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2. Artificial Intelligence and Medical Trainees - Valuable Tool or Learning Impediment?

Author

Salehi, Shirin, Chen, Carolyn, Hu, Di, Tran, Brian, Leung, Kenneth, Pandita, Deepti, and Chow, Emilie

Subjects
artificial intelligence, medical education, clinical documentation, ambient artificial intelligence scribes, natural language processing
Abstract

Background ● Artificial intelligence (AI) assisted clinical documentation tools are becoming increasingly available across outpatient clinical settings● Voice to text recognition programs collect audio from patient-provider interactions and use AI to automatically generate notes documenting the encounter● These notes can then be made available in the electronic health record within minutes● Though these tools are available to attending physicians, there has been no research on attitudes regarding when such tools should be made available to medical trainees, such as medical students and residents● We surveyed US medical students, residents, and attending physicians regarding when such tools should be introduced to learners, if at all, and concerns around such tools Study Design● Cross-sectional survey● Setting: Single institution in the Pacific region● Study population: Medical students, residentphysicians, fellows, and attending physicians (179respondents)● Study timeline: Survey available 5/9/24-6/10/24● Data collection:○ Administered 15 question RedCap survey○ Assessed respondents demographic andprofessional characteristics, including gender, highest level of training, percent of time spent in outpatient practice, time spent on patient interactions, and time spent on clinical documentation● Study outcomes:○ Relationship between respondents’ demographic and professional characteristics and what level of training they felt that AI-assisted clinical documentation tools should be available to trainees, should enter the medical record, and specific concerns with regard to their use (not meeting documentation milestones, detriment to patient-provider experience, accuracy, bias, violation of patient privacy, detriment to forming differential diagnoses, detriment to forming plans, and concerns about using personal devices)● Statistical analysis:○ Chi-squared analysis to determine association between demographic/professional characteristics and outcomes with significance level set at p < 0.05○ Cramer’s values calculated to determine strength of association○ Descriptive characterisation of respondentsResults40% of female attending physicians believed that AI tools should not be available to trainees at all, compared to 25% of attending physicians overall and 17% of respondents in generalFemale respondents were far more likely to agree with the statement “I am concerned about AI-assisted clinical documentation violating patient privacy” and far less likely to agree with running the software on a personal deviceSummary● Attending physicians, particularly female attending physicians, felt that AI assisted clinical documentation tools should be introduced to trainees later on and were more likely to believe that trainees should not be able to generate notes using such tools● Female respondents were far more likely to have concerns about these tools adversely affecting trainees in achieving clinical documentation milestones and were far more likely to have concerns about privacy and use of personal devices surrounding these tools● Respondents who spent more time with patients (P = 0.01, Cramer’s value = 0.19) and more time writing notes (P = 0.03, Cramer’s value = 0.20) were less likely to believe that that AI-assisted clinical documentation tools should be available to trainees Limitations● Single institution survey● Responses restricted to provided survey options● Data not collected on experience with ambient clinicaldocumentation tools within cohort Discussion ● Previous research has shown that physicians and medical students have positive attitudes and a willingness to learn about AI tools in healthcare● However, our data suggests that attending physicians and female respondents in general have more concerns about privacy with regard to AI for clinical documentation tools and favor later introduction of such tools to trainees● While trainees are amenable to learning about AI tools, faculty may recommended delaying the introduction of these tools to residency or later● More research is needed to better understand why female physicians are more concerned about privacy with regard to AI tools and how these tools should be introduced to medical trainees● Next steps: conducting interviews with respondents for more nuanced recommendations/understanding of concernsReferencesAlZaabi A, AlMaskari S, AalAbdulsalam A. Are physicians and medical students ready for artificial intelligence applications in healthcare? DIGITAL HEALTH. 2023;9. doi:10.1177/20552076231152167Giavina-Bianchi M, Amaro Jr E, Machado BS, Medical Expectations of Physicians on AI Solutions in Daily Practice: Cross-Sectional Survey Study, JMIRx Med 2024;5:e50803, doi: 10.2196/50803Waheed MA, Liu L, Perceptions of Family Physicians About Applying AI in Primary Health Care: Case Study From a Premier Health Care Organization, JMIR AI 2024;3:e40781, doi: 10.2196/40781

Published
2024

16. Chapter 4 Design Options, Implementation Issues and Evaluating Success of Ecologically Engineered Shorelines

Author

Morris, Rebecca L., Heery, Eliza C., Loke, Lynette H.L., Lau, Edward, Strain, Elisabeth M.A., Airoldi, Laura, Alexander, Karen A., Bishop, Melanie J., Coleman, Ross A., Cordell, Jeffery R., Dong, Yun-Wei, Firth, Louise B., Hawkins, Stephen J., Heath, Tom, Kokora, Michael, Lee, Shing Yip, Miller, Jon K., Perkol-Finkel, Shimrit, Rella, Andrew, Steinberg, Peter D., Takeuchi, Ichiro, Thompson, Richard C., Todd, Peter A., and Leung, Kenneth M.Y.

