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Evaluating the safety and patient impacts of an artificial intelligence command centre in acute hospital care: a mixed-methods protocol
Get PDFYesThis paper presents a mixed-methods study protocol that will be used to evaluate a recent implementation of a real-time, centralised hospital command centre in the UK. The command centre represents a complex intervention within a complex adaptive system. It could support better operational decision-making and facilitate identification and mitigation of threats to patient safety. There is, however, limited research on the impact of such complex health information technology on patient safety, reliability and operational efficiency of healthcare delivery and this study aims to help address that gap.
We will conduct a longitudinal mixed-method evaluation that will be informed by public-and-patient involvement and engagement. Interviews and ethnographic observations will inform iterations with quantitative analysis that will sensitise further qualitative work. Quantitative work will take an iterative approach to identify relevant outcome measures from both the literature and pragmatically from datasets of routinely collected electronic health records.
This protocol has been approved by the University of Leeds Engineering and Physical Sciences Research Ethics Committee (#MEEC 20-016) and the National Health Service Health Research Authority (IRAS No.: 285933). Our results will be communicated through peer-reviewed publications in international journals and conferences. We will provide ongoing feedback as part of our engagement work with local trust stakeholders.National Institute for Health Research Health Service and Delivery Research Programme (NIHR129483
Participants' perspectives of their involvement in medical device trials: A focus groups study
Get PDFYesMedical technologies have the potential to improve quality and efficiency of healthcare. The design of clinical trials should consider participants' perspectives to optimise enrolment, engagement and satisfaction. This study aims to assess patients' perceptions of their involvement in medical device trials, to inform the designs of future medical technology implementation and evaluation.
Four focus groups were undertaken with a total of 16 participants who had participated in a study testing hospital inpatient remote monitoring devices. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis.
Four main themes emerged: patients' motivations for participating in medical device research; patients' perceptions of technology in medicine; patients' understanding of trial methodology; and patients' perceptions of the benefits of involvement in medical device trials. The appeal of new technology is a contributing factor to the decision to consent, although concerns remain regarding risks associated with technology in healthcare settings. Perceived benefits of participating in device trials include extra care, social benefits and comradery with other participants seen using the devices, although there is a perceived lack of confidence in using technology amongst older patients.
Future device trials should prioritise information sharing with participants both before and after the trial. Verbal and written information alongside practical demonstrations can help to combat a lack of confidence with technology. Randomised trials and those with placebo- or sham-controlled arms should not be considered as barriers to participation. Study results should be disseminated to participants in lay format as soon as possible, subject to participant permission.The patients in this study were participating in a randomised controlled trial funded by a Health Foundation Innovating for Improvement Award (Grant number: GIFTS 7643 CRM 2674). Candice Downey is in possession of a Doctoral Research Fellowship (DRF-2016-09- 037) supported by the National Institute for Health Research. DGJ received funding support through an NIHR Research Professorship. The research is supported by the NIHR infrastructure at Leeds
High Glucose Increases DNA Damage and Elevates the Expression of Multiple DDR Genes
Get PDFYesThe DNA Damage Response (DDR) pathways sense DNA damage and coordinate robust DNA repair and bypass mechanisms. A series of repair proteins are recruited depending on the type of breaks and lesions to ensure overall survival. An increase in glucose levels was shown to induce genome instability, yet the links between DDR and glucose are still not well investigated. In this study, we aimed to identify dysregulation in the transcriptome of normal and cancerous breast cell lines upon changing glucose levels. We first performed bioinformatics analysis using a microarray dataset containing the triple-negative breast cancer (TNBC) MDA-MB-231 and the normal human mammary epithelium MCF10A cell lines grown in high glucose (HG) or in the presence of the glycolysis inhibitor 2-deoxyglucose (2DG). Interestingly, multiple DDR genes were significantly upregulated in both cell lines grown in HG. In the wet lab, we remarkably found that HG results in severe DNA damage to TNBC cells as observed using the comet assay. In addition, several DDR genes were confirmed to be upregulated using qPCR analysis in the same cell line. Our results propose a strong need for DDR pathways in the presence of HG to oppose the severe DNA damage induced in cells.Wellcome Trus
