Using Knowledge Graphs and Human-Centric Artificial Intelligence for Reconfigurable Supply Chains: A Research Framework

Reconfigurable supply chains received increasing interest from academia and industry in the past years, especially because recent events such as the COVID-19 pandemic revealed the vulnerability of present supply chains. Especially the rapid digitalization and the emergence of artificial intelligence in supply chain management create new opportunities for implementing reconfigurable supply chains. In this paper, we propose a concept that uses a knowledge graph and graph-based artificial intelligence to recommend reconfigurations of the supply chain. Due to the importance of these strategic decisions, the concept considers a humancentric approach using a recommender system. The knowledge graph exploits the inherent graph structure of supply chains to create a machine-readable and human-understandable database that also supports reasoning. Finally, we provide three research hypotheses and examine the integration of open-source knowledge graphs and news monitoring tools. Copyright (C) 2022 The Authors.

COVID-19 in CHILDREN: WORSENING OUTCOMES during DELTA VARIANT WAVE

Background: Pediatric cases of COVID-19 surged in the summer/fall of 2021 coinciding with the SARS-CoV-2 Delta variant. It is unclear whether the Delta variant caused more severe illness among pediatric patients. We leveraged the Children and COVID-19 in Colorado database to determine whether differences exist in demographics, underlying comorbidities, and outcomes among children requiring hospital admission due to the SARS-CoV-2 Delta variant vs. wild type virus. Methods: We performed a retrospective review of children <21 years with symptomatic COVID-19 and detectable SARS-CoV-2 NAAT hospitalized at Children's Hospital Colorado during pre-Delta (Mar-Nov 2020) and Delta (Jun-Sep 2021) periods. We compared variables using Fisher's exact or Pearson's chi square tests for categorical variables and Wilcoxon rank sum tests for continuous variables. Results: There were 119 children hospitalized with symptomatic COVID-19 during the pre-Delta and 137 in the Delta period. There was a slight male predominance in both periods. Children hospitalized during the Delta period were younger, with median (interquartile range) age of 5.9 (1.0-14.5) vs. 12.2 (1.5-16.9) years, p=0.02;and were less likely to identify as Hispanic and Spanish-speaking, compared to the pre-Delta period (Table). There was a trend toward decreasing proportions of hospitalized children with underlying comorbidities in the Delta vs. pre-Delta period (59.1% vs. 69.8%;p=0.07). The most prevalent types of comorbidities were similar between periods;but the proportion of hospitalized immunocompromised patients was lower in the Delta vs. pre-Delta period (p=0.005). Half of all children were overweight/obese in both periods. Similar proportions of hospitalized children required respiratory support in both periods, but more children required intensive care in the Delta vs. pre-Delta periods (36.5% vs. 23.5%, p=0.03). Conclusion: Children hospitalized with the Delta variant of COVID-19 were younger, less likely to be Hispanic, and had fewer comorbidities than children hospitalized with wild type SARS-CoV-2. Children hospitalized with the Delta variant were more likely to require ICU admission compared to children hospitalized with wild type SARS-CoV-2, which may indicate increased severity of the Delta variant in the pediatric population. Close monitoring of pediatric outcomes is needed as new SARS-CoV-2 variants emerge.

Implementation of a Telephone-Based Cognitive Rehabilitation Group for Older Adult Veterans

Background: Cognitive rehabilitation group therapies, such as Motivationally Enhanced Compensatory Cognitive Training for Mild Cognitive Impairment (ME-CCT-MCI), are associated with improvements in cognitive functioning, cognitive complaints, and subjective daily functioning domains. While traditionally delivered via in-person, the COVID-19 pandemic resulted in a transition to video visit delivery by many providers and health organizations, including the VA. However, many older adults are unable to participate in video telehealth due to low technological literacy or lack of internet access. Expanding dissemination approaches to include telephone- based delivery may improve access to cognitive rehabilitation services for many older adults. This study assessed the feasibility, acceptability, and preliminary efficacy of an 8-week, telephone-based ME-CCT-MCI group for older adult veterans without technical literacy during the COVID-19 pandemic. Methods: A convenience sample of eleven older adult veterans (Mage=77.72, SD=4.12) with subjective memory complaints and stated inability to use the VA's Video Connect system for video visits was recruited from geriatric clinics within a Veterans Affairs Medical Center. Two rounds of 8-week ME-CCT-MCI groups were conducted, with each group meeting by telephone for one hour a week. Participants completed a battery of measures before and after participation and change over time was evaluated using paired samples t-tests. Measures included the Montreal Cognitive Assessment - Blind, Multifactorial Memory Questionnaire, Geriatric Depression Scale, Geriatric Anxiety Scale, Short Form Health Survey (SF-12) and a group satisfaction questionnaire. Results: Feasibility was demonstrated through good rates of session attendance (M = 6.72 out of 8 sessions), and acceptability was demonstrated through excellent self-reported measures of group satisfaction (M = 9.18/10). Participants demonstrated significant improvements in cognitive functioning (p = .03), subjective memory satisfaction (p = .01) and subjective memory abilities (p < .01) between pre-test and post-test measures. No differences were found for subjective memory strategies, depression, anxiety, or perceived health. Conclusions: Findings offer preliminary support for the feasibility, acceptability, and efficacy of telephone-based ME-CCT-MCI for technologically unready older veterans.