Subjects
design, implementation, ecologically engineered shorelines, bic Book Industry Communication::R Earth sciences, geography, environment, planning
Abstract

Human population growth and accelerating coastal development have been the drivers for unprecedented construction of artificial structures along shorelines globally. Construction has been recently amplified by societal responses to reduce flood and erosion risks from rising sea levels and more extreme storms resulting from climate change. Such structures, leading to highly modified shorelines, deliver societal benefits, but they also create significant socioeconomic and environmental challenges. The planning, design and deployment of these coastal structures should aim to provide multiple goals through the application of ecoengineering to shoreline development. Such developments should be designed and built with the overarching objective of reducing negative impacts on nature, using hard, soft and hybrid ecological engineering approaches. The design of ecologically sensitive shorelines should be context-dependent and combine engineering, environmental and socioeconomic considerations. The costs and benefits of ecoengineered shoreline design options should be considered across all three of these disciplinary domains when setting objectives, informing plans for their subsequent maintenance and management and ultimately monitoring and evaluating their success. To date, successful ecoengineered shoreline projects have engaged with multiple stakeholders (e.g. architects, engineers, ecologists, coastal/port managers and the general public) during their conception and construction, but few have evaluated engineering, ecological and socioeconomic outcomes in a comprehensive manner. Increasing global awareness of climate change impacts (increased frequency or magnitude of extreme weather events and sea level rise), coupled with future predictions for coastal development (due to population growth leading to urban development and renewal, land reclamation and establishment of renewable energy infrastructure in the sea) will increase the demand for adaptive techniques to protect coastlines. In this review, we present an overview of current ecoengineered shoreline design options, the drivers and constraints that influence implementation and factors to consider when evaluating the success of such ecologically engineered shorelines.

Published
2019

27. Characterization and source apportionment of volatile organic compounds in Hong Kong: A 5-year study for three different archetypical sites

Author

Mai, Yuchen, Cheung, Vincent, Louie, Peter, K.K., Leung, Kenneth, Fung, Jimmy Chi Hung, Lau, Alexis Kai Hon, Blake, Donald R., Gu, Dasa, Mai, Yuchen, Cheung, Vincent, Louie, Peter, K.K., Leung, Kenneth, Fung, Jimmy Chi Hung, Lau, Alexis Kai Hon, Blake, Donald R., and Gu, Dasa

Abstract

Initial success has been achieved in Hong Kong in controlling primary air pollutants, but ambient ozone levels kept increasing during the past three decades. Volatile organic compounds (VOCs) are important for mitigating ozone pollution as its major precursors. This study analyzed VOC characteristics of roadside, suburban, and rural sites in Hong Kong to investigate their compositions, concentrations, and source contributions. Here we show that the TVOC concentrations were 23.05 ± 13.24, 12.68 ± 15.36, and 5.16 ± 5.48 ppbv for roadside, suburban, and rural sites between May 2015 to June 2019, respectively. By using Positive Matrix Factorization (PMF) model, six sources were identified at the roadside site over five years: Liquefied petroleum gas (LPG) usage (33–46%), gasoline evaporation (8–31%), aged air mass (11–28%), gasoline exhaust (5–16%), diesel exhaust (2–16%) and fuel filling (7–9%). Similarly, six sources were distinguished at the suburban site, including LPG usage (30–33%), solvent usage (20–26%), diesel exhaust (14–26%), gasoline evaporation (8–16%), aged air mass (4–11%), and biogenic emissions (2–5%). At the rural site, four sources were identified, including aged air mass (33–51%), solvent usage (25–30%), vehicular emissions (11–28%), and biogenic emissions (6–12%). The analysis further revealed that fuel filling and LPG usage were the primary contributors to OFP and OH reactivity at the roadside site, while solvent usage and biogenic emissions accounted for almost half of OFP and OH reactivity at the suburban and rural sites, respectively. These findings highlight the importance of identifying and characterizing VOC sources at different sites to help policymakers develop targeted measures for pollution mitigation in specific areas.

Published
2025

29. Fixing the Core, Earnings Management, and Sustainable Emergence From Financial Distress: Evidence From China's Special Treatment System.

