Background

Computer-aided detection (CAD) systems hold promise for improving tuberculosis (TB) detection on digital chest radiographs. However, data on their performance in exclusively paediatric populations are scarce.

Methods

We conducted a retrospective diagnostic accuracy study evaluating the performance of CAD4TBv7 (Computer-Aided Detection for Tuberculosis version 7) using digital chest radiographs from well-characterised cohorts of Gambian children aged <15 years with presumed pulmonary TB. The children were consecutively recruited between 2012 and 2022. We measured CAD4TBv7 performance against a microbiological reference standard (MRS) of confirmed TB, and also performed Bayesian latent class analysis (LCA) to address the inherent limitations of the MRS in children. Diagnostic performance was assessed using the area under the receiver operating characteristic curve (AUROC) and point estimates of sensitivity and specificity.

Results

A total of 724 children were included in the analysis, with confirmed TB in 58 (8%), unconfirmed TB in 145 (20%) and unlikely TB in 521 (72%). Using the MRS, CAD4TBv7 showed an AUROC of 0.70 (95% CI 0.60–0.79), and demonstrated sensitivity and specificity of 19.0% (95% CI 11–31%) and 99.0% (95% CI 98.0–100.0%), respectively. Applying Bayesian LCA with the assumption of conditional independence between tests, sensitivity and specificity estimates for CAD4TBv7 were 42.7% (95% CrI 29.2–57.5%) and 97.9% (95% CrI 96.6–98.8%), respectively. When allowing for conditional dependence between culture and Xpert assay, CAD4TBv7 demonstrated a sensitivity of 50.3% (95% CrI 32.9–70.0%) and specificity of 98.0% (95% CrI 96.7–98.9%).

Conclusion

Although CAD4TBv7 demonstrated high specificity, its suboptimal sensitivity underscores the crucial need for optimisation of CAD4TBv7 for detecting TB in children.

PURPOSE

Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.

METHODS

This descriptive cross-sectional study used 2016 Medicaid claims data from the Transformed Medicaid Statistical Information System and from 2016-2017 American Board of Family Medicine certification questionnaire responses to examine the diversity and Medicaid participation of FPs. We explored the diversity of FP Medicaid patient panels and whether they saw ≥150 beneficiaries in 2016. Using logistic regression models, we controlled for FP demographics, practice characteristics, and characteristics of the communities in which they practiced.

RESULTS

Of 13,096 FPs, Latine, Hispanic, or of Spanish Origin (LHS) FPs and non-LHS Black FPs saw more Medicaid beneficiaries compared with non-LHS White and non-LHS Asian FPs. The patient panels of URiM FPs had a much greater proportion of Medicaid beneficiaries from racial and ethnic minority groups. Overall, non-LHS Black and LHS FPs had greater odds of seeing ≥150 Medicaid beneficiaries in 2016.

CONCLUSIONS

These findings clearly show the critical role URiM FPs play in caring for Medicaid beneficiaries, suggesting physician race and ethnicity are correlated with Medicaid participation. Diversity in the health care workforce is essential for addressing racial health inequities. Policies need to address problems in pathways to medical education, including failures to recruit, nurture, and retain URiM students.

The City of Vancouver council has reneged on a previous commitment to a living wage for its employees.

The post City of Vancouver to lowest paid workers: Let them eat cuts! appeared first on rabble.ca.

Chris has a normal amount of coffee on his shirt. Kelley conks her cat on the head with a controller. And Josh thinks Maglam Lord is a contraceptive device.

The post RPG Cast – Episode 617: “Yoko Taro Made This While Queuing for His Raid” appeared first on RPGamer.

Chris suffers from "The Curse of the Steam Deck." Kelley can't pickpocket, so she mugs people at night. And Ryan likes practical grave robbers. Curl up in your clothmap quilt and enjoy our cozy '60s demon world.

The post RPG Cast – Episode 681: “Ganon Is Afraid of Homemade Apple Pie” appeared first on RPGamer.

Matt makes twenty slices of toast. Josh is still fighting sewer rat six. Kelley's dog is NOT a baby. And Chris saves E3 with the power of...no...he can't do it. No GEX allowed.

