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Multitask learning has led to significant advances in Natural Language Processing, including the decaNLP benchmark where question answering is used to frame 10 natural language understanding tasks in a single model. In this work we show how models trained to solve decaNLP fail with simple paraphrasing of the question. We contribute a crowd-sourced corpus of paraphrased questions (PQ-decaNLP), annotated with paraphrase phenomena. This enables analysis of how transformations such as swapping the class labels and changing the sentence modality lead to a large performance degradation. Training both MQAN and the newer T5 model using PQ-decaNLP improves their robustness and for some tasks improves the performance on the original questions, demonstrating the benefits of a model which is more robust to paraphrasing. Additionally, we explore how paraphrasing knowledge is transferred between tasks, with the aim of exploiting the multitask property to improve the robustness of the models. We explore the addition of paraphrase detection and paraphrase generation tasks, and find that while both models are able to learn these new tasks, knowledge about paraphrasing does not transfer to other decaNLP tasks.

Objectives Health apps are software programs that are designed to prevent, diagnose, monitor, or manage conditions. Inconsistent terminology for apps is used in research literature and bibliographic database subject headings. It can therefore be challenging to retrieve evidence about them in literature searches. Information specialists at the United Kingdom's National Institute for Health and Care Excellence (NICE) have developed novel validated search filters to retrieve evidence about apps from MEDLINE and Embase (Ovid). Methods A selection of medical informatics journals was hand searched to identify a “gold standard” (GS) set of references about apps. The GS set was divided into a development and validation set. The filters’ search terms were derived from and tested against the development set. An external development set containing app references from published NICE products was also used to inform the development of the filters. The filters were then validated using the validation set. Target recall was >90 percent. The filters’ overall recall, specificity, and precision were calculated using all the references identified from the hand search. Results Both filters achieved 98.6 percent recall against their validation sets. Overall, the MEDLINE filter had 98.8 percent recall, 71.3 percent specificity, and 22.6 percent precision. The Embase filter had 98.6 percent recall, 74.9 percent specificity, and 24.5 percent precision. Conclusions The NICE health apps search filters retrieve evidence about apps from MEDLINE and Embase with high recall. They can be applied to literature searches to retrieve evidence about the interventions by information professionals, researchers, and clinicians.

Background Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. Objectives To assess the effects and safety of antiseptics for the treatment of burns in any care setting. Search methods In September 2016 we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions based on language, date of publication or study setting. Selection criteria We included randomised controlled trials (RCTs) that enrolled people with any burn wound and assessed the use of a topical treatment with antiseptic properties. Data collection and analysis Two review authors independently performed study selection, risk of bias assessment and data extraction. Main results We included 56 RCTs with 5807 randomised participants. Almost all trials had poorly reported methodology, meaning that it is unclear whether they were at high risk of bias. In many cases the primary review outcomes, wound healing and infection, were not reported, or were reported incompletely. Most trials enrolled people with recent burns, described as second-degree and less than 40% of total body surface area; most participants were adults. Antiseptic agents assessed were: silver-based, honey, Aloe Vera, iodine-based, chlorhexidine or polyhexanide (biguanides), sodium hypochlorite, merbromin, ethacridine lactate, cerium nitrate and Arnebia euchroma. Most studies compared antiseptic with a topical antibiotic, primarily silver sulfadiazine (SSD); others compared antiseptic with a non-antibacterial treatment or another antiseptic. Most evidence was assessed as low or very low certainty, often because of imprecision resulting from few participants, low event rates, or both, often in single studies. Antiseptics versus topical antibiotics Compared with the topical antibiotic, SSD, there is low certainty evidence that, on average, there is no clear difference in the hazard of healing (chance of healing over time), between silver-based antiseptics and SSD (HR 1.25, 95% CI 0.94 to 1.67; I2 = 0%; 3 studies; 259 participants); silver-based antiseptics may, on average, increase the number of healing events over 21 or 28 days' follow-up (RR 1.17 95% CI 1.00 to 1.37; I2 = 45%; 5 studies; 408 participants) and may, on average, reduce mean time to healing (difference in means -3.33 days; 95% CI -4.96 to -1.70; I2 = 87%; 10 studies; 979 participants). There is moderate certainty evidence that, on average, burns treated with honey are probably more likely to heal over time compared with topical antibiotics (HR 2.45, 95% CI 1.71 to 3.52; I2 = 66%; 5 studies; 140 participants). There is low certainty evidence from single trials that sodium hypochlorite may, on average, slightly reduce mean time to healing compared with SSD (difference in means -2.10 days, 95% CI -3.87 to -0.33, 10 participants (20 burns)) as may merbromin compared with zinc sulfadiazine (difference in means -3.48 days, 95% CI -6.85 to -0.11, 50 relevant participants). Other comparisons with low or very low certainty evidence did not find clear differences between groups. Most comparisons did not report data on infection. Based on the available data we cannot be certain if antiseptic treatments increase or reduce the risk of infection compared with topical antibiotics (very low certainty evidence). Antiseptics versus alternative antiseptics There may be some reduction in mean time to healing for wounds treated with povidone iodine compared with chlorhexidine (MD -2.21 days, 95% CI 0.34 to 4.08). Other evidence showed no clear differences and is of low or very low certainty. Antiseptics versus non-antibacterial comparators We found high certainty evidence that treating burns with honey, on average, reduced mean times to healing in comparison with non-antibacterial treatments (difference in means -5.3 days, 95% CI -6.30 to -4.34; I2 = 71%; 4 studies; 1156 participants) but this comparison included some unconventional treatments such as amniotic membrane and potato peel. There is moderate certainty evidence that honey probably also increases the likelihood of wounds healing over time compared to unconventional anti-bacterial treatments (HR 2.86, 95% C 1.60 to 5.11; I2 = 50%; 2 studies; 154 participants). There is moderate certainty evidence that, on average, burns treated with nanocrystalline silver dressings probably have a slightly shorter mean time to healing than those treated with Vaseline gauze (difference in means -3.49 days, 95% CI -4.46 to -2.52; I2 = 0%; 2 studies, 204 participants), but low certainty evidence that there may be little or no difference in numbers of healing events at 14 days between burns treated with silver xenograft or paraffin gauze (RR 1.13, 95% CI 0.59 to 2.16 1 study; 32 participants). Other comparisons represented low or very low certainty evidence. It is uncertain whether infection rates in burns treated with either silver-based antiseptics or honey differ compared with non-antimicrobial treatments (very low certainty evidence). There is probably no difference in infection rates between an iodine-based treatment compared with moist exposed burn ointment (moderate certainty evidence). It is also uncertain whether infection rates differ for SSD plus cerium nitrate, compared with SSD alone (low certainty evidence). Mortality was low where reported. Most comparisons provided low certainty evidence that there may be little or no difference between many treatments. There may be fewer deaths in groups treated with cerium nitrate plus SSD compared with SSD alone (RR 0.22, 95% CI 0.05 to 0.99; I2 = 0%, 2 studies, 214 participants) (low certainty evidence). Authors' conclusions It was often uncertain whether antiseptics were associated with any difference in healing, infections, or other outcomes. Where there is moderate or high certainty evidence, decision makers need to consider the applicability of the evidence from the comparison to their patients. Reporting was poor, to the extent that we are not confident that most trials are free from risk of bias.

