Mcdonoughnash5735

Language instruction plays an essential role in the natural language grounded navigation tasks. However, navigators trained with limited human-annotated instructions may have difficulties in accurately capturing key information from the complicated instruction at different timesteps, leading to poor navigation performance. In this paper, we exploit to train a more robust navigator which is capable of dynamically extracting crucial factors from the long instruction, by using an adversarial attacking paradigm. Specifically, we propose a Dynamic Reinforced Instruction Attacker (DR-Attacker), which learns to mislead the navigator to move to the wrong target by destroying the most instructive information in instructions at different timesteps. By formulating the perturbation generation as a Markov Decision Process, DR-Attacker is optimized by the reinforcement learning algorithm to generate perturbed instructions sequentially during the navigation, according to a learnable attack score. Then, the perturbed instructions, which serve as hard samples, are used for improving the robustness of the navigator with an effective adversarial training strategy and an auxiliary self-supervised reasoning task. Experimental results on both Vision-and-Language Navigation (VLN) and Navigation from Dialog History (NDH) tasks show the superiority of our proposed method over state-of-the-art methods. Moreover, the visualization analysis shows the effectiveness of the proposed DR-Attacker, which can successfully attack crucial information in the instructions at different timesteps.Monocular depth prediction plays a crucial role in understanding 3D scene geometry. Although recent methods have achieved impressive progress in evaluation metrics such as the pixel-wise relative error, most methods neglect the geometric constraints in the 3D space. We show the importance of the high-order 3D geometric constraints for depth prediction. By designing a loss term that enforces a simple geometric constraint, virtual normal directions determined by randomly sampled three points in the reconstructed 3D space, we significantly improve the accuracy and robustness of monocular depth estimation. The virtual normal loss disentangles the scale information and enrich the model with better shape information. We show state-of-the-art results on NYU Depth-V2 and KITTI. Besides, we are now able to recover good 3D structures of the scene such as the point cloud and surface normal directly from the depth with better qualities, eliminating the necessity of training new sub-models as was previously done. Furthermore, when not having absolute metric depth training data, we can use virtual normal to learn a robust affine-invariant depth generated on diverse scenes. We construct a large-scale and diverse dataset for training affine-invariant depth, termed Diverse Scene Depth dataset (DiverseDepth), which consists of a broad range of scenes.We present an image-based navigation solution for a surgical robotic system with a Continuum Manipulator (CM). Our navigation system uses only fluoroscopic images from a mobile C-arm to estimate the CM shape and pose with respect to the bone anatomy. The CM pose and shape estimation is achieved using image intensity-based 2D/3D registration. A learning-based framework is used to automatically detect the CM in X-ray images, identifying landmark features that are used to initialize and regularize image registration. We also propose a modified hand-eye calibration method that numerically optimizes the hand-eye matrix during image registration. The proposed navigation system for CM positioning was tested in simulation and cadaveric studies. In simulation, the proposed registration achieved a mean error of 1.10 0.72 mm between the CM tip and a target entry point on the femur. In cadaveric experiments, the mean CM tip position error was 2.86 0.80 mm after registration and repositioning of the CM. The results suggest that our proposed fluoroscopic navigation is sufficient to guide the CM for orthopedic applications.Extracellular electrophysiology and two-photon calcium imaging are widely used methods for measuring physiological activity with single-cell resolution across large populations of cortical neurons. While each of these two modalities has distinct advantages and disadvantages, neither provides complete, unbiased information about the underlying neural population. Here, we compare evoked responses in visual cortex recorded in awake mice under highly standardized conditions using either imaging of genetically expressed GCaMP6f or electrophysiology with silicon probes. Across all stimulus conditions tested, we observe a larger fraction of responsive neurons in electrophysiology and higher stimulus selectivity in calcium imaging, which was partially reconciled by applying a spikes-to-calcium forward model to the electrophysiology data. However, the forward model could only reconcile differences in responsiveness when restricted to neurons with low contamination and an event rate above a minimum threshold. This work established how the biases of these two modalities impact functional metrics that are fundamental for characterizing sensory-evoked responses.

Obstructive sleep apnea is prevalent among military members despite fewer traditional risk factors. We sought to determine the incidence and longitudinal predictors of obstructive sleep apnea in a large population of survivors of combat-related traumatic injury and a matched control group.

Retrospective cohort study of military service members deployed to conflict zones from 2002-2016 with longitudinal follow-up in the Veterans Affairs and Military Health Systems. Two cohorts of service members were developed (1) those who sustained combat injuries and (2) matched, non-injured participants.

