Evaluating the translation of implementation science to clinical artificial intelligence: a bibliometric study of qualitative research.

Introduction: Whilst a theoretical basis for implementation research is seen as advantageous, there is little clarity over if and how the application of theories, models or frameworks (TMF) impact implementation outcomes. Clinical artificial intelligence (AI) continues to receive multi-stakeholder interest and investment, yet a significant implementation gap remains. This bibliometric study aims to measure and characterize TMF application in qualitative clinical AI research to identify opportunities to improve research practice and its impact on clinical AI implementation. Methods: Qualitative research of stakeholder perspectives on clinical AI published between January 2014 and October 2022 was systematically identified. Eligible studies were characterized by their publication type, clinical and geographical context, type of clinical AI studied, data collection method, participants and application of any TMF. Each TMF applied by eligible studies, its justification and mode of application was characterized. Results: Of 202 eligible studies, 70 (34.7%) applied a TMF. There was an 8-fold increase in the number of publications between 2014 and 2022 but no significant increase in the proportion applying TMFs. Of the 50 TMFs applied, 40 (80%) were only applied once, with the Technology Acceptance Model applied most frequently (n = 9). Seven TMFs were novel contributions embedded within an eligible study. A minority of studies justified TMF application (n = 51,58.6%) and it was uncommon to discuss an alternative TMF or the limitations of the one selected (n = 11,12.6%). The most common way in which a TMF was applied in eligible studies was data analysis (n = 44,50.6%). Implementation guidelines or tools were explicitly referenced by 2 reports (1.0%). Conclusion: TMFs have not been commonly applied in qualitative research of clinical AI. When TMFs have been applied there has been (i) little consensus on TMF selection (ii) limited description of selection rationale and (iii) lack of clarity over how TMFs inform research. We consider this to represent an opportunity to improve implementation science's translation to clinical AI research and clinical AI into practice by promoting the rigor and frequency of TMF application. We recommend that the finite resources of the implementation science community are diverted toward increasing accessibility and engagement with theory informed practices. The considered application of theories, models and frameworks (TMF) are thought to contribute to the impact of implementation science on the translation of innovations into real-world care. The frequency and nature of TMF use are yet to be described within digital health innovations, including the prominent field of clinical AI. A well-known implementation gap, coined as the "AI chasm" continues to limit the impact of clinical AI on real-world care. From this bibliometric study of the frequency and quality of TMF use within qualitative clinical AI research, we found that TMFs are usually not applied, their selection is highly varied between studies and there is not often a convincing rationale for their selection. Promoting the rigor and frequency of TMF use appears to present an opportunity to improve the translation of clinical AI into practice.

Anesthetic efficacy of ketamine, ketamine-tramadol and ketamine-ketorolac in chicks.

BACKGROUND: Ketamine produces ordinary general anesthesia characterized by weak hypnosis and analgesia leading to complications during surgical operations. AIMS: The aim of this study was to evaluate the combination of ketorolac or tramadol to enhance ketamine anesthesia in 7 to 20-day-old chicks and its feasibility and practical application for induction of general anesthesia in veterinary medicine. METHODS: Hypnotic and analgesic Median Effective Doses (ED50s) of ketamine alone and combination with tramadol or ketorolac were determined by the up-and-down method, then the ED50 values of these combinations were used for measurement of hypnotic and analgesic criteria moreover, their effect on serum Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) was assayed. RESULTS: Ketamine hypnosis and analgesia were increased when mixed with tramadol (26 and 39%) or ketorolac (27 and 40%), respectively. Ketamine-ketorolac mixture was better combination of inducing the faster onset of anesthesia and short recovery with the longest duration of action and enhancing analgesia when compared to ketamine alone or in combination with tramadol and is preferred for induction of anesthesia. The liver function enzymes, including AST and ALT, showed no significant difference among all above mentioned groups. CONCLUSION: The data of this experimental study reveal the superiority of using ketorolac (instead of tramadol) in combination with ketamine for induction of general anesthesia in the chicks.

Capture probability of released males of two Bactrocera species (Diptera: Tephritidae) in detection traps in California.

The genus Bactrocera (Diptera: Tephritidae) includes approximately 70 polyphagous species that are major pests of fruit and vegetable crops. Most Bactrocera species have limited geographic distributions, but several species are invasive, and many countries operate continuous trapping programs to detect infestations. In the United States, California maintains approximately 25,000 traps (baited with male lures) specifically for Bactrocera detection distributed over an area of approximately 6,400 km2 (2,500 miles2) in the Los Angeles area. Although prior studies have used male lures to describe movement of Bactrocera males, they do not explicitly relate capture probability with fly distance from lure-baited traps; consequently, they do not address the relative effectiveness of male lures in detecting incipient populations of Bactrocera species. The objective of this study was to measure the distance-dependent capture probability of marked, released males of Bactrocera dorsalis (Hendel) and Bactrocera cucurbitae (Coquillett) (methyl eugenol- and cue lure-responding species, respectively) within the detection trapping grid operating in southern California. These data were then used to compute simple probability estimates for detecting populations of different sizes of the two species. Methyl eugenol was the more powerful attractant, and based on the mark-recapture data, we estimated that B. dorsalis populations with as few as approximately 50 males would always (>99.9%) be detected using the current trap density of five methyl eugenol-baited traps per 2.6 km2 (1 mile2). By contrast, we estimated that certain detection of B. cucurbitae populations would not occur until these contained approximately 350 males. The implications of the results for the California trapping system are discussed, and the findings are compared with mark-release-recapture data obtained for the same two species in Hawaii.

Metoclopramide protection of diazinon-induced toxicosis in chickens.

The efficacy of metoclopramide for preventing organophosphate insecticide-induced (diazinon) toxicosis was evaluated in 7~14 days old chicks. Injection of metoclopramide at 25 mg/kg, s.c. 15 min before diazinon increased the oral 24 h median lethal dose of the insecticide in the chicks by 80%. Metoclopramide alone inhibited the in vitro and in vivo plasma and whole brain cholinesterase activities of the chicks. Metoclopramide pretreatment at 100 mg/kg, s.c. reduced the extent of cholinesterase inhibition that was caused by diazinon (10 mg/kg, p.o.) in the plasma and whole brain by 24% and 7%, respectively. Diazinon at 10 mg/kg, p.o. produced signs of cholinergic toxicosis in the chicks, and these signs included salivation, lacrimation, gasping and convulsions within 2 h, and the 2-h and 24-h lethalities were 88 and 100%, respectively. Metoclopramide at the dose rates of 12.5, 25, 50, 100 and 200 mg/kg, s.c. given 15 min before diazinon (10 mg/kg, p.o.) variably decreased the occurrence of toxic manifestations in the chicks. The highest dose of metoclopramide (200 mg/kg, s.c.) reduced the 2-h and 24-h lethality of diazinon to 75% each and it reduced the overall toxicity score of diazinon by 32%. The data suggest that metoclopramide pretreatment only partially protected chicks against the acute toxicity of diazinon.