Qualitative Description of Synchronous Online Discussions During Weekly Academic Conference

Study Objectives: COVID-19 dramatically changed weekly academic conferences with virtual presentations replacing in-person didactics. Through group chat functions, modern communication platforms provide the opportunity for synchronous online discussions to occur in parallel with didactic presentations. We sought to qualitatively characterize the content, nature, and educational uses of synchronous online discussions occurring during weekly academic conferences and to assess the attitudes of lecturers and audience members towards these discussions. Methods: Transcripts of synchronous online discussions occurring from 7/1/20 to 12/31/20 were qualitatively analyzed using a grounded theory approach. Initial themes were identified by the primary author. Following a preliminary coding by the study authors, the themes were iteratively refined to arrive at a final coding strategy. Each month’s transcripts were coded by 2 study authors. When there was disagreement between coders, the primary author made a final coding determination. Following the study period, a survey distributed to residents and faculty assessed attitudes towards the synchronous online discussions. Results: The qualitative analysis of the transcripts identified 2352 coded messages. The final coding schema can be seen in Figure 1. Of 1720 identified content codes, the most commonly identified themes were cultural communications (40.8%) and knowledge sharing (39.0%). Within the broader theme of knowledge sharing, participants were most likely to share individual practice experience (366/671 codes). Statements with uncited data/evidence (113 codes) occurred in similar frequency to sharing of academic resources (137 codes). Questions directed towards other members of the audience (48.8% of questions) were only slightly less common than questions directed to the lecturer (51.2% of questions). There were 56 respondents to the survey (30 residents, 25 faculty, 1 fellow). Of the 44 respondents that had presented didactics, 54.5% (24/44) identified that it was challenging to keep up with the synchronous online discussion. From the perspective of the audience, 82.1% (46/56) felt it was easy to keep up with the discussion. Presenters of didactics felt identifying a member of the audience as a surrogate was the easiest means to keep up with the discussion (75%, 33/44 presenters). Audience members agreed that they were much more likely to ask a question in a synchronous online discussion as opposed to speaking out loud (71.4%, 40/56). Conclusions: Weekly academic conferences are a critical component of residency education, enabling not only the acquisition of knowledge but also the social sharing of knowledge/experiences developing of robust communities of practice. Our qualitative analysis found that cultural communication occurred with near equal frequency to knowledge sharing and that sharing of individual practice experiences was more common than sharing of academic resources. These synchronous online discussions may make it more likely for audience members to ask questions of each other or the lecturer but keeping up with the discussion was challenging for lecturers. [Formula presented]

Prospective assessment of employees stress during the COVID-19 pandemic

Purpose or Objective: The COVID-19 pandemic has required rapid and repetitive adjustment of radiotherapy practice, hospital and department organization and hygienic measures. This has been in parallel with significant changes in everyone’s private life. In the Department of Radiation Oncology, University Zurich, all employees were invited to participate in weekly assessments of their stress levels, aiming to rapidly and precisely implement anti-stress measures. Materials and Methods: Starting from March 31st 2020, weekly anonymized surveys were distributed to all employees (n=134) of the Department of Radiation Oncology, University of Zurich. Survey Monkey was used, and distribution was performed via email. The survey asked about the profession (clinician, medical physics and dosimetry, RTT, nurse, administration and research) and whether work in the last week was performed in hospital with or without patient contact or in home office. Global stress level during the last week was assessed on a 10-point scale. Additionally, stress was assessed in the sub-categories: concerns about own health;concerns about health of family & friends;concerns about patients` health. Results: Between March 31st 2020 and February 17th 2021, a total of 47 surveys resulted in 1733 responses, 37 responses on average (range 26 and 54). Response rate was 28% on average and did not change over time, overall and in each profession. Averaged over all responses, the global stress level varied substantially between professions, ranging between 2.8 for administration and 6.8 for RTTs. The global stress level was highest for in-hospital work with patient contact with an average of 4.7, whereas stress was similar for in-hospital work without patient contact and home-office with 3.5 and 3.8, respectively. Concerns about health were highest about family & friends with 4.0 on average compared to concerns about the own health and of the patients with average values of 3.1 and 3.5, respectively. Changes of global stress level over the 47 weeks were strongly associated with development of the pandemic (figure). Averaged over all employees, the global stress level stated with 4.8 on average in March 2020 and dropped continuously in the spring and summer months until the second COVID-19 wave started in September 2020 with two peaks in November and December with 5.5 and 5.7 on average, respectively. Interventions against high stress levels were performed for all professions and especially the RTT subgroup with highest stress levels (workshops;meditation room;detailed information about hospital-specific infection rates;information about hospital wide possibilities for coping mechanisms, effectiveness of PPE;team meetings).

