Coherence, engagement, and usefulness as sensemaking criteria in participatory media practice

When skilled practitioners create media artifacts such as web pages, newspaper articles, videos, or business presentations, they are engaging in a pursuit which has consequences for the people who will interact with those artifacts. The juncture of practice, artifact, and consequences involves diverse normative considerations. We have summarized these into three criteria: coherence, engagement, and usefulness. In this paper we report on initial progress to develop a method for assessing these criteria in a particular form of skilled real-time media practice

Making Representations Matter: Understanding Practitioner Experience in Participatory Sensemaking

Appropriating new technologies in order to foster collaboration and participatory engagement is a focus for many fields, but there is relatively little research on the experience of practitioners who do so. The role of technology-use mediators is to help make such technologies amenable and of value to the people who interact with them and each other. When the nature of the technology is to provide textual and visual representations of ideas and discussions, issues of form and shaping arise, along with questions of professional ethics. This thesis examines such participatory representational practice, specifically how practitioners make participatory visual representations (pictures, diagrams, knowledge maps) coherent, engaging and useful for groups tackling complex societal and organizational challenges. This thesis develops and applies a method to analyze, characterize, and compare instances of participatory representational practice in such a way as to highlight experiential aspects such as aesthetics, narrative, improvisation, sensemaking, and ethics. It extends taxonomies of such practices found in related research, and contributes to a critique of functionalist or techno-rationalist approaches to studying professional practice. It studies how fourteen practitioners using a visual hypermedia tool engaged participants with the hypermedia representations, and the ways they made the representations matter to the participants. It focuses on the sensemaking challenges that the practitioners encountered in their sessions, and on the ways that the form they gave the visual representations (aesthetics) related to the service they were trying to provide to their participants. Qualitative research methods such as grounded theory are employed to analyze video recordings of the participatory representational sessions. Analytical tools were developed to provide a multi-perspective view on each session. Conceptual and normative frameworks for understanding the practitioner experience in participatory representational practice in context, especially in terms of aesthetics, ethics, narrative, sensemaking, and improvisation, are proposed. The thesis places these concerns in context of other kinds of facilitative and mediation practices as well as research on reflective practice, aesthetic experience, critical HCI, and participatory design

Diabetes in Midlife and Cognitive Change Over 20 Years: A Cohort Study

Type 2 diabetes mellitus is associated with dementia risk, however evidence is limited for possible associations of diabetes and pre-diabetes with cognitive decline

The trans-ancestral genomic architecture of glycemic traits

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 x 10(-8)), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution. A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.Peer reviewe

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

Supporting Collaborative Analysis and Design with Hypertext Functionality

Many research efforts and several commercial products have attempted to harness the potential of argumentation-based hypertext tools to enhance the design process. Yet few researchers have reported successful applications of this technology in industry settings. This paper reports on Conversational Modeling, a technique that has been used successfully in a number of collaborative systems analysis, requirements gathering and work process redesign projects in a telecommunications company. The success of the technique appears to be due to the combination of hypertext functionality, a structured modeling framework, and group facilitation strategies. The combination of these elements addresses some of the difficulties reported in the design rationale literature with regard to argumentation-based hypertext tools