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An Evidential Reasoning Rule Based Feature Selection for Improving Trauma Outcome Prediction
No full textVarious demographic and medical factors can be linked to severe deterioration of patients suffering from traumatic injuries. Accurate identification of the most relevant variables is essential for building more accurate prediction models and making more rapid life-saving medical decision. The intention of this paper is to select a number of features that can be used to accurately predict patients’ outcomes through three feature selection methods: random forest, ReliefF and the evidential reasoning (ER) rule. The impact of an outcome’s class imbalance on feature selection is discussed, and synthetic minority over-sampling technique (SMOTE) is performed to show the differences in the selected features. The results show that length of stay in hospital, length of stay in intensive care unit, age and Glasgow Coma Scale (GCS) are the most selected features across different techniques. The prediction models based on the features selected by the ER rule show the highest prediction performance represented by the area under the receiver operating characteristic curve (AUC) values, which has a median of 0.895 for the model employed by the ten highest-weighted variables, while the median AUC values are 0.827 and 0.885 if the ten highest-weighted variables are selected by ReliefF and random forest respectively. The results also show that after the ten most important features, increasing the number of the less important features has only a slight increase in prediction accuracy
Current recommendations for cancer surveillance in Gorlin syndrome:a report from the SIOPE host genome working group (SIOPE HGWG)
No full textGorlin syndrome (MIM 109,400), a cancer predisposition syndrome related to a constitutional pathogenic variation (PV) of a gene in the Sonic Hedgehog pathway (PTCH1 or SUFU), is associated with a broad spectrum of benign and malignant tumors. Basal cell carcinomas (BCC), odontogenic keratocysts and medulloblastomas are the main tumor types encountered, but meningiomas, ovarian or cardiac fibromas and sarcomas have also been described. The clinical features and tumor risks are different depending on the causative gene. Due to the rarity of this condition, there is little data on phenotype-genotype correlations. This report summarizes genotype-based recommendations for screening patients with PTCH1 and SUFU-related Gorlin syndrome, discussed during a workshop of the Host Genome Working Group of the European branch of the International Society of Pediatric Oncology (SIOPE HGWG) held in January 2020. In order to allow early detection of BCC, dermatologic examination should start at age 10 in PTCH1, and at age 20 in SUFU PV carriers. Odontogenic keratocyst screening, based on odontologic examination, should begin at age 2 with annual orthopantogram beginning around age 8 for PTCH1 PV carriers only. For medulloblastomas, repeated brain MRI from birth to 5 years should be proposed for SUFU PV carriers only. Brain MRI for meningiomas and pelvic ultrasound for ovarian fibromas should be offered to both PTCH1 and SUFU PV carriers. Follow-up of patients treated with radiotherapy should be prolonged and thorough because of the risk of secondary malignancies. Prospective evaluation of evidence of the effectiveness of these surveillance recommendations is required.</p
Compulsory Citizenship Behaviour and Work-family Conflict: The Role of Proactive Personality
No full textThe purpose of this study is to test the factors that impact the effects that compulsory citizenship behaviour (CCB) has on work-family conflict based on the theory of Conservation of Resources. Data were collected from 505 employees in 13 high-tech enterprises in China. It revealed that (1) employees’ compulsory citizenship behaviour is positively related to levels of work-family conflict, (2) work stress mediates the relationship between CCB and work-family conflict, and (3) proactive personality moderates the effects of CCB on employees’ work stress and work-family conflict, with the relationship more positive when proactive personality is high. The study contributes to the CCB literature through its identification of work stress as an important psychological mediation mechanism that amplifies the mechanism through which CCB has an effect on employees. The results provide a deeper understanding of important boundary conditions (in this case proactive personality) that impact the CCB to employee’s work-family conflict relationship. The findings also enrich the proactive personality literature. Paradoxically if organizations attempt to foster citizenship behaviors by selecting people with the sort of proactive personality that might assist citizenship, they end up exacerbating the impact on work stress and work-family conflict. Theoretical and practical implications, limitations and promising avenues for future study are discussed
