Persistent Mismatch Research Articles

Can public hospital reform reduce medical resource mismatches? Evidence from China

BackgroundThe mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the “Healthy China” strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.MethodsA Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.ResultsPHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform’s effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.ConclusionsThis study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.

Bridging the Skills Gap Through Education Supply Chain to Meet Industry Requirements

In Bangladesh, a persistent mismatch exists between the skills fresh graduates possess and the competencies demanded by employers. This gap affects graduate employability and hampers economic growth. This article explores how key components— Program Curriculum Development (PCD), Instructor Portfolio Management (IPM), University Culture and Networking Platform (UCN), and University Facilities (UF)—can collectively address this issue. By integrating these elements into the educational supply chain, universities can produce skilled graduates who are better equipped to meet industry needs. The proposed framework offers a comprehensive approach to align academic outputs with labor market demands. The study highlights the importance of adapting curricula, engaging industry professionals in teaching, fostering strong university-industry connections, and investing in modern facilities to close the skills gap. This holistic approach ensures that graduates are employable, contributing to national development and societal betterment. The article concludes by emphasizing the need for further research on technological advancements and policy reforms to enhance higher education in Bangladesh.

Fabrication of enhanced electrochemical AlBiO3/g-CN nanocomposite electrode material via hydrothermal approach for supercapacitor applications

The fundamental discrepancy in energy produced from renewable sources indicates that there is a persistent mismatch between the supply and demand of energy. Researching and developing appropriate materials for employing energy-storing devices is an efficient approach to resolving this recurring issue. Using a hydrothermal preparation technique, AlBiO3 and AlBiO3/g-CN nanocomposites are produced in this work. Galvanostatic charge/discharge (GCD) analysis at 1 A g−1 were used to determine the specific capacitance (Cs) value for AlBiO3 and AlBiO3/g-CN which were 888 and 1508 F g−1, respectively. Over 10000th cycles, the AlBiO3 and AlBiO3/g-CN showed outstanding performance and outstanding cycling stability. The synergistic association between AlBiO3 and g-CN generated higher specific surface area (SSA) and extra active spots for higher charge transfer with less impedance. The outcomes of the electrochemical investigation exposed that the AlBiO3/g-CN composites architecture performed more effectively than the AlBiO3, suggesting that it is useful structure for energy-storage devices. Further, symmetric investigation was also confirmed that AlBiO3/g-CN nanocomposite promising electrode material for practical application.

Can a global mean sea-level rise reduce the Last Interglacial model–data mismatch in East Asia?

The Last Interglacial (LIG), with its many reconstructions and simulations, provides an ideal analog for investigating the future warmer climate. However, there has been a persistent mismatch between simulated and reconstructed LIG climates in East Asia, with simulations generally indicating a colder and drier climate than reconstructions. In this study, utilizing the Norwegian Earth System Model (NorESM1-F), the authors investigated whether incorporating the global mean sea-level rise in LIG simulation experiments can reduce the model–data mismatch. The new experiments reveal a discernible, yet insufficient, warming and wetting effect in East Asia resulting from the sea-level rise. Therefore, the model–data mismatch remains unresolved. Based on these results, the authors explore alternative factors that may contribute to this mismatch, offering insights for future studies.

Bell-nonlocality quantifiers and their persistent mismatch with the entropy of entanglement

For some commonly used nonlocality quantifiers, the maximally nonlocal state may not coincide with the maximally entangled state, what became known as the anomaly of nonlocality. More recently, nonanomalous quantifiers have been defined, for which maximal entanglement and maximal nonlocality do coincide. In this work we investigate in detail how these quantifiers behave for nonmaximal-resource states and show that some mismatch remains between the studied figures of merit. Besides the nonlocal volume (a quantifier that counts the volume of the set of behaviors accessible to a specific state that gives rise to nonlocality), we present an alternative quantity referring to states and based on behaviors, the trace-weighted nonlocal volume. The construction is based on the nonlocal volume integral, but weighted by a quantifier of nonlocality for behaviors (the shortest distance between the behavior and the local set). Although in all investigated scenarios the anomaly is not present, the nonlocality quantifiers as compared to the entropy of entanglement are inversely related for some set of states within some Bell scenarios. In the investigated situations this phenomenon occurs when the considered states go through a change of rank. This fact is discussed in general and illustrated through computations for the (2,3,2) scenario.