The post RPG Cast – Episode 684: “Remember What I Said at the Fazoli’s Drive Thru?” appeared first on RPGamer.

A hotel worker called 911 to request urgent assistance before musician Liam Payne fell to his death from the third floor of the building in Buenos Aires on Wednesday.

The 31-year-old British singer and former member of the boy band One Direction died after he “jumped from the balcony of his room,” Buenos Aires Security Ministry Communications Director Pablo Policicchio told the Associated Press. He added that police had been called to the Casa Sur Hotel in the Argentine capital after receiving an emergency call shortly after 5 p.m. local time about an “aggressive man who could be under the influence of drugs or alcohol.”

A transcript of a 911 call published by the BBC shows a worker at the hotel telling the operator that they have “a guest who is high on drugs and who is trashing the room” and the staff therefore “need someone to come.”

Read more at The Daily Beast.

Part of the fun of Dragon Age's fantasy is that it's inconsistent - or at least, inconsistent by the standards of fantasy RPGs, which often break down into a million neatly organised and interlocking codex entries. It all rides on who you speak to. The humans believe one thing about the origins and workings of Thedas, the elves another, the qunari something else entirely. These differences are the basis for many factional disagreements and thus, many core series plot developments. According to former lead writer David Gaider, however, there's an "uber-plot" behind it all that may one day be resolved and bring the series to a close, assuming BioWare continue to refer to his original (and closely guarded) narrative documents.

Read more

Calling a game ‘no frills’ or ‘no nonsense’ is always a back-handed compliment, because it sounds like you're saying it's a bit straightforward and simple. And yes, that’s exactly what I’m saying here. Acts Of Blood feels like a spiffy PS2 action brawler; a slightly tighter old Yakuza game, or a stripped-back Sifu. It’s snacky and a bit janky, but it’s also great coffee break fodder, assuming you want to spend your break breaking a selection of heavy objects over the crumbly skulls of ne’er-do-wells. I mean, they might have done some things well, I don’t know them. But they aren’t doing any well to my character in the game, so violence it is.

Read more

Finance guru Laura Pomfret explained how changes to inheritance tax in the budget may hit people in a way they hadn't realised

Depending on PC config you may see up to a 30fps uplift with anti-tamper tech ditched.

Just like Eli Manning in 2004, Deion Sanders said he would tell NFL teams his son, Shedeur Sanders, won't play for them if it's not the right fit.

It turns out microplastics have an effect on the weather and climate.

Nintendo just announced that Animal Crossing: Pocket Camp (Free) is shutting down on November 28th at 3 PM UTC. Animal …

Continue reading "‘Animal Crossing: Pocket Camp’ Shutting Down This November, New Paid Game Set To Release With Save Transfer"

President-elect Trump has promised mass deportations, including workplace raids like those that took place during his first term at chicken processing plants in rural Mississippi.

Baidu, which is often called China's answer to Google, has launched its own pair of AI-powered smart glasses at its annual World Conference event in Shanghai. The device will run on the company's ERNIE generative AI technology and was designed to "become a private assistant," according to the Financial Times. Users will reportedly be able to interact with the device using their voice and ask it questions about what it sees in their current environment. They can also tell it to play music and even track their calories consumption. And since the glasses are equipped with cameras, they can ask it to snap photos or take videos. 

When the glasses start shipping sometime next year, they could become the Chinese consumers' alternative to Meta's and Snap's devices. Meta teamed up with Ray Ban a few years ago to release a pair of smart sunglasses that can livestream and send photos hands-free. Its latest model comes built-in with Meta's generative AI assistant that users can talk to. However, the company's device isn't officially sold in China, because its servers are blocked in the country. Baidu has yet to announce how much its glasses would cost, but Meta is selling its device for $299. 

The Baidu World Conference had a huge focus on the company's AI efforts, as it takes steps to make sure ERNIE can keep up with its competitors' technologies. It also launched a new AI image generator called iRAG that apparently experiences fewer hallucinations than its predecessor, along with a tool that enables people to create software programs even if they don't have coding expertise. According to The Times, ByteDance's Doubao is now the leading AI chatbot in China based on monthly active users as observed by Sensor Tower. ByteDance is also growing its hardware offerings and recently launched a pair of earbuds with access to its AI assistant Doubao. 

