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This paper examines the rapid introduction of AI and automation technologies within essential industries amid the COVID-19 pandemic. Drawing on participant observation and interviews within two sites of waste labor in the United States, we consider the substantial effort performed by frontline workers who smooth the relationship between robotics and their social and material environment. Over the course of the research, we found workers engaged in continuous acts of calibration, troubleshooting, and repair required to support AI technologies over time. In interrogating these sites, we develop the concept of "patchwork": human labor that occurs in the space between what AI purports to do and what it actually accomplishes. We argue that it is necessary to consider the often-undervalued frontline work that makes up for AI's shortcomings during implementation, particularly as CSCW increasingly turns to discussions of Human-AI collaboration. © 2023 Owner/Author.
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With the worldwide spread of COVID-19, existing face-to-face activities, especially social activities, have been incorporated as part of online services in the pandemic era. Therefore, the digital divide that continues to change with the development of technology has also become a serious social problem in the aftermath of COVID-19. This study aims to illuminate how the divide in a more digitized society and changes in Internet use caused by COVID-19 affect satisfaction with social participation activities. The analysis revealed that the motivation to use digital devices has a static effect on satisfaction with social participation activities. The variance in Internet social participation due to COVID-19 showed a significant mediating effect between digital motivation and social participation satisfaction. Furthermore, mobile usage skills were found to have static moderating effects between digital motivation and variance in Internet social participation, digital motivation, and satisfaction with social participation. These results suggest that there is a clear gap in social participation according to individual digital capabilities in the spread of information and communication technology services after COVID-19. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Introduction: Obesity has been on the rise in children, adolescents and young adults during the Corona virus disesase-2019 (COVID-19) outbreak. Obesity is known as the main risk factor for a number of diseases including type 2 diabetes mellitus (T2DM) and more than 90 percent of T2DM patients are overweight or obese. Along with the rise in obesity during the COVID-19 pandemic, we investigated the impact of COVD-19 pandemic on type 2 diabetes in children and adolescents. Material(s) and Method(s): A retrospective case analysis of children and adolescents diagnosed with T2DM who visited Korea University Hospital in both 2019 and 2020. We investigated changes in weight and body mass index (BMI)-standard deviation scores (SDS), glycated hemoglobin (HbA1c), diabetic complications, and management from 2019 to 2020. Result(s): The Mean age of patients at study was 15.48 +/- 2.15 years old and the mean disease duration was 2.56 +/- 1.51 years. 70.6 % of patients were obese and the mean BMI-SDS was higher in 2020 than before the COVID-19 pandemic (2.21 +/- 1.25 vs 2.35 +/- 1.43, P=0.044). From 2019 to 2020, HbA1c level has also increased (6.5+/-2.72 mg/dL vs 7.3+/-3.70 mg/dL, P<0.001) and blood pressure (BP), total cholesterol, non-high density lipoprotein (HDL) cholesterol have also significantly increased. Obesity was found to be independent predictor of increased HbA1c in multivariable analysis (95% confidence interval 1.071-50.384, P=0.042). In non-obese subjects, HbA1c level has not significantly increased during the COVID-19 outbreak. In obese subjects, HbA1c and BMI-SDS have increased during the COVID-19 outbreak (6.45+/-2.30 mg/dL vs 7.20+/-3.05 mg/dL, P<0.001, 2.88 +/- 0.75 vs 3.08+/-0.98, P=0.045, respectively). Diastolic BP, total cholesterol were also higher in 2020 compared to 2019 (P=0.037, 0.019 repectively). Conclusion(s): During the COVID-19 outbreak, glycemic control and complications of type 2 DM have deteriorated in children and adolescents. This tendency was prominent in obese patients. Obese type 2 DM patients should be more closely monitored in glycemic control and complications.
