Patient Perspectives on the Use of Artificial Intelligence in Health Care: A Scoping Review.

Purpose: Artificial intelligence (AI) technology is being rapidly adopted into many different branches of medicine. Although research has started to highlight the impact of AI on health care, the focus on patient perspectives of AI is scarce. This scoping review aimed to explore the literature on adult patients' perspectives on the use of an array of AI technologies in the health care setting for design and deployment. Methods: This scoping review followed Arksey and O'Malley's framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR). To evaluate patient perspectives, we conducted a comprehensive literature search using eight interdisciplinary electronic databases, including grey literature. Articles published from 2015 to 2022 that focused on patient views regarding AI technology in health care were included. Thematic analysis was performed on the extracted articles. Results: Of the 10,571 imported studies, 37 articles were included and extracted. From the 33 peer-reviewed and 4 grey literature articles, the following themes on AI emerged: (i) Patient attitudes, (ii) Influences on patient attitudes, (iii) Considerations for design, and (iv) Considerations for use. Conclusions: Patients are key stakeholders essential to the uptake of AI in health care. The findings indicate that patients' needs and expectations are not fully considered in the application of AI in health care. Therefore, there is a need for patient voices in the development of AI in health care.

Organizational benefits of neurodiversity: Preliminary findings on autism and the bystander effect.

Although the bystander effect is one of the most important findings in the psychological literature, researchers have not explored whether autistic individuals are prone to the bystander effect. The present research examines whether autistic employees are more likely to report issues or concerns in an organization's systems and practices that are inefficient or dysfunctional. By bringing attention to these issues, autistic employees may foster opportunities to improve organizational performance, leading to the development of a more adaptive, high performing, and ethical culture. Thirty-three autistic employees and 34 nonautistic employees completed an online survey to determine whether employees on the autism spectrum (1) are more likely to report they would voice concerns about organizational dysfunctions, (2) are less likely to report they were influenced by the number of other witnesses to the dysfunction, (3) if they do not voice concerns, are more likely to acknowledge the influence of other people on the decision, (4) are less likely to formulate "elaborate rationales" for their decisions to intervene or not, and (5) whether any differences between autistic and nonautistic employees with regards to the first two hypotheses, intervention likelihood and degree of influence, are moderated by individual differences in camouflaging. Results indicate that autistic employees may be less susceptible to the bystander effect than nonautistic employees. As a result, autistic employees may contribute to improvements in organizational performance because they are more likely to identify and report inefficient processes and dysfunctional practices when they witness them. These preliminary findings suggesting potential benefits of neurodiversity in the workplace are promising. However, further research is required.

A grease for domain walls motion in HfO2-based ferroelectrics.

A large coercive fieldECof HfO2based ferroelectric devices poses critical performance issues in their applications as ferroelectric memories and ferroelectric field effect transistors. A new design to reduceECby fabricating nanolaminate Hf0.5Zr0.5O2/ZrO2(HZZ) thin films is used, followed by an ensuing annealing process at a comparatively high temperature 700 °C. High-resolution electron microscopy imaging detects tetragonal-like domain walls between orthorhombic polar regions. These walls decrease the potential barrier of polarization reversal in HfO2based films compared to the conventional domain walls with a single non-polar spacer, causing about a 40% decrease inEC. Capacitance versus electric field measurements on HZZ thin film uncovered a substantial increase of dielectric permittivity near theECcompared to the conventional Hf0.5Zr0.5O2thin film, justifying the higher mobility of domain walls in the developed HZZ film. The tetragonal-like regions served as grease easing the movement of the domain wall and reducingEC.

Development of a coupled geophysical-geothermal scheme for quantification of hydrates in gas hydrate-bearing permafrost sediments.

Quantification of hydrates in permafrost sediments using conventional seismic techniques has always been a major challenge in the study of the climate-driven evolution of gas hydrate-bearing permafrost sediments due to almost identical acoustic properties of hydrates and ice. In this article, a coupled geophysical-geothermal scheme is developed, for the first time, to predict hydrate saturation in gas hydrate-bearing permafrost sediments by utilising their geophysical and geothermal responses. The scheme includes a geophysical part which interprets the measured elastic wave velocities using a rock-physics model, coupled with a geothermal part, interpreting the measured effective thermal conductivity (ETC) using a new pore-scale model. By conducting a series of sensitivity analyses, it is shown that the ETC model is able to incorporate the effect of the hydrate pore-scale habit and hydrate/ice-forced heave as well as the effect of unfrozen water saturation under frozen conditions. Given that the geophysical and geothermal responses depend on the overburden pressure, the elastic wave velocities and ETC of methane hydrate-bearing permafrost sediment samples were measured at different effective overburden pressures and the results were provided. These experimental data together with the results of our recent study on the geophysical and geothermal responses of gas hydrate-bearing permafrost sediment samples at different hydrate saturations are used to validate the performance of the coupled scheme. By comparing the predicted saturations with those obtained experimentally, it is shown that the coupled scheme is able to quantify the saturation of the co-existing phases with an acceptable accuracy in a wide range of hydrate saturations and at different overburden pressures.