Recent analyses of major incidents, such as BP's Texas City disaster and the loss of the space shuttle Columbia, have moved from considering immediate factors and basic organisational failings to considering cultural issues. Cultural issues are, however, even more difficult to incorporate into incident investigations and analyses than are organisational factors. This paper provides a structured approach to analysing individual, organisational and cultural/regulatory factors based upon the Bow Tie methodology, using well-defined rules to distinguish three levels of causation. Level 1 analysis describes barriers implemented at the individual and immediate hardware level; Level 2 describes the organisational factors that support level one barriers; Level 3 describes the cultural and regulatory environment that ensures that the organisation implements level 2, thereby ensuring the integrity of level 1 barriers. Incident investigation and analysis can be performed as a structured search for failed barriers at any or all of these three levels. Both organisational failure (L2) and problems with the safety culture and regulatory environment (L3) can be reliably identified, rather than relying upon the intuitions of investigators.

We will present the development of a remote Precision Photonic Readout for Focal Plane Array Detectors. Its underlying principles, design and tests as well as limitations will be discussed. The design, in essence, constitutes a remote, via fiber optics, analog-to-digital converter, where the low level focal plane signals are encoded as differential optical phase shifts. These phase shifts are then recovered as digital numbers at a location external to the detector dewar. The input transducer, a waveguide modulator is electrically passive with a response, which is absolute and unaffected by temperature. The design also provides for nearly complete EMI immunity and appears to be tolerant to radiation effects. As presently comprised it can satisfy the requirements of resolution, precision, bandwidth and dynamic range for all existing Focal Plane Imagers, as well as for future ones under development. Its small size, negligible mass and minimal heatload contribute to its use where these factors are important. We present quantitative data supporting these points, as well as visible and IR Imagery, which were obtained and transmitted off the focal plane by a prototype design.

Moffatt M, ed; Biggs Harris K, associate ed. Thorofare, NJ 08086, Slack Inc, 2006, paperback, 160 pp, illus, ISBN: 1-55642-670-4; $50.95. This book is 1 of a series of 4 books ( Musculoskeletal Essentials, Neuromuscular Essentials, Cardiovascular Essentials, and Integumentary Essentials ) that are designed to help physical therapists, physical therapist assistants, and students use the American Physical Therapy Association's Guide to Physical Therapist Practice (Guide). Integumentary Essentials uses patient cases to illustrate the application of the patient/client management model to each of the 5 integumentary system practice patterns. The first chapter addresses the prevention and risk reduction for integumentary disorders practice pattern. Chapters 2 through 5 cover the other integumentary practice patterns that are based on depth of tissue loss. Each chapter begins with a …

Involvement of the retroperitoneal space in traumatic perforation of the rectum has been discussed. The anatomic limits of the retroperitoneal space are outlined. Transverse colostomy should be contemplated in all perforating wounds of the rectum. Extraperitoneal drainage of retroperitoneal abscess is stressed.

A method of surgical repair of ectropion of mucosa occurring after an improperly-performed amputative type of hemorrhoidectomy has been described. Results after anoplasty, employing the S-plasty technic, have been excellent.

The records of 200 patients with adenomatous polyps of the rectum, followed 3 to 15 years, were reviewed. Rectal adenomas were most prevalent in patients between the ages of 45 to 65 years. Men predominated over women (ratio, 1.6 : 1.0). The recurrence rate of adenomatous polyps of the rectum was 31 per cent.

To help improve therapeutic results for treatment of bone tumors, high intensity focused ultrasound (HIFU) is being investigated as a non-invasive alternative to surgery and radiotherapy. HIFU ablative treatments require an imaging modality for guidance, and magnetic resonance (MR) imaging is currently the strongest choice as it is able to provide temperature mapping throughout the treatment process. Unfortunately, the temperature feedback that is critical to ensuring safety and optimal soft tissue ablation is often unobtainable in bone structures. As an alternative to obtaining feedback, this project is focused on developing a simulator that is capable of predicting the temperature distribution in and around bone tissue during HIFU therapy. Having such a simulation would provide a better understanding of the thermal dosages incurred by the bone during HIFU treatment of tumors.