The Generic Drug Trilemma

More than 90% of prescriptions dispensed in the United States each year are for off-patent drugs. Yet the bulk of scholarship on prescription drug policy focuses on patented drugs. Discussions of prescription drugs are typically oriented around the “innovation-access dilemma”—the trade-off between stronger patent-based incentives for innovators and higher prices for purchasers of patented products. But for drugs in the “patent afterlife”—the period after patent protection and other forms of market exclusivity have expired—the innovation-access dilemma is not the fundamental policy trade-off. Higher prices do not necessarily redound to the benefit of innovators, and price is not the only significant impediment to access: drug shortages—often triggered by safety concerns—also prevent patients from obtaining the medicines they need.This chapter seeks to provide scholars and policy makers with a unifying framework for analyzing the variegated challenges of the pharmaceutical patent afterlife. We argue that the key trade-offs in off-patent drug policy take the form of a trilemma—the three corners of which are price, quantity, and quality (i.e., safety and efficacy). The generally accepted goal of off-patent drug policy is to facilitate (1) low prices and (2) sufficient quantities of drugs that are (3) equivalent or similar to brand-name drugs approved by the Food and Drug Administration. But policies that improve outcomes along one or two of those dimensions typically entail some sacrifice along the third.The trilemma framing yields several analytical payoffs. First, it sheds light on the root causes of puzzling problems plaguing some off-patent drug markets, such as sudden price spikes and persistent mismatches between supply and demand. Second, it draws attention to the noninnovation costs of recent drug pricing reform proposals—costs that are often overlooked amid the emphasis on innovation versus access. Finally, it motivates a search for solutions that can transcend the trilemma and optimize along all three dimensions of off-patent drug policy. That search brings us, full circle, back to innovation and access—the concerns that dominate discussions of pharmaceutical policy at the beginning of the patent life. But this time, the focus is on innovation—and, specifically, manufacturing innovation—in service of rather than in tension with access.

The Dallas Donation after Circulatory Death Transplantation Summit: expanding donation after circulatory death procedures through process improvement, broader utilization, and innovation.

Despite a significant increase in utilization over the past decade, the number of donation after circulatory death (DCD) organs that are procured and transplanted in the United States (US) remains well below its potential. There is still room for expansion, as utilizing DCD organs to the fullest extent is currently the most viable solution to the persistent mismatch between supply and demand in transplantation. We convened a multidisciplinary transplantation summit to examine various aspects of DCD, with faculty members from around the world with clinical and academic interest in DCD donation and transplantation, including abdominal and cardiothoracic surgeons, organ procurement organization directors, hepatologists, and gastroenterologists. The conference focused on identifying barriers to DCD organ utilization and strategies to overcome these barriers. We divide the barriers to DCD utilization into three mains categories: (I) policy and process variation; (II) logistical and transportation challenges; and (III) higher risk perceptions related to DCD outcomes. For each barrier, we proposed a variety of solutions, providing an overview of the status of DCD donation in the US and suggestions on how to increase the use of DCD. There is a specific focus on ex situ machine perfusion, normothermic regional perfusion, and other opportunities to expand DCD utilization without negatively impacting recipient outcomes.

Towers Once in the Park: Uprooting Toronto's Welfare Landscapes

This article is published as part of the Geografiska Annaler: Series B, Human Geography special issue ‘Revisiting the green geographies of welfare planning’, edited by Johan Pries and Mattias Qviström. ABSTRACT In the midst of the growing ecological crisis, the ‘compact city’ has become the mainstream urban paradigm for the sustainable future of western cities. However, the uneven implementation of densification policies can have adverse impacts on the amount and quality of urban green spaces, which are vital resources for local communities. This paper explores the controversies of introducing compactness in the case of Toronto’s ‘towers in the park’: housing estates built in comprehensively planned neighbourhoods from the 1950s through the 1970s. It does so through the lenses of urban design and landscape planning, by tracking the evolution of narratives that underpin the current urban regime, and by assessing their legitimacy from the perspective of residents. The findings highlight a persistent mismatch between Toronto’s dominant urban design paradigm and the sociomaterial context of its uncritical application. Exemplar episodes of tower infill show two discursive tropes to justify compactness: the alleged underuse of open spaces, and the creation of a proper public realm by replacing these spaces with buildings and streets. Beyond uncovering the fallacy of both claims, this paper outlines an alternative perspective for more equitable strategies for common green spaces, outside unconditional protection and zealous quest for “value uplift.”