Towards an ideal high-κ HfO2-ZrO2-based dielectric.

The existence of a morphotropic phase boundary (MPB) inside HfO2-ZrO2 solid solution thin films has been predicted; if it exists, it provides a new path toward an ideal silicon-compatible dielectric. Herein, we investigate the structural evolution along with the dielectric and ferroelectric behaviors of differently designed HfO2-ZrO2 thin films to engineer the density of the MPB inside the film structure and consequently, enhance the dielectric properties. Polarization vs. electric field (P-E) measurements of Hf0.25Zr0.75O2 thin films reveal ferroelectric (FE)-antiferroelectric (AFE) characteristics. For this composition, the dielectric constant εr is higher than those of FE Hf0.5Zr0.5O2 and AFE ZrO2 thin films; the difference is attributed to the formation of the MPB. To increase the density of the MPB and subsequently the dielectric properties, 10 nm Hf0.5Zr0.5O2 (FE)/ZrO2 (AFE) nanolaminates were prepared with different lamina thicknesses tL. The coexistence of FE and AFE properties was confirmed by structural characterization studies and P-E measurements. The thinnest layered nanolaminate (tL = 6 Å) showed the strongest dielectric constant εr∼ 60 under a small signal ac electric field of ∼50 kV cm-1; this is the highest εr so far observed in HfO2-ZrO2 thin films. This behavior was attributed to the formation of an MPB near FE/AFE interfaces. The new design provides a promising approach to achieve an ideal high-κ CMOS-compatible device for the current electronic industry.

Insights into the climate-driven evolution of gas hydrate-bearing permafrost sediments: implications for prediction of environmental impacts and security of energy in cold regions.

The present study investigates the evolution of gas hydrate-bearing permafrost sediments against the environmental temperature change. The elastic wave velocities and effective thermal conductivity (ETC) of simulated gas hydrate-bearing sediment samples were measured at a typical range of temperature in permafrost and wide range of hydrate saturation. The experimental results reveal the influence of several complex and interdependent pore-scale factors on the elastic wave velocities and ETC. It was observed that the geophysical and geothermal properties of the system are essentially governed by the thermal state, saturation and more significantly, pore-scale distribution of the co-existing phases. In particular, unfrozen water content substantially controls the heat transfer at sub-zero temperatures close to the freezing point. A conceptual pore-scale model was also proposed to describe the pore-scale distribution of each phase in a typical gas hydrate-bearing permafrost sediment. This study underpins necessity of distinguishing ice from gas hydrates in frozen sediments, and its outcome is essential to be considered not only for development of large-scale permafrost monitoring systems, bus also accurate quantification of natural gas hydrate as a potential sustainable energy resource in cold regions.

The incidence of mTOR marker in tracheal adenoid cystic carcinoma by immunohistochemical staining.

INTRODUCTION: There is an association between the activation of mammalian target of rapamycin (mTOR) signaling and aggressive tumor growth in multiple forms of cancer,including adenoid cystic carcinoma (ACC). ACCs are uncommon yet a malignant form of neoplasms that arises within the secretory glands. Therefore, the aim of this study was to investigate the increase of mTOR in the ACC tumors in order to survey the possibility of treating these tumors with mTOR inhibitors. MATERIAL AND METHODS: Samples from known cases of the lung and tracheal ACC were retrievedfrom the archives of the pa-thology department of Masih Daneshvari hospital, and immunohistochemical (IHC) staining for mTOR was performed on them. After preparation of the blocks with specific antibodies, tumor cells with cytoplasmic and/or nuclear expression of mTOR were considered as positive cells by applying a specific scoring method introduced in this study. RESULTS: The paraffin blocks of 26 patients were surveyed and the IHC marker of mTOR was positive in the tumors of 10 patients (38.5%). Out of 10 mTOR positive cases, 5 were females and 5 were males. The primary site of the surveyed tumors was the trachea and bronchus in 12 cases (46%), salivary glands in 7 individuals (27%), and lung tissue in 7 cases (27%), and there was no significant correlation between the primary site of the ACC tumors and the existence of the mTOR markers in them (P = 0.67). From all cases, 13 patients (50%) had cribriform and tubular cells without solid components, 9 cases (34.6%) had cribriform and tubular with less than 30% of solid components, and 4 cases (15.4%) had cribriform and tubular cells with more than 30% of solid com-ponents. There was no significant difference between the morphologies and the existence of mTOR markers in them (P = 0.741). CONCLUSIONS: As the incidence of mTOR markers is seen in patients with tracheal ACC, evaluation and scoring of mTOR in these persons can be helpful as further studies can distinguish the use of it in the treatment of the disease. .

