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Framework for uncertainty evaluation in optical surface topography measurement using a virtual instrument
Get PDFUncertainty evaluation in the measurement of surfaces with complex topography using optical techniques remains a challenge due to the complex interaction between light and the surfaces. The ISO 25178 part 600 specification standard simplifies uncertainty evaluation by introducing a set of agreed metrological characteristics that can be propagated through a mathematical model. To complement this, we developed a virtual coherence scanning interferometer to model error sources and provide task-specific uncertainty evaluation. This paper presents a framework for evaluating measurement uncertainty of areal surface texture parameters, using both the metrological characteristics approach and the virtual instrument method. We demonstrate this framework by assessing the uncertainty of the Sq parameter, which represents the root-mean-square of surface heights, for sinusoidal and quasi-random surfaces. By comparing the combined standard uncertainty from both approaches, we quantify the contribution of topography fidelity, a key but difficult-to-evaluate characteristic. The proposed method offers a comprehensive understanding of uncertainty in optical surface measurement, leading to improved tolerancing in manufacturing
A survey of deep-learning-based radiology report generation using multimodal inputs
Get PDFAutomatic radiology report generation can alleviate the workload for physicians and minimize regional disparities in medical resources, therefore becoming an important topic in the medical image analysis field. It is a challenging task, as the computational model needs to mimic physicians to obtain information from multi-modal input data (i.e., medical images, clinical information, medical knowledge, etc.), and produce comprehensive and accurate reports. Recently, numerous works have emerged to address this issue using deep-learning-based methods, such as transformers, contrastive learning, and knowledge-base construction. This survey summarizes the key techniques developed in the most recent works and proposes a general workflow for deep-learning-based report generation with five main components, including multi-modality data acquisition, data preparation, feature learning, feature fusion and interaction, and report generation. The state-of-the-art methods for each of these components are highlighted. Additionally, we summarize the latest developments in large model-based methods and model explainability, along with public datasets, evaluation methods, current challenges, and future directions in this field. We have also conducted a quantitative comparison between different methods in the same experimental setting. This is the most up-to-date survey that focuses on multi-modality inputs and data fusion for radiology report generation. The aim is to provide comprehensive and rich information for researchers interested in automatic clinical report generation and medical image analysis, especially when using multimodal inputs, and to assist them in developing new algorithms to advance the field
Luck framing supports the avoidance of collective disaster when inequalities in vulnerability exist
Get PDFCollective action problems describe situations such as climate change in which the efforts of multiple individuals are required to achieve joint outcomes. Many of these problems feature a threshold (e.g. limiting global warming to 1.5 °C above pre-industrial levels) that must be achieved in order to avoid a collective disaster (e.g. catastrophic climate change) that may affect individuals to varying degrees. Here we adapt a collective action game called the collective-risk social dilemma in which players in small groups make successive financial contributions towards a group target in order to avoid disaster. We investigate the extent to which different levels (resilient vs. vulnerable) and sources (luck vs. merit) of vulnerability to the disaster influence efforts to avoid it. We find that luck framing supports the avoidance of disaster: 76 % of groups with luck-based inequalities successfully achieve the group target compared with 40 % of groups with merit-based inequalities. This difference is driven by higher contributions towards the target from players whose level of vulnerability is determined by luck rather than merit. We also find that despite having different levels of vulnerability to the disaster, resilient and vulnerable players contribute similarly towards the group target. Our findings highlight the potential importance of luck framing in collective action problems that involve individuals with different levels of vulnerability to a collective risk. We discuss implications for policymakers and groups seeking to solve such problems
Reimagining Dementia Care: A Complex Intervention Systematic Review on Optimising Social Prescribing (SP) for Carers of People Living With Dementia (PLWD) in the United Kingdom
Get PDFIntroductionCarers of people living with dementia (PLWD) face a range of complex needs, including medical, emotional, social and practical challenges, often exacerbated by social isolation and barriers to accessing support. Social prescribing (SP) addresses these needs by increasing access to non-clinical support and services. However, existing research lacks detailed descriptions of SP interventions for carers of PLWD, with limited understanding of the needs they target, the reasons for participation, their effectiveness and their potential to improve outcomes for carers of PLWD.MethodsA complex intervention systematic review of SP for carers of PLWD was undertaken using iterative logic modelling and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-CI) extension statement and checklist. Six databases and grey literature were searched, supplemented by hand searching reference lists of included studies. Results were