Futureproofing Medical Education Through Scenario Analysis: Instrumental Case Study.

Developments in technology and climate change, as well as other "megatrends" are having lasting impacts in society and healthcare. A scenario analysis was conducted to explore the impact of megatrends on medical education. Three scenarios were developed for the year 2035, showing varying levels of technological integration and environmental focus. Implications for an updated curricula focus on health inequalities, digital health, and globalization effects.

Delphi method applicability in drug foresight.

BACKGROUND: The aim of the current study was to assess the accuracy of expert predictions, which were derived using a Delphi panel foresight study between 2009 and 2011, on a variety of drug-related topics in Finland in 2020. METHODS: The material used to evaluate the accuracy of the predictions consists of published reports on statistics, survey results, official register data, wastewater analyses and official documents. Whenever possible, we used multiple information sources to ascertain possible changes related to the predictions. RESULTS: Between 2009 and 2011, the majority - but not all - of the experts accurately predicted an increase in drug use. Indeed, more people experimented with or used drugs, and more drug residues were found in wastewater monitoring. The experts also correctly predicted an increase in population-level approval of drug use, but this development has been rather slow. Contrary to predictions, there was no marked increase in the use of new synthetic drugs. However, the misuse of buprenorphine increased during the 2010s. In the drug market, unit prices were surprisingly stable over the ten-year period. There were no changes in legislation related to the legal status of drugs, as was foreseen by the experts. However, enforcement moved in the direction foreseen by the experts: more lenient measures have been taken against users. Drug care system reforms favored a combination of mental health and addiction care units between 2009 and 2011, and 2020, as foreseen by the experts. CONCLUSIONS: It seems to have been easier for the experts to foresee the continuation of existing trends, e.g., increasing use of drugs or widening approval of drugs, than to predict possible changes in the popularity of distinct groups of drugs such as new psychoactive substances (NPS). Even armed with the prediction that drug imports and wholesale would increasingly fall into the domain of organized crime, this undesirable development could not be stopped. Expert disagreement can also be seen as a valuable indication of uncertainty regarding the future. Foresight related to drug-related issues can produce relatively accurate and realistic views of the future at least up to ten years ahead.

Human-AI Teaming in Critical Care: A Comparative Analysis of Data Scientists' and Clinicians' Perspectives on AI Augmentation and Automation.

BACKGROUND: Artificial intelligence (AI) holds immense potential for enhancing clinical and administrative health care tasks. However, slow adoption and implementation challenges highlight the need to consider how humans can effectively collaborate with AI within broader socio-technical systems in health care. OBJECTIVE: In the example of intensive care units (ICUs), we compare data scientists' and clinicians' assessments of the optimal utilization of human and AI capabilities by determining suitable levels of human-AI teaming for safely and meaningfully augmenting or automating 6 core tasks. The goal is to provide actionable recommendations for policy makers and health care practitioners regarding AI design and implementation. METHODS: In this multimethod study, we combine a systematic task analysis across 6 ICUs with an international Delphi survey involving 19 health data scientists from the industry and academia and 61 ICU clinicians (25 physicians and 36 nurses) to define and assess optimal levels of human-AI teaming (level 1=no performance benefits; level 2=AI augments human performance; level 3=humans augment AI performance; level 4=AI performs without human input). Stakeholder groups also considered ethical and social implications. RESULTS: Both stakeholder groups chose level 2 and 3 human-AI teaming for 4 out of 6 core tasks in the ICU. For one task (monitoring), level 4 was the preferred design choice. For the task of patient interactions, both data scientists and clinicians agreed that AI should not be used regardless of technological feasibility due to the importance of the physician-patient and nurse-patient relationship and ethical concerns. Human-AI design choices rely on interpretability, predictability, and control over AI systems. If these conditions are not met and AI performs below human-level reliability, a reduction to level 1 or shifting accountability away from human end users is advised. If AI performs at or beyond human-level reliability and these conditions are not met, shifting to level 4 automation should be considered to ensure safe and efficient human-AI teaming. CONCLUSIONS: By considering the sociotechnical system and determining appropriate levels of human-AI teaming, our study showcases the potential for improving the safety and effectiveness of AI usage in ICUs and broader health care settings. Regulatory measures should prioritize interpretability, predictability, and control if clinicians hold full accountability. Ethical and social implications must be carefully evaluated to ensure effective collaboration between humans and AI, particularly considering the most recent advancements in generative AI.