Orbital variations as a major driver of climate and biome distribution during the greenhouse to icehouse transition.

Recent studies suggest increasing sensitivity to orbital variations across the Eocene-Oligocene greenhouse to icehouse climate transition. However, climate simulations and paleoenvironmental studies mostly provide snapshots of the past climate, therefore overlooking the role of this short-term variability in driving major environmental changes and possibly biasing model-data comparisons. We address this problem by performing numerical simulations describing the end-members of eccentricity, obliquity, and precession. The orbitally induced biome variability obtained in our simulations allows to reconcile previous apparent mismatch between models and paleobotanical compilations. We show that precession-driven intermittent monsoon-like climate may have taken place during the Eocene, resulting in biomes shifting from shrubland to tropical forest in the intertropical convergence zone migration region. Our Oligocene simulations suggest that, along with decreased pCO2, orbital variations crucially modulated major faunal dispersal events around the EOT such as the Grande Coupure by creating and fragmenting the biome corridors along several key land bridges.

Chapter 6 - The hypothalamo–pituitary–adrenal axis and the autonomic nervous system in burnout

Burnout constitutes a serious health concern in the modern working environment. It is a stress-related condition that has developed as a result of a prolonged psychosocial stress exposure causing a persistent mismatch between demands and resources. The main symptom is emotional exhaustion, but physical fatigue, diminished professional efficacy, cynicism, and cognitive impairments are also associated with this condition. Burnout has been used both as a psychologic term in occupational settings and as a clinical diagnosis in patient populations, and there is currently no universally accepted definition and diagnostic criteria of burnout. It has been hypothesized that the two main stress response systems, the autonomic nervous system (ANS) and the hypothalamus-pituitary-adrenal axis (HPA axis), are involved in the pathogenesis of burnout. A common hypothesis is that in the early stages of chronic stress, the HPA axis and sympathetic ANS activity tend to be higher, while it will decrease with a longer duration of chronic stress to ultimately reach a state of hypoactivity in clinical burnout. The current research in this field shows many contradictory results. Thus there is no compelling evidence of either ANS or HPA dysfunction in burnout. However, there is partial support for the hypothesis of HPA and sympathetic hyperactivity in early stages, and HPA hyporeactivity and low vagal activity in more severe burnout cases, but high-quality studies investigating the causal links are still lacking.

Lessons from the reintroduction of listed plant species in California

Reintroduction is an increasingly common practice to conserve and recover threatened and endangered plant species, so understanding how practitioners view their work and identifying persistent resource mismatches are key to the long-term viability of these listed species. We interviewed practitioners involved in reintroduction projects for 14 species in the state of California to understand (1) how they defined recovery; (2) their assessment of the likelihood of recovery; (3) what advice they would share with other practitioners to improve reintroduction efforts; and (4) what resources could make future projects more successful. Practitioners’ definitions of recovery aligned with ecological theory and emphasized the importance of self-sustaining populations and large populations, as well as the presence of multiple populations. However, most practitioners felt that recovery was unlikely or did not think the species they worked with should or would be de-listed without the guarantee of perpetual future interventions. Practitioners thought that studying basic biology and natural history, using experiments to determine the best techniques, and repeatedly planting populations were important to project success. However, practitioners also felt they were missing critical resources, including long-term funding for implementation and maintenance, successful and positive relationships between members of the practitioner-agency-scientist-landowner nexus, and assurances/safe harbor agreements for experimental populations. Overall, rare plant reintroductions are complicated by persistent mismatches in timing and goals, but some individuals have been able to successfully navigate these challenges. Longer duration funding mechanisms for monitoring and maintenance and better data handling, storage, and dissemination would benefit future projects.

Abstract WP15: Correlation of 24-Hour Infarct Volumes and Imaging Reperfusion With Functional Independence in DEFUSE 3

