In the United States, the Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of patient data and requires the informed consent of the patient and approval of the ...Internal Review Board to use data for research purposes, but these requirements can be waived if data is de-identified. For clinical data to be considered de-identified, the HIPAA "Safe Harbor" technique requires 18 data elements (called PHI: Protected Health Information) to be removed. The de-identification of narrative text documents is often realized manually, and requires significant resources. Well aware of these issues, several authors have investigated automated de-identification of narrative text documents from the electronic health record, and a review of recent research in this domain is presented here.
This review focuses on recently published research (after 1995), and includes relevant publications from bibliographic queries in PubMed, conference proceedings, the ACM Digital Library, and interesting publications referenced in already included papers.
The literature search returned more than 200 publications. The majority focused only on structured data de-identification instead of narrative text, on image de-identification, or described manual de-identification, and were therefore excluded. Finally, 18 publications describing automated text de-identification were selected for detailed analysis of the architecture and methods used, the types of PHI detected and removed, the external resources used, and the types of clinical documents targeted. All text de-identification systems aimed to identify and remove person names, and many included other types of PHI. Most systems used only one or two specific clinical document types, and were mostly based on two different groups of methodologies: pattern matching and machine learning. Many systems combined both approaches for different types of PHI, but the majority relied only on pattern matching, rules, and dictionaries.
In general, methods based on dictionaries performed better with PHI that is rarely mentioned in clinical text, but are more difficult to generalize. Methods based on machine learning tend to perform better, especially with PHI that is not mentioned in the dictionaries used. Finally, the issues of anonymization, sufficient performance, and "over-scrubbing" are discussed in this publication.
Compulsive smartphone use has attracted extensive social attention because of serious and even fatal outcomes associated with it. However, there has been little theory-driven research systematically ...investigating the mechanism of compulsive behavior in smartphone use. Although a significant line of literature exists in the area of personal-computer based technology addiction, the mechanism underpinning compulsive smartphone use differs significantly because the unique and specific characteristics of smartphones have given rise to a fundamentally different usage context with new usage behavioral patterns. In order to comprehensively theorize this issue, we first defined compulsive behavior in smartphone use, focusing on mobile social networking services (SNSs) in particular, and then extended the stimulus-response-reinforcement framework to investigate the theoretical network of compulsive use of mobile SNSs. We used online survey data from 368 active mobile SNS users in China to empirically test and validate the proposed model and hypotheses. Our results indicate that both positive and negative reinforcements, as well as the compensatory component, invoke the feeling of urge that leads to compulsive mobile SNS use. The positive effects of interactivity as an incentive stimulus on those reinforcements and compulsive mobile SNS use were also found to be significant.
Sharing trial results with participants is an ethical imperative but often does not happen. We tested an Enhanced Webpage versus a Basic Webpage, Mailed Printed Summary versus no Mailed Printed ...Summary, and Email List Invitation versus no Email List Invitation to see which approach resulted in the highest patient satisfaction with how the results were communicated.