Repeatability of quantitative MRI in patients with rheumatoid arthritis
Get PDFYesIntroduction : Rheumatoid arthritis (RA) affects 1% of the population and is principally associated with joint inflammation. It is suggested however that muscle involvement may be one of the earliest clinical features of RA. It is therefore important that techniques exist to accurately assess muscle health in those with RA to enable successful treatment. This study assesses the inter-rater and intra-rater repeatability of Diffusion Tensor MRI (DTI), 2-Point Dixon fat fraction, and T2 relaxation of the thigh muscle in patients with RA using manual regions of interest (ROI). Methods: Nineteen patients (10/19 males; mean age 59; range 18-85) diagnosed with RA had an MRI scan of their hamstrings and quadriceps muscles to obtain fat fraction (FF), mean diffusivity (MD), fractional anisotropy (FA), and T2 quantitative measurements. Two raters (R#1 & R#2) (initials removed for review) independently contoured ROIs for each patient. R#1 repeated the ROI for the same 19 patients after a 6-month hiatus to assess intra-rater repeatability. Inter-rater and intra-rater repeatability for the ROI measurements were compared using Inter Class Correlation (ICC) and Bland-Altman plots. Results: There was excellent agreement for both inter-rater and intra-rater repeatability. ICC results ranged from 0.900-0.998 (P<0.001), and intra-rater ICC results ranged from 0.977-0.999 (P<0.001). Bland-Altman plots also showed excellent agreement. Conclusions: ICC measurements and Bland-Altman plots showed excellent repeatability and agreement with no statistically significant differences when assessing the inter-rater and intra-rater repeatability of FF, MD, FA, and T2 relaxation of the thigh muscle using manual regions of interest in patients with RA. Implications for practice: Manual ROI drawing does not introduce significant errors obtaining FF, MD, FA, and T2 MRI measurements in an RA population.This research is funded by the NIHR infrastructure at Leeds
Applications and life cycle assessment of shape memory polyethylene terephthalate in concrete for crack closure
Get PDFYesShape memory polymer (SMP) products have been developed for application as crack closure de-vices in concrete. They have been made from PET in the form of both fibres and hollow tubes. Here, manufacturing methods using die-drawing and mandrel-drawing to induce shape memory are reported. The fibre-based devices are incorporated into concrete and, upon triggering, exert shrinkage restraint forces that close cracks in the concrete. The evolution of shrinkage restraint force in the fibres as manufactured was measured as a function of temperature, showing stresses in excess of 35 MPa. Tendons consisting of fibre bundles are incorporated into concreate beams subjected to controlled cracking. When activated, the tendons reduce the crack widths by 80%. The same fibres are used to produce another class of device known as knotted fibres, which have knotted ends that act as anchor points when they incorporated directly into concrete. Upon acti-vation within the cracked concrete, these devices are shown to completely close cracks. The tubes are used to enclose and restrain prestressed Kevlar fibres. When the tubes are triggered, they shrink and release the prestress force in the Kevlar, which is transferred to the surrounding con-crete in the form of a compressive force, thereby closing cracks. The Kevlar fibres also provide substantial reinforcement after activation. The devices are shown to be able to partially and fully close cracks that have been opened to 0.3 mm and achieve post-activation flexural strengths com-parable to those of conventional reinforced and prestressed structural elements. Finally, a pre-liminary life cycle assessment study was used to assess the carbon footprint a nominal unit of concrete made with SMPs fibres compared to conventional concrete.This research was funded by the UKRI-EPSRC Resilient Materials 4 Life (RM4L), grant number EP/P02081X/1 and the support of ARUP via the UKIMEA research funding
Exploring the role of social capital mechanisms in cooperative resilience
Get PDFYesWe contribute to research on cooperative resilience by examining how their main advantage of social foundations may facilitate the assembly of resilience capabilities. Drawing from the social capital literature, we focus on the strategies and activities of a nationally known rural cooperative in Indonesia to reveal social capital mechanisms, specifically channeling and targeting social capital, that underlie diverse sets of resilience capabilities. By conceptualizing cooperative resilience according to cooperatives’ dual objectives of economic and social viability, we build an empirically grounded framework that encompasses social capital-driven mechanisms that underlie cooperative resilience. Economically, strengthening social capital (channeling) may result in organizational transparency and collaborative work, while widening social networks (targeting) develops velocity and flexibility. Socially, both mechanisms lead to the emergence of individual-level resilience capabilities. Our study informs business research on resilience by conceptualizing it in the context of cooperatives and shedding light on its underlying social capital-driven mechanisms
An Optimisation Model for Designing Social Distancing Enhanced Physical Spaces
