Actual Steps Research Articles

Clipping via the Transsylvian Approach:From Basic to Advanced Surgical Techniques

The transsylvian approach is one of the most commonly used approaches in neurosurgery and is essential for clipping aneurysms located in the anterior cranial circulation, such as the middle cerebral artery, internal carotid artery, and anterior communicating artery. Moreover, basilar artery aneurysms can be clipped using this approach, albeit with some modifications. Important tips for dissecting the Sylvian fissures include reliable visualization, anatomical recognition, and steady manipulation. The actual steps are as follows: determine the affiliation of the arteries and veins, gently move the brain to create a wide space, cut the arachnoid mater, and follow the course of the arteries. In case of subarachnoid hemorrhage, irrigation and flushing out the hematoma is the key step involved in recognizing the structure and safely performing surgery. Here, we describe the basic key operative techniques for performing clipping via the transsylvian approach.

The difficulties and solutions in operationalising a hybrid operating room.

As the population ages and grows, health services must evolve in ways to offer versatile patient care, whilst improving patient outcomes and maintaining long-term economic viability. A facility assisting in the provision of such healthcare is the hybrid operating room (HOR): a specialised suite allowing simultaneous radiological and surgical diagnostics and therapeutics in a single episode of care. Versatile and customizable, the HOR is utilised by a broad range of subspecialties in elective and emergency settings, including (but not limited to) vascular surgery, trauma surgery and interventional radiology. Though the benefits of hybrid techniques to patient care are well known, the actual steps in operationalising the HOR can be challenging if not considered and coordinated appropriately. The intention of this narrative review is to highlight issues and suggest solutions in the design and commissioning of an HOR. Key areas in need of specific attention include stakeholder involvement, economic feasibility, suite location, workflow planning, hybrid equipment choice, and team organisation.

Halal Labels and Religious Commitment: Their Impact on Bottled Water Purchases

Research Aims: To determine how halal labelling affects purchasing decisions for bottled drinking water products among Muslim students in Solo Design/methodology/approach: The study used quantitative descriptive analysis with primary data. The data analysis method used multiple linear regression analysis with independent variables, namely halal labelling (X1) and religiosity (X2). The number of samples in the study was 183 respondents. This study uses a purposive sampling technique with specific criteria. The study's dependent variable (Y) is the decision to purchase bottled drinking water Research Findings: halal labelling and religiosity have a positive and significant effect on customer decisions to buy bottled mineral water drinks. The value of the coefficient of determination concluded that the contribution of the independent variables in the regression model can explain the variation of the dependent variable by 48,6%. In contrast, the rest is explained by other variables outside the regression equation model. Based on the analysis results, actual steps need to follow up on purchasing decisions for halal bottled drinking water products, one of which is that the university can provide and facilitate the availability of bottled drinking water (AMDK) products on the campus. Besides increasing awareness of halal drinking water, it can also positively impact the development of halal products in universities in Solo. Theoretical Contribution/Originality: The research highlights the simultaneous and partial influence of halal labelling and religiosity on purchasing decisions for bottled drinking water in universities in Solo. This adds a nuanced understanding of consumer behavior in a specific religious and educational context. The study emphasizes the need for further research into the urgency of providing halal AMDK, suggesting that such products are crucial for consumer assurance. This calls attention to a potentially underserved market segment. Keywords: Halal Label, Religiosity, Purchase Decision, Bottled Drinking Water.

Visual Illusion Created by a Striped Pattern Through Augmented Reality for the Prevention of Tumbling on Stairs.

A fall on stairs can be a dangerous accident. An important indicator of falling risk is the foot clearance, which is the height of the foot when ascending stairs or the distance of the foot from the step when descending. We developed an augmented reality system with a holographic lens using a visual illusion to improve the foot clearance on stairs. The system draws a vertical striped pattern on the stair riser as the participant ascends the stairs to create the illusion that the steps are higher than the actual steps, and draws a horizontal striped pattern on the stair tread as the participant descends the stairs to create the illusion of narrower stairs. We experimentally evaluated the accuracy of the system and fitted a model to determine the appropriate stripe thickness. Finally, participants ascended and descended stairs before, during, and after using the augmented reality system. The foot clearance significantly improved, not only while the participants used the system but also after they used the system compared with before.