screened in a two-step process, followed by data extraction. Gough's Weight of Evidence Framework was used to assess the risk of bias in the included studies.ResultsFifty-two studies were included. Findings indicated SP for carers of PLWD in the United Kingdom is varied and operates in a largely uncoordinated process involving initiation by diverse stakeholders and institutions across multiple sectors. The classification of SP interventions for carers of PLWD is inconsistent, and participation is often opportunistic. Positive outcomes included improved carer mood, social connections, practical support, quality of life and better PLWD–carer relationships. However, negative outcomes were associated with intervention suitability, emotional impact, relevance and strained PLWD–carer relationships.DiscussionWhile the evidence suggests SP is a promising intervention for carers of PLWD, its long-term impacts, challenges of tailoring prescriptions to carers' needs and overcoming logistical issues remain. Additionally, further research is required to evaluate long-term impact, investigate specific mechanisms to tailor SP to specific carer needs and explore in greater detail the PLWD–carer relationship and its effects on SP uptake and maintenance.Patient and Public ContributionsA PPI advisory group was involved in the review, including providing insights into review questions, the logic model, findings and results. The group consisted of one person living with dementia and a caregiver
Cognitive impairment and health outcomes in non-dialysis chronic kidney disease: a systematic review and meta-analysis
Get PDFBackgroundCognitive impairment is prevalent in individuals with chronic kidney disease (CKD), but its effects on health outcomes remain unclear. While cognitive impairment can affect self-management, its role in CKD has been insufficiently explored. This systematic review aimed to examine the association between cognitive impairment and health outcomes or self-management ability among persons with CKD.MethodsSearches were performed in June 2024 on Embase, MEDLINE, CINAHL, PsycINFO, Web of Science, PubMed and grey literature databases for longitudinal or cross-sectional studies examining associations between cognitive impairment (using any validated measure) and health outcomes or ability to self-manage in adults with CKD not on kidney replacement therapy. Health outcomes included mortality, kidney disease progression, hospitalisation and healthcare utilisation, cardiovascular and cerebrovascular events, and health-related quality of life (HRQoL). Risk of bias was assessed using the ROBINS-E tool.Results14 studies were included. Cognitive impairment was associated with increased all-cause and cardiovascular mortality, higher risk of cardiac arrhythmia, stroke and transient ischaemic attack, lower HRQoL, and higher healthcare utilisation. Mixed results were seen in studies examining the association between cognitive impairment and kidney disease progression. No studies with self-management measures as an outcome were identified.ConclusionsCognitive impairment is associated with poor health outcomes in persons with CKD, although evidence was limited for some outcomes. No causal link could be established due to potential residual confounding by frailty or shared comorbidities. Further research is required to explore potential causal pathways and the role of cognitive impairment in CKD self-management
Inter- and intra-observer variability of software quantified bowel motility measurements of small bowel Crohn’s disease: findings from the MOTILITY trial
Get PDFObjectivesMotility magnetic resonance imaging (mMRI) is a potential marker of disease activity of small bowel Crohn’s disease (SBCD), but there is limited data on its reproducibility. We assessed inter- and intra-observer agreement of small bowel motility as part of a prospective multicentre trial investigating whether mMRI can predict longer-term response to biologic therapy in active, non-stricturing SB-CD (MOTILITY Trial).Methods297 segmental small bowel motility scores from 104 SBCD patients (mean age 38.9 years, 43 female) recruited to the MOTILITY trial were measured independently by two radiologists experienced in mMRI, using GIQuant software. Twenty-six datasets were re-read by both radiologists to test intra-observer variability after a washout period of at least 6 weeks. Five gastrointestinal radiologists inexperienced in mMRI derived 66 segmental motility scores from the same 30 randomly selected patients. Agreement was quantified using the intra-class correlation coefficient (ICC).ResultsThere was moderate agreement for mMRI-derived segmental small bowel motility measurements for both mMRI-experienced and inexperienced radiologists (ICC 0.59 (95% CI: 0.51, 0.66) and 0.70 (95% CI: 0.61, 0.78), respectively). Agreement remained moderate to good, combining the experienced trial MRI reader measurements with those of the five inexperienced radiologists (ICC 0.69 (95% CI: 0.61, 0.78). Intra-observer agreement for the two mMRI experienced radiologists was (0.71 (95% CI: 0.44, 0.86) and 0.70 (95% CI: 0.44, 0.86)).ConclusionsThere is moderate to good interobserver agreement for mMRI measurements of segmental small bowel motility for both experienced and inexperienced radiologists.Critical relevance statementStudy findings support the continuing clinical translation of motility MRI as a reproducible biomarker of disease activity and treatment response in Crohn’s disease.Key PointsMotility MRI is a novel biomarker of small bowel Crohn’s disease activity.Currently, limited data on intra- and inter-observer variability exists.Motility MRI shows moderate to good inter- and intra-observer agreement.Intraclass correlation was 0.59–0.71 for experienced and inexperienced radiologists.Motility MRI is reproducible, supporting its utility as a biomarker of disease activity
Pharmacological blocking of microfibrillar-associated protein 4 reduces retinal neoangiogenesis and vascular leakage
