A Large, Simple Trial Leading to Complex Questions.
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ABSTRACT:
SUBMITTER: Harrington DP
PROVIDER: S-EPMC7727323 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
A Large, Simple Trial Leading to Complex Questions.
Harrington David P DP Baden Lindsey R LR Hogan Joseph W JW
The New England journal of medicine 20201202 6
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Project description:When human and non-human animals learn sequences, they manage to implicitly extract statistical regularities through associative learning mechanisms. In two experiments conducted with a non-human primate species (Guinea baboons, Papio papio), we addressed simple questions on the learning of simple AB associations appearing in longer noisy sequences. Using a serial reaction time task, we manipulated the position of AB within the sequence, such that it could be either fixed (by appearing always at the beginning, middle, or end of a four-element sequence; Experiment 1) or variable (Experiment 2). We also tested the effect of sequence length in Experiment 2 by comparing the performance on AB when it was presented at a variable position within a sequence of four or five elements. The slope of RTs from A to B was taken for each condition as a measurement of learning rate. While all conditions differed significantly from a no-regularity baseline, we found strong evidence that the learning rate did not differ between the conditions. These results indicate that regularity extraction is not impacted by the position of the regularity within a sequence and by the length of the sequence. These data provide novel general empirical constraints for modeling associative mechanisms in sequence learning.
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Project description:ObjectiveThe aim of this research was to evaluate the validity of the questions developed by Thai periodontists on self-reported periodontal status and symptoms in identifying severe periodontitis amongst adults in Thailand.MethodsRegistered Electricity Generating Authority of Thailand (EGAT) employees completed medical examinations and full-mouth periodontal examinations. They also were interviewed using a self-reported questionnaire that was developed by Thai periodontists. The questions pertained to their periodontal status and symptoms comprising swollen gums, bad breath, loose teeth, bleeding on brushing, painful gums, and pus or abscesses. The participants were categorised as having nonsevere and severe periodontitis according to the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology (CDC/AAP) case definitions. Self-reported periodontal status and symptom results were compared with actual periodontal status. The area under the receiver operating characteristic curve (AUROCC), sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated.ResultsA total of 1393 EGAT employees participated in this study. The questions on self-reported periodontal status and all symptoms poorly identified patients with severe periodontitis, with an AUROCC of 0.52 to 0.60. The sensitivity was 5.0% to 40.2%; however, the specificity was good, at 73.2% to 99.1%. The validity of the self-reported questions was comparable amongst the sex, education, and income subgroups.ConclusionsThis study demonstrated that self-reported periodontal status and symptoms were inadequate in identifying patients with severe periodontal disease.
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Project description:Load Theory (Lavie, 1995, 2005) states that the level of perceptual load in a task (i.e., the amount of information involved in processing task-relevant stimuli) determines the efficiency of selective attention. There is evidence that perceptual load affects distractor processing, with increased inattentional blindness under high load. Given that high load can result in individuals failing to report seeing obvious objects, it is conceivable that load may also impair memory for the scene. The current study is the first to assess the effect of perceptual load on eyewitness memory. Across three experiments (two video-based and one in a driving simulator), the effect of perceptual load on eyewitness memory was assessed. The results showed that eyewitnesses were less accurate under high load, in particular for peripheral details. For example, memory for the central character in the video was not affected by load but memory for a witness who passed by the window at the edge of the scene was significantly worse under high load. High load memories were also more open to suggestion, showing increased susceptibility to leading questions. High visual perceptual load also affected recall for auditory information, illustrating a possible cross-modal perceptual load effect on memory accuracy. These results have implications for eyewitness memory researchers and forensic professionals.