Episodic foresight, episodic memory, and executive functions in children engaged with Child Protective Services: The role of cumulative risk.

Previous studies have determined that exposure to risk and adversities may impair children's cognitive abilities. In particular, children engaged with Child Protective Services (CPS) seem to be at greater risk for enhanced detrimental effects resulting from the cumulative risk factors to which they are exposed. However, little is known about children's future thinking when they face adverse circumstances, and it is not clear how the associations among episodic foresight abilities, episodic memory, and executive functions work with children under such circumstances. The current study describes the episodic foresight abilities of CPS-involved school-aged children, its association with other cognitive abilities, and how this association is affected by the exposure to cumulative risk and adversity factors. Episodic foresight, episodic memory, executive functions, and a composite of cumulative risk factors were analyzed in a sample of 95 school-aged children engaged with CPS in Portugal. Results suggest the detrimental effect of cumulative risk on the episodic foresight abilities of CPS-involved children. Episodic memory and cognitive flexibility were significant predictors of episodic foresight abilities, and cumulative risk exposure moderated the relation between episodic memory and episodic foresight. The current study provides a better understanding of the influences of multiple adversities on CPS-involved children's episodic foresight abilities and related cognitive outcomes.

What do recently housed young people imagine for the future of third places? Using game-based inquiry to (re)imagine affirming, youth-centered third places.

Third places-public and community settings like parks and libraries-are theorized to serve as sources of social connection, community, and play. Yet, young people who hold marginalized identities, such as those experiencing homelessness and housing instability, often endure discrimination in third place settings. This study used game-based inquiry to partner with recently housed young people who have experienced chronic housing instability (N = 21) to understand how they would (re)imagine future third places. We then analyzed transcripts from these game sessions through qualitative thematic analysis. Participants suggested that certain tenets must be present in third places: they must offer opportunities for agency and individualization; they must meet everyday needs; and they must be explicitly inclusive. To actualize these tenets, participants imagined places that meet many needs and do many things; portable and adaptable physical spaces; freedom to choose how to play; attending to and subverting oppressive social hierarchies; providing choice for privacy or connection; knowing people will be around; and free amenities. These findings have implications for theoretical development, practices in present and future third places, and methodological development of games in research.

How will technology change people's home care in the next 20 years? A strategic foresight study.

The rapid expansion of home health care has raised many unresolved issues and will have far-reaching consequences that can only be overcome with a holistic approach to help build and use collective intelligence in a structured, systemic way to anticipate developments. In this frame, the set of issues covered by the human factors research field will significantly impact the safety, quality, and effectiveness of home health care. However, only with a gaze of strategic foresight will we be capable of exploring, anticipating, and shaping the future. A group of researchers from the Italian Society of Ergonomics and Human Factors (SIE) has developed a road map to help all the stakeholders involved in this process.

A Strategic Foresight study was conducted to define a preferred scenario of home care in the next 20 years. A hybrid survey method called Human-Centred Foresight was applied. The results achieved in the study show a possible scenario of home care that can define medium- and long-term goals from today until 2041.

A Long Way to Go: A Scenario for Clinical Trials of PI3K Inhibitors in Treating Cancer.