Gas hydrates in sustainable chemistry.

Gas hydrates have received considerable attention due to their important role in flow assurance for the oil and gas industry, their extensive natural occurrence on Earth and extraterrestrial planets, and their significant applications in sustainable technologies including but not limited to gas and energy storage, gas separation, and water desalination. Given not only their inherent structural flexibility depending on the type of guest gas molecules and formation conditions, but also the synthetic effects of a wide range of chemical additives on their properties, these variabilities could be exploited to optimise the role of gas hydrates. This includes increasing their industrial applications, understanding and utilising their role in Nature, identifying potential methods for safely extracting natural gases stored in naturally occurring hydrates within the Earth, and for developing green technologies. This review summarizes the different properties of gas hydrates as well as their formation and dissociation kinetics and then reviews the fast-growing literature reporting their role and applications in the aforementioned fields, mainly concentrating on advances during the last decade. Challenges, limitations, and future perspectives of each field are briefly discussed. The overall objective of this review is to provide readers with an extensive overview of gas hydrates that we hope will stimulate further work on this riveting field.

Identification of Sonographic Features for Predicting Benign Versus Malignant Mediastinal or Hilar Lymph Nodes Using Endobronchial Ultrasound.

OBJECTIVES: In countries with a high prevalence of tuberculosis, such as Iran, the differentiation of malignant from non-malignant tumors is crucial. We attempted to find a reliable model in determining malignant nodes by investigating the sonographic characteristics of lymph nodes (LNs). METHODS: In this prospective study, the morphologic characteristics of LNs, including size, shape, vascular pattern, echogenicity, margin, coagulation necrosis sign, calcification, and central hilar structure, which had been obtained during endobronchial ultrasound-guided transbronchial needle aspiration, were compared with the final pathology results. RESULTS: We examined 253 LNs from 93 patients. Round shape, non-hilar vascular pattern, heterogeneous echogenicity, hyperechogenicity, distinct margin, and the existence of necrosis signs were significantly higher in malignant nodes. On the other hand, the existence of calcification, as well as the presence of central hilar structure, were highly suggestive of benign nodes (p < 0.050). Multivariate logistic regression revealed that size > 1 cm, heterogeneous echogenicity, hyperechogenicity, the existence of necrosis signs, and the lack of central hilar structure are independent predictive factors for malignancy. The accuracy of each of the aforementioned characteristics are 42.3%, 71.5%, 71.9%, 73.5%, and 65.6%, respectively. Of 74 malignant LNs, 100% had at least one of these independent factors. CONCLUSIONS: The morphological features of LNs based on endobronchial ultrasound-guided transbronchial needle aspiration can play a role in predicting malignancy.

The utility of elastography during EBUS-TBNA in a population with a high prevalence of anthracosis.

BACKGROUND: Ultrasound elastography, is a pioneer sonographic modality that is conducted during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in order to increase the accuracy of sampling location. The current study aims to evaluate the usefulness of elastography during EBUS-TBNA in a population with a high prevalence of anthracosis. METHODS: This prospective single-blinded study was performed on 69 lymph nodes (LNs) of patients with mediastinal lymphadenopathy undergoing EBUS-TBNA and EBUS-elastography from October 2017 to July 2018. The stiffness level of the tissue was translated into a color to demonstrate the hardness of tissue. Blue and total areas of each section were measured to calculate the hardness of each LN. RESULTS: Sixty-nine LNs were evaluated by elastography. Twenty percent of LNs were malignant. There was a statistical difference between malignant and non-malignant nodes based on color dominancy (P = 0.032). However, with the exclusion of anthracosis nodes from the analysis, the difference was more significant (P < 0.001). Moreover, when the blue dominancy was used as the predictor of malignancy or anthracosis, the results showed a significant correlation (P < 001). CONCLUSION: The usefulness of elastography in selecting the hardest area of tissue that is appropriate for diagnosing diseases has been proven previously. Since in countries with a high prevalence of anthracosis, blue color achieved using elastography predicts either malignancy or anthracosis so, cases with blue dominancy of LNs in elastography and the white color in the EBUS-TBNA indicate anthracosis-caused calcification should be reconsidered.

Amniotic membrane and its epithelial and mesenchymal stem cells as an appropriate source for skin tissue engineering and regenerative medicine.