Detection of ChatGPT fake science with the xFakeSci learning algorithm

Generative AI tools exemplified by ChatGPT are becoming a new reality. This study is motivated by the premise that “AI generated content may exhibit a distinctive behavior that can be separated from scientific articles”. In this study, we show how articles can be generated using means of prompt engineering for various diseases and conditions. We then show how we tested this premise in two phases and prove its validity. Subsequently, we introduce xFakeSci, a novel learning algorithm, that is capable of distinguishing ChatGPT-generated articles from publications produced by scientists. The algorithm is trained using network models driven from both sources. To mitigate overfitting issues, we incorporated a calibration step that is built upon data-driven heuristics, including proximity and ratios. Specifically, from a total of a 3952 fake articles for three different medical conditions, the algorithm was trained using only 100 articles, but calibrated using folds of 100 articles. As for the classification step, it was performed using 300 articles per condition. The actual label steps took place against an equal mix of 50 generated articles and 50 authentic PubMed abstracts. The testing also spanned publication periods from 2010 to 2024 and encompassed research on three distinct diseases: cancer, depression, and Alzheimer’s. Further, we evaluated the accuracy of the xFakeSci algorithm against some of the classical data mining algorithms (e.g., Support Vector Machines, Regression, and Naive Bayes). The xFakeSci algorithm achieved F1 scores ranging from 80 to 94%, outperforming common data mining algorithms, which scored F1 values between 38 and 52%. We attribute the noticeable difference to the introduction of calibration and a proximity distance heuristic, which underscores this promising performance. Indeed, the prediction of fake science generated by ChatGPT presents a considerable challenge. Nonetheless, the introduction of the xFakeSci algorithm is a significant step on the way to combating fake science.

The effects of resolution method of child custody and support plans on parental well‐being during the divorce process: Implications from and for divorce education

AbstractThe majority of research on the impact of divorce on parents, children, and families focuses on what occurs after the divorce has been finalized. However, data derived from divorce education programs present opportunities for research on the experience of parents during the divorce process. Guided by the divorce‐stress‐adjustment model, this study sought to understand how the divorce process impacts parental well‐being by examining some of the most pressing child‐related concerns divorcing parents have while going through a divorce. Specifically, we looked at how the approach parents took to resolve child‐related issues (i.e., internally, through outside intervention, or unresolved) was related to the perceived fairness of child custody arrangements, parental concerns regarding how divorce impacts children, financial concerns, and their overall well‐being. Perceived fairness of the child custody arrangement, concerns regarding how divorce impacts children, and financial concerns were associated with parental well‐being, and also served as an indirect path through which approaches to resolve child‐related issues impacted parental well‐being. Understanding what parents think and feel during the divorce process, and how those thoughts and feelings are related to the actual steps to getting a divorce, could help inform divorce education typically administered as part of divorce proceedings.

Association of Daily Step Count With Patient Knowledge, Step Tracking, and Physical Factors in Patients With Spine Pathology

Up to 10,000 steps per day may be associated with lower risk of all-cause mortality as well as cancer and cardiovascular disease mortality. Here, we evaluate daily step count in patients seen in spine clinic and its association with step goal knowledge, step tracking, and physical factors affecting walking. Of the 575 clinic patients, 368 met criteria and agreed to participate (mean age range 60-69 years; 52% female; 54% prior spine surgery). Of the population surveyed for actual daily steps, 55% reported <2000 and 9% reported >8000. Patients with a higher knowledge of the ideal step goal and who possessed a step counter (64%) had a higher number of actual daily steps ( P < .001). The main prohibiting factor to actual walking was pain (64%). Prior spine surgery and the use of a walking assist was associated with less daily steps ( P < .04, 6% reported >8000 steps; and P < .001, 0% reported >8000 steps, respectively). Patients presenting for evaluation in spine clinic underestimate the recommended number of steps taken daily to help decrease all-cause mortality, and cancer and cardiovascular disease mortality.

Accuracy of wrist-worn activity trackers for measuring steps in patients after major abdominal surgery: A validation study.