BACKGROUND: Alterations in PI3K function are directly related to cancer, making PI3K inhibitors suitable options for anticancer therapies. Information on therapy using different types of PI3K inhibitors is available in literature, providing indications of trends in developing new therapies. Although some studies on PI3K inhibitors for cancer treatment provide clinical evidence, they do not allow a careful search for potential PI3K inhibitors conducted by development indicators. Here, we performed a foresight study of clinical trials involving PI3K inhibitors from the past 11 years using indicators of clinical evolution to identify technological trends and provide data for supporting recommendations for new study designs. METHODS: A comprehensive foresight study was designed based on documents from clinical trials on PI3K inhibitors to perform a systematic and comparative analysis, in order to identify technological trends on new cancer therapies. RESULTS: Our results demonstrate that total number of clinical trials has decreased over the years and, currently, there is a clear prevalence of studies using isoform-specific inhibitors in combined interventions. Clinical trials in Phases I and II were the most frequently found in the database, whereas Phase III trials correspond to 7% of studies. The measurement of clinical trials progression using indicators (drugs in Phase III profile, top-10 drugs, and top-10 combined drugs) demonstrated that the 3 new medicines BKM120, IBI-376, and PF-05212384 have a high potential to provide more efficient cancer treatment in combined interventions. These data also include the groups of targets for each drug, providing a useful and reliable source for design new combinations to overcome the resistance and the poor tolerability observed in some PI3K therapies. CONCLUSIONS: The establishment of development indicators based on clinical trials for cancer treatment was useful to highlight the clinical investment in 3 new PI3K drugs and the advantages of combine therapy using FDA-approved drugs.

International regional competitiveness of rural territories as a factor of their socio-economic development: Methodological aspects.

The study aims to develop a scientific and methodological approach to the formation of a model for managing the international competitiveness of rural areas based on an assessment of the existing export and production potential to form priorities for their socio-economic development. Research methods involve a systematic approach, an integrated approach, an algorithmization using methods of integral assessment of competitiveness, etc. The research allowed the development of a conceptual model for managing the international competitiveness of rural regions. The model includes a variable list of determinants and indicators of the formation of competitive advantages of rural territories depending on the export-production potential and strategic goals of their development. The paper presents a model management algorithm and a set of complementary methodological techniques used to assess international and regional competitiveness. The scientific novelty lies in the developed scientific and methodological approaches and practical recommendations for the formation of international and regional competitiveness in rural areas. Moreover, a system of determinants of the competitiveness formation of rural territories and a system of indicators for its assessment have been developed.

Bibliometrics and visualization-based analysis of research landscape of exosomes and foresight / 中国组织工程研究

BACKGROUND:Exosomes have become one of the frontiers of biomedical research in recent years because of their promising applications in clinical diagnosis and therapy. OBJECTIVE:To reveal the basic research and technology development trend of exosomes at home and abroad,and provide suggestions for related scientific and technological research and development in China. METHODS:This paper presented a quantitative analysis of the overall research and development situation,the frontier hotspots and future development trends in this research area by means of bibliometric methods and tools. RESULTS AND CONCLUSION:The research and development hotspots in this area have entered a high growth phase with the application of new tools and methods.Many new technologies and products are facing clinical applications and markets with the development of a large number of clinical translation experiments.Comparative analysis at home and abroad reveals that China has made more remarkable achievements in basic research in this field,but there are still weaknesses in the possession of independent intellectual property rights,clinical technology translation,and regulatory system standardization and management,which need to be further strengthened in the future.

Preparing the occupational safety and health workforce for future disruptions.

BACKGROUND: Despite some emerging lessons learned from the COVID-19 pandemic, evidence suggests the world remains largely underprepared for-and vulnerable to-similar threats in the future. METHODS: In 2022, researchers at the US National Institute for Occupational Safety and Health (NIOSH) led a team of volunteers to explore how future disruptions, such as pandemics, might impact work and the practice of occupational safety and health (OSH). This qualitative inquiry was framed as a strategic foresight project and included a series of activities designed to help better understand, prepare for, and influence the future. RESULTS: Findings from a thorough search for indicators of change were synthesized into nine critical uncertainties and four plausible future scenarios. Analysis of these outputs elucidated three key challenges that may impact OSH research, policy, and practice during future disruptions: (1) data access, (2) direct-to-worker communications, and (3) mis- and dis-information management. CONCLUSIONS: A robust strategic response is offered to address these challenges, and next steps are proposed to enhance OSH preparedness and institutionalize strategic foresight across the OSH community.

