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    A Second-Generation (44-Channel) Suprachoroidal Retinal Prosthesis: A Single-Arm Clinical Trial of Feasibility

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    PURPOSE: To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years. DESIGN: Prospective, single-arm, unmasked interventional clinical trial. PARTICIPANTS: Four participants, with advanced RP and bare-light perception vision. METHODS: The 44-channel suprachoroidal retinal prosthesis was implanted in the worse-seeing eye. Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation. MAIN OUTCOME MEASURES: Serious adverse event (SAE) reporting, visual response outcomes, functional vision outcomes, and quality-of-life outcomes. RESULTS: All 4 participants (aged 39-66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants' daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. Emotional well-being was not impacted by device implantation or usage. CONCLUSIONS: The completed clinical study demonstrates that the suprachoroidal prosthesis raises no safety concerns and provides improvements in functional vision, activities of daily living, and observer-rated quality of life. FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article

    Collecting population-representative bike-riding GPS data to understand bike-riding activity and patterns using smartphones and Bluetooth beacons

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    Bike-riding GPS data offers detailed insights and individual-level mobility information which are critical for understanding bike-riding travel behaviour, enhancing transportation safety and equity, and developing models to estimate bike route choice and volumes at high spatio-temporal resolution. Yet, large-scale bicycling-specific GPS data collection studies are infrequent, with many existing studies lacking robust spatial and/or temporal coverage, or have been influenced by sampling biases leading to these data lacking representativeness. Additionally, accurately detecting bike-riding trips from continuously collected raw GPS data without human intervention remains a challenge. This study presents a novel GPS data collection approach by leveraging the combination of a smartphone application with a Bluetooth beacon attached to a participant’s bike. Aided by minimal heuristic post-processing, our method limits data collection to trips taken by bike without the need for participant intervention, carefully optimising between survey participation, privacy challenges, participant workload, and robust bike-riding trip detection. Our method is applied to collect 19,782 bike trips from 673 adults spanning eight months and three seasons in Greater Melbourne, Australia. The collected dataset is shown to represent the underlying adult bike-riding population in terms of demographics (sex, occupation and employment type), temporal and spatial patterns. The average trip length (median = 4.8 km), duration (median = 20.9 min), and frequency of bicycling trips (median = 2.7 trips/week) were greater among men, middle-aged and older adults. The ‘Interested but Concerned’ riders (classified using Geller typology) rode more frequently, while the ‘Strong and Fearless’ and ‘Enthused and Confident’ groups rode greater distances and for longer. Participants rode on roads/streets without bike infrastructure for more than half of their trips by distance, while spending 24% and 17% on off-road paths and bike lanes respectively. This population-representative dataset will be key in the context of urban planning and policymaking

    Agent System Event Data: Concepts, Dimensions, Applications

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    Event data is a collection of recorded events that capture performed actions and observed states of business processes supported by information systems. It describes the times of event occurrences, event types, event attributes, and process cases of events identified by one or more objects the events relate to. Process mining uses event data to analyze and improve the processes in organizations. These processes are often performed by actors or agents, such as employees, resources, and systems, in different roles within organizations. In this paper, we present Agent System Event Data (ASED), a new type of event data that describes business processes as interactions of agents. ASED provides a new scope for analyzing individual agents involved in multiple processes, interactions of agents, and systems of agents that enact the processes. We formalize ASED as a conceptual data model, discuss its dimensional data modeling aspects, and argue that event data, in general, benefits from dimensional representation. We review existing event data types and discuss the complementary nature of existing models and ASED. Finally, we validate ASED by demonstrating its ability to express existing business process compliance rules, significantly expanding the scope of compliance analysis addressed by existing data models

    Surveillance, Data Collection and Privacy at Work: A New Application of Equitable Obligations?

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    Employers are gathering a sizeable body of employee data, some of which is sensitive and highly personal. However, privacy law in Australia remains fundamentally ill-adapted for protecting employee interests, due to significant exceptions for small businesses and employee records, and minimal protection of privacy rights at the federal level. Drawing on comparative doctrinal analysis of the UK and Australia, this article frames the dramatic regulatory gaps for employee data in Australia. It argues that equitable breach of confidence might prove to be a critical complement to the employment contract and other forms of legal regulation, to enable the protection of employees’ sensitive data. This is particularly pertinent in jurisdictions like Australia, with limited statutory or human rights protection of privacy. However, it could also prove to be an important complement to other protections in jurisdictions like the UK, with statutory privacy law, human rights, contract law and equitable doctrines offering complementary protections

    Austral Ancestors in Ernest Favenc's Frontier Gothic

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    This article argues that aging and ancestry is integral to Ernest Favenc’s late-colonial frontier Gothic writing. Through his repeated attention to scenes of settler death, and his creation of ghostly seventeenth-century and nineteenth-century explorers, Favenc makes the desert a graveyard and generates sets of settler ancestors, who stake a claim on the land for Euro-Australians. Written in a context of ‘doomed race theory’, which recognised Indigenous generational presence yet foreclosed their futures, white Australians in Favenc’s work become a younger ‘first’ peoples with their own history of dying on the land, just as older Aboriginal Australians en masse are written as going extinct. Whereas ageist rhetoric in the late colonial period indexes Aboriginal Australians as decrepit and weak, white remains and ghosts in Favenc’s works articulate age as a positive, as settlers dying on the land become ancestors. Favenc’s Austral ancestors enact a replacement narrative, writing over Indigenous peoples and further legitimising settlement. Reading aging and ancestry in Favenc’s frontier Gothic therefore augments readings of the colonial Australian Gothic as imbricated in the settler-colonial project rather than unsettling it

    Whiteness in Nineteenth-Century Speculative Writing

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    Apixaban overdose in children: case report and proposed management. A brief communication from the Pediatric and Neonatal Thrombosis and Hemostasis SSC of ISTH.

