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Regulation and governance for the implementation and management of point-of-care testing in Australia : a scoping review
Get PDFFunding: The Victorian Department of Health provided funding for this work. DAW is funded by an Investigator Grant of the Australian National Health and Medical Research Council (APP1174555). JP is supported by an Australian Government Research Training Program Scholarship.Background: Point-of-care testing (PoCT) is an increasingly important diagnostic tool in the healthcare system for accessible pathology testing in hospital, primary care, and community care settings. Clear regulation and governance models are important to ensure quality of PoCT results for patient care. Methods: This review aimed to identify existing regulation and guidelines for management of PoCT and how this has been implemented within Australian healthcare services. We conducted a search of academic publications in PubMed and grey literature (national, state, and independent organisations) and other publicly available information from internet searches for governance of PoCT in Australia. Relevant data from these sources were extracted and narratively synthesised. Results: Forty-seven sources (17 studies from PubMed, 30 grey literature) were included in the final review. Of the grey literature sources, fifteen current PoCT governance documents comprising of six standards, five guidelines and four frameworks at the international, national and jurisdictional level were included with an increasing number of grey literature sources since the onset of the COVID-19 pandemic in 2020. The seventeen included research articles were categorised according to implementation barriers and facilitators with the themes of workforce, clinical governance, PoCT workflow, and cost. An understanding of the clinical and cultural context for PoCT was the most frequently reported facilitator of PoCT, while the most frequently reported barrier was related to inadequate data management. Conclusion: This review demonstrated limited and inconsistent sources on regulatory and governance models for implementing and managing PoCT in Australia. Identified PoCT programs showcased diverse implementation and governance models to support quality PoCT, with few reporting formal accreditation. Streamlined, practical regulation and governance for PoCT may increase adoption across healthcare settings while ensuring quality results and meeting the needs of patients and healthcare practitioners.Peer reviewe
Medical students’ and educators’ opinions of teleconsultation in practice and undergraduate education : a UK-based mixed-methods study
Get PDFIntroduction As information and communication technology continues to shape the healthcare landscape, future medical practitioners need to be equipped with skills and competencies that ensure safe, high-quality, and person-centred healthcare in a digitised healthcare system. This study investigated undergraduate medical students’ and medical educators’ opinions of teleconsultation practice in general and their opinions of teleconsultation education. Methods This study used a cross-sectional, mixed-methods approach, utilising the additional coverage design to sequence and integrate qualitative and quantitative data. An online questionnaire was sent out to all medical schools in the UK, inviting undergraduate medical students and medical educators to participate. Questionnaire participants were given the opportunity to take part in a qualitative semi-structured interview. Descriptive and correlation analyses and a thematic analysis were conducted. Results A total of 248 participants completed the questionnaire and 23 interviews were conducted. Saving time and the reduced risks of transmitting infectious diseases were identified as common advantages of using teleconsultation. However, concerns about confidentiality and accessibility to services were expressed by students and educators. Eight themes were identified from the thematic analysis. The themes relevant to teleconsultation practice were (1) The benefit of teleconsultations, (2) A second-best option, (3) Patient choice, (4) Teleconsultations differ from in-person interactions, and (5) Impact on the healthcare system. The themes relevant to teleconsultation education were (6) Considerations and reflections on required skills, (7) Learning and teaching content, and (8) The future of teleconsultation education. Discussion The results of this study have implications for both medical practice and education. Patient confidentiality, safety, respecting patients’ preferences, and accessibility are important considerations for implementing teleconsultations in practice. Education should focus on assessing the appropriateness of teleconsultations, offering accessible and equal care, and developing skills for effective communication and clinical reasoning. High-quality teleconsultation education can influence teleconsultation practice.Peer reviewe
Towards real-world continual learning for human activity recognition
Get PDFSensor-based human activity recognition (HAR) is essential for applications in health monitoring, smart homes, and manufacturing. However, the long-term deployment of HAR systems presents a significant challenge: how to automatically evolve a HAR model to adapt to changes in the environment or activity patterns. This thesis addresses this issue by introducing an online continual learning (OCL) scenario for HAR, where sensor data streams contain unlabeled samples from both known and new activities. We propose OCL-HAR, a technique that performs real-time predictions on streaming sensor data while simultaneously discovering new activities. Empirical evaluations on four HAR datasets demonstrate that the OCL scenario is challenging for state-of-the-art continual learning (CL) techniques. In contrast, OCL-HAR consistently outperforms these techniques by up to 17% and 23% in micro and macro F1 scores, respectively.