This article originally appeared on Engadget at https://www.engadget.com/ai/baidu-announces-its-own-pair-of-ai-smart-glasses-143044805.html?src=rss

The secretary of the Union Ayush Ministry, Dr Rajesh Kotecha, will inaugurate the 61st Ayurveda Seminar organized by the Kottakkal Aryavaidyasala (Kottakkal AVS) on November 10 at Kottakkal in

On this date 349 years ago, Samuel Pepys relates in his famous diary a remarkable story about an upcoming medical experiment. As far as I can tell, this is the first written description of a paid research subject.

According to his account, the man (who he describes as “a little frantic”) was to be paid to undergo a blood transfusion from a sheep. It was hypothesized that the blood of this calm and docile animal would help to calm the man.

Some interesting things to note about this experiment:

• Equipoise. There is explicit disagreement about what effect the experimental treatment will have: according to Pepys, "some think it may have a good effect upon him as a frantic man by cooling his blood, others that it will not have any effect at all".
• Results published. An account of the experiment was published just two weeks later in the journal Philosophical Transactions. 
• Medical Privacy. In this subsequent write-up, the research subject is identified as Arthur Coga, a former Cambridge divinity student. According to at least one account, being publicly identified had a bad effect on Coga, as people who had heard of him allegedly succeeded in getting him to spend his stipend on drink (though no sources are provided to confirm this story).
• Patient Reported Outcome. Coga was apparently chosen because, although mentally ill, he was still considered educated enough to give an accurate description of the treatment effect. 

Depending on your perspective, this may also be a very early account of the placebo effect, or a classic case of ignoring the patient’s experience. Because even though his report was positive, the clinicians remained skeptical. From the journal article:

The Man after this operation, as well as in it, found himself very well, and hath given in his own Narrative under his own hand, enlarging more upon the benefit, he thinks, he hath received by it, than we think fit to own as yet.

…and in fact, a subsequent diary entry from Pepys mentions meeting Coga, with similarly mixed impressions: “he finds himself much better since, and as a new man, but he is cracked a little in his head”.

The amount Coga was paid for his participation? Twenty shillings – at the time, that was exactly one Guinea.

[Image credit: Wellcome Images]

Whitney Haggerson — vice president of health equity and Medicaid at Providence — discussed the significance of her role, as well as how her health system is working to give all employees, regardless of title, the skills needed to help reduce health inequities.

The post Inside Providence’s Health Equity & Medicaid Strategy appeared first on MedCity News.

Between 1999 and 2014, opioid use disorder (OUD) among pregnant women more than quadrupled, risking the health of the women—before and after giving birth—and their infants. As states grapple with COVID-19’s exacerbation of the opioid crisis, several are taking innovative steps to address the needs of high-risk groups, including low-income, postpartum patients with OUD.

InComm Incentives takes the stress out of planning and executing rewards and promotions with an easy-to-use, B2B e-commerce portal.

The New KitchenAid� Artisan� Mini Stand Mixer: Small Yet Mighty

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Members, bestow yourselves with back pats of honor, for everything is going exactly as planned!

Hi everybody.

The question I get most is: "Where do you get your ideas?"

Generally, when I'm asked this question, it's at a book event where it's difficult to answer, because… Well, the answer is long, and complicated, and hard to pin down, and most of the time, I don't really remember how it happened. When an idea starts to arrive, I get to work. I'm not paying attention to how it's happening, or how it would look to an outsider. 

But — a few weeks ago, a new book idea started knocking on the door of my mind. And this time, I decided to pay attention!

What follows is probably the most detailed explanation I'll ever give of where my ideas come from. More specifically, where this particular idea came from, because it's not always the same. But my experience of the past few weeks has been fairly typical for me, and I'll add that there are a few activities I need to engage in every single time, if I want an idea to take root. Namely: PATIENCE. LISTENING. And, LABOR. Book ideas require a certain honed receptiveness, and they require a LOT OF WORK. 

I'm yelling because I'm trying to push back against the idea that ideas simply come to writers. Yes, some parts of ideas come to writers. But when I first get a book idea, what "comes to me" probably comprises about 0.1% of what could properly be called a book idea. Often, it's little more than an inchoate feeling. With patience, listening, and labor, I transform the idea into something I can grasp, and work with.

