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Visual and auditory signs of patient functioning have long been used for clinical diagnosis, treatment selection, and prognosis. Direct measurement and quantification of these signals can aim to improve the consistency, sensitivity, and scalability of clinical assessment. Currently, we investigate if machine learning-based computer vision (CV), semantic, and acoustic analysis can capture clinical features from free speech responses to a brief interview 1 month post-trauma that accurately classify major depressive disorder (MDD) and posttraumatic stress disorder (PTSD).
Methods
N = 81 patients admitted to an emergency department (ED) of a Level-1 Trauma Unit following a life-threatening traumatic event participated in an open-ended qualitative interview with a para-professional about their experience 1 month following admission. A deep neural network was utilized to extract facial features of emotion and their intensity, movement parameters, speech prosody, and natural language content. These features were utilized as inputs to classify PTSD and MDD cross-sectionally.
Results
Both video- and audio-based markers contributed to good discriminatory classification accuracy. The algorithm discriminates PTSD status at 1 month after ED admission with an AUC of 0.90 (weighted average precision = 0.83, recall = 0.84, and f1-score = 0.83) as well as depression status at 1 month after ED admission with an AUC of 0.86 (weighted average precision = 0.83, recall = 0.82, and f1-score = 0.82).
Conclusions
Direct clinical observation during post-trauma free speech using deep learning identifies digital markers that can be utilized to classify MDD and PTSD status.
Richard Rorty sings in the antifoundationalist chorus. His song equates the rise of foundationalist epistemology with the professionalization of philosophy. The discordant notes he finds in the foundationalist score become, as a consequence, subversive of philosophy as an autonomous discipline.
Nonetheless, the most salient feature of Rorty's recent book, Philosophy and the Mirror of Nature, is that it is by a professional philosopher, for professional philosophers and about the future of philosophy as a profession. The early chapters of the book are polished pieces of professional philosophical prose addressed to issues which have provoked interest in recent years among members of academic philosophy departments. They represent efforts to undermine foundationalist epistemology even in some of its currently fashionable guises as philosophy of language.
Reports of bloodstream infections caused by methicillin-resistant Staphylococcus aureus among chronic hemodialysis patients to 2 Centers for Disease Control and Prevention surveillance systems (National Healthcare Safety Network Dialysis Event and Emerging Infections Program) were compared to evaluate completeness of reporting. Many methicillin-resistant S. aureus bloodstream infections identified in hospitals were not reported to National Healthcare Safety Network Dialysis Event.
Infect. Control Hosp. Epidemiol. 2016;37(2):205–207
Kalisch and colleagues identify several routes to a better understanding of mechanisms underlying resilience and highlight the need to integrate findings from neuroscience and animal learning. We argue that appreciating methodological complexity and integrating neurobiological perspectives will advance the science of resilience and ultimately help improve the lives of those exposed to stress and adversity.
Traumatic injuries affect millions of patients each year, and resulting post-traumatic stress disorder (PTSD) significantly contributes to subsequent impairment.
Aims
To map the distinctive long-term trajectories of PTSD responses over 6 years by using latent growth mixture modelling.
Method
Randomly selected injury patients (n = 1084) admitted to four hospitals around Australia were assessed in hospital, and at 3, 12, 24 and 72 months. Lifetime psychiatric history and current PTSD severity and functioning were assessed.
Results
Five trajectories of PTSD response were noted across the 6 years: (a) chronic (4%), (b) recovery (6%), (c) worsening/recovery (8%), (d) worsening (10%) and (e) resilient (73%). A poorer trajectory was predicted by female gender, recent life stressors, presence of mild traumatic brain injury and admission to intensive care unit.
Conclusions
These findings demonstrate the long-term PTSD effects that can occur following traumatic injury. The different trajectories highlight that monitoring a subset of patients over time is probably a more accurate means of identifying PTSD rather than relying on factors that can be assessed during hospital admission.
Isaac Levi is one of the preeminent philosophers in the areas of pragmatic rationality and epistemology. This collection of essays constitutes an important presentation of his original and influential ideas about rational choice and belief. A wide range of topics is covered, including consequentialism and sequential choice, consensus, voluntarism of belief, and the tolerance of the opinions of others. The essays elaborate on the idea that principles of rationality are norms that regulate the coherence of our beliefs and values with our rational choices. The norms impose minimal constraints on deliberation and inquiry, but they also impose demands well beyond the capacities of deliberating agents. This major collection will be eagerly sought out by a wide range of philosophers in epistemology, logic, and philosophy of science, as well as economists, decision theorists, and statisticians.
It is a commonplace that in making decisions agents often have to juggle competing values, and that no choice will maximise satisfaction of them all. However, the prevailing account of these cases assumes that there is always a single ranking of the agent's values, and therefore no unresolvable conflict between them. Isaac Levi denies this assumption, arguing that agents often must choose without having balanced their different values and that to be rational, an act does not have to be optimal, only what Levi terms 'admissible'. This book explores the consequences of denying the assumption and develops a general approach to decision-making under unresolved conflict. Professor Levi discusses conflicts of value in several domains - those arising in moral dilemmas, the drawing of scientific inferences, decisions taken under uncertainty, and in social choice. In each of these he adapts his theoretical framework, showing how conflict may often be reduced though not always altogether eliminated.
