A hybrid knowledge and ensemble classification approach for prediction of venous thromboembolism

Clinical narratives such as progress summaries, lab reports, surgical reports, and other narrative texts contain key biomarkers about a patient's health. Evidence-based preventive medicine needs accurate semantic and sentiment analysis to extract and classify medical features as the input to appropriate machine learning classifiers. However, the traditional approach of using single classifiers is limited by the need for dimensionality reduction techniques, statistical feature correlation, a faster learning rate, and the lack of consideration of the semantic relations among features. Hence, extracting semantic and sentiment-based features from clinical text and combining multiple classifiers to create an ensemble intelligent system overcomes many limitations and provides a more robust prediction outcome. The selection of an appropriate approach and its interparameter dependency becomes key for the success of the ensemble method. This paper proposes a hybrid knowledge and ensemble learning framework for prediction of venous thromboembolism (VTE) diagnosis consisting of the following components: a VTE ontology, semantic extraction and sentiment assessment of risk factor framework, and an ensemble classifier. Therefore, a component-based analysis approach was adopted for evaluation using a data set of 250 clinical narratives where knowledge and ensemble achieved the following results with and without semantic extraction and sentiment assessment of risk factor, respectively: a precision of 81.8% and 62.9%, a recall of 81.8% and 57.6%, an F measure of 81.8% and 53.8%, and a receiving operating characteristic of 80.1% and 58.5% in identifying cases of VTE.     

Social licence: power imbalances and levels of consciousness – two case studies

ABSTRACT

Social licence to operate (SLO) is a term that is finding increasing acceptance in a number of industries. Like all new terms, its precise meaning and implications are still being investigated. Using data from previous studies, this paper offers an analysis of the SLO of two case studies with each study being viewed separately through the grid of a distinct theoretical framework. Case study 1 looks at the development of differential social licence negotiated in the Hamlet of Cambridge Bay, Nunavut, as a result of an impact and benefit agreement negotiated between Tahera Diamond Corp. and the Kitikmeot Inuit Organisation in 2004. The study demonstrates that general acceptance of resource development can be uneven and reflect an unequal distribution of decision-making power. In case study 2, stakeholders of a failed mineral development project were queried across time about the specifics of the proposed mine development and were queried about resource development across different levels of consciousness. Perhaps, SLO is variable across different levels of consciousness. The paper concludes with observations about the variable nature of SLO acceptance across populations and across levels of consciousness within individuals. Perhaps, the concept of SLO is, in fact, complex, difficult to define and measure and, at this point, of limited utility as a measure of resource development acceptance.     

Carbon Chain Length Modulates MDA-MB-231 Breast Cancer Cell Killing Mechanisms by Mitochondrially Targeted Aryl−Urea Fatty Acids

Targeting the tumor cell mitochondrion could produce novel anticancer agents. We designed an aryl−urea fatty acid ( 1 g ; 16({[4-chloro-3-(trifluoromethyl)phenyl]carbamoyl}amino)hexadecanoic acid) that disrupted the mitochondrion and decreased MDA-MB-231 breast cancer cell viability. To optimize the aryl−ureas the present study evaluated mitochondrial targeting by 1 g analogues containing alkyl chains between 10–17 carbons. Using the dye JC-1, the C12−C17 analogues efficiently disrupted the mitochondrial membrane potential (IC₅₀s 3.5±1.2 to 7.6±1.1 μM) and impaired ATP production; shorter analogues were less active. 7-Aminoactinomycin D/annexin V staining and flow cytometry showed that these agents activated the killing mechanisms of necrosis and apoptosis to varying extents (7-aminoactinomycin D/annexin V staining ratios 4.3–6.0). Indeed, 1 g and its C17 analogue preferentially activated necrosis and apoptosis, respectively (ratios 2.1 and 16). Taken together, alkyl chain length is a determinant of mitochondrial targeting by aryl−ureas and can be varied to develop analogues that activate apoptosis or necrosis in a regulated fashion.     

Sensitive Mother-to-Adolescent Disclosures After Divorce: Is the Experience of Sons Different From That of Daughters?

