Real-world Experiences Research Articles

A study of spatial cognition in the rural heritage based on VR 3D eye-tracking experiments

Traditional Chinese villages act as the essential carriers of China’s rural heritage. Such villages are considered to retain living practices of intangible heritage through know-how, artistic and folk customs, as well as a well-preserved architectural appearance. However, their conservation is at stake due to degradation, abandonment, and urbanization. Spatial cognition is one way of bringing people to the matter of what is important to conserve (attributes) and why they are important (values). This is done by analysing how people perceive and value rural heritage. Traditional methods of gathering spatial cognition data, such as laborious fieldwork or subjective qualitative analyses, often fall short of providing a holistic representation of real-world experiences. This article presents an innovative method for analysing cognitive features in traditional village spaces using an immersive virtual reality equipped with an eye-tracking system. We selected Cheng and Jitou, two traditional Chinese villages, as our case studies. In two virtual reality environments, we captured accurate 3D cognitive data, including participants’ locomotion, gaze point, and sightline. The results indicate that the accessibility of village roads affects the distribution of people’s locomotion, which in turn affects the distribution of people’s areas of interest; the changes in the rhythm of the sightline scale reflect the rhythm of spatial changes in the villages. By broadening the understanding of spatial cognition in traditional Chinese villages related to people’s values, this paper sheds light on an alternative approach to assess the cultural significance of such villages for higher conservation and sustainability.

Teaching Note—The Dynamic Duo: Use of Standardized Clients Across the Social Work Practice and Field Curricula

ABSTRACT This reflection from one department of social work showcases the use of simulation as an integrated tool of practice-based education and assessment for social work education within generalist and specialized practice classes. We show several ways we are using simulation as both a learning and assessment tool for social work practice skills. This includes in-class simulations using paid standardized patient as clients, the use of objective standard clinical examination as an assessment tool in the standardized patient suite within the university, the use of field instructors as feedback mechanisms for standardized patient experiences, and translating and linking student skills in the classroom to real-world field experiences. Challenges, lessons learned, and opportunities for future exploration are discussed.

Abstract PO4-16-12: Patient initiated centricity towards improved communication, side effect management and follow-up care by Real World Evidence Survey from patients for patients – Preview of the Breast BRIDGister Platform

Abstract Background Treatment adherence is crucial for outcome improvement. Still up to 50% of patients interrupt e.g. endocrine treatment or other effective treatment choices due to side effects or miscommunication. Reasons may include limited time spent for patient information in daily routine and the intrinsic barriers to frankly tell the truth to the attending physicians. Therefore, a patient initiated survey has been compiled to comprehensively address all clinical, diagnostic and critical aspects of importance for patients by decentral data capture from patients at home via smart devices in a pseudonymized & interactive fashion to refocus on challenges regarding patients needs, fears and wishes to support evidence based statistical analysis of Real World Data. Materials and Methods Establishing a cloud-based IT Platform enabling nationwide, decentral data entry using Climedo clinical trial software tools without the need of any commercial app utilities and therefore obeying GDPR conform standards to create an interconnected online platform integrating 36 interconnected surveys comprising >1.200 singular questions has been set up between 2020 and 2022 based on patients content elaboration & wishes. The questionnaires address all Real World experiences e.g. at initial diagnosis, during primary treatment and all subsequent lines as well as side effect management with complementary medicine and follow up care realities. After 100 patients a preplanned statistical analysis has been performed to evaluate the feasibility of the patient oriented ePRO approach and demonstrate relevance of proof-of-concept results before entering international trial expansion. Descriptive analysis by Excel as well as Correlation analysis; Chi square and Partitioning tests using the SAS JMP® 9.0.0 software were performed. Results Despite in depth complexity > 85% of patients completed the whole survey. Age distribution of the pilot cohort revealed comparably younger patient age (28% between 30-39 years, 40% between 40-49 years, 24% between 50-59 and 10% being above 60 years) and dominance of Triple Negative Patients (~39%) participating the online survey in the pilot cohort. 97% of patients were treated in certified breast centers (50% in larger centers of bigger towns,15% in central clinics, 23% in university sites, 5% in local hospitals and 7% at office based doctors). Interestingly, 25% of patients did not or only partially understand their diagnosis and upcoming treatment. Time spent for communicating initial breast cancer diagnosis was less than 10 minutes for 25% of patients, while 13% did not remember. Exclusively one treatment option was discussed with 86% of patients. 78% have been informed about their initial breast cancer diagnosis in personal meetings, while 21% were informed by phone calls. 37% of patients had been informed about their patient rights. At preplanned interim analysis 38% of patients were lymphnode positive and 6% metastasized at initial diagnosis. 56% of patients were satisfied with their guideline conform follow-up-care, while 42% did pay for additional follow up care on their own. 85% of patients wished to have a risk-adopted, more individualized follow-up care. Conclusion Despite complexity and lengthiness > 85% of patients did complete the survey. There is an apparent need to have more time for initial confrontation with diagnosis and treatment options. Patients are frequently not informed about alternative treatment options as well as patient rights. Patients frequently feel under pressure in their life threatening situation and suffer substantial lack of information as well as appropriate personal communication. Patient centricity should focus on elaborated communication and information systems that support treatment decision acceptance and adherence. Further details analysis will become available in upcoming subanalysis of the Breast BRIDGister platform survey. Citation Format: Cornelia Stuewe, Ralph Wirtz, Christa Gress, Lena Schmidt, Veronika Schweighart, Sebastian Eidt, Claudia Schumacher, Julia Habraschka, Heidi Lehmann, Katrin Schuere. Patient initiated centricity towards improved communication, side effect management and follow-up care by Real World Evidence Survey from patients for patients – Preview of the Breast BRIDGister Platform [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-16-12.