Background: In DEFUSE 3, infarct volumes 24 hours after randomization did not significantly differ in EVT vs. medical management only (MM) groups. We hypothesized that this lack of difference was due underestimation of the final infarct volume among patients who had persistent penumbral tissue 24 hours after randomization that subsequently progressed to infarction. In this substudy, we evaluated if the 24 hr post-randomization DWI volumes correlated with functional independence. Methods: We correlated the 24-hr post-randomization DWI volumes and penumbral profiles with 90-day functional independence. Results: 182 patients, 92 were randomized to EVT, 90 to MM. 24 hr post-randomization Tmax and DWI volume were assessable for 75 EVT and 69 MM. Infarct volumes at 24 hr follow-up did not differ between EVT and MM median (IQR) ml 35.0 (17.6-81.6) vs 41.0(25.4-106.2), P=0.185. Still, 24 hr infarct volumes independently correlated with 90 day functional independence: median (IQR) 30.3 ml (9.0-55.6) vs. 47.5 ml (25.4-132.3), aOR=0.93 (95%CI=0.89-0.98, P=0.004) for achieving functional independence vs. disability for each additional 5 ml of infarct volume after adjustment for baseline NIHSS, age, glucose, and treatment, figure 1. EVT resulted in higher rates of reperfusion (>90% reduction in Tmax>6 seconds at 24 hrs in 79% of EVT vs. 18% of MM, P<0.001). Patients who achieved successful reperfusion with no evidence of remaining penumbra had smaller 24- hr infarct volumes: 32.9 (17.6-67.0) vs. 59.3 (24.7-126.3), P=0.007), figure 2 and a higher odds of functional independence aOR=10.9, 95%CI 3.6-39.8, P<0.001, compared to those who had remaining penumbral tissue, figure 3. Conclusion: 24 hr- post randomization infarct volumes independently correlated with functional independence in DEFUSE 3. Patients who had complete reperfusion had smaller follow-up infarct volumes and a higher odds of functional independence as compared to those with persistent penumbral mismatch.

The role of place-based narratives of change in climate risk governance

In this introduction, we situate the topic of this Special Issue on ‘narratives of change’ in the scholarly literature about how we inform climate risk governance, including through climate services. We argue that many places experience a persistent mismatch between predominantly science-based and technical framings of climatic risk on the one hand, and the place-based understandings of climate extremes and responses of people living in these places on the other. We introduce the case studies presented in this issue and highlight their common focus on ‘narratives of change’ as one missing link in climate governance. Narratives of change address the past, present and future of a specific place understood as a weather-world, adding a cultural dimension to climate change experienced as a succession of weather and seasons. We focus on memories of extreme weather events and how people coped with them, in order to improve climate governance under future climatic change. We argue that attention to local narratives expands the scope of issues covered by climate information and improves its integration into social and cultural life. We offer up seven lessons for why it is important to incorporate narratives in climate governance and suggest some creative methods for doing so. Post-normal science, art-science cooperation, and the inclusion of the humanities mark the difference that the individual contributions make to the literature about climate governance and democratic decision-making.

Error-Driven Retrieval in Agreement Attraction Rarely Leads to Misinterpretation.

Previous work on agreement computation in sentence comprehension motivates a model in which the parser predicts the verb’s number and engages in retrieval of the agreement controller only when it detects a mismatch between the prediction and the bottom-up input. It is the error-driven second stage of this process that is prone to similarity-based interference and can result in the illusory licensing of a subject–verb number agreement violation in the presence of a structurally irrelevant noun matching the number marking on the verb (‘The bed by the lamps were…’), giving rise to an effect known as ‘agreement attraction’. Here we ask to what extent the error-driven retrieval process underlying the illusory licensing alters the structural and thematic representation of the sentence. We use a novel dual-task paradigm that combines self-paced reading with a speeded forced choice task to investigate whether agreement attraction leads comprehenders to erroneously interpret the attractor as the thematic subject, which would indicate structural reanalysis. Participants read sentence fragments (‘The bed by the lamp/lamps was/were undoubtedly quite’) and completed the sentences by choosing between two adjectives (‘comfortable’/’bright’) which were either compatible with the subject’s head noun or with the attractor. We found the expected agreement attraction profile in the self-paced reading data but the interpretive error occurs on only a small subset of attraction trials, suggesting that in agreement attraction agreement checking rarely matches the thematic relation. We propose that illusory licensing of an agreement violation often reflects a low-level rechecking process that is only concerned with number and does not have an impact on the structural representation of the sentence. Interestingly, this suggests that error-driven repair processes can result in a globally inconsistent final sentence representation with a persistent mismatch between the subject and the verb.

Persistent Target Mismatch Profile >24 Hours After Stroke Onset in DEFUSE 3.

