211 research outputs found
AI-carus
I write this poem to express my distrust for artificial intelligence because I think AI cannot represent humans in any way. Nowadays, people are confused and cannot tell human values from capitalistic and scientific values. We are like Icarus; we use technology to gain material success and escape cruel nature. However, if we cannot recognise and reflect on the difference between humans and AI, catastrophe will eventually burn us like what it did to Icarus. 
Dynamics of a suspended nanowire driven by an ac Josephson current in an inhomogeneous magnetic field
We consider a voltage-biased nanoelectromechanical Josephson junction, where
a suspended nanowire forms a superconducting weak-link, in an inhomogeneous
magnetic field. We show that a nonlinear coupling between the Josephson current
and the magnetic field generates a Laplace force that induces a whirling motion
of the nanowire. By performing an analytical and a numerical analysis, we
demonstrate that at resonance, the amplitude-phase dynamics of the whirling
movement present different regimes depending on the degree of inhomogeneity of
the magnetic field: time independent, periodic and chaotic. Transitions between
these regimes are also discussed.Comment: 7 pages, 5 figure
Entanglement transformation between sets of bipartite pure quantum states using local operations
Alice and Bob are given an unknown initial state chosen from a set of pure
quantum states. Their task is to transform the initial state to a corresponding
final pure state using local operations only. We prove necessary and sufficient
conditions on the existence of such a transformation. We also provide efficient
algorithms that can quickly rule out the possibility of transforming a set of
initial states to a set of final states.Comment: 19 pages, 1 figure, minor revision, to appear in J.Math.Phy
Tales from the EMR: Does a 21st-Century Data Warehouse Facilitate Clinical Research for Pancreatic Cancer?
Background: The importance of an electronic medical record has been highlighted for both clinical care and research. In the current era, data warehouses and repositories have been established to serve the dual function of patient care and investigation.
Purpose: The aim of this study was to compare a newly developed institutional clinical data warehouse, linked with the hospital information system (HIS), to a prospectively-maintained departmental database.
Methods: A novel HIS-linked institutional clinical data warehouse was queried for 9 primary and secondary ICD-9-CM discharge diagnosis codes for pancreatic cancer. The database captured inpatient and outpatient clinical and billing information from a pool of over 2 million patients evaluated at an academic medical institution and its affiliates since 1995. A cohort was identified; following Institutional Review Board approval, demographic and clinical data was obtained. This data was compared to a manually-entered and prospectively-maintained surgical oncology database of the same institution, tracking 394 patients since 1999. Duplicated patients, and those unique to either dataset, were flagged. Patients with diagnosis dates prior to 1999 were excluded to allow comparison over the same time period. For validation purposes, a 10% random sample of remaining patients unique to each dataset underwent manual review of medical records including clinic notes, admission/discharge notes, diagnostic imaging, and pathology reports.
Results: 1107 patients were identified from the HIS-linked dataset with pancreatic neoplasm-associated diagnosis codes dating from 1999 to 2009. Of these, 254 (22.9%) were captured in both datasets, while 853 (77.1%) were only in the HIS-linked dataset. Manual review of the 10% subset of the HIS-only group demonstrated that 55.6% of patients were without identifiable pancreatic pathology, suggesting miscoding, while 31.7% had diagnoses consistent with pancreatic neoplasm, and 12.7% had pseudocyst or pancreatitis. Of the 394 patients tracked by surgical oncology, 254 (64.5%) were captured in both datasets, while 140 (35.5%) had not been captured in the HIS-linked dataset. Manual review of the 10% subset of the non-captured patients demonstrated 93.3% with pancreatic neoplasm and 6.7% with pseudocyst or pancreatitis. Lastly, a review of the 10% subset of the 254 patient overlap demonstrated that 87.5% of patients were with pancreatic neoplasm, 8.3% with pseudocyst or pancreatitis, and 4.2% without pancreatic pathology.