A validation study of the kidney failure risk equation in advanced chronic kidney disease according to disease aetiology with evaluation of discrimination, calibration and clinical utility
No full textBackground The Kidney Failure Risk Equation (KFRE) predicts the 2- and 5-year risk of end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD) stages 3a-5. Its predictive performance in advanced CKD and in specific disease aetiologies requires further exploration. This study validates the 4- and 8-variable KFREs in an advanced CKD population in the United Kingdom by evaluating discrimination, calibration and clinical utility. Methods Patients enrolled in the Salford Kidney Study who were referred to the Advanced Kidney Care Service (AKCS) clinic at Salford Royal Hospital NHS Foundation Trust between 2011 and 2018 were included. The 4- and 8-variable KFREs were calculated on the first AKCS visit and the observed events of ESRD (dialysis or pre-emptive transplantation) within 2- and 5-years were the primary outcome. The area under the receiver operator characteristic curve (AUC) and calibration plots were used to evaluate discrimination and calibration respectively in the whole cohort and in specific disease aetiologies: diabetic nephropathy, hypertensive nephropathy, glomerulonephritis, autosomal dominant polycystic kidney disease (ADPKD) and other diseases. Clinical utility was assessed with decision curve analyses, comparing the net benefit of using the KFREs against estimated glomerular filtration rate (eGFR) cut-offs of <20ml/min/1.73m2 and <15ml/min/1.73m2 to guide further treatment. Results A total of 743 patients comprised the 2-year analysis and 613 patients were in the 5-year analysis. Discrimination was good in the whole cohort: the 4-variable KFRE had an AUC of 0.796 (95% confidence interval [CI] 0.762-0.831) for predicting ESRD at 2-years and 0.773 (95% CI 0.736-0.810) at 5-years, and there was good-to-excellent discrimination across disease aetiologies. Calibration plots revealed underestimation of risk at 2-years and overestimation of risk at 5-years, especially in high-risk patients. There was, however, underestimation of risk in patients with ADPKD for all KFRE calculations. The predictive accuracy was similar between the 4- and 8-variable KFREs. Finally, compared to eGFR-based thresholds, the KFRE was the optimal tool to guide further care based on decision curve analyses. Conclusions The 4- and 8-variable KFREs demonstrate adequate discrimination and calibration for predicting ESRD in an advanced CKD population and, importantly, can provide better clinical utility than using an eGFR-based strategy to inform decision-making
How and why do Educational Psychology Services engage with an ACE-informed approach?
No full textAdverse childhood experiences (ACEs) and related approaches are receiving increasing focus from education policy makers and educational psychologists. However, the extent to which ACEs research and theory can be used to inform practice continues to be a topic for debate. The present paper explores the development of ACE-informed practice within two UK local authority educational psychology services, through use of focus groups and interviews with educational psychologists. Rationale, facilitators and barriers to the development of current ACE-informed practice are reported. Implications for educational psychology practice, including consideration of risk and reliance factors, the importance of consistent implementation of approaches, and future research are also considered
Opportunities and challenges for flexible and printable electrodes in electroencephalography
No full textThe electroencephalogram (EEG) is a commonly used non-invasive approach to monitoring the brain, and has been used in applications from epilepsy diagnosis to Brain-Computer Interfaces (BCI). The EEG electrode plays a crucial role in the setup of the EEG. While many bulk metal rigid electrodes are available commercially, flexible and stretchable electrodes are needed to improve user comfort, speed of set up, and signal quality. This paper overviews the current state-of-theart in flexible EEG electrode manufacturing methods, including 3D printing, screen printing, inkjet printing, and other nonprinting techniques such as chemical fabrications and classical molding, highlighting the opportunities and challenges present
Sequential Chemotherapy-Radiotherapy as Adjuvant Treatment of High-Risk Endometrial Carcinoma: the Manchester Experience
