User testing of a Scottish Intercollegiate Guideline Network public guideline for the parents of children with autism

Background The Scottish Intercollegiate Guidelines Network (SIGN) is the leading national clinical guideline producer in Scotland. Improved design and dissemination of guidelines produced for the public can empower people to take an active role in self-management and shared decision-making. The public version of the guideline examined covered getting assessed and diagnosed with autism, and approaches that can help. The aim of this study was to test a public version of a guideline for the parents of children and young people with autism, implement improvements, and identify what works in making it usable and accessible. Methods We recruited mothers from across Scotland. User testing involved formal ‘think aloud’ semi-structured interviews that guided users through the booklet. Interviews took place individually and were recorded and transcribed. Key findings were identified and themed using the honeycomb user experience model. Results Fourteen user-testing interviews were conducted. Facilitators for usability and desirability of the guideline included the chunking of text, consistent use of colour and boxes to highlight important information. Simple language, written in a tone of partnership, helped to engage mothers. Value arose from the guidelines ability to explain the process of diagnosis and make mothers feel empowered in their relationships with healthcare professionals. There was a lack of consensus on the usefulness of rating the strength of evidence and recommendations. Conclusion There was a marked similarity between what was important to the mothers and what has been found to be important to other groups. The involvement of service users and carers in the guidelines development was key to its credibility. One size does not fit all in presenting evidence-based recommendations to the public and it is a challenge to provide sufficient information while avoiding information overload. Recommendations and evidence levels are suitable for use in public versions, but these should be kept as simple as possible.

Identification of the First C1 Subgenotype of Enterovirus 71 in Mainland of China in a Retrospective Study

The C4 sub-genotype of Enterovirus 71(EV71) is identified as the most dominant sub-genotype circulating in Chinese mainland since 1998, while the circulation situation of EV71 before 1998 is not well established due to insufficient experimental data. The C1 sub-genotype of EV71 has not been reported in Chinese mainland by now. Based on AFP surveillance system of the mainland of China, this study performed a retrospective study of AFP cases for 1985-1999༚A strain of EV-A71 C1 sub-genotype was found. To our knowledge, this strain (SD92-41) is the first C1 sub-genotype reported in Chinese mainland. This study proves that the C1 gene subtype also appeared in Chinese mainland, but it is not clear whether it is an imported or a local epidemic strain. With sufficient information from retrospective studies, the source of the SD92-41 strain will be identified, and the prevalence of EV-A71 in Chinese mainland before 1998 will be clearer.

Design multivariate statistical process control procedure in the case of Ethio cement

PurposeThis study aims to design a multivariate control chart that improves the applicability of the traditional Hotelling T2 chart. This new type of multivariate control chart displays sufficient information about the states and relationships of the variables in the production process. It is used to make better quality control decisions during the production process.Design/methodology/approachMultivariate data are collected at an equal time interval and are represented by nodes of the graph. The edges connecting the nodes represent the sequence of operation. Each node is plotted on the control chart based on their Hotelling T2 statistical distance. The changing behavior of each pair of input and output nodes is studied by the neural network. A case study from the cement industry is conducted to validate the control chart.FindingsThe finding of this paper is that the points and lines in the classic Hotelling T2 chart are effectively substituted by nodes and edges of the graph respectively. Nodes and edges have dimension and color and represent several attributes. As a result, this control chart displays much more information than the traditional Hotelling T2 control chart. The pattern of the plot represents whether the process is normal or not. The effect of the sequence of operation is visible in the control chart. The frequency of the happening of nodes is recognized by the size of nodes. The decision to change the product feature is assisted by finding the shortest path between nodes. Moreover, consecutive nodes have different behaviors, and that behavior change is recognized by neural network.Originality/valueModifying the classical Hotelling T2 control chart by integrating with the concept of graph theory and neural network is new of its kind.