Author

Jing, Jiao, Leung, Kenneth, Ng, Jeffrey, and Zhang, Janus Jian

Subjects
EARNINGS management, BUSINESS cycles, GOVERNMENT business enterprises, PSYCHOLOGICAL distress, INDUSTRIAL management
Abstract

Throughout their business life cycle, firms may experience financial distress. Successful emergence from such distress is important to their multiple stakeholders. Using a sample of publicly listed firms in China that emerged from Special Treatment (an indicator of delisting risk), we focus on the key actions such firms take prior to emergence, namely, fixing the core of the business and earnings management. We examine how these actions are associated with sustainable emergence, which we define as emergence from Special Treatment without reentry in the next 5 years. Consistent with the expectation that shortcut fixes to problems do not yield a long-term solution, we find that repairing the core of the business by improving operating efficiency is positively associated with sustainable emergence, whereas earnings management is negatively associated with it. We also find that the positive (negative) association between fixing the core (earnings management) and sustainable emergence is pronounced only for state-owned enterprises. Our article adds to the limited literature that examines issues related to distressed firms' sustainable turnaround. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Contributors

Author

Ajmal, Zeeshan, primary, Anis, Muhammad, additional, Arasavilli, Srija, additional, Asem, Dhaneshwaree, additional, Balasubramanian, Rajasekhar, additional, Bekele, Tadiyose Girma, additional, Bhagat, Chandrashekhar, additional, Bhattacharjee, Pritha, additional, Bhattacharya, Jayanta, additional, Bhushan, Mayank, additional, Biswal, Basanta Kumar, additional, Chakraborty, Samarshi, additional, Chand, Ravneel, additional, Chaudhuri, Punarbasu, additional, Chaudhuri, Rupa, additional, Chauhan, Sahil, additional, Chen, Xunfeng, additional, Chowdari, Jabili, additional, Chowdhury, Shamik, additional, Das, Chinmayee, additional, Deng, Linjing, additional, Dubey, Brajesh Kumar, additional, Ghangrekar, Makarand M., additional, Guhananthan, A., additional, Jiang, Xia, additional, John Horta, Mahima, additional, Kumar, Manish, additional, Kumar, Vajinder, additional, Kumari, Mahima, additional, Kuttykattil, Aswin, additional, Leung, Kenneth M.Y., additional, Lincy G., Mario Vino, additional, Liu, Mengyang, additional, Liu, Sisi, additional, Manik, Rima, additional, Menon, Manjula, additional, Mittal, Sunil, additional, Mohanraj, Rangaswamy, additional, Mukherjee, Tirtha, additional, Mukhopadhyay, Aniruddha, additional, Mwizerwa, Innocent Tayari, additional, N., Seetha, additional, Pal, Sukdeb, additional, Palanisami, Thavamani, additional, Patro, Ashmita, additional, Qadeer, Abdul, additional, Rajasekhar, Bokam, additional, Rajendran, Selvakumar, additional, Rosengren, Rhonda J., additional, Sachdeva, Saloni, additional, Sahoo, Prafulla Kumar, additional, Saravanan, Mridula, additional, Shafi, Tajamul, additional, Singh, L. Robindro, additional, Sivagami, Krishanasamy, additional, Subramanian, Aishwarya, additional, Taksal, Prakash Ajay, additional, Webb, Hunter D.J., additional, Wang, Shuhang, additional, Xingru, Zhao, additional, and Zhou, Pei, additional

Published
2023
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46. Spread of SARS-CoV-2 aerosols via two connected drainage stacks in a high-rise housing outbreak of COVID-19

Author

Wang, Qun, Lin, Zhang, Niu, Jianlei, Choi, Garnet Kwan-Yue, Fung, Jimmy C.H., Lau, Alexis K.H., Louie, Peter, Leung, Kenneth K.M., Huang, Jianxiang, Cheng, Pan, Zhao, Pengcheng, Chen, Wenzhao, Zhang, Sheng, Fu, Liye, Chan, PW, Wong, Ann Han, Tse, Herman, Wong, Sally Cheuk Ying, Lai, Raymond Wai Man, Hui, David SC, Yuen, Kwok-Yung, Lung, David Christopher, and Li, Yuguo

Published
2022
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49. Photodissociation of particulate nitrate as a source of daytime tropospheric Cl2

Author

Peng, Xiang, Wang, Tao, Wang, Weihao, Ravishankara, A. R., George, Christian, Xia, Men, Cai, Min, Li, Qinyi, Salvador, Christian Mark, Lau, Chiho, Lyu, Xiaopu, Poon, Chun Nan, Mellouki, Abdelwahid, Mu, Yujing, Hallquist, Mattias, Saiz-Lopez, Alfonso, Guo, Hai, Herrmann, Hartmut, Yu, Chuan, Dai, Jianing, Wang, Yanan, Wang, Xinke, Yu, Alfred, Leung, Kenneth, Lee, Shuncheng, and Chen, Jianmin

Published
2022
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