“It Is a Moving Process”:Understanding the Evolution of Explainability Needs of Clinicians in Pulmonary Medicine

Clinicians increasingly pay attention to Artificial Intelligence (AI) to improve the quality and timeliness of their services. There are converging opinions on the need for Explainable AI (XAI) in healthcare. However, prior work considers explanations as stationary entities with no account for the temporal dynamics of patient care. In this work, we involve 16 Idiopathic Pulmonary Fibrosis (IPF) clinicians from a European university medical centre and investigate their evolving uses and purposes for explainability throughout patient care. By applying a patient journey map for IPF, we elucidate clinicians' informational needs, how human agency and patient-specific conditions can influence the interaction with XAI systems, and the content, delivery, and relevance of explanations over time. We discuss implications for integrating XAI in clinical contexts and more broadly how explainability is defined and evaluated. Furthermore, we reflect on the role of medical education in addressing epistemic challenges related to AI literacy.</p

Mitochondrial Genome Evolution and a Novel RNA Editing System in Deep-Branching Heteroloboseids

Discoba (Excavata) is an evolutionarily important group of eukaryotes that includes Jakobida, with the most bacterial-like mitochondrial genomes known, and Euglenozoa, many of which have extensively fragmented mitochondrial genomes. However, little is known about the mitochondrial genomes of Heterolobosea, the third main group of Discoba. Here, we studied two heteroloboseids—an undescribed amoeba “BB2” and Pharyngomonas kirbyi. Phylogenomic analysis revealed that they form a clade that is a sister group to all other Heterolobosea. We characterized the mitochondrial genomes of BB2 and P. kirbyi, which encoded 44 and 48 putative protein-coding genes respectively. Their gene contents were similar to that of Naegleria. In BB2, mitochondrially encoded RNAs were heavily edited, with ∼500 mononucleotide insertion events, mostly guanosines. These insertions always have the same identity as an adjacent nucleotide. Editing occurs in all ribosomal RNAs and protein-coding transcripts except one, and half of the transfer RNAs. Analysis of Illumina deep-sequencing data suggested that this RNA editing is very accurate and efficient, and most likely co-transcriptional. The dissimilarity of this editing process to other RNA editing phenomena in discobids, as well as its apparent absence in P. kirbyi, suggest that this remarkably extensive system of insertional editing evolved independently in the BB2 lineage, after its divergence from the P. kirbyi lineage

“It Is a Moving Process”:Understanding the Evolution of Explainability Needs of Clinicians in Pulmonary Medicine

Clinicians increasingly pay attention to Artificial Intelligence (AI) to improve the quality and timeliness of their services. There are converging opinions on the need for Explainable AI (XAI) in healthcare. However, prior work considers explanations as stationary entities with no account for the temporal dynamics of patient care. In this work, we involve 16 Idiopathic Pulmonary Fibrosis (IPF) clinicians from a European university medical centre and investigate their evolving uses and purposes for explainability throughout patient care. By applying a patient journey map for IPF, we elucidate clinicians' informational needs, how human agency and patient-specific conditions can influence the interaction with XAI systems, and the content, delivery, and relevance of explanations over time. We discuss implications for integrating XAI in clinical contexts and more broadly how explainability is defined and evaluated. Furthermore, we reflect on the role of medical education in addressing epistemic challenges related to AI literacy.</p

Understanding Cultural Issues in the Diabetes Self-Management Behaviors of Korean Immigrants

PURPOSE: The purpose of this study was to explore potential factors affecting self-management behaviors in Korean immigrants with type 2 diabetes mellitus (KIT2Ds). METHODS: A qualitative descriptive design guided this study. Semi-structured interviews lasting 45-60 minutes were conducted with 20 KIT2Ds in the participant’s preferred language; in all cases this was Korean. Each interview was audio-taped, transcribed, and analyzed using conventional content analysis. Data analysis was performed in two steps. The data written in Korean were initially analyzed by three bilingual researchers. A qualitative researcher then participated in the analysis to refine the findings for presentation to an English speaking audience while staying true to the data and preserving the nuanced Korean meanings. RESULTS: The mean age of the sample was 64. 5 ± 11.6 years (9 men and 11 women). The mean years of staying in the U. S. and age at diabetes mellitus diagnosis were 23.6 ± 9.7 years and 52.5 ± 12.3 years, respectively. Three major ideas were identified: (a) issues on treatment regimen related to both medications and diet, (b) resources that helped or hindered their ability to manage diabetes, and (c) the physician/patient relationship. CONCLUSIONS: There were important cultural nuances that need to be addressed to better prepare KIT2Ds to manage their diabetes more effectively. A culture specific program should extend beyond a diabetes self-management education delivered in Korean language. Rather, content and education methods need to consider acculturation effects on diabetes management behaviors

Design of Single-modal Take-over Request in SAE Level 2 & 3 Automated Vehicle

Recently, cutting-edge technology has led to the development of automated vehicles, but the limitations of the related technology may lead to hazardous situations. This resulted in the remarkable significance of the interaction between automated vehicles and drivers. In particular, the transition between the driver and the automated vehicle in accordance with Level 3 of SAE J3016 is inevitable, and guidelines or standards regarding the takeover should be provided. Therefore, we aim to prepare the safety guidelines for the takeover and to conduct a comparative test. First, guidelines for visual, auditory, and haptic displays in existing vehicles were examined. Second, preliminary research was conducted on the modality of automated vehicles. Third, we carried out a modality investigation regarding the partially automated vehicle. Based on this, we proposed visual, auditory, and haptic signals for each modality. This will serve as a significant starting point for future research based on multimodal methods

Simultaneous evaluation of treatment efficacy and toxicity for bispecific T-cell engager therapeutics in a humanized mouse model.

Immuno-oncology (IO)-based therapies such as checkpoint inhibitors, bi-specific antibodies, and CAR-T-cell therapies have shown significant success in the treat- ment of several cancer indications. However, these therapies can result in the de- velopment of severe adverse events, including cytokine release syndrome (CRS). Currently, there is a paucity of in vivo models that can evaluate dose-response relationships for both tumor control and CRS-related safety issues. We tested an in vivo PBMC humanized mouse model to assess both treatment efficacy against specific tumors and the concurrent cytokine release profiles for individual human donors after treatment with a CD19xCD3 bispecific T-cell engager (BiTE). Using this model, we evaluated tumor burden, T-cell activation, and cytokine release in response to bispecific T-cell-engaging antibody in humanized mice generated with different PBMC donors. The results show that PBMC engrafted NOD-scid Il2rgnull mice lacking expression of mouse MHC class I and II (NSG-MHC-DKO mice) and implanted with a tumor xenograft predict both efficacy for tumor control by CD19xCD3 BiTE and stimulated cytokine release. Moreover, our find- ings indicate that this PBMC-engrafted model captures variability among donors for tumor control and cytokine release following treatment. Tumor control and cytokine release were reproducible for the same PBMC donor in separate experi- ments. The PBMC humanized mouse model described here is a sensitive and re- producible platform that identifies specific patient/cancer/therapy combinations for treatment efficacy and development of complications