Semantic-enabled architecture for auditable privacy-preserving data analysis

Small and medium-sized organisations face challenges in acquiring, storing and analysing personal data, particularly sensitive data (e.g., data of medical nature), due to data protection regulations, such as the GDPR in the EU, which stipulates high standards in data protection. Consequently, these organisations often refrain from collecting data centrally, which means losing the potential of data analytics and learning from aggregated user data. To enable organisations to leverage the full-potential of the collected personal data, two main technical challenges need to be addressed: (i) organisations must preserve the privacy of individual users and honour their consent, while (ii) being able to provide data and algorithmic governance, e.g., in the form of audit trails, to increase trust in the result and support reproducibility of the data analysis tasks performed on the collected data. Such an auditable, privacy-preserving data analysis is currently challenging to achieve, as existing methods and tools only offer partial solutions to this problem, e.g., data representation of audit trails and user consent, automatic checking of usage policies or data anonymisation. To the best of our knowledge, there exists no approach providing an integrated architecture for auditable, privacy-preserving data analysis. To address these gaps, as the main contribution of this paper, we propose the WellFort approach, a semantic-enabled architecture for auditable, privacy-preserving data analysis which provides secure storage for users’ sensitive data with explicit consent, and delivers a trusted, auditable analysis environment for executing data analytic processes in a privacy-preserving manner. Additional contributions include the adaptation of Semantic Web technologies as an integral part of the WellFort architecture, and the demonstration of the approach through a feasibility study with a prototype supporting use cases from the medical domain. Our evaluation shows that WellFort enables privacy preserving analysis of data, and collects sufficient information in an automated way to support its auditability at the same time.

The Company Prosodic Deficits Keep Following Right Hemisphere Stroke: A Systematic Review

Objectives: The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. Methods: One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. Results: Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. Conclusions: This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.

Construction and Validation of a Risk Prediction Model for Acute Kidney Injury in Patients Suffering from Septic Shock

Background. Acute kidney injury (AKI) is an important complication in critically ill patients, especially in sepsis and septic shock patients. Early prediction of AKI in septic shock can provide clinicians with sufficient information for timely intervention so that improve the patients’ survival rate and quality of life. The aim of this study was to establish a nomogram that predicts the risk of AKI in patients with septic shock in the intensive care unit (ICU). Methods. The data were collected from the Medical Information Mart for Intensive Care III (MIMIC-III) database between 2001 and 2012. The primary outcome was AKI in the 48 h following ICU admission. Univariate and multivariate logistic regression analyses were used to screen the independent risk factors of AKI. The performance of the nomogram was evaluated according to the calibration curve, receiver operating characteristic (ROC) curve, decision curve analysis, and clinical impact curve. Results. A total of 2415 patients with septic shock were included in this study. In the training and validation cohort, 1091 (64.48%) of 1690 patients and 475 (65.52%) of 725 patients developed AKI, respectively. The predictive factors for nomogram construction were gender, ethnicity, congestive heart failure, diabetes, obesity, Simplified Acute Physiology Score II (SAPS II), angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARBs), bilirubin, creatinine, blood urea nitrogen (BUN), and mechanical ventilation. The model had a good discrimination with the area under the ROC curve of 0.756 and 0.760 in the training and validation cohorts, respectively. The calibration curve for probability of AKI in septic shock showed optimal agreement between prediction by nomogram and actual observation. Decision curve and clinical impact curve analysis indicated that the nomogram conferred high clinical net benefit. Conclusion. The proposed nomogram can quickly and effectively predict the risk of AKI at an early stage in patients with septic shock in ICU, which can provide information for timely and efficient intervention in patients with septic shock in the ICU setting.

Design Proposal for Masonry Infill Walls Subject to Seismic Actions

Several factors influence the behaviour of masonry infilled frames, which have been the subject of previous research with moderate success. The new generation of European design standards imposes the need to prevent the brittle collapse of infills and makes the structural engineer accountable for this requirement, yet it fails to provide sufficient information for masonry infill design. The present study aimed to compare experimental results with the provisions of the standard for the computation of the demand and capacity of infilled frames. Three reinforced concrete buildings with different infill solutions were constructed at a 1:1.5 scale. The infill walls were tested until collapse, or severe damage, using the shake table of the National Laboratory for Civil Engineering, Portugal, and their response was measured using accelerometers attached to the walls. The European normative standard provides results close to the experimental ones as far as demand and capacity are concerned. Based on the experiments, two design proposals for infill walls are presented here, one for the definition of the natural frequency of the infills, and another for a reduction factor to account for the presence of openings in the out-of-plane capacity of infills.

