Advancing the digital and computational capabilities of healthcare providers: A qualitative study of a hospital organisation in the NHS

Objective: Healthcare systems require transformation to meet societal challenges and projected health demands. Digital and computational tools and approaches are fundamental to this transformation, and hospitals have a key role to play in their development and implementation. This paper reports on a study with the objective of exploring the challenges encountered by hospital leaders and innovators as they implement a strategy to become a data-driven hospital organisation. In doing so, this paper provides guidance to future leaders and innovators seeking to build computational and digital capabilities in complex clinical settings. Methods: Interviews were undertaken with 42 participants associated with a large public hospital organisation within England's National Health Service. Using the concept of institutional readiness as an analytical framework, the paper explores participants’ perspectives on the organisation's capacity to support the development of, and benefit from, digital and computational approaches. Results: Participants’ accounts reveal a range of specific institutional readiness criteria relating to organisational vision, technical capability, organisational agility, and talent and skills that, when met, enhance the organisations’ capacity to support the development and implementation of digital and computational tools. Participant accounts also reveal challenges relating to these criteria, such as unrealistic expectations and the necessary prioritisation of clinical work in resource-constrained settings. Conclusions: The paper identifies a general set of institutional readiness criteria that can guide future hospital leaders and innovators aiming to improve their organisation's digital and computational capability. The paper also illustrates the challenges of pursuing digital and computational innovation in resource-constrained hospital environments

Polarization Gradient Study of Interstellar Medium Turbulence Using The Canadian Galactic Plane Survey

We have investigated the magneto-ionic turbulence in the interstellar medium through spatial gradients of the complex radio polarization vector in the Canadian Galactic Plane Survey (CGPS). The CGPS data cover 1300 square-degrees, over the range ${53^{\circ}}\leq{\ell}\leq{192^{\circ}}$, ${-3^{\circ}}\leq{b}\leq{5^{\circ}}$ with an extension to ${b}={17.5^{\circ}}$ in the range ${101^{\circ}}\leq{\ell}\leq{116^{\circ}}$, and arcminute resolution at 1420 MHz. Previous studies found a correlation between the skewness and kurtosis of the polarization gradient and the Mach number of the turbulence, or assumed this correlation to deduce the Mach number of an observed turbulent region. We present polarization gradient images of the entire CGPS dataset, and analyze the dependence of these images on angular resolution. The polarization gradients are filamentary, and the length of these filaments is largest towards the Galactic anti-center, and smallest towards the inner Galaxy. This may imply that small-scale turbulence is stronger in the inner Galaxy, or that we observe more distant features at low Galactic longitudes. For every resolution studied, the skewness of the polarization gradient is influenced by the edges of bright polarization gradient regions, which are not related to the turbulence revealed by the polarization gradients. We also find that the skewness of the polarization gradient is sensitive to the size of the box used to calculate the skewness, but insensitive to Galactic longitude, implying that the skewness only probes the number and magnitude of the inhomogeneities within the box. We conclude that the skewness and kurtosis of the polarization gradient are not ideal statistics for probing natural magneto-ionic turbulence.Comment: 21 pages, 15 figures, accepted by Ap

The Value of Data: Applying a Public Value Model to the English National Health Service

Research and innovation in biomedicine and health care increasingly depend on electronic data. The emergence of data-driven technologies and associated digital transformations has focused attention on the value of such data. Despite the broad consensus of the value of health data, there is less consensus on the basis for that value; thus, the nature and extent of health data value remain unclear. Much of the existing literature presupposes that the value of data is to be understood primarily in financial terms, and assumes that a single financial value can be assigned. We here argue that the value of a dataset is instead relational; that is, the value depends on who wants to use it and for what purposes. Moreover, data are valued for both nonfinancial and financial reasons. Thus, it may be more accurate to discuss the values (plural) of a dataset rather than the singular value. This plurality of values opens up an important set of questions about how health data should be valued for the purposes of public policy. We argue that public value models provide a useful approach in this regard. According to public value theory, public value is created, or captured, to the extent that public sector institutions further their democratically established goals, and their impact on improving the lives of citizens. This article outlines how adopting such an approach might be operationalized within existing health care systems such as the English National Health Service, with particular focus on actionable conclusions