Additionally, on-device CL is crucial for deploying applications on battery-powered devices, balancing privacy needs and adaptability. However, existing CL techniques can be cost-prohibitive for such devices, requiring quantised operations with reduced precision for practical deployment. Current fully quantized training (FQT) solutions fail to converge in low-precision CL. To address this, we propose hadamard domain quantized training (HDQT), which utilises the Hadamard transform to enable 4-bit FQT with integer operands. HDQT facilitates low-precision, on-device training where other FQT solutions fail. HDQT achieves better gradient alignment with unquantised baselines in early feature detection layers, leading to consistently improved learning performance, as reflected in loss landscapes trajectories. This research highlights the potential of OCL-HAR and HDQT for efficient, real-time, and low-power CL in practical HAR applications
Gender(ed) performances : women’s impression management in stand-up comedy
Get PDFHow do women navigate and make space for themselves in workspaces where they are not perceived to fit? Women in male-dominated careers often face perceptions of role misfit, leading them to engage in impression management. Using a mixed-methods design, we investigate if women stand-up comedians present as female gendered at work in two settings – one dominated by male performers (N = 257) and one featuring more gender diverse performers (N = 843). Women, as compared with men, presented more gendered in the more gender diverse performer setting and less gendered in the male-performer dominated setting. Using Lorber’s taxonomy of feminisms as a lens, assessment of how women presented their gender further implied greater constraint on women in the male-dominated, compared with the diverse, setting. Our findings support Roberts’ theory of social identity-based impression management (SIM) in the novel context of stand-up comedy, refine the theory by presenting a fifth SIM strategy, and demonstrate how women are able to adapt their feminism to the characteristics of the situation, thus helping secure their position in settings where they may be unwelcomed. These findings have theoretical implications for impression management and feminism, and practical implications for workplace equality initiatives.Peer reviewe
A multiresonant thermally activated delayed fluorescent dendrimer with intramolecular energy transfer : application for efficient host-free green solution-processed organic light-emitting diodes
Get PDFFunding: S.W. thanks the China Scholarship Council (201906250199). D.S. acknowledges support from the Royal Academy of Engineering Enterprise Fellowship (EF2122-13106). D.C. acknowledges support from China Postdoctoral Science Foundation (Grant No. 2022TQ0227) and the Natural Science Foundation of Jiangsu Province, China (Grant No. BK20230508). X.-H. Z. acknowledges support from the National Natural Science Foundation of China (Grant No. 52130304 and 51821002) and the Collaborative Innovation Center of Suzhou Nano Science & Technology. E.Z-.C. acknowledges support from the Engineering and Physical Sciences Research Council (EPSRC; EP/W015137/1 and EP/W007517/1).The development of narrowband emissive, bright, and stable solution-processed organic light-emitting diodes (SP-OLEDs) remains a challenge. Here, a strategy is presented that merges within a single emitter a TADF sensitizer responsible for exciton harvesting and an MR-TADF motif that provides bright and narrowband emission. This emitter design also shows strong resistance to aggregate formation and aggregation-cause quenching. It is based on a known MR-TADF emitter DtBuCzB with a donor-acceptor TADF moiety consisting of either tert-butylcarbazole donors (tBuCzCO2HDCzB) or second-generation carbazole-based donor dendrons (2GtBuCzCO2HDCzB) and a benzoate acceptor. The TADF moiety acts as an exciton harvesting antenna and transfers these excitons via Förster resonance energy transfer to the MR-TADF emissive core. The SP-OLEDs with 2GtBuCzCO2HDCzB and tBuCzCO2HDCzB thus show very high maximum external quantum efficiencies (EQEmax of 27.9 and 22.0%) and minimal efficiency roll-off out to 5000 cd m−2.Peer reviewe
Selectivity in buttress drumming tree properties among chimpanzees (Pan troglodytes schweinfurtii) of the Waibira community in Budongo Forest, Uganda