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Project description:BackgroundMeta-research can involve manual retrieval and evaluation of research, which is resource intensive. Creation of high throughput methods (e.g., search heuristics, crowdsourcing) has improved feasibility of large meta-research questions, but possibly at the cost of accuracy.ObjectiveTo evaluate the use of double sampling combined with multiple imputation (DS + MI) to address meta-research questions, using as an example adherence of PubMed entries to two simple consolidated standards of reporting trials guidelines for titles and abstracts.MethodsFor the DS large sample, we retrieved all PubMed entries satisfying the filters: RCT, human, abstract available, and English language (n = 322, 107). For the DS subsample, we randomly sampled 500 entries from the large sample. The large sample was evaluated with a lower rigor, higher throughput (RLOTHI) method using search heuristics, while the subsample was evaluated using a higher rigor, lower throughput (RHITLO) human rating method. Multiple imputation of the missing-completely at-random RHITLO data for the large sample was informed by: RHITLO data from the subsample; RLOTHI data from the large sample; whether a study was an RCT; and country and year of publication.ResultsThe RHITLO and RLOTHI methods in the subsample largely agreed (phi coefficients: title = 1.00, abstract = 0.92). Compliance with abstract and title criteria has increased over time, with non-US countries improving more rapidly. DS + MI logistic regression estimates were more precise than subsample estimates (e.g., 95% CI for change in title and abstract compliance by year: subsample RHITLO 1.050-1.174 vs. DS + MI 1.082-1.151). As evidence of improved accuracy, DS + MI coefficient estimates were closer to RHITLO than the large sample RLOTHI.ConclusionOur results support our hypothesis that DS + MI would result in improved precision and accuracy. This method is flexible and may provide a practical way to examine large corpora of literature.
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Project description:UNLABELLED:Of the numerous instruments available to detect nutritional risk, the most widely used is the Mini Nutritional Assessment (MNA), but it takes 15-20 min to complete and its systematic administration in primary care units is not feasible in practice. We developed a tool to evaluate malnutrition risk that can be completed more rapidly using just clinical variables. Between 2008 and 2013, we conducted a cross-sectional study of 418 women aged ≥60 years from Mexico. Our outcome was positive MNA and our secondary variables included were: physical activity, diabetes mellitus, hypertension, educational level, dentition, psychological problems, living arrangements, history of falls, age and the number of tablets taken daily. The sample was divided randomly into two groups: construction and validation. Construction: a risk table was constructed to estimate the likelihood of the outcome, and risk groups were formed. VALIDATION:the area under the ROC curve (AUC) was calculated and we compared the expected and the observed outcomes. The following risk factors were identified: physical activity, hypertension, diabetes, dentition, psychological problems and living with the family. The AUC was 0.77 (95% CI [0.68-0.86], p < 0.001). No differences were found between the expected and the observed outcomes (p = 0.902). This study presents a new malnutrition screening test for use in elderly women. The test is based on six very simple, quick and easy-to-evaluate questions, enabling the MNA to be reserved for confirmation. However, it should be used with caution until validation studies have been performed in other geographical areas.
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Project description:A healthy lifestyle, myocardial revascularisation and medical therapy constitute the three pillars for the treatment of ischaemic heart disease. Lifestyle and optimal medical therapy should be used in all cases. However, the selection of cases for revascularisation among stable patients remains controversial. The ISCHEMIA trial compared an early invasive strategy with revascularisation plus optimal medical therapy against initial optimal medical therapy alone with revascularisation reserved for cases in which symptom control was insufficient. The study included over 5,000 patients with stable coronary artery disease and moderate to severe myocardial ischaemia. No differences were found in relevant clinical outcomes, including all-cause mortality, cardiovascular death, MI, heart failure and stroke, over a follow-up of 3.2 years. Conversely, angina control was better in patients with severe symptomatic angina. Following the tradition of all trials comparing medical therapy alone with revascularisation, the ISCHEMIA trial results are controversial, but an analysis of the design and results of the trial offers important information to better understand, evaluate and treat the growing number of patients with stable chronic ischaemic heart disease and moderate to severe myocardial ischaemia.