Background and Purpose- Efficacy of endovascular thrombectomy has been demonstrated up to 24 hours after stroke onset in patients selected with perfusion imaging. We hypothesized that a persistent favorable perfusion profile exists in some patients beyond 24 hours from the onset and can be predicted by a lower baseline hypoperfusion intensity ratio, which indicates favorable collaterals. Methods- We identified control arm patients from the DEFUSE 3 trial (The Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke) with a diffusion weighted imaging and perfusion magnetic resonance imaging performed 24 hours following randomization and compared imaging and clinical variables between patients with persistent mismatch versus patients who no longer had a mismatch 24 hours after randomization. Results- Eighteen percent of the control arm patients had a persistent favorable profile >38 hours after last known well time. These patients had similar baseline diffusion weighted imaging and Tmax >6 seconds volumes as patients whose initially favorable perfusion profile became unfavorable (diffusion weighted imaging lesion 7 versus 17 mL; P=0.17, Tmax >6 seconds 98 versus 100 mL; P=0.48) yet experienced less infarct growth (15 versus 59 mL; P<0.001) and had 3-fold smaller infarct volumes (15 versus 59 mL; P<0.001) 24 hours after randomization. Patients with a persistent favorable perfusion profile had a significantly lower hypoperfusion intensity ratio on baseline imaging (0.2 versus 0.4; P<0.01). Favorable clinical outcome at 90 days occurred in only 10% of the persistent mismatch patients. Conclusions- About 20% of patients with a middle cerebral artery or internal carotid artery occlusion who present in an extended time window and are not treated with thrombectomy have a persistent mismatch for at least an additional 24 hours. These patients have a favorable hypoperfusion intensity ratio at presentation, may experience delayed infarct expansion, and have poor clinical outcomes. Clinical trials are needed to determine if patients with a favorable perfusion profile benefit from reperfusion beyond 24 hours. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02586415.

Abstract 165: CT Perfusion Collateral Score Predicts Which Patients Will Maintain a Penumbral Profile on MRI for Greater than 24 Hours

Introduction: The DAWN and DEFUSE 3 trials demonstrated efficacy of endovascular treatment in patients selected using perfusion imaging or MR Diffusion Weighted Imaging (DWI) and treated up to 24h after stroke onset. Hypothesis: We hypothesized that a persistent favorable perfusion profile (target mismatch, which indicates the presence of penumbral tissue) exists in some patients beyond 24h from onset and can be predicted by lower baseline hypoperfusion intensity ratio (HIR, proportion of Tmax &gt;6s lesion having &gt;10s delay), which indicates favorable collaterals. Methods: We identified control arm patients from the DEFUSE 3 trial with a DWI and perfusion MRI performed 24h following randomization and defined 3 subgroups: Group 1) patients with spontaneous reperfusion; Group 2) persistent hypoperfusion lesion, but loss of the target mismatch perfusion profile; Group 3) persistent target mismatch profile. We compared group 2 with group 3 in terms of baseline, 24h and clinical outcome variables. Results: 55/90 patients in the medical arm had DWI and perfusion MRI follow-up imaging 24 hours after randomization and were included. 18% had spontaneous reperfusion, 64% had a persisting Tmax lesion with an unfavorable profile, and 18% had a persistent target mismatch profile. Patients with a persistent target mismatch profile had a significantly lower HIR on baseline imaging (0.2 vs 0.4, p&lt;0.01) and significantly less infarct growth (15mL vs 59mL, p&lt;0.001) than patients with loss of the target mismatch profile. The persistent target mismatch was documented a median of 38 hours after last known well time. There was no association between baseline clinical characteristics or clinical outcomes and a persistent favorable profile. Conclusions: Approximately 20% of medical arm patients in DEFUSE 3 had a persistent mismatch at a median of 38 hours after stroke onset. These patients have very slowly expanding infarcts but eventually suffer very poor clinical outcomes. Clinical trials are needed to determine if late patients presenting with penumbral tissue benefit from thrombectomy more than 24 hours from symptom onset.

