Innovation and Design in the Age of Artificial Intelligence

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Qualitative versus automatic evaluation of CT perfusion parameters in acute posterior circulation ischaemic stroke

Purpose To compare the diagnostic accuracy (ACC) in the detection of acute posterior circulation strokes between qualitative evaluation of software-generated colour maps and automatic assessment of CT perfusion (CTP) parameters. Methods Were retrospectively collected 50 patients suspected of acute posterior circulation stroke who underwent to CTP (GE “Lightspeed”, 64 slices) within 24 h after symptom onset between January 2016 and December 2018. The Posterior circulation-Acute Stroke Prognosis Early CT Score (pc-ASPECTS) was used for quantifying the extent of ischaemic areas on non-contrast (NC)CT and colour-coded maps generated by CTP4 (GE) and RAPID (iSchemia View) software. Final pc-ASPECTS was calculated on follow-up NCCT and/or MRI (Philips Intera 3.0 T or Philips Achieva Ingenia 1.5 T). RAPID software also elaborated automatic quantitative mismatch maps. Results By qualitative evaluation of colour-coded maps, MTT-CTP4D and Tmax-RAPID showed the highest sensitivity (SE) (88.6% and 90.9%, respectively) and ACC (84% and 88%, respectively) compared with the other perfusion parameters (CBV, CBF). Baseline NCCT and CBF provided by RAPID quantitative perfusion mismatchmaps had the lowest SE (29.6%and 6.8%, respectively) and ACC (38% and 18%, respectively). CBF and Tmax assessment provided by quantitative RAPID perfusion mismatch maps showed significant lower SE and ACC than qualitative evaluation. No significant differences were found between the pc-ASPECTSs assessed on colour-coded MTT and Tmax maps neither between the scores assessed on colourcoded CBV-CTP4D and CBF-RAPID maps. Conclusion Qualitative analysis of colour-codedmaps resultedmore sensitive and accurate in the detection of ischaemic changes than automatic quantitative analysis

Design in the Age of Artificial Intelligence

Artificial Intelligence (AI) is affecting the scenario in which innovation takes place. What are the implications for our understanding of design? Is AI just another digital technology that, akin to many others, will not significantly question what we know about design? Or will it create transformations in design that our current frameworks cannot capture? To address these questions, we have investigated two pioneering cases at the frontier of AI, Netflix and AirBnB (complemented with analyses in Microsoft and Tesla), which offer a privileged window on the future evolution of design. We found that AI does not undermine the basic principles of Design Thinking (people-centered, abductive and iterative). Rather, it enables to overcome past limitations (in scale, scope and learning) of human- intense design processes. In the context of AI factories solutions may even be more user-centered (to an extreme level of granularity, i.e. being designed for every single person), more creative, and continuously updated through learning iterations that span the entire life cycle of a product. Yet, we found that AI profoundly changes the practice of design. Problem solving tasks, traditionally carried on by designers, are now automated into learning loops that operate without limitations of volume and speed. These loops think in a radically different way than a designer: they address complex problems through very simple tasks, iterated exponentially. The article therefore proposes a new framework for understanding design practice in the age of AI. We also discuss the implications for design and innovation theory. Specifically, we observe that, as creative problem solving is significantly conducted by algorithms, human design increasingly becomes an activity of sense making, i.e. to understand which problems make sense to be addressed. This shift in focus calls for new theories and brings design closer to leadership, which is, inherently, an activity of sense making

Novel pathogenic TGFBR1 and SMAD3 variants identified after cerebrovascular events in adult patients with Loeys-Dietz syndrome

INTRODUCTION: Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder due to heterozygous pathogenic variants in transforming growth factor beta (TGFβ) signaling-related genes. LDS types 1-6 are distinguished depending on the involved gene. LDS is characterized by multiple arterial aneurysms and dissections in addition to variable neurological and systemic manifestations. Patient 1: a 68-year-old man was admitted due to an aphasic transient ischemic attack (TIA). Brain CT-scan and CT angiography revealed a chronic and asymptomatic right vertebral artery dissection. Stroke diagnostic panel was unremarkable. His history showed mild stroke familiarity. At age of 49, he was treated for dissecting-aneurysm of the ascending aorta and started anticoagulation therapy. Seven years later, he underwent surgery for dissecting aneurysm involving aortic arch, descending-thoracic aorta, left subclavian artery, and both iliac arteries. Patient 2: a 47-year-old man presented a left hemiparesis due to right middle cerebral artery (MCA) and anterior cerebral artery (ACA) occlusion caused by right internal carotid artery (ICA) dissection after sport activity. Despite i.v. thrombolysis and mechanical thrombectomy, he developed malignant cerebral infarction and underwent decompressive hemicraniectomy. Digital subtraction angiography showed bilateral carotid and vertebral kinking, aneurysmatic dilatation on both common iliac arteries and proximal ectasia of the descending aorta. His father and his uncle died because of an ischemic stroke and a cerebral aneurysm rupture with a subarachnoid hemorrhage (SAH), respectively. DISCUSSION: in both cases, considering the family history and the multiple dissections and aneurysms, LDS molecular analysis was performed. In patient 1, the novel NM_005902.3 (SMAD3): c.840T > G; p.(Asn280Lys) likely pathogenic variant was identified, thus leading to a diagnosis of LDS type 3. In patient 2, the novel NM_004612.2 (TGFBR1): c.1225T > G; p.(Trp409Gly) likely pathogenic variant was found, allowing for a diagnosis of LDS type 1. CONCLUSION: LDS is characterized by genetic and clinical variability. Our report suggests that this genetically-determined connective tissue disorder is probably underestimated, as it might firstly show up with cerebrovascular events, although mild systemic manifestations. These findings could lead to identify people at risk of severe vascular complications (i.e., through genetic consult on asymptomatic relatives), in order to perform adequate vascular assessments and follow-up to prevent complications such as stroke

Arts and design as translational mechanisms for academic entrepreneurship: The metaLAB at Harvard case study

This paper proposes arts and design as translational mechanisms to connect and align stakeholders, particularly in the context of academic entrepreneurship where multiple stakeholders with different expertise and interests work together in joint endeavors. Insights gathered from an ethnographic investigation carried out at metaLAB - an academic laboratory located at Harvard University (Cambridge, MA, USA) - build the empirical foundation. Findings show that various forms of arts and design (including poetry, photography, art installations, motion graphics videos, data visualization) play an important role in connecting metaLAB to external stakeholders and in activating multiple value drivers. The adoption of arts- and design-based initiatives allows the translation of different needs and wants of stakeholders into shared meanings, but also supports emotional and cognitive engagement and creative and divergent viewpoints. This paper contributes to existing studies focusing on how arts-based initiatives can support organizations in exploiting their potential for organizational value creation