One of the main goals of tissue engineering and regenerative medicine is to develop skin substitutes for treating deep dermal and full thickness wounds. In this regard, both scaffold and cell source have a fundamental role to achieve exactly the same histological and physiological analog of skin. Amnion epithelial and mesenchymal cells possess the characteristics of pluripotent stem cells which have the capability to differentiate into all three germ layers and can be obtained without any ethical concern. Amniotic cells also produce different growth factors, angio-modulatory cytokines, anti-bacterial peptides and a wide range of anti-inflammatory agents which eventually cause acceleration in wound healing. In addition, amniotic membrane matrix exhibits characteristics of an ideal scaffold and skin substitute through various types of extracellular proteins such as collagens, laminins and fibronectins which serve as an anchor for cell attachment and proliferation, a bed for cell delivery and a reservoir of drugs and growth factors involved in wound healing process. Recently, isolation of amniotic cells exosomes, surface modification and cross-linking approaches, construction of amnion based nanocomposites and impregnation of amnion with nanoparticles, construction of amnion hydrogel and micronizing process promoted its properties for tissue engineering. In this manuscript, the recent progress was reviewed which approve that amnion-derived cells and matrix have potential to be involved in skin substitutes; an enriched cell containing scaffold which has a great capability to be translated into the clinic.

Experimental validation of a three-dimensional reduced-order continuum model of phonation.

Due to the complex nature of the phonation process, a one-dimensional (1D) glottal flow description is often used in current phonation models. Although widely used in voice research, these 1D flow-based phonation models have not been rigorously validated against experiments. In this study, a 1D glottal flow model is coupled with a three-dimensional nonlinear continuum model of the vocal fold and its predictions are compared to physical model experiments. The results show that the 1D flow-based model is able to predict the phonation threshold pressure and onset frequency within reasonable accuracy and to reproduce major vibratory features observed in the experiments.

A computational study of the effect of intraglottal vortex-induced negative pressure on vocal fold vibration.

Recent studies reported the formation of intraglottal vortices for medium and high subglottal pressures in excised-larynx experiments, and hypothesized that the suction force created by these vortices might affect vocal fold vibration. However, high subglottal pressures often lead to large vocal fold elastic recoil forces, and it is unclear if the vortex-induced suction force is large enough compared with the elastic recoil force to have noticeable effects on vocal fold vibration. In this study, the validity of this hypothesis was examined using a computational model. The results suggest that intraglottal vortices might only have small effects on vocal fold vibration.

A numerical and experimental investigation of the effect of false vocal fold geometry on glottal flow.

The false vocal folds are hypothesized to affect the laryngeal flow during phonation. This hypothesis is tested both computationally and experimentally using rigid models of the human larynges. The computations are performed using an incompressible Navier-Stokes solver with a second order, sharp, immersed-boundary formulation, while the experiments are carried out in a wind tunnel with physiologic speeds and dimensions. The computational flow structures are compared with available glottal flow visualizations and are employed to study the vortex dynamics of the glottal flow. Furthermore, pressure data are collected on the surface of the laryngeal models experimentally and computationally. The investigation focuses on three geometric features: the size of the false vocal fold gap; the height between the true and false vocal folds; and the width of the laryngeal ventricle. It is shown that the false vocal fold gap has a significant effect on glottal flow aerodynamics, whereas the second and the third geometric parameters are of lesser importance. The link between pressure distribution on the surface of the larynx and false vocal fold geometry is discussed in the context of vortex evolution in the supraglottal region. It was found that the formation of the starting vortex considerably affects the pressure distribution on the surface of the larynx. The interaction of this vortex structure with false vocal folds creates rebound vortices in the laryngeal ventricle. In the cases of small false vocal fold gap, these rebound vortices are able to reach the true vocal folds during a time period comparable with one cycle of the phonation. Moreover, they can create complex vorticity patterns, which result in significant pressure fluctuations on the surface of the larynx.

Lithium inhibits the development of physical dependence to clonidine in mice.

Based on our previous finding that chronic lithium treatment reduced naloxone-precipitated withdrawal syndrome in morphine-treated mice, the effect of chronic lithium treatment was evaluated on the development of dependence to clonidine. Dependence was induced by injection of either morphine (50, 50 and 75 mg/kg, intraperitoneally with 3 hr interval for 3 consecutive days), or clonidine (2 mg/kg/day, intraperitoneally for 10 days). Naloxone (4 mg/kg, intraperitoneally) precipitated withdrawal signs in both morphine- and clonidine-treated mice. Yohimbine (5 mg/kg, intraperitoneally) precipitated withdrawal signs in the clonidine-treated mice, similar to morphine withdrawal signs; but failed to precipitate any significant sign in the morphine-treated mice. Coadministration of lithium was carried out by adding lithium chloride to drinking water (600 mg/l for 20 days; 10 days before the beginning of clonidine administration and 17 days before the administration of morphine to allow the lithium concentration to reach steady-state). The results indicated that chronic lithium administration significantly attenuated the withdrawal signs, precipitated either by yohimbine or naloxone, in clonidine-treated mice. As a conclusion, clonidine withdrawal signs are very similar to opioid withdrawal signs, and lithium is able to prevent the development of physical dependence to clonidine.