ArUco-based stylus reliability for reproductible 3D digitalisation of shoulder cartilage contours.

Imaging techniques in anatomy have developed rapidly over the last decades through the emergence of various 3D scanning systems. Depending on the dissection level, non-contact or tactile contact methods can be applied on the targeted structure. The aim of this study was to assess the inter and intra-observer reproducibility of an ArUco-based localisation stylus, that is, a manual technique on a hand-held stylus. Ten fresh-frozen, unembalmed adult arms were used to digitalise the glenoid cartilage related to the glenohumeral joint and the contour of the clavicle cartilage related to the acromioclavicular joint. Three operators performed consecutive digitalisations of each cartilage contour using an ArUco-based localisation stylus recorded by a single monocular camera. The shape of each cartilage was defined by nine shape parameters. Intra-observer repeatability and inter-observer reproducibility were computed using an intra-class correlation (ICC) for each of these parameters. Overall, 35.2 ± 2.4 s and 26.6 ± 10.2 s were required by each examiner to digitalise the contour of a glenoid and acromioclavicular cartilage, respectively. For most parameters, good-to-excellent agreements were observed concerning intra-observer (ICC ranging between 0.81 and 1.00) and inter-observer (ICC ranging between 0.75 and 0.99) reproducibility. To conclude, through a fast and versatile process, the use of an ArUco-based localisation stylus can be a reliable low-cost alternative to conventional imaging methods to digitalise shoulder cartilage contours.

Taming the Chimaera-Hydra: disconnecting from the net to fortify our mental health.

In our ever digitalising society, our engagement with the online world has significant potential to have a negative impact on our mental health. Although the roles of public health and psychiatry are debated, clinicians are in a strategic position to assess usage and intervene, to prevent harms from problematic engagement with the internet.

The future backbone of nutritional science: integrating public health priorities with system-oriented precision nutrition.

Adopting policies that promote health for the entire biosphere (One Health) requires human societies to transition towards a more sustainable food supply as well as to deepen the understanding of the metabolic and health effects of evolving food habits. At the same time, life sciences are experiencing rapid and groundbreaking technological developments, in particular in laboratory analytics and biocomputing, placing nutrition research in an unprecedented position to produce knowledge that can be translated into practice in line with One Health policies. In this dynamic context, nutrition research needs to be strategically organised to respond to these societal expectations. One key element of this strategy is to integrate precision nutrition into epidemiological research. This position article therefore reviews the recent developments in nutrition research and proposes how they could be integrated into cohort studies, with a focus on the Swiss research landscape specifically.

Enhancing patient informed consent in elective skin cancer surgeries: a comparative study of traditional and digital approaches in a German public hospital.

BACKGROUND: This study aims to investigate the integration of modern sources of patient information, such as videos, internet-based resources, and scientific abstracts, into the traditional patient informed consent process in outpatient elective surgeries. The goal is to optimize the informed consent experience, enhance patient satisfaction, and promote shared decision making (SDM) between patients and surgeons. By exploring different patient informed consent formats and their impact on patient satisfaction, this research seeks to improve healthcare practices and ultimately enhance patient outcomes. The findings of this study will contribute to the ongoing efforts to improve the informed consent process in public hospitals and advance patient-centred care. METHODS: Data collection occurred at the day care clinic of a prominent German public hospital, forming an integral component of a prospective clinical investigation. The study exclusively focused on individuals who had undergone surgical intervention for skin cancer. For the purpose of meticulous data examination, the statistical software SPSS version 21 was harnessed. In the course of this study, a chi-square test was aptly employed. Its purpose was to scrutinize the nuances in patient experiences pertaining to informed consent across four distinct categories, viz., oral informed consent discussion (Oral ICD), written informed consent discussion (Written ICD), video-assisted informed consent discussion (video-assisted ICD), and digitally assisted informed consent discussion (digital-assisted ICD). The primary dataset of this inquiry was diligently gathered via a structured questionnaire administered to a targeted cohort of 160 patients. Within this sample, a balanced representation of genders was observed, encompassing 82 males and 78 females. Their collective age span ranged from 18 to 92 years, with an average age of 71 years. A randomized selection methodology was employed to include participants in this study during the period spanning from July 2017 to August 2018. RESULTS: Significant differences were observed across the groups for all research questions, highlighting variations in patient responses. Video-assisted and digital-assisted IC were rated as superior in patient satisfaction with information compared to written and oral IC. Demographic profiles of the four study groups were found to be comparable. CONCLUSION: The findings of this study indicate that the incorporation of digital technologies in the informed consent process can enhance patient understanding during outpatient elective skin cancer surgeries. These results have important implications for increasing patient satisfaction and improving the SDM process within the hospital environment.

