Author Archives: Jacqueline Ashby

Background

WHO, as requested by its member states, launched the Expanded Programme on Immunization (EPI) in 1974 to make life-saving vaccines available to all globally. To mark the 50-year anniversary of EPI, we sought to quantify the public health impact of vaccination globally since the programme’s inception.

Methods

In this modelling study, we used a suite of mathematical and statistical models to estimate the global and regional public health impact of 50 years of vaccination against 14 pathogens in EPI. For the modelled pathogens, we considered coverage of all routine and supplementary vaccines delivered since 1974 and estimated the mortality and morbidity averted for each age cohort relative to a hypothetical scenario of no historical vaccination. We then used these modelled outcomes to estimate the contribution of vaccination to globally declining infant and child mortality rates over this period.

Findings

Since 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10·2 billion years of full health gained. We estimate that vaccination has accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

Interpretation

Since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

Read more on Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization via The Lancet.

“Bats’ skill with echolocation—pinpointing prey on the wing and in the dark—has long been a source of inspiration for scientists and engineers, resulting in advances that include novel medical devices for the visually impaired and sophisticated radar systems. Now researchers have created a 3D sonar system that, when combined with high-speed cameras, makes it easier to ‘see’ bat echolocation in action. The new tech, which could reveal more valuable insights into echolocation and predator-prey interactions, is described in a study published 8 January in IEEE Sensors Letters. It could also potentially pave the way for even more bat-inspired technologies in the future.”

Read more on Sonar System “Sees” Bat Echolocation in Action: The tech could help develop more bat-inspired devices in the future via IEEE Spectrum.

Anduril Founder Palmer Luckey, the designer of the virtual-reality headset Oculus Rift, laid out his vision for the future of the IVAS program Tuesday in a blog post titled, “Turning Soldiers into Superheroes.”

“For me, this announcement is deeply personal. Since my pre-Oculus days as a teenager who had the opportunity to do a tiny bit of work on the Army’s BRAVEMIND project, I’ve believed there would be a headset on every soldier long before there is a headset on every civilian,” Luckey wrote.

He wrote that IVAS will allow troops to “surpass the limits of human form and cognition, seamlessly teaming enhanced humans with large packs of robotic and biologic teammates.”

The Army has conducted IVAS-controlled drone flights for microdrones, such as the Black Hornet and other squad-level drones. The device is also used for inter- and intra-squad communication, both through voice and chat. Users can share map information, coordinates or other data via the headset.

Read more on Oculus founder wants to help troops ‘surpass the limits of human form’ via Military Times

One discovers the light in darkness, that is what darkness is for; but everything in our lives depends on how we bear the light. It is necessary, while in darkness, to know that there is a light somewhere, to know that in oneself, waiting to be found, there is a light. ~ James Baldwin

“The real encounter
is a meeting
an interchange
that literally
turns us around.”

~ Otto Bollnow

You can find my work at The Art Box located Silk Purse Arts Centre, 1570 Argyle Ave, West Vancouver and at the The Birds: Annual Invitational 2025, Smith & Vallee International Art Gallery, WA (Group). View here.

“I find television very educating. Every time somebody turns on the set, I go into the other room and read a book.” ~ Groucho Marx

My family installed a Little Free Library in our community 11 years ago, and it has been an incredible experience ever since. Children of all ages stop by to pick up a book or two, and sometimes they even make special requests. This has shown me how important it is for each of us to contribute to promoting literacy in our neighborhood. Together, we can inspire a love for reading and make a lasting impact!

Read more on my experience.

OBJECTIVE

Concussions can occur at any level of ice hockey. Incidence estimates of concussions in ice hockey vary, and optimal prevention strategies and return-to-play (RTP) considerations have remained in evolution. The authors performed a mixed-methods study with the aim of elucidating the landscape of concussion in ice hockey and catalyzing initiatives to standardize preventative mechanisms and RTP considerations.

METHODS

The authors performed a five-part mixed-methods study that includes: 1) an analysis of the impact of concussions on games missed and income for National Hockey League (NHL) players using a publicly available database, 2) a systematic review of the incidence of concussion in ice hockey, 3) a systematic review of preventative strategies, 4) a systematic review of RTP, and 5) a policy review of documents from major governing bodies related to concussions in sports with a focus on ice hockey. The PubMed, Embase, and Scopus databases were used for the systematic reviews and focused on any level of hockey.

RESULTS

In the NHL, 689 players had 1054 concussions from the 2000–2001 to 2022–2023 seasons. A concussion led to a mean of 13.77 ± 19.23 (range 1–82) games missed during the same season. After cap hit per game data became available in 2008–2009, players missed 10,024 games due to 668 concussions (mean 15.13 ± 3.81 per concussion, range 8.81–22.60 per concussion), with a cap hit per game missed of $35,880.85 ± $25,010.48 (range $5792.68–$134,146.30). The total cap hit of all missed games was $385,960,790.00, equating to $577,635.91 per concussion and $25,724,052.70 per NHL season. On systematic review, the incidence of concussions was 0.54–1.18 per 1000 athlete-exposures. Prevention mechanisms involved education, behavioral and cognitive interventions, protective equipment, biomechanical studies, and policy/rule changes. Rules prohibiting body checking in youth players were most effective. Determination of RTP was variable. Concussion protocols from both North American governing bodies and two leagues mandated that a player suspected of having a concussion be removed from play and undergo a six-step RTP strategy. The 6th International Conference on Concussion in Sport recommended the use of mouthguards for children and adolescents and disallowing body checking for all children and most levels of adolescents.