Wearable activity trackers provide a simple and objective measurement of postoperative mobilization. However, few have validated the accuracy of trackers in patients after major abdominal surgery. To examine the accuracy of wrist-worn activity trackers to measure steps of patients in early mobilization after major abdominal surgery, and to explore the influence of clinical variables and gait parameters on the accuracy of trackers. Forty-five patients after major abdominal surgery were recruited to participate in modified six-minute walk tests wearing three trackers simultaneously, the Fitbit Inspire HR, Xiaomi MI 4, and HONOR 5. The differences in displayed steps before and after the walking test were considered as the step counts measured by the trackers; the actual steps taken were determined as the average of the values manually counted by two researchers. The intraclass correlation coefficient, Bland-Altman method, mean percentage error, and mean absolute percentage error were used to assess the accuracy of trackers with reference to manual step counts. The three trackers undercounted postoperative steps by -65.5% to -23.5%. Analysis showed low-to-good agreement between step counts recorded by trackers and actual steps (ICC = 0.35-0.75); the mean absolute percentage errors ranged from 24.5% to 65.7%. For all trackers, mean absolute percentage errors correlated negatively with postoperative days (r = -0.626 to -0.744), walking speed (r = -0.714 to -0.854), step length (r = -0.466 to -0.615), and cadence (r = -0.681 to -0.790), while there were positive correlations between mean absolute percentage errors and the number of abdominal drains (r = 0.450-0.514). The specific activity trackers used in this study might not be reliable tools for measuring steps counts during the walking test in the early postoperative period for patients undergoing major abdominal surgery.

CONTINGENCY PLANNING AND STYLES OF PREPARATION FOR FUTURE CARE BY OLDER GRANDPARENT CAREGIVERS

Abstract The COVID-19 pandemic heightened attention to contingency planning in every area of life including family caregiving. Extended time in the caregiver role can increase problem-solving abilities; yet low rates of traditional contingency planning exist among custodial grandparents. This research applied Steele and colleagues’ four styles of preparation for future care (2003)—avoider, thinker, planner, or consenter—to older custodial grandparents raising adolescent grandchildren. Nineteen grandparents participated in face-to-face interviews. Criteria were: primary caregiver for a grandchild 12 or older; grandchild in home at least 3 days weekly; and grandparent 40 or older. Recruitment included word of mouth, newspapers, and flyers. Participants were asked “What is your thinking about caregiving arrangements for your grandchild in case you are no longer able to provide care? What actual steps, if any, have you taken to begin these caregiving arrangements?” Interviews were audiotaped, transcribed verbatim, and analyzed using conventional content analysis. The racial and ethnic composition of the grandparents were white (n=10), Black/African American (n=7), Native American (n=1), and Filipino (n=1). Most respondents were married (58%), white (53%), grandmothers (84%), with some college education or higher (79%), and an average age of 66 years. Grandparents identified as thinkers (42%), planners (32%), consenters (21%), and avoiders (5%). Two married grandfathers reported conflicting preparation styles (thinkers) in comparison to their spouses (planners). Grandparents often relied on oral opposed to formal written plans. Findings suggest research, practice, and education is needed to assess factors inhibiting aspects of contingency planning for future care among thinkers and avoiders, particularly older grandfathers.

Inferring actual treatment pathways from patient records

Objective:Treatment pathways are step-by-step plans outlining the recommended medical care for specific diseases; they get revised when different treatments are found to improve patient outcomes. Examining health records is an important part of this revision process, but inferring patients’ actual treatments from health data is challenging due to complex event-coding schemes and the absence of pathway-related annotations. The objective of this study is to develop a method for inferring actual treatment steps for a particular patient group from administrative health records — a common form of tabular healthcare data — and address several technique- and methodology-based gaps in treatment pathway-inference research. Methods:We introduce Defrag, a method for examining health records to infer the real-world treatment steps for a particular patient group. Defrag learns the semantic and temporal meaning of healthcare event sequences, allowing it to reliably infer treatment steps from complex healthcare data. To our knowledge, Defrag is the first pathway-inference method to utilise a neural network (NN), an approach made possible by a novel, self-supervised learning objective. We also developed a testing and validation framework for pathway inference, which we use to characterise and evaluate Defrag’s pathway inference ability, establish benchmarks, and compare against baselines. Results:We demonstrate Defrag’s effectiveness by identifying best-practice pathway fragments for breast cancer, lung cancer, and melanoma in public healthcare records. Additionally, we use synthetic data experiments to demonstrate the characteristics of the Defrag inference method, and to compare Defrag to several baselines, where it significantly outperforms non-NN-based methods. Conclusions:Defrag offers an innovative and effective approach for inferring treatment pathways from complex health data. Defrag significantly outperforms several existing pathway-inference methods, but computationally-derived treatment pathways are still difficult to compare against clinical guidelines. Furthermore, the open-source code for Defrag and the testing framework are provided to encourage further research in this area.

Validation of orthopedic allograft preparation process: a new application of media fill test.

