Viruses are ubiquitous in the environment. While many impart no deleterious effects on their hosts, several are major pathogens. This risk of pathogenicity, alongside the fact that many viruses can ...rapidly mutate highlights the need for suitable, rapid diagnostic measures. This review provides a critical analysis of widely used methods and examines their advantages and limitations. Currently, nucleic-acid detection and immunoassay methods are among the most popular means for quickly identifying viral infection directly from source. Nucleic acid-based detection generally offers high sensitivity, but can be time-consuming, costly, and require trained staff. The use of isothermal-based amplification systems for detection could aid in the reduction of results turnaround and equipment-associated costs, making them appealing for point-of-use applications, or when high volume/fast turnaround testing is required. Alternatively, immunoassays offer robustness and reduced costs. Furthermore, some immunoassay formats, such as those using lateral-flow technology, can generate results very rapidly. However, immunoassays typically cannot achieve comparable sensitivity to nucleic acid-based detection methods. Alongside these methods, the application of next-generation sequencing can provide highly specific results. In addition, the ability to sequence large numbers of viral genomes would provide researchers with enhanced information and assist in tracing infections.
Artificial intelligence (AI) systems have increasingly achieved expert-level performance in medical imaging applications. However, there is growing concern that such AI systems may reflect and ...amplify human bias, and reduce the quality of their performance in historically under-served populations such as female patients, Black patients, or patients of low socioeconomic status. Such biases are especially troubling in the context of underdiagnosis, whereby the AI algorithm would inaccurately label an individual with a disease as healthy, potentially delaying access to care. Here, we examine algorithmic underdiagnosis in chest X-ray pathology classification across three large chest X-ray datasets, as well as one multi-source dataset. We find that classifiers produced using state-of-the-art computer vision techniques consistently and selectively underdiagnosed under-served patient populations and that the underdiagnosis rate was higher for intersectional under-served subpopulations, for example, Hispanic female patients. Deployment of AI systems using medical imaging for disease diagnosis with such biases risks exacerbation of existing care biases and can potentially lead to unequal access to medical treatment, thereby raising ethical concerns for the use of these models in the clinic.
ABSTRACTIntroductionEffective medical staffing is pivotal for a successful healthcare system, demanding strategic planning to ensure a high‐quality service. Although the UK’s doctor to population ...ratio has improved over time, it remains below global averages. The COVID‐19 pandemic has exacerbated existing challenges, resulting in an unprecedented NHS waiting list with Ear, Nose, and Throat (ENT) surgeries ranking third highest in waiting times amongst all specialties.MethodsThis study utilized a national jotform survey to gather data from ENTUK members, primarily focusing on consultant staffing within ENT departments across the UK. Additional information collected encompassed registration status, part‐time roles, gender, vacancies, locum roles, associate specialists, registrars and other junior doctors, and advanced nurse practitioners. When survey responses were inadequate, direct communication was established with departmental consultants or secretaries, followed by Freedom of Information requests as necessary. All data were compiled using Microsoft Excel.ResultsAmong the 65 responses to the ENTUK survey, 53 individual trusts were identified. These included 41 English acute trusts, with supplementary participation from Scotland, Wales, and Northern Ireland. Data from 749 consultants across 115 English acute trusts were collected in combination with a Freedom of Information request.ConclusionDespite an increased number of ENT consultants, the persistence of unfilled posts coincides with mounting waiting lists. The pandemic’s effects, including early retirements and part‐time roles, emphasise the urgency of expanding training positions to counterbalance these shifts. Local and national interventions are essential to fortify and diversify the ENT workforce through a variety of strategies.
Medicine is a high-status, high-skill occupation which has traditionally provided access to good quality jobs and relatively high salaries. In Ireland, historic underfunding combined with ...austerity-related cutbacks has negatively impacted job quality to the extent that hospital medical jobs have begun to resemble extreme jobs. Extreme jobs combine components of a good quality job-high pay, high job control, challenging demands, with those of a low-quality job-long working hours, heavy workloads. Deteriorating job quality and the normalisation of extreme working is driving doctor emigration from Ireland and deterring return.
Semi-structured qualitative interviews were conducted with 40 Irish emigrant doctors in Australia who had emigrated from Ireland since 2008. Interviews were held in July-August 2018.
Respondents reflected on their experiences of working in the Irish health system, describing hospital workplaces that were understaffed, overstretched and within which extreme working had become normalised, particularly in relation to long working hours, fast working pace, doing more with less and fighting a climate of negativity. Drawing on Hirschman's work on exit, voice and loyalty (1970), the authors consider doctor emigration as exit and present respondent experiences of voice prior to emigration. Only 14/40 respondent emigrant doctors intend to return to work in Ireland.