This study addressed two main questions: (a) Are adolescent sons and daughters exposed to sensitive maternal disclosures after divorce with similar frequency and in similar detail? and (b) Does gender act as a moderator in the association between maternal disclosures and adolescent adjustment difficulties? Forced-choice and open-ended data were collected from 194 adolescents within 2 years after their parents' divorce. Quantitative analyses revealed that although the majority of adolescents experience some level of maternal disclosure, neither frequency nor detail of maternal disclosure differed as a function of adolescent gender. Frequent and detailed maternal disclosures were associated with adolescent adjustment difficulties, primarily psychological distress. Gender did not moderate that significant association. Qualitative analysis shed light on the link between maternal disclosures and adolescent distress, suggested the importance of how disclosures are made, and revealed several gender differences in reactions to maternal disclosures. Implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Support and Social Strain Among Husbands and Wives: A Multilevel Analysis.

In response to recent calls in the literature for within-person examinations of social support processes over time, this study explores the relationships of spousal support, spousal strain, and well-being among husbands and wives, both within the same day and across days. Eighty-three couples were interviewed and completed a structured diary twice daily for 1 week. The results of multilevel hierarchical modeling suggest that both spousal support and spousal strain made significant, independent contributions to concurrent negative affect, although only spousal support was a significant predictor of next-day negative affect. Spousal strain interacted with spousal support to predict next-day negative affect. Direct and moderating effects of perceived marital adjustment on negative affect were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Management gaps analysis: a case study of groundwater resource management in New Zealand

The primary objective of this project is to identify gaps, whether real or perceived, that hinder effective groundwater management in New Zealand. These gaps show as gaps in information, gaps in implementation, gaps in technological and management tools, and gaps in understanding of fundamental processes. The secondary objective is to propose a management strategy to close the identified gaps. Several methods are used to meet these objectives: surveys distributed to selected staff in each regional council; the review of various written reports; the analysis of land-use databases; and private consultation within each regional council. Results show that groundwater management in New Zealand is generally reactionary with the main gaps being in strategic planning and national guidelines. Most gaps appear to be predominantly information and implementation issues. In some cases there are gaps in the understanding of fundamental processes within an aquifer system, including the long-term effects of land-use on groundwater quality. An adaptive management approach is suggested as a means of closing these gaps.     

Korsakoff's syndrome, cognition and clonidine

Eighteen patients suffering from Alcoholic Korsakoff's Syndrome participated in a placebo-controlled double-blind cross-over trial of clonidine 0.3 mg b.d. for two weeks versus matched placebo for two weeks. A detailed neuropsychological assessment was carried out at the end of each treatment phase and staff ratings of behaviour were also obtained. Clonidine treatment resulted in no significant improvement over placebo on any of the cognitive measures employed. The results contradict previous smaller studies which had suggested that chronic treatment with clonidine had a memory-enhancing effect in Korsakoff's syndrome.     

Providing information to clients about psychological tests: A survey of attorneys' and law students' attitudes.

Surveyed 70 practicing attorneys and 150 law students to determine the extent to which they felt it was their responsibility to inform clients they referred for psychological testing about the testing process and about the validity scales on tests. Results showed that almost 50% of the attorneys and over 33% of the students believe that clients referred for testing always or usually should be informed of validity scales on tests. These results suggest that many test takers, particularly in forensic settings, may have information about validity scales that facilitates their giving biased responses without detection. Psychologists doing forensic evaluations should be alert to this possibility and should consider using more than one approach to detect response distortions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dedicated defense team strengthens liability protection

Primary psoas abscess is a relatively rare disease with highest incidence in children and adolescents. It usually presents with fever, abdominal pain and limp. Limping tends to incriminate musculoskeletal problems below the pelvis, but movement of the hip involves the psoas muscle which is mostly retroperitoneal and intimately related to pelvic and intraperitoneal organs. Although the current tendency is to use abdominal sonography, rectal examination is still a valuable step in clinical examination, and may help to assess a pelvic mass or abscess. The following case report describes the elusive nature of psoas abscess and a rare occurrence of abscess rupture and peritonitis, immediately after rectal examination.