Health system performance assessment: embedding resilience through performance intelligence.

Health systems around the world are facing challenges in achieving their goals. In the wake of the coronavirus disease pandemic, the need for resilient health systems has become even more apparent. This article argues that embedding resilience into health system performance assessment (HSPA) frameworks can be a valuable approach for improving health system performance. This perspective examines key challenges threatening health systems and makes a case for the continued relevance of HSPA by embedding resilience-related performance intelligence.

Reviewing the current state of virtual reality integration in medical education - a scoping review.

BACKGROUND: In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula. METHODS: This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR. RESULTS: A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages. DISCUSSION: Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements.

[Digital health applications (DiGA) in the area of tension between progress and criticism : Discussion paper from the "Digital health" specialist group of the German Informatics Society]. / Digitale Gesundheitsanwendungen (DiGA) im Spannungsfeld von Fortschritt und Kritik : Diskussionsbeitrag der Fachgruppe "Digital Health" der Gesellschaft für Informatik e. V.

Since December 2019, digital health applications (DiGA) have been included in standard care in Germany and are therefore reimbursed by the statutory health insurance funds to support patients in the treatment of diseases or impairments. There are 48 registered DiGA listed in the directory of the Federal Institute of Drugs and Medical Devices (BfArM), mainly in the areas of mental health; hormones and metabolism; and muscles, bones, and joints. In this article, the "Digital Health" specialist group of the German Informatics Society describes the current developments around DiGA as well as the current sentiment on topics such as user-centricity, patient and practitioner acceptance, and innovation potential. In summary, over the past three years, DiGA have experienced a positive development, characterized by a gradually increasing availability of various DiGA and coverage areas as well as prescription numbers. Nevertheless, significant regulatory adjustments are still required in some areas to establish DiGA as a well-established instrument in long-term routine healthcare. Key challenges include user-centeredness and the sustainable use of the applications.

[Mis- and disinformation in social media: mitigating risks in digital health communication]. / Falsch- und Desinformation in sozialen Medien: Ansätze zur Minimierung von Risiken in digitaler Kommunikation über Gesundheit.

Misinformation and disinformation in social media have become a challenge for effective public health measures. Here, we examine factors that influence believing and sharing false information, both misinformation and disinformation, at individual, social, and contextual levels and discuss intervention possibilities.At the individual level, knowledge deficits, lack of skills, and emotional motivation have been associated with believing in false information. Lower health literacy, a conspiracy mindset and certain beliefs increase susceptibility to false information. At the social level, the credibility of information sources and social norms influence the sharing of false information. At the contextual level, emotions and the repetition of messages affect belief in and sharing of false information.Interventions at the individual level involve measures to improve knowledge and skills. At the social level, addressing social processes and social norms can reduce the sharing of false information. At the contextual level, regulatory approaches involving social networks is considered an important point of intervention.Social inequalities play an important role in the exposure to and processing of misinformation. It remains unclear to which degree the susceptibility to belief in and share misinformation is an individual characteristic and/or context dependent. Complex interventions are required that should take into account multiple influencing factors.

[Implementation of an Advanced Planning and Scheduling System in a pharmaceutical context]. / Mise en place d'un système de planification et d'ordonnancement avancé dans un contexte pharmaceutique.

Optimizing its supply chain has now become more than a necessity for any company seeking to expand its national and international market, so that it is able to continue its progress and fulfil its obligations towards its employees and its customers, particularly in the pharmaceutical context. The Covid-19 pandemic has shown the importance of resilience in the pharmaceutical industry to deal with unexpected disruptions and high demand from patients and authorities. Better production planning based on data management and predictive analysis, through the use of new Industry 4.0 tools, improves operational performance in terms of productivity and flexibility in relation to the vagaries of the request. It is in this vision that we approach the implementation of an "Advanced Planning and Scheduling -APS" system, in a pharmaceutical laboratory. It is a leading company in the Tunisian pharmaceutical market that seeks to expand its national and international market. In this work, we describe its project to implement an "Advanced Planning and Scheduling" system and its integration with its already functional "Enterprise Resource Planning" software system, as complementary decision-making tools.

When the digits don't add up: Research strategies for post-digital peacebuilding.