Foresight for ethical AI.

There is growing expectation that artificial intelligence (AI) developers foresee and mitigate harms that might result from their creations; however, this is exceptionally difficult given the prevalence of emergent behaviors that occur when integrating AI into complex sociotechnical systems. We argue that Naturalistic Decision Making (NDM) principles, models, and tools are well-suited to tackling this challenge. Already applied in high-consequence domains, NDM tools such as the premortem, and others, have been shown to uncover a reasonable set of risks of underlying factors that would lead to ethical harms. Such NDM tools have already been used to develop AI that is more trustworthy and resilient, and can help avoid unintended consequences of AI built with noble intentions. We present predictive policing algorithms as a use case, highlighting various factors that led to ethical harms and how NDM tools could help foresee and mitigate such harms.

Valorization for Biodiversity and Ecosystem Services in the Agri-Food Value Chain.

This article defines the term valorization of biodiversity and ecosystem services (BES) measures, as distinguished from their valuation, and underpins it with an assessment of private valorization examples along the agri-food value chain. Valorization incentivizes measures for promoting BES, while valuation refers to its quantification. Valuation can be a step of valorization but is not indispensable. In scientific literature, the terms valorization and valuation are often used interchangeably. In addition, there is a lack of research on private options versus conventional, public policy options. Therefore, we searched for private valorization options primarily in public sources (gray literature and websites). This led to the identification of four clusters (markets for voluntary services, labeling, and certification, environmental management/CSR, and tradable permits and quotas). Based on these clusters the options were assessed from a legal and systems dynamics perspective. In addition, the viability of selected valorization options in different future scenarios was examined. The analysis revealed a wide range of private valorization options, which in contrast to public policy options that focus almost entirely on the production stage, are spread across the agri-food value chain. Their suitability differs under different future scenarios, legal and systems conditions.

Seven open questions in the futures of human genome editing.

Scholarly discussion around the governance of human genome editing (HGE) recognizes that development and application of HGE techniques could result in unexpected societal outcomes. However, it contains few to no methodological models for how to anticipate, prepare for, or shape such outcomes. This article presents early-stage results from research guided by anticipatory governance, a framework for broad expert and public consideration of innovation processes and purposes. We present and discuss key themes emerging from a set of future-oriented interviews with genome editing practitioners and experts, designed to inform broadly scoped deliberations about plausible futures of HGE. We articulate our results as seven "open questions," the answers to which will be important components of HGE's eventual shape and outcomes. Some themes are perennial in studies of science and society, and others are more novel to HGE. Each helps to reframe HGE beyond a simple comparison of risk and benefit. Such reframing opens up new and important terrain for discussion among policymakers, academics, scientists, and publics. We suggest that discussion framed around broad and reflexive questions like those presented here will help governance efforts to better acknowledge and flexibly respond to the uncertainty and complexities of HGE developments.

Research progress and perspectives on carbon capture, utilization, and storage (CCUS) technologies in China and the USA: a bibliometric analysis.