Musculoskeletal allografts represent an important practice in orthopedic surgeries and the demand for them has been growing. For this reason, in order to reduce clinical risk and to more efficiently manage the increase of allograft usage and also to optimize timing of the surgeries, the thawing and washing processes with aseptic technique were centralized in the department of Hospital Pharmacy. This study describe the design and execution of an adapted Media Fill Test (MFT) to demonstrate aseptic thawing and washing of allografts. For this specific and innovative setting, to better simulate the actual processing steps, a surrogate system was developed to simulate the tendon allograft. The aseptic technique of four operators was assessed and an initial performance validation and the first revalidation were described. All MFT were completed successfully, with no observation of turbidity. The readapted MFT shown in this study can provide insight into this innovative and growing field to other health professionals who want to implement this service.

Investigation of the Bonding Mechanism between Overlapping Textile Layers for FRP Repair Based on Dry Textile Patches.

Lots of damaged fiber-reinforced plastic (FRP) components are replaced by new components instead of repairing. Furthermore, only very labor-intensive repair methods are available on the market to fully restore the integrity of the structure. This requires a high level of experience or, alternatively, very cost-intensive technology, such as the use of computer tomography and robotics. The high costs and CO2 emissions caused by the manufacture of FRP components then bear no relation to their service life. The research project IGF-21985 BR "FRP-Repair" aims to solve the named challenges. Using semiconductor oxide catalysts, the matrix can be locally depolymerized by ultraviolet (UV) radiation, and thus removed from the damaged area of the FRP component. Subsequently, the damaged fibers in this area can be detached. By using customized textile repair patches and local thermoset reinfiltration, the repair area is restored. With this process, the fiber structure can be repaired locally with new fibers on the textile level. The repair is similar to the original production of a fiber composite in an infusion process. No additional adhesive material is used. As a result, repaired FRP structures with restored mechanics and a near-original surface can be realized. This article provides an insight into the actual steps of the development of the FRP component repair process using dry textile patches. The empirical investigation of overlapped rovings and UD material showed the expected results. Residual fracture forces of up to 86% could be achieved. The most interesting approach on the roving level was splicing the overlapping fibers. The free ends of the fibers of the patch and part are mechanically bonded. This bond at the textile level is further strengthened by infusion with matrix.

Mechanical Properties of Sheet Pile Cofferdam during Adjacent Open Cut Tunnel Construction near Lake Bottom

In water-related projects, the application of steel sheet pile cofferdams is becoming more and more widespread, and the influence of tunnel construction on the mechanical properties of adjacent cofferdams is important. In this study, the object of research was the mechanical properties of large-span steel sheet pile cofferdams. The open-cut tunnel project was located in Suzhou Yinshan Lake, China. According to the actual construction steps of the tunnel foundation pit, assuming that the soil was a small strain hardening soil model, combined with on-site monitoring data, a three-dimensional elastoplastic finite difference model was established. The results show that during tunnel construction, the maximum settlement of the cofferdam appeared at 0.27~0.53 m on the side of the foundation pit; the maximum horizontal displacement of the steel sheet pile occurred at the pile bottom of foundation pit side, and the seepage gradually increased during construction, eventually resulting in water gushing at the bottom of the foundation pit. After the completion of tunnel construction, the settlement value of the cofferdam presented a pattern that first increased and then decreased from the side of the foundation pit to the side of the adjacent lakeside; the steel cofferdam tilted toward the side of the foundation pit, with a maximum inclination angle of 3.37°. It should be pointed out that as the construction progressed, the axial force of the tie rods in the steel cofferdam changed from a U-shaped distribution to a V-shaped distribution. This study could provide a reference for the impact of tunnel foundation pit construction on adjacent steel cofferdam and could also provide a reference for the safety research of open-cut tunnel construction.

Examination of the Protein Drug Supply Chain in a Swedish University Hospital: Focus on Handling Risks and Mitigation Measures

Protein drugs, such as monoclonal antibodies, have proved successful in treating cancer and immune system diseases. The structural complexity of these molecules requires careful handling to ensure integrity and stability of the drug. In this study, a failure mode and effects analysis was performed based on a Gemba Walk method in a Swedish University Hospital. The Gemba Walk is focused on pharmacists observing the actual supply process steps from distributor, pharmacy cleanroom to patient administration. Relevant protein drugs are chosen based on sales statistics within the hospital and the corresponding wards were observed. Further is the Double Diamond design method used to identify major risks and deliver mitigation strategies. The study identified potential stress factors such as temperature, shock by impact, shaking, vibration and light exposure. There were also risks associated with porters’ and healthcare professionals’ lack of awareness and access to information. These risk factors may cause loss of efficacy and quality of the protein drug, potentially leading to patient safety concerns. In this study, a simulation is also performed to list measures that theoretically should be in place to ensure the quality of the protein drug, for example validated and protocol-based compounding in cleanroom, training and validated transports.