This article develops a post-digital perspective for the study of international peacebuilding and elaborates its merits. Contrary to narratives in policy and practice that tend to fetishize the digital, digital peacebuilding cannot be meaningfully separated from peacebuilding before digitalization. Resisting the call for a "digital turn," a post-digital lens helps to research, rewrite, and rework the digital while simultaneously staying with and moving beyond digitalization. It aims to demystify the role of digital technologies while enabling critical scrutiny of their impact on contemporary and future peacebuilding. More specifically, the post-digital helps us to (1) establish a critical distance to narratives of fast-paced innovation and progress that fetishize the digital, (2) scrutinize how digitalization compounds contemporary approaches and constellations of peacebuilding, (3) engage with the uneven temporalities of digital peacebuilding and its diverse global manifestations, (4) shed light on its real, embodied, and tangible effects on conflict-affected populations, (5) hold digitalization accountable by unearthing disillusionments and failures, (6) re-adjust our focus on human agency in the development and use of the socio-technical systems that constitute digital peacebuilding, (7) and finally, take a rhizomatic view that is concerned with how power relations make and break digitalized peacebuilding networks.

The effects of digitalisation on health and social care work: a qualitative descriptive study of the perceptions of professionals and managers.

BACKGROUND: Today, digitalisation is strongly present in health and social care, and it increasingly affects the organisation of work, work requirements, tasks and tools. Due to the constant change in work, up-to-date knowledge is needed about these micro-level effects of digitalisation and how professionals experience the effects in their work. Furthermore, even though managers play a key role in implementing new digital services, their perceptions of the effects of digitalisation and whether they match the views of professionals remain unknown. This study examined how health and social care professionals and managers perceive the effects of digitalisation on the work of professionals. METHODS: We used a qualitative approach and conducted eight semi-structured focus group interviews with health and social care professionals (n = 30) and 21 individual interviews with managers in 2020 in four health centres in Finland. The qualitative content analysis included both an inductive and a deductive approach. RESULTS: Digitalisation was perceived to have changed professionals' 1) workload and pace, 2) the field and nature of work, 3) work community communication and interaction, and 4) information flow and security. Both professionals and managers identified effects such as accelerated work, reduction in workload, constant learning of technical skills, complicated work due to vulnerable information systems, and reduction in face-to-face encounters. However, managers did not bring up all the effects that professionals considered important, such as the creation of new work tasks, increased and duplicated work, or insufficient time to get acquainted with the systems. CONCLUSIONS: The findings suggest that some of the effects of digitalisation on professionals' work and changes in the workplace may receive too little or no recognition from managers. This increases the risk that the potential negative effects may be overlooked and that managers will adopt systems that do not support the work of professionals. To reach a common understanding of the effects of digitalisation, continuous discussions between employees and different management levels are required. This contributes to professionals' well-being and adaptation to changes, as well as the provision of quality health and social services.

A Cost-Benefit Analysis Simulation for the Digitalisation of Cold Supply Chains.

This paper investigates using simulation to predict the benefits and costs of digitalising cold distribution chains. The study focuses on the distribution of refrigerated beef in the UK, where digitalisation was implemented to re-route cargo carriers. By comparing simulations of both digitalised and non-digitalised supply chains, the study found that digitalisation can reduce beef waste and decrease the number of miles driven per successful delivery, leading to potential cost savings. Note that this work is not attempting to prove that digitalisation is appropriate for the chosen scenario, only to justify a simulation approach as a decision making tool. The proposed modelling approach provides decision-makers with more accurate predictions of the cost-benefit of increased sensorisation in supply chains. By accounting for stochastic and variable parameters, such as weather and demand fluctuations, simulation can be used to identify potential challenges and estimate the economic benefits of digitalisation. Moreover, qualitative assessments of the impact on customer satisfaction and product quality can help decision-makers consider the broader impacts of digitalisation. Overall, the study suggests that simulation can play a crucial role in facilitating informed decisions about the implementation of digital technologies in the food supply chain. By providing a better understanding of the potential costs and benefits of digitalisation, simulation can help organisations make more strategic and effective decisions.

Field Evaluation of a Rising Plate Meter to Estimate Herbage Mass in Austrian Pastures.