Carbon dioxide capture, utilization, and storage (CCUS) technology is an emerging technology with large-scale emission reduction potential and an essential component of the global response to climate change to achieve net-zero goals. As the two most important countries in global climate governance, it is necessary to review and examine the current status and trends of research in the field of CCUS in China and the USA. This paper uses bibliometric tools to review and analyze peer-reviewed articles in the Web of Science from both countries during 2000-2022. The results show a significant increase in research interest among scholars from both countries. The number of publications in the CCUS field in China and the USA was 1196 and 1302, respectively, showing an increasing trend. China and the USA have become the most influential countries in CCUS. And the USA has a more significant academic influence on a global scale. Furthermore, the research hotspots in the field of CCUS are diverse and differentiated. That is, China and the USA pay attention to different research hotspots or have different focuses in different periods. This paper also finds that new capture materials and technology development, geological storage monitoring and early warning, CO2 utilization and new energy development, sustainable business models, incentive policies and measures, and public awareness are critical directions for future research in the field of CCUS, to provide a comprehensive review and comparison of CCUS technology development in China and the USA. It helps to gain insight into the research differences and linkages between the two countries in the field of CCUS and identify the research gaps between them. And place some consensus that policymakers can use.

Self-initiating and applying episodic foresight in middle childhood.

This study provides an important extension to the growing literature on prospection in children by providing the first test of whether one's ability to engage in the functional (as opposed to the purely phenomenological) aspect of episodic foresight improves across middle childhood. Of the various forms of prospection, episodic foresight has been proposed to be one of the most flexible and functionally powerful, defined as the ability to not only imagine future events (simulative aspect) but also use those imaginings to guide behavior in the present (functional aspect). The current study tested 80 typically developing children aged 8 to 12 years using an extensive cognitive battery comprising Virtual Week Foresight, the Autobiographical Interview, and a series of crystallized and fluid intelligence measures. Whereas data indicated age-related improvements in detecting future-oriented problems and taking steps in the present in service of solving these, all children in this age bracket demonstrated a similar capacity for problem resolution (i.e., the ability to subsequently solve successfully identified problems). Results also revealed the importance of broader crystallized and fluid intelligence, but not episodic memory or episodic future thinking, in engaging in this capacity. Research is now required to understand the real-life consequences of episodic foresight during this developmental period as well as the ways in which parents and teachers can help to foster this capacity and consequently help to support children's growing desire for independence during this time.

Exploring the potential of mapped soil properties, rhizobium inoculation, and phosphorus supplementation for predicting soybean yield in the savanna areas of Nigeria.

Rapid and accurate soybean yield prediction at an on-farm scale is important for ensuring sustainable yield increases and contributing to food security maintenance in Nigeria. We used multiple approaches to assess the benefits of rhizobium (Rh) inoculation and phosphorus (P) fertilization on soybean yield increase and profitability from large-scale conducted trials in the savanna areas of Nigeria [i.e., the Sudan Savanna (SS), Northern Guinea Savanna (NGS), and Southern Guinea Savanna (SGS)]. Soybean yield results from the established trials managed by farmers with four treatments (i.e., the control without inoculation and P fertilizer, Rh inoculation, P fertilizer, and Rh + P combination treatments) were predicted using mapped soil properties and weather variables in ensemble machine-learning techniques, specifically the conditional inference regression random forest (RF) model. Using the IMPACT model, scenario analyses were employed to simulate long-term adoption impacts on national soybean trade and currency. Our study found that yields of the Rh + P combination were consistently higher than the control in the three agroecological zones. Average yield increases were 128%, 111%, and 162% higher in the Rh + P combination compared to the control treatment in the SS, NGS, and SGS agroecological zones, respectively. The NGS agroecological zone showed a higher yield than SS and SGS. The highest training coefficient of determination (R2 = 0.75) for yield prediction was from the NGS dataset, and the lowest coefficient (R2 = 0.46) was from the SS samples. The results from the IMPACT model showed a reduction of 10% and 22% for the low (35% adoption scenario) and high (75% adoption scenario) soybean imports from 2029 in Nigeria, respectively. A significant reduction in soybean imports is feasible if the Rh + P inputs are large-scaled implemented at the on-farm field and massively adopted by farmers in Nigeria.

Innovation signals: leveraging machine learning to separate noise from news.