CONCLUSIONS

Concussions in ice hockey lead to substantial missed time from play. The authors strongly encourage all hockey leagues to adopt and adhere to age-appropriate rules to limit hits to the head, increase compliance in wearing protective equipment, and utilize high-quality concussion protocols.

Learn more on Concussions in ice hockey: mixed methods study including assessment of concussions on games missed and cap hit among National Hockey League players, systematic review, and concussion protocol analysis via Journal of Neurosurgery.

Image of JT Miller and Filip Hronek. Wear your helmet during warm up Hronek… 🙂

Objective: To systematically assess literature examining the impact of being a gamer or participating in video-game-based training on surgical skills acquisition amongst medical students.

Background: Video games and surgical procedures share similar skills such as visuospatial abilities and hand-eye coordination; therefore, video games can be a valuable tool for surgical training amongst medical students. However, comprehensive, up-to-date systematic reviews are necessary to confirm.

Methods: A systematic literature search of PubMed, MEDLINE, and EMBASE was performed in April 2020 with no limits set on the date of publication. Observational and randomized controlled studies were included. Quality and bias were assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Grading of Recommendations Assessment, Development and Evaluation system for randomized studies.

Results: A total of 575 participants from 16 studies were included. The most common surgical skills tested were laparoscopy (n = 283, from 8 studies) and robotic surgery (n = 199, from 5 studies). A history of gaming and video-game-based training were associated with improved metrics in robotic surgery and laparoscopy, respectively. Neither was beneficial in arthroscopy or bronchoscopy. Studies using the Wii U and Underground reported significant improvement in overall laparoscopic performance.

Conclusion: Video games demonstrate potential as adjunctive training in surgical skill education, with a history of gaming and video-game-based training being beneficial in robotic surgery and laparoscopy, respectively. Methodological heterogeneity amongst included studies limit the ability to make conclusive decisions; thus, future studies with long-term follow-up, larger sample sizes, outcomes stratified by video-game characteristics, and up-to-date technology are necessary.

Read more on Can video games enhance surgical skills acquisition for medical students? A systematic review via Surgery.

“Background and Study Aim. Attention and concentration, fundamental psychological skills, are crucial in situations where the opponent moves rapidly and incessantly. Reaction time is also of paramount importance in winning a game in fencing, which requires both offensive and defensive actions. Understanding the factors that affect reaction time is essential for improving performance. This study aimed to investigate the impact of disruptions in attention and concentration on reaction time in fencing.

Material and Methods. Thirty-four healthy male and female fencers participated in two testing sessions. In the initial session, participants filled out a personal information form and took the d2 Attention Test to determine their attention levels. They also completed items representing the concentration disruption subscale of the Sport Anxiety Scale-2 (SAS-2) to measure concentration levels. In the second session, participants underwent the Favero Electronic Fencing Target (EFT-1) test to measure their reaction times. To analyze the obtained data, SPSS 20 was used. The Pearson correlation coefficient between attention, concentration disruption, and participants’ reaction times was calculated. Then, linear regression analysis was employed to test whether attention and concentration scores could predict the reaction times.

Results. The findings indicated that there is a significant positive relationship between E (r = .603, p < .01), E% (r = .628, p < .01), E1 (r = .584, p < .01), E2 (r = .533, p < .01), and reaction time. Additionally, a significant negative relationship was revealed between concentration performance and reaction times (r = -.456, p < .01). A significant positive correlation was observed between fencers’ concentration disruption and reaction times (r = .416, p < .05).

Conclusions. Our study results emphasize the importance of attention and concentration in disciplines that require quick reactions. These cognitive factors need to be considered in the development of sports performance.”

Read more on the Examining the effects of attention and concentration levels on reaction time in fencing via Physical Education of Students.

“Generative artificial intelligence (AI) models are increasingly utilized for medical applications. We tested whether such models are prone to human-like cognitive biases when offering medical recommendations. We explored the performance of OpenAI generative pretrained transformer (GPT)-4 and Google Gemini-1.0-Pro with clinical cases that involved 10 cognitive biases and system prompts that created synthetic clinician respondents.

Medical recommendations from generative AI were compared with strict axioms of rationality and prior results from clinicians. We found that significant discrepancies were apparent for most biases. For example, surgery was recommended more frequently for lung cancer when framed in survival rather than mortality statistics (framing effect: 75% vs. 12%; P<0.001). Similarly, pulmonary embolism was more likely to be listed in the differential diagnoses if the opening sentence mentioned hemoptysis rather than chronic obstructive pulmonary disease (primacy effect: 100% vs. 26%; P<0.001). In addition, the same emergency department treatment was more likely to be rated as inappropriate if the patient subsequently died rather than recovered (hindsight bias: 85% vs. 0%; P<0.001). One exception was base-rate neglect that showed no bias when interpreting a positive viral screening test (correction for false positives: 94% vs. 93%; P=0.431).

The extent of these biases varied minimally with the characteristics of synthetic respondents, was generally larger than observed in prior research with practicing clinicians, and differed between generative AI models. We suggest that generative AI models display human-like cognitive biases and that the magnitude of bias can be larger than observed in practicing clinicians.”

More on Cognitive Biases & Artificial Intelligence via NEJM AI.