The Music Therapy Assessment Manual: A Guide to Data-Based Decision Making

Scholars have published ample literature about music therapy assessment. Some of this literature includes journal reviews of music therapy assessment instruments, chapters with assessment overviews, practical guides to music therapy assessment, advanced practice texts in assessment tools and psychometrics, and more overview texts of music therapy assessment. (Isenberg-Grzeda, 1988; Chase, 2002; Hanser, 2018; Jacobsen et al., 2018; Gattino, 2021). While there are publications about music therapy assessment instruments, the importance of assessment, and advanced assessment practices; music therapy assessment has not been examined with a step-by-step guide for undergraduate-level pedagogical purposes in music therapy. Therefore, the release of The Music Therapy Assessment Manual: A Guide to Data-Based Decision Making (Waldon, 2021), is a necessary addition to the literature. The Music Therapy Assessment Manual: A Guide to Data-Based Decision Making is an effective resource for use in undergraduate music therapy curriculum. In the foreword, Dr. David E. Wolfe, Professor Emeritus at University of the Pacific, described this text as bringing together “the essential components of clinical assessment…[with] details of the actual steps that a clinician can take to systematically implement procedures that can be used from the onset of a clinical referral/intake to the final termination stages of treatment” (p. x). This text is accessible to all music therapists and approaches to teaching music therapy, as the data-based decision-making methodology is not bound to one approach, rather it can be implemented in any practice to improve therapeutic outcomes.

Meaningful goal setting: Practitioners’ perspectives on goal setting in the illness management and recovery program.

The aim of our study was to gain insight into how practitioners in mental health care support people with severe psychiatric disabilities in setting and pursuing personal goals that are meaningful to them. We conducted focus groups with 36 mental health practitioners in Norway and interpreted the data by using reflexive thematic analysis. Four themes emerged from the analysis: (a) active collaboration to understand what is meaningful to the individual, (b) being nonjudgmental during the process of goal setting, (c) helping individuals break goals into smaller goals and steps, and (d) allowing time for the process of trying to achieve goals. Although goal setting is central to the Illness Management and Recovery program, practitioners perceive the work as quite demanding. To succeed, practitioners need to acknowledge goal setting as a long-lasting and shared process, not as a means to an end. As people with severe psychiatric disability often need help in goal setting, practitioners should play an important role in supporting them in setting goals, making plans for achieving them, and taking actual steps in that direction. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Developing a self-funding model for private schools in Jordan

The purpose of the study was to identify the sources of self-financing in private Jordanian schools from the perspective of shareholders, the challenges that limit the increase and diversification of self-financing sources, and the actual procedural steps that school principals need to take to increase and diversify these sources in private schools. The researcher used the mixed method (quantitative and qualitative) as the general method for the study. To achieve the objectives of the study, two instruments were used to collect data. The first was a one-on-one semi-structured interview with school shareholders to explore the sources of self-financing of private schools, and the second was a five-scale questionnaire that included two axes. The first axis refers to the actual procedural steps taken by private school principals to increase and diversify sources of self-financing. The second axis was intended to capture the challenges faced by principals of these schools that limit their ability to increase and diversify these resources. The validity and reliability of the study instruments were tested. The study sample included (50) shareholders and (250) school principals in the capital city of Amman.The results of the study showed that from the shareholders’ perspective, school fees ranked first in relative importance as a source of self-financing for private schools and that the best executive measure that would lead to increased self-financing is the “Providing additional paid academic services for students (notes, question banks, photocopying, etc).” The results also showed that the biggest challenge that would limit self-financing is the “Limited purchasing power of local community members in light of emergency crises such as the Corona pandemic.” The findings also showed that school principals believe that expanding executive procedures to diversify resources would reduce the challenges they might face. The study recommended the development of a strategic plan to diversify the self-financing sources of private schools in Jordan to reduce their dependence on student fee as basic funding, as well as the development of an appropriate procedural guide to assist school principals in implementing the strategic plan.