Mental health in Parkinson’s: Uncovering real-world patient experiences in psychological support and care

Mental health in Parkinson’s: Uncovering real-world patient experiences in psychological support and care

Content analysis of Reddit posts about coadministration of selective serotonin reuptake inhibitors and psilocybin mushrooms.

Treatments with the serotonergic psychedelic psilocybin are being investigated for multiple neuropsychiatric disorders. Because many patients with these disorders use selective serotonin reuptake inhibitors (SSRIs), understanding interactions between psilocybin and SSRIs is critical for evaluating the safety, efficacy, and scalability of psilocybin-based treatments. Current knowledge about these interactions is limited, as most clinical psilocybin research has prohibited concomittant SSRI use. We aimed to explore potential interactions between psilocybin and SSRIs by characterizing peoples' real-world experiences using psilocybin mushrooms and SSRIs together. We conducted a systematic search of Reddit for posts describing psilocybin mushroom and SSRI coadministration. We identified 443 eligible posts and applied qualitative content analysis to each. 8% of posts reported negative physical or psychological effects resulting from coadministration. These included 13 reports that may reflect serotonin toxicity, and 1 concerning for a psychotic/manic episode. 54% of posts described reduced intensity of the acute psilocybin experience, but 39% reported unchanged intensity with SSRI coadministration. Psilocybin's interactions with SSRIs are likely complex and may depend on multiple factors. Prospective studies are needed to evaluate whether psilocybin treatments are reliably safe and effective in the setting of SSRI use.

Patient Experience Survey Of Anti-VEGF Treatment for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema.

Understanding patient perspectives of treatment may improve adherence and outcomes. This study explored real-world patient experiences with anti-vascular endothelial growth factor (anti-VEGF) treatment for diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD). This multinational, non-interventional, quantitative, cross-sectional, observational survey assessed treatment barriers/burden, patient-reported visual functioning, and treatment satisfaction in DME and nAMD patients in the United States, United Kingdom, Canada, France, Italy, and Spain. Treatment patterns and visual outcomes were extracted from medical charts. Regression models evaluated relationships between adherence, total missed visits, number of anti-VEGF injections and clinical and patient-reported outcomes for visual functioning. Association between treatment satisfaction and aspects of burden were assessed. The survey was completed by 183 DME and 391 nAMD patients. Patients had moderately high vision-related functioning (25-item National Eye Institute Visual Functioning Questionnaire score: mean=74.8) and were satisfied with their current treatment (mean total score: Macular Disease Treatment Satisfaction Questionnaire=59.2; Retinopathy Treatment Satisfaction Questionnaire=61.3). Treatment satisfaction scores were worse with higher time-related impacts of treatment (nAMD/DME), higher impacts on finances and daily life (nAMD), negative impact on employment and lower expectations for treatment effectiveness (DME). Most patients reported ≥1 barrier (66.1% DME, 49.2% nAMD patients) related to treatment (35.0%), clinic (32.6%), and COVID-19 (21.1%). Moreover, 44.9% of patients reported some impairment in activities of daily living. Work absenteeism was observed among >60% of working patients. Nearly one-quarter (24.2%) of patients needed ≥1 day to recover from intravitreal injections; most reported ≥30 minutes of travel time (73.7%) and clinic wait time (54.2%). In unadjusted univariable analyses, treatment adherence (vs non adherence) was related to higher most recent visual acuity (β = 8.98 letters; CI, 1.34-16.62) and lower odds of visual acuity below driving vision (≤ 69 letters) (OR = 0.50; CI, 0.25-1.00) . More durable treatments with reduced frequency of injections/visits may reduce treatment burden and improve patient satisfaction, which may enhance adherence and visual outcomes.