I'll add that yes, we do hear sometimes of writers whose ideas "simply came to them," fully formed. I'm going to take a guess that (1) this doesn't happen very often, if ever, with books that have complicated structures or plots, and (2) writers who are blessed by ideas in this way probably have a long-honed practice of receptiveness.

Anyway. Warning upfront that this may be a little unstructured, because the process is a little unstructured. It's challenging to describe, and I'm still in the middle of it. But here's what my last few weeks have been like.

A few weeks ago, while watching a TV show that had a certain mood/aura that'd really sucked me in, I found myself drawn to the idea of a story involving three characters. I'm not going to tell you what TV show I was watching, and I'm not going to tell you anything about my three characters, because story ideas are intensely, intensely private. The first time I say anything publicly about it will probably be years from now, if and when this book is ever scheduled for release. But let me try to explain a bit about that moment when the first glimmering of the idea appeared. 

Like I said, I'd been watching a TV show when it happened. But my three characters weren't characters in that TV show. Nor did anyone in that TV show relate to each other the way my three characters seemed to want to relate. Nor did my three characters seem to live in a world like the world of the TV show. The TV show helped to launch the idea at me because of the show's mood and its feeling, and how much I cared about the people in it. But my idea? As is often the case, my idea came from something I saw missing in the TV show. Not missing because there was a flaw in the TV writers' story; I loved their story! But missing (for me and possibly only me) because their story was not the story I would have told.

I think that a lot of my idea seeds come from my adoration of other people's stories, but also from my noticing what's missing in those stories, for me. What story I would've like to have seen told; what characters the story lacked.

Anyway. So this idea of these three characters came to me. But when I say "idea of these three characters," already that sounds more substantial than it was. I knew they were three humans (or humanoids; I didn't know what genre the story was, so they could've been aliens on another planet, for all I knew. In fact, I actively considered whether they might have different biology than ours). I knew they cared about each other, but I didn't know in what way. I knew they were facing a challenge that would strain all of their relationships. I thought they might be grown-ups, but I wasn't sure. I thought I knew at least two of their genders, but I wasn't sure. I knew they lived in a world with magic, but I didn't know what "magic" meant in the context of their world. I didn't know where they lived, or when they lived (past? future? futuristic past? postindustrial future? any of about a hundred other possibilities). I knew a whole lot of things that the characters weren't, and that the world wasn't — which is another way of saying that my sense of what this story was was actually more defined by all the things I knew it wasn't. (Apologies if this is vague. I'm not being intentionally vague! I'll try for some concrete examples: I knew I didn't want to write a story where partway through, someone suddenly discovers they have an inborn power they didn't know they had. I knew I didn't want to write a love triangle. There's a certain kind of high-handed fantasy tone that I knew wasn't right for this story. But I didn't know what I did want yet at this point.)

Really, all I knew was that I seemed to be having an idea.

So, like a writer, I did what I needed to do: 

• I made space in my mind for receptiveness. (I scheduled uninterruptable alone time. I stopped listening to podcasts while I was out walking, and instead, just walked, so my mind could wander. I put aside non-urgent tasks for a while so that I didn't have the feeling of a to-do list hanging over my head. I gave myself permission to wool-gather, to become vague and absent-minded. I set three timers any time I cooked anything so I could feel free to forget I was cooking, but also not burn the house down. I remembered to thank my husband frequently for being willing to live with a space cadet.)
• I thought about what fertilizer might help the idea to grow, especially fertilizer in the form of books, TV, and movies. I put all other books, TV, and movies aside. (I kept watching that same TV show, and I also began reading almost exclusively one writer who had a narrative tone — and also subject matter — that helped me sustain a mood that felt concurrent with the mood of my own idea. Why does this kind of intake help? It keeps my mind in a story space, while also giving me something to bounce my own ideas off of. It's a kind of reading, or watching, that involves a state of constant interactivity and reactivity. Everything I'm consuming becomes about something else that I'm looking for. It's difficult to explain, maybe because it gets back to that inexplicable moment when new ideas form.)
• I made sure that every single time I had any new thoughts relating to my idea, I wrote them down. (This meant making reminders on my phone; sending strings of emails to myself; choosing a notebook where I began to jot things down; sending texts to myself on my husband's phone, if his phone was closer to hand than mine.)
• I looked at my schedule to give myself a sense of if and when I might have a few days soon to put my current writing project aside and give some true, devoted time to this new idea. (I was, and still am, in the middle of revisions of the next Graceling Realm book when this happened, and that was, and still is, my absolute first priority. As exciting and intense as a new idea can be, it can't unseat me from my current object of devotion.)