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    BACKGROUND: Direct oral anticoagulants are commonly prescribed for adults and increasingly also for children requiring anticoagulation therapy. While household medications should not be accessible to children, accidental, and intentional overdoses occur. KEY CLINICAL QUESTION: How should apixaban overdose in children be managed?. CLINICAL APPROACH: We present a case of an accidental overdose with the factor Xa antagonist apixaban in a young child and propose an approach to the management of cases of apixaban overdose in children. CONCLUSION: Given the increasing use of direct oral anticoagulants, it is important to have an approach to the management of overdose of these medications

    Are physiotherapists expected to be competent in digital health practice? Meta-synthesis of international physiotherapy practice competency standards

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    BACKGROUND: Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging. OBJECTIVE: Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice. METHODS: Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes. RESULTS: Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities. CONCLUSIONS: Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice

    A naturalistic cohort study of first-episode schizophrenia spectrum disorder: A description of the early phase of illness in the PSYSCAN cohort.

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    BACKGROUND: We examined the course of illness over a 12-month period in a large, international multi-center cohort of people with a first-episode schizophrenia spectrum disorder (FES) in a naturalistic, prospective study (PSYSCAN). METHOD: Patients with a first episode of schizophrenia, schizoaffective disorder (depressive type) or schizophreniform disorder were recruited at 16 institutions in Europe, Israel and Australia. Participants (N = 304) received clinical treatment as usual throughout the study. RESULTS: The mean age of the cohort was 24.3 years (SD = 5.6), and 67 % were male. At baseline, participants presented with a range of intensities of psychotic symptoms, 80 % were taking antipsychotic medication, 68 % were receiving psychological treatment, with 46.5 % in symptomatic remission. The mean duration of untreated psychosis was 6.2 months (SD = 17.0). After one year, 67 % were in symptomatic remission and 61 % were in functional remission, but 31 % had been readmitted to hospital at some time after baseline. In the cohort as a whole, depressive symptoms remained stable over the follow-up period. In patients with a current depressive episode at baseline, depressive symptoms slightly improved. Alcohol, tobacco and cannabis were the most commonly used substances, with daily users of cannabis ranging between 9 and 11 % throughout the follow-up period. CONCLUSIONS: This study provides valuable insight into the early course of a broad range of clinical and functional aspects of illness in FES patients in routine clinical practice

    Inpatients' experiences of falls: A qualitative meta-synthesis

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    OBJECTIVES: Identify and synthesize published qualitative research reporting inpatient experiences of a fall to determine novel insights and understandings of this longstanding complex problem. RESEARCH DESIGN: Qualitative meta-synthesis. METHODS: Online databases were searched to systematically identify published research reporting inpatient experiences of a fall. The included studies were inductively analysed and interpreted then reported as a meta-synthesis. DATA SOURCES: Databases Ovid MEDLINE, Embase, Ovid Emcare, CINAHL Complete, Scopus and ProQuest Dissertations and Theses Global were searched on 3rd August, 2023. RESULTS: From 10 included publications, four new themes of inpatients' experiences of a fall were constructed. Themes one, two and three related to antecedents of patient falls, and theme four related to consequences. Theme one, 'My foot didn't come with me: Physiological and anatomical changes', encompassed patients' experiences of medical conditions, medication, and anatomical changes. These aspects contributed to alterations in balance and strength, and misconceptions of capability in activities of daily (inpatient) living. Theme two, 'I was in a hurry: Help-seeking', encompassed patients' experiences striving for independence while balancing power and control, minimizing their own needs over care of others', and unavailability of support. Theme three, 'I couldn't find the call light: Environment and equipment', encompassed patients' experiences of not being able to reach or use equipment, and environment changes. Theme four, 'It was my fault too: Blame and confidence', encompassed patients' expressions of blame after their fall, blame directed at both themselves and/or others, and impacts on confidence and fear in mobilizing. CONCLUSIONS: Inpatient falls are embedded in a complexity of individual, relational, and environmental factors, yet there are potential ways forward both informed and led by the patient's voice. Strength-based approaches to address the tenuous balance between independence and support may be one opportunity to explore as a next step in complementing the existing multifaceted interventions. IMPACT: Inpatient falls are a complex and costly health safety and quality problem. Despite global initiatives in the prevention of inpatient falls, they remain intractable. This meta-synthesis provides an in-depth exploration of extant qualitative data on patients' experiences of falls in hospitals. Four themes were constructed expressing the inpatients' experiences: physiological and anatomical changes, help-seeking, environment and equipment, and blame and confidence. Novel considerations for future investigation are offered, drawing from self-determination theory and positive psychological interventions. IMPLICATIONS FOR PATIENT CARE: This meta-synthesis elicits new considerations for future interventions based on people's experiences of their fall in hospital, offering healthcare professionals novel directions in fall prevention. REPORTING METHOD: The review was reported according to the Enhancing transparency in reporting the synthesis of qualitative research statement (ENTREQ; Tong et al., 2012). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. REGISTRATION: PROSPERO CRD42023445279

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