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Background: Evolution toward remote lifestyles, including healthcare access, has accelerated due to the COVID-19 pandemic. Challenges related to participant recruitment and retention mean clinical trial design is also evolving toward a remote model where trials use digital health technologies and services to improve patient experience. A Decentralized Clinical Trial (DCT) is an emerging model where assessment of patients can occur outside of a traditional site, including at a patient's own home. Hybrid trials which incorporate some DCT components increase convenience and enhance accessibility to patients. Several professional organizations including the Clinical Trials Transformation Initiative and Decentralized Trials and Research Alliance advocate DCT design in clinical studies. Draft guidance on the use of digital health technology for remote data acquisition from participants in clinical trials has been recently issued by the FDA. They recognize that to improve participant recruitment and retention, and increase patient diversity, remote data collection can allow more frequent or even continuous data collection that may better represent real-world experience with the study drug. DCTs are particularly relevant for rare diseases such as PBC where patients may not be in close proximity to a specialist. In fact, 70% of patients with PBC surveyed indicated they would be more likely to participate in a clinical trial if remote options were available. Method(s): The Phase 3 GLISTEN trial (NCT04950127) is investigating the efficacy and safety of linerixibat for the treatment of cholestatic pruritus in patients with PBC. Several operating models are in place, including a fully decentralized option (Figure). DCT elements included in GLISTEN include digital recruitment of patients via social media/patient groups, remote completion of informed consent, telemedicine, electronic clinical and patient-reported outcome (PRO) assessments, home health visits, and direct shipment of study drug/placebo to the patient's home. The primary endpoint in GLISTEN is a PRO, making it compatible with a DCT approach. Result(s): Patient recruitment is ongoing;the study is active at physical study sites worldwide and as a fully remote DCT in the USA. Conclusion(s): Incorporation of DCT design elements into GLISTEN is expected to address the issues of limited numbers and diversity of patients recruited, which is particularly important for a rare disease such as PBC.
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Background/Case Studies: Platelet transfusions are an essential treatment for attenuating bleeding but are often ineffective in cases of intractable hemorrhage. Although anucleate, mature platelets synthesize protein de novo, making them amenable to mRNA gene therapy;however, there remains to be an effective transfection technique. Advancements in lipid nanoparticle (LNP) technology has enabled leading COVID vaccines and is an efficient method to deliver nucleic acids into target cells. Recently, a LNP approach to successfully express exogenous protein in donor platelets [unpublished data] has been developed, a first step towards demonstrating that donor platelet coagulability can be engineered. However, the effects of LNP treatment on platelet function has yet to be investigated. Study Design/Methods: Donated, pooled platelets were obtained from a regional blood for research centre. The hemostatic profiles of LNP-treated and clinical donor platelets were assessed using an adapted rotational thromboelastometry model of dilutional coagulopathy. Coagulability of whole blood (WB) and hemodiluted WB were assessed. Untreated and LNP-treated platelets were then supplemented into hemodiluted WB and activated using INTEM (ellagic acid) to generate a hemostatic profile. LNP-treated platelets were also stimulated with platelet agonists thrombin (0.1U/mL) and ADP (10 mM) and CD62p levels were evaluated to test if the activation response was similar to clinical platelets using flow cytometry. Statistical analysis was conducted by one-way ANOVA and significance defined by P < 0.05. Results/Findings: LNP-treated platelets have a comparable hemostatic profile to clinically transfused platelets and significantly contributed to clot strength when spiked into hemodiluted WB. After INTEM activation, the maximum clot firmness (MCF) of LNP-treated (45.67 +/-1.15) and untreated platelets (49.77 +/- 0.58) was significantly increased (P < 0.05) compared to diluted WB alone (35.00 +/- 1.00). No significant difference between untreated and LNP-treated donor platelets was observed although MCF trended down. No statistical difference in thrombin or ADP responsiveness, indicated by median fluorescent intensity of CD62p surface presentation, was observed between LNP treated and untreated platelets (P > 0.05). Conclusion(s): LNPs are an effective way to deliver exogenous nucleic acids into platelets;they do not significantly impair the platelet contribution to clot strength or responsiveness to agonists stimulation. The minimal effect of LNP exposure on in vitro platelet characteristics demonstrate that LNP engineering is a promising new approach to load platelets with nucleic acids encoding therapeutic protein to enhance their function.