We carried out a cluster randomised, 2 by 2 by 2 factorial, nonblinded study within a trial, with semistructured qualitative interviews with some patients (ISRCTN96189403). Each cluster was a UK hospital participating in the ICON8 ovarian cancer trial. Interventions were shared with 384 ICON8 participants who were alive and considered well enough to be contacted, at 43 hospitals. Hospitals were allocated to share results with participants through one of the 8 intervention combinations based on random permutation within blocks of 8, stratified by number of participants. All interventions contained a written plain English summary of the results. The Enhanced Webpage also contained a short video. Both the Enhanced Webpage and Email contained links to further information and support. The Mailed Printed Summary was opt-out. Follow-up questionnaires were sent 1 month after patients had been offered the interventions. Patients' reported satisfaction was measured using a 5-point scale, analysed by ordinal logistic regression estimating main effects for all 3 interventions, with random effects for site, restricted to those who reported receiving the results and assuming no interaction. Data collection took place in 2018 to 2019. Questionnaires were sent to 275/384 randomly selected participants and returned by 180: 90/142 allocated Basic Webpage, 90/133 Enhanced Webpage; 91/141 no Mailed Printed Summary, 89/134 Mailed Printed Summary; 82/129 no Email List Invitation, 98/146 Email List Invitation. Only 3 patients opted out of receiving the Mailed Printed Summary; no patients signed up to the email list. Patients' satisfaction was greater at sites allocated the Mailed Printed Summary, where 65/81 (80%) were quite or very satisfied compared to sites with no Mailed Printed Summary 39/64 (61%), ordinal odds ratio (OR) = 3.15 (1.66 to 5.98, p < 0.001). We found no effect on patient satisfaction from the Enhanced Webpage, OR = 1.47 (0.78 to 2.76, p = 0.235) or Email List Invitation, OR = 1.38 (0.72 to 2.63, p = 0.327). Interviewees described the results as interesting, important, and disappointing (the ICON8 trial found no benefit). Finding out the results made some feel their trial participation had been more worthwhile. Regardless of allocated group, patients who received results generally reported that the information was easy to understand and find, were glad and did not regret finding out the results. The main limitation of our study is the 65% response rate.
Nearly all respondents wanted to know the results and were glad to receive them. Adding an opt-out Mailed Printed Summary alongside a webpage yielded the highest reported satisfaction. This study provides evidence on how to share results with other similar trial populations. Further research is needed to look at different results scenarios and patient populations.
ISRCTN: ISRCTN96189403.
Backgrounds
The adenoma‐carcinoma and serrated pathways offer a window of opportunity for the removal of pre‐malignant polyps and prevention of colorectal cancer (CRC) through the use of colonoscopy. ...The aim of this study was to investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located.
Methods
This study is based on the colonoscopy data collected prospectively over a one‐year period in multiple South Australian rural centres, 24 general surgeons contributed to this study. All histopathology results were subsequently entered into the dataset.
Results
A total of 3497 colonoscopies were performed, with a total of 2221 adenomatous and serrated polyps removed. Both serrated and adenomatous polyps were more common in the distal colon. Patients of male gender, aged 70 years and over and with an indication of polyp surveillance had higher adenoma and serrated polyp detection rates (ADR and SPDR). Patients aged 40–49 years old who underwent colonoscopy for positive faecal occult blood had an ADR and SPDR of 25.0% and 6.3%, respectively.
Conclusions
This study has shown variation in ADR and SPDR depending on age, gender and indication for colonoscopy. This variation will help further develop key performance indicators in colonoscopy. The high ADR and SPDR in patients aged 40–49 years old whom underwent colonoscopy for positive faecal occult blood may support lowering the age of commencement of CRC screening in Australia.
This study is based on the data collected prospectively over a one‐year period in seven South Australian rural centres. We investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located. Variation may impact colorectal cancer screening practices and assist in developing appropriate key performance indicators in colonoscopy for adenoma and serrated polyp detection rate.
Dry reforming catalysts, especially those with activity at moderate temperatures, have been intensely investigated to enhance the conversion of biogas. Here, Ru is evaluated as a promoter for Ni-Mg ...based catalysts. Catalysts based on 1.4 wt%Ni-1.0 wt%Mg-Ce0.6Zr0.4O2 with Ru (0.02–0.32 wt%) were prepared using incipient wetness. The reducibility of the catalysts and conversions increased with increasing Ru content. Increases in conversions with increasing Ru loading was attributed to the additional active sites and synergistic effect between Ru and Ni, which weakened Ni-Mg interactions. Samples showed dry reforming activity at low temperatures (450–510 °C). Reaction rates and activation energies of higher loading Ru samples (1.4 wt%Ni-1.0 wt%Mg/Ce0.6Zr0.4 O2 with 0.16 and 0.32 wt%Ru) decreased when the reduction temperature was raised from 300 to 400 °C. A 20 h TOS study showed stable catalytic activity with minimal coke deposition. The results suggest that Ru is an alternative to Pt in promoting low temperature dry reforming of methane.