By chance, last week, I did in fact have some time away from my revision while it was briefly with my editor. I was able to devote an entire week to the new book idea. So, next, I'll try to describe what a week of intense idea-gathering looks like for me! (Though I should say that this will differ from book to book. It's been pretty clear to me from the beginning that this new idea is going to be slow to grow — planning this book will take way more than a week. In contrast, last fall, I found myself with a new and sudden book idea that coincided with the end of another project, so I had some free time and was able to sit down and hammer out the entire book plan, which took only a few days. I think this is because that book was shorter and less emotionally complicated than this new book will be, and was set in a less complex world. Also, at the time, I was absolutely thrumming with the adrenaline and momentum of having just finished a writing project, so book-planning became a way to channel that energy. Often these processes are subject to whatever else is going on in my life.)

So. My week of intense idea-gathering looked a lot like what I've already described — reading, watching TV, but now also with long hours of sitting staring at a blank page and/or lying on my back staring at the ceiling — but with a more specific goal. Namely, I was trying to figure out what my main questions were. For me, every book starts (and continues, as I write) with an extremely long list of questions that I'm trying to find the answers to, but it takes work to figure out what the questions are. The questions can be very different from book to book. And it's essential, at the beginning, to identify what the main questions are.

When I'm first idea-gathering, I use very short notebooks in which I scribble down all my random thoughts as they come (I like using these twenty-page notebooks from Laughing Elephant, because they're short enough not to feel intimidatingly important). Then I have one longer, thicker notebook which is for my more coherent thoughts — my more serious book planning. During my week of active idea-gathering, I came up with the following list of major questions, worthy of being written down in my thick, "serious" planning notebook:

MAJOR QUESTIONS.

• What is magic?
• How does bad human behavior manifest in this world? (for real *)
• Where/what culture does each of them come from? What family?
• How is society governed?
• Who is each of them — as a person and as a power manifestation?
• How is the narrative positioned?
• What is the plot?
• How do humans relate to the rest of the natural world?
• What is gender? (for real *)

* and by societal definition

So. I'm not sure how closely you looked at those questions — but they are pretty gigantic questions! It took me a week to identify all of them. It's going to take me much, much longer to answer them. Which goes back to my point that ideas don't just "come to me." The merest seed of an idea might come to me, and after that, I make the space, and do the work.

As I began to hammer out my questions, I continued to read, watch things, and wool-gather, but with more intense focus. Because now I was also trying to answer these questions as they came. It was interesting to observe the order in which I began to find the answers. Not surprisingly, probably since my novels tend to be character-based, it was the character-based questions that drew me in first. “What is gender" in particular, because I have a sense that in this story, my characters' relationships to gender are absolutely integral to who they are, and I can’t get very far with a book plan if I don’t know who my characters are. I also started to gather some clues about their personalities and their strengths. Enough that after a couple of days, I got to the point where I suddenly knew I needed their names. Names ground everything, and they can also change some things; at a certain point, I can't make any further progress without names. I spent one entire day last week mostly just trying to figure out three people's names. Once I had the names, I was able to return to my questions.

Then, not too long after that, a moment arose where I knew, again quite suddenly, that what I needed next was at least the broad strokes of a plot. If I’m a little scornful about the concept of inspiration — because it’s a concept that dismisses how hard I work! — I do believe in intuition, and also in experience. Intuition and experience told me that I'd reached the point in my planning where the needs of my plot would hold the answer to a lot of my other questions. Like, how this place is governed; what constitutes bad behavior; and even some character things, like what culture each of my characters is from. Sometimes, once you know what needs to happen in a story, it becomes easier to picture the structure of your world. Because a plot comes with needs; once a plot exists, it limits some of your other options. For example, let's say your plot involves a particular kind of government-based corruption. Well, thinking about that corruption will probably start to show you some of your options for the structure of the government. Once you know the structure of the government, you might begin to understand who holds governmental power — which can lead to answers about how families are structured. Which can lead to answers about culture, which can lead to answers about the societal definition of bad behavior, etc.

