-intensity, logging-induced forest degradation at broad scales, demonstrating the clear potential of remote sensing methods to effectively monitor both legal and illegal selective logging in tropical forests
The political integration of armed groups in a changing global security landscape:Implications for sustainable peace
No full textThis paper discusses the prospects for political integration of armed groups in the context of contemporary dynamics of armed conflict. While the conversion of insurgent movements into political actors is not new, shifting global conflict dynamics are challenging the established liberal peace framework. Drawing on insights from comparative case studies of both negotiated settlements and rebel victories, the paper argues that wartime organisational cohesion, governance capacity, ideology, and external engagement decisively shape prospects or post-war political integration of armed groups. It introduces a novel typology that highlights diverse pathways towards and constraints to demilitarisation and party formation. The analysis offers policy recommendations tailored to group type and context, situated within contemporary conflict environments marked by fragmentation and internationalisation. Ultimately, the paper argues that sustainable peace requires recognising rebel legacies, supporting incremental reforms, and fostering inclusive governance in the long term
Topology and geometry optimization of grid-shells incorporating design-dependent self-weight loading
Get PDFThis manuscript presents the first approach that is capable of finding the optimal connectivity and elevation of grid-shell structures acting in pure compression (or pure tension) for long-span scenarios; i.e., under the combined effects of a prescribed external loading and the design-dependent self-weight of the structure itself. The method derived herein involves solving a second-order cone optimization problem, thereby ensuring convexity and obtaining globally optimal results for a given discretization of the design domain. Several numerical examples are presented, illustrating hitherto unknown or unconfirmed characteristics of this class of optimal structures. For example, it is found that, as self-weight becomes more significant, both the optimal topology and the optimal elevation profile of the structure change, highlighting the importance of optimizing both topology and geometry simultaneously from the earliest stages of design. It is shown that this approach can obtain solutions with greater accuracy and several orders of magnitude more quickly than a standard 3D layout/truss topology optimization approach. Python scripts and Rhino/Grasshopper files are provided for the examples shown
On the occurrence of λ Boötis stars in star clusters
Get PDFλ Boötis stars are a subset of chemically peculiar A-stars that display Solar abundances in lighter elements (C, N, O, S, etc.) but a deficiency in Iron-peak elements. This difference has been attributed to the A-stars accreting pristine (metal deficient) gas from the Interstellar Medium. However, the recent discovery of λ Boötis stars in clusters challenges this theory, due to the presence of ionising radiation from intermediate/massive (>5 M⊙) stars, which could prevent accretion of pristine ISM gas. We use N-body simulations to track the dynamical histories of A-stars during the evolution of a star cluster. We find that some stars leave the confines of the cluster and travel beyond the tidal radius, where they may be able to accrete pristine ISM gas. These A-stars then sometimes move back into the inner regions of the cluster, but the photoionising radiation flux they receive is not high enough to prevent λ Boötis abundances from occurring in these A-stars. We find that A-stars can develop λ Boötis abundances and subsequently form a wide (>100 au) binary system, meaning that observations of binary systems that have different abundances between the component stars would not rule out the ISM accretion scenario. Whilst we have shown that λ Boötis stars can reside in and around star clusters, further research is required to assess the validity of the accretion rates required to explain their abundance patterns
Association of Time to Antibiotics With Outcome in Pediatric Patients Receiving Chemotherapy for Cancer With Fever in Neutropenia-An International Individual Patient Data Meta-Analysis
Get PDFPURPOSE: Fever in neutropenia (FN) is a potentially lethal complication of chemotherapy for cancer. Prompt administration of broad-spectrum antibiotics is standard of care. Despite conflicting results on the association of time to antibiotics (TTA) with outcomes, TTA limits are used as FN quality measure both in adult and pediatric oncology. This individual patient data (IPD) meta-analysis studied the association between TTA and outcomes in pediatric patients with FN. PATIENTS AND METHODS: IPD on TTA in pediatric patients with FN receiving chemotherapy for any malignancy was collected internationally. Three-level mixed binomial logistic regression analyzed the association of TTA with safety relevant events (SRE; death, admission to intensive care unit [ICU], bacteremia), primarily in patients with severe disease at presentation and secondarily in all patients. RESULTS: Data on 4006 FN episodes in 2073 patients, diagnosed 2016-2023, were reported from 15 study sites in eight countries. Median TTA was 61 min overall and 53 min in the 345 (8.6%) episodes with severe disease at presentation. Among these with severe disease, an SRE was reported in 119 (34%) episodes. Longer TTA (> 60 vs. ≤ 60 min) was associated with less SRE (odds ratio, 0.41; 95% CI, 0.24-0.70). This primary finding was confirmed in secondary and additional exploratory analyses. CONCLUSION: This large, international and adequately powered IPD meta-analysis found no association between shorter TTA and improved clinical outcomes in pediatric patients with FN. This finding was consistent across analyses. These results challenge the continued use of TTA limits as a quality measure for pediatric oncology centers
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