Get PDFFunding: This research was supported by funding from the European Union's 8th Framework Programme, Horizon 2020, under grant agreement no 802719 to C.H. and by the St Leonard's College Postgraduate Travel Award to W.W. K.K. was funded by a SNSF Eccellenza Professorial Fellowship (no. PCEFP3_186967).Wild chimpanzees drum on tree buttresses during dominance displays and travel, generating low-frequency sounds that are audible over distances of more than 1 km. Western chimpanzees (Pan troglodytes verus) in the Nimba Mountains of Guinea selectively choose trees and buttresses when drumming, potentially based on their resonant properties, suggesting that these chimpanzees are optimizing their drumming signals. We investigated whether male eastern chimpanzees (Pan troglodytes schweinfurthii) from the Waibira community in the Budongo Forest, Uganda, also show preferences in tree and buttress choice, exploring whether selectivity is a species-wide feature. We tested chimpanzee preferences for tree species and diameter, number of buttresses, and buttress area and width, by comparing trees and buttresses used in drumming bouts with nearby unused trees and buttresses. Waibira chimpanzees drummed preferentially on two tree species: the tropical hardwood Cynometra alexandrii and the softwood Chrysophyllum albidum. Chimpanzees selected trees with a larger diameter over nearby trees with a smaller diameter, and buttresses were more likely to be used for drumming if they had a larger area or larger width. These results suggest that chimpanzees in the Waibira community select trees and buttresses based on physical properties, most likely related to acoustically relevant characteristics. These findings support the argument that buttress drumming is a goal-directed behavior and contributes to our understanding of chimpanzees' use and optimization of their long-distance acoustic signals.Peer reviewe
Improving the integration of artificial intelligence into existing ecological inference workflows
Get PDFFunding: AC was funded under the NERC SUPER DTP (Grant reference number NE/S007342/1 and website https://superdtp.st-andrews.ac.uk/). XL was in receipt of Leverhulme Fellowship RF-2024-363.1. Artificial intelligence (AI) has revolutionised the process of identifying species and individuals in audio recordings and camera trap images. However, despite developments in sensor technology, machine learning and statistical methods, a general AI-assisted data-to-inference pipeline has yet to emerge. 2. We argue that this is, in part, due to a lack of clarity around several decisions in existing workflows, including: the choice of classifier used (e.g. semi- vs. fully automated); how classifier confidence scores are used and interpreted; and the availability and selection of appropriate statistical methods for drawing ecological inferences. 3. Here, we attempt to conceptualise a general workflow associated with automated tools in ecology. We motivate this perspective using our experiences with occupancy modelling using monitoring data collected through passive acoustic monitoring and camera trapping, identifying priority areas for future developments. 4. We offer an accessible guide to support the ecological community in navigating and capitalising on rapid technological and methodological advances. We describe how different error types arise from both sensor-based monitoring and from classifiers themselves; how different error types are handled at each stage of the workflow; and finally, implications and opportunities associated with deciding on methods used at each step of the pipeline. 5. We recommend that ‘black box’ tools like neural network classification algorithms should be embraced in ecology, but widespread uptake requires more formal integration of AI into the existing ecological inference workflows. Like ecological AI more broadly, however, successful development of new data-to-inference pipelines is a multidisciplinary endeavour that requires input from everyone invested in collecting, processing, analysing and using ecological monitoring data.Peer reviewe
Predicting the effects of climate change on the fertility of aquatic animals using a meta-analytic approach
