Governance in the age of social machines: the web observatory

The World Wide Web has provided unprecedented access to information; as humans and machines increasingly interact with it they provide more and more data. The challenge is how to analyse and interpret this data within the context that it was created, and to present it in a way that both researchers and practitioners can more easily make sense of. The first step is to have access to open and interoperable data sets, which Governments around the world are increasingly subscribing to. But having ‘open’ data is just the beginning and does not necessarily lead to better decision making or policy development. This is because data do not provide the answers – they need to be analysed, interpreted and understood within the context of their creation, and the business imperative of the organisation using them. The major corporate entities, such as Google, Amazon, Microsoft, Apple and Facebook, have the capabilities to do this, but are driven by their own commercial imperatives, and their data are largely siloed and held within ‘walled gardens’ of information. All too often governments and non-profit groups lack these capabilities, and are driven by very different mandates. In addition they have far more complex community relationships, and must abide by regulatory constraints which dictate how they can use the data they hold. As such they struggle to maximise the value of this emerging ‘digital currency’ and are therefore largely beholden to commercial vendors. What has emerged is a public-private data ecosystem that has huge policy implications (including the twin challenges of privacy and security). Many within the public sector lack the skills to address these challenges because they lack the literacy required within the digital context. This project seeks to address some of these problems by bringing together a safe and secure Australian-based data platform (facilitating the sharing of data, analytics and visualisation) with policy analysis and governance expertise in order to create a collaborative working model of a ‘Government Web Observatory’. This neutral space, hosted by an Australian university, can serve as a powerful complement to existing Open Data initiatives in Australia, and enable research and education to combine to support the development of a more digitally literate public service. The project aims to explore where, and in which contexts, people, things, data and the Internet meet and result in evolving observable phenomena which can inform better government policy development and service delivery.&nbsp

One-dimensional Continuum Electronic Structure with the Density Matrix Renormalization Group and Its Implications For Density Functional Theory

We extend the density matrix renormalization group to compute exact ground states of continuum many-electron systems in one dimension with long-range interactions. We find the exact ground state of a chain of 100 strongly correlated artificial hydrogen atoms. The method can be used to simulate 1d cold atom systems and to study density functional theory in an exact setting. To illustrate, we find an interacting, extended system which is an insulator but whose Kohn-Sham system is metallic.Comment: 5 pages, 4 figures. Published version, including new section on exact Kohn-Sham gap of a Mott insulato

Cardiovascular and renal outcomes following percutaneous coronary intervention in a population with renal disease: a case-control study

Background Patients with renal disease are less likely to undergo percutaneous coronary intervention (PCI) due to concerns about poor outcomes. Aim We describe outcomes following PCI in individuals with chronic kidney disease (CKD), as compared with matched controls with comparable CKD who did not undergo PCI. We also identified factors predictive of poor outcomes following PCI amongst patients with CKD. Design Retrospective observational case-control study. Methods Cases were individuals with CKD (stages 1–5) undergoing PCI between 2008 and 2014. Controls were age, gender and creatinine-matched individuals not requiring PCI. We compared mortality between groups using Kaplan–Meier curves and Cox regression modelling. We assessed changes in serum creatinine using Wilcoxon Rank testing. We explored the relationship between biochemical and haematological measures (baseline creatinine, calcium, phosphate, calcium-phosphate product, parathyroid hormone, white cell count, haemoglobin, platelet count, c-reactive protein and total cholesterol) and post-PCI mortality, using logistic regression. Results We identified 144 cases and 144 controls. Mortality was significantly lower amongst cases compared with controls [hazard ratio 0.46 (95% confidence intervals 0.31, 0.69)]. PCI did not result in a significant change in renal function (P=0.52). Amongst cases, serum creatinine and calcium-phosphate product were predictors of mortality following PCI. Conclusion Cases undergoing PCI had lower mortality, and PCI was not associated with accelerated CKD progression. On this data, PCI should not be deferred as a treatment option in patients with CKD. Serum creatinine and calcium-phosphate product predict mortality following PCI in this cohort, and may be useful in risk-stratifying patients with CKD being considered for PCI