Get PDFNeovascular age-related macular degeneration and diabetic macular edema are leading causes of vision loss evoked by retinal neovascularization and vascular leakage. The glycoprotein microfibrillar-associated protein 4 (MFAP4) is an integrin αVβ3/5/6 ligand present in the extracellular matrix. Single-cell transcriptomics reveal MFAP4 expression in cell types in close proximity to vascular endothelial cells, including choroidal vascular mural cells, retinal astrocytes, and Müller cells. Binding of the anti-MFAP4 antibody, hAS0326, makes MFAP4 inaccessible for integrin receptor interaction, and thereby hAS0326 blocked endothelial cell motility in vitro. Intravitreal hAS0326 inhibited retinal vascular lesion area and neovessel volume in a laser-induced choroidal neovascularization mouse model, vascular permeability in streptozotocin-induced retinopathy, and vascular leakage area in a chronic non-human primate model of DL-2-aminoadipic acid-induced retinopathy. One dose of hAS0326 showed duration of efficacy of at least 12 weeks in the latter model. Moreover, hAS0326 treatment significantly enriched Gene Ontology terms involving reduction of integrin binding. Our data suggest that hAS0326 constitutes a promising treatment of neovascularization and vascular leakage in retinal diseases
Target product profiles for digital health technologies including those with artificial intelligence: a systematic review
Get PDFDigital health technologies (DHTs), including those incorporating artificial intelligence (AI), have the potential to improve healthcare access, efficiency, and quality, reducing gaps between healthcare capacity and demand. Despite prioritisation in health policy, the adoption of DHTs remains limited, especially for AI, in part due to complex system requirements. Target product profiles (TPPs) are documents outlining the characteristics necessary for medical technologies to be utilised in practice and offer a way to align DHTs’ research and development with health systems’ needs. This systematic review examines current DHT TPPs’ methodologies, stakeholders, and contents. A total of 14 TPPs were identified, most targeted at low- and middle-income settings and communicable diseases. Only one TPP outlined the requirements for an AI device specifically. In total, 248 different characteristics were reported across the TPPs identified and were consolidated down to 33 key characteristics. Some considerations for DHTs’ successful adoption, such as regulatory requirements or environmental sustainability, were reported inconsistently or not at all. There was little standardisation in TPP development or contents, and limited transparency in reporting. Our findings emphasise the need for guidelines for TPP development, could help inform these, and could be used as a basis to develop future DHT TPPs. Systematic Review Registration: https://www.researchprotocols.org/2024/1/e50568/authors
Comparison of Differentially Expressed Genes in Human and Canine Osteosarcoma
Get PDFOsteosarcoma (OSA) is the most prevalent bone malignancy in people and dogs. Current survival rates show the need for advances in novel therapies to help overcome the growth, survival and metastatic progression of the cancer. Canine models are often used to advance prognostic and treatment opportunities for OSA due to the similarities in the disease between species. This study focusses on the genetic and molecular similarities of OSA between human and canine specimens. Differentially expressed genes (DEGs) were compared and identified in canine and human OSA tumours, revealing 86 common genes, 36 having high and 50 having low expression. Further immunohistochemical analysis of the corresponding proteins of three identified DEGs (ASPN, STK3, BAMBI) allowed for the visualisation of protein expression in canine OSA tissues (n = 19). Overall nuclear and cytoplasmic H-scores were generated, and nuclear and cytoplasmic scores in males and females and in different anatomical locations (axial versus appendicular) were also investigated, presenting unique opportunities to understand the expression in this cancer type. This study contributes to a deeper knowledge of genetic pathways changes and identifies avenues for the diagnosis, prognosis and treatment of OSA in people and dogs, whilst encompassing the One Health concept in medicine
Responses to listening difficulty in in-person conversation: a scoping review of primary evidence
Get PDFObjectiveExisting evidence regarding the ways in which people with hearing loss respond to listening difficulty in verbal conversation is fragmented. To advance understanding of the experience of listening difficulty in in-person verbal conversation, this review seeks to map the current evidence, focusing on behavioural and affective responses.DesignScoping review following PRISMA-ScR guidelines. Articles were identified through systematic searches in five reference databases, and through reference checking. Thematic synthesis was used to collate and condense data into distinct themes and categories.Study sampleLiterature examining adults’ behavioural, and/or affective responses to listening difficulty in in-person conversation.ResultsThe literature search identified 8503 studies, and 81 were selected for inclusion. Responses from people with hearing loss, people with normal hearing, and communication partners were identified, and were assembled into five themes, each consisting of multiple categories.ConclusionPeople with hearing loss and their communication partners respond to listening difficulty in conversation in a wide range of ways, covering diverse aspects of communication. People with normal hearing report most of the same response types as people with hearing loss. Nevertheless, there is a paucity of evidence regarding responses of people with normal hearing, indicating a need for more comparative studies
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