Automated Radiology Report Generation: A Review of Recent Advances.

Increasing demands on medical imaging departments are taking a toll on the radiologist's ability to deliver timely and accurate reports. Recent technological advances in artificial intelligence have demonstrated great potential for automatic radiology report generation (ARRG), sparking an explosion of research. This survey paper conducts a methodological review of contemporary ARRG approaches by way of (i) assessing datasets based on characteristics, such as availability, size, and adoption rate, (ii) examining deep learning training methods, such as contrastive learning and reinforcement learning, (iii) exploring state-of-the-art model architectures, including variations of CNN and transformer models, (iv) outlining techniques integrating clinical knowledge through multimodal inputs and knowledge graphs, and (v) scrutinising current model evaluation techniques, including commonly applied NLP metrics and qualitative clinical reviews. Furthermore, the quantitative results of the reviewed models are analysed, where the top performing models are examined to seek further insights. Finally, potential new directions are highlighted, with the adoption of additional datasets from other radiological modalities and improved evaluation methods predicted as important areas of future development.

The Effect of Body Weight Support on Energy Expenditure in an Individual With High-Level Lower Extremity Amputation.

BACKGROUND: High-level lower extremity amputation (HLLEA) has significant impact on an individual's ability to ambulate and maintain cardiovascular fitness for extended periods of time. OBJECTIVE: The purpose of this study was to evaluate whether body weight support (BWS) would improve energy efficiency in an individual with HLLEA to achieve appropriate target cardiovascular intensity for aerobic training. DESIGN: This was an exploratory single-subject study. METHODS: The participant was a 45-year-old woman, 4.5 years after left hip disarticulation secondary to necrotizing fasciitis with resultant organ failure and cardiomyopathy. She was wearing a well-fitted prosthesis and had a goal of ambulating in the community with less fatigue. Vital signs and expiratory gases were recorded, and oxygen uptake efficiency slope was calculated during treadmill walking at 0%, 20%, and 40% unweighting. An age-matched control completed 0% unweighting baseline testing. RESULTS: Under all conditions of treadmill walking, the participant's heart rate, blood pressure, and rate of perceived exertion consistently increased as speed and time increased. The participant's oxygen uptake efficiency slope was most efficient at 20% unweighting, and the economy of movement improved as the percentage of BWS increased, bringing values closer to the age-matched control. The participant reported only minimal pain immediately following 20% unweighting. LIMITATIONS: The primary limitation of this study is generalizability of findings because of minimal information for comparing the effects of BWS on aerobic capacity in individuals with HLLEA. Additionally, the percentages of unweighting using BWS were extrapolated based on corollary preexisting research; thus, there were no set parameters defined for this specific population. CONCLUSIONS: BWS allowed the participant to work more efficiently, which suggests that if used during an intervention, BWS might enable individuals with HLLEA to achieve recommended levels of training for aerobic conditioning. In future studies, it is recommended that 20% BWS be used at a speed that results in moderate-intensity exercise for individuals with HLLEA as determined by 50% to 70% of maximum heart rate for 20 to 30 minutes.

The role of pyrosequencing in head and neck cancer epigenetics: correlation of quantitative methylation data with gene expression.

OBJECTIVE: To evaluate promoter methylation quantitation using recently described pyrosequencing techniques by correlation with messenger RNA (mRNA) expression. DESIGN: DNA was extracted from tissue samples and was subjected to bisulphite conversion. Quantitative methylation data for multiple CpG sites in each of 9 gene promoters were obtained for tumors using pyrosequencing. RNA was extracted and converted to complementary DNA, and this formed the template for relative quantitation assays of the expression of each gene by real-time reverse transcription-polymerase chain reaction. SETTING: Academic research. PATIENTS: Thirty-seven patients with head and neck squamous cell carcinoma. MAIN OUTCOME MEASURES: The genes studied were P16 (OMIM 600160), cyclin A1 (OMIM 604036), RARB (OMIM 180220), E-cadherin (OMIM 192090), MGMT (OMIM 156569), STAT1 (OMIM 600555), ATM (OMIM 607585), hMLH1 (OMIM 120436), and TIMP3 (OMIM 188826). Immunohistochemistry was also performed for p16. RESULTS: STAT1, TIMP3, ATM, and hMLH1 promoters were essentially unmethylated in all cases. The data for cyclin A1 (Spearman rank correlation, rho = -0.53; P < .001), MGMT (rho = -0.53, P < .001), and RARB (rho = -0.34, P =.02) showed the expected negative correlation between levels of methylation and mRNA expression. The data relating to E-cadherin were inconclusive. Surprisingly, P16 expression was statistically significantly greater in those cases with higher levels of methylation (rho = 0.57, P < .001), a finding at odds with assumptions usually made in the literature relating gene promoter methylation to reduced gene expression. The results from p16 immunohistochemistry were in keeping with the mRNA data, but the number of positive staining samples proved too few for statistical analysis. CONCLUSIONS: These data present a novel perspective on head and neck cancer epigenetics and reveal new and some unexpected associations and findings. The advantages of pyrosequencing over nonquantitative techniques are discussed in analyses of this nature.

Kant on the history of nature: the ambiguous heritage of the critical philosophy for natural history.

This paper seeks to show Kant's importance for the formal distinction between descriptive natural history and a developmental history of nature that entered natural history discussions in the late eighteenth century. It is argued that he developed this distinction initially upon Buffon's distinctions of 'abstract' and 'physical' truths, and applied these initially in his distinction of 'varieties' from 'races' in anthropology. In the 1770s, Kant appears to have given theoretical preference to the 'history' of nature [Naturgeschichte] over 'description' of nature [Naturbeschreibung]. Following Kant's confrontations with Johann Herder and Georg Forster in the late 1780s, Kant weakened the epistemic status of the 'history of nature' and gave theoretical preference to 'description of nature'. As a result, Kant's successors, such as Goethe, could draw from Kant either a justification for a developmental history of nature, or, as this paper argues, a warrant from the critical philosophy for denying the validity of the developmental history of nature as anything more than a 'regulative' idea of reason.

How was teleology eliminated in early molecular biology?

This paper approaches the issue of the status of teleological reasoning in contemporary biology through a historical examination of events of the 1930s that surrounded Niels Bohr's efforts to introduce 'complementarity' into biological discussions. The paper examines responses of three theoretical physicists who engaged boundary questions between the biological and physical sciences in this period in response to Bohr-Ernst Pascual Jordan (1902-80), Erwin Schrödinger (1887-1961), and Max Delbrück (1906-81). It is claimed that none of these physicists sufficiently understood Bohr's 'critical' teleological arguments, which are traced to the lineage of Kant and Harald Høffding and their respective resolutions of the Antinomy of Teleological Judgment. The positions of these four historical actors are discussed in terms of Ernst Mayr's distinction of 'teleological,' 'teleomatic,' and 'teleonomic' explanations. A return to some of the views articulated by Bohr, and behind him, to Høffding and Kant, is claimed to provide a framework for reintroducing a 'critical' teleology into biological discussions.