Get PDFYesIn the wake of the COVID-19 pandemic, social distancing has become an essential element of our daily lives. As a result, the development of technological solutions for the design and re-design of physical spaces with the necessary physical distancing measures is an important problem that must be addressed. In this paper, we show how automatic design optimisation can be used to simulate the layout of physical spaces subject to a given social distancing requirement. We use a well known mathematical technique based on the circle packing to address this challenge. Thus, given the dimensions and the necessary constraints on the physical space, we formulate the design as a solution to a constrained nonlinear optimisation problem. We then solve the optimisation problem to arrive at a number of feasible design solutions from which the user can pick the most desirable option. By way of examples, in this paper, we show how the proposed model can be practically applied.University of Bradford’s COVID-19 Response Fund, the Spanish Ministry of Science, Innovation, and Universities (Computer Science National Program) under grant #TIN2017-89275-R of the Agencia Estatal de Investigacion and European Funds (AEI/FEDER, UE
A novel meander bowtie-shaped antenna with multi-resonant and rejection bands for modern 5G communications
Get PDFYesTo support various fifth generation (5G) wireless applications, a small, printed bowtie-shaped microstrip antenna with meandered arms is reported in this article. Because it spans the broad legal range, the developed antenna can serve or reject a variety of applications such as wireless fidelity (Wi-Fi), sub-6 GHz, and ultra-wideband (UWB) 5G communications due to its multiband characterization and optimized rejection bands. The antenna is built on an FR-4 substrate and powered via a 50-Ω microstrip feed line linked to the right bowtie's side. The bowtie's left side is coupled via a shorting pin to a partial ground at the antenna's back side. A gradually increasing meandering microstrip line is connected to both sides of the bowtie to enhance the rejection and operating bands. The designed antenna has seven operating frequency bands of (2.43-3.03) GHz, (3.71-4.23) GHz, (4.76-5.38) GHz, (5.83-6.54) GHz, (6.85-7.44) GHz, (7.56-8.01) GHz, and (9.27-13.88) GHz. The simulated scattering parameter S11 reveals six rejection bands with percentage bandwidths of 33.87%, 15.73%, 11.71, 7.63%, 6.99%, and 12.22%, respectively. The maximum gain of the proposed antenna is 4.46 dB. The suggested antenna has been built, and the simulation and measurement results are very similar. The reported antenna is expanded to a four-element design to investigate its MIMO characteristics.British Council “2019 UK-China-BRI Countries Partnership Initiative”progra
Sustainable process synthesis, design, and analysis: Challenges and opportunities
Get PDFYesIn this perspective paper, we present challenges and opportunities that the chemical, biochemical and related industries pose to the process system engineering community to help deliver reliable and novel sustainable alternatives. More specifically, we highlight the need for a systems approach where model-based sustainable process synthesis, design, and analysis serve as opportunities to tackle the challenges. Three technology areas (interlinked to each other) that impact the sustainability of earth, namely, chemical processes linked with CO2 capture and utilization, biorefineries and water desalination are selected to highlight our views as well as the need for further development of computer-aided tools to efficiently solve the large and complex mathematical systems the problems represent. Analysis of these problems and their reported solutions indicate that opportunity exists for development of a new class of model-based methods and tools and their integration with the currently available ones to obtain the desired sustainability development goals
Properties of geopolymers sourced from construction and demolition waste: A review
Get PDFYesGeopolymers have been recognised as a viable replacement to ordinary Portland cement (OPC), providing a cleaner solution since it can significantly reduce greenhouse gas emissions as well as accomplishing effective waste recycling. Construction and demolition waste (CDW) has been recently identified as raw materials for geopolymers due to its availability and high contents of silica and alumina. This paper aimed at reviewing the current state-of-the-art on the geopolymer paste, mortar, and concrete production and their properties, with special attention paid to geopolymers incorporating CDWs. The review covers brief assessment of using CDWs in concrete, the mix design of geopolymer mixtures in addition to identification of the main factors influencing the performance of geopolymer containing CDW. The most recent data related to the mechanical and durability properties of CDW-based geopolymers are presented, while the cost and environmental impacts of using recycled materials in producing geopolymer concretes are also discussed. Geopolymer concretes have a vast range of possible applications, however, there are still several barriers facing commercialisation of geopolymers in construction industry. The review indicated that it is possible to produce geopolymer concretes from CDW-based materials with properties comparable to OPC-based ones; however, the selection of proper material composition should be carefully considered, especially under normal curing conditions