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The study objective was to develop and validate a clinical decision support system (CDSS) to guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings. The \"TBorNotTB\" CDSS was developed using a modified Delphi method. The CDSS assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, and sputum/bronchoscopy results. Below a set point threshold, airborne isolation precautions are automatically discontinued; otherwise, additional evaluation, including infection control review, is recommended. The model was validated through retrospective application of the CDSS to all individuals hospitalized in the Mass General Brigham system from July 2016 to December 2022 with culture-confirmed pulmonary TB (cases) and equal numbers of age and date of testing-matched controls with three negative respiratory mycobacterial cultures. 104 individuals with TB (cases) and 104 controls were identified. Prior residence in a highly endemic country, positive interferon release assay, weight loss, absence of symptom resolution with treatment for alternative diagnoses, and findings concerning for TB on chest imaging were significant predictors of TB (all < 0.05). CDSS contents and scoring were refined based on the case-control analysis. The final CDSS demonstrated 100% sensitivity and 27% specificity for TB with an AUC of 0.87. The TBorNotTB CDSS demonstrated modest specificity and high sensitivity to detect TB even when AFB smears were negative. This CDSS, embedded into the electronic medical record system, could help reduce risks of nosocomial TB transmission, patient-time in airborne isolation, and person-time spent reviewing individuals with suspected TB.

No detailed description available for \"Coleridge's \"Dejection\"\".

The publication in 1954 of Robert Mayo's admirable paper, “The Contemporaneity of the Lyrical Ballads ,” has made it seem incautious if not foolhardy to claim novelty of theme or technique for the volume of 1798. As Mayo appears to have shown, the Lyrical Ballads conformed in nearly all respects to the patterns prevailing in magazine poetry of the 1790's; the volume's “originality” lay less in any innovations it attempted than in the freshness and intensity with which it developed already familiar conventions. As for the “experiments” alluded to in the 1798 Advertisement and the 1800 Preface, they were, as the comments of Coleridge and others seem to confirm, largely experiments in language alone, and wholly within the boundaries of popular taste.

When Coleridge, after looking over the third edition of Lyrical Ballads with its enlarged preface, confided to William Sotheby (13 July 1802) his troubled belief that between Wordsworth and himself there lay “a radical Difference” of opinion about poetry, he was recognizing a disagreement that must have dated almost from his earliest talks with Wordsworth. Writing to Robert Southey two weeks later (29 July), Coleridge proposed to “go to the Bottom” of the difference in a forthcoming volume of critical essays. When the proposal finally matured, in scattered chapters of Biographia Lileraria —fifteen years later—Coleridge declared it as a main object “to effect, as far as possible, a settlement of the long continuées, controversy concerning the true nature of poetic diction.”