Uterine rupture

The increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations for the actual surgical steps to be followed to minimize the risks of uterine rupture (UR) during TOLAC. Uterine scar condition, intrapartum management and maternal health status correlate to uterine scar rupture risk and provide guidance for parturient TOLAC eligibility. TOLAC and vaginal delivery success rate as reported by the largest studies is between 60% and 77%. Uterine rupture is more prevalent in VBAC-2 patients (1.59%) in contrast to VBAC-1 (0.72%). Additionally, VBAC-2 patients have higher incidence of caesarean hysterectomy 0.56% vs. 0.19% for VBAC-1. The chances of successful VBAC increase when the interpregnancy/interdelivery interval is less than 6.3 years and less than 24 months, respectively. No difference was detected between the techniques of uterine incision closure of the previous CS and TOLAC results, although closure of the CS uterine incision in 2 layers seems to be practiced more widely. Niche or isthmocele presents another complication of CS. Secondary infertility due to niche, will eventually direct to hysteroscopic or laparoscopic repair, depending on the residual myometrial thickness (RMT) as measured by US scan. When RMT is below 3 mm or 2.5 mm surgery can be performed, to prevent any spontaneous UR in case of pregnancy. Monitoring by US scanning of hysterotomy scar after myomectomy can detect hematoma. In patients with severe postoperative pain but hemodynamically stable follow up by US scan examination can direct the management decision. In those patients with active bleeding and deterioration of hysterotomy scar edema will be an indication to surgery. There is no firm evidence regarding which type of thread, knotting or sequence of suturing is more favorable to reduce the risk of UR after VBAC or hysterotomy after myomectomy.

Generative AI Art: Copyright Infringement and Fair Use

The discussion of AI copyright infringement or fair use often skips over all the required steps of the infringement analysis in order to focus on the most intriguing question, “Could a visual generative AI generate a work that potentially infringes a preexisting copyrighted work?” and then the discussion skips further ahead to, “Would the AI have a fair use defense, most likely under the transformative test?” These are relevant questions, but without considering the actual steps of the copyright infringement analysis, the discussion is misleading or even irrelevant. This neglecting of topics and stages of the infringement analysis fails to direct our attention to a properly accused party or entity whose actions prompt the question. Making a sudden transition from a question of infringement in the creation of training datasets to the creation of foundation models that draw from the training data to the actual operation of the generative AI system to produce images makes a false equivalency regarding the processes themselves and the persons responsible for them. The questions ought to shift focus from the persons compiling the training dataset used to train the AI system and the designers and creators of the AI system itself to the end users of the AI system who conceive of and cause the creation of images. The analysis of infringement or fair use in the generative AI context has suffered from widespread misunderstanding concerning the generative AI processes and the control and authorship of the end-user. Claimants, commentators, and regulators have made incorrect assumptions and inaccurate simplifications concerning the process, which I refer to as the Magic File Drawer theory, the Magic Copy Machine theory, and the Magic Box Artist theory. These theories, if they were true, would be much easier to envision and understand than the actual science and technology that goes into the creation and operation of a contemporary visual generative AI system. Throughout this Article, I will attempt to clarify and correct the understanding of the science and technology of the generative AI processes and explain the different roles of the training dataset designers, the generative AI system designers, and the end-users in the rendering of visual works by a generative AI system. Part II will discuss the requirements of a claim of copyright infringement including each step from the copyrightability of the claimant’s work, the doctrines that limit copyrightability, the requirement of an act of copying, and the infringement elements. Part III will summarize the copyright fair use test paying particular attention to the purpose and character of the use analysis, 17 U.S.C. § 107(1), and the current interpretation of the “transformative” test after Andy Warhol Foundation v. Goldsmith, particularly in circumstances relating to technology and the use of copyrighted or copyrightable data sources. Part IV will analyze potential infringement or fair use by the creators of generative AI training datasets. Part V will analyze potential infringement or fair use by the creators of visual generative AI systems. Part VI will analyze potential infringement or fair use by the end-users of visual generative AI systems. For all their complexity, visual generative AI systems are tools that depend on an end-user who conceives of and designs the image and provides the system with a prompt to set the generative process in motion. The end-users are responsible for crafting the prompt or series of prompts used, for evaluating the outputs of the generative AI, for adjusting and editing the iterations of images offered by the AI system, and ultimately for selecting and adopting one of the images generated by the AI as the final image. The end-users then make further decisions about the actual use and its function and purpose for the images the end-users selected and adopted from the outputs of the AI. While working with the AI tool to try to produce a certain image, an end-user might steer the system to produce a work that could, under an infringement analysis, be regarded as potentially infringing, which would lead us again to the fair use analysis based on the end-user’s use of the image.

Strategies to evaluate the quality of hospital design with clinical data.

Strategies to evaluate the quality of hospital design with clinical data.