Abstract
Ensembles of nitrogen-vacancy (NV) centres in diamond are a leading platform for practical quantum sensors. Reproducible and scalable fabrication of NV-ensembles with desired properties is ...crucial, as is an understanding of how those properties influence performance. This work addresses these issues by characterising nitrogen-doped diamond produced by the chemical vapour deposition (CVD) method across a range of synthesis conditions. This is shown to produce material with widely differing absorption characteristics, which is linked to the level of defects other than substitutional nitrogen (N
S
) and NV. In such material, the achievable concentration of NV
−
(NV
−
) is found to be influenced by the as-grown properties. At the 10–20 ppm level for N
S
, the production of CVD-grown material with strain levels sufficient not to limit achievable device sensitivity is demonstrated and a favourable product of NV
−
and
T
2
*
is obtained. Additionally, reproducible properties over a batch of 23 samples from a single synthesis run are achieved, which appears promising for the scalability efforts underway in this area of research.
The number of characters in a movie is an important feature. However, it is non-trivial to measure directly, for example naive metrics such as the number of credited characters vary wildly. Here, we ...show that a metric based on the notion of ecological diversity as expressed through a Shannon-entropy based metric can characterise the number of characters in a movie, and is useful in taxonomic classification. We also show how the metric can be generalised using Jensen-Shannon divergence to provide a measure of the similarity of characters appearing in different movies, for instance of use in recommendation systems, e.g., Netflix. We apply our measures to the Marvel Cinematic Universe (MCU), and show what they teach us about this highly successful franchise of movies. In particular, these measures provide a useful predictor of success for films in the MCU, as well as a natural means to understand the relationships between the stories in the overall film arc.
Despite new combination therapies improving survival of breast cancer patients with estrogen receptor α (ER+) tumors, the molecular mechanisms for endocrine-resistant disease remain unresolved. ...Previously we demonstrated that expression of the RNA binding protein and N6-methyladenosine (m6A) reader HNRNPA2B1 (A2B1) is higher in LCC9 and LY2 tamoxifen (TAM)-resistant ERα breast cancer cells relative to parental TAM-sensitive MCF-7 cells. Here we report that A2B1 protein expression is higher in breast tumors than paired normal breast tissue. Modest stable overexpression of A2B1 in MCF-7 cells (MCF-7-A2B1 cells) resulted in TAM- and fulvestrant- resistance whereas knockdown of A2B1 in LCC9 and LY2 cells restored TAM and fulvestrant, endocrine-sensitivity. MCF-7-A2B1 cells gained hallmarks of TAM-resistant metastatic behavior: increased migration and invasion, clonogenicity, and soft agar colony size, which were attenuated by A2B1 knockdown in MCF-7-A2B1 and the TAM-resistant LCC9 and LY2 cells. MCF-7-A2B1, LCC9, and LY2 cells have a higher proportion of CD44+/CD24-/low cancer stem cells (CSC) compared to MCF-7 cells. MCF-7-A2B1 cells have increased ERα and reduced miR-222-3p that targets ERα. Like LCC9 cells, MCF-7-A2B1 have activated AKT and MAPK that depend on A2B1 expression and are growth inhibited by inhibitors of these pathways. These data support that targeting A2B1 could provide a complimentary therapeutic approach to reduce acquired endocrine resistance.
•HNRNPA2B1 (A2B1) is higher in breast tumors and is upregulated in tamoxifen (TAM)-resistant LCC9 and LY2 breast cancer cells.•Stable A2B1 expression in MCF-7 cells blocks inhibition by TAM and fulvestrant and increases mesenchymal-like properties.•Knockdown of A2B1 restores TAM and fulvestrant sensitivity in TAM-resistant LCC9 and LY2 cells.•A2B1 confers properties of endocrine resistance including activated AKT and MAPK and increased cancer stem cells.
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