Pasture management is an important topic for dairy farms with grazing systems. Herbage mass (HM) is a key measure, and estimations of HM content in pastures allow for informed decisions in pasture management. A common method of estimating the HM content in pastures requires manually collected grass samples, which are subjected to laboratory analysis to determine the dry matter (DM) content. However, in recent years, new methods have emerged that generate digital data and aim to expedite, facilitate and improve the measurement of HM. This study aimed to evaluate the accuracy of a rising plate meter (RPM) tool in a practical setting to estimate HM in Austrian pastures. With this study, we also attempted to answer whether the tool is ready for use by farmers with its default settings. This study was conducted on the teaching and research farm of the University of Veterinary Medicine in Vienna, Austria. Data were collected from May to October 2021 in five different pastures. To evaluate the accuracy of the RPM tool, grass samples were collected and dried in an oven to extract their DM and calculate the HM. The HM obtained from the grass samples was used as the gold standard for this study. In total, 3796 RPM measurements and 203 grass samples yielding 49 measurement points were used for the evaluation of the RPM tool. Despite the differences in pasture composition, the averaged HM from the RPM tool showed a strong correlation with the gold standard (R2 = 0.73, rp = 0.86, RMSE = 517.86, CV = 33.67%). However, the results may not be good enough to justify the use of the tool, because simulations in economic studies suggest that the error of prediction should be lower than 15%. Furthermore, in some pastures, the RPM obtained poor results, indicating an additional need for pasture-specific calibrations, which complicates the use of the RPM tool.

Assessment of COVID-19 Positive Rates Amongst COVID-19 Close Contacts Through the Health Risk Warning System.

From 6 Jan 22 to 17 Feb 22, a total of 729,367 close contacts classified into four distinct groups (i.e., household, social, school and nursing/ welfare home contacts) were managed by the Health Risk Warning system. High COVID-19-positive rates were demonstrated amongst household contacts, i.e., 10.9% (37,220/342,302) were detected via antigen rapid test kits and 56.5% (4,952/8,767) were detected via polymerase chain reaction testing. Household contacts represent the highest risk of being infected by virtue of the sustained close-proximity interactions in the household setting. Social, school and nursing/ welfare home contacts continue to remain at-risk groups for close monitoring. At a population level, household and symptomatic close contacts should be the groups of focus in the early phases of the pandemic, including future potential waves involving COVID-19 variants of concern.

COVID-19 Close Contact Management: An Evolution of Operations Harnessing the Digital Edge.

Singapore, like many other nations globally, had to contend with significant caseloads arising from the Coronavirus disease (COVID-19) pandemic. This paper focuses on using technology as an intervention for pandemic management. With scant scientific evidence on effective medications and vaccinations (i.e., pharmaceutical interventions) initially, disease containment strategies predominated during the early phases. Non-pharmaceutical interventions were critical in slowing disease transmission and preventing public healthcare institutions from being overwhelmed. Such interventions could be broadly divided into case-based interventions (e.g., contact tracing and quarantining of close contacts) and population-based measures (e.g., mask use and social distancing). The paper describes Singapore's experience in the operational implementation of contact-based interventions, and illustrates how harnessing the digital edge enabled fast, accurate, resource-efficient, and flexible execution of ground operations. Singapore applied digital technology and developed an integrated system to facilitate issuance and acknowledgement of quarantine orders, submission of COVID-19 test results, and collection of antigen rapid test kits at the population level. Data was obtained from this proprietary centralised, automated platform. The paper demonstrates how such simple, yet elegant systems could have a direct impact on disease transmission in an outbreak setting and on population health. Moving forward, it is recommended that technology and digital solutions feature prominently in work process designs beyond COVID-19 such as in the management of emerging infectious diseases and non-communicable diseases.

Deploying digitalisation and artificial intelligence in sustainable development research.

Many industrialised countries have benefited from the advent of twenty-first century technologies, especially automation, that have fundamentally changed manufacturing and industrial production processes. The next step in the evolution of automation is the development of artificial intelligence (AI), i.e. intelligence which is demonstrated by machines and systems, which cannot only perform tasks but also work synergistically with humans and nature. Intelligent systems that can see, analyse situations and respond sensitively to real-time cues, from human gestures and facial expressions to pedestrians crossing a busy street, will reshape transportation, precision agriculture, biodiversity conservation, environmental modelling, public health, construction and manufacturing, as well as initiatives designed to promote prosperity on Earth. This paper explores the connections between AI systems and sustainable development (SD) research. By means of a literature review, world survey, and case studies, ways in which AI can support research on SD and, inter alia, contribute to a more sustainable and equitable world, are identified.

Exploring artificial intelligence in the Nigerian medical educational space: An online cross-sectional study of perceptions, risks and benefits among students and lecturers from ten universities.