Advanced Diagnostics for the Study of Linearly Polarized Emission. II: Application to Diffuse Interstellar Radio Synchrotron Emission

Diagnostics of polarized emission provide us with valuable information on the Galactic magnetic field and the state of turbulence in the interstellar medium, which cannot be obtained from synchrotron intensity alone. In Paper I (Herron et al. 2017b), we derived polarization diagnostics that are rotationally and translationally invariant in the $Q$-$U$ plane, similar to the polarization gradient. In this paper, we apply these diagnostics to simulations of ideal magnetohydrodynamic turbulence that have a range of sonic and Alfv\'enic Mach numbers. We generate synthetic images of Stokes $Q$ and $U$ for these simulations, for the cases where the turbulence is illuminated from behind by uniform polarized emission, and where the polarized emission originates from within the turbulent volume. From these simulated images we calculate the polarization diagnostics derived in Paper I, for different lines of sight relative to the mean magnetic field, and for a range of frequencies. For all of our simulations, we find that the polarization gradient is very similar to the generalized polarization gradient, and that both trace spatial variations in the magnetoionic medium for the case where emission originates within the turbulent volume, provided that the medium is not supersonic. We propose a method for distinguishing the cases of emission coming from behind or within a turbulent, Faraday rotating medium, and a method to partly map the rotation measure of the observed region. We also speculate on statistics of these diagnostics that may allow us to constrain the physical properties of an observed turbulent region.Comment: 34 pages, 25 figures, accepted for publication in Ap

Synthesis of CdS and CdSe nanocrystallites using a novel single-molecule precursors approach

The synthesis of CdS and CdSe nanocrystallites using the thermolysis of several dithioor diselenocarbamato complexes of cadmium in trioctylphosphine oxide (TOPO) is reported. The nanodispersed materials obtained show quantum size effects in their optical spectra and exhibit near band-edge luminescence. The influence of experimental parameters on the properties of the nanocrystallites is discussed. HRTEM images of these materials show well-defined, crystalline nanosized particles. Standard size fractionation procedures can be performed in order to narrow the size dispersion of the samples. The TOPO-capped CdS and CdSe nanocrystallites and simple organic bridging ligands, such as 2,2¢-bipyrimidine, are used as the starting materials for the preparation of novel nanocomposites. The optical properties shown by these new nanocomposites are compared with those of the starting nanodispersed materials

Functional cardiac fibroblasts derived from human pluripotent stem cells via second heart field progenitors

Cardiac fibroblasts (CFs) play critical roles in heart development, homeostasis, and disease. The limited availability of human CFs from native heart impedes investigations of CF biology and their role in disease. Human pluripotent stem cells (hPSCs) provide a highly renewable and genetically defined cell source, but efficient methods to generate CFs from hPSCs have not been described. Here, we show differentiation of hPSCs using sequential modulation of Wnt and FGF signaling to generate second heart field progenitors that efficiently give rise to hPSC-CFs. The hPSC-CFs resemble native heart CFs in cell morphology, proliferation, gene expression, fibroblast marker expression, production of extracellular matrix and myofibroblast transformation induced by TGFβ1 and angiotensin II. Furthermore, hPSC-CFs exhibit a more embryonic phenotype when compared to fetal and adult primary human CFs. Co-culture of hPSC-CFs with hPSC-derived cardiomyocytes distinctly alters the electrophysiological properties of the cardiomyocytes compared to co-culture with dermal fibroblasts. The hPSC-CFs provide a powerful cell source for research, drug discovery, precision medicine, and therapeutic applications in cardiac regeneration.J.L.C. received funding from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and Fundação de Amparo à Pesquisa do Distrito Federal. The work was funded by NIH R01 HL129798 (T.J.K.); NIH U01 HL134764 (T.J.K.); S10RR025644 (T.J.K.); and the UW Institute for Clinical and Translational Research, grant UL1TR000427, from the Clinical and Translational Science Award of the NCATS/NIH.S