COVID-19: information access, trust and adherence to health advice among migrants in Norway

Background Migrants in Norway bear a higher burden of COVID-19 infections and hospitalization as compared to non-migrants. The aim of our study was to understand how migrants perceive their own health risk, how they access information regarding the preventive measures, the degree of trust in this information, in the Norwegian authorities and the news media, and migrants’ adherence to authorities’ recommendations regarding the pandemic. Methods An online survey was performed between May and July 2020 among 529 Polish, Arabic, Somali, Tamil, and Spanish-speaking migrants in Norway. For each outcome presented in the aims, unweighted and weighted descriptive analyses were performed for all migrants together and for each language group. Results Sixty-one percent of migrants perceived their health as excellent or very good, with the lowest value (42%) in the Tamil group and the highest among Somalians (85%). The majority of respondents (82%) felt they had received sufficient information. Press conferences from the government, health authorities’ websites, and Norwegian news media were the preferred channels of information for all groups. Most migrants reported a high level of adherence to preventive measures (88%) and trust in Norwegian authorities (79%). However, there were variations among groups regarding the importance of sources of information and level of trust, which was lowest for the Polish group. Conclusion Migrants in Norway reported receiving sufficient information about COVID-19 and high adherence to preventive measures. However, the levels of trust in the information sources, the services and the authorities varied among the groups. Understanding how migrants are dealing with this pandemic is crucial to improve the dissemination of information and trust in the health authorities for the different groups.

Transparency in port governance: setting a research agenda

This study examines the concept of transparency as practiced (or not) in ports. It explores the availability of information to the general public and port stakeholders through the ports’ most public face—its website, studying public ports in North America, Europe, and Latin America and the Caribbean. This exploratory research centred on identifying the parameters that would be useful for the general public to have sufficient information to monitor, review and in many cases, participate in the decision-making processes carried out by the port authority, irrespective of whether or not laws mandate such disclosure. Fifty-one items were identified for the examination of each port’s website, focusing primarily on four major categories: decision-making governance, port communications and accessibility, transparency in reporting and in port operational activities. Using nine items as proxies for the 51, the research reveals uneven levels of port transparency both regionally and by governance model. The study reveals a need for increasing and differentiating the existing levels and standards of transparency in the governance of the port industry, and for greater consistency between ports within and across regions. The study concludes with a research agenda for future research.

Evaluation of two AI software for the diagnosis of TB infection : A study protocol (Preprint)

BACKGROUND Tuberculosis (TB) profile in Malaysia showed an average annual growth rate of 2.23%, with an estimated 92 cases per 100,000 people reported in 2018. CXR remains the best conventional method for the early detection of pulmonary TB infection. The intervention of AI in TB diagnosis could efficiently aid human interpreters and reduce health professionals' work burden. To date, no evaluation of AI studies has been carried out in Malaysia. OBJECTIVE This study aims to determine the diagnostic accuracy and evaluate the performance of Qure.ai and Putra Analytica AI software. METHODS We will conduct a retrospective case-control study in Respiratory Medicine Institute (IPR), Kuala Lumpur Health Clinic and Bandar Botanik Klang Health Clinic. Patients' medical reports on TB investigation will be retrieved by accessing electronic and hardcopy medical records and collecting demographic data. Prior to conducting the study, patients' PTB status will be obtained by identifying MTB culture (reference standard) results in order to create a case and a control group. A total of 2000 CXR images will be retrieved, of which 1000 images will be the case (abnormality). Normal and abnormal CXR will be categorized into film and digital CXR, which will be screened onto the said AI software (index tests). RESULTS Results obtained from the AI software will be compared with the reference standard, and significant statistical analysis will be computed CONCLUSIONS We hope that the findings of this evaluation study will provide sufficient information for stakeholders and to implement AI technology in the medical imaging field for better management of TB in hospital and clinic settings.