Background: The impact of artificial intelligence (AI) has been compared to that of the Internet and printing, evoking both apprehension and anticipation in an uncertain world. Objective: This study aimed to explore the perceptions of medical students and faculty members from ten universities across Nigeria regarding AI. Methods: Using Google Forms and WhatsApp, a cross-sectional online survey was administered to clinical year medical students and their lecturers from ten medical schools representing all the six geopolitical zones of Nigeria. Results: The survey received 1003 responses, of which 708 (70.7%) were from students and 294 (29.3%) were from lecturers. Both groups displayed an average level of knowledge, with students (Median:4, range -5 to 12) significantly outperforming lecturers (Median:3, range -5 to 15). Social media (61.2%) was the most common form of first contact with AI. Participants demonstrated a favourable attitude towards AI, with a median score of 6.8 out of 10. Grammar checkers (62.3%) were the most commonly reported AI tool used, while ChatGPT (43.6%) was the most frequently mentioned dedicated AI tool. Students were significantly more likely than lecturers to have used AI tools in the past but <5% of both groups had received prior AI training. Excitement about the potential of AI slightly outweighed concerns regarding future risks. A significantly higher proportion of students compared to lecturers believed that AI could dehumanise health care (70.6% vs. 60.8%), render physicians redundant (57.6% vs. 34.7%), diminish physicians' skills (79.3% vs. 71.3%) and ultimately harm patients (28.6% vs. 20.6%). Conclusion: The simultaneous fascination and apprehension with AI observed among both lecturers and students in our study mirrors the global trend. This finding was particularly evident in students who, despite possessing greater knowledge of AI compared to their lecturers, did not exhibit a corresponding reduction in their fear of AI.

Leading the digitalisation process in K-12 schools - The school leaders' perspective.

Digital technologies have increased worldwide in the last years. In addition, the pandemic has strengthened digital technologies' roles in education, requiring twenty-first-century skills, such as digital competence, and indicating a new normal. Digitalisation in education creates opportunities that could lead to positive effects if digital technologies are applied correctly. However, applying digital technologies can incorrectly trigger a negative development - for example, increasing workload due to nonfriendly user interfaces in software and reducing the motivation to apply digital technologies in education due to a lack of digital competence. Teachers require access to digital technologies and digital competence related to educational issues that influence equality within and among K-12 schools, thus making school leaders' roles crucial in digitalising education. Three group interviews and a survey were used to collect the data in a network of three municipalities in Sweden. The data have been categorised and analysed with thematic analysis. The results show that school leaders describe the digitalisation process in the form of digital competence for teachers, access to hardware and software, and a shared culture. School leaders explain that clear guidelines, collaboration between teachers, and enough time enable digitalisation in education. However, the lack of support and the lack of resources constrain digitalisation in education. At the same time, school leaders do not often discuss their own digital competence. The school leaders' roles in the digitalisation of K-12 schools are important, requiring digital competence for leading the digitalisation process.

Metarules, Judgment and the Algorithmic Future of Financial Regulation in the UK.

UK financial regulators are experimenting with the conversion of rulebook content into machine-readable and executable code. A major driver of these initiatives is the belief that the use of algorithms will eliminate the need for human interpretation as a deliberative process, and that this would be a welcome development because it will improve effectiveness while cutting time and costs for regulators and the industry alike. In this article, I set out to explain why human interpretation should be preserved and further harnessed if data-driven governance is to work at all. To support my thesis, I bring attention to the limited translatability of rulebook content into code, and to the difficulties for machines to engage with the full spectrum of tasks of analogical reasoning. I further contend that it would be desirable to preserve human interpretation on procedural grounds pertaining to the legitimacy of financial regulators. I conclude with recommendations about the future design of the financial rulebooks.

Suspension of face-to-face teaching and ad hoc transition to digital learning under Covid-19 conditions - a qualitative study among dental students and lecturers.

BACKGROUND: In mid-March 2020, the coronavirus pandemic led to a national lockdown in Germany. Face-to-face teaching was cancelled in universities for the 2020 summer semester. Teaching moved online with no prior IT testing and lecturer training. The study analyses experiences of the suspension of face-to-face teaching and the move to digitalised learning for students and lecturers of dentistry at Kiel. METHODS: In summer 2020, qualitative guided interviews were conducted with students (4th, 6th, 8th, and 10th semesters), and lecturers. Deductive and inductive qualitative content analysis of the results was carried out. RESULTS: Thirty-nine students (69% female) and 19 lecturers (32% female) were interviewed. Reactions to the changes in teaching were observed. Feelings ranged from an essentially positive attitude, through insecurity and uncertainty to a failure to fully appreciate the situation. The loss of social contact was lamented. Digitalisation was associated with technological challenges and additional work. However, it also fostered learning independent of time and place, and encouraged autonomy. Negative aspects of digitalisation included a lack of feedback and loss of interaction. CONCLUSION: The introduction of ad hoc digitalisation challenged both students and lecturers alike. Dealing with lockdown and the changes in teaching and studying required significant flexibility.