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Background/Case Studies: Platelets are transfused therapeutically for hemostasis and are an integral part of hemorrhage management. Transfusions, however, can be ineffective in the most severe cases of hemorrhage. Platelets are also a potential cell therapy in other applications, but development has been hindered by inadequate methods to control which proteins are expressed by platelets. Currently, there are no methods to express exogenous proteins in transfusable platelets, which would expand their use to help treat the diseases they modulate. A method is therefore needed to modify transfusable platelets, and thus enhance their protein composition for specific applications. Lipid nanoparticles (LNPs) represent the most clinically advanced system for non-viral gene delivery, and can potentially be used to transfect donor-derived platelets with mRNA to produce transfusable platelets with an enhanced functional repertoire. The recent advances through the COVID-19 mRNA vaccines demonstrates the clinical safety and efficacy of LNP-mediated gene therapy, and thus offers a promising strategy to effectively engineer modified platelets. Study Design/Methods: Donor-derived platelets were washed and subsequently incubated with a systematic array of LNPs encapsulating Cy5-labeled mRNA encoding for nanoluciferase in comparison to the commercial transfection reagents, lipofectamine and Ribojuice. LNP uptake and platelet activation via CD62p levels was assessed following 4 h by flow cytometry, while nanoluciferase expression was assessed by normalizing the luminescence intensity (RLU) to the total protein content. Data was analyzed via a one-way unpaired Student or Welch's t-test or one-way analysis of variance (ANOVA) as appropriate. A p-value < 0.05 was considered significant. Results/Findings: Platelets internalized the mRNA through all conditions tested, with Ribojuice yielding the highest significant increase in Cy5 median fluorescence intensity relative to the LNP (59815 +/- 6466 A.U. vs. 1253 +/- 44 A.U., respectively, p = 0.002). Nanoluciferase was only expressed, however, in platelets treated with LNPs, yielding a normalized luminescence signal of 62 +/- 17 RLU/mug protein, and not with either of the commercial reagents. Systematically optimizing LNPs increased nanoluciferase expression nine-fold to 589 +/- 241 RLU/mug protein relative to pre-optimized LNPs (p = 0.031). A Pearson correlation analysis revealed that the expression of exogenous protein expression did not appear to correlate with the mRNA uptake (Pearson correlation coefficient, r = -0.35) nor platelet activation (r = -0.07). Conclusion(s): Transfecting platelets with LNPs containing mRNA enable the expression of exogenous protein. Further optimization can eventually lead to the creation of a platform technology that in the long-term will allow platelets to deliver therapeutic proteins and yield more effective platelet products.
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Introduction: Following assessment of the effectiveness and feasibility based on the results from a two-year population-based nationwide prospective multi-center trial, the Korean government implemented a national lung cancer screening program using low-dose computed tomography (LDCT) for high-risk smokers in 2019. Methods: National Health Insurance Corporation selected high risk targets who are current smokers aged 54 to 74 years with 30 packs per year or more smoking history on the basis of national health-screening database. (Figure 1). Those eligible were offered lung cancer screening by invitation letters in every two years. Screening units provide LDCT using radiation less than 3mGy by at least 16-row multi-detector CT scanners. Screening results were reported by Lung Imaging Reporting and Data System (Lung-RADS). The examinee received results by mail or e-mail;after then, counseling on results and mandatory smoking cessation counselling were provided by certified doctors. National Cancer Center monitored participation rates, post-counseling rates and statistics of screening result for quality control. Screening positive rate is defined as proportion of Lung-RADS category 3 and 4 nodules. Results: The participation rate gradually increased from 24.8% among 332,244 eligible targets in 2019, 25.9% in 2020, to 38.7% among 310,260 targets in 2021, however, the proportion of examinees who participated in post-counseling decreased from 46.3% in 2019 to 32.7% in 2021 due to the COVID-19 pandemic (Figure 2). The positive rates slightly decreased from 9.2% in 2019 to 8.7% in 2021. The variation in positive rates of screening units showed a tendency to decrease (in 2019, the 1st quartile was 4.3%, and the 3rd quartile was 12.9%;and in 2021, 5.2% and 12.5% respectively). Conclusions: National lung cancer screening program has been implemented successfully in Korea with controlling screening positive rates not so high. Controlling false negatives and strengthening post-screening management including smoking cessation counselling needs to improve. [Formula presented] [Formula presented] Keywords: National Lung Cancer Screening, Quality control