So. I reached the point where I needed at least a sense of my plot. But: plotting is a HUGE job. I knew it wasn't something I could do in just a few days, and at this point I also knew that I was going to need to return to my revision soon. So, intuition told me that it was time to stop. Not stop being receptive; not necessarily stop reading or watching the helpful things; not stop sending myself emails, texts, and reminders; but stop trying to make any real, meaty, major progress on this book idea. I needed to save the job of plotting for when I next had a stretch of uninterrupted worktime. Maybe another free week or two somewhere, between other projects.

So, I did some final organizing of my notebook. I transferred things into it from other notebooks and I designating a huge number of empty pages in it for future plot thoughts and future character thoughts. I did this even though in this book, as in most of my books, I sense that character and plot will ultimately end up being the same thing, so it's not going to matter much which thoughts I file where. (In other words, most of my plot is going to spring from who my characters are, and many of my characters will spring from the needs of the plot.) But at this messy stage in planning, it's important to me to feel organized. The illusion of organization stops me from feeling as overwhelmed as I probably should be feeling. So I label things, and delude myself that I can contain this messy process inside a nice neat notebook ????. 

I organized my notebook, and then I put it aside. Today I'm still open to thoughts about my new book idea, but it's not my entire worklife anymore... it's more of a promise for the future. It'll probably be good to have it simmering on the back burner for a while. I'll be able to approach it with a new freshness when I sit down with it again one day.

So. I'm not sure how satisfyingly I've answered the question "Where do you get your ideas?" After all, this idea is still very much in progress. I figured out a lot of stuff last week, but mostly what I figured out is a long list of all the things I don't know yet. There will be many, many more workweeks to go before I'll be able to claim that I truly have an idea for a book. 

But this is my best shot at an answer to the question of where my ideas come from! I guess the point I want to convey is this: I don’t necessarily believe in inspiration. But I believe that sometimes a writer will start to get the merest sense of a story that's missing from the world, and find herself wanting to write that story. At that point, if circumstance allows her the time and space to enter a state that is extremely internally-focused and possibly involves a lot of intake (reading, watching other stories), or if not that, at least an extreme level of sensitivity and receptiveness, of seeing, of listening... And if she puts in the work… her idea-seed will start to take root, and grow into a real, workable idea that might one day be the beginnings of a book! 

And of course, every writer does this differently. Many writers don't plan or plot ahead of time. They figure out the idea as they write. So there's no right or wrong way to do it. 

But this is my best explanation of how I do it.

Godspeed to all writers.

As Israel continues to block lifesaving humanitarian aid from entering northern Gaza, humanitarian organizations are describing its siege as “apocalyptic” and warning of mass Palestinian starvation and death. “The situation is absolutely desperate,” says Rachael Cummings of the aid group Save the Children International. Cummings joins us from Deir al-Balah in central Gaza, where aid organizations have been halted from entering the north. She responds to news of Israel’s bombing of a polio vaccination center in an area that had been marked for an official humanitarian pause, and the Knesset’s vote to ban the U.N. relief agency UNRWA.

The AAR, Tamil Nadu in the case of M/s. CMA CGM Global Business Services (India) (P.) Ltd., In Re [Order No. 15/ARA/2024 dated July 15, 2024] ruled that an Assessee is eligible to avail input services in respect of leasing/ renting/ hiring of motor vehicles of motor vehicles to provide transportatio

Dear Experts,

In GSTR 1, under which table should we show the RCM amount on rent paid to an
unregistered Landlord.

Pls. advice.

Dear Sir,

We have a godown in Porur, and we pay rent every month after TDS is deducted. Recently, my friend mentioned that RCM is applicable for commercial rent payments to an unregistered person (URP). Could you please clarify my doubts?

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