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Evaluating locally run large language models for obstructive sleep apnea diagnosis and treatment : a real-world polysomnography study
Get PDFPurpose: Sleep medicine is a highly resource-intensive field where large language models (LLMs) could offer a promising solution by supporting diagnostic processes. As web-based LLMs have obvious data protection constraints, locally run LLMs are essential for clinical implementation. This study is the first to investigate the performance of locally run LLMs in the interpretation of real-world polysomnographic (PSG) results. Methods: We randomly selected N=30 patients (18 male, 12 female, mean age 50.5 ± 11.1 years, mean body mass index 29.7 ± 5.5 kg/m², mean apnea hypopnea index 30.9 ± 23.8) from the clinical database of our sleep laboratory who underwent PSG due to clinical complaints typical of obstructive sleep apnea (OSA). The board-certified sleep physician’s interpretations of diagnosis, suitable first-line therapy or alternative therapy were compared with those of three locally run LLMs (Gemma2, Llama3 and Mistral Nemo) assessing the level of concordance. Results: Gemma2 showed the lowest concordance of 33% (10/30 patients) with the board-certified sleep physician regarding OSA severity, followed by Mistral Nemo at 47% (14/30 patients) and Llama3 at 50% (15/30 patients). For automatic positive airway pressure (aPAP) recommendations, Mistral Nemo showed the highest concordance at 90% (27/30 patients), followed by Gemma2 and Llama3 with 83% (25/30 patients) each. Conclusion: Although locally run LLMs bypass data security constraints and show promising potential for clinical practice, their performance needs significant improvement prior to real-world implementation. Therefore, at present, the routine implementation of locally run LLMs in sleep medicine needs more refinement and fine tuning before they can be used for interpretation of real-world PSG results.Peer reviewe
From ‘living death’ to ‘becoming-with’ : caring for dementia beyond the human
Get PDFFunding: This work was undertaken as part of Aikaterini Mentzou’s PhD at the University of Dundee, awarded by the Scottish Graduate School of Social Sciences (SGSSS) and funded by the Economic and Social Research Council (ESRC). SGSSS and ESRC had no role in writing the manuscript, or the decision to submit the paper for publication.This essay provides a critical overview of historical and contemporary conceptualisations of selfhood in dementia. We explore the intersections of psychological and sociological research, as well as care practices, in dementia scholarship and how these have evolved in the years leading to and proceeding the start of the 21st century. Focusing on historical discourses of dementia and the metaphor of dementia as a ‘living death’, this essay maps the development of prominent conceptualisations of dementia in western cultures, from their roots in Cartesian philosophy to modernist values and existential anxieties. We firstly explore historical notions of selfhood in people living with dementia and the presumed erosion of the self that culminates in a so-called living death. Then, we discuss the radical shift in attitudes that arose around the start of the 21st century towards perseverance of selfhood in dementia and person-centred care. We finally consider whether our current understanding of selfhood in dementia could benefit from a posthuman approach, which requires a radical shift towards a more relational, multiple, and ultimately affirmative ways of caring for dementia.Peer reviewe
Natalie Duddington’s religious translations from Russian : faith in translation
Get PDFFunding: The author gratefully acknowledges funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement no. 802437).This article examines translations of religious texts from Russian into English by Natalie Duddington (1886-1972), better known as an assistant to the prolific translator Constance Garnett. I consider ‘religious’ to refer to both spiritual and scriptural texts, given the overlap between religious and secular values in Russian culture. I explore Duddington’s career as a translator from the perspective of her traditionally female habitus (Simeoni, 1998) which dictates Duddington’s “invisibility” (Venuti, 2008). I argue, however, that invisibility is not necessarily imposed on a female translator by the rules of the cultural field in which she operates. Instead, I analyse Duddington’s translatorial hexis (Charlston, 2013) to show that, somewhat counter-intuitively, a translator can choose voluntarily to relinquish her own voice in the process of intercultural mediation, to further her perceived higher spiritual purposes. Duddington contributed to the British cultural field as a translator of Russian religious philosophy and literature, and as an author of her own philosophical works. Through these activities, she did not seek a more privileged position in society or to receive great personal gain. On the contrary, her main objective was to bring British and Russian people closer through shared spiritual wisdom.Peer reviewe
Connettività come ragione di sistema. Il caso dell’Asia Centrale