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Background: There is still controversy about the efficacy of COVID-19 vaccination and its extent in lowering immunogenicity of Rheumatoid Arthritis (RA) patients. The guideline in whether immunosuppressive agents need to be discontinued before the vaccination is continuously updated because it is considered to lower immunogenicity. Furthermore, there is great discussion on the effectiveness of the COVID-19 booster vaccine and interest in antibody generation in different types of vaccine, as in South Korea there are many patients who were prescribed the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine. Objectives: Thus, we investigated the differences of antibody production between patients who received only two doses of ChAdOx1-S nCoV-19 and those who received the mRNA booster vaccine. Also, antibody production under different types of immunosuppressive agents was analyzed. Methods: From October 14, 2021 to January 21, 2022 at a tertiary referral center, two patient groups diagnosed with RA were studied prospectively;one group that completed 1st and 2nd doses of ChAdOx1-S nCoV-19 vaccine, second group that completed mRNA booster vaccine as well as two doses of ChAdOx1-S nCoV-19 vaccine. SARS-CoV-2 antibody testing on the semiquantitative anti-SARS-CoV-2 S enzyme immunoassay was done, and differences in antibody titers were analyzed in patients who received different immunosup-pressive agents such as csDMARD, TNF inhibitor, JAK inhibitor, Tocilizumab, Abatacept and Corticosteroid. Statistical analysis with a multivariate logistic regression model was performed. Results: In a total of 261 patients, 153 patients had completed two doses of ChAdOx1-S nCoV-19, 108 patients had completed third mRNA booster vaccine. Anti-SARS-CoV-2 RBD antibody positive rate (titer>0.8U/mL) was 97%(149/153) and 99%(107/108) respectively, and only 5 patients showed negative result. In the aspect of high antibody titer(>250U/mL), which is the upper limit of the RBD antibody immunoassay, the result showed rate of 31% (47/153) in the non-booster group and 94%(102/108) in the booster group respectively. Among the different immunosuppressive agents and other clinical aspects, multivariate analysis revealed that corticosteroid use (OR 0.91;95% CI: 0.86-0.98), older age(OR 4.33;95% CI: 1.34-13.91), and male gender(OR 0.35;95% CI 0.16-0.75) were signifcantly associated with low rate of high antibody titer. Furthermore, out of 14 patients who underwent antibody test twice before and after the mRNA booster vaccine, other than four patients who already showed high titer of >250U/mL before the mRNA booster vaccine, 10 patients showed an increase in titer after the booster vaccine and 7 patients were acquired high titer of >250U/mL. Conclusion: Anti-SARS-CoV-2 RBD antibody positive rate was 97% or more regardless of the mRNA booster vaccination. However, patients who received the mRNA booster vaccine after two doses of ChAdOx1-S nCoV-19 vaccine showed high antibody titer (>250U/mL) three times more than those who did not receive the booster shot. Our fndings also showed that corticosteroid use, old age, and male gender is signifcantly associated with low rate of acquiring high antibody titer.
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This paper aims to elevate essential worker accounts of the introduction of AI technology amid the COVID-19 pandemic. Drawing from a mix of ethnographic observations, interviews, and participatory design encounters with frontline staff, we examine the experiences of workers in a waste management facility in the United States newly tasked with overseeing autonomous floor cleaning robots. To complement and extend managerial and engineering descriptions emphasizing the functionality and performance of these devices, we used recuperative approaches to re-center the socio-material realities of workers on-the-ground. For example, workers reported concerns on the safety of the devices in congested areas and a need for more comprehensive training across all levels of the organization. This research seeks to expand the discourse on ethical AI by situating essential workers as a key source in developing best practices for deploying new technologies and evaluating pilot projects. © 2022 Owner/Author.