A qualitative study exploring how undergraduate pharmacy students undertake a drug allergy history

Abstract Introduction If antimicrobial resistance (AMR) is not controlled, a post-antibiotic era could result in common infections and minor injuries becoming fatal. One way to combat AMR is the ‘de-labelling’ or removal of incorrect antibiotic allergy labels. At least 92% of labels corresponding to penicillin allergy are incorrect when tested.[1] This means that patients may not be receiving the correct antibiotic treatment and take longer to recover. Therefore, taking an accurate allergy history is important. Pharmacists routinely take drug allergy histories. From 2026, pharmacy students in England will graduate as prescribers, highlighting the importance of drug allergy knowledge and skills. Aim To explore how undergraduate pharmacy students undertake a drug allergy history. Methods A qualitative study utilising a constructivist approach involving a low-fidelity simulation followed by a one-to-one face-to-face semi-structured interview was conducted. Final year undergraduate Master of Pharmacy students of an English school of pharmacy were recruited via email and word-of-mouth to take part in this study. Following informed consent, participants simulated taking a drug allergy history with a student researcher. The simulation was audio-recorded and then played back to the participant as a cue for a subsequent audio-recorded semi-structured interview that explored their thought-process when taking a drug allergy history. All audio-recordings were transcribed verbatim. Transcripts were analysed using reflexive thematic analysis.[2] Results Nine participants took part in the study. The simulation and interview lasted seven minutes on average. Four themes were generated through the analysis. Theme 1: taking drug allergy history is learnt mainly through practice-based learning. Theme 2: nature, type and severity of allergic reactions information were deemed important for making clinical judgements. Theme 3: skills for taking drug allergy history are underdeveloped despite having knowledge. Theme 4: real patient contact exposure is needed to translate learning into practice. Most participants remembered learning about taking drug allergy history through practice-based learning sessions such as workshops, objective structured clinical examinations (OSCEs) and hospital placements. Participants seemed to follow a set of ‘rules’ when undertaking the simulation. For example, they stopped asking questions about allergies and decide not to dispense penicillin when they were informed that the patient was allergic to penicillin. Most participants recognised the risk of serious harm to patients if they made a mistake about patient allergies, and the need to have more real-world experiences to help translate their learning into practice. Conclusion Pharmacy students appeared to have the theoretical knowledge about drug allergies, but they were not yet able to make an appropriate clinical judgement in real-world situations. An increase in real-world clinical experience such as patient consultations in work-based placements can provide pharmacy students with valuable opportunities. By knowing how to undertake an accurate allergy history, fewer people will be inaccurately labelled as allergic, promoting antimicrobial stewardship. To our knowledge, this is the first study investigating how United Kingdom undergraduate pharmacy students undertake a drug allergy history. Our participants studied in one pharmacy school and undergraduate pharmacy students studying in other pharmacy schools may have different experiences around drug allergy history taking.