The deterioration in medical job quality and the normalisation of extreme working is a key driver of doctor emigration from Ireland, and deterring return. Irish trained hospital doctors emigrate to access good quality jobs in Australia and are increasingly likely to remain abroad once they have secured them. To improve doctor retention, health systems and employers must mitigate a gainst the emergence of extreme work in healthcare. Employee voice (about working conditions, about patient safety, etc.) should be encouraged and used to inform health system improvement and to mitigate exit.
In this article, we argue that the ability of a firm to access a variety of knowledge resources and, in turn, upgrade its products depends on its being tied not simply to any or many organizations ...and institutions, but rather to those that act as social and knowledge bridges between previously isolated producer communities. Through a multimethod analysis of the recent transformation of the Argentine wine industry, we highlight how distinct governance rules for new government support institutions can anchor their multiplex, cross-cutting network qualities, which underpin their ability to provide improved collective resources and reshape the ties between firms.
Abstract Loss of mnemonic function is among the earliest and most disconcerting consequences of the aging process. This study was designed to provide a comprehensive profile of spatial mnemonic ...abilities in male Fischer 344 (F344) rats across the lifespan. Young, middle-aged, and aged F344 rats were trained in spatial reference and working memory versions of the water maze task. There was a progressive age-related decline in spatial reference memory across the lifespan. Reliable individual differences were observed among aged rats, with some aged rats performing as well as young cohorts and others performing outside this range. An age-related delay-dependent decline was observed on a working memory version of the water maze task although no relationship between performance on reference and working memory tasks was present. Notably, middle-aged rats were impaired relative to young on both tasks. Together these data demonstrate that individual differences in spatial reference memory exist among aged F344 rats and provide novel data demonstrating an unrelated decline in working memory across the lifespan, suggesting that age-related mnemonic dysfunction may occur across multiple brain systems.
A new class of metal-insulator tunneling transistor (MITT) devices is proposed and investigated. The planar dual-gate structure allows for complete gate field penetration of the transistor channel to ...modulate tunneling current across the channel. For a 5-nm channel length, with contact geometries that reflect the reality of fabricating at such a scale, we show that a 10% decrease in the effective electron tunneling length results in a <inline-formula> <tex-math notation="LaTeX">5.5\times </tex-math></inline-formula> increase in current up to <inline-formula> <tex-math notation="LaTeX">4.4{\times }10^{-6} mA/\mu {}m </tex-math></inline-formula>. The device demonstrates an ON-/ OFF-current ratio that is <inline-formula> <tex-math notation="LaTeX">2.5\times </tex-math></inline-formula> greater than that of a complementary metal-oxide-semiconductor (CMOS)-style MITT with a 5-nm channel length. Without the use of a second gate insulator, the source-to-drain current density is more than 10 4 times greater than the source-to-gate leakage current density, indicating the efficacy of the presented realistic MITT implementation.
Background. The rationale and lessons learned through the evolution of the National Survey for the Susceptibility of Bacteroides fragilis Group from its initiation in 1981 through 2007 are reviewed ...here. The survey was conceived in 1980 to track emerging antimicrobial resistance in Bacteroides species. Methods. Data from the last 11 years of the survey (1997–2007), including 6574 isolates from 13 medical centers, were analyzed for in vitro antimicrobial resistance to both frequently used and newly developed anti-anaerobic agents. The minimum inhibitory concentrations of the antibiotics were determined using agar dilution in accordance with Clinical and Laboratory Standards Institute recommendations. Results. The analyses revealed that the carbapenems (imipenem, meropenem, ertapenem, and doripenem) and piperacillin-tazobactam were the most active agents against these pathogens, with resistance rates of 0.9%–2.3%. In the most recent 3 years of the survey (2005–2007), resistance to some agents was shown to depend on the species, such as ampicillin-sulbactam against Bacteroides distasonis (20.6%) and tigecycline against Bacteroides uniformis and Bacteroides eggerthii (∼7%). Very high resistance rates (>50%) were noted for moxifloxacin and trovafloxacin, particularly against Bacteroides vulgatus. During that period of study, non-B. fragilis Bacteroides species had >40% resistance to clindamycin. Metronidazole-resistant Bacteroides strains were also first reported during that period. Conclusions. In summary, resistance to antibiotics was greater among non-B. fragilis Bacteroides species than among B. fragilis and was especially greater among species with a low frequency of isolation, such as Bacteroides caccae and B. uniformis. The emergence of resistance among the non-B. fragilis Bacteroides species underscores the need for speciation of B. fragilis group isolates and for clinicians to be aware of associations between species and drug resistance.
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