КТ диагностика заболеваний, проявляющихся утолщением стенки толстой кишки

Thickening of the wall of the colon (TC) is one of the easily detectable and common symptoms of TC diseases detected by computed tomography (CT). The aim of the study was to reveal the possibilities of standard abdominal CT in the diagnosis of TC disease. To achieve this goal, 359 CT of the abdominal cavity performed according to the standard Protocol were analyzed. The average age of patients was 64.1+15.8 years. Gender ratio: prevalence of male patients 1,3:1,0. The normal thickness of the wall of the colon depends on the degree of expansion of the lumen or stretching and in most cases is changeable. The thickening of the TC wall was considered to be a persistent mismatch of its thickness to the inner lumen or outer diameter, taking into account the extreme values of the norms according to the literature data from 2 to 10 mm. The Analyzed cases of thickening of the TC wall were divided into 3 groups: focal (53%), segmental (30%) or diffuse thickening (17%). Wall thickening defined in nonspecific inflammatory diseases (Crohn’s disease, ulcerative colitis, undifferentiated, pseudomebranous and ischemic colitis) often had segmental (12%) or diffuse (16%) length, with a minimum in the group of focal thickening - 1% in Crohn’s disease. The authors determined a significant difference in the length of TC wall thickening in benign and malignant processes (p<0.05). The probability of diagnosis of TC cancer significantly increases with a decrease in the length of the determined thickening of the TC wall to the focal, with an inverse relationship with an increase and a high probability of inflammatory disease (p<0.01). Thus, the symptom of thickening of the wall of the TC is a marker symptom of diseases of the TC. In our study, the thickening of the TC wall was found in both malignant and benign diseases, with the prevalence of the latter, and a large proportion of inflammatory diseases in them (p<0.05). In the group of focal thickenings, the leader, not taking into account diverticulitis due to easily recognizable signs of this disease, was TC cancer, which indicates in favor of the high specificity of the sign (p<0.01). However, the analysis of additional features was crucial in the differential diagnosis of TC pathology: the type and nature of contrast enhancement, changes in mesentery, fiber and adjacent vessels.

A metabolic approach during normothermic regional perfusion in uncontrolled donors after circulatory death-A pilot study.

The use of donation after circulatory death (DCD) has increased significantly to face the persistent mismatch between supply and demand of organs for transplantation. While controlled (c) DCDs have warm ischemic time (WIT) that can be estimated, the WIT is often inexact and extended in uncontrolled DCD (uDCD), making assessment of injury difficult. We aimed at investigating the effects of cold ischemia on potential donor organ damage in the course of nRP by assessing the dynamic variations of transaminases and creatinine values in 17 uDCD donors. In our series, lactate values did not show significant changes during the study period (P=0.147). Creatinine values did not significantly changed while transaminases progressive increased throughout the study period, even if it was significant only for AST (P=0.035). According to our data, nRP duration affects splanchnic organs, being the liver sensitive to hypoperfusion, and serial biochemical measurements could help in detecting organ functional status.

Automated generation of ‘good enough’ transcripts as a first step to transcription of audio-recorded data

In the last decade, automated captioning services have appeared in mainstream technology use. Until now, the focus of these services have been on the technical aspects, supporting pupils with special educational needs and supporting teaching and learning of second language students. Only limited explorations have been attempted regarding its use for research purposes: transcription of audio recordings. This article presents a proof-of-concept exploration utilising three examples of automated transcription of audio recordings from different contexts; an interview, a public hearing and a classroom setting, and compares them against ‘manual’ transcription techniques in each case. It begins with an overview of literature on automated captioning and the use of voice recognition tools for the purposes of transcription. An account is provided of the specific processes and tools used for the generation of the automated captions followed by some basic processing of the captions to produce automated transcripts. Originality checking software was used to determine a percentage match between the automated transcript and a manual version as a basic measure of the potential usability of each of the automated transcripts. Some analysis of the more common and persistent mismatches observed between automated and manual transcripts is provided, revealing that the majority of mismatches would be easily identified and rectified in a review and edit of the automated transcript. Finally, some of the challenges and limitations of the approach are considered. These limitations notwithstanding, we conclude that this form of automated transcription provides ‘good enough’ transcription for first versions of transcripts. The time and cost advantages of this could be considerable, even for the production of summary or gisted transcripts.

Liver transplant donation

Orthotopic liver transplantation provides definitive management of end-stage liver disease. While short and long-term outcomes for graft survival and patient survival are excellent, a limiting factor has been persistent mismatch of the number of available donors to the number of recipients in need of organs. Strategies to address these donor short falls include: utilization of living related donors, split liver transplantation, donation by cardiac death, hepatitis serology positive donors, and marginal liver donors. With careful recipient selection, the overall outcomes do not appear to differ between the use of standard neurologic death donors and these extended criteria donors. As indications for liver transplantation continue to expand, innovative strategies to increase the donor pool are necessary to mitigate patient mortality while on liver transplant wait lists and morbidity of end-stage liver disease.