Real-world effectiveness and satisfaction with intravenous eptinezumab treatment in patients with chronic migraine: REVIEW, an observational, multi-site, US-based study

BackgroundDespite recent advancements in migraine treatment, some patients continue to endure significant disease burden. Due to the controlled nature of randomized trials in migraine prevention, many real-world patients with comorbidities or prior exposure to certain therapies are excluded. Capturing evidence of the effectiveness of treatment in real-world clinical settings can further shape treatment paradigms. The objective of this study was to develop a comprehensive understanding of both patients’ and physicians’ real-world experiences with eptinezumab for chronic migraine (CM).MethodsREVIEW (Real-world EVidence and Insights into Experiences With eptinezumab) is an observational, multi-site (n = 4), US-based study designed to evaluate real-world experiences of patients treated with eptinezumab and their treating physicians. Patients were ≥ 18 years of age, with a diagnosis of CM, who had completed ≥ 2 consecutive eptinezumab infusion cycles (≥ 6 months of exposure). The study included a retrospective chart review, a patient survey, and a semi-structured physician interview that assessed patient and/or physician satisfaction with elements of daily living / well-being, migraine symptomology, and perspectives of the eptinezumab infusion experience.ResultsOf the 94 patients enrolled, 83% (78/94) were female, the mean age was 49.2 years, and the mean time since migraine diagnosis was 15.4 years. Before eptinezumab treatment, patients experienced a mean of 8 self-reported “good” days/month, which increased to 18 after treatment. Most patients took, on average, ≥ 10 days/month of prescription and/or over-the-counter medication (81% [75/93] and 66% [61/93], respectively) to treat migraine attacks before eptinezumab treatment, which dropped to 26% (24/93) and 23% (21/93) following eptinezumab treatment. Prior to receiving eptinezumab, 62% (58/93) of patients indicated being at least slightly concerned about infusions; after eptinezumab infusion, this dropped to 14% (13/93). These patient survey findings were consistent with physician responses.ConclusionThis real-world evidence study demonstrated high overall satisfaction with the effectiveness of eptinezumab treatment for CM among most patients and their physicians.

Implementing and Marketing an Online Social–Emotional Learning Yoga Program: A Collaborative Approach

Physical education teacher education and sport marketing courses both require their majors to apply theory into real-world experiences that simulate the professional experience upon earning their degrees. After-school programming serves as a potential field site for teacher candidates and can also provide sport marketing students with the opportunity to authentically engage in the process of marketing and promotion. This article describes a collaboration between two university courses focused on implementing and marketing a middle school social-emotional learning yoga after-school program. The yoga program was virtual due to the pandemic, and it was led by university personnel. Teacher candidates learning basic teaching behaviors in their coursework logged in and engaged with the students and the content throughout the semester. Sport marketing students completed a project focused on marketing the program to secure additional student participants, and they also developed group names and logos to engage the community beyond the program. Collaborations across disciplines can enhance community-engaged partnerships, practical experiences for college students, and youth experiences in after-school programming.

Now Is the Time to Strengthen Government-Academic Data Infrastructures to Jump-Start Future Public Health Crisis Response.

During public health crises, the significance of rapid data sharing cannot be overstated. In attempts to accelerate COVID-19 pandemic responses, discussions within society and scholarly research have focused on data sharing among health care providers, across government departments at different levels, and on an international scale. A lesser-addressed yet equally important approach to sharing data during the COVID-19 pandemic and other crises involves cross-sector collaboration between government entities and academic researchers. Specifically, this refers to dedicated projects in which a government entity shares public health data with an academic research team for data analysis to receive data insights to inform policy. In this viewpoint, we identify and outline documented data sharing challenges in the context of COVID-19 and other public health crises, as well as broader crisis scenarios encompassing natural disasters and humanitarian emergencies. We then argue that government-academic data collaborations have the potential to alleviate these challenges, which should place them at the forefront of future research attention. In particular, for researchers, data collaborations with government entities should be considered part of the social infrastructure that bolsters their research efforts toward public health crisis response. Looking ahead, we propose a shift from ad hoc, intermittent collaborations to cultivating robust and enduring partnerships. Thus, we need to move beyond viewing government-academic data interactions as 1-time sharing events. Additionally, given the scarcity of scholarly exploration in this domain, we advocate for further investigation into the real-world practices and experiences related to sharing data from government sources with researchers during public health crises.