The early detection of and an adequate response to meaningful signals of change have a defining impact on the competitive vitality and the competitive advantage of companies. For this strategically important task, companies apply corporate foresight, aiming to enable superior company performance. With the growing dynamics of global markets, the amount of data to be analyzed for this purpose is constantly increasing. As a result, these analyses are often performed with an unreasonably high investment of financial and human resources, or are even not performed at all. To address this challenge, this paper presents a machine-learning-based approach to help companies identify early signals of change with a higher level of automation than before. For this, we combine a newly-proposed quantitative approach with the existing qualitative approaches by Cooper (stage-gate model) and by Rohrbeck (corporate foresight process). After a search field of interest has been defined, the related data is collected from web news sites, early signals are identified and selected automatically, and domain experts then assess these signals with respect to their relevance and novelty. Once it has been set up, the approach can be executed iteratively at regular time intervals in order to continuously scan for new signals of change. By means of three case studies supported by domain experts we demonstrate the effectiveness of our approach. After presenting our findings and discussing possible limitations of the approach, we suggest future research opportunities to further advance this field.

Four Futures for Occupational Safety and Health.

Rapid changes to the nature of work have challenged the capacity of existing occupational safety and health (OSH) systems to ensure safe and productive workplaces. An effective response will require an expanded focus that includes new tools for anticipating and preparing for an uncertain future. Researchers at the U.S. National Institute for Occupational Safety and Health (NIOSH) have adopted the practice of strategic foresight to structure inquiry into how the future will impact OSH. Rooted in futures studies and strategic management, foresight creates well-researched and informed future scenarios that help organizations better prepare for potential challenges and take advantage of new opportunities. This paper summarizes the inaugural NIOSH strategic foresight project, which sought to promote institutional capacity in applied foresight while exploring the future of OSH research and practice activities. With multidisciplinary teams of subject matter experts at NIOSH, we undertook extensive exploration and information synthesis to inform the development of four alternative future scenarios for OSH. We describe the methods we developed to craft these futures and discuss their implications for OSH, including strategic responses that can serve as the basis for an action-oriented roadmap toward a preferred future.

Back to the future: Are we trapped in our past?

This paper is a reflection on how evaluators could approach theories of change through a foresight lens. It explores the role of assumptions and especially anticipatory assumptions in how we design our theories of change. It argues for a more open approach, a transdisciplinary approach to the multiple knowledges we bring to bear. It goes on to argue that if we do not build and use our imaginations to think differently about the future than the past, as evaluators we risk being trapped in findings and recommendations that assume continuity in a highly discontinuous world.

The Landscape of Neutralizing Monoclonal Antibodies (nAbs) for Treatment and Prevention of COVID-19.

Purpose: After nearly 3 years of the COVID-19 pandemic, even though a vast body of knowledge and products (including vaccines and treatments) have been developed and disseminated, the virus is still evolving and new variants arising. Consequently, thousands of lives continue to be lost. Neutralizing monoclonal antibodies (nAbs) are promising drugs that emerged to treat SARS-CoV-2. In the uncertainty of the current situation, there is the question of whether organizations should continue to invest in this technology. To help decision-making in scientifical and pharmaceutical organizations, it is of major importance to monitor the development of products and technologies. Therefore, the aim of this study is analyze the landscape of nAbs for COVID-19. Methods: The scenario of 473 biotherapeutics focusing on nAbs was evaluated using foresight techniques and a review of literature. Data were obtained from structured and semi-structured databases and processed for treatment, cleaning, consistency, validation, and enrichment. Results: We identified 227 nAbs and performed an extensive literature review of 16 nAbs in late clinical development, including development technologies, responses to variants of concern (VOCs), manufacturing, and clinical aspects. Conclusions: Even though the emergence of new VOCs is a threat to the effectiveness of this treatment, demanding constant genomic surveillance, the use of nAbs to treat and prevent COVID-19 will probably continue to be relevant due to excellent safety profiles and the possibility of immediate immunity transfer, especially in patients showing inadequate immunological response to vaccination. Therefore, we suggest that organizations should keep investing in improvements in this technology.