Get PDFNegli ultimi anni, la parola ‘connettività’ è stata spesso associata all’ Asia centrale nell’ambito di progetti infrastrutturali, logistici, commerciali, ed economici. Dato che la regione non è provvista di sbocchi sul mare, e dipende da partner ester-ni per il raggiungimento di mercati extra-regionali, gli investimenti in Asia centrale sulla facilitazione del transito di beni, persone e capitali sono in continuo aumento. Tuttavia, il carattere normativo e politico della ‘connettività’ rimane, ad oggi, solo parzialmente colto ed analizzato dalla letteratura esistente. Per ovviare a questa lacuna, questo scritto analizza il concetto di connettività in Asia centrale attraver-so il prisma della ‘ragione di sistema’, che si riferisce all’interesse non meramente nazionale ed egoistico degli stati, ma piuttosto a quello sistemico, che ha valore in quanto socializzante e catalizzante dell’interdipendenza alla base dell’ordine politico regionale. L’utilità di questo focus analitico è mostrare alla comunità scienti"ca, così come a quella del policy-making, che lo sviluppo della connettività in Asia centra-le non risponde solo a logiche di calcolo economico e politico, ma risponde ad un mutato contesto regionale in cui la connettività diventa punto cardinale del mante-nimento dell’ordine regionale stesso.Peer reviewe
Knowing what is said & other essays on knowledge, understanding, and communication
Get PDFThis dissertation consists of five separate papers, an introduction, and a conclusion. Chapter 1 introduces the issues to be discussed and provides an overview of the dissertation. Chapter 2 provides an account of how we come to know what other people say to us on particular occasions. Your friend utters the sentence ‘butterflies have taste receptors on their feet’ in your presence, and you come to know right away that she said that butterflies have taste receptors on their feet. How do you come to know this fact? It is argued that we know facts about what a speaker has said in making an utterance partly in virtue of knowing other facts, including facts about what words mean, and facts about the context of the utterance. Chapter 3 defends an account of what it is to understand an utterance. What does it take for you to understand your friend’s utterance about butterflies? And what is the relation between utterance understanding and knowledge? It is argued that understanding cannot be understood in terms of knowledge of what is said, because such knowledge is neither necessary nor sufficient for understanding. It is suggested that understanding must be understood in terms of a notion closely related to that of knowledge, namely cognitive achievement. Chapter 4 turns to testimonial justification. Suppose you adopt the belief that butterflies have taste receptors on their feet on the basis of your friend’s utterance. What does it take for you to be justified in this belief? It is argued that testimonial justification cannot be understood as a kind of immediate or non-inferential justification. Chapter 5 provides a positive account of testimonial justification. It defends a middle ground between reductionism and anti-reductionism. Chapter 6 turns from issues concerning communication to issues concerning our capacity to understand the world more generally. What does it take to understand why something is the case, for instance why the Tacoma Narrows Bridge collapsed? A common answer is that understanding why something is the case is a matter of knowing a fact about why it is the case. It is argued that if knowledge is stakes sensitive, this answer cannot be true, since understanding is not stakes sensitive. There will be cases in which knowledge and understanding come apart
Tax justice : a pathway to better health
Get PDFNational governments, independently through their policy choices and collectively through global institutions, influence nearly all determinants of health: from providing access to public health care, adequate housing, social protection, and universal education, to ensuring decent work and employment, a fair income, food security, and a sustainably healthy environment. To do so, governments must raise revenue through taxation and use it effectively and accountably.Taxes have been described as society’s superpower. Yet deep historic and structural global injustices mean governments are often unable or unwilling to effectively generate and allocate taxes in ways that dismantle inequalities. Tax injustice infringes on the lives, rights, and well-being of all people and further marginalizes discriminated groups. This is the status quo. There is an alternate path possible, the status futurus. Activist communities and engaged policymakers are already shaping a world where tax abuse is being stemmed, tax systems within and across countries are becoming fairer, and taxes are effectively contributing to healthier societies. Resistance to this movement is strong and from many sides; what role are health activists playing in challenging this resistance? This chapter examines the current status quo and what can be done to change the situation in tax to improve public health; it is written specifically for the health workers and health activists
Journeys in storytelling : representations of Iran in British travel writing (1800-1859)
Get PDFWhen the first wave of British diplomats journeyed to Iran in the opening decades of the nineteenth century, they observed a trait that seemed to define every area of Iranian life: duality. To James Morier, John Malcolm, and James Baillie Fraser, the behaviors, thoughts, artforms, and cultural practices of Iran’s people appeared inherently contradictory yet inseparable from the very subjects with which they were in conflict. At this time, Iran was relatively unknown to Britain. As these early travelers embarked on voyages of cultural and anthropological exploration, they witnessed the hostilities between Iran’s newly established Qajar dynasty, its warring regional tribes, and an increasingly powerful clerical class. Meanwhile, Iran’s jarring encounters with British, Russian, and French imperial power during this period forced the nation to confront some unpleasant realities about the shortcomings of its ruling establishments.