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Project description:This study aims to evaluate the feasibility of large language model (LLM) in answering pathology questions based on pathology reports (PRs) of colorectal cancer (CRC). Four common questions (CQs) and corresponding answers about pathology were retrieved from public webpages. These questions were input as prompts for Chat Generative Pretrained Transformer (ChatGPT) (gpt-3.5-turbo). The quality indicators (understanding, scientificity, satisfaction) of all answers were evaluated by gastroenterologists. Standard PRs from 5 CRC patients who received radical surgeries in Shanghai Changzheng Hospital were selected. Six report questions (RQs) and corresponding answers were generated by a gastroenterologist and a pathologist. We developed an interactive PRs interpretation system which allows users to upload standard PRs as JPG images. Then the ChatGPT's responses to the RQs were generated. The quality indicators of all answers were evaluated by gastroenterologists and out-patients. As for CQs, gastroenterologists rated AI answers similarly to non-AI answers in understanding, scientificity, and satisfaction. As for RQ1-3, gastroenterologists and patients rated the AI mean scores higher than non-AI scores among the quality indicators. However, as for RQ4-6, gastroenterologists rated the AI mean scores lower than non-AI scores in understanding and satisfaction. In RQ4, gastroenterologists rated the AI scores lower than non-AI scores in scientificity (P = 0.011); patients rated the AI scores lower than non-AI scores in understanding (P = 0.004) and satisfaction (P = 0.011). In conclusion, LLM could generate credible answers to common pathology questions and conceptual questions on the PRs. It holds great potential in improving doctor-patient communication.
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Project description:BackgroundTelerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change.ObjectivesThe purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization.DesignThis study was a pilot randomized controlled trial.SettingTraining was done in the participant's home. Testing was done in separate research labs involving functional magnetic resonance imaging (fMRI) and multi-camera gait analysis.PatientsSixteen participants with chronic stroke and impaired ankle dorsiflexion were assigned randomly to receive 4 weeks of telerehabilitation of the paretic ankle.InterventionParticipants received either computerized complex movement training (track group) or simple movement training (move group).MeasurementsBehavioral changes were measured with the 10-m walk test and gait analysis using a motion capture system. Brain reorganization was measured with ankle tracking during fMRI.ResultsDorsiflexion during gait was significantly larger in the track group compared with the move group. For fMRI, although the volume, percent volume, and intensity of cortical activation failed to show significant changes, the frequency count of the number of participants showing an increase versus a decrease in these values from pretest to posttest measurements was significantly different between the 2 groups, with the track group decreasing and the move group increasing.LimitationsLimitations of this study were that no follow-up test was conducted and that a small sample size was used.ConclusionsThe results suggest that telerehabilitation, emphasizing complex task training with the paretic limb, is feasible and can be effective in promoting further dorsiflexion in people with chronic stroke.
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Project description:Transmembrane helical segments (TMs) can be classified into two groups of so-called 'simple' and 'complex' TMs. Whereas the first group represents mere hydrophobic anchors with an overrepresentation of aliphatic hydrophobic residues that are likely attributed to convergent evolution in many cases, the complex ones embody ancestral information and tend to have structural and functional roles beyond just membrane immersion. Hence, the sequence homology concept is not applicable on simple TMs. In practice, these simple TMs can attract statistically significant but evolutionarily unrelated hits during similarity searches (whether through BLAST- or HMM-based approaches). This is especially problematic for membrane proteins that contain both globular segments and TMs. As such, we have developed the transmembrane helix: simple or complex (TMSOC) webserver for the identification of simple and complex TMs. By masking simple TM segments in seed sequences prior to sequence similarity searches, the false-discovery rate decreases without sacrificing sensitivity. Therefore, TMSOC is a novel and necessary sequence analytic tool for both the experimentalists and the computational biology community working on membrane proteins. It is freely accessible at http://tmsoc.bii.a-star.edu.sg or available for download.
| S-EPMC3394259 | biostudies-literature