Global real-world experiences with pembrolizumab in advanced urothelial carcinoma after platinum-based chemotherapy: the ARON-2 study

BackgroundImmune checkpoint inhibitors have changed previous treatment paradigm of advanced urothelial carcinoma (UC). The ARON-2 study (NCT05290038) aimed to assess the real-world effectiveness of pembrolizumab in patients recurred or progressed after platinum-based chemotherapy.Patients and MethodsMedical records of patients with documented metastatic UC treated by pembrolizumab as second-line therapy were retrospectively collected from 88 institutions in 23 countries. Patients were assessed for overall survival (OS), progression-free survival (PFS) and overall response rate (ORR). Cox proportional hazards models were adopted to explore the presence of prognostic factors.ResultsIn total, 836 patients were included: 544 patients (65%) received pembrolizumab after progression to first-line platinum-based chemotherapy in the metastatic setting (cohort A) and 292 (35%) after recurring within < 12 months since the completion of adjuvant or neoadjuvant chemotherapy (cohort B). The median follow-up time was 15.3 months. The median OS and the ORR were 10.5 months and 31% in the overall study population, 9.1 months and 29% in cohort A and 14.6 months and 37% in cohort B. At multivariate analysis, ECOG-PS ≥ 2, bone metastases, liver metastases and pembrolizumab setting (cohort A vs B) proved to be significantly associated with worst OS and PFS. Stratified by the presence of 0, 1–2 or 3–4 prognostic factors, the median OS was 29.4, 12.5 and 4.1 months (p < 0.001), while the median PFS was 12.2, 6.4 and 2.8 months, respectively (p < 0.001).ConclusionsOur study confirms that pembrolizumab is effective in the advanced UC real-world context, showing outcome differences between patients recurred or progressed after platinum-based chemotherapy.

Railing through reality: Trains and mobility in Victorian ghost stories

This paper explores the multifaceted cultural history of ghost trains in Victorian fiction by situating three little-known ghost stories in the publishing and social history of the second half of the nineteenth century. The figure of the ghost train offers a route into the entangled history of publishing and railways by contextualising the anxieties presented in railway ghost stories with the real-world experiences of passengers. Taking ideas of mobility as a focal point, this paper brings together discussions of virtual travel and the supernatural to demonstrate some of the impact railways had on reading and writing about train travel. More so than tales of other haunted transport technologies, it is the ghost train's unnatural capacity for movement that disturbs both passengers and readers. By both enhancing and warping reality, railways are ripe source material for Victorian ghost stories to entertain and demand questions of spatio-temporal experience from their reading passengers.

Supportive communication between apprentices and supervisors: development of a digital role play game

PurposeThis paper describes the development of a digital role play game (RPG) designed to help construction apprentices to better communicate with their supervisors about issues with the potential to impact on their physical and psychological health and safety.Design/methodology/approachA participatory approach was adopted to utilise the knowledge and insights of the target users to inform the digital RPG development. Apprentices and supervisors were interviewed to identify characteristics of effective supervisor-apprentice communication, which became the RPG’s learning objectives. The scenarios constructed in the RPG were drawn from lived experiences shared by the apprentices in the interviews. During the development process, consultations were conducted with an advisory committee comprising of apprentices and supervisors to improve the realism of the RPG scenarios.FindingsThree scenarios were developed for the RPG. In each scenario, players are asked to make decisions at various interaction points about how the characters should respond to the unfolding and challenging situations. Scripts were developed for the game, which were acted out and motion captured to animate digital MetaHuman characters embedded in a virtual construction site. Two example situations are introduced in this paper to illustrate the development process.Originality/valueTo our knowledge, the RPG introduced is one of the first applications of digital game-based training in the construction industry. The adoption of a participatory design approach ensures that the game content relates to real-world experiences. The digital RPG is highly interactive and engaging in nature and presents a novel approach to developing “soft” skills in construction.

Letermovir prophylaxis for cytomegalovirus in lung-transplant recipients: a comprehensive study with literature review of off-label use and real-world experiences

Letermovir, initially approved for cytomegalovirus (CMV) prophylaxis in hematopoietic stem-cell transplantation, has gained attention for off-label use in lung-transplant (LTx) recipients. Given the high susceptibility of LTx recipients to CMV infection, this study explores the effectiveness and safety of letermovir prophylaxis. A retrospective analysis of using letermovir for LTx recipients at Tohoku University Hospital (January 2000 to November 2023) was conducted. Case summaries from other Japanese transplant centers and a literature review were included. Six cases at Tohoku University Hospital and one at Kyoto University Hospital were identified. Prophylactic letermovir use showed positive outcomes in managing myelosuppression and preventing CMV replication. The literature review supported the safety of letermovir in high-risk LTx recipients. Despite limited reports, our findings suggest letermovir’s potential as prophylaxis for LTx recipients intolerant to valganciclovir. Safety, especially in managing myelosuppression, positions letermovir as a promising option. However, careful consideration is important in judiciously integrating letermovir into the treatment protocol.