Travel and its themes of uncertainty, instability, introspection, and retrospection would serve as the framework for the representations of Iran that these writers brought to the British public. These works are critical and insightful, and played a crucial role in shaping British attitudes about Iran. Central to their observations of Iranian duality is a tension between the nation’s institutional powers and its people, whose understanding of their wider cultural history often conflicts with dynastic and clerical policy. That tension’s portrayal in the works of Morier, Malcolm, Fraser, and Edward FitzGerald will be the primary focus of this study
Fine-scale residency and temperature-driven habitat selection in a migratory shark species
Get PDFFunding: This work was supported by funding from NatureScot (project code: 015960); Marine Scotland (project codes: SP004 and SP02B0); the Marine Alliance for Science and Technology in Scotland (MASTS) Sharks, Skates and Rays in the Offshore and Coastal zone of Scotland (SIORC) community project - MASTS is funded by the Scottish Funding Council (grant reference HR09011) and contributing institutions.Many marine species exhibit complex and diverse movements that vary across spatial and temporal scales. These movements must be accounted for when designing effective management and conservation efforts. While environmental cues such as temperature and salinity have been shown to influence the movements of mobile species, it is increasingly documented that social factors can also influence space use and population behaviour. Understanding how various factors influence movement enhances our ability to predict the space use of highly dynamic ocean species. Spurdog (Squalus acanthias), known for their tendency to aggregate and use of both coastal and oceanic environments, are an ideal model species for studying drivers of movement. To investigate movement and habitat selection in spurdog, we conducted an acoustic telemetry study from June 2016 to July 2017, tagging 51 spurdog in a partially enclosed fjordic sea loch on the west coast of Scotland. The thermal profile of Loch Etive was recorded to complement the movement data. Our study revealed temperature as a pivotal driver of movement and habitat selection in spurdog, with the unique thermal environment of the fjord enabling year-round residency at a previously undocumented spatial scale, suggesting that such habitats may be especially important for mobile marine species. This study demonstrates the importance of understanding environmental influences on space use and movement to develop effective, climate-resilient management strategies for spurdog and other mobile marine species.Peer reviewe
A new implicit formulation of the enthalpy method using flag updates
Get PDFFunding: This work was supported by the Engineering and Physical Sciences Research Council, United Kingdom , grant no EP/V012479/1.In the computation of problems involving phase changes, numerical approaches formulated on enthalpy offer numerous advantages to ‘front-tracking’ methods where the moving boundary between phases is explicitly tracked. However, due to the piecewise definition of enthalpy, such formulations effectively insert additional nonlinearity into the governing equations, thus adding increased complexity to implicit time-evolution schemes. In this paper, we develop and present a new ‘flag-update’ enthalpy method that crucially results in a linear set of equations at each time step. The equations can then be formulated as a sparse linear system, and subsequently solved using a more efficient inversion process. In a detailed error analysis, and via benchmarking on the classic Stefan problem in 1D and 2D, we show that the flag-update scheme is significantly faster than traditional implicit (Gauss–Seidel SOR) methods. However, speedup does not persist in 3D due to the significant memory and storage manipulations required. This study highlights the need to develop rigorous numerical analysis thresholds on such schemes.Peer reviewe
A one-billion-year-old Scottish meteorite impact
Get PDFFunding: Research in the GeoHistory Facility, JdLC, Curtin University, is supported by AuScope and the Australian Government via the National Collaborative Research Infrastructure Strategy. Inductively coupled plasma–mass spectrometry (ICP-MS) instrumentation was obtained via funding from the Australian Research Council.The Stoer Group in northwest Scotland is one of the oldest well-preserved sedimentary successions in Europe and includes the Stac Fada Member, an impact ejecta deposit. Here we report U-Pb analyses on shocked zircon grains that yield an age of 990 ± 22 Ma, consistent with an early Tonian Pb-loss event that affected the Stac Fada Member but not its bounding strata. We interpret these data to record the timing of impact, which occurred some 200 m.y. after the previously determined 1177 Ma alkali feldspar 40Ar/39Ar age. The alkali feldspar we find within the Stac Fada Member yields Rb-Sr ages of ca. 1735 Ma and 1675 Ma, consistent with a detrital provenance from Paleoproterozoic granites. Our new age constrains the Stoer Group to the early Tonian and suggests a new Neoproterozoic plate tectonic context for these rocks. These data revise the age of some of the oldest known nonmarine microfossils in the UK and their role for timing the eukaryotic colonization of land.Peer reviewe
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