No full textApproximately 15% of women with endometrial cancer present with high-risk disease which increases the risk of progression and death. The optimal adjuvant treatment of high-risk endometrial cancer after primary debulking surgery remains incompletely defined. Here we report the outcomes of such patients treating with sequential chemotherapy-radiotherapy at a large cancer centre in Manchester, UK.A retrospective analysis was carried out of 111 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk patients were defined as those with FIGO 2009 stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or LVSI, stage II-III endometrioid carcinoma, or any other high-risk histological subtype with stage I-III disease. Patients were followed up for a median of 67 months to measure recurrence free survival (RFS) and overall survival (OS), as well as treatment-related toxicity.Patients had a mean age of 67 years (range 33-82), a median body mass index (BMI) of 29.1 (range 16.3-59); the majority had endometrioid histology (48%). Seventy-six percent of patients were treated with sequential chemotherapy-radiotherapy; the reason for receiving single modality adjuvant therapy was mainly patient choice or contra-indications to treatment. Patients who received sequential chemotherapy-radiotherapy had a 5-year RFS of 70% (95% CI 60.8-80.6%) and a 5-year OS of 71.4% (95% CI 62.3-81.7%). Patients tolerated treatment well with 96% of patients completing planned sequential chemotherapy-radiotherapy treatment, and only 18% of patients had grade 3 or above adverse events.Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was associated with good progression free and overall survival outcomes, consistent with the results of recent phase III clinical trials. Further research is needed to determine the impact of molecular subgroups on prognosis and efficacy of adjuvant therapy.<br/
Spin-valley collective modes of the electron liquid in graphene
No full textWe develop the theory of collective modes supported by a Fermi liquid of electrons in pristine graphene. Under reasonable assumptions regarding the electron-electron interaction, all the modes but the plasmon are over-damped. In addition to the SU(2) symmetric spin mode, these include also the valley imbalance modes obeying a U(1) symmetry, and a U(2) symmetric valley spin imbalance mode. We derive the interactions and diffusion constants characterizing the over-damped modes. The corresponding relaxation rates set fundamental constraints on graphene valley- and spintronics applications
Evaluating and Investigating Knowledge Management Practices and ICT in Healthcare: An Emerging Economies Perspective
No full textWe contribute by developing this special issue in the Journal of Knowledge Management, through the extension of scholarship on the role of information communication technology (ICT) in shaping knowledge management practices, specifically, in the context of healthcare, in emerging economies. In this editorial, we provide an overview of the intersection between knowledge management (KM), ICT, within the emerging economies context. This special issue includes seven key papers that take a wide variety of approaches to exploring KM and ICT in healthcare in emerging economies. These studies based on a broad range of research designs; address issues related to diverse research contexts and provide insights that help in enhancing our understanding of the phenomenon. We present a conceptual model summarizing the contribution(s) of the issue and present a critique of the papers included herein. We conclude by offering suggestions for future research and examining the generalizability of the studies included in this special issue
Blood Prestin Levels in Normal Hearing and in Sensorineural Hearing Loss: a Scoping Review
No full textRecently it has been hypothesized that blood prestin concentration levels may reflect cochlear damage and thus serve as an easily measurable, early sensorineural hearing loss biomarker. This is a scoping review aiming to identify and critically appraise current evidence on prestin blood levels and their temporal variation in rodents and humans with normal hearing and with sensorineural hearing loss. This study was designed and held according to PRISMA Extension for Scoping Reviews (PRISMAScR) guidelines. With no limitation with regards to study type, animal and human studies focusing on prestin blood levels in normal hearing and in sensorineural hearing loss were sought in major databases such as Medline, Central. Scopus, PROSPERO and Clinicaltrials.gov. Results have been then hand-searched. A data charting form was developed including the parameters of interest. Seven studies focusing on measuring prestin blood levels by means of ELISA in rodents and human subjects with normal hearing and noise-induced, drug-induced, or idiopathic sudden hearing loss were found eligible and were included in the analysis. According to these proof-of concept studies, prestin can be detected in the circulation of subjects with no hearing loss, however normal ranges remain unclear. After cochlear damage, blood prestin levels seem to initially rise and then return to near or below baseline. The degree of their change relates with subjects’ degree of hearing loss, damaged cochlear region and recovery. Prestin blood levels and their temporal variation seem to correlate with cochlear damage, however methodological weaknesses, such as small sample size, lack of detailed phenotyping, insufficient exclusion of confounding factors and short follow-up do not allow for robust conclusions. To conclude, current findings support the value of studying blood prestin levels in normal hearing and hearing loss, and highlight a need for larger scale longitudinal research