ET cool home: innovative educational activities on evapotranspiration and urban heat

Abstract. Teaching evapotranspiration (ET) in university courses often focuses on either oversimplified process descriptions or complex empirical calculations, both of which lack grounding in students' real-world experiences and prior knowledge. This calls for a more applied approach to teaching about ET that connects concepts to experience for improved educational outcomes. One such opportunity exists at the intersections between ET and heat in cities, where a growing majority of the world's population lives, including many of our students. In this work we describe an ET educational activity that integrates theory with practical design, taking advantage of the close link between ET processes and urban heat patterns. In a benchtop experiment, students measure ET variations across common land surfaces (e.g., asphalt, grass, and mulch) through water and energy balance approaches. The experiment is paired with an “urban heat tour” in the campus environment, facilitated by portable infrared cameras, offering firsthand observation of urban heat patterns. These two activities, together, provide context in which students can understand the difference in ET across various land covers, describe the relationship between ET and land surface temperatures, and explain the impacts of urban design on heat dynamics. The activities are adaptable to serve a diversity of student backgrounds and to different educational contexts, including public demonstrations and pre-university classrooms.

Real-World Experiences of Parkinson's Disease OFF Time and Role of Demographics.

OFF periods are episodes when Parkinson's disease (PD) medications work suboptimally, with symptoms returning and impacting quality of life. We aimed to characterize OFF periods using patient-reported frequency, severity, and duration, as well as determine these characteristics' associations with demographics. A retrospective cohort study using Fox Insight Data Exploration Network (Fox DEN) database was conducted. Eligible patients had PD and were >18 years. The experience of OFF periods was characterized by frequency (number of episodes/day), duration (duration/episode), and severity (impact on activities). Significance level was Bonferroni-corrected for multivariate analyses. From a population of 6,757 persons with PD, 88% were non-Hispanic Whites (mean age: 66 ± 8.8 years); 52.7% were males versus 47.3% females; mean PD duration was 5.7 ± 5.2; and 51% experienced OFF periods. Subsequent analyses were limited to non-Hispanic Whites, as they constituted a large majority of the participants and were the subgroup that had the sample size to derive reliable inferences. The analyses showed that 67% experienced 1-2 episodes/day, 90% experienced >15-minute episodes, and 55% reported slight-mild severity/episode. Lower age was associated with a higher frequency (incidence rate ratio [IRR]: 0.992; P<0.001) and severity (odds ratio [OR]: 0.985; P=0.001) of OFF episodes. Income of <$35,000 was associated with 15.1% more episodes/day (IRR: 1.15, p<0.001) and 66.5% higher odds of a severe episode (OR: 1.66; P<0.001). Females experienced 7.5% more episodes compared to males (IRR: 1.075; P=0.003). Longer PD duration was associated with 1.3% more episodes/day (IRR: 1.013; P<0.001) and 10% higher odds of a severe episode (OR: 1.10; P<0.001). Lower age, income <$35,000, longer PD duration, female gender, and being unemployed are associated with a higher frequency and severity of OFF periods with no associations for duration/episode among non-Hispanic Whites with PD. In time-constrained clinic environments, clinicians should tailor OFF periods management counseling to vulnerable demographic groups to enhance care delivery.(J Patient Cent Res Rev. 2024;11:8-17.).