Dewey and Peirce shared a common focus on the elaboration of a model of inquiry that seeks to remove doubt concerning the answer to some question by identifying potential answers to the question, ascertaining the evidence available for evaluating the candidacy of such answers as solutions to the problem posed, conducting experiments to acquire more evidence and deciding on the basis of the available evidence which of the potential answers to add to the stock of knowledge. My own proposals concerning how to model well-conducted inquiry depart in several respects from the proposals of both Peirce and Dewey. But these two great philosophers gave classical expression to the ideas that inspired the projects I have undertaken. In this essay, I shall comment on some aspects of Dewey's vision of the logic of inquiry, pointing to important respects in which I depart from his approach. Because I shall be arguing with Dewey, I wish to emphasize here and now that I am arguing not to dismiss him or his ideas but to sharpen some of my ideas by confrontation with one of the points of view that inspired them.
This book by one of the world's foremost philosophers in the fields of epistemology and logic offers an account of suppositional reasoning relevant to practical deliberation, explanation, prediction and hypothesis testing. Suppositions made 'for the sake of argument' sometimes conflict with our beliefs, and when they do, some beliefs are rejected and others retained. Thanks to such belief contravention, adding content to a supposition can undermine conclusions reached without it. Subversion can also arise because suppositional reasoning is ampliative. These two types of nonmonotonic logic are the focus of this book. A detailed comparison of nonmonotonicity appropriate to both belief contravening and ampliative suppositional reasoning reveals important differences that have been overlooked.
This is a collection of Isaac Levi's philosophical papers. Over the period represented by the work here, Professor Levi has developed an interrelated set of views, in the tradition of Peirce and Dewey, on epistemology and the philosophy of science and social science. This focus has been on the problem of induction and the growth of knowledge, the foundations of probability and the theory of rational decision-making. His most important essays in these areas are assembled here, with an introduction setting out their main themes and connections. As a whole the volume presents a coherent, elaborated position which will be of great interest to a range of philosophers, decision theorists, welfare and social choice theorists and cognitive scientists.
Isaac Levi's new book is concerned with how one can justify changing one's beliefs. The discussion is deeply informed by the belief-doubt model advocated by C. S. Peirce and John Dewey, of which the book provides a substantial analysis. Professor Levi then addresses the conceptual framework of potential changes available to an inquirer. A structural approach to propositional attitudes is proposed, which rejects the conventional view that a propositional attitude involves a relation between an agent and either a linguistic entity or some other intentional object such as a proposition or set of possible worlds. The last two chapters offer an account of change in states of full belief understood as changes in commitments rather than changes in performance; one chapter deals with adding new information to a belief state, the other with giving up information. The book builds upon topics discussed in some of Levi's earlier work. It will be of particular interest to discussion theorists, epistemologists, philosophers of science, computer scientists, and cognitive psychologists.
Koehler's target article attempts a balanced view of the relevance of knowledge of base rates to judgments of subjective or credal probability, but he is not sensitive enough to the difference between requiring and permitting the equation of probability judgments with base rates, the interaction between precision of base rate and reference class information, and the possibility of indeterminate probability judgment.
This paper describes an investigation into the relationship between senile dementia and slowing of peripheral nerve conduction velocity. Twenty-eight demented patients and 19 controls were studied. Each patient was rated clinically and given a battery of simple psychological tests in addition to the physiological recordings. The results were as follows: (1) Motor nerve conduction was slower in the demented group than in the control group but this difference was not significant. (2) When subjects were divided according to their dementia score, those with scores above 7 were found to have motor nerve conductions which were significantly slower than those with scores of 7 or less. (3) There was a significant correlation between the severity of the dementia as measured by the rating scale and the psychological tests and the degree of slowing of motor nerve conduction. (4) In those patients who were retested after one year, increase in dementia was significantly correlated with a further slowing of conduction in motor nerves. (5) The possible role of vitamin deficiency was investigated in a small sub-group of demented patients. Deficiencies of thiamine, nicotinic acid, and vitamin B12 were not thought to be important but some patients had low folate levels. The significance of these results is discussed.
Specific cortical somatosensory evoked responses were recorded in nine patients suffering from senile dementia and eight elderly depressed patients. The results were as follows. (1) The latencies of each peak were longer in the demented than in the depressed group but this difference was significant only for peak 3 (the second negative deviation). (2) The late negative deviation (peak 5) was either absent or very flat in demented patients. The ratio of the amplitude of this late wave to that of the first peak discriminated between demented and non-demented patients at the 0·5% level. (3) The value of this ratio combined with that of the latency of peak 3 could be used to classify all but one patient into the correct diagnostic group. The results are discussed in the light of the relevant literature. It is suggested that slowing of conduction in the nervous system may be a very basic disturbance associated with cognitive impairment in old age and that measurements of this kind may come to assist in the diagnosis of dementia.
In The Enterprise of Knowledge (Levi, 1980a), I proposed a general theory of rational choice which I intended as a characterization of a prescriptive theory of ideal rationality. A cardinal tenet of this theory is that assessments of expected value or expected utility in the Bayesian sense may not be representable by a numerical indicator or indeed induce an ordering of feasible options in a context of deliberation. My reasons for taking this position are related to my commitment to the inquiry-oriented approach to human knowledge and valuation favored by the American pragmatists, Charles Peirce and John Dewey. A feature of any acceptable view of inquiry ought to be that during an inquiry points under dispute ought to be kept in suspense pending resolution through inquiry.