17,570 service members were retrospectively analyzed for a median of 8.4 years. After adjustment, traumatic brain injury (HR 1.39, 95% CI 1.20-1.60), posttraumatic stress disorder (HR 1.24, 95% CI 1.05-1.46), depression (HR 1.52, 95% CI 1.30-1.79), anxiety (HR 1.40, 95% CI 1.21-1.62), insomnia (HR 1.71, 95% CI 1.44-2.02), and obesity (HR 2.40, 95% CI 2.09-2.74) were associated with development of obstructive sleep apnea. While combat injury was associated with obstructive sleep apnea in the univariate analysis (HR 1.25, 95% CI 1.17-1.33), the direction of this association was reversed in the multivariable model (HR 0.74, 95% CI 0.65-0.84). In a nested analysis, this was determined to be due to the effect of mental health diagnoses.

The incidence of OSA is higher among injured service members (29.1 per 1000 person years) compared to uninjured service members (23.9 per 1000 person years). this website This association appears to be driven by traumatic brain injury and the long-term mental health sequelae of injury.

The incidence of OSA is higher among injured service members (29.1 per 1000 person years) compared to uninjured service members (23.9 per 1000 person years). This association appears to be driven by traumatic brain injury and the long-term mental health sequelae of injury.

The aim of the Improving CPAP Adherence Program (I-CAP study) was to assess the impact of a multidimensional treatment framework based on shared decision-making, patient activation, and caregiver engagement on improving long-term positive airway pressure (PAP) adherence in patients newly diagnosed with obstructive sleep apnea (OSA).

In this pilot study, patients aged ≥ 18 years with new OSA diagnosis, who qualified for PAP treatment and lived with a caregiver, were randomly assigned to receive either the multidimensional treatment (intervention, n=28) or unrelated education (control group, n=32). All patients and their caregivers participated in a group visit. The intervention group attended four structured sessions interactive education, peer coaching, hands-on experience, and a semi-structured motivational interview. The control group was educated on physical activity and lifestyle only. Objective PAP adherence data were obtained at baseline (day received PAP machine to group visit), group visit-3 months, and 3-6 months.

In an age-adjusted model, the mean daily use (MDU) of PAP increased significantly over the three time periods (p=0.03). Intervention-arm participants gained a mean 1.23 (CI 0.33 - 2.13) hour in PAP MDU between 3 and 6 months, vs. that of the control arm (p=0.008). We saw no difference in the percentage of PAP adherence across time between the two arms.

A multifaceted patient-centered intervention with caregiver engagement improved PAP adherence

. control levels, a beneficial effect sustained for the 6 months. Our findings suggest that caregivers, with the appropriate training, can improve patients' PAP adherence by providing a socially supportive environment.

A multifaceted patient-centered intervention with caregiver engagement improved PAP adherence vs. control levels, a beneficial effect sustained for the 6 months. Our findings suggest that caregivers, with the appropriate training, can improve patients' PAP adherence by providing a socially supportive environment.Gaucher disease (GD) is an autosomal recessive disease characterized by the buildup of glucocerebrosides in macrophages, resulting in the formation of "Gaucher cells." These cells predominantly infiltrate the liver, spleen, and bone marrow leading to hepatosplenomegaly, cytopenia, and bone pain. Anemia in GD is typically considered to result from non-hemolytic processes. Although rare, a higher rate of hemolytic anemia of the autoimmune type has been reported in GD than in the general population. The literature on non-immune hemolytic anemia in GD is scarce. We review the literature on hemolytic anemia in GD and report on a case of non-immune hemolytic anemia secondary to GD. We believe this is the first description of a patient with confirmed GD and symptomatic non-immune hemolytic anemia that responded to GD-specific treatment.Mutations in FGF23, KL, and GALNT3 have been identified as the cause for the development of hyperphosphatemic familial tumoral calcinosis (HFTC). Patients with HFTC typically present in childhood or adolescence with periarticular soft tissue deposits that eventually progress to disrupt normal joint articulation. Mutations in the GALNT3 gene were shown to account for the hyperphosphatemic state in both HFTC and hyperostosis-hyperphosphatemia syndrome (HHS), the latter characterized by bone involvement. We present the case of a patient of a Druze ethnic origin with known HFTC that presented to our department with the first documented case of pathologic fracture occurring secondary to the disease. Our report introduces this new phenotypic presentation, suggests a potential role for prophylactic bone screening, and highlights the need for preconception genetic screening in selected populations.

The objective of this study was to retrospectively review clinical data, management protocols, and clinical outcomes of patients with fibromatoses of head and neck region treated at our tertiary care center.

We retrospectively reviewed the medical records of 11 patients with confirmed histopathological diagnosis of fibromatosis registered in the Department of Head and Neck Surgery at Tata Memorial Centre, India, between 2009 and 2019. Various clinical and pathological features and treatment modalities were evaluated.

Age at diagnosis ranged between 18 and 74 years, with a median age of 36 years. The female-to-male ratio was 56. Supraclavicular fossa (n=4) was the most common subsite of origin in the neck (n=8). The lateral (n=2) and posterior cervical regions (n=2) were other common neck subsites. Less commonly involved sites were the mandible (n=1), maxilla (n=1), and thyroid (n=1). A total of eight patients underwent surgery at other centers before being referred to us for further management. Out of a total 11 patients, nine patients had unresectable disease at presentation.