Virtual reality with e-learning model in business management and knowledge complex environment for gaming analysis

Nearly real-world experiences in a variety of industries may be had with virtual reality (VR) technology. Virtual reality (VR) settings are widely used, and as a result, a large quantity of data is being collected from them. The data-driven development paradigm must be advanced and analytical procedures must be created as the amount of data increases. There are several trends and possibilities that have emerged from integration of artificial intelligence (AI) as well as machine learning (ML) in business intelligence. Modern technology has completely changed how companies gather data, draw conclusions, decide. In order to analyse complex environments, this study uses gamification and virtual reality in business intelligence modelling for e-learning. Here, virtual reality-based e-learning is modelled for business intelligence, and gamification using reinforcement alexnet Q-kernel component neural networks is used to analyse the network’s complexity. Prediction accuracy, AUC, average precision, sensitivity, quadratic normalised square error are metrics used in experimental study. The evaluation’s findings demonstrate the usefulness of our solution for classifying and forecasting pay levels in the business sector, which in turn helps business analytics in intricate AI settings.

‘Bridal Outfits from the Heart of Filmland’: Clothes Rationing, Wartime Film Production and Gainsborough Pictures’ Studio Hire Service

This article explores the Studio Hire Service, a wardrobe ‘pooling’ scheme set up by Gainsborough Pictures at the Shepherd’s Bush film studio following the introduction of clothes rationing in 1941. The Service enabled producers to hire rather than purchase items of clothing for use in their films, saving them money, reducing the number of new outfits required for each production and allowing clothing coupons, which film-makers were expected to use sparingly, to be spent on only the most important or unusual costumes. Vital to the production sector in wartime Britain, the Studio Hire Service also played a notable role outside the film industry, not least in that it loaned outfits – including those worn by major female stars in films such as Love Story (1944) and Waterloo Road (1945) – to women for them to use as wedding dresses. In the last years of the war and the early years of the peace, hundreds (and possibly thousands) of British brides were married wearing a film-studio dress. The contribution that costume made to contemporary enjoyment of many of Gainsborough’s most famous films has been noted by scholars; this article shows that some of these same costumes also had a significant role to play in the real-world experiences of many ordinary Britons, offering access to a glamorous bridal outfit in a period of widespread sartorial scarcity and providing a noteworthy example of the way in which the bond between the picturegoer and the cinema extends beyond the auditorium.

Governing AI through interaction: situated actions as an informal mechanism for AI regulation

AbstractThis article presents a perspective that the interplay between high-level ethical principles, ethical praxis, plans, situated actions, and procedural norms influences ethical AI practices. This is grounded in six case studies, drawn from fifty interviews with stakeholders involved in AI governance in Russia. Each case study focuses on a different ethical principle—privacy, fairness, transparency, human oversight, social impact, and accuracy. The paper proposes a feedback loop that emerges from human-AI interactions. This loop begins with the operationalization of high-level ethical principles at the company level into ethical praxis, and plans derived from it. However, real-world implementation introduces situated actions—unforeseen events that challenge the original plans. These turn into procedural norms via routinization and feed back into the understanding of operationalized ethical principles. This feedback loop serves as an informal regulatory mechanism, refining ethical praxis based on contextual experiences. The study underscores the importance of bottom-up experiences in shaping AI's ethical boundaries and calls for policies that acknowledge both high-level principles and emerging micro-level norms. This approach can foster responsive AI governance, rooted in both ethical principles and real-world experiences.

Women and girls with inherited bleeding disorders: Focus on haemophilia carriers and heavy menstrual bleeding.

Raising awareness and improving recognition, accurate classification, and enhanced access to new treatments represent current key challenges for carriers of haemophilia. Women and girls carrying genes for haemophilia often experience significant bleeding and/or low factor levels. The bleeding associated with female haemophilia is frequently overlooked, has a weak correlation with factor levels, and manifests differently than in males, with heavy menstrual bleeding being a predominant symptom. Recent changes in terminology now allow the diagnosis of haemophilia in females with low factor levels and differentiate between symptomatic and asymptomatic carriers of the gene. Observations from real-world experiences and limited clinical trial data have highlighted the positive impact of various new haemophilia treatments for women and girls with clotting factor deficiencies. There is an urgent need for initiatives that increase their access to these treatments and encourage well-designed clinical trials focusing on female-specific outcomes. In women with inherited bleeding disorders, early recognition and optimal management of heavy menstrual bleeding are crucial. However, treatment options and guidance from high-quality clinical trials are currently insufficient. Menstrual health assessment should be a regular part of monitoring women and girls with inherited bleeding disorders throughout their lives, emphasizing the importance of gathering data to improve future management.