Validation of the Spanish version of the Fear of Self Questionnaire

Cognitive models, from both the appraisal and inferential confusion perspectives, propose that the self is a relevant variable in the development and maintenance of obsessive-compulsive (OC) disorder. In this study, we examined the psychometric properties of the Spanish version of the Fear of Self Questionnaire (FSQ) and analyzed the role of the fear of self (the sort of person we are afraid of becoming) as a predictor of OC beliefs and symptoms. A sample of 359 non-clinical participants completed a set of questionnaires, including the FSQ. Confirmatory factor analysis replicated the original one-factor solution for both the FSQ-8- and 20-item versions. The FSQ demonstrated excellent reliability, and fear of self predicted OC symptoms and cognitions, especially unacceptable obsessions

Acute kidney injury in children based on electronic alerts

Objective To define the incidence and outcome of acute kidney injury (AKI) in pediatrics using data collected from a national electronic alert system. Study design A prospective national cohort study was undertaken to collect data on all cases of pediatric AKI, excluding neonates, identified by an e-alert, from April 2015 to March 2019. Results There were 2472 alerts in a total of 1719 patients, giving an incidence of 77.3 per 100 000 person-years. Of the patients, 84.2% of all AKI were stage 1 and 58.3% occurred with a triggering creatinine within the reference range. The incidence of AKI was associated with measures of social deprivation. Thirty-day mortality was 1.7% but was significantly higher in hospital-acquired AKI (2.1%), compared with community-acquired AKI (0.8%, P < .001) and was associated with the severity of AKI at presentation. A significant proportion of patients had no repeat measure of creatinine (39.8%). This was higher in community-acquired AKI (69.7%) compared with hospital-acquired AKI (43.0%, P < .001), and higher in patients alerting with patients triggering with a creatinine within the reference range (48.4% vs 24.5%, P < .001). The majority of patients (84.7%) experienced only 1 AKI episode. Repeated episodes of AKI were associated with increased 30-mortaltiy (11.6% vs 4.6%, P < .001) and higher residual renal impairment (13.3% vs 5.4%, P < .001). Conclusions The results suggest that the significance of the alert is missed in many cases reflecting that a large proportion of cases represent modest elevations in serum creatinine (SCr), triggered by a SCr level that may be interpreted as being normal despite a significant increase from the baseline for the patient

Using electronic AKI alerts to define the epidemiology of acute kidney injury in renal transplants

Background: Little is known regarding the impact of acute kidney injury (AKI) on renal transplant outcome. Our aim was to define the incidence and outcome of AKI in renal transplant patients using data collected from a national AKI electronic alert system Methods: The study represents a prospective national cohort study collecting data on 1224 renal transplants recipients with a functioning renal transplant, between April 2015 and March 2019. Results: Four hundred forty patients experienced at least one episode of AKI giving an incidence rate of 35.4%. Sixty-four point seven% of episodes were AKI stage 1, 7.3% AKI stage 2 and 28% AKI stage 3. Only 6.2% of episodes occurred in the context of rejection. Forty-three point five% of AKI episodes were associated with sepsis. AKI was associated with pre-existing renal dysfunction, and a primary renal diagnosis of diabetic nephropathy. AKI was more prevalent in recipients from a donor after cardiac death (26.4% vs. 21.4%, p < 0.05) compared to the non-AKI cohort. Following AKI, 30-day mortality was 19.8% and overall mortality was 34.8%, compared to 8.4% in the non AKI cohort (RR 4.06, 95% CI 3.1–5.3, p < 0.001). Graft survival (GS), and death censored graft survival (DCGS) censored at 4 years, in the AKI cohort were significantly lower than in the non AKI group (p < 0.0001 for GS and DCGS). Conclusion: The study provides a detailed characterisation of AKI in renal transplant recipients highlighting its significant negative impact on patient and graft survival