Conclusions: While technological advances provide a powerful means to automate institutional-level cohort identification and data collection, a high degree of misclassification may be present if queries are based solely on ICD-9-CM discharge codes. For that reason, careful validation and data cleaning are critical steps prior to research use. These results also suggest cautious interpretation of national-level administrative data utilizing ICD-9-CM diagnosis codes. Our findings suggest that the current state-of-the-art data warehouses continue to require clinical correlation and validation through traditional retrospective mechanisms
Assessing the implementation and effectiveness of the Electronic Patient Reported Outcome Tool for Seniors with Complex Care Needs:Mixed Methods Study
BACKGROUND: Goal-oriented care is being adopted to deliver person-centered primary care to older adults with multimorbidity and complex care needs. Although this model holds promise, its implementation remains a challenge. Digital health solutions may enable processes to improve adoption; however, they require evaluation to determine feasibility and impact. OBJECTIVE: This study aims to evaluate the implementation and effectiveness of the electronic Patient-Reported Outcome (ePRO) mobile app and portal system, designed to enable goal-oriented care delivery in interprofessional primary care practices. The research questions driving this study are as follows: Does ePRO improve quality of life and self-management in older adults with complex needs? What mechanisms are likely driving observed outcomes? METHODS: A multimethod, pragmatic randomized controlled trial using a stepped-wedge design and ethnographic case studies was conducted over a 15-month period in 6 comprehensive primary care practices across Ontario with a target enrollment of 176 patients. The 6 practices were randomized into either early (3-month control period; 12-month intervention) or late (6-month control period; 9-month intervention) groups. The primary outcome measure of interest was the Assessment of Quality of Life-4D (AQoL-4D). Data were collected at baseline and at 3 monthly intervals for the duration of the trial. Ethnographic data included observations and interviews with patients and providers at the midpoint and end of the intervention. Outcome data were analyzed using linear models conducted at the individual level, accounting for cluster effects at the practice level, and ethnographic data were analyzed using qualitative description and framework analysis methods. RESULTS: Recruitment challenges resulted in fewer sites and participants than expected; of the 176 target, only 142 (80.6%) patients were identified as eligible to participate because of lower-than-expected provider participation and fewer-than-expected patients willing to participate or perceived as ready to engage in goal-setting. Of the 142 patients approached, 45 (32%) participated. Patients set a variety of goals related to self-management, mental health, social health, and overall well-being. Owing to underpowering, the impact of ePRO on quality of life could not be definitively assessed; however, the intervention group, ePRO plus usual care (mean 15.28, SD 18.60) demonstrated a nonsignificant decrease in quality of life (t(24)=â1.20; P=.24) when compared with usual care only (mean 21.76, SD 2.17). The ethnographic data reveal a complex implementation process in which the meaningfulness (or coherence) of the technology to individualsâ lives and work acted as a key driver of adoption and tool appraisal. CONCLUSIONS: This trial experienced many unexpected and significant implementation challenges related to recruitment and engagement. Future studies could be improved through better alignment of the research methods and intervention to the complex and diverse clinical settings, dynamic goal-oriented care process, and readiness of provider and patient participants. TRIAL REGISTRATION: ClinicalTrials.gov NCT02917954; https://clinicaltrials.gov/ct2/show/NCT0291795
Interplay of brain structure and function in neonatal congenital heart disease
Objective: To evaluate whether structural and microstructural brain abnormalities in neonates with congenital heart disease (CHD) correlate with neuronal network dysfunction measured by analysis of EEG connectivity. Methods: We studied a prospective cohort of 20 neonates with CHD who underwent continuous EEG monitoring before surgery to assess functional brain maturation and network connectivity, structural magnetic resonance imaging (MRI) to determine the presence of brain injury and structural brain development, and diffusion tensor MRI to assess brain microstructural development. Results: Neonates with MRI brain injury and delayed structural and microstructural brain development demonstrated significantly stronger high-frequency (beta and gamma frequency band) connectivity. Furthermore, neonates with delayed microstructural brain development demonstrated significantly weaker low-frequency (delta, theta, alpha frequency band) connectivity. Neonates with brain injury also displayed delayed functional maturation of EEG background activity, characterized by greater background discontinuity. Interpretation: These data provide new evidence that early structural and microstructural developmental brain abnormalities can have immediate functional consequences that manifest as characteristic alterations of neuronal network connectivity. Such early perturbations of developing neuronal networks, if sustained, may be responsible for the persistent neurocognitive impairment prevalent in adolescent survivors of CHD. These foundational insights into the complex interplay between evolving brain structure and function may have relevance for a wide spectrum of neurological disorders manifesting early developmental brain injury
A Relation Between Approaches to Integrability in Superconformal Yang-Mills Theory
We make contact between the infinite-dimensional non-local symmetry of the
typeIIB superstring on AdS5xS5 worldsheet theory and a non-abelian
infinite-dimensional symmetry algebra for the weakly coupled superconformal
gauge theory. We explain why the planar limit of the one-loop dilatation
operator is the Hamiltonian of a spin chain, and show that it commutes with the
g*2 N = 0 limit of the non-abelian charges.Comment: 19 pages, harvma
Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia
The attached file is a pre-published version of the full and final paper which can be found at the link below.This article has been made available through the Brunel Open Access Publishing Fund.Qualitative research methods that focus on the lived experience of people with health conditions are relatively
underutilised in physiotherapy research. This article aims to introduce interpretative phenomenological analysis
(IPA), a research methodology oriented toward exploring and understanding the experience of a particular
phenomenon (e.g., living with spinal cord injury or chronic pain, or being the carer of someone with a particular
health condition). Researchers using IPA try to find out how people make sense of their experiences and the
meanings they attach to them. The findings from IPA research are highly nuanced and offer a fine grained
understanding that can be used to contextualise existing quantitative research, to inform understanding of novel
or underresearched topics or, in their own right, to provoke a reappraisal of what is considered known about
a specified phenomenon. We advocate IPA as a useful and accessible approach to qualitative research that
can be used in the clinical setting to inform physiotherapy practice and the development of services from the
perspective of individuals with particular health conditions.This article is available through the Brunel Open Access Publishing Fund
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