The Co-occurrence of child and intimate partner maltreatment in the family: characteristics of the violent perpetrators

This study considers the characteristics associated with mothers and fathers who maltreat their child and each other in comparison to parents who only maltreat their child. One hundred and sixty-two parents who had allegations of child maltreatment made against them were considered. The sample consisted of 43 fathers (Paternal Family—PF) and 23 mothers (Maternal Family—MF) who perpetrated both partner and child maltreatment, together with 23 fathers (Paternal Child—PC) and 26 mothers (Maternal Child—MC) who perpetrated child maltreatment only. In addition, 2 fathers (Paternal Victim—PV) and 23 mothers (Maternal Victim—MV) were victims of intimate partner maltreatment and perpetrators of child maltreatment and 7 fathers (Paternal Non-abusive Carer—PNC) and 15 mothers (Maternal Non-abusive Carer—MNC) did not maltreat the child but lived with an individual who did. Within their family unit, 40.7% of parents perpetrated both intimate partner and child maltreatment. However, fathers were significantly more likely to maltreat both their partner and child than mothers and mothers were significantly more likely to be victims of intimate partner violence than fathers. PF fathers conducted the highest amount of physical and/or sexual child maltreatment while MC and MV mothers perpetrated the highest amount of child neglect. Few significant differences between mothers were found. PF fathers had significantly more factors associated with development of a criminogenic lifestyle than PC fathers. Marked sex differences were demonstrated with PF fathers demonstrating significantly more antisocial characteristics, less mental health problems and fewer feelings of isolation than MF mothers. MC mothers had significantly more childhood abuse, mental health problems, parenting risk factors and were significantly more likely to be biologically related to the child than PC fathers. This study suggests that violent families should be assessed and treated in a holistic manner, considering the effects of partner violence upon all family members, rather than exclusively intervening with the violent man

Anti-cancer effects and mechanism of actions of aspirin analogues in the treatment of glioma cancer

INTRODUCTION: In the past 25 years only modest advancements in glioma treatment have been made, with patient prognosis and median survival time following diagnosis only increasing from 3 to 7 months. A substantial body of clinical and preclinical evidence has suggested a role for aspirin in the treatment of cancer with multiple mechanisms of action proposed including COX 2 inhibition, down regulation of EGFR expression, and NF-κB signaling affecting Bcl-2 expression. However, with serious side effects such as stroke and gastrointestinal bleeding, aspirin analogues with improved potency and side effect profiles are being developed. METHOD: Effects on cell viability following 24 hr incubation of four aspirin derivatives (PN508, 517, 526 and 529) were compared to cisplatin, aspirin and di-aspirin in four glioma cell lines (U87 MG, SVG P12, GOS – 3, and 1321N1), using the PrestoBlue assay, establishing IC50 and examining the time course of drug effects. RESULTS: All compounds were found to decrease cell viability in a concentration and time dependant manner. Significantly, the analogue PN517 (IC50 2mM) showed approximately a twofold increase in potency when compared to aspirin (3.7mM) and cisplatin (4.3mM) in U87 cells, with similar increased potency in SVG P12 cells. Other analogues demonstrated similar potency to aspirin and cisplatin. CONCLUSION: These results support the further development and characterization of novel NSAID derivatives for the treatment of glioma

New On Line Resource for Psycholinguistic

Picture naming is a widely used technique in psycholinguistic studies. Here, we describe new on-line resources that our project has compiled and made available to researchers on the world wide web at http://crl.ucsd.edu/~aszekely/ipnp/. The website provides access to a wide range of picture stimuli and related norms in seven languages. Picture naming norms, including indices of name agreement and latency, for 520 black-and-white drawings of common objects and 275 concrete transitive and intransitive actions are presented. Norms for age-of-acquisition, word-frequency, familiarity, goodness-of-depiction, and visual complexity are included. An on-line database query system can be used to select a specific range of stimuli, based on parameters of interest for a wide range of studies on healthy and clinical populations, as well as studies of language development