[Effects of the SARS-CoV­2 pandemic on the otolaryngology university hospitals in the field of research, student teaching and specialist training]. / Auswirkungen der SARS-CoV­2-Pandemie auf die universitäre Hals-Nasen-Ohren-Heilkunde im Bereich der Forschung, Lehre und Weiterbildung.

BACKGROUND: From spring 2020, SARS-CoV­2 began to spread worldwide, with what is now known as the first wave of the pandemic, starting in March 2020. This resulted in restructuring and shift of resources at many hospitals. The aim of our work was to detect the effects of the pandemic on the german Oto-Rhino-Laryngology (ORL) university hospitals in terms of research, student teaching and further specialist training. MATERIAL AND METHODS: The chairmen of the 39 ORL university hospitals in Germany were asked about the effects of the pandemic on research, student teaching and ORL specialist training (residency) in the period from March to April 2020 using a structured online survey. RESULTS: All 39 chairmen took part in the survey. Of these, 74.4% (29/39) stated that their research activities had deteriorated as a result of the pandemic. In 61.5% (24/39) pandemic-related research issues were addressed. All hospitals reported a restriction for in-house teaching and 97.5% (38/39) introduced new digital teaching methods. During the observation period, 74.4% of the chairmen did not see ORL specialist training (residency)at risk. CONCLUSION: Our results provide an insight into the heterogeneous effects of the pandemic. The fast processing of pandemic-related research topics and the introduction of innovative digital concepts for student teaching impressively demonstrates the great innovative potential and the ability of the ORL university hospitals to react quickly in order to maintain their tasks in research, student teaching and ORL specialist training in the best possible way even during the pandemic.

Potential of blockchain technology for supply chain and purchasing

Covid 19 and the increasing risk of trade wars are putting established supply chains under pressure. One consequence is that new suppliers may have to be found at very short notice. Following this, it would be helpful if certifications that international suppliers claim to have, could be checked quickly. At this point, blockchain technology could be very helpful. On that base the managers at NETZSCH Pumpen & Systeme GmbH have scientifically investigated possible applications for the use of blockchain technology in the areas of supply chain and purchasing. © 2020, G I T O Verlag. All rights reserved.

[Effects of the SARS-CoV-2 pandemic on the otorhinolaryngology university hospitals in the field of medical care]. / Auswirkungen der SARS-CoV-2-Pandemie auf die universitäre Hals-Nasen-Ohrenheilkunde im Bereich der Krankenversorgung.

INTRODUCTION: Since December 2019, the SARS-CoV-2 virus has been rapidly spreading worldwide. In Germany, an exponential increase in the number of infections was registered at the beginning of March 2020 and led to a call of the Ministry of Health to create more capacity for intensive medical treatment in hospitals. The aim of the present study was to determine the effects of the SARS-CoV-2 pandemic on Oto-Rhino-Laryngology (ORL) university hospitals regarding patient care. MATERIALS AND METHODS: An online survey was sent out to all chairmen of the 39 ORL university hospitals in Germany. The answers to the questions referred to the defined period from March 15th to April 15th 2020 and were carried out using the online survey tool "SurveyMonkey". 87 questions focused on general information, health care, and structural effects in the respective institution. RESULTS: All chairmen of the 39 university hospitals in Germany participated in the survey. The collected data prove the considerable impact on organizational, structural and medical aspects of patient care. For example, the surveyed clinics reported a decrease in outpatient cases by 73.8 % to 26.2 ±â€Š14.2 % and in surgical treatments by 65.9 % to 34.1 ±â€Š13.9 %. In contrast, emergency treatment remained unchanged or even increased in 80 % of the facilities and surgical treatment of emergency patients remained unchanged or even increased in more than 90 %. Emergency outpatient and surgical treatment of patients was provided throughout the pandemic in all facilities. In total, about 35 000 outpatients and about 12 000 surgical cases were postponed. As a result of the acute structural changes, the potential danger of falling below current treatment standards was seen in individual areas of patient care. DISCUSSION: The assessment of the impact of the SARS-CoV-2 pandemic is heterogeneous. The majority of the chairmen are critically aware of the risk of falling below current medical treatment standards or guidelines. In the phase of an exponential increase in the number of infections, significant changes in treatment processes had to be accepted for understandable reasons. However, with the currently significantly reduced number of infections, falling below treatment standards and guidelines should not be allowed to remain constant and tolerated. SUMMARY: This study shows a differentiated picture with regard to the effects of the SARS-CoV-2 pandemic on outpatient, inpatient and operative patient care at the ORL university hospitals in Germany and illustrates the importance of these institutions for ensuring patient care during this critical phase.