Get PDFGiven that reproductive physiology is highly sensitive to thermal stress, there is increasing concern about the effects of climate change on animal fertility. Even a slight reduction in fertility can have consequences for population growth and survival, so it is critical to better understand and predict the potential effects of climate change on reproductive traits. We synthesised 1894 effect sizes across 276 studies on 241 species to examine thermal effects on fertility in aquatic animals. Our meta-analysis revealed that external fertilisers tend to be more vulnerable to warming than internal fertilisers, especially in freshwater species. We also found that increased temperature is particularly detrimental for gametes and that under certain conditions, female fertility is more sensitive to warming than male fertility, challenging the prevailing view that males are more vulnerable. This work provides valuable new insights into the effects of temperature on fertility, with potential consequences for population viability.Peer reviewe
No right to an open future
Get PDFLiberals writing about the family frequently cite the child's ‘right to an open future’ in discussions of the ethics of parental decision-making for young children. This purported right grounds certain claims on behalf of children in considerations related to their future autonomy. In this article, I argue that there is no compelling argument in favor of a distinctive ‘right to an open future’ construed as either a negative or a positive right. Insofar as claims made about the content of this purported right are justified, they can be grounded in the interests of the child or in other uncontroversial rights. Talk of a ‘right to an open future’ serves only to obscure the ethical considerations that actually matter and citing the right is not helpful in deciding what may or should be done. I illustrate this claim by reference to two examples of how the ‘right to an open future’ has been applied: one regarding genetic testing for adult-onset disorders and one regarding selection for disabilities.Peer reviewe
Dehydropolymerization of H3B·NMeH2 mediated by cationic iridium(III) precatalysts bearing κ3-iPr-PNRP pincer ligands (R = H, Me) : an unexpected inner-sphere mechanism
Get PDFFunding: EPSRC (EP/M024210/2, EP/T019867/1, DTP to TMB), The University of York via the EPSRC Impact Acceleration Account.The dehydropolymerization of H3B·NMeH2 to form N-methylpolyaminoborane using neutral and cationic catalysts based on the {Ir(iPr-PNHP)} fragment [iPr-PNHP = κ3-(CH2CH2PiPr2)2NH] is reported. Neutral Ir(iPr-PNHP)H3 or Ir(iPr-PNHP)H2Cl precatalysts show no, or poor and unselective, activity respectively at 298 K in 1,2-F2C6H4 solution. In contrast, addition of [NMeH3][BArF4] (ArF = 3,5-(CF3)2C6H3) to Ir(iPr-PNHP)H3 immediately starts catalysis, suggesting that a cationic catalytic manifold operates. Consistent with this, independently synthesized cationic precatalysts are active (tested between 0.5 and 2.0 mol % loading) producing poly(N-methylaminoborane) with Mn ∼ 40,000 g/mol, Đ ∼1.5, i.e., dihydrogen/dihydride, [Ir(iPr-PNHP)(H)2(H2)][BArF4]; σ-amine-borane [Ir(iPr-PNHP)(H)2(H3B·NMe3)][BArF4]; and [Ir(iPr-PNHP)(H)2(NMeH2)][BArF4]. Density functional theory (DFT) calculations probe hydride exchange processes in two of these complexes and also show that the barrier to amine-borane dehydrogenation is lower (22.5 kcal/mol) for the cationic system compared with the neutral system (24.3 kcal/mol). The calculations show that the dehydrogenation proceeds via an inner-sphere process without metal−ligand cooperativity, and this is supported experimentally by N−Me substituted [Ir(iPr-PNMeP)(H)2(H3B·NMe3)][BArF4] being an active catalyst. Key to the lower barrier calculated for the cationic system is the outer-sphere coordination of an additional H3B·NMeH2 with the N−H group of the ligand. Experimentally, kinetic studies indicate a complex reaction manifold that shows pronounced deceleratory temporal profiles. As supported by speciation and DFT studies, a key observation is that deprotonation of [Ir(iPr-NHP)(H)2(H2)][BArF4], formed upon amine-borane dehydrogenation, by the slow in situ formation of NMeH2 (via B−N bond cleavage), results in the formation of essentially inactive Ir(iPr-PNHP)H3, with a coproduct of [NMeH3]+/[H2B(NMeH2)2]+. While reprotonation of Ir(iPr-PNHP)H3 results in a return to the cationic cycle, it is proposed, supported by doping experiments, that reprotonation is attenuated by entrainment of the [NMeH3]+/[H2B(NMeH2)2]+/catalyst in insoluble polyaminoborane. The role of [NMeH3]+/[H2B(NMeH2)]+ as chain control agents is also noted.Peer reviewe
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